Potassium, your invisible friend

I recognise that I spent a lot of time telling people what does not cause heart disease, and what does not protect against heart disease. My sister told me… ‘well, what advice would you give people, then?’ I usually shrug my shoulders and reply ‘there is no shortage of advice around, I don’t think I need to add to the daily bombardment.

However, I shall break the habit of a lifetime and, with slight trepidation, announce that I strongly believe that Potassium is good for you.  If you consume more of it you will, most likely, live both longer and in better health.

How much should you consume? A couple of extra grams a day should do the trick. Having said this, I do recognise that most people will not have the faintest idea how much potassium they consume and, frankly, neither do I. But you are probably not consuming enough, and your kidneys will easily get rid of any excess.

For those who are not keen on bananas, spinach and broccoli, and other foods high in potassium, you could take it as a tablet. Potassium bicarbonate or potassium citrate appears to be the best formulation. Depending on which brand you decide to buy, it should cost about £15 – 20/year.

Why this sudden potassiumophilia? Well, there is a growing body of research which points to the fact that potassium is very good for you. The first time I became aware that it might be good for you was when I first looked at the Scottish Heart Health study. The researchers looked at twenty seven different ‘factors’ they thought might cause, or protect against, heart disease – and overall mortality.  The authors noted that:

“[There was] an unexpectedly powerful protective relation of dietary potassium to all-cause mortality,” the study concluded.

The paper showed that:

  • Men consuming an average of 5400 mg of potassium per day vs 1840 mg were 55% less likely to die during 7.6 year study (the highest one-fifth of men vs the lowest one-fifth of men)
  • Men consuming an average of 5400 mg of potassium per day vs 3350 mg were 22% less likely to die during 7.6 year study (the highest one-fifth of men vs the second highest one-fifth of men)
  • Women consuming an average of 4500 mg of potassium per day vs 1560 mg were 59% less likely to die during 7.6 year study (the highest one-fifth of women vs the lowest one-fifth of women)
  • Women consuming an average of 4500 mg of potassium per day vs 2700 mg were 15% less likely to die during 7.6 year study (the highest one-fifth of women vs the second highest one-fifth of women

The study can most easily be found here http://www.ncbi.nlm.nih.gov/pubmed/9314758

I immediately liked this finding. Mainly because it was almost completely unexpected, and unexpected findings are always far more likely to be correct than expected findings. Also, this was a very large effect indeed.  It turned out that increased potassium consumption was very nearly as protective as smoking was damaging.

Of course, this was an observational study, so I filed it under – most interesting – but did nothing much more about it. As the authors said themselves: ‘ Potassium excretion was very significantly related to risk of death from all causes, having a protective role, whereas its role in coronary events was weaker and that of sodium excretion weak and even paradoxical. These results are unifactorial, without correction other than for age and sex. Our findings need corroboration from elsewhere and more detailed analysis with more events from longer follow-up.’

Since then, a large number of other studies have followed up, and appear to have confirmed that potassium has considerable health benefits. Some of these studies were not just observational, they were interventional. Here is summary of the potential beneficial effects. Potassium:

  • lowers blood pressure
  • lowers the risk of arrhythmias
  • lowers the risk of cardiovascular disease
  • lowers the risk of stroke
  • lowers the risk of heart attacks
  • lowers the risk of cancer, and
  • lowers the risk of death

These benefits have been confirmed in a number of different studies.  However, as this is a blog, I am not going to turn it into a medical paper and provide references for every statement, so I will stick to a couple of referenced studies. (If enough people are interested I can point you at additional papers).

With regard to blood pressure, a study published in 1997 found that adding roughly 2 grams (2000 mg) of potassium per day lowered blood pressure in older people by 15/8 mm Hg. As good, if not better, than any antihypertensive drug1.  And with no side-effects at all.

When it comes to stroke, it has been found that having a low potassium level is a very potent risk factor for both bleeding (haemorrhagic) and clotting (ischaemic strokes). In an American study it was found that in those with low potassium levels the relative risk of ischaemic stroke increased by 206%. The relative risk increased by 329% for haemorrhagic stroke2.

Admittedly, these two studies were done in people with high blood pressure to start with, but these effects are also found in healthy people.  However, to my mind, the most important thing about potassium is that I cannot find any study, anywhere, which suggests that increasing potassium consumption may be harmful. In short, it seems to be something that does only good.

I do recognise that a lot of doctors will shudder at the thought of adding potassium to the diet, as they have all been taught that a high potassium level is something terribly dangerous. A condition  that needs immediate treatment, or else it will cause arrhythmias and death.

It is true that you need to be careful of adding potassium to the diet of patients taking medications that can raise potassium levels. These are mainly drugs used to lower blood pressure. However, even in this group the risk of overdosing on potassium is exceedingly small. For everyone else the risk seems to be zero. This is why I now recommend potassium supplementation as a good way to live a longer, healthier life.

My goodness, I think this is the first time I have ever recommended a dietary supplement. Must go and lie down.

1: ‘Long term potassium supplementation lowers blood pressure in elderly hypertensive subjects’ Fotherby M.D. et al: Int J Clin Practice 1997 41(4): 219 – 222)

2: Smith NL, et al: ‘Serum potassium and stroke risk among treated hypertensive adults.’ Am J Hypertens. 2003 Oct;16(10):806-13

134 thoughts on “Potassium, your invisible friend

  1. dearieme

    Back in the autumn a nurse at my GP’s practice told me off for eating a banana every day: “a maximum of three a week” said she. So I decided to halve my breakfast banana, my wife eating the other half. Since then her blood pressure has fallen from a-bit-of-a-worry to tickety-boo, while I have been hospitalised with a heart arrhythmia. So more spinach and broccoli in future I suppose. What else, doc?

