{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T15:03:03Z","timestamp":1785855783896,"version":"3.56.0"},"reference-count":25,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,4,6]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:p>We present a case involving a male patient in his 30s who was admitted to hospital due to recurrent episodes of hypokalaemia over the past 5 years. His medical history revealed hypertension, attention deficit hyperactivity disorder (ADHD), autism, and paranoia. He was taking citalopram, ramipril, amlodipine, and pramipexole. Tests indicated normal levels of aldosterone\/renin ratio and plasma metanephrines. On reviewing his dietary history, it was noted that he consumed 3 to 3.5 L of cola-flavoured drinks on a daily basis. Normal potassium levels were achieved after a significant reduction in cola-flavoured drinks intake and potassium replacement. Subsequent outpatient clinic follow-up revealed that normal potassium levels were maintained even after the patient ceased taking potassium replacement tablets. Given the rarity of hypokalaemia associated with fizzy drinks, the underlying mechanism for this association remains unclear. In this case report, we attempt to provide a possible explanation for the involved mechanisms.<\/jats:p>","DOI":"10.1136\/bcr-2023-258873","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T12:35:21Z","timestamp":1713789321000},"page":"e258873","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Hypokalaemia associated with excessive cola-flavoured drinks consumption"],"prefix":"10.1136","volume":"17","author":[{"given":"Sara","family":"Baba-Aissa","sequence":"first","affiliation":[{"name":"The Medical School, University of Buckingham, Buckingham, Buckinghamshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"Cooke","sequence":"additional","affiliation":[{"name":"Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Alner","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8045-6996","authenticated-orcid":false,"given":"Mohamed H","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK"},{"name":"Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK"},{"name":"Honorary Senior Lecturer of the Faculty of Medicine and Health Sciences, University of Buckingham, Buckingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,4,22]]},"reference":[{"key":"2025082722015068000_17.4.e258873.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199808133390707"},{"key":"2025082722015068000_17.4.e258873.2","doi-asserted-by":"publisher","DOI":"10.1530\/EC-18-0109"},{"key":"2025082722015068000_17.4.e258873.3","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.16.2429"},{"key":"2025082722015068000_17.4.e258873.4","first-page":"569","article-title":"Excessive cola consumption as a cause of hypokalaemia paralysis","volume":"15","author":"Koul","year":"2010","journal-title":"Respirology"},{"key":"2025082722015068000_17.4.e258873.5","first-page":"1039","article-title":"Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: the Framingham Osteoporosis Study","volume":"90","author":"Tucker","year":"2009","journal-title":"Am J Clin Nutr"},{"key":"2025082722015068000_17.4.e258873.6","first-page":"55","article-title":"Hypokalemia: a review of causes and management","volume":"33","author":"Green","year":"2022","journal-title":"Endocr Rev"},{"key":"2025082722015068000_17.4.e258873.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2016.09.046"},{"key":"2025082722015068000_17.4.e258873.8","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3180646338"},{"key":"2025082722015068000_17.4.e258873.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.physbeh.2009.12.022"},{"key":"2025082722015068000_17.4.e258873.10","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1111\/j.1742-1241.2009.02051.x","article-title":"Cola-induced hypokalaemia: pathophysiological mechanisms and clinical implications","volume":"63","author":"Tsimihodimos","year":"2009","journal-title":"Int J Clin Pract"},{"key":"2025082722015068000_17.4.e258873.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-7176.2008.08575.x"},{"key":"2025082722015068000_17.4.e258873.12","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfm355"},{"key":"2025082722015068000_17.4.e258873.13","doi-asserted-by":"crossref","DOI":"10.1186\/s12882-021-02465-0","article-title":"Caffeine-induced hypokalemia: a case report","volume":"22","author":"Han","year":"2021","journal-title":"BMC Nephrol"},{"key":"2025082722015068000_17.4.e258873.14","doi-asserted-by":"publisher","DOI":"10.1016\/0278-6915(93)90080-I"},{"key":"2025082722015068000_17.4.e258873.15","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-009-0975-3"},{"key":"2025082722015068000_17.4.e258873.16","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.7.803"},{"key":"2025082722015068000_17.4.e258873.17","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1055\/s-0029-1212011","article-title":"High-dose phosphate treatment leads to hypokalemia in hypophosphatemic osteomalacia","volume":"106","author":"Haris","year":"1998","journal-title":"Exp Clin Endocrinol Diabetes"},{"key":"2025082722015068000_17.4.e258873.18","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2014.07.002"},{"key":"2025082722015068000_17.4.e258873.19","doi-asserted-by":"publisher","DOI":"10.4158\/EP12241.CR"},{"key":"2025082722015068000_17.4.e258873.20","article-title":"Association between excessive cola consumption and hypokalemia: a case series","volume":"3","author":"Packer","year":"2010","journal-title":"Cases J"},{"key":"2025082722015068000_17.4.e258873.21","doi-asserted-by":"publisher","DOI":"10.3121\/cmr.2013.1167"},{"key":"2025082722015068000_17.4.e258873.22","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1177\/0890117120969057","article-title":"Beverage advertisement receptivity associated with sugary drink intake and harm perceptions among California adolescents","volume":"35","author":"Chaffee","year":"2021","journal-title":"Am J Health Promot"},{"key":"2025082722015068000_17.4.e258873.23","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1007\/s11606-012-2126-1","article-title":"Causal or casual? The association between consumption of artificially sweetened carbonated beverages and vascular disease","volume":"27","author":"Anand","year":"2012","journal-title":"J Gen Intern Med"},{"key":"2025082722015068000_17.4.e258873.24","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2005.083782"},{"key":"2025082722015068000_17.4.e258873.25","unstructured":"What is in Coca-Cola? A briefing on our ingredients. Available: https:\/\/ba.coca-colahellenic.com\/content\/dam\/cch\/ba\/documents\/our-24-7-portfolio\/125year_a6leaflet_v6.pdf [Accessed 29 Mar 2024]."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-258873","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:01:57Z","timestamp":1756357317000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-258873"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":25,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,22]]},"published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1136\/bcr-2023-258873"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-258873","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]}}}