Is Nausea a Symptom of Hyperkalemia & Is There a Treatment for Hyperkalemia?

What is Hyperkalemia and What Are Its Symptoms?

On a day-to-day basis, the cells in our body need some amount of potassium to function correctly. However, it may happen at times that the body gets an overdose of potassium, a condition known as hyperkalemia.(1, 2, 3) When you get too much potassium in the body, the kidneys will typically work to eliminate the excess amount of this nutrient. However, if your kidney is not functioning properly, then this extra potassium can start to accumulate in the bloodstream. This build-up of excess potassium can have an impact on the functioning of your nerves and muscles throughout the body. In some cases, it may even affect the respiratory and cardiovascular functioning.(4, 5, 6)

Many times it is not immediately apparent that there is too much potassium in the bloodstream. Many people do not experience any symptoms of hyperkalemia, while others may experience some mild and rather vague symptoms.(7) These may include:

  • Muscle pain
  • Muscle weakness
  • Tingling sensations, especially in the limbs
  • Numbness
  • Palpitations

If the blood potassium levels remain persistently high, the symptoms may begin to worsen over a period of time. As the symptoms of hyperkalemia tend to come and go, most people remain unaware that they have high potassium until it gets diagnosed in some routine blood tests.

Often, hyperkalemia does not get discovered until it causes a dangerous complication.(8) These may include:

Is Nausea a Symptom of Hyperkalemia

When hyperkalemia begins to cause problems with the muscles and nerves in the body, it can also affect the digestive tract. If you have high levels of potassium, you are likely to feel a generalized sick in the stomach feeling or even experience symptoms like:

If you keep experiencing frequent nausea, it is a good idea to consult a doctor and also have a blood test done to check your potassium levels.

Ideally, potassium levels should be in the range of 3.6 to 5.0 millimoles per liter (mmol/L). If you find that your potassium level is over 5.0 millimoles per liter, it could be related to hyperkalemia, which could be the reason behind your persistent nausea.(9)

Potassium levels over 6.0 millimoles per liter are considered to be severely high.

Who is At Risk For Hyperkalemia?

There are some medical conditions that increase the risk of developing high potassium levels. The first is kidney disease since the kidneys are primarily responsible for maintaining the balance of potassium in the body. The risk of developing hyperkalemia is even greater in the following cases:(10)

  • If you take medicines that increase the potassium levels in the body.
  • If you use salt substitutes.
  • If you have a diet high in potassium.
  • If you take dietary supplements that are rich in potassium.

Some other health conditions that can cause high potassium levels in the blood include:

It is also possible to develop high potassium levels if you take certain medications that can prevent the kidneys from eliminating the extra potassium from the body. These medications can include:

Is There A Treatment For Hyperkalemia?

There are many treatment options for hyperkalemia. The exact treatment depends on whether you are at a high risk of hyperkalemia, if you have mild to moderate hyperkalemia, or you are having an acute attack at present. Hyperkalemia treatment revolves around managing the underlying conditions and stopping any medications that might be responsible for the high levels of potassium. Controlling hyperkalemia will help resolve the symptoms you are experiencing, including nausea. Here are some of the treatment options available for hyperkalemia.

  1. Medications To Help Eliminate The Excess Potassium

    Treatment for hyperkalemia focuses on the ongoing management of high potassium levels. This may include taking medications to help the body get rid of the extra potassium. For this, your doctor may prescribe the following:

    • Potassium Binders – These medications help the body flush out the extra potassium through stool.(12, 13)
    • Diuretics – These medications help the kidneys remove potassium through urine.(14)
  2. Following a Low-Potassium Diet

    It is possible to manage high potassium levels by switching to a low-potassium diet. However, you should never make the switch to a low-potassium diet before consulting with your doctor. This is because too little potassium in the body can also be dangerous. This is why you should discuss any such dietary changes with your doctor. Regular monitoring while changing your potassium intake through dietary changes is required.(15)

    Some foods that are high in potassium and should be avoided by people with hyperkalemia include:

    • Legumes including kidney beans, lentils, and soybeans.
    • Vegetables like potatoes, squash, and spinach.
    • Fruits including bananas, apricots, cantaloupe, as well as fruit juices, and dried fruits.
    • Non-fat and low-fat dairy like yogurt and milk.

    You should try to include fish, poultry, and meat in your diet. Even though they contain some amount of potassium, they are also excellent sources of protein, which is beneficial to include in your diet.

    Your doctor will also provide you with a detailed list of foods you can eat and the ones to avoid when you are watching your potassium intake. It is also a good idea to ask your doctor for a referral to a dietitian so that you can find out more about getting the right balance of potassium in your diet. A dietitian will also be able to guide you better about other important nutrients you should be having for your overall well-being.

  3. Treating Acute Hyperkalemia

    An acute attack of hyperkalemia would require lifesaving measures. This may include:

    • Dialysis to help the body remove the excess potassium(16, 17)
    • Cardiac monitoring

    In some cases, intravenous treatment may also be required. This may include:

    • Calcium
    • Insulin
    • Glucose
    • Diuretics (only if you are not on dialysis)
    • Sodium bicarbonate

    These lifesaving measures may help restore the body’s electrolyte balance.

