Mild forms are generally asymptomatic, but in more severe conditions (potassium below 3.0 mmol/L), symptoms include tiredness, weakness, muscle pain and constipation. When severe (below 2.5 mmol/L), serious neuromuscular problems occur: severe weakness and paralysis, respiratory failure, bowel paralysis, tingling, numbness and muscle spasms.
Extensive investigations include bloods, urine checks and CT scans.
Management is almost always by potassium replacement. The amount and urgency depends on the severity, risk factors for arrhythmias (such as being elderly or having heart disease) and risk of ongoing losses (such as continuing diarrhoea). If below 2.5 mmol/L, admission is usually indicated, but if mild it may be treated more conservatively with oral replacement and regular monitoring. Underlying causes need treating, and medication such as thiazides may need to be replaced.
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