
How do diuretics cause hypokalemia?

Hypokalemia [low potassium] is caused by the diuretics effects on the sodium/potassium pump which leads to potassium excretion in the urine.
Diuretics
Diuretics are often used as part of a weight loss program to help patients eliminate sodium and drop excess water weight. Some diuretics can also cause you to eliminate more potassium and magnesium in your urine. This can lead to low levels of these essential nutrients in your blood.
Loss of magnesium and potassium can lead to complications such as:
- Fatigue
- Heart rhythm problems (arrhythmias)
- Muscle cramps
- Weakness
Essential Magnesium & Potassium
Magnesium & Potassium are vital minerals which play an important role in hundreds of the body’s physiological functions, including processes related to energy regulation. The complementary roles of magnesium and potassium are essential for good health. These minerals are involved in supporting the nervous system‚ muscle functioning‚ cardiovascular well-being‚ and metabolic function.
Despite the importance of magnesium, most Americans do not obtain enough magnesium from dietary sources.

Potassium is another essential mineral which is important for muscle contraction, healthy heart function, and fluid and mineral balance. “Fewer than two percent of people in the U.S. consume enough potassium“ (Ware, 2018).

Other causes of low magnesium and/or low potassium:
Exercise: magnesium and potassium levels are primarily excreted in sweat so they may be depleted from exercise.
Diet: Many Americans’ diets are loaded with high sugar, processed foods, and are otherwise deficient in magnesium and potassium-rich foods. However, even an otherwise healthy diet can result in insufficient magnesium/potassium intake (example: KETO).
Low Magnesium: Low levels of magnesium accelerates the loss of potassium
References:
Akbari P, Khorasani-Zadeh A. Thiazide Diuretics. [Updated 2021 Jul 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532918/
Ware, M. (2018). Everything you need to know about potassium. Medical News Today. Retrieved from: https://www.medicalnewstoday.com/articles/287212.php
LEWIS KULLER, NOEL FARRIER, ARLENE CAGGIULA, NEMAT BORHANI, SIGNE DUNKLE, RELATIONSHIP OF DIURETIC THERAPY AND SERUM MAGNESIUM LEVELS AMONG PARTICIPANTS IN THE MULTIPLE RISK FACTOR INTERVENTION TRIAL, American Journal of Epidemiology, Volume 122, Issue 6, December 1985, Pages 1045–1059, https://doi.org/10.1093/oxfordjournals.aje.a114186
Cervoni, B. (2020). What Is Potassium? Verywell health. Retrieved from: https://www.verywellhealth.com/health-benefits-of-potassium-4588613