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Potassium dilemma?

Bee

Messages
16
Location
London, UK
One year ago, when I was given high doses of B12 & folic acid, I developed heart failure symptoms – chest pains, shortness of breath, palpitations at the slightest exertion, and arrhythmia. I ended up in the ER. Also I was so weak that I could barely stand without leaning on something; my arms and head felt like blood couldn't pump into them -- especially if I tried to raise my arms. The same symptoms recurred a few months later when I was given B12 injections (along with IV glutathione).

Reading this forum, I understand that this was probably hypokalemia – every time I was given extra B12 & folic acid, it over-drove my methylation. This must have caused a bad shortage of potassium. Around the time of those bad symptoms, my blood tests showed my potassium as 4.3. But I understand that the serum result doesn't show what is in the cells.

The confusing part is, my NutrEval results (from mid-August) show that my potassium is on the HIGH side; this is Red Blood Cell potassium. The range is 2,220 - 3,626 and my result is 3,551. I wasn't having the cardiac symptoms when I had the NutrEval test, so it doesn't show what the value would be at the time of symptoms.

So now I'm confused and afraid to supplement with potassium... I understand that the symptoms of both hypo- and hyper- are similar, but how come my potassium is HIGH? I haven't been eating any high-potassium foods. The cardiac symptoms always happen when I over-drive my methylation, so it should match the “hypo” scenario.

The NutrEval test was done after stopping all supplements for 10 days, so my potassium level could have come up during that time, without methylation support. But still, would it go up to the high end of normal?

Is the RBC potassium (as in NutrEval) a reliable marker of potassium in the cells? Any reason why over-methylation would cause high potassium, instead of low? And finally, could the cardiac symptoms be caused by a different side effect of over-methylation, e.g. high sulfur issues? (I am hetero for CBS C699T, but I never have symptoms from eating high-sulfur vegetables. But when I'm experiencing these symptoms, eating meat makes them worse).

Thanks for any insights!
 

Victronix

Senior Member
Messages
418
Location
California
My guess is that because potassium levels can change very rapidly, it likely accounts for some of your symptoms.

I would recommend trying a low dose of B-12 (1000 or 500), making sure you are also taking as many of the supporting nutrients that Fredd recommends -- Bs, minerals, etc. -- and make sure to supplement with a lot of food potassium to see if that helps. If you eat high-potassium foods you cannot overdose. If you find those help -- several bananas per day, coconut water, dates, etc., then you could try moving onto elemental potassium powders, like potassium gluconate, as you increase the B-12 and add in mfolate.

Not everyone may agree with my process, but that's what I'd do.
 

Bee

Messages
16
Location
London, UK
@Gondwanaland – It could be ammonia... I thought it was ammonia at first, but that doesn't explain why I didn't have brain symptoms, like brain fog, confusion etc, while I had the heart problems. I've had high ammonia episodes where my brain was severely affected, without heart problems.

But I've just done some quick research, and it seems that ammonia, heart failure, and potassium are connected. Though the cause & effect isn't clear:
  • This says high ammonia may be due to HYPER-kalemia: "Hyperammonemia during rest periods is a dysfunction in heart failure (HF). [...] Hyperkalemia in response to physical exercise is common in HF and may contribute to a contractile inefficiency in type II fibers, leading to early fatigue. We tested the hypothesis that during resistance exercise of high intensity and low volume, this disorder of ammonia metabolism would be more intense, due to the hyperkalemia present in HF. […] These findings suggest that hyperkalemia may play an important role in the disorders of purine metabolism (i.e. ammonia disorders)." http://cpr.sagepub.com/content/early/2012/09/05/2047487312460520
So it's still puzzling because I can't tell the CAUSE from the EFFECT in my case – was the root cause ammonia? Or was it a potassium imbalance (low or high) that led to possible ammonia & heart failure?
 

Bee

Messages
16
Location
London, UK
@Victronix – Thanks for the analysis – that helps. It's a very good idea to try the food-based potassium, and see what changes. I need to go very carefully in case I have high potassium.

I wish I could try the B12 experiment, but I'm afraid it isn't safe for me right now. Ever since I was given the high doses of B12 (orally and several injections), I am extremely sensitive to anything that stimulates my methylation. Along with heart symptoms, this can cause severe brain problems and suicidal panic, depression, etc that can last for weeks. I've recently had an episode like that...it also caused some chest pain and shortness of breath, which is why I'm trying to understand what caused my heart trouble in all these instances.

