TRT and hyperkalemia? Could there be a connection?

[Mprtz]

I've had problems recently with an irregular heartbeat which I believed to be due to low iron levels.
Although my heart symptoms have gotten much better, the other symptom that went with it - numb feeling in my hands - has persisted.

I now have another possible explanation - hyperkalemia: excess potassium in the blood.

My last blood test showed potassium levels at 5.3 (3.5-5.2). Now this is barely out of range, but the symptoms of hyperkalemia specifically mention skipped heartbeats and tingling hands and feet.

From my research, there are a few possible causes:

1) Renal insufficiency. My ALT and AST were good last time they were tested, but that was before these symptoms started.

2) Hemolysis. Is it possible that platelet apheresis contributes to elevated serum potassium through hemolysis?

3) Rhabdomyolysis. Releases potassium (among other stuff) from muscle cells. Could I be overtraining?

4) Excess potassium intake. I've looked at all the supplements I take and don't find anything that could be the source.


I'm considering taking some oral calcium gluconate which is supposed to counteract the effects of potassium to see if the tingling goes away. IV calcium gluconate is used to treat acute hyperkalemia.


Anyone have any experience with this or insights?

 

[Havasu]

I've had problems recently with an irregular heartbeat which I believed to be due to low iron levels.
Although my heart symptoms have gotten much better, the other symptom that went with it - numb feeling in my hands - has persisted.

I now have another possible explanation - hyperkalemia: excess potassium in the blood.

My last blood test showed potassium levels at 5.3 (3.5-5.2). Now this is barely out of range, but the symptoms of hyperkalemia specifically mention skipped heartbeats and tingling hands and feet.

From my research, there are a few possible causes:

1) Renal insufficiency. My ALT and AST were good last time they were tested, but that was before these symptoms started.

2) Hemolysis. Is it possible that platelet apheresis contributes to elevated serum potassium through hemolysis?

3) Rhabdomyolysis. Releases potassium (among other stuff) from muscle cells. Could I be overtraining?

4) Excess potassium intake. I've looked at all the supplements I take and don't find anything that could be the source.


I'm considering taking some oral calcium gluconate which is supposed to counteract the effects of potassium to see if the tingling goes away. IV calcium gluconate is used to treat acute hyperkalemia.


Anyone have any experience with this or insights?

There are other reasons for the "skipped heart beat" feeling. It can be pre-atrial fibrillation. It causes a premature heart beat which comes out of rhythm early, and feels like a skpped heart beat. THe contraction just happens early, then the heart has to get back in time. This happens to me when my magnesium is low. Apparently I like my mother am a hyper excretor of Magnesium. I take 1200mg a day of Magnesium and my Magnesium levels maintain at the very bottom of the Magnesium scale. I believe, because of that, my calcium level also stays in the very low part of the scale while I take 1200mg of Calcium a day as well.

So, potassium could be the issue, however low potassium, and high potassium can exhibit the same symptoms. I would check your magnesium and calcium levels to see where they are at. As far as potassium, drop any potassium supplements you take, or any that have potassium in them. Also, take a look at your diet and drop any foods high in potassium. I'm on trt at 140mg per week, and my potassium levels have not changed from what they were pre-TRT.

 

[Mprtz]

I just got extensively checked out by cardiologist... arrhythmia was premature ventricular contraction (PVC) and considered harmless. The numb/tingling hands feeling has persisted.

I have been supplementing magnesium and it has seemed to help greatly with the arrhythmia (or it's coincidence). Last time I tested magnesium (last October prior to my issues) it was kind of midrange: 2.0 (1.6 - 2.6)

Low potassium is unlikely, as I wrote my potassium tested just over normal range. I've already checked my supps and diet and can't find any sources of potassium that would explain this.

 

[Chiefy]

AST and ALT are measures of liver function, not kidney function.

What other medications, Rx or OTC, do you take?

 

[Mprtz]

AST and ALT are measures of liver function, not kidney function.

What other medications, Rx or OTC, do you take?

thanks, got that mixed up. It's GFR for kidneys? Mine's been kind of borderline low.

Taking small amounts of arimidex (0.5mg per week or less). HCG 500-700iu per week. Low dose aspirin. Occasional Cialis. NAC. Melatonin....

 

[Chiefy]

thanks, got that mixed up. It's GFR for kidneys? Mine's been kind of borderline low.

