HIGH POTASSIUM LEVELS IN BLOOD

[TREESE]

Hello, All - May I ask if any of you with Microscopic Colitis have experienced a Blood Test that showed High Potassium Levels?

My Primary Care Physician gave me 2 Blood Tests, a week apart, just to be sure the Results were not a fluke. Both showed the Potassium Level at 5.8. Normal Range on the High End is 5.2. Now, he wants to send me to a Kidney Specialist.

I was on Lialda, but am off now, as of last month. Could the Lialda have affected my Levels?

Not eating any especially high potassium containing foods. Not on any pain Meds or conflicting Meds of any kind. My Daily Vits don't show any Potassium. I take very little added Magnesium with a Vitamin low D supplement every other day.

Any Ideas? Please Reply. Thanks, ALL!

TREESE

[tex]

Hi Treese,

Usually we are more likely to have the opposite problem due to excessive diarrhea. It's not likely that the Lialda would cause hyperkalemia. At least that hasn't been documented previously. Outside of certain meds, dehydration can cause the problem. But it seems unlikely that you would be that dehydrated twice in a row for the blood draws.

The most likely problem (as your PCP obviously suspects) is compromised kidney function. I note that when I had the acute magnesium deficiency last spring my kidney function (for the first time in my life) headed south in a hurry. Doubling my magnesium intake resolved the problem. If you have a magnesium blood test to check your magnesium level, be sure that on the day of the blood draw you do not take a magnesium supplement, because if you do, I'll guarantee that the test result will be "normal", no matter how severe your magnesium deficiency might actually be. Been there, done that.

Tex

[TREESE]

Hi, TEX - Do you think I should begin an increase in my Magnesium Supplement? I presently only take 1 Tablet every other day, which equals 100mgs. The recommended dose is 2 Tablets twice a day.

The Brand is: Doctor's Best High Absorption 100% Chelated Magnesium.

Do I have to take Vit "D" or any other Vitamins with it? I am on Caltrate "D" for my Osteoperosis and I take a GF Multivit daily, too.

Forget to mention... having some acidy feeling in my stomach lately, and bloat. But no Big D for like 6 months or more, now. Still can't do raw vegies or fruit, but have added back many foods. Still on GF Diet, too.

Thanks so much for your Reply, Tex! Your guidance has done more for my remission than All the Docs put together!

TREESE

[tex]

Treese,

Most of the "experts" with a good track record now recommend that if a calcium supplement is taken, then an equal amount of magnesium supplement should also be taken so as to keep the ratio as close to 1:1 as possible (the old guidelines recommended 2:1 — twice as much calcium as magnesium).

So yes, you need additional magnesium in order to properly utilize the calcium supplement you are taking. However, if I were in your situation I would wait to see what needs to be done to resolve the potassium imbalance before making a big adjustment in my magnesium supplementation. A slight increase probably wouldn't matter, but the problem is that if whatever is causing the potassium imbalance also has the effect of wasting magnesium, taking more supplements than you can currently utilize might increase the workload on your kidneys, and that's not a good idea when their function is already compromised.

Deep down, I have a hunch that a magnesium deficiency (plus a possible vitamin D deficiency) is the reason why your kidneys are not functioning properly, and this is the reason why the unneeded potassium is not being properly removed from your blood, thus causing the level to build up. I would take twice as much magnesium as you're taking (scattered through the day). And Caltrate+D only contains 800 IU of vitamin D. I would be taking 5,000 IU (in fact, I am taking 5,000 IU of vitamin D). But I'm not a doctor, so I can't give medical advice, and I certainly don't want to make any recommendations that might damage your health.

Is your calcium blood level normal? Normally, if vitamin D and magnesium are not available at adequate levels, blood calcium will either be high or at least in the upper part of the "normal" range.

High potassium can cause diarrhea and/or abdominal pain, or muscle cramps or pain, so there's a good chance that it might be the reason why your stomach feels out of sorts.

Tex

[TREESE]

Very Interesting, TEX - Since this Stomach distress was preceded by an unexplainable 3 week Back Pain and Spasm episode, now I am wondering if the two are connected with the High Potassium levels.

