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Crohn's Disease Forum » Treatment » Prednisone/Entocort » Hypokalemia (low potassium)


04-25-2013, 04:33 AM   #1
SarahD
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Hypokalemia (low potassium)

I was recently put on a course of prednisolone and developed hypokalemia which resolved once I finished the pred. The hypokalemia was almost certainly caused by the pred because I've just started another course of pred and lo and behold one week later my potassium level has dropped dangerously low again.

I've been on pred several times in the past and have never had a problem with my potassium levels, so I'm wondering what might be different now. The only difference treatment-wise is that I'm now taking Azathioprine, which I wasn't in the past. Could the Azathioprine be interacting with the prednisolone in someway to be causing the hypokalemia? My doctors are stumped. If anyone has any ideas or insight I'd be very interested to hear.

Many thanks,

Sarah
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Symptoms from the age of 12. Mis-diagnosed with UC at the age of 13, and later diagnosed with Crohn's in January 2012 at 24 years old. Disease mainly in terminal ileum.


Current meds:
Azathioprine, Allopurinol, Calcichew D3-Forte, Fortijuice, Alendronic acid, Ranitidine

Previous meds:
Augmentin, Doxycycline, Lansoprazole, Asacol, Pentasa, Prednisolone, Entocort, Cipro, Flagyl, Elemental Extra 028
04-25-2013, 05:21 AM   #2
Catherine
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Maybe Magnesium deficiency.

http://www.nlm.nih.gov/medlineplus/e...cle/000479.htm
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Catherine
Mother of Sarah dx aged 16, Jan 2012
DX - CD 1/12, asthma
Small bowel to small bowel fistula

Meds: ), azathioprine 200mg, Mesalazine 1.2g x 2, seretide 250 x 2 (asthma), ventolin (as needed)

Currently no supplements.

Has previously taken Multi B, Caltrate, B12 & Iron

Prednisolone (from 30 mg 01/02/2012 to 17/06/2012, 30mg 24/10/12-28/12/12, 50mg 24/1/13-27/4/13)
04-25-2013, 06:01 AM   #3
SarahD
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Thanks Catherine. I got my GP to check my magnesium and calcium levels and they were both comfortably in the normal range.
04-25-2013, 06:34 AM   #4
Catherine
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I know David post something about a problem with the range. Do you know whether your level was on the low end of normal.
04-25-2013, 02:52 PM   #5
David
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Thanks for the tag Catherine.

Sarah, believe it or not, low MAGNESIUM can actually cause low potassium. Have your doctors tested your magnesium level or tried supplementing it? In my opinion, low magnesium is a chronic problem in people with Crohn's disease and proper supplementation can make a HUGE difference. In fact, I believe that magnesium deficiency will eventually be found to play a critical role in the pathogenesis of some forms of Crohn's disease.
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04-26-2013, 01:55 AM   #6
SarahD
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Hi David, I had my magnesium and calcium levels tested as I'd read that both play a role in potassium absorption - I'm not sure if I have a copy of the results to tell you the exact numbers but I remember my GP showing them to me and they were both comfortably in the normal range - unless there is a problem with the range as Catherine suggested?
04-26-2013, 08:29 AM   #7
David
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When it comes to magnesium, unfortunately there is a big problem. I'm sure you had a serum test. That can be normal yet the body stores of magnesium can be depleted. Magnesium is the only mineral I recommend supplementing blindly, but under the care of a doctor as doing it wrong can lead to diarrhea. I like small doses multiple times a day.

Give this a read.
05-18-2014, 03:38 PM   #8
SarahD
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Hi David,

Sorry to drag up an old thread, I'm still having trouble with low potassium despite having been off the pred for about a year. My GP has been completely unsupportive and has flat out refused to refer me to an endocrinologist for further tests, and so I'm stuck taking a reasonably high dose of potassium on a daily basis and struggling to get the help I need to get this sorted out.

Is there a blood test, other than serum magnesium, that would give a better idea of my magnesium stores? I started taking a high strength multivitamin which contains 60mg magnesium but it's made little impact to how my potassium I require, so I've been considering buying a magnesium supplement on its own in order to get a better intake. Do you know if there's a particular type of mg that is easier to absorb than others?

Thanks for any ideas you might have!

Sarah
05-18-2014, 03:51 PM   #9
David
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Hi Sarah,

I'm sorry to hear you're still struggling with your potassium levels

I don't know a better blood test, sorry. This is the form of Mg I take: http://www.amazon.com/Designs-Health.../dp/B000FGWBK6

Let me know if there's anything else I can help with.

*hugs*
05-19-2014, 01:13 AM   #10
SarahD
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Thanks David, that's helpful
05-19-2014, 04:07 PM   #11
kel
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David do you know anything about epsom salt baths for magnesium?
05-20-2014, 08:15 AM   #12
David
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Hi Kel,

Whenever I take a bath, I add epsom salts. I know Mg is absorbed through the skin but I don't know how much.

Sorry, I know that's not much help.
05-20-2014, 09:07 AM   #13
kel
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That's ok. Good to know I'm not crazy for doing it at least
05-20-2014, 01:30 PM   #14
SarahD
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Kel, if you look at this thread David posted a link in response to a comment I made about magnesium from Epsom salts (near the bottom of the page).

I've ordered a 2-month supply of magnesium glycinate so will start using them as soon as they arrive, building up slowly of course so that they don't give me diahrrea. I won't try adjusting my potassium supplement dose for a while, but maybe after a couple of months on the magnesium supplement I'll slowly drop my potassium supplement dose and see if I become hypokalemic again. Fingers crossed all goes well!
05-20-2014, 06:35 PM   #15
kel
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Thanks sarah. Good luck!
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