Is Too Much Potassium Bad for You? Understanding Hyperkalemia

Jane Brainard
a few seconds ago
4 min read

If you've ever gotten muscle cramps before, one piece of advice you may have heard is "Make sure you eat some bananas!" Why? Because bananas have a lot of potassium. Potassium is an essential electrolyte that helps muscles and nerves function.

What is hyperkalemia?

While potassium is important, too much potassium can cause problems in your body. The most serious problems it can cause include paralysis and cardiac arrest (stopping your heart).

"Hyperkalemia" the medical term for high potassium. It can develop quickly within a few hours or more slowly over weeks or even months.

What causes hyperkalemia?

Hyperkalemia can be caused by certain medications, diets, and diseases. Below is a list with some examples.

Medications

Mineralocorticoid receptor antagonists (ex: spironolactone, eplerenone)
Angiotensin-converting enzyme (ACE) inhibitors (ex: lisinopril, enalapril)
Angiotensin II receptor blockers (ARBs) (ex: losartan, valsartan)
Potassium-sparing diuretics (ex: triamterene, amiloride)
NSAIDs (ex: ibuprofen, naproxen)

Diet

Foods high in potassium (ex: bananas, leafy greens such as spinach)
Potassium supplements
Low sodium diets that use potassium salt substitutes instead of sodium chloride salts

Diseases

Diabetes mellitus
Heart failure
Kidney disease

What are the symptoms of hyperkalemia?

People often do not experience symptoms if they have hyperkalemia. If they do have symptoms, the symptoms are usually mild. Mild symptoms include the following:

Nausea
Muscle weakness, pains, or cramps
Tiredness

If your potassium levels rise rapidly or you have very high levels of potassium, you may experience more severe symptoms. Severe symptoms include the following:

Irregular heartbeat (this may feel like your heart is pounding, racing, or skipping a beat)
Shortness of breath
Chest pain
Vomiting

Very high potassium levels can be life-threatening and therefore need medical attention right away.

How is hyperkalemia treated?

The treatment for hyperkalemia depends on how high your potassium level is and how serious the symptoms are that you may be experiencing. It also depends on other factors, such as what diseases you may have.

If you have hyperkalemia, one of the medications that you may be given is a potassium binder. These medications come as a powder that you mix with liquid and then drink. They lower your potassium level by moving potassium from your blood into your digestive tract, where the potassium is then eliminated from your body.

Another medication that you may be given is a diuretic. These are medications that you take by mouth that move potassium into your urine. They basically help you to pee out the extra potassium.

If your potassium levels remain high even with these medications, your doctor may ask you to eat less potassium. However, foods that are high in potassium are nutritious and beneficial to your body in many ways, so don't stop eating these foods unless your doctor recommends that you eat less of them.

Severe Hyperkalemia

When the potassium levels are high enough to need immediate treatment, you will be admitted into the hospital where the following steps are taken:

If there are potassium-related changes to the heart's activity, a medication called calcium gluconate is given as an intravenous (IV) injection.
Next, insulin and dextrose are given through the IV route.
1. Insulin helps cells in the body to take up the potassium, thus decreasing your blood potassium levels. However, insulin also lowers blood sugar levels. Dextrose is a sugar that is given with insulin in order to ensure that blood sugar levels do not get too low.
Albuterol is then given as an inhalation through a nebulizer. This medication also helps your body's cells to take up potassium and further lowers your blood potassium levels.
If you have metabolic acidosis - meaning that your blood is too acidic - you might be given a medication called sodium bicarbonate through an IV.
1. Metabolic acidosis happens in some people who have hyperkalemia because potassium decreases the production of a compound called ammonia. One of the things ammonia does in the body is keep the blood from getting acidic.
Although insulin and albuterol help to decrease the levels of potassium in your blood, they only provide a temporary solution since the potassium is still in the cells in your body. In order to actually get the extra potassium out of your body, diuretics are also given.
In addition to diuretics, potassium binders are given to further eliminate potassium from the body.

How do I know if I have hyperkalemia?

Since the milder symptoms of hyperkalemia are vague and could be caused by any number of things, it is hard to know if you have hyperkalemia. However, if you are starting a new medication or have a disease state that could cause you to have hyperkalemia, your doctor will check your potassium levels regularly to make sure they aren't high. This is done through a typical blood draw.

What should I do if I think I have hyperkalemia?

If you are experiencing any of the severe symptoms of hyperkalemia, including an irregular heartbeat (such as feeling like your heart is racing, pounding, or skipping a beat), shortness of breath, or chest pain, make sure you seek medical attention right away.

If you have one of the milder symptoms of hyperkalemia, talk to your doctor. There are many things that could cause these symptoms - not just hyperkalemia - and your doctor will help determine the cause.

References

Harris, A.N., Grimm P.R., Lee H.W., Delpire E., Fang L., Verlander J.W., Welling P.A., & Weiner I.D. (2018). Journal of the American Society of Nephrology, 29(5), 1411-1425. https://doi.org/doi:10.1681/ASN.2017111163

National Institutes of Health. (2022). Potassium. https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/

National Kidney Foundation. (2025). High potassium (hyperkalemia). https://www.kidney.org/kidney-topics/hyperkalemia-high-potassium#:~:text=serious%20heart%20problems.-,Signs%20and%20Symptoms,It%20requires%20immediate%20medical%20care

Palmer, B.F. & Clegg, D.J. (2024). Hyperkalemia treatment standard. Nephrology Dialysis Transplantation, 39(7), 1097–1104. https://doi.org/10.1093/ndt/gfae056

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