What is the disease of pain and weakness?

Many people will feel soreness, pain and fatigue all over their body after being tired. This is a normal phenomenon. However, if the body aches for a long time without reason and there are symptoms of fatigue, then you should pay attention. If necessary, you should go to the hospital for a detailed examination and timely treatment. Pain and weakness all over the body are likely signs of potassium deficiency. Let us now understand what potassium deficiency is. How to treat and prevent it.

The serum potassium (K+) concentration was between 3.5 and 5.5 mmol/L, with an average of 4.2 mmol/L. Usually, serum potassium <3.5mmol/L is called hypokalemia. However, a decrease in serum potassium does not necessarily mean that the body is deficient in potassium. It only means that the concentration of potassium in the extracellular fluid is reduced. When the body is deficient in potassium, serum potassium does not necessarily decrease. Therefore, clinical analysis should be combined with medical history and clinical manifestations.

Clinical manifestations

The severity of clinical manifestations depends on the degree of potassium deficiency inside and outside the cells and the speed at which potassium deficiency occurs. The symptoms of acute hypokalemia are more severe than those of chronic hypokalemia with the same level of potassium deficiency.

1. Neuromuscular system

Common symptoms are muscle weakness and paroxysmal flaccid paralysis. The latter may precede muscle weakness. Although the attack is related to the absolute level of plasma K+, it is more closely related to the K+ gradient inside and outside the cells. The larger the gradient, the greater the difference between the resting potential and the threshold potential, resulting in reduced muscle excitability. Paralysis may also occur when plasma K+ rises. The attacks are more common at night and after fatigue. The most common muscles affected are the limbs. The muscles of the head and neck are generally not affected, but the respiratory muscles may be affected and breathing difficulties may occur. There may be numbness of the limbs before the attack, followed by fatigue, and finally complete disappearance of autonomous activity. Generally, the symptoms of proximal muscles are slightly milder than those of distal muscles. Patients cannot stand, walk, sit or squat and cannot stand up. Those with milder symptoms can barely stand up by holding on to a support with their hands, but cannot turn over on their own. Painful cramps or hand and foot cramps may also occur. The central nervous system is mostly normal and the patient is conscious. There may be mental symptoms such as apathy, depression, drowsiness, memory and orientation impairment or loss. Cranial nerves are rarely affected, and superficial nerve reflexes are weakened or completely disappeared, but deep tendon reflexes and abdominal wall reflexes are less affected.

2. Cardiovascular system

Low potassium can reduce myocardial excitability and cause various arrhythmias and conduction blocks. Mild cases include sinus tachycardia, premature atrial or ventricular contractions, and atrioventricular conduction block. Severe cases include paroxysmal atrial or ventricular tachycardia, and even ventricular fibrillation. Potassium deficiency can aggravate digitalis and antimony poisoning, and may lead to death. Peripheral peripheral vasodilation and blood pressure may drop. Reduced myocardial tension can cause cardiac enlargement. In severe cases, heart failure occurs and U waves appear on the electrocardiogram, often indicating that the body has lost at least 500mmol/L of potassium.

3. Urinary system

Long-term hypokalemia can damage the renal tubules and cause potassium-deficient nephropathy. The renal tubular concentration, ammonia synthesis, hydrogen secretion and chloride ion reabsorption functions can all be reduced or enhanced. The sodium excretion function or sodium reabsorption function can also be reduced, resulting in metabolic hypokalemia and hypochlorite alkali poisoning.

4. Endocrine and metabolic system

Hypokalemia may cause impaired glucose tolerance. Children with long-term potassium deficiency will have delayed growth and development. In patients with hypokalemia, urinary potassium excretion is reduced (24 hours), but in those caused by renal tubular acidosis and acute renal failure, urinary potassium excretion increases (>40mmol/24 hours).

5. Digestive system

Potassium deficiency can slow down intestinal motility. People with mild potassium deficiency only experience loss of appetite, abdominal distension, nausea and constipation; severe potassium deficiency can cause paralytic ileus.

treat

1. Acute hypokalemia

Emergency measures should be taken for treatment; for chronic hypokalemia, as long as the blood potassium is not lower than 3mmol/L, the cause can be checked first and then treated accordingly.

2. Potassium supplement

It should be determined based on blood potassium levels. Patients with blood potassium levels between 3.5 and 4 mmol/L do not need additional potassium supplements. They only need to be encouraged to eat more foods rich in potassium, such as fresh vegetables, fruit juice and meat. When blood potassium is between 3.0 and 3.5 mmol/L, whether potassium supplementation is necessary should be determined based on the patient's specific situation. Potassium supplements should be taken if the patient has had arrhythmia, congestive heart failure, heart failure being treated with digitalis, ischemic heart disease, or a history of myocardial infarction. Patients who are generally in good condition may only be encouraged to eat foods rich in potassium or take oral potassium preparations. Those with blood potassium levels below 3.0mmol/L should take potassium supplements.

For mild cases, only oral potassium is needed, with 10% potassium chloride being the preferred medicine. Serum potassium should be monitored during oral potassium preparations. If the blood magnesium level is lower than 0.5mmol/L, 50% magnesium sulfate should be injected intramuscularly. 10% magnesium sulfate can also be taken orally.

Severely ill patients (including those with arrhythmia, rapid ventricular rate, severe cardiomyopathy, and familial periodic paralysis) should receive intravenous potassium preparations, and potassium chloride is also the commonly used preparation. Serum potassium should be monitored during the infusion or by electrocardiogram. For patients with acidosis or without hypochloremia, 20 ml of 31.5% potassium glutamate solution should be added to 5% glucose solution and slowly dripped intravenously. Potassium chloride should not be used at this time.

3. Correct water and other electrolyte metabolism disorders

Many of the causes of hypokalemia can simultaneously cause the loss of water and other electrolytes such as sodium and magnesium. Therefore, they should be checked promptly and must be actively treated once discovered. As mentioned above, if hypokalemia is caused by magnesium deficiency, potassium supplementation alone will be ineffective without magnesium supplementation.