What Happens When Your Potassium Levels Are Too High
By Dr. Vishesh Bharucha +2 more
Medically reviewed by Dr. Vishesh Bharucha
Last updated: May 30, 2025 Published on: May 30, 2025
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By Dr. Vishesh Bharucha +2 more
Table of Contents
Potassium is the most abundant positively charged ion (cation) inside your cells1. It plays a crucial role in maintaining normal cell function2. This is especially important in tissues like the heart, nerves, and muscles, where potassium and sodium primarily regulate the resting membrane potential and action potentials that control nerve impulses and muscle contractions1,2.
Usually, a slight increase in potassium does not cause any noticeable symptoms. Even at a moderately high level, some patients may only have subtle electrocardiogram (ECG) changes. However, significantly high potassium level can be dangerous. It can disrupt the heart’s rhythm, potentially leading to life-threatening arrhythmias, as well as causing muscle weakness or even paralysis2.
Therefore, understanding the reasons for high potassium is essential for addressing this potentially serious condition. In this article, we will explore the causes, symptoms, diagnosis, treatment, and management of elevated potassium levels, helping you understand how to recognise and manage this condition.
Potassium is a type of mineral and electrolyte that our body needs to function properly2. It’s found naturally in many foods, especially fruits and vegetables like bananas, oranges, spinach, and potatoes3.
Majority of potassium in our body is stored inside cells, particularly in muscles (around 98%). The remaining potassium (2%) lies in bones, and important organs like the liver, lungs, and brain. Only a small amount is found outside the cells, where it plays a critical role in keeping the cells healthy and maintaining their proper function3. Potassium helps regulate the body’s fluid balance, supports normal nerve signals, and ensures that muscles, including that of the heart, contract properly. It also helps maintain healthy blood pressure2,3.
Potassium levels in the blood are carefully regulated because they play a vital role in maintaining the normal electrical activity of cells, especially in the heart, muscles, and nerves.
You may be wondering, what is the main cause of high potassium? This will be discussed in the next section.
High potassium levels in the blood can occur when your body either retains too much potassium or releases too much of it from the cells into the bloodstream2. Normally, the kidneys work to keep potassium levels in balance, but several factors can interfere with this process1. Common high potassium levels causes include:
Now that you are aware of the causes, you may be worried about what if potassium is high and how it could affect your health. Let’s move to the next sections to understand this better.
High potassium symptoms often develop gradually but may be absent in mild cases; however, sudden severe elevations can cause rapid symptoms2. These can range from mild to severe and may include:
Since some symptoms of hyperkalaemia can be subtle or mistaken for other conditions, it’s important to get medical attention if you’re at risk or experiencing any unusual signs, especially if you have a known kidney condition or are on medications that affect potassium levels.
If high potassium levels are not identified and addressed in time, they might lead to serious complications4. Since potassium plays a vital role in nerve and muscle function, especially in the heart, excess potassium can disrupt normal body processes in dangerous ways. Key complications include:
Thus, it’s important to diagnose hyperkalaemia promptly and avoid complications, which may even become life-threatening.
Diagnosing high potassium in body usually begins with a review of your symptoms, medical history, and medications, especially if you have kidney disease or are taking drugs that affect potassium levels. After initial examination, routine tests are performed. Key diagnostic tests include:
The most common and reliable way to diagnose hyperkalaemia is through a serum potassium test6. It is important to get tested at a reputable laboratory because proper blood sample handling is crucial. This is because haemolysis (damage to blood cells) during sample collection or processing can falsely elevate potassium levels, a phenomenon known as pseudohyperkalemia.
Measuring the amount of potassium in your urine can help doctors determine whether your body is excreting potassium properly. Tests such as the urine potassium-to-creatinine ratio or a 24-hour urine potassium collection are especially useful in distinguishing whether hyperkalaemia is caused by kidney or non-kidney related factors⁸.
Since high potassium can affect heart function, your doctor may perform an ECG to check for changes in your heart rhythm2.
Since the kidneys are responsible for filtering out excess potassium, tests such as serum creatinine and blood urea nitrogen (BUN) may be done to assess kidney health and determine whether kidney problems are contributing to high potassium9.
Depending on your symptoms and health history, your doctor may also order tests for adrenal function, blood sugar levels, or acid-base balance, particularly if conditions like diabetes or adrenal disorders are suspected2.
Early diagnosis is key to avoiding complications. If you’re at risk due to kidney issues, medications, or chronic illnesses, regular blood tests, such as the Potassium (K+) Test, can help monitor your potassium levels and identify problems early on.
