All concepts, explanations, trials, and studies have been re-written in plain English and may contain errors. I am not a doctor ----------------------------------------------------------- Symptoms and Diagnosis Of Potassium Imbalance Severe hypokalemia (blood potassium under 3 mEq/L) may produce muscle weakness and lead to paralysis and respiratory failure. Other muscular dysfunction includes muscle cramping, twitching, loss of intestinal function, too-light breathing, too-low blood pressure, or nervous hyper-excitability. Persistent hypokalemia can impair kidney function, producing heavy urination in a short period of time, with extreme thirst. High blood pH (metabolic alkalosis) often occurs. Heart-related effects of too-low potassium level usually become strong when level drops under 3 mEq/L. This may cause premature ventricular and atrial contractions, ventricular and atrial tachy-arrhythmias, and second or third degree heart block. Patients with prior existing heart disease or those taking digoxin are at risk for arrhythmia even from fairly mild hypokalemia. The characteristic EKG changes are ST segment depression, increased U-wave amplitude, and T-wave amplitude less than U-wave amplitude (in the same lead). Hypokalemia is diagnosed when blood potassium level is less than 3.5 mEq/L.