Q. Last August through September I landed in two different emergency rooms with very low potassium in my blood.  I was admitted to hospital for five days and then into sub-acute rehab nursing care.  After I was discharged, I had to go back to another emergency room with the same problem.

I saw a doctor twice at a family practice that has a geriatric physician on staff.  During all of this, I had prescriptions filled at two different pharmacies for potassium chloride.  I am eighty and take Vasotec for blood pressure, a diuretic and a dose of prednisone.

I kept feeling worse and finally stopped the prescribed potassium.  I have experienced slow improvement and am eating high potassium foods.

When I purchased the book, Top Screwups Doctors Make and How to Avoid Them… I found that my PROBLEM was Screwup #9. Two different pharmacists had also “screwed up.”  It was frightening to realize that Vasotec, prednisone and potassium drugs may cause dangerous interactions in the elderly.

 3 ERs, 2 Pharmacists, 1 SubAcute Rehab, and 1 doctor–2 times.  Am I too old to go to med school? 

 Thank you for writing the book and for looking out for all of us.

A. We don’t know why your potassium was low to start with, but we agree that potassium imbalance–either too low or too high–is frightening. People in this situation may die before the problem is discovered. 

We offer a list of high-potassium foods that you can use to keep your equilibrium. Remember that Vasotec (enalapril) can boost potassium, so if you are eating a lot of these foods and taking that drug you should have your potassium checked from time to time: 

Potassium-Rich Foods 

  • Apricots
  • Artichokes
  • Asparagus
  • Avocado
  • Bananas
  • Bean sprouts
  • Beet greens
  • Beets
  • Bell peppers
  • Black bass
  • Blackberries
  • Blackstrap molasses
  • Brazil nuts
  • Broccoli
  • Brussels sprouts
  • Cabbage
  • Cantaloupe
  • Carambola
  • Carrots
  • Catfish
  • Cauliflower
  • Chard
  • Chicken
  • Clams
  • Cocoa (not alkali-processed)
  • Cod
  • Collards*
  • Dates
  • Flounder
  • Guava
  • Hamburger
  • Halibut
  • Kidney beans
  • Lentils
  • Lima beans
  • Liver
  • Milk
  • Mullet
  • Mushrooms
  • Mussels
  • Nectarines
  • Oatmeal
  • Oranges
  • Oysters
  • Peaches
  • Peanuts
  • Pecans
  • Perch
  • Plums
  • Pomegranate
  • Pork chops
  • Potatoes (baked with skin)
  • Prickly pear
  • Prunes
  • Raisins
  • Raspberries
  • Salmon
  • Shrimp
  • Snapper
  • Spinach
  • Squash
  • Strawberries
  • Sweet potato
  • Tomatoes
  • Tuna
  • Veal
  • Wheat germ
  • Yeast
  • Yogurt

 Others who would like to learn about the other nine screwups (and tips to avoid them!) may wish to check out our book, Top Screwups Doctors Make and How to Avoid Them.

Have you ever experienced an error? What about somone you know or love? Share your story below. Most important, learn about the best ways to protect yourself from medical mistakes!

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  1. faninfla
    Reply

    You might want to check into lymphatic drainage. It is a gentle, manual therapy (non-invasive) that is used to help the lymphatic system remove excess fluids. It is used, for example, by folks before and after plastic surgery and those with lymphadema. Make sure to find someone certified in it.

  2. Helen M
    Reply

    KH – I found I could not wear compression knee highs, my knees blew up with fluid over the course of the day, and by the night, the knee highs left a deep mark. So I went to thigh highs, the kind with the silicone inside the top band because I did not want to wear a garter belt. I also tried the panty hose, something I never liked, and had to spend ten to fifteen minutes to get those up.
    Recently, on e-bay, someone had two pair of stockings, Jobst which I like the best, and a pair of athletic compression socks. I made an offer and got all three for $40, discovered I love the socks!!!!! A nice wide band on top, no digging. These things are made for men, and you know men would never put up with discomfort. I am 5’6″ now, down an inch and a quarter, and weigh 190. A large is perfect. A caveat tho, since I had the lymphedema massage, I no longer swell like I used to.

  3. Helen M
    Reply

    I am in 3rd stage renal failure too, with only one 76 year old kidney, diabetes for over 30 years. Lost the other to cancer; almost lost this one too; however, had cryoablation to remove it’s cancer five years ago. Sigh. Never feel well, I am sure you know how that goes.
    Look up side effects for calcitriol. See if you have any. I assume your doctor wants to build up your vitamin D levels; however calcitriol is not D3. I would think you would be better off taking a high dose of D3 a day, which has no side effects. I take 5000 every day, 25(OH) hydroxy is now up to 49. I have read over 50 is better, have added three more pills per week. The calcitriol raises the 125 levels, which I also take, because I do not have working parathyroids. And I do have the side effects.
    Not that I do this: a plant diet, raw as much as possible, is supposed to provide a lot of anti-oxidants which will help protect the kidney. I have added greens I never even looked at before, tho I do cook the collards, kale and mustard ones, eat a salad for lunch almost daily and have lowered meat intake. An added benefit would be the plant derived calcium, potassium and magnesium. Before you have your next bloodwork, make sure the doctor has checked the magnesium box, it is not part of the regular blood panel. Low mag can also lead to leg cramps.

  4. MH
    Reply

    You may want to check with your Doctor about your balance. I believe some of the medications you are taking is affecting your balance. That’s what happened to me.