The severity of the problem and its cause will determine how high potassium levels are addressed. The intention is to deal with the root cause, protect the heart, and quickly bring potassium levels down to a safe range. Your doctor might recommend the following methods to accomplish this:
Limiting high-potassium foods, such as bananas, oranges, potatoes, tomatoes, and spinach, may be recommended, especially for individuals with kidney problems2.
If a medication or supplement is contributing to high potassium levels, your doctor may adjust the dose or switch to an alternative. Common contributors to hyperkalaemia include potassium-sparing diuretics, NSAIDs, ACE inhibitors, ARBs, certain beta blockers, and potassium supplements2,4.
To remove excess potassium from the body, doctors may use:
Note: Loop and thiazide diuretics promote potassium excretion and can help lower potassium levels, whereas potassium-sparing diuretics may worsen hyperkalaemia.
If potassium levels are dangerously high or if there are signs of heart involvement, emergency addressal is needed. This may include:
Finally, managing the root cause, like improving blood sugar control in diabetes or addressing adrenal gland issues, is essential to avoid hyperkalaemia from recurring.
Avoiding high potassium levels involves a combination of lifestyle choices, regular monitoring, and medical management, especially for those at higher risk, such as people with kidney disease, diabetes, or those taking certain medications. Here are some effective ways to avoid potassium buildup:
While potassium is essential for health, people at risk of hyperkalaemia may need to limit foods that are high in potassium. This includes2,11:
Your doctor or a dietitian can help create a meal plan if needed.
Some medications can raise potassium levels. If you’re taking drugs like ACE inhibitors, ARBs, potassium-sparing diuretics, or potassium supplements, it’s important to take them exactly as prescribed6. Never adjust or stop medications without consulting your doctor.
Nowadays, many salt alternatives are available in the market that swap potassium chloride for sodium. While this may be healthy for some people, it can be dangerous for those at risk of hyperkalaemia4. Always check labels and consult your doctor before using salt alternatives.
Drinking enough fluids, like water, helps support kidney function. This, in turn, helps your body naturally excrete excess potassium2. However, in patients with advanced kidney disease or heart failure, fluid intake may need to be restricted to prevent fluid overload, so hydration advice should be individualised by a healthcare professional.
Routine blood tests to check potassium levels are especially important if you have kidney disease, heart failure, or diabetes, or if you’re on medications that affect potassium balance. Early detection helps avoid serious complications.
Keeping conditions like diabetes, high blood pressure, and kidney disease under control reduces the risk of potassium imbalances. This may involve certain lifestyle changes or medications/supplements. Make sure to have regular follow ups with your doctor to address any underlying issues.
It’s important to seek medical attention if you suspect the effects of high potassium, especially if you have a condition that puts you at risk.
You should see a doctor if you experience2,4:
Additionally, consult your doctor if:
It’s critical to understand the significance of potassium balance for safeguarding general health, particularly for the optimal functioning of your heart, muscles, and nerve cells. While potassium is an essential nutrient, its excessive levels or hyperkalaemia can be harmful. These occur more commonly in individuals with kidney disease or taking certain medications which affect potassium excretion.
Symptoms of hyperkalaemia often develop late and may be nonspecific or even absent initially. Therefore, early detection of high potassium levels mainly relies on regular blood tests for individuals at risk, rather than symptom recognition alone. Taking proactive steps, such as managing chronic conditions, following medical advice, and monitoring potassium levels, can help control hyperkalaemia. With proper awareness and care, it is entirely possible to maintain healthy potassium levels and avoid potentially dangerous complications from imbalance.
Yes, mildly elevated potassium levels often have no symptoms2.This is why regular blood tests are important for people at risk. As potassium levels rise, symptoms like fatigue, muscle weakness, or irregular heartbeat may appear.
Many multivitamins contain small amounts of potassium, but potassium supplements should only be taken if prescribed4. People with kidney disease or on potassium-affecting medications should avoid over-the-counter potassium supplements unless approved by their doctor.
While stress doesn’t directly raise potassium levels, physical stress (such as illness, injury, or surgery) can impact hormonal balance and kidney function, potentially contributing to shifts in potassium levels, especially in people with underlying conditions2,6.
No, not always. Sometimes, a false high reading can occur due to how the blood sample was handled (e.g., if red blood cells rupture during collection, which is called pseudohyperkalaemia)2. Your doctor could repeat the blood test to make sure whether your potassium levels are abnormally high.
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
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