Potassium

Potassium and sodium work together

Symptoms of potassium deficiency

Causes of potassium deficiency

Sources of potassium

References

Potassium and sodium work together

Potassium is an abundant, essential element needed by your muscles, blood vessels, glandular and nervous systems. Potassium and sodium are the key two body electrolytes that work together to maintain the pH of your blood. The sodium / potassium ratio is a long-term determinant of heart, blood vessel, bone, muscle, and kidney health, and the risk of death and overall health and longevity. (1, 2, 3, 4, 5)

A diet high in sugars, refined carbohydrates, processed foods and proteins is likely to be high in sodium, whereas a diet high in vegetables and other plants is high in potassium. Simply eat more vegetables (and some fruits) and less sweet, processed and pre-prepared food to normalise this ratio.

Sodium and potassium are the key pair of electrolytes. Sodium is held more tightly than potassium. The key synergy ratio is one part sodium to two parts potassium. People on a Standard American Diet are often so potassium-deficient that this ratio is in reverse.

The required dietary intake from food for an adult is 2,300 mg sodium per day, and 4,700 mg potassium. However, research shows that the level of potassium in the diet on which humans evolved was more than three times this amount, at about 15,000 mg per day. (10)

The sodium-potassium pump is the key process which maintains body electrolytes. Potassium is more quickly taken up and more quickly excreted through the kidneys to maintain the 1:2 crucial balance between the two elements.

Low levels of potassium cause the retention of sodium. (5, 8, 9)

Potassium deficiency is the inverse of sodium excess. Conventional doctors focus on sodium excess and put their patients on a low-salt diet. The standard medical advice for someone with a high level of sodium is a low salt diet. This actually makes the symptoms worse, starting with feeling tired and having low energy when starting a low salt diet. On a low salt diet the patient will be deficient in both sodium and potassium, as well as the Na/K ratio being lower than 1:2. A better therapy is to increase potassium.

Potassium prevents the accumulation of calcium deposits in the body, for example in the arteries as atherosclerosis or in the kidneys as kidney stones.

Potassium stimulates the release of nitric oxide in the body. (6) Nitric oxide has numerous health giving properties (7), and is also stimulated by sunshine on the skin. Sodium inhibits nitric oxide. This is one of the reasons that maintaining a good potassium / sodium ratio is essential.

Symptoms of potassium deficiency (hypokalemia)

There is no quick and easy test for potassium deficiency. Early symptoms of potassium deficiency may include weakness in the diaphragm and weakness in breathing. There may also be general fatigue or heart palpitations. Over time, the symptoms listed below may emerge.

• High blood pressure (hypertension) with vascular stiffness.
• Faster than normal pulse rate, sometimes accompanied by tinnitus or the ability to hear one's own pulse. Most typically, when you are in bed at night you can hear your pulse in the ear facing the pillow.
• Heart arrhythmia.
• Constipation.
• Oedema.
• Muscle cramps, leg cramps.
• Fatigue, low energy.
• Alkalosis, where body fluids have excess base (alkali). This is the opposite of excess acid (acidosis).
• Insomnia.
• Muscle weakness, including weak breathing and poor colon peristalsis sometimes causing constipation.
• Insulin resistance, then diabetes. (8, 9)
• Increased risk of:
  Atherosclerosis,
  Cancer,
  Cholesterol imbalance,
  Coronary heart disease,
  Dementia,
  Gout,
  Heart attack
  Kidney diseases and in particular, kidney stones,
  Osteoporosis,
  PCOS,
  Stroke
  and overall mortality.

Causes of potassium deficiency

• Standard American Diet (SAD). Processed foods always have excessive salt (sodium chloride) added. High levels of sodium cause the leaching of potassium. Sugar and refined carbohydrates also leach away potassium. The SAD is low in plant foods (vegetables) so it is deficient in potassium.
• Diarrhoea or vomiting, in which potassium is lost in the more general loss of electrolytes. Laxatives can cause potassium loss.
• Low magnesium.
• Stress hormones cause the loss of potassium. This can come with the kind of psychological stress caused by fear, anxiety or depression, and also with stress directly on the body from trauma injury or surgery.
• Diabetes. Diabetics are nearly always potassium-deficient.
• Excess water drinking. Those who drink excess water risk losing body electrolytes, particularly potassium salts. It is quite easy to drink excess water when one sips it all day, drinks a couple of litres per day, and is not sweating significantly due to heavy exercise or a hot environment.
• Diuretics. A diuretic is a medicine that increases the production of urine. They increase the excretion of water from the body, through the kidneys. Diuretics also remove electrolyte salts including sodium and potassium. They are often taken to lower blood pressure. The thiazide class of drugs deplete potassium and raise the risk of insulin resistance and diabetes. (8, 9)
• Other pharmaceutical drugs that lower the level of potassium include steroids and penicillin.
• Starting a ketogenic diet. A ketogenic diet is a good and healthy approach to eating, but when starting such a diet and during the adaptation period, there is a loss of glycogen, potassium and sodium at this time.
• Kidney disease or Addison's disease.

