What is Hyperkalemia? Hyperkalemia is the medical term for when you experience high potassium levels in your blood. In terms of numbers, a healthy individual will have between 3.6mmol/L and 5.2mmol/L in their body. Anything higher than that is officially classified as hyperkalemia. Between 5.3mmol/L and 6.0mmol/L is mild hyperkalemia. Between 6.1mmol/L and 7.0 mmol/L is moderate hyperkalemia. Above 7mmol/L is severe hyperkalemia. Why is Too Much Potassium Harmful? Potassium is healthy for you in the right doses. Your body needs it to function properly. It is an incredibly important substance that plays a vital role in your nerves and muscle cells. This means that you need it for your heart to work. Like with anything else, too much of a good thing is not good. The more common form of hyperkalemia only rears mild to moderate symptoms. The most extreme severities of this condition can result in death. Symptoms of Hyperkalemia Generally, until your hyperkalemia is severe, you may not even experience or recognize any of the symptoms. As your levels soar to dangerous heights, you may experience one or more of the following symptoms: Muscle weakness or pain. Your muscles may feel tender or even painful. It may feel as though you just finished an intense workout. Fatigue. Despite getting adequate sleep, you may feel sluggish and tired the entire day or you may be too weak to function. Nausea. An upset stomach may or may not be accompanied by some vomiting. This is a common sign of hyperkalemia. Breathing problems. You may find it difficult to take deep breaths or find yourself forced to gasp for air. Irregular heartbeat. Your heart may beat funnily or feel weird in your chest. This is always a symptom to bring up to your doctor immediately. Chest pains. Chest pains ranging from mild to severe are a common result of hyperkalemia. In the most extreme cases, hyperkalemia left untreated can cause cardiac arrest and death. What Causes Hyperkalemia? There are several known causes of hyperkalemia, which range from medical disorders to lifestyle habits. Hyperkalemia is known to have many causes. These include: Kidney Disease The main function of a kidney is that it filters everything in your body. When there is something wrong with your kidneys, it can mess up all sorts of vitamin levels in your body. Potassium is just one of them. Heart Disease Heart disease results in a variety of factors that make it more likely to have problems with your potassium levels. Hormone Imbalances Having abnormally low amounts of aldosterone can result in potassium problems. This can happen due to a variety of conditions, including hypoaldosteronism and congenital adrenal hyperplasia. Diabetes A lack of insulin may be the culprit behind enhanced potassium levels. This is something that would be more likely to occur if diabetes is undermanaged (or undiagnosed). [youmaylike] Medications Side effects of certain medications could cause potassium levels to rise. You may be surprised to see that some common medications will do this. Non-steroidal, anti-inflammatory drugs, such as ibuprofen and naproxen, will do it. Some of the other medications that can do this are heparin, mannitol, beta-blockers, angiotensin inhibitors, calcium blockers, and cyclosporine. Diet Medications are not the only way to introduce potassium to the body. There are lots of foods that can lead to heightened potassium levels. Many of these foods are healthy, but to a person at risk for hyperkalemia, they can be dangerous if not eaten in responsible quantities. There is also the chance that you are a victim of pseudo hyperkalemia. As the name suggests, you do not have any potassium problems. Sometimes due to faulty equipment, you will get a wrong reading. Hyperkalemia Treatment To determine how to treat hyperkalemia, it is important that you first identify the cause of it in yourself. Getting advice from a licensed medical physician is the best way to determine your treatments. Diet Change Changing your diet can do wonders for your health. If you battle hyperkalemia, consider limiting your intake of foods rich in potassium like cucumbers, pumpkins, potatoes, bananas, grapefruit, oranges, eggplants and peas. Intravenous Calcium or Insulin and Glucose Medical injections are an efficient and fast technique to lower calcium levels. When diet alone is not enough, these can drop your potassium levels to a safer place in a pinch. Albuterol Doctors may also administer albuterol alone or in addition to other treatments. Unfortunately, this does not work for everyone. Changing Medications If a certain medication is causing dangerous, unwanted side effects, you may want to talk to your doctor about switching.
Diabetic Macular Edema Explained
Diabetic macular edema (DME) is a complication of diabetes that occurs when excess fluid starts to build up in the eye's macula. The macula is the part of the eye that allows us to focus and see fine details, and it is located in the retina, which is full of blood vessels. High blood sugar levels can damage the retina's blood vessels. The damaged blood vessels then begin to leak fluid, thereby causing swelling and other complications. This damage is called retinopathy and generally develops over time.
