Patient N.V.C. (41 years old, Hanoi) was admitted to the National Hospital for Tropical Diseases in a state of weakness in both hands and feet, unable to stand up and walk on his own.
About 2 years ago, he had numbness, weakness in his limbs and thought he had hypocalcemia, so he supplemented himself with calcium, felt better and then did not go to the doctor. This time, the symptoms started with pain and fatigue in both legs, then muscle weakness quickly spread to both arms.
Thinking the old disease had recurred, the family called medical staff to transfuse calcium, but the condition did not improve. Upon admission, tests showed that the patient had severe hypokalemia.
Patients are replenished with potassium and closely monitored. However, blood potassium continues to tend to decrease, forcing doctors to find the cause instead of just supplementing potassium.
According to Dr. Bui Thi Tang, Department of General Internal Medicine, hypokalemia may be due to insufficient potassium intake, potassium loss through the digestive tract, through the kidneys, or related to endocrine and metabolic disorders. Severe or recurrent cases of hypokalemia need to be found for the cause to be treated correctly and prevent recurrence.
Through in-depth tests, doctors discovered that the patient had hyperthyroidism, which was identified as a cause related to hypokalemia and muscle weakness.
In this case, hypokalemia needs to be treated immediately, but the underlying cause is hyperthyroidism. If only supplementing potassium without controlling hyperthyroidism, hypokalemia can recur and muscle weakness is at risk of reappearing," Dr. Tang said.
The patient was treated simultaneously with hypokalemia and hyperthyroidism. After 6 days, muscle weakness improved significantly, mobility gradually recovered, blood potassium maintained at about 3.5-4.0 mmol/L. The patient continued to be treated for hyperthyroidism and is expected to be re-examined after one month.
Dr. Tran Thi Hai Ninh, Head of the General Internal Medicine Department, said that the patient mistook the symptoms for hypocalcemia because she had experienced a similar situation before.
Hypocalcemia and hypokalemia are two different electrolyte disorders but can cause some similar manifestations. Hypocalcemia often causes muscle numbness, contractions, or spasms; while hypokalemia can cause fatigue, pain, and muscle weakness. When potassium is severely reduced, patients can become weak and paralyzed, and even experience heart rhythm disorders.
Therefore, people should not self-diagnose "calcium deficiency" or arbitrarily drink or infuse calcium without identification tests. The symptoms of numbness, pain, and weakness in limbs are not enough to accurately distinguish electrolyte disorders.
Doctors recommend that if muscle weakness appears suddenly, increases rapidly or causes the patient to be unable to stand or walk, they need to go to a medical facility for examination and timely tests.
For people with hyperthyroidism, it is necessary to adhere to treatment, periodic check-ups and not arbitrarily stop or change the dose of medication. Good thyroid disease control helps maintain stable potassium and limit the risk of muscle weakness recurrence.
