What Can Cause A Potassium Deficiency?

Dear Dr. Kim,

I am an avid reader of your newsletter and like the greens also very much. Thank you for your wonderful work.

A question for you. I have a good friend and client (I do some home health care for her) who was recently placed in the hospital for severe leg cramping. Since she has congestive heart failure, it was thought that perhaps her heart had thrown off a clot which blocked the circulation.....however, no signs were found of a clot. After several days in the hospital and many, many tests, she was sent home without much additional knowledge. Then, upon entering the house, we got a phone call from the lab saying that her potassium was dangerously low. She has consistently been on the equivalent of 4,500 mg. of potassium per day to counteract the potassium loss from the diuretics she is on for her heart. That has now been changed to 6,000 mg.

It seems to me that such large amounts should not be necessary if she is absorbing it well and I have encouraged her to eat more potassium rich foods which she is doing. The cramping has stopped for now but I would still like to understand what might block proper absorption of the supplements. I know licorice can interfere but that is not an issue here. Any other thoughts you might have would be useful.

Thank you so much!!!

Sharon Summers

***

Thank you, Sharon for bringing up this important issue. With cardiovascular disease and diuretic use being as prevalent as they are, potassium deficiency has become a relatively common health challenge for many.

Beyond the factors that you have already noted, other possible causes of potassium deficiency are:

1. Dehydration brought about by prolonged diarrhea or vomiting.

2. Some types of kidney disease.

3. A magnesium deficiency.

4. Alcoholism.

5. A dependency on laxatives.

6. Anorexia nervosa or bulima

I doubt that your friend's potassium deficiency is the result of some form of kidney disease, as almost all types of kidney disease that can cause a potassium deficiency are relatively easy to detect with routine diagnostic testing.

Without being able to do a full work up myself, I would continue to encourage your friend to regularly eat potassium-rich foods such as:

Potatoes (with their skins)
Bananas
Spinach
Acorn squash
Lima beans
Raisins or dried prunes (less than a handful per day)

I would also encourage her to ensure a steady intake of magnesium from healthy, whole foods such as:

Brown rice
Raw almonds (that have been soaked)
Swiss chard
Avocado

Spinach and lima beans are good sources of both potassium and magnesium.

One other point to consider: I have found that muscle cramping is often caused by a calcium deficiency. Regardless of what her blood work shows with regards to her calcium status, I think it would be worth her while to ensure sufficient intake of calcium from healthy, whole foods such as:

Chinese cabbage
Kale
Wild salmon with their bones
Cooked white beans
Lightly steamed broccoli

Another potential cause of severe leg cramping is pressure on a nerve root or group of nerve roots in her lower spinal column region. But I imagine that her doctor has ruled this out through appropriate neurological and orthopedic testing.

Hope this answer is useful, and that your friend experiences a full and speedy recovery.