Sources of potassium

• The best source of potassium is leafy green vegetables. One cup of leafy greens provides 500-800 mg of potassium. Other food sources of potassium include beet leaves, sweet potato, potato, taro, carrot, squash, spinach, seaweed, fruits (particularly banana and avocado), black strap molasses, tree nuts and whole grains. Some fish such as salmon also have significant potassium content. However, as explained in Grow Youthful, molasses, sweet fruits like bananas, and grains should generally be avoided. A banana only contains 300 mg potassium, so you can see that you would need to eat more than 15 bananas per day to get your (too low) daily RDA potassium need. 15 bananas per day would give you a massive fructose hit! White rice is low in potassium. Sugar, refined salt, coffee and alcohol all leach potassium from your body.
• Potassium chloride can be purchased as a supplement. It should be pure with no other ingredients, so it is food grade. It is a fine white powder with an intense salt taste; the taste disappears quickly in the mouth. The best way to use it is to mix it with the sea salt that you normally use. I use one quarter potassium chloride mixed with three quarters sea salt.

Your comments about any of your experiences - positive or negative - with your use of potassium are welcome at Grow Youthful. I am always curious about your use of and experience with natural remedies, and your feedback is very welcome.

References

1. Morris RC Jr et al. Relationship and interaction between sodium and potassium. Journal of the American College of Nutrition 2006 Jun;25(3 suppl):262S-270S.

2. Cook NR et al. Joint effects of sodium and potassium intake on subsequent cardiovascular disease: the Trials of Hypertension Prevention follow-up study. Archives of Internal Medicine 2009 Jan 12;169(1):32-40, pmid.us/19139321.

3. Yang Q et al. Sodium and potassium intake and mortality among US adults: prospective data from the Third National Health and Nutrition Examination Survey. Archives of Internal Medicine 2011 Jul 11;171(13):1183-91.

4. Ellison DH, Terker AS. Why Your Mother Was Right: How Potassium Intake Reduces Blood Pressure. Trans Am Clin Climatol Assoc. 2015;126:46-55. PMID: 26330658; PMCID: PMC4530669.

5. Antonio Delgado-Almeida. Reinterpreting Sodium-Potassium Data in Salt-Sensitivity Hypertension: A Prospective Debate. 3 Jan 2005. Hypertension, Vol 45, No 2.

6. Oberleithner H, Callies C, Kusche-Vihrog K, Schillers H, Shahin V, Riethmuller C, Macgregor GA, de Wardener HE. Potassium softens vascular endothelium and increases nitric oxide release. Proc Natl Acad Sci U S A. 2009 Feb 24;106(8):2829-34. doi: 10.1073/pnas.0813069106. Epub 2009 Feb 6. PMID: 19202069; PMCID: PMC2637279.

7. Kobayashi J, Ohtake K, Uchida H. NO-Rich Diet for Lifestyle-Related Diseases. Nutrients. 2015 Jun 17;7(6):4911-37. doi: 10.3390/nu7064911. PMID: 26091235; PMCID: PMC4488823.

8. Chatterjee R, Yeh HC, Edelman D, Brancati F. Potassium and risk of Type 2 diabetes. Expert Rev Endocrinol Metab. 2011 Sep;6(5):665-672. doi: 10.1586/eem.11.60. PMID: 22025927; PMCID: PMC3197792.

9. Ferrannini E, Galvan AQ, Santoro D, Natali A. Potassium as a link between insulin and the renin-angiotensin-aldosterone system. J Hypertens Suppl. 1992 Apr;10(1):S5-10. doi: 10.1097/00004872-199204001-00002. PMID: 1619503.

10. Biff F Palmer, Deborah J Clegg. Achieving the Benefits of a High-Potassium, Paleolithic Diet, Without the Toxicity. 3 March 2016. DOI:10.1016. j.mayocp.2016.01.012.