Hyperkalemia and hypokalemia are both caused by changes in the level of potassium in your blood. Hyperkalemia occurs when your blood potassium level is very high. On the other hand, hypokalemia is a condition where your blood potassium is too low. Potassium is the main intracellular electrolyte in the body that plays a vital role in the normal functioning of the nerves and muscles, especially the muscle cells in your heart. Your kidneys are responsible for regulating potassium levels in the body by excreting excess potassium via sweat or urine.

Optimal potassium levels should be between 3.6 and 5.2mmol/L. A normal blood potassium level is important for maintaining a normal electrical heart rhythm. If your potassium level is too low, less than 3.3mmol/L, it is known as hypokalemia. On the other hand, if your potassium level is too high, more than 5.5mmol/L it is known as hyperkalemia. Both conditions can cause an abnormal heart rhythm.

What are the signs and symptoms of hypokalemia and hyperkalemia?

Both hyperkalemia and hypokalemia are asymptomatic, which means that they show no symptoms. Symptoms usually appear when the blood potassium level is extremely high or low. It is important you know the symptoms of hyperkalemia and hypokalemia, so that you seek medical attention if necessary. Hypokalemia may not show any symptoms until your blood potassium level is dangerously low. If you experience muscle cramping, heart palpitations, fatigue, and weakness, you should seek immediate medical attention. In some cases, hyperkalemia may not cause symptoms, however some symptoms may emerge if the potassium levels are high enough.

  • Fatigue
  • Nausea
  • Weakness
  • Irregular heartbeats
  • Difficulty breathing

In severe cases, when left untreated, hypokalemia and hyperkalemia may cause paralysis.

Causes of Hyperkalemia and Hypokalemia

There are many factors which can contribute to hypokalemia or low potassium levels. Usually, hypokalemia is a symptom of another medical condition, such as Cushing syndrome. It may also be brought on by diabetic ketoacidosis, hyperthyroidism, high doses of penicillin, or even insulin. On the other hand, hyperkalemia is commonly caused by kidney failure. It can also be caused by dehydration, type 1 diabetes, or Addison’s disease.


If you have mild or severe hypokalemia or hyperkalemia, it is important you seek medical attention to reduce the risk of complications. Hyperkalemia and hypokalemia are both serious conditions that may become life threatening if not treated. Treatment of low or high blood potassium is normally directed to the root cause. If you are diagnosed with hypokalemia, you may require to be hospitalized. At the hospital, your doctor will treat the underlying cause of your condition. The next step will be to restore your potassium levels back to normal. Your doctor may prescribe potassium supplements. If your potassium level is very low, IV drip may be needed. During your stay at the hospital, your health-care provider will monitor your potassium level so that it doesn’t rise to dangerous levels. Once you have left the hospital, you may be recommended by your doctor to start a diet that is rich in potassium. If you are diagnosed with hyperkalemia, the treatment goal will be to reduce your potassium level and ensure your heart is stabilized. If you have a high blood potassium level as a result of kidney failure, hemodialysis is required. Medications such as diuretics and calcium gluconate may be used to reduce high potassium levels.


Disclaimer: Please note that the contents of this community article are strictly for informational purposes and should not be considered as medical advice. This article, and other community articles, are not written or reviewed for medical validity by Canadian Insulin or its staff. All views and opinions expressed by the contributing authors are not endorsed by Canadian Insulin. Always consult a medical professional for medical advice, diagnosis, and treatment.