Should You See A Doctor For Nausea In Hyperkalemia?

It is important to understand that there is no way of finding out your potassium levels without getting a blood test done. This is true no matter what symptoms you have. If you are experiencing persistent nausea, it is a good idea to consult your doctor and let them know you suspect high potassium levels. They will prescribe a simple blood test that will let you know whether your potassium levels are high or not.

If you have a pre-existing medical condition like kidney disease, diabetes, liver disease, or heart disease, and you suddenly develop new symptoms, including nausea, you must see your doctor at the earliest. Remember to let your doctor know about all the medications and supplements you are taking, including both over-the-counter and prescription drugs for your medical condition.

Severe hyperkalemia should be treated as a life-threatening event. You need to seek immediate medical assistance if you observe any of the following symptoms suddenly:

Conclusion

Hyperkalemia is a condition in which you have high levels of potassium in the bloodstream. In people with kidney disease, potassium levels increase because the kidneys are unable to get rid of the excess potassium successfully. But, if your kidneys are functioning correctly, they should be able to remove any excess potassium automatically. This is why it is usually uncommon to develop hyperkalemia unless there is some problem with the functioning of the kidneys.

Nausea, fatigue, and weakness are some of the common symptoms of hyperkalemia. However, the condition might not cause any symptoms until the excess potassium in the bloodstream reaches dangerously high levels. The only way to determine your potassium levels is through a blood test. This is why it is important to consult your doctor if you experience any symptoms of hyperkalemia so that you can undergo proper testing and begin treatment at the earliest if needed.

References:

  1. Hollander-Rodriguez, J.C. and Calvert, J.F., 2006. Hyperkalemia. American family physician, 73(2), pp.283-290.
  2. Evans, K.J. and Greenberg, A., 2005. Hyperkalemia: a review. Journal of intensive care medicine, 20(5), pp.272-290.
  3. Lehnhardt, A. and Kemper, M.J., 2011. Pathogenesis, diagnosis and management of hyperkalemia. Pediatric nephrology, 26(3), pp.377-384.
  4. Kovesdy, C.P., 2015. Management of hyperkalemia: an update for the internist. The American journal of medicine, 128(12), pp.1281-1287.
  5. 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.
  6. Kovesdy, C.P., 2015. Management of hyperkalemia: an update for the internist. The American journal of medicine, 128(12), pp.1281-1287.
  7. Pfortmüller, C.A., Leichtle, A.B., Fiedler, G.M., Exadaktylos, A.K. and Lindner, G., 2013. Hyperkalemia in the emergency department: etiology, symptoms and outcome of a life threatening electrolyte disorder. European journal of internal medicine, 24(5), pp.e59-60.
  8. Montford, J.R. and Linas, S., 2017. How dangerous is hyperkalemia?. Journal of the American Society of Nephrology, 28(11), pp.3155-3165.
  9. Parham, W.A., Mehdirad, A.A., Biermann, K.M. and Fredman, C.S., 2006. Hyperkalemia revisited. Texas Heart Institute Journal, 33(1), p.40.
  10. Williams, M.E., 1991. Hyperkalemia. Critical care clinics, 7(1), pp.155-174.
  11. Uribarri, J., Oh, M.S. and Carroll, H.J., 1990. Hyperkalemia in diabetes mellitus. Journal of Diabetic Complications, 4(1), pp.3-7.
  12. Pitt, B. and Bakris, G.L., 2015. New potassium binders for the treatment of hyperkalemia: current data and opportunities for the future. Hypertension, 66(4), pp.731-738.
  13. Palmer, B.F., 2020, February. Potassium binders for hyperkalemia in chronic kidney disease—diet, renin-angiotensin-aldosterone system inhibitor therapy, and hemodialysis. In Mayo Clinic Proceedings (Vol. 95, No. 2, pp. 339-354). Elsevier.
  14. Weir, M.R., Mayo, M.R., Garza, D., Arthur, S.A., Berman, L., Bushinsky, D., Wilson, D.J. and Epstein, M., 2017. Effectiveness of patiromer in the treatment of hyperkalemia in chronic kidney disease patients with hypertension on diuretics. Journal of hypertension, 35(Suppl 1), p.S57.
  15. Boscardin, E., Perrier, R., Sergi, C., Maillard, M., Loffing, J., Loffing-Cueni, D., Koesters, R., Rossier, B.C. and Hummler, E., 2017. Severe hyperkalemia is rescued by low-potassium diet in renal βENaC-deficient mice. Pflügers Archiv-European Journal of Physiology, 469(10), pp.1387-1399.
  16. Putcha, N. and Allon, M., 2007, September. Management of hyperkalemia in dialysis patients. In Seminars in dialysis (Vol. 20, No. 5, pp. 431-439). Oxford, UK: Blackwell Publishing Ltd.
  17. Sterns, R.H., Grieff, M. and Bernstein, P.L., 2016. Treatment of hyperkalemia: something old, something new. Kidney international, 89(3), pp.546-554.

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