Taking small amounts of arimidex (0.5mg per week or less). HCG 500-700iu per week. Low dose aspirin. Occasional Cialis. NAC. Melatonin....

I wouldn't sweat it too much if I were you man, at least, not yet. Your K value is only slightly out of range, and could be explained by something benign like dehydration, NSAID use, or even a false positive from blood cell rupture after collection. Most doctors will want a retest on something like this.

Were your other electrolytes good to go on your bloodwork? Did your EKG show signs of hyperkalemia, or just the PVCs?

 

[Mprtz]

I wouldn't sweat it too much if I were you man, at least, not yet. Your K value is only slightly out of range, and could be explained by something benign like dehydration, NSAID use, or even a false positive from blood cell rupture after collection. Most doctors will want a retest on something like this.

Were your other electrolytes good to go on your bloodwork? Did your EKG show signs of hyperkalemia, or just the PVCs?

Thanks, other electrolytes were normal, though only a few were tested recently:

sodium 142 (135-145)
potassium H 5.3 (3.5-5.2)
chloride 102 (97-108)
carbon dioxide 28 (22-32)

eGFR levels were 66, 69, 66, 59 (L), 61 over the last 18 months, with a range of >59

 

[juced_porkchop]

I've had problems recently with an irregular heartbeat which I believed to be due to low iron levels.
Although my heart symptoms have gotten much better, the other symptom that went with it - numb feeling in my hands - has persisted.

I now have another possible explanation - hyperkalemia: excess potassium in the blood.

My last blood test showed potassium levels at 5.3 (3.5-5.2). Now this is barely out of range, but the symptoms of hyperkalemia specifically mention skipped heartbeats and tingling hands and feet.

From my research, there are a few possible causes:

1) Renal insufficiency. My ALT and AST were good last time they were tested, but that was before these symptoms started.

2) Hemolysis. Is it possible that platelet apheresis contributes to elevated serum potassium through hemolysis?

3) Rhabdomyolysis. Releases potassium (among other stuff) from muscle cells. Could I be overtraining?

4) Excess potassium intake. I've looked at all the supplements I take and don't find anything that could be the source.


I'm considering taking some oral calcium gluconate which is supposed to counteract the effects of potassium to see if the tingling goes away. IV calcium gluconate is used to treat acute hyperkalemia.


Anyone have any experience with this or insights?

coral calcium you might find better.
taurine is good for hear, body, mind et.c. I rec 1-3g ed regardless of what your goals are

 

[Chiefy]

Thanks, other electrolytes were normal, though only a few were tested recently:

sodium 142 (135-145)
potassium H 5.3 (3.5-5.2)
chloride 102 (97-108)
carbon dioxide 28 (22-32)

eGFR levels were 66, 69, 66, 59 (L), 61 over the last 18 months, with a range of >59

What about your EKG, did it show signs of hyperkalemia?

 

[Gbrad]

Elevated BP? Take anything for it? Some bp meds are potassium sparing so K can climb. Idk if hyperkalemia is your prob but wanted to offer that tid bit up for consideration.

 

[Mprtz]

What about your EKG, did it show signs of hyperkalemia?

Sorry, forgot to answer that. EKG was normal, did not show any of the characteristic signs.

 

[Mprtz]

Elevated BP? Take anything for it? Some bp meds are potassium sparing so K can climb. Idk if hyperkalemia is your prob but wanted to offer that tid bit up for consideration.

BP has always been normal, never took any BP meds.

 

[Megatron28]

Ever take any SERMs? They can affect calcium levels.

 

[Mprtz]

Ever take any SERMs? They can affect calcium levels.

Only very briefly took some nolvadex, well before my last blood test that included calcium (half a year ago):

Calcium, Serum 9.6 8.7-10.2 mg/dL

 

[Chiefy]

Sorry, forgot to answer that. EKG was normal, did not show any of the characteristic signs.

I really wouldn't stress about it too much then. Mild hyperkalemia on bloodwork alone could easily be the result of one of many benign causes. When it starts causing peaked T waves on your EKG, that's when it's of serious concern. When it starts affecting the morphology of the P waves, that's a really bad sign. Your K level isn't anywhere near the point that it would be causing something like that though.

At this point I'd say the next course of action should be to retest your K level through bloodwork. If it comes back elevated again, then it might make sense for your doctor to address the issue.

Did your cardiologist suggest a stress test or stress echo? The PVCs are probably benign, but it might not hurt to dig a little deeper to see if there is something else going on.