    Reply
  2. Alan

    Potassium supplements seem to be limited to 100mg tablets. Someone, somewhere, doesn’t want us supplementing to 4000mg a day methinks. As such, I shall start to do so immediately.

    Reply
    1. Price Weston

      One can buy potassium citrate, chloride, bicarbonate, etc in bulk form (search bulk or powder and you potassium of choice). For a very cheap option, potassium chloride is sold food grade as a water softener component in 40 lb bags at home stores in the USA. That should last a long time. Haven’t used it but others have dissolved measured amounts in a measured amount of water so they know how much potassium per tablespoon and dose accordingly (I calculate at $29 USD for 40 lbs, it’s 1.3 cents a day for 4 grams of potassium). The two best studies I’ve seen on paleo man with respect to daily potassium consumption were 10.5 Grams/day, yes that grams, and about 15 grams per day +/- 4.5 grams (400 meq +/- 125 meq in the study.)

      Reply
  3. Al

    I’m slightly puzzled by the £15 – 20/year cost bit if you can only get 100 mg tablets. That means for 4000 mg you need 40 of those nasty chalky things a day, which means a bottle of 90 will last 2 days or thereabouts.

    Could you confirm the dosage you would recommend, all things being equal?

    By the way are ACE Inhibitors (Lisinopril to be exact) the type of thing that comes up as a red flag with potassium supplementation?

    Thanks – by the way I understand that any reply doesn’t equal medical advice, etc., etc,.

    Reply
      1. Sherri

        I know this is an old subject, but noticed the question didn’t get answered.

        You can get potassium bicarbonate from wine supply stores. Because it is used for regulating wine acidity, it is food grade. Don’t get the stuff made for fish tanks because it isn’t food grade.

      2. Karen Carr

        I believe potassium is limited by regulation to 99 miligrams per tab. Even the bulk suppliers recommend a dosage of 275 miligrams per day of potassium carbonate (yielding 99 miligrams of elemental potassium). When first exploring a possible diagnosis of Andersen Tawil Syndrome for my children and I, I supplemented with 8 tabs four times a day while sticking to a very low carb low sodium diet. Insulin surge in some individuals with ion channel disorders can cause enough potassium fluctuation to cause symptoms of periodic paralysis. Now with diet and potassium sparing diuretics I dose with 100 meqs of potassium. In an accute attack I take usually 40 to 60 meqs to abort the attack. I have also discovered I feel what I can only explain as normal. when my serum level is in the 5.6 mm level.
        A quick google found this. Don’t know if this answers the question as to whether there is a law or reg.
        posted by Raymond Marble at 10:16 PM on January 4, 2011

        21 CFR 216.24: “The following drug products were withdrawn or removed from the market because such drug products or components of such drug products were found to be unsafe or not effective. The following drug products may not be compounded under the exemptions provided by section 503A(a) of the Federal Food, Drug, and Cosmetic Act:

        Potassium chloride: All solid oral dosage form drug products containing potassium chloride that supply 100 milligrams or more of potassium per dosage unit (except for controlled-release dosage forms and those products formulated for preparation of solution prior to ingestion).”
        posted by jedicus at 6:51 AM on January 5, 2011

        And some further regulations: 21 CFR 201.306 that, among other things, requires the use of the prescription caution statement for potassium supplements of 100mg or more.
        posted by jedicus at 6:55 AM on January 5, 2011

      3. sundancer55

        @ Alan: Are you sure they were 500 grams?? Maybe 500 mg?

        Also, if you’re looking for good food sources of potassium, you can’t beat spinach and beets. Also, the beet tops are an excellent source of Vitamin C, Vitamin A and carotenoids. I sometimes actually use beet root powder mixed into my morning cup of WARM water mixed with fresh lemon juice. I don’t like juiced fruits and veggies (I think it promotes too much sugar, but that’s just my opinion) but I do have a citrus juicer for my lemons. Thing is, I do still supplement because I get tired of the powder and that’s a fact. I am, right now, using potassium aspartate and I have no idea if that is a good source or not, but it supplies a very small amount of potassium (something like 60 mg per pill). I need/want to work up slowly because sometimes supplements can have the opposite effect on me, like causing heart pounding that I’m trying to get away from in the first place.

        I know this has probably been answered here somewhere but I don’t have time to read all the comments. Can someone please tell me the brand they use, where they got it, how many mg (in American lexicon!), and what type of potassium it is they have the best results with. Most of what I’ve seen on the ‘net comes in mg, not grams, and I prefer to start with mg’s (a gram is 1,000 mg, and a mcg is 1,000 mg, no?). Like I said, I want to start with small amounts and work up, if possible.

        Also, beets help with homocysteine levels.

        I sometimes steam them and eat them with a goodly amount of quality butter and sea salt. YUM! I’m not big on the cooked green tops yet, but I’m working on liking them!

        Some good tips here (scroll down to the part about *health benefits*): http://www.nutrition-and-you.com/beets.html

        Any additional info appreciated.

    1. Karen Carr

      Mark potassium chloride for execution is injected into the veins directly and can indeed cause fatal rrhythmias. When take by mouth.. the way most people take supplements they go through the gastrointestinal track and excess is exreted through the kidneys. Large doses and kidney failure together can result in hyperkalemia in some individuals since the kidneys are unable to filter excess in kidney failure. Or if the individual suffers from a genetic form of hyperkalemia.

      Reply
  4. Pingback: RDA for potassium

    1. Dr. Malcolm Kendrick Post author

      This is, I suppose, an advert. After recommending potassium as a supplement, I was told you could only get 100mg tabs (not enough). This iHerb lot may have more reasonable quantities. I cannot vouch for this company as I have never heard of them before. But, they do seem to have sufficient quantities – at a reasonable price. So, perhaps check them out. Maybe you could let me know if they are any good.

