High Potassium Levels (Hyperkalemia): Causes, Symptoms & Treatment

High potassium levels are essential for various physiological processes such as the transport of substances across cells and the conduction of nerve impulses. It is also necessary for the proper functioning of the heart, ensuring that it beats properly and maintains a healthy rhythm.

Yet, too much of it can seriously harm our bodies and even prove fatal. It affects 5% of the general population and up to 10% of hospital patients. Let’s dive in and find out more.

What is hyperkalemia?

Hyperkalemia is the elevation of potassium levels above the upper limits of their normal range. In practice, this usually means levels greater than 5.0 mEq/L to 5.5 mEq/L. The term comes from the word ‘hyper’ meaning more or increased and ‘kalemia’ or level of Kalium(The Latin name for Potassium) in the blood.

Hyperkalemia should be distinguished from pseudo hyperkalemia in which potassium levels are falsely reported as elevated due to errors in sample collection, handling and processing. 

Common causes of Hyperkalemia

There are three main categories of causes behind hyperkalemia

Increased Potassium Intake

A major cause is increased potassium uptake in the diet

Some foods that contain high amounts of Potassium are

  • Fruits such as bananas, kiwis, mangoes, melons, cantaloupes, avocados, citrus fruits 
  • Veggies like potatoes, beets, carrots, squash, spinach, broccoli, tomatoes 
  • Red meats
  • Nuts and dry fruits
  • Seaweed

It should be noted that most of these foods are completely safe to consume and are usually only a health risk to those with underlying renal disorders and potassium balance issues.

Another mechanism behind increased potassium intake can be the excessive administration of K-containing IV fluids.

Increased Potassium Release into the blood

The most common cause for this is the excessive breakdown of cells from

  • Accidents and trauma such as crush injuries leading to rhabdomyolysis or muscle breakdown
  • Breakdown of red blood cells due to hemolytic or blood-destroying disorders 
  • Derangements in the acid-base balance system leading to metabolic acidosis
  • Insulin deficiency and diabetic ketoacidosis in uncontrolled diabetics
  • Severe burns

Decreased Potassium Excretion

Potassium levels can be elevated due to impaired renal function. 

Other causes of impaired Potassium excretion are

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Many medications can also lead to high levels of Potassium

  • Drugs for high blood pressure such as the ACE-inhibitors, Beta-blockers, and ARBs
  • Blood thinners like Heparin
  • Pain medicines from the NSAIDs family
  • Potassium-sparing diuretics such as spironolactone
  • Antibiotics
  • Potassium supplements

Symptoms of High potassium levels

Mild cases of hyperkalemia are usually asymptomatic and pass unnoticed. These may include

  • Fatigue
  • Muscle weakness and spasms
  • Nausea and vomiting
  • Chest pain
  • Heart flutters and arrhythmias

Severe cases of hyperkalemia can arise suddenly with severe chest pain and heart flutters. This is a medical emergency and the patient should be rushed to the nearest hospital.

Also read: Hyperphosphatemia: Symptoms, Treatment, Causes

Treatment options for managing high potassium levels

High potassium levels can be easily managed with the proper medications and lifestyle changes-

  • You may need to cut out extrinsic sources of potassium and reduce the amount of potassium you consume in your diet. This means staying away from the aforementioned high-potassium foods.
  • Your doctor may change your blood pressure medications or other drugs that might be precipitating hyperkalemia.
  • Medicines known as diuretics and potassium binders may be advised
  • In case of renal disorders, a nephrologist’s opinion may be needed and in cases of kidney failure dialysis is required
  • An endocrinologist may be required if you have adrenal insufficiency
  • A heart examination may be needed as even mild hyperkalemia over extended periods of time can be cardiotoxic.

Foods to eat and avoid

Some foods that contain high amounts of Potassium are

  • Fruits such as bananas, kiwis, mangoes, melons, cantaloupes, avocados, citrus fruits
  • Veggies like potatoes, beets, carrots, squash, spinach, broccoli, and tomatoes 
  • Red meats
  • Nuts and dry fruits
  • Seaweed

You are best served by avoiding these foods. Instead, you can try incorporating these substitutes into your diet

  • Fruits like apples, blueberries, cranberries, grapes, peaches, pears, pineapples, and watermelons
  • Veggies like broccoli, cabbage, kale, peas, peppers, watercress, mushrooms, eggplant, cucumber
  • Lean meats like chicken
  • Noodles, pasta, rice

You can also try a cooking technique known as leeching to drastically reduce the amount of Potassium in vegetables that are otherwise high in potassium. 

Also read: Benefits of potassium-rich foods

When to seek medical help 

You should call your doctor immediately if you suddenly feel the symptoms of hyperkalemia

  • Extreme pain in your muscles or chest
  • Palpitations, heart flutters, and dysrhythmias
  • Difficulty in breathing
  • Severe abdominal pain


Potassium is a vital mineral for normal functioning but too much can be fatal. The symptoms may be mild but can be harmful over the long term. Understanding the causes and making appropriate tweaks to your lifestyle will allow you to prevent it and continue enjoying a normal and healthy life. 

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