What Causes Diabetic Macular Edema?
As earlier stated, DME usually occurs due to high blood sugar levels. Other factors such as high blood pressure and high cholesterol levels can also contribute to blood vessel damage. In other instances of diabetes, pregnancy may also increase the risk of developing DME.
Since DME results from high blood sugar levels, it is common for people with diabetes, especially uncontrolled diabetes, to be at risk for DME. Additional risk factors that can lead to DME include:
- Poor blood sugar management
- High cholesterol
- High blood pressure
- Kidney disease (nephropathy)
- Sleep apnea
Associated Symptoms of Diabetic Macular Edema
In its early stages, there may be no symptoms. However, if you have diabetes, it is important to see an eye care doctor every year so they can examine your eyes for any changes. If you also notice any sign of retinopathy or DME, early treatment can prevent or restore vision loss. Let’s take a look at some of the common signs and symptoms of diabetic macular edema:
- Blurry or blocked central vision
- Distorted or "wavy" central vision (called metamorphopsia)
- Seeing floaters or strings of floaters in your vision
- Blind or dark areas or spots in your field of vision
- Difficulty reading at any distance
- Colors appear more washed out than usual
When to Call the Doctor
Call your eye doctor right away if you notice any of the above symptoms. Be sure to tell your eye doctor if you have any of the following symptoms:
- Blurry vision
- Seeing colors that look washed out
- Seeing more floaters in your vision
- Double vision
Diagnosis and Different Treatment Options
Diabetic macular edema can be diagnosed through a comprehensive eye examination. There are effective treatments available for DME. Be sure to talk to your doctor to find the right option that will work for you. If you have received a DME diagnosis, ensure that you start treatment quickly to help prevent long-term eye damage and vision loss. Your doctor can recommend any of the following treatments:
Laser therapy involves the use of tiny lasers to target damaged areas in the retina. This process seals leaking blood vessels and prevents abnormal blood vessel growth. Laser therapy is effective in maintaining your current vision level and helps prevent further loss of vision. You’ll likely need several laser treatments overtime to repair eye damage and may require additional treatments if more eye damage occurs.
When you have DME, your body tends to produce a protein called VEGF in excess. When this happens, your blood vessels begin to grow too quickly; so, they are weak and leak blood and fluid into your retina and macula.
There are three types of anti-VEGF medicines usually used for DME; they include aflibercept (Eylea), bevacizumab (Avastin), and ranibizumab (Lucentis). These Anti-VEGF shots help to inhibit the effects of the VEGF protein. However, anti-VEGF shots may not be helpful for everyone and should not be used during pregnancy.
Focal-Grid Macular Laser Surgery
This treatment type works by sealing blood vessels in your retina to slow leaking and bring down swelling. If you have DME in both eyes, your doctor will treat one eye at a time, usually within a few weeks. In some cases, a laser may be used along with anti-VEGF shots if the shots alone are not helping.
These drugs are often called steroids and are used to target inflammation. They are usually prescribed to help lessen swelling in your retina. Steroids are usually not as effective as anti-VEGF shots, and they can cause other eye problems, like cataracts and glaucoma. They are not traditionally given as first treatment.
NSAID Eye Drops
Doctors sometimes use eye drops as a preventive measure for DME before or after you have eye surgery. These drugs are called non-steroidal anti-inflammatory drugs (NSAIDs) because they help fight inflammation like steroids but do not have the same side effects. Doctors usually prescribe NSAIDs to prevent or ease swelling.
Can Diabetic Macular Edema Be Prevented?
You may not be able to prevent macular edema if you have diabetes, a pre-existing eye condition, or have suffered an eye injury in the past. However, you can follow the nutrition and lifestyle recommendations from your health care provider to avoid developing diabetes in the first place. You will likely be advised to do the following:
- Keep your blood sugar level under control. Check your blood sugar level several times a day (ask your doctor exactly how often). The American Diabetes Association recommends people with diabetes keep their A1C levels under 7%.
- Stop smoking or do not start. Ask your doctor for help quitting. Smoking increases your risk of diabetic retinopathy, age-related macular degeneration, and blocked retinal blood vessels. All those toxins damage the eyes’ tiny vessels.
- Exercise often. Try not to go more than two days between exercising. If you do, the glucose-metabolizing effects of physical exercise will wear off.
- Eat healthy. Follow your doctor's nutritional guidelines but, in general, avoid junk food and fast food, and try to eat more fresh fruits and vegetables, especially dark, leafy greens such as spinach, kale, and collard greens.