Brief Answer: Low potassium < Steroids to stop, Detailed Answer: Good Day again XXXX! Thank you for asking. My name is Dr S Khan and and i would like to help you with your underlying cause for this episodic drop in potassium resulting in these symptoms which are a classic presentation of hypokalemia in emergency medicine. Miss XXXX i recall you as a sarcoid patient asking for relief of dyspnea , if so one sure reason i can say in your cse of hypokalemia is Steroids which you used like candies for sarcoidosis.But any ho lets talk about possibilities Such symptoms occur as a result of constellation of symptoms that involve the GI, renal, musculoskeletal, cardiac, and nervous systems and then it can be said for sure what is causing the low potassium. I am afraid it will need a lot of work up to reach the cause as it has many Renal losses of potassium occurs by 1-Renal tubular acidosis 2-Hyperaldosteronism (Hormonal Imbalance) 3-Magnesium depletion 4-Leukemia (mechanism uncertain) GI losses (source may be medical or psychiatric , ie, anorexia or bulimia) 1-Vomiting or nasogastric suctioning 2-Diarrhea 3-Enemas or laxative use 4-Ileal loop Medication effects Involve Diuretics (most common cause) Beta-adrenergic agonists Steroids ( Most probable in your case as you have used them for your sarcoidosis) Theophylline Aminoglycosides So my advice , you need a triad of internist, nephrologist and a psychiatrist to reach a diagnosis. Hope XXXX You got your help. Kindly keep me posted about your follow ups. I would love to be of some help. Dont forget to close the discussion please and rate the answer as per your experience. Regards Dr S Khan

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