      Reply
      1. Anne Lucas

        I Herb are an excellent on line supplement supplier. They have a huge range. Some more effective than others and some are what I would call gimmicky. They do have a review scale for all the products and you can usually sort the wheat from the chaff.
        I believe I need more potassium to work with my magnesium and boron. Current blood test was 4.6 mm of serum potassium but I am getting a lot of pain in my shoulders sort of like frozen shoulder. advice has been the boron and Mag are shifting calcium deposits out of joints and it will take a while to clear and that I should make sure I get potassium as well for balance. I think it would be hard to get it from food and agree with you to try for food and supplement as well. However which supplement to use is the question as w ll as how much is actually absorbed.

      2. karen

        i supplement with potassium citrate (amazon). supposedly dissolves kidney stones too!

      3. AH Notepad

        :Lol: I bought 4kg of potassium citrate ( I have 2kg of potassium chloride too but it doesn’t taste so good). I mix about a gram or two in with my 2 to 3 gram vitamin c drinks about 4 times a day, but missing the potassium a couple of times.

      4. sundancer55

        @ Anne Lucas: sounds to me like you need to be moving the calcium into the bones. In order to do that, I would recommend (and this is just my opinion; do some research yourself first) taking D3 at 5,000 mg daily ALONG WITH MK-7 (Vitamin K2). Or drink a lot of raw dairy, not pasteurized dead dairy. Too much calcium isn’t a good thing and in order to move it to the bones and out of the arteries, you’ll need K2 and D3. There’s some good information about this subject at the Weston A. Price dot org site. Once there, just type K2 into the search box (or something similar).

  5. labrat

    Most “real food” is pretty high in potassium. Potato has a ton, you don’t have to eat bananas. I can’t imagine one needing to supplement 4000mgs a day. I’d say it would be more prudent to calculate a rough estimate of one’s daily intake based on the foods they do eat and then decide if they might want to bump it up a bit with a supplement.

    Reply
    1. Dr. Malcolm Kendrick Post author

      I think you might be right. But I also think that it may be more dangerous to have too little, rather than too much potassium. I am sure the kidneys can get rid of any excess without difficulty (unless you are taking BP lowering meds, in which case, have a care).

      Reply
      1. Anne Lucas

        I’ve looked into this and for the life of me cannot get the recommended 4700 mg per day of potassium. I am trying hard. I currently eat a LCHF diet but usually only eat twice a day. Don’t eat potatoes or banana’s and can’t eat bucketfuls of salad so I feel I am pushing a barrow up hill. As far as supplements go you can;t buy them in Australia It’s prescription only.You should have seen the look on the pharmacists face when I said I wanted to supplement. I can’t see any GP giving a prescription for say Slow K (600mg per tablet) because I say I need to ingest more.

    2. karen

      too many carbs (sugar) in potatoes. i mix the potassium citrate in with my NaCl and use just like i would for regular salt: in soups, on meats and veggies.

      Reply
  6. Al

    I use iHerb and they are good; it’s slightly odd that it is cheaper to import supplements from the US than to walk outside and buy them from a high street shop here but there we are. I’ve not had any issues with them and use them for an array of diabetic vitamin supplements (alpha lipoic acid and the like).

    Reply
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  8. Tony

    Search for “Potassium Chloride” and go to the ebay site where APC Pure brand is offered at £2.50 for 500g or £3.25 for 1kg. That should keep you going!

    Reply
      1. aletheablack

        Potassium bicarbonate is better than KCl. We all already have enough Cl, from salt; it’s the bicarb that’s needed. You can buy Potassium bicarb powder on Amazon. $20 per pound. Each tsp is 1300-1500 mg. 3 teaspoons daily is working wonders.

  9. joemurphy

    Interesting article, but why supplement when you can improve your diet? Many vegetables have levels of pottasium much higher than the pills being discussed here. I recommend the website “nutritiondata.self.com” to anyone interested in increasing their nutrient intake. As well as allowing you to search for a particular food and obtain nutritional data, it also allows you to search for a particular nutrient (tools menu) and obtain listings of foods rich in what you need. I would rather have the veggies than a chalky little pill.

    Reply
    1. sundancer55

      That’s what I said but these people are afraid of carbs, which is ridiculous. Too much of anything isn’t good, but a potato now and again or a half a banana isn’t going to kill you. What might kill them is stressing over the foods they THINK they shouldn’t be eating. What a waste of time to sort out the good and bad. Just eat what you’re hungry for because you’re body will tell you what it needs, in most cases. Potatoes are loaded with potassium, so are beets, spinach and winter squash (many other things too, but that’s a start). I would never NOT eat something just because it had a carbs. Good grief.

      Reply
      1. johnwinner

        There are a LOT of reasons not to eat potatoes, beets or spinach! A lot of people with Ankylosing Spondylitis avoid starchy food and get way better. Beets and spinach are very high in oxalyc acid (oxalates) and can cause huge health problems in some people (like me!). Also a lot of people has some bacterias imbalance and the bad bugs can feed on carbs and make you feel a lot worse. In these cases avoiding carbs may be part of the solution. The gut microbiome is way more complex than what you think. Please a little bit more humility.

      2. Bill In Oz

        Sundancer. surely this depends on the minerals in the soil and the ph. of the soil where the potatoes are grown. In very acidic soils which potatoes can grow in, potassium may be missing or simply unavailable. If soil is high ph ( very alkaline from excess Calcium ) again potassium unavailable or simply missing from the soil.

