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Potassium still required with gentle methylation protocol?

Kitsune

Senior Member
Messages
136
Hello, I guess this is mainly a question for those who have had experience with supplementing potassium on a methylation protocol, especially if you're taking smaller amounts of methylfolate and methylcobalamin (something more similar to Rich's than Fredd's protocol). I've been trying to balance everything out for myself and get into a normal routine with my supplements, but am still struggling, particularly with potassium.

I am taking Swanson's Ultra High Potency Activated B-complex, one a day. It contains 50mg of the main B-vitamins, plus 800mcg methylfolate and 500mcg methylcobalamin. On top of this, I take Solgar's sublingual mB12, 1000mcg. So that's a total of 1500mcg mB12 and 800mcg methylfolate a day. Then a few other supplements in generous amounts - vitamin C, magnesium citrate, fish oil, and Himalayan sea salt. I've tried taking larger amounts of mB12 and methylfolate, plus other methylation supplements, but have always come back to this basic core that seems to work better for me than anything else. Higher doses of B-vitamins are overstimulating for me.

What I can't work out is how to fit potassium in. While I was taking larger doses of methylation supplements, I had to supplement potassium; I'm one of those people who ends up getting an insatiable need for the stuff when I go too high. But with the doses of mB12 and folate I'm taking now, I didn't know if I'd even have to supplement potassium at all. I experimented with this for a while, using a potassium gluconate powder, and felt I was fluctuating between hypokalemia and hyperkalemia symptoms, sometimes not being able to tell the difference. The most I ended up taking was a 800mg dose in the morning, and the same again with dinner. I ended up feeling irritable and overstimulated, and got occasional heart flutters and a slight headache, as well as mild digestion problems.

Finally I stopped taking it altogether the past couple of days, thinking surely I'm getting enough from my diet, and can't have much of an extra need from the small doses of supplements I'm taking. I ended up feeling 'normal' again in the sense that the irritability went away and I could cope better with stress. However, the overall body-ache that I had been feeling fairly regularly for the past several months came back with a vengeance, and I was in quite a lot of pain yesterday that even NSAIDs didn't address. Then my heart flutters came back, and I had a pretty rough night of feeling unwell and not being able to sleep much, and this morning I was having palpitations. Eventually I decided that this was probably due to an electrolyte imbalance, and since I take generous amounts of sea salt and magnesium, the only missing puzzle piece seemed to be potassium. So at about 10 a.m. I took an 800mg dose of the gluconate powder, and it has indeed stabilised my heart. At the moment I feel quite relieved.

What I'm wondering now is how on earth to arrive at a routine of dose and timing of potassium that will work for me, without giving me hypo or hyper symptoms. It looks like I do need to supplement, but maybe not as much as I was? And yet I took 400mg last night before bed (gluconate tablets rather than powder, as it was less faff at midnight), and it didn't seem to help. The larger dose of the powder this morning did. It's very confusing, especially since before my recent experiments with methylation, I had been taking the supplements I listed above for a year or more without these problems, save the generalised achiness. It's almost like my body got used to the extra potassium and is saying, 'Keep giving me that, I like it'. I just don't know.

Any ideas are welcome, thanks.
 

cman89

Senior Member
Messages
429
Location
Hayden, Idaho
This is actually a great question, and the short answer is, yes you should probably be on some sort of potassium no matter what. There are many symptoms that can mimic hypokalemia, but what you want to do is eliminate the ones that are truly due to the Potassium issue. On the other hand, you probably wouldn't need to be taking massive amounts of the stuff, just enough to keep it in your system to prevent an electrolyte bonk. Ive tried to go without it, and symptoms always pop up in some way or another
 

cman89

Senior Member
Messages
429
Location
Hayden, Idaho
Keep in mind that even "gentle" methylation regimens involve taking more B12 than is a dietary average, so the potassium requirements for the average bub would not apply
 

Mary

Moderator Resource
Messages
17,335
Location
Southern California
@Kitsune - It's generally not recommended to take a large dose of potassium all at once, which seems to be what you're doing. 800 mg. is a lot to take all at once. What works for me is to take it throughout the day in divided doses. I take some with breakfast, lunch and dinner, as well as before bed. Yeah, 4 times a day, but it works.

I also drink low-sodium V8, which has 900 mg. in an 8 oz. glass.

