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>> Does anyone else have low potassium (mine was 3.0, normal being 3.5 to 5.0)? Is this another diabetes thing? <<
Yes, this IS another diabetes thing. It would happen to anyone who was "starving
to death". Normally, in our bodies, sodium is primarily in the bloodstream and
potassium is inside the cells. There is an energy requiring mechanism in the
cell walls called the Na+/K+ pump. Inside the cell the concentration of
potassium is about the same as the concentration of sodium outside the cell and
vice versa. Without a pump the concentration would be the same inside and out.
Our bodies use this gradient to create electricity. This is what makes our
nerves work. Our muscles require this same gradient to work, too. In fact nerves
are specialized muscle cells embryologically (if I remember what Dr Galen taught
me when I was in school several hundred years ago ;^)
If something happens that halts the cell's ability to run this ion pump then
sodium will leak into the cells and potassium will leak out. When there is
excess sodium in the bloodstream the kidneys save it and put it back into the
bloodstream. Potassium, on the other hand, is passively removed. So, the more
potassium you have in your blood, the more you pee out. This can cause a
significant loss of potassium from your body over a period of days or months.
Measuring serum potassium to estimate total body potassium is like measuring the
oil in your car by looking at the oil spot on the driveway under your car. Sure,
if there were a LOT of fresh oil there you would suspect that your car would be
low on oil, but the best way would be to pull out the dipstick and have a look.
Unfortunately it is quite a bit more difficult to measure the intracellular
content of potassium and sodium. So clinicians commonly measure the serum ions
Whenever your serum insulin level drops your cells start to starve. They depend
on insulin to get the food IN. If they don't get the food they start to lose
some of their normal function. One of the normal cellular functions, as I have
already said, is to keep the potassium in. When your serum insulin level drops
you lose potassium from inside your cells. When that happens you lose the
potassium in your urine and it is GONE. For that you need to take potassium
supplements. One way is to eat foods high in potassium. Bananas are the
"notorious" food that is supposed to be high in potassium. It just isn't so.
They have no more potassium than any other fruit. Oranges have just as much
potassium per gram and per calorie as bananas. One of the highest dietary
sources of potassium is blackstrap molasses. On the other hand, the highest
concentration of potassium per calorie of food value is tomatoes. This
information is from COMPOSITION OF FOODS published by the Agricultural Research
Service of the United States Department of Agriculture (also known as
AGRICULTURE HANDBOOK NO.8). This is a GREAT reference book about foodstuffs. It
was about ten bucks twenty years ago when I purchased my copy.
Nowadays there is an even easier way to add potassium to your diet. NO SALT,
which is a salt substitute available at your local grocery store, is potassium
chloride. It tastes a little different if you are really used to a lot of salt,
but I have come to really like it.
Incidentally the loss of potassium from inside your cells causes a whole LOT of
symptoms which, as diabetics, we are ALL more than likely to be familiar with.
IRRITABILITY is the major one. Both muscle irritability as well as central
nervous system irritability. Postural hypotension, almost passing out when you
stand up from bending over, is common, too. Some of the symptoms of
gastroparesis are common, too, when the gut muscle cells cannot contract
normally. The same happen in the bladder. ALL the cells in your body lose their
ability to contract normally when their potassium is missing. Your heart muscle
is NOT immune. You can very well have angina when your heart is unable to pump
enough blood through it's own arteries.
I guess this anatomy and physiology lesson has gone far enough for now. I will
stay after class to answer any questions.
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