DR. HOOK- No kidding: Keep potassium levels high

K is such a powerful letter! A "Mart" isn't good enough. Kmart is so much better. In fact, in my little home town of Kenton, Ohio, the only major shopping center is the Kmart– and a few years ago when rumors of bankruptcy abounded, all the Kentonites didn't feel oK. They thought the world was Korrupt.

 Special-K cereal boasts it can help you lose weight– maybe a few Kgs? K-Fed married and divorced Britney Spears... K sera sera. The KKK no longer does cross burnings– no, they have evolved into doing cross "lightings." (Is that like George Bush's thousand points of light?) 

K is the chemical symbol for potassium. I was a chemistry major in college, but little did I know how important K would be in my medical world– and I don't mean the illegal club drug K. 

Potassium is essential in the cellular world of your body. Sodium (Na) and potassium are vital in charging up or down the cells for things to work right. However, if the body becomes depleted of potassium, bad things happen. In general, serum potassium is 3.5-5.0 is about right. However, if your K drops less than 3.0 and in particular less than 2.5, it will put a cramp in your style– or muscles, more like it.

Weakness of the legs occurs first– and we have all been disappointed seeing Summer Olympians come crashing down due to leg cramps, spasms, and weakness from hypokalemia (low potassium). (Again proof that figure skating is a superior sport!) Severe muscle breakdown can occur because potassium increases blood flow to muscles– so if Carl Lewis is running like The Flash, but there isn't enough blood flow to the legs, the muscles will die off. Orange juice, please!

Even the GI muscles can become paralyzed so that food just doesn't go forwards. (There I sat, broken hearted, went to poop, but I had hypokalemia.) Because a state of ileus (no intestinal movement) occurs, nausea, vomiting, constipation, and anorexia occurs. Ah, beans, please? 

The deadly outcome of hypokalemia lies in cardiac arrhythmias. You know that funny tune, "The Popcorn Song" by Hot Butter? Well, that's what happens when the heart's rhythm jumps all over the place. As with high potassium (hyperkalemia), hypokalemia can also stop the heart from beating. Ah, someone throw me a banana.

Hypokalemia can mimic symptoms of diabetes: excessive thirst, urinating too much, and waking up at least three times a night to urinate. Because low potassium interferes with the kidney's ability to concentrate urine, a dunce can become quite a whiz.

Rarely a person can stop breathing from hypokalemia, but usually a person is in the ER by the time the potassium is that low. Oooh, I could have had a V-8!

Diuretics probably cause the most cases of hypokalemia because they cause potassium as well as magnesium to be excreted. (Magnesium is important in keeping potassium up.)

A person who experiences angina can become hypokalemic from the sympathetic response, because epinephrine drives serum potassium down. (Hmm, I wonder if roller coaster rides cause transient hypokalemia, especially if you vomit afterwards– which makes you lose potassium.) Diarrhea and laxatives make you lose potassium too.

Juices, fruits, and vegetables have potassium, such as the ones I named above. Doctors can prescribe KCl– potassium chloride– to bring the levels up.

Now you know what K is in your body. I prescribe K to many patients who are low in potassium. I wonder, though, if I can give my computer some K when it is low in memory– as in kbytes.