“Are Hypokalaemia and Hypoglycaemia related?”
I have had recurring hypokalaemia for a year or so now and have had multiple tests done ie adrenal insufficiency, barters syndrome, etc. They all came out negative so my doctors have taken to accusing me of bulimia which I don’t have. Recently, I was ill and wasn’t eating as I usually do. I ended up with hypoglycaemia (glucose level 2.3). I usually eat abnormally high amounts of sugar and my blood sugar still remains normal, when I ate a slightly lower sugar diet as I had the flu and couldn’t eat much, I ended up with hypoglycaemia. Is there any way in which the two are related or am I just overthinking?
Female | 16 years old
Complaint duration: 1 year
Medications: Sando K
3 Answers
DoctorDoctor
I believe that when you say that you have a glucose level of 2.3, which is in moles, which is a glucose of 41 mg/dl in United States nomenclature. That is extremely low. If you indeed are eating normally then, no bulimia, now diarrhea, no vomiting, no excess exercise without eating, no drinking alcohol on an empty stomach and no weight loss, then you may have an
insulin secreting tumor probably in the pancreas. The way to diagnose this is to under observation start a fast and have the glucose checked every hour by finger stick. If the glucose falls and becomes low then an insulin level, c peptide and proinsulin level will be obtained. The insulin level will be higher than expected if one has an insulinoma.
Paul Norwood, MD
insulin secreting tumor probably in the pancreas. The way to diagnose this is to under observation start a fast and have the glucose checked every hour by finger stick. If the glucose falls and becomes low then an insulin level, c peptide and proinsulin level will be obtained. The insulin level will be higher than expected if one has an insulinoma.
Paul Norwood, MD
Yes, insulin induces movement of glucose and potassium from the blood into the cells. While unusual, having elevated insulin levels can contribute to hypokalemia.
Dear patient,
Complex question; first, adrenal insufficiency causes high potassium because of lack of hormones excreting potassium. Cushings disease and hyperaldosteronism lower potassium. Excess insulin due to overeating carbs will move potassium into cells, causing low potassium and in severe bulimia when blood volume low potassium is lost due increased aldosterone excretion by adrenal glands. In severe insulin-induced hypoglycemia, a low potassium would reflect intracellular shifts of potassium. You don't mentIon eating licorice, which can also cause low potassium. I would suggest you speak to your physician and possibly be referred to an endocrinologist and nephrologist.
Respectfully,
Marvin A. Leder, MD FACP FACE
Complex question; first, adrenal insufficiency causes high potassium because of lack of hormones excreting potassium. Cushings disease and hyperaldosteronism lower potassium. Excess insulin due to overeating carbs will move potassium into cells, causing low potassium and in severe bulimia when blood volume low potassium is lost due increased aldosterone excretion by adrenal glands. In severe insulin-induced hypoglycemia, a low potassium would reflect intracellular shifts of potassium. You don't mentIon eating licorice, which can also cause low potassium. I would suggest you speak to your physician and possibly be referred to an endocrinologist and nephrologist.
Respectfully,
Marvin A. Leder, MD FACP FACE
