Excess potassium - causes, symptoms and treatment

Excess potassium - causes, symptoms and treatment

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If there is an excess of potassium, or hyperkalaemia, the level of potassium in the blood is increased. Various causes can be responsible for this. Symptoms usually only appear when the excess of potassium is massive. If this is not the case, hyperkalaemia can be a coincidental finding as part of an extended blood test. Before we talk about too much potassium, let's first look at the tasks of potassium in the human body.

Potassium is one of the most important minerals in the human body. Around 98 percent of them are inside the cells, the rest are extracellular. Potassium is especially important for energy production. There should always be enough potassium in the body to ensure normal cell function. This mineral is important for the electrical processes in the cells, for the work of the nerves, their excitability and the function of the muscles. The acid-base balance and the water balance of the organism also depend on potassium. Both a potassium excess and a potassium deficiency can restrict the body's functions, in the worst case this can be life-threatening.

In addition, potassium in conjunction with sodium maintains the osmotic pressure between the inside and the outside of the cell. In order for the cells of the heart muscle to function properly, they rely on this important mineral. Small changes in the amount of potassium in the blood can already cause electrical excitability disorders and cardiac arrhythmias.

Potassium in food

The potassium requirement is usually covered by a balanced diet. Fruit (especially bananas), dried fruit, vegetables, nuts, whole grains, cocoa and chocolate contain a lot of potassium. The following table shows foods that are known for their particularly high potassium content.

Potassium-rich foods - approximate amounts per 100 grams
Chanterelles5379 milligrams
Fresh bananas375 milligrams
Dried bananas1447 milligrams
Dried apricots1700 milligrams
Soybeans1800 milligrams
White beans1310 milligrams
parsley1000 milligrams
Edam657 milligrams
spinach365 milligrams
avocado480 milligrams
Potatoes440 milligrams

Causes of increased potassium in the blood

The causes of an excess of potassium in the blood are primarily kidney diseases in which the kidney's excretion capacity is restricted, such as kidney failure.

Acute cell damage is also one of the causes, such as in

  • Burns,
  • Infarcts
  • or ischemia (insufficient supply of organs with blood).

Some medications can also be "to blame" for hyperkalemia. These include, among others

  • ACE inhibitors,
  • Potassium-saving diuretics,
  • Beta blockers
  • and digitalis glycosides.

In healthy people, an increased potassium intake through food is hardly possible. The situation is different when there is renal insufficiency. Other causes include ketoacidosis, which can develop as part of a diabetes mellitus disease, and massive muscle breakdown, for example triggered by trauma. Furthermore, the possible causes include the two endocrine diseases hypocortisolism (lack of cortisol in the context of adrenal insufficiency) and hypoaldosteronism (lack of aldosterone). A common cause of an erroneous finding of hyperkalaemia in everyday life is if the blood was stowed too long or a needle that was too thin was used to draw blood.


A slight excess of potassium usually does not cause any symptoms. Those affected may experience muscle weakness. General complaints include

  • Fatigue,
  • Displeasure,
  • Weakness,
  • general malaise,
  • confusion
  • and diarrhea.

In addition, there are neuromuscular symptoms such as muscle weakness, abnormal sensations in the arms and / or legs as well as a furry tongue and symptoms of paralysis. Symptoms affecting the heart are a slow heartbeat and cardiac arrhythmias, in the worst case there is a risk of cardiac arrest. Metabolic acidosis, a metabolic acidity, is also possible.


Hyperkalaemia is diagnosed by a blood test that measures the sodium, potassium, calcium and chloride content in the blood and also determines the pH. A detailed medical history, a physical exam and an EKG are also part of such an exam. It is important to clarify the list of medications for existing diseases, since one or the other means, as already mentioned, can lead to a potassium excess. If there is kidney disease, symptoms such as ringing in the ears or muscle weakness must be clarified. In the event of muscle twitching and cardiac arrhythmia, a doctor must be consulted.


The treatment of the underlying disease comes first. The exogenous amount of potassium may have to be reduced due to an incorrect diet. Medications that are to blame for the excess of potassium are discontinued or converted under medical supervision. Highly increased potassium in the blood is a case for the intensive care unit because a life-threatening situation can develop. Medications are used to stimulate kidney excretion and potassium uptake in the cells. Insulin and glucose promote intracellular potassium intake. Calcium infusion can prevent cardiac arrhythmias. If nothing helps, blood washing is the treatment of choice.


An excess of potassium is very rare. However, if this is the case, symptoms that confirm the suspicion of hyperkalaemia must be taken seriously and medically clarified. This applies especially to older patients who suffer from kidney diseases and who may also be taking additional medication. If there is an underlying disease and a wide variety of medicines are prescribed, this may lead to drug interactions. Extreme caution is required here. (sw)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Susanne Waschke, Dr. med. Andreas Schilling


  • James L. Lewis: Hyperkalaemia, MSD Manual, (accessed July 10, 2019), MSD
  • Pschyrembel Online: Hyperkalaemia, Pschyrembel Online, (accessed July 10, 2019), pschyrembel
  • Ulrich Kuhlmann et al .: Nephrologie, Thieme Verlag, 6th edition, 2015
  • James L. Lewis: Overview of Potassium Concentration Disorders, MSD Manual, (accessed July 10, 2019), MSD
  • Abdol A. Ameri: Hyperkalemia: A Problem in Management of Kidney and Heart Failure, CardioVasc, Issue 5/2016

ICD codes for this disease: E87.5ICD codes are internationally valid encryption codes for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.

Video: High Potassium (August 2022).