I think dividing up your doses will help prevent both hyper and hypokalemia. The 400 mg. may not have worked for you because you were too depleted. However, you have to remedy potassium depletion gradually - it's not good to try to do it all in one dose. I've read that taking a large dose all at once is difficult for our bodies to process and can cause problems, and the large doses could be causing hyperkalemia symptoms, because your body can't properly absorb or use a high dose all at once, when in fact you may be hypokalemic. I hope this makes sense!
 

Kitsune

Senior Member
Messages
136
Thank you both - this all makes good sense. I have been dealing with a horrible headache all day, and my heart is acting up again, so I need to get this sorted. My last-resort option would be to discontinue the extra 1000mcg sublingual B12, but I've been taking that for over a year and it's always felt like it gives me more energy and motivation, so if I can I'd rather remedy these other problems.

cman89, can I ask how much potassium you take, and when?
 

cman89

Senior Member
Messages
429
Location
Hayden, Idaho
Thank you both - this all makes good sense. I have been dealing with a horrible headache all day, and my heart is acting up again, so I need to get this sorted. My last-resort option would be to discontinue the extra 1000mcg sublingual B12, but I've been taking that for over a year and it's always felt like it gives me more energy and motivation, so if I can I'd rather remedy these other problems.

cman89, can I ask how much potassium you take, and when?
I take a varying amount, but roughly 300-400 milligrams in the morning. That is usually enough for me unless I can certainly feel symptoms, then ill take some in the evening as well.
 

Kitsune

Senior Member
Messages
136
OK, having stabilised for now, I think I'm going to try taking 200mg 4 times a day. I already take my magnesium at those times, so it should fit right in. Here's hoping :)
 

Kitsune

Senior Member
Messages
136
OK, I'm really struggling to work out how to do this. I think it's worthwhile making the effort, because when I seem to get the dose right, I have more energy and my mood is much improved - that's enough for me to keep trying. But I don't think I've ever had this much trouble establishing a routine with a particular supplement before.

I tried potassium chloride powder, but it made me feel pretty bad. I already have plenty of sea salt in my diet, so I assume I don't need the extra chloride, which may have been throwing my electrolytes off balance. I'm taking gluconate now, a mixture of powder and tablets depending on how convenient it is to mix it up in a glass.

I don't seem to get much of an effect from a 200mg dose. Yet when I take 400mg, I can end up with symptoms after a couple of hours, as if it's too much all at once (or as if my body is crashing for some reason I don't understand). I fluctuate from feeling like I'm getting hyper symptoms to hypo symptoms, and often can't tell the difference because they are so similar. Both, for example, seem to give me fatigue and a fluttery heart.

Yesterday I had a 400mg dose at about 3pm. Didn't supplement again that day, though I was having some mild symptoms overnight that continued into this morning. This morning I took 200mg, then 200mg with lunch, but mild symptoms are still persisting. I intended to take another 200mg with dinner, and possibly 200mg before bed if I felt I needed it. But frankly, I don't know what I need - I'm confused! Surely these can't be hyper symptoms if I've only supplemented the equivalent of a banana today. I'm not eating huge amounts either, as I'm trying to lose weight, so I know I'm not getting massive amounts of potassium through my diet.

Maybe I should look at taking a form other than gluconate? I was reading a thread here that said it raises insulin levels - though I think this is naturally what potassium is supposed to do anyway through its action on the pancreas. If I take enough potassium, it not only gets rid of cravings but helps dampen my appetite, which are no unwelcome things. Hmmmm, just don't know what to do.

Added in edit
Not long after I posted this, I started getting a fluttery heart that was progressing slowly into palpitations, with increasing fatigue and low mood. I took 200mg of potassium at about 5pm, but as usual that didn't have much effect, so I took 200 more, and that did. That took me to a total of 800mg of supplemental potassium for the day.

It's now 5 hours later, having had my dinner about an hour after that last dose of potassium. I don't think there's any reason why I should start getting hypo symptoms after all that, but I feel a bit jittery, my heart is starting to flutter again, and I think my body has been stressed for most of the evening (I won't go into all the symptoms that tell me this, but after over a decade of them, I know). So something's still not right; but I suspect that if I take more potassium, I'd be in for a difficult night.

It's almost as if the larger (400mg) doses of potassium are giving me a 'hit' or a 'spike' or some kind - increased amounts of a substance (serotonin? aldosterone?) that I'm low in, maybe? And after a few hours I seem to crash somehow. That would explain these weird effects, which would be caused by an effect of the potassium rather than the potassium itself. The problem is, if I just give it all up, eventually I'll get the hypo symptoms (if that is indeed what they are) coming back until my heart is in a terrible state. I seem to have begun something somehow that I can't end, but can't work out how to deal with either. It's kind of scary.