      3. sundancer55

        @ Bill in Oz: Well, the soil certainly does make a difference but unless you analyze every potato or piece of spinach you eat, you simply do not know what’s in it these days (as far as nutrition). So, we simply have to do what we can do. If I’m not able to grow my own garden I try to buy food from the local farmers markets or our local food co-op and hope for the best. It seems to be about as good as we can do in these uncertain times. If we utilize an ACA, knowing your farmer and his growing methods, etc., (whether it’s meats or veggies or fruits) is part of the equation, if you don’t grow your own and control your own soil amendments. This year I was unable to plant a garden due to our crazy weather, and a very busy schedule of work. I simply have to trust that we’re eating the best we can. I’m sure that stressing over food is not good for us, either.

      4. Bill In Oz

        Sundancer, Speaking asa retired organic farmer, I am simply responding to the simplistic comments made by a few people here & elsewhere that “xxxx” is high in “yyyyy” ( For example potatoes rich in potassium ).

        It may once have been possible to rely on such ‘scientific’ statements . But I seriously doubt it in an age of mass production conventional farming. In our modern conventional framing systems the emphasis is on harvesting as big a crop as possible for as long as possible.. And that process inevitably depletes the minerals naturally found in farm soils.

        Spuds cannot accumulate potassium in them structure, if the soil they grow in, is very poor in it.
        Potassium is an interesting example as it is readily leached by water from the soil unless it is present in a non water soluble form – ie rock. But that means it is also hard for plant roots to access it.

        Possible solutions ? Growing your own vegetables in your gardens is one way. And buying from farmers who are managing their farms & soils sustainably with soil tests as part of their SOP farming practice. The only way I know to ascertain that is via an farm accreditation scheme such as Organic certification. Or supplement to make good the deficiencies. Or via local farmers markets maybe.

  10. NevadaSmith

    Potassium bicarbonate is available on Amazon. It is not recommended to take more than one teaspoon a day and that should be taken in divided doses. Start with 1/4 teaspoon once a day for a week and then go to twice a day and three times a day and then 4 times a day. When you get to that level you could take a half teaspoon twice a day. This will provide you with 2000 to 2500 mg of potassium a day.

    Please note that increasing serum potassium too much can be lethal. It is a good idea to rule out any problems that may exist that cause high potassium levels in the blood.

    See the book, Potassium Nutrition: In Heart Disease, Rheumatoid Arthritis, Gout, Diabetes, and Metabolic Shock at http://www.amazon.co.uk/Potassium-Nutrition-Rheumatoid-Arthritis-Metabolic/dp/1462017533/ref=sr_1_4?s=books&ie=UTF8&qid=1367454900&sr=1-4&keywords=potassium

    Reply
    1. Dr. Malcolm Kendrick Post author

      Thanks for you comment. I would say that a fit healthy person, not on any meds that have affect the kidneys, (usually blood pressure lowering tablets) should be fine. But I appreciate your warning. I want people to be fit and well and enjoying life.

      Reply
  11. amie

    My husband had a mild stroke a week ago. He has atrial fibrillation but no other risk factors such as smoking, high blood pressure or obesity and has always been a runner. (In fact his early ultramarathons may be correlated to to the AF) He is 64. He will be put on warfarin as soon as he can get an appointment at the anti coag clinic, which is 13th May. Until then, he has to be on Fragmin injections. My son, a great fan of yours- has recommended my husband take potassium citrate. As you say, we have it in the 100mg capsules. But I was a little concerned as the pamphlet reads: Uncommon side effects which may affect more than 1 person in 1000: Increased levels of potassium in your blood. (symptoms may include temporary muscle weakness. loss of feeling and changes in your heartbeat.) It is off course the last symptom that concerns me.
    Or you may say 100 or 200mg is too slight to be either of benefit or harm.

    Reply
  12. Sydney

    I had Conn’s Syndrome which was misdiagnosed for four years, one of the side effects being loss of potassium. As you will know Conn’s causes severe hypertension. This surely reinforces your potassium advice.
    Having read your potassium blog I’m thinking the single banana and spinach I put in our family breakfast smoothie might need to be increased.
    Fascinating reading, thank you.

    Reply
  13. NevadaSmith

    8 oz. of coconut water contains 495 mg of potassium.
    Wholesome organic black strap molasses contains 730 mg in one tablespoon

    I don’t think either of them were mentioned in this discussion!

    Reply
  14. Philip Thackray

    Dr Kendrick,

    See Dr Eades blog from 2009 here:
    http://www.proteinpower.com/drmike/saturated-fat/rapid-health-improvements-with-a-paleolithic-diet/

    Table 2 in the main article lists potassium levels for the “Paleo diet” tested at 339 mmol. That would be about 13 grams. Seems like a lot. I went to the Pub Med link in the article but could only get the abstract. Does not seem possible to get to this level of potassium just by eating the listed foods although quantities were not given.

    I have been supplimenting K using the Potassium Bicarboate suppliment from the location that Nevada Smith referenced above.

    Regards,
    Phil

    Reply
    1. AH Notepad

      When were the tests done in order to compile that list? Some lists to do with for qualities were done long ago, and the food is no longer as nutritious.

      Reply
    2. Bill In Oz

      Look please be aware that the character of the soil is crucial when thinking about potassium rich foods. The ph of the soil, the organic content of the soil, the ‘structural’ nature ( sand or clay ) are all important. Also important is the mineral content of the soil. Does the fertilser program included added potassium ? We farmers cannot get potassium into our food crops from soil which lacks potassium or where the potassium is bound and unavailable.
      A final note : potassium compounds dissolve in water very easily. That means that it is easily leached out of many soils. And thus rare when plant roots go searching for it.

      Reply
      1. Ed Covney

        Thank you !!
        Excellent list which I’ve downloaded in case it should ever go away.