I checked my Calcium Levels on the Blood Test Results and they are right where they should be. That's good, anyway.

Does anything help the stomach calm down until I can see the Kidney Doctor? Go back on the Lialda or take some Pepto Bismol? Should I be eating bland food for a while?

Thank You, Tex!
TREESE

[tex]

It sounds as though the kidney issues may have come first, but of course whatever caused the kidney problem came even earlier.

Are you by any chance taking any blood pressure medications, such as an ACE inhibitor? Ace inhibitors can cause hperkalemia in some individuals.

Pepto-Bismol might help, but I would be reluctant to use mesalamine (the active ingredient in Lialda) when kidney function is in question because mesalamine can cause kidney damage in some patients. It's definitely not common (it happens to roughly 1 in 400 mesalamine users). Was your creatinine test result high? If so, that might suggest that mesalamine was responsible for kidney damage.

Yes, bland, easy to digest foods might be helpful.

You're very welcome,
Tex

[TREESE]

Hello again, TEX - In Reply to your previous e-mail, my BUN and CREATINE were Normal (Creatine 0.92) BUN and CREATINE Ratio is Not reported when levels are Normal, the Test Result said.

Also HIGH were ALT and MPV, which I haven't a Clue what they even are. ALT was 40 and MPV was 7.0.

I won't go back on the LIALDA but I might try some Pepto.

How about IMMODIUM to protect me when I have to be Out? I don't have "D" yet, but the rumbling and the feeling of the Ocean in my Stomach suggests that I might.


Thank You, TEX!

[tex]

Normal creatinine suggests that you probably aren't having an allergic reaction to a med. MPV means that the average size of your platelets is larger than normal. Larger platelets are new platelets (they shrink after a few days in circulation). If your platelet count was normal, then it's nothing to get excited about. My MPV was elevated during the January–February period both this year and the year before, but tests done during other times of the year showed normal levels. If your MPV is elevated though, and your platelet count is low, that suggests that your bone marrow is producing new platelets faster than normal, and that would need to be checked out.

ALT is a liver enzyme. Mesalamine and various other meds can cause increased ALT levels. Your lab apparently uses different normal ranges than mine, but those numbers don't appear to be elevated enough to get excited about.

Sure, lmodium should almost always be safe for anyone (but of course, don't take it if you have C). It sounds as though your immune system may be taking offense at something in your diet.

Tex

[TREESE]

Sorry I wasn't able to Reply sooner, TEX. I spent a good deal of the Day at the Doctor again. He wanted more Blood and an EKG and stuff.

Thank you for sharing your knowledge and for your Guidance. And especially your quick Replies. Hearing from you is so re-assuring! It relieves so much of the anxiety of this mystery of on-again off-again Microscopic Colitis.

Will let you know what happens when I see the Kidney Doc. That will be May 23rd. But for now, I'll stay with a bland Diet until the stomach calms down again.

Hoping you are well,
TREESE

[tex]

Good luck with the appointment.

Tex

[TREESE]

Hi, TEX - A New Development in the High Potassium Case.

Stomach really OFF, so I took One LIALDA on Monday. Hadn't taken Any since April 25th. My Primary Care Doc called me to schedule yet another Blood Test, the 3rd, for Tuesday morning. I fasted Monday night and took the Test Tuesday Morning. The Results came back Completely Normal. No High ANYHING!

My guess is the LIALDA had some effect. BUT...does that mean I Still have a Kidney Issue? Or was the High Potassium simply due to the Microscopic Colitis issue????

Once again, I am stumped! Can you Advise, please?

Thanks,
TREESE

[tex]

Hmmmmm. You're asking some tough questions, and about all I can do is guess at the answers. The cause of the hiccup in the first place appears to be a mystery. IOW, it appears that the elevated potassium level was probably associated with compromised kidney function, but since the problem resolved on it's own, there are no real clues as to the root cause.

