Dr. Gott: Exploring high potassium levels

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Dear Dr. Gott: Please explain to me what causes high potassium levels.

Dear Reader: The technical name for high potassium is hyperkalemia. Normal readings are between 3.6 and 4.8 milliequivalents per liter (mEq/L) determined by simple lab testing.

The most common causes are related to the kidneys and include either acute kidney failure or chronic kidney failure. Less common causes are type I diabetes, the excessive use of alcohol, Addison's disease, ACE inhibitors, red-blood-cell destruction, NSAIDs and an excessive use of supplements containing potassium. Let's hit on these briefly.

Kidney failure is the inability of the kidneys to function properly. Acute failure is marked by low amounts of urine with a rapid buildup of nitrogen waste in the blood. Causes include acute infection, a blocked urinary tract, injury, burns and other causes.

Type I (insulin-dependent) diabetes is caused either by failure of the pancreas to release adequate insulin into the body or by a defect in the portions of the cells that accept the insulin.

Excessive alcohol consumption or drug use can cause a breakdown of muscle fibers, resulting in the release of potassium into the bloodstream.

Addison's disease is caused by partial or complete failure of the adrenal gland, which is responsible for many bodily functions. Causes include infection, bleeding into the gland and tumors.

Ace inhibitors are drugs prescribed for several purposes, one
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of which is to lower blood pressure readings. Unfortunately, some individuals with renal-artery narrowing can experience a worsening of kidney function.

Red-blood-cell destruction can occur because of a number of conditions and diseases. This autoimmune disorder can either be inherited or acquired.

NSAIDs (non-steroidal anti-inflammatory drugs) are available over-the-counter for control of headaches, mild to moderate pain from exercise such as gardening or sports injuries, fever, menstrual cramps and more. Examples include aspirin, ibuprofen and naproxen. If you are consuming NSAIDs, speak with your physician regarding other options.

Potassium deficiency is rare with a balanced diet, but excesses are certainly a possibility if supplements are taken. Average intake for individuals 10 and over is 2,000 mg or 51 Meq per day. This essential mineral is readily available in many foods, including salmon, cod, chicken, broccoli, peas, tomatoes, lettuce, spinach, potatoes and potato skins, apples, avocados, bananas and a great deal more. Potassium regulates acidity, water balance and blood pressure. Not all vitamin supplements contain potassium so label reading is vital. Should you be on a supplement and consume a regular healthful diet, this alone might be the cause for your hyperkalemia.

Write to Dr. Gott c/o United Media, 200 Madison Ave., 4th fl., New York, NY 10016.