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  16. Kevin

    Ok to take a gram or two of the Pot. Bicarb if I am on Plavix and an aspirin daily after an angioplasty, as well as an amlodipine and a half daily for High Blood Pressure, and also 1 metoprolol. I’d love to get rid of the last two meds. They make me drowsy, and I’ve cut off eating grains and sugar in any form. I’m supposed to take a rosuvastatin ev. two days supposedly to lower inflamation of the arteries. But after six months of it, I’ve decided to cut it out. Hope I’m not making a big mistake, but I am sick of pharmaceuticals.

    Reply
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  20. Tommy Lee

    The reason why potassium supplements are never 100mg+ is because a sudden increase in potassium levels is highly dangerous.

    Reply
    1. Dr. Malcolm Kendrick Post author

      Sorry, Tommy, that is nonsense. Yes, a sudden increases in potassium levels is highly dangerous. That does not mean that a sudden increase in potassium consumption is dangerous. The meta-analysis quoted by Ted Hutchison, and read by me in full, recommends an overall increase in potassium of 1.5 grams per person, per day. The reason by potassium supplements are never greater than > 100mg is because the pharmaceutical industry is on a long-term mission to destroy the nutritional supplement industry by forcing bonkers regulations on it, and restricting nutritional supplements to a level that cannot provide any real benefit. Money is the driver for this, not health

      Reply
      1. Tommy Lee

        “Potassium salts are also available in tablets or capsules, which for therapeutic purposes are formulated to allow potassium to leach slowly out of a matrix, as very high concentrations of potassium ion (which might occur next to a solid tablet of potassium chloride) can kill tissue, and cause injury to the gastric or intestinal mucosa. For this reason, non-prescription supplement potassium pills are limited by law in the US to only 99 mg of potassium.”

    2. tedhutchinson

      However it seems from “Potassium-rich diet and risk of stroke: Updated meta-analysis” link to paper in previous comment, shows an increase in population dietary K intake of 1.5 g/day could avert over one million deaths from stroke per year on a worldwide scale and is expected to produce overall health benefits by reducing the impact of consequent disabilities.
      1.5g = 15 x 150mg
      This shows what happens when you give people with mild hypertension 10 Potassium bicarbonate pills daily
      Effects of Potassium Chloride and Potassium Bicarbonate on Endothelial Function, Cardiovascular Risk Factors, and Bone Turnover in Mild Hypertensives
      “These results demonstrated that an increase in potassium intake had beneficial effects on the cardiovascular system, and potassium bicarbonate may improve bone health. Importantly, these effects were found in individuals who already had a relatively low-salt and high-potassium intake.”
      How dangerous is that?

      Reply
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  23. Tyrannocaster

    Note that potassium bicarbonate, while easily available, will also work to neutralize stomach acid, which is not necessarily a good thing. Perhaps, for those wanting to get bigger doses than the pitiful little 99mg pills provide, potassium gluconate might be a better choice. It seems to be available in one pound sizes – NOW makes it, and so do some others, and I saw them on the Swansons Vitamins site.

    Reply
    1. Ali

      I take half a level teaspoon of potassium bicarbonate (bought in powder from from a well known online auction site) every other day. I alternate it with sodium bicarbonate. If taken first thing in the morning, it will not neutralise stomach acid because you haven’t eaten anything! Allow half an hour minimum before eating and there is no problem at all. Besides, bicarbonate is made in the stomach lining to protect it from the acid, so you are not adding anything that isn’t already there.

      Some people take it before bed instead, or as well as in the morning, but I have a slow digestion due to various factors so food can still be in my stomach until the early hours.

      I do feel that whilst the potassium is important, bicarbonate levels lower as we get older too, so adding some extra is no bad thing and can be very beneficial. Since I added the PB and SB my constipation has gone away…..

      Reply
      1. Ali

        As a rider, I have just come to realise that my potassium levels have probably been too low (or my needs too high) for a long time – like, decades.

        I have, or have had most of the suggested deficiency symptoms in the list in the following link over the years, but then I have never been a huge fruit or vegetable eater. It improved a bit after dumping gluten and most carbs 9 years ago, but only marginally because there was less demand.

        My digestion had all but collapsed back then (after being given evil Byetta for my diabetes) and I now suspect low potassium had a hand in that. It can, as I discovered once again three weeks ago, lead effectively to paralysis of the digestive system.

        Blood tests are pretty useless as they only test plasma levels. As the body will always try to maintain plasma stability but leaching minerals out of the cells, it is not until cellular levels reach critical that plasma levels will start to drop. Also, other factors can affect the plasma level. Serum tests would give a clearer picture of cellular levels of all the electrolytes, but they are rarely done….

        http://www.rethinkingcancer.org/resources/magazine-articles/18_7-8/potassium.php

  24. FatPhilipp

    Just eat about 300-400g Potatoes a day. Blood Pressure dropped from 150/105 to 120/90 in about 1 week! NO Joke!

    Reply
    1. Ali

      Wish it was that easy, but my diabetes won’t let me. Potatoes contain a lot of starch which pushes my blood sugar through the ceiling…..

      Reply
      1. Gary Ogden

        Ali: Cook the potatoes, then chill them in the fridge (potato salad). This converts part of the starch into resistant starch, which is indigestible to you, but happily devoured by your intestinal microbes. Marks Daily Apple has good info about this.

  25. John Daws

    Hello Dr. Kendricks. Thank you for a very interesting article. I take BP medicines. Does this mean I shouldn’t take potassium supplements, or that I should take less than people not on BP meds? Is a gram a day ok?

    Reply
  26. James

    Hello,

    I’m taking 3 BP meds, but in low doses, 5mg amlodipine 2x daily; plavix 1x day; metoprolol 1x daily before sleep. I’m thinking of eliminating one of them, since they increase phlegm and sneezing and coughing.

    Anyway, is there a problem taking 2gm potassium daily along with the meds? Or should I definitely try eliminating gradually one or more of them?

    Also, what is a good dose of l-arginine.

    BTW, I’m 70 yrs. old.