MC shouldn't/isn't known to cause high potassium levels. MC typically causes low potassium levels, because of the associated diarrhea and dehydration. Was your kidney function (glomerular filtration rate) also back to normal on this last group of tests? It took mine a while to get back to normal when I had the antibiotic/magnesium problem last spring, but my doctor stopped testing after it was clear that it was headed back to normal.

If your kidney function and potassium level are both back in the normal range, then it appears that some unknown event was responsible for causing a relatively short-term health issue, but you may never know what it was. Sometimes stuff just happens.

Thanks for the update.

Tex

[tex]

Thinking about this, my glomerular filtration rate took a nose dive in the fall of 2014 when I had a kidney stone problem. This was prior to my realization that I had a chronic magnesium deficiency despite taking a magnesium supplement, so I have no doubt that the kidney stones were caused by a chronic magnesium deficiency. Kidney stones are known to be a common symptom of magnesium deficiency.

What I'm trying to say is that I wonder if there is a possibility that you might have had a minor kidney stone event without realizing it. When I had the problem I thought that maybe I had an intestinal blockage or my guts had simply stopped working, because the dull pain reminded me somewhat of constipation. It never dawned on me that it could be a kidney stone problem until the ER doc ordered a CT scan and a stone was visible in the ureter just below my right kidney. My glomerular filtration rate was 47 that day, if I recall correctly. My glucose level was high, but creatinine was normal, and so was potassium and all of the other electrolytes.

It happened again about 3 weeks later, but since I realized what it was that time, I didn't bother to go to the ER. I just drank plenty of water and the problem passed within a few hours.

Tex

[TREESE]

Hello, Again, TEX - Sounds like you don't feel that the One LIALDA Pill the day before that 3rd Blood Test would have affected those Test Results any.

Well, I e-mailed both my Primary Care Physician, who took the Tests, and my Gastroenterologist, who treats my MC and has a Copy of those first 2 Tests showing the Potassium as High. I told them Both about having taken that single LIALDA Pill a day before that 3rd Test, when the Test Results were Normal, but no Replies from Either of them, as yet.

A Minor Kidney Stone...hmmm...never had one of those. I do drink enough Water each day, though. But, who knows, right?!

Magnesium Levels always show as Normal, but even if they are, is a Supplement still good because of our MC? And the same question for the "D"? I DO take a lot of Caltrate "D" for my lower spine's Osteoporosis, which got a little worse again, since the MC began a year ago. I know it needs certain supplements to help it absorb, thanks to your having told me.

I'll let you know what the Doctor's say about all this when they Reply.

Thanks again!
TREESE

[tex]

Treese,

I don't see how a single mesalamine tablet or capsule could have a positive effect on kidney function. It could definitely have a negative effect though, on both kidney function and liver enzymes, if you happen to be sensitive to it.

If you are taking caltrate D and not taking a magnesium supplement then IMO you probably have a magnesium deficiency and you have a risk of developing kidney stones. This is because calcium depletes magnesium. The old recommendations were for a 2:1 calcium to magnesium ratio. But the most up-to-date recommendations on calcium supplementation advise that the supplement rate should be on a 1:1 ratio. IOW equal amounts of calcium and magnesium should be supplemented if you are going to supplement calcium. Otherwise, in the long run your magnesium reserves will be depleted, and without adequate magnesium available, the calcium cannot be properly utilized for conversion and storage in bone tissue. Calcium can build up in blood vessels, joints and various other places where it shouldn't be, including precipitating out as kidney stones.

I have posted many, many times about how the blood tests for magnesium levels are worthless unless the body is almost totally out of magnesium (dangerously low). As long as any magnesium can still be found in muscle cells (where it is stored), the system will draw on that source to keep the blood level in the normal range (even though the muscle cells in the body are starving for magnesium.

Your osteoporosis is probably worse since the advent of MC because MC depletes magnesium, and so do the calcium supplements you are taking to try to correct the osteoporosis. Most people have plenty of calcium in their diet — it's magnesium they need. And magnesium is never even on most doctors' radar. You cannot stop or reverse osteoporosis without adequate magnesium and vitamin D. And that's not just my opinion — it's a medical fact.

You're very welcome

Tex