Hyperkalemia: What It Is, Why It Happens, and How to Keep Potassium in Check

If your blood test shows a potassium level above 5.0 mmol/L, you’re looking at hyperkalemia. In plain words, it means there’s too much potassium floating around your bloodstream. Potassium helps your heart, muscles, and nerves work, but too much can turn those systems into a ticking time bomb.

Most people think potassium only comes from bananas, but it’s in every cell. Your kidneys act like the kitchen sink that drains the extra, keeping the level steady. When the kidneys can’t do their job or you add too much potassium at once, the balance tips, and symptoms start to appear.

Common Triggers You Might Not Expect

Kidney disease tops the list. Even a mild drop in kidney function makes it harder to dump excess potassium. Certain prescription meds—like ACE inhibitors, ARBs, potassium‑sparing diuretics, and some NSAIDs—also hold potassium back.

Don’t forget over‑the‑counter supplements. Many people take potassium chloride for cramps without checking their blood levels. A high‑protein diet or excessive red meat can add up too, especially if you’re already on a kidney‑friendly plan.

Sudden tissue breakdown, such as after a severe burn, muscle injury, or high‑dose steroids, pushes potassium out of cells into the blood. Even a bout of diarrhea can cause a shift, because the body tries to conserve water and electrolytes.

Quick Steps to Lower Potassium Safely

First, get a clear lab result. A single reading tells you where you stand, but a repeat test confirms whether the level is staying high or coming down. If you’re over 6.5 mmol/L and feel any heart‑related symptoms (palpitations, skipped beats, or chest tightness), treat it as an emergency and call 911.

For mild cases (5.0–6.0 mmol/L), start with diet tweaks. Cut back on potassium‑rich foods like bananas, oranges, potatoes, tomatoes, and avocados. Swap them for lower‑potassium options: apples, berries, cauliflower, and white rice.

Stay hydrated, but avoid sugary drinks. Water helps the kidneys flush out extra potassium. If you’re on a diuretic, talk to your doctor about adjusting the dose.

Some doctors prescribe medications that bind potassium in the gut—like sodium polystyrene sulfonate—or give a short‑term IV calcium gluconate to protect the heart while other treatments kick in. In severe cases, dialysis is the fastest way to pull potassium out.

Never stop a prescribed drug without checking with a healthcare professional. Suddenly quitting an ACE inhibitor, for instance, can spike blood pressure and cause other problems.

Keep a symptom diary. Note any muscle weakness, tingling, or irregular heartbeats. Sharing this with your doctor speeds up the decision‑making process.

Bottom line: hyperkalemia is manageable if you catch it early, adjust your diet, review your meds, and stay in touch with your doctor. Regular labs, especially if you have kidney issues or take potassium‑affecting drugs, are the best insurance against a dangerous potassium surge.