    Thank you!

    Reply
      1. James

        Thank you! BTW, I made a mistake and put Plavix instead of Micardia (telmisartan). I am starting to eliminate the metoprolol, since you think beta blockers are the worst. Once I get the potassium, I’ll start eliminating the amlodipine, and save the telmisartan for last. As it is, I’m only taking minimal doses of each: telmisartan 20mg daily; amlodipine 5mg daily in two 2.5 mg doses. I was taking 50mg daily of metoprolol, and I’m cutting it to 25mg daily for a week or so, and then stopping it altogether.

        I’m not taking Plavix at all–nor any other statin. I gave them up about a year ago.

        All good wishes!

      2. annewatts1

        I would be cautious combining telmisartan and potassium because it can make you retain potassium and should be monitored.

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  28. clive lary

    Thank you for such valuable research. I take 1 Aliskiren 150mg, 1 Bisoprolol 2.5mg, 2 Doxazosin 4mg, 2 Lisinopril 20mg, 4 Phenoxybenzamine 10mg daily for hypertension.
    Do you know if any of these would cause retention of potassium so making it inadvisable to supplement with 1 gram or 2 of potassium? Or perhaps just a lower dose would be ok?

    Reply
    1. annewatts1

      Aliskiren and lisinopril can increase potassium so you should discuss with your doctor about monitoring any changes.

      Reply
  29. Tom

    Good article.

    I feel the Hyperkalmeia risk has been extemely over played by the FDA et al (or should i say there pay masters The Pharmaceutical industry) in order to scare and provoke fear of Potassium supplements.

    I feel this is because a Potassium Deficency has such a devastating effect on human health resulting in a multidude of chronic (and profitable) symtpoms (it is my belief that potassium deficency is one of the primary causes of cell apoptosis).

    As the study the Doc mentioned in his article shows, Potassium seems to have a kind of protective effect over the entire body. Again i feel this is due to its importance in cellular health.

    Ofcourse the same could be said of all nutrient supplements. Be under no illusion all illness and disease (or at the very least 95%) is a result of nutrional deficencies and your pharmaceutical masters know this.

    All disease can be traced back to cellular malfunction/apoptosis. There are 2 causes of cellular malfuntion that is nutrional defcencies (the most important one because with ample nutrtion the homeostatic powers of the human body will easily deal with the other cause …) and systemic Toxemia i.e a overpolluted toxic body.

    Ofcourse it is better and more ideal to get your nutrients (in total you require 91 essential nutrients in optimal amounts) via food but in this day and age with the soil depletion and toxicity of the soil etc its simply not possible even on a all “organic” (nothings truly organic any more the worlds too poisoned) “healthy” produce filled diet.

    That means supplementation is critical in our toxic world. Orthomolecular medicine has already proven beyond doubt (in particular i urge readers to research the work of Dr Linus Pauling PHD pn megadose Vitamin C) the powers supplementation (specificially megadose Vitamin C which has proven to be the most potent antibacterial, antiviral, antihistamine and anti TOXIN -it literally neutralise all known toxins) can have on acute and chronic illnesses and overall general health and longevity.

    Theres really not much to fear in overdosing on most supplements (if there of a high qulaity free of binders etc and from whole food sources) there are some that should be used wisely ofcourse and obviously certain medical conditions may cause mitigating circumstances but in general there very safe.

    Especially when compared to there allopathic drug counterparts which are responsible for hundreds of thousands of deaths (thats not including the physical misery they cause with there toxic side effects) a year and the main reason that Iatrogenesis (death caused by medical treatment) is the 3rd leading cause of death (according to offical figures imo its probably the leading cause).

    I will link in a seperate comment to the comparison of deaths from supplements vs drugs.

    Anyway back to potassium first off its very water soluble making it quite safe and second the human bodies innate wisdom has various ways of dealing with excess (in particular of course the amazing kidneys) and anyway it would give you plenty of warning via symptoms before you was even close to death from overdosing if you know your body your know when too much is too much.

    And as metnione already our ansectors were consuming in the tens of thousands of mg a day!! At the end of the day potassoum is potassium weather from food or supplements.

    Ofcourse food has other co factors and binding nutriets making it more bio available and healthful and ideal but with regards to toxicity its just potassium. So if they were eating tens of thousands i think we should and if we have to supplement some of that then so be it.

    I have been supplementing 3-4 gram of ELEMENTAL potassium a day in the form of a Potassium Gluconate powder (note only 16% of gluconate is potassium so ive been consuming around 21 grams of potassium gluconate) i get mine from a UK company called Health leads (google them) 15 pound (ish) for 500grams godd quality.

    Other forms are fine too. There are a few differences in the ph of the other salts (gluconates neutral, bicarbonate alkaline and chloride acidic for example) but id say its personally prefernce maybe try them all see what suits your body (we are all different).

    Here is a good article (letter) id suggest you read if worried about supplementing potassium (this guy supplemented megadoses!)

    http://www.newmediaexplorer.org/sepp/2004/05/03/potassium_deficiency_widespread_and_often_neglected.htm

    Reply
    1. AH Notepad

      I note that natural potassium contains 0.0118% of a beta isotope (40K). Who here knows what risk that presents, if any?

      Reply
    2. AH Notepad

      Potassium chloride is available from http://aletom.co.uk/potassium-chloride-food-grade/111-potassium-chloride-kcl-food-grade-10-kg-8592861122035.html. There are smaller quantities available if you think 10kg is a bit over the top. Does anyone have knowledge of the effect of excess chloride ions in the system?

