Exercise Tips for People with Hyperkalemia

What Role Does Potassium Play In The Body?

Potassium is an important mineral and electrolyte that the body needs. There are many biological processes, like maintaining the health of cells, nerves, and proper muscle function, all rely on this essential mineral.(1,2,3) However, there is such a thing as too much potassium, which can harm the body. The body needs to have just the right amount of potassium in the bloodstream to ensure the well-being and good health. Too little potassium (a condition known as hypokalemia) or too much potassium (hyperkalemia) can both interfere with the proper functioning of nerves and muscles in the body.(4,5) Both conditions can even be dangerous if left unchecked and untreated.(6)

The normal blood levels of potassium should fall within a range of around 3.5 to 5 millimoles per liter (mmol/L).(7) However, many laboratories use slightly varying levels.

But why does hyperkalemia happen? The body depends on the kidneys to flush out the excess potassium from the blood. When the kidneys are functioning properly, they are able to flush out the extra potassium from the body through urine. However, there are certain health conditions like kidney disease, diabetes or heart disease that can affect the functioning of the kidneys and their ability to control the potassium levels in the body. This increases the risk of hyperkalemia.(8,9,10)

When the potassium levels in the bloodstream reach well above the normal range, it might lead to sudden and severe symptoms like shortness of breath, heart palpitations, chest pain, vomiting or nausea. In some cases, this can be life-threatening and require emergency medical assistance.

In cases where there are no heart-related problems but the potassium levels remain mildly elevated, there are several other measures you can take to manage hyperkalemia.

Relation Between Potassium Levels and Exercise

When you exercise, the muscles of the body lose potassium. This causes a significant increase in the levels of blood potassium. For most people, the kidneys are able to filter out this excess potassium quite quickly, which brings the potassium levels to normal within a few minutes of resting after exercising. However, when you have a health condition like heart disease or hyperkalemia, a sudden increase in the blood potassium levels can cause a serious problem with your heart rhythm. This is known as exercise-induced arrhythmia.

Nevertheless, exercising regularly is very important for maintaining a healthy lifestyle and is helpful in many ways, including:

  • Strengthening muscles
  • Increasing flexibility
  • Enhancing mood
  • Boosting mental health
  • Maintaining a healthy weight
  • Improving overall health

Research has found that regular physical training may help lower the increase in potassium levels that happens during exercise.(11)

Exercise Tips for People with Hyperkalemia

High potassium levels in the blood can be dangerous. This is why it is important to discuss with your doctor before you begin a new exercise routine. Your doctor will assess your overall risk factors and recommend an exercise routine that is safe for you and keeps in mind your high potassium levels. Some of the risk factors your doctor will look for include:

  • Your age and overall health
  • If you have any other co-existing health conditions
  • What medications you are taking
  • If you have chronic or acute hyperkalemia
  • The extent of heart damage or kidney disease

Here are some exercise tips that will help you remain active safely even with hyperkalemia.

  • Remain Hydrated: It is important to stay hydrated when you exercise. This is true not just for people with hyperkalemia but in general as well. However, if you have kidney disease, make sure that you follow the doctor’s guidelines about restricting your fluid intake accordingly.
  • Think About Walking: Regardless of what your previous level of exercise or activity was, once you have been diagnosed with hyperkalemia, walking is the best choice of activity. You can slowly start increasing the speed and length of your walks. You will also be getting some fresh air while walking outside.
  • Don’t Forget The Importance Of Stretching: Begin your day with some light stretching exercises that will increase your overall flexibility and get you going for the day. You should also make sure to stretch before and after finishing your exercise routine.
  • Keep Moving Throughout The Day: Whenever possible, try to add more movement to your day. For example, if your work involves you sitting in one place for long hours, make it a point to move around for a couple of minutes after every hour. If you are running errands, take the stairs instead of the elevator. Park further away from the entrances when you reach a place. Taking short breaks to walk your dog or just play with your pet for some time in the day will also ensure some level of activity during the day.
  • Avoid Straining Yourself: It is never a good idea to immediately start your exercise routine with high-intensity workouts. Always start with a low-intensity workout and gradually build up the intensity. If you feel like you are overdoing it, do not push yourself. You must pull back immediately and try again after some time. Increasing your level of activity slowly will ensure that there is no rapid spike in potassium levels. Only add more rigorous activities to your routine with your doctor’s approval, and spread it out over a period of time.
  • Take Rest: Never push yourself too hard. Take whatever time you need to rest and let your muscles recover after exercising.
  • Follow a Routine For Exercising: Taking some time out to exercise every day is important. However, it is better if you are able to schedule your exercise routine for earlier in the day and follow the same time every day. Exercising too close to your bedtime can prevent you from having a good night’s rest.

Of course, the most important thing is to work together with your doctor. Do not skip your doctor appointments, take the medications that your doctor prescribed, and continue to manage any other underlying health conditions. If you have any concerns about exercise, make sure to bring them up with your doctor.

How to Stay Motivated to Exercise When You Have Hyperkalemia?

People with hyperkalemia might need some extra motivation to continue to exercise and remain active. Here are some tips:

  • Join a walking group or have a friend or neighbor walk with you.
  • Use a step counter or fitness app to track your progress. It will also keep on reminding you to be on the move.
  • Invest in an exercise bike or treadmill if you don’t want to go outside to walk. You can use these exercise devices while watching your favorite show or listening to music.
  • They are also a good backup exercising plan in case of inclement weather outside.
  • Always choose an exercise or physical activity you enjoy. This makes it more likely that you will stick with it.
  • Try something new like tai chi or yoga. You might end up liking it. It’s also more exciting to try out new activities.
  • Begin by setting small and achievable goals. This way, you will feel more motivated when you meet it. Then set another small and achievable goal to meet.

