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Diuretics: A cause of low potassium?
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/blood-pressure/AN00352
- With Mayo Clinic emeritus hypertension specialist
Sheldon G. Sheps, M.D.
read biographyclose windowBiography of
Sheldon G. Sheps, M.D.
Sheldon Sheps, M.D.
Dr. Sheldon Sheps, emeritus professor of medicine and former chair of the Division of Nephrology and Hypertension in the Department of Medicine at Mayo Clinic, has been with Mayo Clinic since 1960.
Dr. Sheps, a Winnipeg, Manitoba, native, is board certified in internal medicine and specializes in hypertension and peripheral vascular diseases. He developed a multidisciplinary approach with specially trained nurses, dietitians, technicians and educators to help form a team approach to the treatment of patients with abnormal blood pressure.
"I have always believed in involving the patient and family in their health care," Dr. Sheps says. "I have asked for their understanding of the illness and issues and for participation in decisions. The Web is a natural extension of that, and now many more people can be informed."
Dr. Sheps chaired the sixth working group, and he participated in the fourth, fifth and seventh groups that developed the then-latest guidelines for hypertension under the auspices of the National Heart, Lung, and Blood Institute (NHLBI). He helped write the latest American Heart Association (AHA) report on blood pressure measurement. He chaired an AHA group that produced an online accreditation for blood pressure measurement for health professionals.
Dr. Sheps has co-authored books, newsletters, CD-ROMs and other Mayo Clinic health information material. He joined Mayo Clinic's Web team in 1998. He was medical editor-in-chief of both editions of the "Mayo Clinic on High Blood Pressure" book; the last edition was published in 2003. He was also medical editor-in-chief of "Mayo Clinic 5 Steps to Controlling High Blood Pressure," published in 2008.
In addition, Dr. Sheps was section editor for each of the first three editions of "Hypertension Primer" for the American Heart Association.
Dr. Sheps was also chairman of the Science Base Subcommittee and the National High Blood Pressure Education Program, and he was a consultant to the Hypertension Initiative of the World Health Organization. In 1997, he was honored with the Individual Achievement Award on the 25th anniversary of the National High Blood Pressure Education Program of NHLBI. In 2009, he was honored as a Distinguished Mayo Alumnus.
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Question
Diuretics: A cause of low potassium?
Can diuretics decrease your potassium level?
Answer
from Sheldon G. Sheps, M.D.
Many diuretics (sometimes called water pills) decrease potassium in the blood. Diuretics lower blood pressure by helping your body eliminate sodium and water through your urine, which reduces blood volume and decreases pressure on your artery walls. However, some diuretics can also cause you to eliminate more potassium in your urine. This can lead to low potassium levels in your blood (hypokalemia). Signs and symptoms of hypokalemia include:
- Weakness
- Fatigue
- Muscle cramps
- Constipation
- Problems with your heart's rhythm (arrhythmias)
There are potassium-sparing diuretics that don't cause this problem. These include spironolactone (Aldactone), eplerenone (Inspra) and triamterene (Dyrenium).
Other medications besides diuretics can help reduce your blood pressure: angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs) and renin inhibitors. These medications usually increase potassium levels in your blood, too.
If you're taking an ACE inhibitor with a diuretic and getting enough potassium in your diet but your potassium level is still low, your doctor may recommend further testing to help identify the underlying cause. Rarely, low potassium may be due to overproduction of the hormone aldosterone (hyperaldosteronism), which increases potassium loss by the kidneys.
Treatment of low potassium may include:
- Increasing potassium in your diet
- Use of potassium supplements
- Changing to a potassium-sparing diuretic
Beta blockers: Do they cause weight gain?
- Rose BD. Diuretic-induced hypokalemia. http://www.uptodate.com/home/index.html. Accessed March 17, 2011.
- Moser M, et al. Fifty years of thiazide diuretic therapy for hypertension. Archives of Internal Medicine. 2009;169:1851.
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