      A chloride vs gluconate comparison might be useful http://www.differencebetween.com/difference-between-potassium-chloride-and-vs-potassium-gluconate/

      Reply
      1. tedhutchinson

        http://www.sciencedirect.com/science/article/pii/S0735109715027278
        Prognostic Role of Serum Chloride Levels in Acute Decompensated Heart Failure
        “serum chloride levels at admission are independently and inversely associated with mortality. The prognostic value of serum sodium in ADHF was diminished compared with chloride.”
        Serum Chloride Is an Independent Predictor of Mortality in Hypertensive Patients
        http://hyper.ahajournals.org/content/62/5/836
        ” Low, not high Serum Cl− (<100 mEq/L), is associated with greater mortality risk independent of obvious confounders. "

      2. Dr. Malcolm Kendrick Post author

        Good spot. I looked at chloride levels a few years ago, and found much the same thing. Question, if high NaCl consumption is bad for you, yet low Cl is bad for you, how do explain this?

    1. AH Notepad

      I have found this too. I see a new post, then nothing! Until I post a reply, then there’s dozens of comments arrive.

      Is there a permanent way of getting everything that doesn’t involve posting a reply?

      Reply
  30. James

    Just to report, after 4 mos. (I posted on Sept. 12). I’ve been taking 2 gm. potassium daily in two doses + 2.5 mg. amlodipine daily. BP is now down to 127, and I’m 70 yrs. old. I think the fact that I’ve lost a lot of fat and totally cut-out sugar has also helped.

    Reply
  31. iamkerok

    Potassium levels in many foods are quite high, and a serving of spinach could potentially equal eight of the 100mg tablets you are considering choking down. A cup of spinach (~800mg), half an avocado (~450mg) and a cup of white beans (1100mg) and we are already to 2600mg of potassium. Plus more tasty and not upsetting to your stomach.

    Reply
    1. Gary Ogden

      iamkerok: Chocolate is rich in potassium (and magnesium: 3.28mg/g). I eat 10g of (100%) chocolate each day, which gives me 117 mg. Also rich in potassium: pistachios (10.1 mg/g), sunflower seeds (8.5mg/g), pumpkin seeds (7.87 mg/g), peanuts (7.27 mg/g), almonds (7.05 mg/g), hazelnuts (6.81 mg/g), brazil nuts (6.6 mg/g), ham (6.38 mg/g), and cooked clams (6.28 mg/g).

      Reply
      1. AH Notepad

        They might be “rich” Gary, but those figures mean we are going to have eat 14oz of chocolate/day or 21oz of pumpkin seeds or over 1-1/2lb of ham to get to 4500mg of K. Even if we reduce the amounts of each and spread it out over all of them, it’s a lot of eating to do. Even if the nuts do contain the amounts you suggest, how much of that is available once digested, as it seems nuts get only partially digested?

  32. Gary Ogden

    I just did a back-of-the-envelope estimation of my typical potassium consumption from food, and it was around 3g/day. If we actually need twice the potassium as sodium, I’m a couple of grams short. I eat very well, but it is time to start supplementing.

    Reply
  33. Maxus

    I can tell you on my own experience that potassium helps very much against rapid heart beat and for peopel who experience extrasystoles (premature contraction of the heart). I have them both – the first one after drinking party usually at night time and the other one by itself. Both conditions are treated very well with taking 12 meq of potassium (less of it does not help at all) I usually take 6 – 8 tabs of panangin Forte (each contains 2 meq of potassium) and after 30-40 minutes extrasystoles are gone. Now i’m buying potassium citrate in powder because panangin Forte is too expensive. If you take 1- 2 tablets of it then now effect whatever. It seems the effective range starts from 12 meq of potassium and it’s minimal effective dosage.

    Reply
  34. AH Notepad

    For potassium citrate doses, I managed to find instructions on bulksupplements.com which read

    “Serving Size & Timing
    This supplement should be taken in servings of exactly 275mg per day; no more, no less. Too much Potassium has the potential to be fatal, so it is always best to measure out amounts of this supplement on an accurate milligram scale. Do not attempt to use anything other than a milligram scale. This supplement should be stirred into a full glass of water and consumed that way.

    The FDA recommends taking no more than 100mg elemental Potassium per day. Since this supplement is made up of 36% elemental Potassium, this means that a single serving of 275mg is equal to 99mg, which comes within the recommended daily dosage. If you have any lingering concerns about taking this supplement or your eligibility to take this supplement, it is best to discuss them with a doctor first, as individual needs for Potassium vary greatly.”

    Individual needs vary greatly, so everyone must have no more that 100mg dose. They need to decide what they are saying.

    I am using a really dangerous approach then, with about 1/2 to 1 teaspoon in water with some ascorbic acid 3 or maybe 4 times a day. Reckless or what?

    Reply
    1. Ali

      They are not allowed to recommend any more than 99mg per day, or they could have their knuckles severely rapped by ‘The Establishment’. All supplement manufacturers are constrained by these regulations, sadly. The Establishment has taken it upon themselves to decide what is ‘optimum’ regardless of the fact, as you have said, that everyone’s needs for anything can be totally different, and that is all the supplement manufacturers are allowed to recommend.

      It’s crazy…..

      Reply
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  36. lptscsi

    I suplement myself with potassium and magnesium for my irregular heartbeats. I tried potassium only without magnesium and it did not work at all. Only after i added magnesium the heart started to work normaly. I use potassium citrate and magnesium chloride in solution – totaly 1600 mg elemental potasium and 450 mg elemetal magnesium, daily. The only problem that magnesium suplement causes loose stools – but manageable.