Lifestyle Tips for People with Hyperkalemia

Potassium is one of the most under-consumed nutrients in the standard American diet. However, if you have hyperkalemia, you would benefit from following a low potassium content diet. According to the National Institutes of Health (NIH), the leading dietary source of potassium for adults in the US include:(7)

  • Potatoes
  • Coffee
  • Milk
  • Tea

People with hyperkalemia should work with their doctor or dietitian to cut down their intake of these foods and other foods containing high potassium levels. These include:

  • Legumes like soybeans, lentils, and kidney beans
  • Vegetables like spinach, broccoli, and squash
  • Fruits like bananas, oranges, and apricots
  • Dairy products like yogurt and milk
  • Animal proteins like salmon, chicken, and beef

While reducing these high potassium foods, you should also ensure that your body gets all the nutrients it needs from other dietary sources. For example, if you are following a low sodium diet, avoid taking salt substitutes that contain potassium. Also, keep in mind that some multivitamins also contain potassium. So make sure to check the labels.

Your doctor or dietitian can help you build a customized diet plan for your individual needs while keeping your health concerns in mind. You must take all the medications your doctor prescribed, and also let your doctor know beforehand itself about any dietary supplement you might be taking.

At the same time, getting a good night’s sleep is also equally important. You should ideally try to get eight to nine hours of sleep every night. Studies show that good sleep quality and getting adequate rest are closely linked with better muscle strength.(12)

If you have other underlying health conditions, especially those that are associated with hyperkalemia like kidney disease, you have to work with your doctor to keep these health conditions under control. Your medications also have to be checked to ensure that they do not increase your risk for hyperkalemia. Many commonly prescribed medications for hypertension or heart diseases, such as ACE inhibitors and some types of diuretics, can also increase the risk of hyperkalemia.(13,14)

If you experience any symptoms like muscle fatigue after exercising, make sure to report them to your doctor. Seek emergency medical help if you experience a sudden onset of chest pain, heart palpitations, shortness of breath, nausea, or vomiting.

Conclusion

The body needs potassium for many critical biological processes. Your body cannot function properly without the right levels of potassium. When the potassium levels get too high, it can be dangerous. There are many steps to take to help manage the excess levels of potassium. This includes following a low potassium diet to taking the medications prescribed by your doctor.

Exercise is an important part of ensuring good health and well-being. Physical activity, though, can have an impact on the levels of blood potassium. This is why it is important to discuss with your doctor before you begin exercising and what tips to follow when you are exercising, and you have hyperkalemia.

Always begin with low-intensity workouts, keep up with your doctor appointments, and do not neglect to take your medications to keep your potassium levels under control.

References:

  1. Fenn, W.O., 1940. The role of potassium in physiological processes. Physiological Reviews, 20(3), pp.377-415.
  2. He, F.J. and MacGregor, G.A., 2001. Beneficial effects of potassium. Bmj, 323(7311), pp.497-501.
  3. Kowey, P.R., 2002. The role of potassium. In Women’s Health and Menopause (pp. 151-157). Springer, Boston, MA.
  4. Mandal, A.K., 1997. Hypokalemia and hyperkalemia. Medical Clinics of North America, 81(3), pp.611-639.
  5. Viera, A.J. and Wouk, N., 2015. Potassium disorders: hypokalemia and hyperkalemia. American family physician, 92(6), pp.487-495.
  6. Gennari, F.J., 2002. Disorders of potassium homeostasis: hypokalemia and hyperkalemia. Critical care clinics, 18(2), pp.273-288.
  7. Ods.od.nih.gov. 2021. Office of Dietary Supplements – Potassium. [online] Available at: <https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/> [Accessed 23 October 2021].
  8. Einhorn, L.M., Zhan, M., Walker, L.D., Moen, M.F., Seliger, S.L., Weir, M.R. and Fink, J.C., 2009. The frequency of hyperkalemia and its significance in chronic kidney disease. Archives of internal medicine, 169(12), pp.1156-1162.
  9. Uribarri, J., Oh, M.S. and Carroll, H.J., 1990. Hyperkalemia in diabetes mellitus. Journal of Diabetic Complications, 4(1), pp.3-7.
  10. Sarwar, C.M., Papadimitriou, L., Pitt, B., Piña, I., Zannad, F., Anker, S.D., Gheorghiade, M. and Butler, J., 2016. Hyperkalemia in heart failure. Journal of the American College of Cardiology, 68(14), pp.1575-1589.
  11. Kjeldsen, K.P. and Schmidt, T.A., 2019. Potassium homoeostasis and pathophysiology of hyperkalaemia. European Heart Journal Supplements, 21(Supplement_A), pp.A2-A5.
  12. Chen, Y., Cui, Y., Chen, S. and Wu, Z., 2017. Relationship between sleep and muscle strength among Chinese university students: a cross-sectional study. Journal of musculoskeletal & neuronal interactions, 17(4), p.327.
  13. Perazella, M.A., 2000. Drug-induced hyperkalemia: old culprits and new offenders. The American journal of medicine, 109(4), pp.307-314.
  14. Chang, A.R., Sang, Y., Leddy, J., Yahya, T., Kirchner, H.L., Inker, L.A., Matsushita, K., Ballew, S.H., Coresh, J. and Grams, M.E., 2016. Antihypertensive medications and the prevalence of hyperkalemia in a large health system. Hypertension, 67(6), pp.1181-1188.