In your knowledge, could increased methylation possibly cause hyper-kalemia? Could it raise my potassium, somehow?
 

Bee

Messages
16
Location
London, UK
@Gondwanaland, thank you for the links. Wow, a lot of good information here.

Your suggestion about balancing electrolytes is extremely useful for me. I think you are right -- I need to do that before anything else. I am now realizing that this is critical.

Question: When you said that Vitamin B1 can help to gauge potassium needs, can you explain this? How would I use B1 to understand my potassium needs?

Thank you!
 

Gondwanaland

Senior Member
Messages
5,092
Vitamin B1 improves potassium absorption (using magnesium). I think one will notice when absorption rates normalize. Sorry, I can't say anything more specific, I have been doing self experimentation all along...
 

Bee

Messages
16
Location
London, UK
Vitamin B1 improves potassium absorption (using magnesium). I think one will notice when absorption rates normalize. Sorry, I can't say anything more specific, I have been doing self experimentation all along...

Thanks for this info. That's interesting; I will look into it more.

Yeah, self-experimentation sounds familiar. Doing the same here!
 

Victronix

Senior Member
Messages
418
Location
California
@Victronix
I wish I could try the B12 experiment, but I'm afraid it isn't safe for me right now. Ever since I was given the high doses of B12 (orally and several injections), I am extremely sensitive to anything that stimulates my methylation. Along with heart symptoms, this can cause severe brain problems and suicidal panic, depression, etc that can last for weeks. I've recently had an episode like that...it also caused some chest pain and shortness of breath, which is why I'm trying to understand what caused my heart trouble in all these instances.

Understandable. I definitely felt almost suicidal depression when I stopped B-12 cold turkey for the first time and that triggered panic . . . it's terrible for people like us who are prone to that to get through this stuff. And to some extent you have to make decisions about alternate methods, or stopping and waiting until you have a different outlook, etc.

I have not been able to do methylfolate -- I tried for a whole year. Each time my body would adapt to the amount I was taking, then things would get worse again, so I would increase the dosage, and then have to increase the amount of potassium, and things would be great for 2 weeks, then things would get worse again, the same cycle month after month . . . finally I could no longer manage the potassium needs and had to stop. That took months to recover from after stopped, even though I tapered it down for weeks.

Now I just try to have high folate foods as often as I can.

I've never had that level of difficulty with B12, luckily.

It's likely if you have a big response it's because you need it. People who don't need B12 will take it and say, "so what?" They feel nothing. It's amazing.

In your knowledge, could increased methylation possibly cause hyper-kalemia? Could it raise my potassium, somehow?

No, it cannot, as far as I know. I know the feeling of being paranoid about hyperkalemia because I had that too, and that really delayed my taking the potassium gluconate. It was an incredible struggle for me to get past my fears. Once I did take it, I felt much better, and got my levels checked a few times and realized that it was barely increasing my normal potassium levels.

At a certain point you realize that it's typically more dangerous to get too low in potassium than it is to get too high, and much much easier to get too low than it is to get too high.

It helped me to be able to see several instances of my potassium levels in lab tests for comparison with different things I was doing. That was a tangible way to prove to myself I was not taking too much.
 

Bee

Messages
16
Location
London, UK
@Victronix , thanks for sharing this. I can relate to your experience with the self-treatment – that cycle of adding something, waiting for your body to adapt, then getting symptoms and doing more trial & error. Your methylation must have really escalated as you increased the methylfolate, which is similar to what happened to me with B12. The symptoms were brutal.

It helps to hear about your experience with potassium. I feel that my condition must have been low potassium – that's the most logical explanation. And by the severity of my cardiac symptoms, I'd guess it was *very* low. But the NutrEval test showing high potassium surprised me & threw me off. I wasn't eating any potassium foods prior to the test, so it's puzzling how I have high potassium. I think more lab tests will be the best thing for me to have certainty.

It helped me to be able to see several instances of my potassium levels in lab tests for comparison with different things I was doing. That was a tangible way to prove to myself I was not taking too much.

Which tests did you use to monitor your Potassium levels? Was it Red Blood Cell? Or serum / plasma / something else?

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