    Reply
    1. lptscsi

      And a bit on info on making these solutions. I dissolve 216 grams of potassium citrate in water and make it up to 500 ml volume by adjusting with adding water. Also i dissolve 190 grams of MgCl2 * 6H2O and also make it up to 500 ml. Then i mix two solutions together and let it stay for several days (5 days and shake it occasionally)- the slow reaction turns magnesium into citrate form and potassium into chloride (without it MgCl2 has very salty pungent taste even after high dilution with water). Soe milky residue forms after several days (it seems, it is trimagnesium – dicitrate). Then i dilute this solution (the residue included) 4 times with water (for easier measuring it). I take 40 ml of this solution two times a day. I shake the bottle first (to stir residue), then i add 40 ml of this milky solution to a teacup and add hot water. The solution becomes clear after a minute and i drink it.

      Reply
      1. ree012971

        That is quite the science experiment =) I applaud your efforts. I take 1000 mg magnesium (pill form) and a tablespoon of potassium citrate in my electrolyte drink (natural, stevia sweetened) but I’m still on a BP med that I want to get rid of after I lose another 30 pounds. I’m also in ketosis (LCHF) and healing my life after being overweight and having leg blood clots and a pulmonary embolism. I have to supplement with Mg, Na, and K for my lifestyle. I don’t particularly like the salty taste of the potassium in my electrolyte. It’s not even a nice salty, it’s like a “dirty, soft, chalky” salty. Believe me, I love me some sodium. I also use the potassium chloride salt substitute sometimes for seasoning. I can only eat so much salad to get potassium from real food (I only eat twice a day). Always looking for new ways to get what I need. I really like how my body seems a lot less tense, and I don’t hear/feel my heartbeat in my head every night when I try to get to sleep. Amazon is your friend for supplements these days. Used to be you wondered if you could steal from your local high school lab or vet clinic…

      2. Janet.

        Should you be taking potassium if you are on a bp med. Im on bp meds but would like to get off them like you.

      3. ree012971

        So far I don’t see any problems with it. I take a very low dose, safe BP medication. That’s why I’m pretty sure my pressure problem will go away with weight loss, and I’m not one of those taking two or three meds on top of each other. I need to keep all three electrolytes balanced. Can’t take more sodium or potassium, or magnesium without balance. I don’t see any problems right now. I just want to take the correct kind, and the consensus is potassium citrate is a good choice over others. I wish it tasted better and I could find other ways to ingest it. I’m kind of tired of the electrolyte drink.

      4. lptscsi

        I also noticed that it is better to regulate potassium and magnesium supplementation. If i took it daily (40 mek (1560 mg) of potassium and 400 mg of magnesium devided in two doses) after a month (or a little more) a got some negative effects of oversupplementation. So for now, sometimes, i take short breaks (max 3 days) or take only morning dosage (skipping the evening’s). Now, i have no effects of oversupplementation (Potassium (on its own) can produce noticeable irregular heartbeats if it is taken too much, and magnessium can produce loose stool).

      5. sundancer55

        @ Iptscsi: I agree. I cannot take a lot of potassium at one time, and even divided doses sometimes didn’t agree with me. Ditto for magnesium for the same reasons you stated, which is why I like the foot baths & whole body baths with mag salts. How people can take thousands of mg’s of potassium at once is mystifying to me! I don’t take very many supplements, but during the month of July every year, I stop taking everything in order to give my body a break and sort of do a “reset” or whatever you want to call it. It helps me to know which things I really need the most. I do, however, have some herbal tinctures that I use daily even during my supplement fast. I use a tincture of hawthorn and cactus made up for me by my naturopath (for heart health) and I also take a tincture of Fenugreek, Black walnut, blessed thistle and horse chestnut for my tummy (had some digestion issues last summer and the tincture agreed with me so well I still use it).

        I also sometimes drink hawthorn tea (not the kind with hibiscus in it, however, because hibiscus doesn’t agree with me). In the summer I make it the usual way and then let it cool down a bit and add some ice for a cool drink. I don’t think it hurts the integrity of the hawthorn but I couldn’t attest to it. But I can’t stomach hot tea in the summer when I’m already too hot.

        In the meantime, I’ve been doing some research on both butcher’s broom and horse chestnut and they are both supposed to be excellent for vein and artery health, as well as helping with varicose veins, etc. I don’t have those but I don’t want them, either! I have a couple of friends who have painful varicose veins. I always thought they were just unsightly, not painful. Learn something new every day. 😉

  37. Donal

    Has anyone experimented with potassium bicarbonate foot soaks? Is there any reason why we can’t absorb it this way and by pass the gut and any upset that causes?

    Reply
    1. sundancer55

      I would like to know an answer to this question about soaking our feet, as well. I soak my feet often in magnesium chloride water (using Ancient Minerals or Life-Flo magnesium Chloride flakes) and I think it’s very helpful. Don’t know why it wouldn’t work with other minerals, as well. Sometimes I use epsom salts (which is magnesium sulfate) and can tell you from experience not to mix Epsom salts and mag chloride together!

      Reply
    2. Ali

      Never tried it as a foot soak. Epsom Salts (Mg Sulphate) yes, but not Potassium bicarbonate. I do however ingest it, but only ever take it first thing in the morning on an empty stomach, about half a teaspoonful in water. Never take it after food as it will neutralise stomach acid and affect the digestion. It may possibly be taken at night but only if the stomach is empty of food……

      Reply
  38. Barrycoll

    According to herbs website, 2.7grms of K-bicarb release 1.2 grms of Potassium
    So just how much Pot bicarbonate should one take daily please???

    Reply
  39. Barrycoll

    Just received 1kg of Potassium Bicarbonate, and realise that one teaspoon weighs 16 grms on my scales.
    It is suggested above that one teaspoon only releases 1.5 grms of KCO3, which doesn’t seem right to me
    Any ideas folks?

    Reply
  40. Barrycoll

    You may be right AH
    I have now started using a proper food measurer, which suggest a half teaspoon is only 4 grms, meaning 1 grm of K
    But maybe one should build up to a full 7 grms slowly???

    BUT…how slowly…..all seems a bit hit and miss

    Reply

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