  5. KH
    Reply

    Thanks so much for this advice. I will definitely try and find this cayenne pepper pill that you mention… It might help. Compression stockings are not the answer as they are very hard to get on and off and they also dig into my knees and cut off the circulation. I have worn compression stockings for many years. I even had custom made prescription stockings that cost $100/pair. They were very tight and very uncomfortable. I gave up with those a few years ago. I have bought the ones that are not prescription and have a little less compression… I wear them for only short periods of times and remove them when I can’t stand them anymore.
    My lower legs now have a red rash that is called “stasis dermatitis”. I control it with lotions that are custom made for me. So far the red area has diminished and I see some improvement but the swelling has not gone down in my feet, ankles or lower legs. The Doctor tells me to keep my feet above my heart during the day and wear compression stockings… both of these solutions have not proven very effective or practical.
    I can’t go around with my legs above my heart and I can’t sleep that way either.
    I suffer with sciatica as well and that has really made my situation difficult. That is another story. I was given a botched epidural in 76 and my back has never been the same since.
    What was the reason for your swelling feet?

  6. ladyliza
    Reply

    You might like to try cayenne pepper for the swelling. It took care of my foot swelling in very short order. I am not talking about the one from the grocery store as that is not strong enough. I buy the pills. Make sure they are at least 40000 heat units. I take them with garlic 3 times a day. Your blood pressure will also go down. I take a natural blood thinner too..no pharmaceuticals for me and I feel great at 65.

  7. MAXINE H.
    Reply

    I have leaking heart valves and discovered in an ultrasound a renal artery had stopped up, consequently, I have lost a kidney, but Drs have not removed it, am under the care of a specialists (renal) and he has me on along with the cardiac Drs, lasix 20 mg and potassium cap, and was every day, but could not tolerate that each day, so I take it at least 2-3 times a week. Lasix, reduced from 40mg to 20 mg, and a 10 meq potassium, cap, Drs says as long as my blood tests show it normal I can continue this, but I have leg cramps, and due for another blood test to evaluate the kidney, every 3 mos.
    Am dreading the time if my kidney goes bad, dialysis, I am in the third stage of renal failure as the diagnosis says, but Dr says he can prevent this if I take these meds for my cardiac problems and blood pressure, I am on carvediol,12.5 mg twice a day. Losarten 100mg daily, amlodipine, 25mg, calcitriol 25mg, all daily. Tolerate them very well, what do you think of this? Also have some afib. I am not good with balance anymore but had a fall a year ago and fractured my pelvis in two places, plus had a concussion that seems to keep on, as my head is sore up there where the skin split when I fell.
    Broke a rib and did other damage to an arm, ripped some skin badly, on the right elbow, all in all I was lucky, but all this has effected my balance and we are afraid I will fall again, but am so independent, I am fighting this with all I have, is my meds all o.k? Or is there something in that mix that could cause some of this balance problem. Should I take some therapy? but that does not help much in some cases. Thanks ever so much..

  8. Helen M
    Reply

    Has your doctor mentioned using compression stockings? Or the knee high compression athletic socks? As to flushing the fluid out: you may want to find someone who does lymphedema therapy massage. Very helpful for me, I had idiopathic edema since 1960, caused by a medication no longer in use.
    If I go without the stockings for a day, my legs barely swell up. I began wearing them in 2003, had the lymphedema massage in 2006, lost 32 pounds. When I notice a mysterious weight gain, I do the massage on myself. After a knee replacement the swelling was huge, no way I could get anything on that leg. However I massaged and massaged and when I could get my biggest stocking on, with the help of my husband, I worked my leg down to normal in about three months. Hope this helps. BTW, I do use two mild diuretics for holding onto minerals. But that is another long story.

  9. Abigail
    Reply

    Hamburger is on the list of high potassium foods but not beef. Why is that?

  10. RLB
    Reply

    I confess that doctors scare the hell out of me—and I am not afraid of anything. It is becoming more and more obvious that doctors really do not understand all they know (or think they know) about the way the human body works or what keeps it working. It has become my opinion after years of misdiagnoses and head scratching that if people only went to doctors when they were sick that there would be a lot fewer sick people. Modern medicine only performs maintenance functions.

  11. joan
    Reply

    Some of the newer diuretics are potassium sparing and won’t take the potassium out of your body. Your doctor should know this. My Dr stopped the potassium when he gave me a different diuretic because too much potassium can also be dangerous. My Dr does Blood work every three months to check all my vitamin levels.

  12. KH
    Reply

    Hello
    From my experience with diuretics, they have the ability to reduce your potassium levels considerably. I was advised to eat a banana every day while I was on the diuretic. I didn’t stay on it long as it was not helping my swollen legs and feet at all. I have venous insufficiency in my legs and the doctor thought a diuretic would reduce the swelling. He was wrong.

  13. KT556
    Reply

    Collards on your Potassium Rich Foods List is followed by an asterisk — I find no * note . . .
    Thanks

  14. Barbara
    Reply

    On this list, after collards, there is an asterisk – please clarify – is there more info – I am a big fan of collards

  15. Pat
    Reply

    Your questioner indicated that she takes a diuretic among other meds. Well, there’s your problem right there. I am not a medical professional, but if have some personal experience which leads me to believe that diuretics flush everything out of your system, the good and the bad. The dehydration caused by diuretics can lead to low potassium levels.
    A relative of mine suffers from low potassium. She gets horrible leg cramps that cause her to black out. She abused diuretics at one point in her life, thinking it would help her lose weight. We all need to stay hydrated.

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