Does anyone have any suggestions, or should I try starting a new thread? I've googled and googled this, but can't seem to find any info other than the usual hyper and hypo stuff. It's as if this simply hasn't ever been researched.
 
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Kitsune

Senior Member
Messages
136
It kinda feels like I'm on my own with this, but for the benefit of anyone reading, I thought I'd post one more update. I think I've levelled things off now, though how much potassium I'm going to need in a day still seems to require some guesswork, as it can depend on whether I have any larger-than-usual meals. But I'll get there, I'm sure.

My guess as to why I got into difficulties is that the doses I was initially taking were too large. When I was on Fredd's protocol, I could take potassium like it was candy, and it didn't seem to matter. But now that I'm having lower amounts of mB12 and methylfolate, I obviously have to be more careful.

I've read that when there's an excess of potassium in the bloodstream, the body releases aldosterone to clear it out into the kidneys and increase sodium absorption, which of course aims to keep the body's electrolytes in homeostasis. Now, I know I have adrenal insufficiency; the symptoms alone make it obvious, though years ago I also had saliva cortisol tests that confirmed it. So if I do something that forces my body to make a lot of an adrenal hormone at once, I feel much better for a time, and then crash and burn as the hormone leaves my system, which is wanting more, but will not get it. This, as many are aware, happens with any kind of exciting activity, not just the ones that are upsetting. My daughter got me playing a computer game called Agario for a time, which I found very exciting and rather addictive - but after the initial rush wore off, I would be left feeling quite poorly. Even short sessions with the game were making me ill, and I had to stop altogether.

I can only assume that something similar was going on with doses of supplemental potassium of 400mg or more, often on an empty stomach. That was presumably enough to trigger my body to produce aldosterone to start clearing it out of my bloodstream. I never meant to give myself 'highs' by doing this, not to mention the resulting crashes a couple of hours later. The really annoying thing is that the 'highs' reminded me what it's like to feel normal, or close to it, after 12+ years of this chronic illness. The leaden feeling left my limbs and I actually - actually - felt like I could burst into a run. My libido came back. My depressed mood vanished. My mind was sharp. I guess those of us who have been ill for a long time occasionally get little glimpses of wellness like this for whatever reason - an hour, a day - and it's so hard to let them go. But I knew that I was stressing my system, and would need to normalise things somehow if I wasn't to worsen my condition.

After more experimentation, I am now taking no more than 200mg of supplemental potassium (gluconate) at once, with doses at least 2 hours apart, even if I feel like I need more. If I keep taking it over time, the hypo symptoms go away, though I need to make sure that hyper symptoms don't then kick in. I think I'll probably end up with a total of about 1,000mg a day on average. I wish I didn't have to bother with this at all, but I do think the potassium helps me, even if I'm not getting the 'highs' anymore. My mood is still better, I'm not getting the overall body ache, and I'm not craving sugar like I was. That's something, anyway.

I hope more research is done on this so that people in this situation don't have to feel like they're making wild guesses in how to treat themselves, but I guess it's a fairly specialist topic - 'potassium supplementation in chronic fatigue patients with adrenal insufficiency who are on a methylation protocol'. LOL. Anyway, fingers crossed, I'll keep trying.
 
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Eastman

Senior Member
Messages
526
I've read that when there's an excess of potassium in the bloodstream, the body releases aldosterone to clear it out into the kidneys and increase sodium absorption, which of course aims to keep the body's electrolytes in homeostasis.

This is the reason I try not to supplement with potassium unless I think I really need it. I only supplemented potassium for a short period after starting the methylation protocol, although I'm now considering restarting supplementation.

I was also wondering whether you have a lab reading for your potassium level. While not always reliable, it might give a clue to your status.
 

Kitsune

Senior Member
Messages
136
The message I see most often about this is that if you're taking any methylation supplements, it's a good idea to either eat extra potassium or supplement it. The advice I've come across for CFS in general, however, is not as clear. I've read that potassium can be low in CFS, but that if you have adrenal fatigue you can have high potassium and low sodium. In which case, a bit of trial and error to see what works for you might help. I've found that for myself, 200mg of supplemental potassium, even on an empty stomach, does not give me the high followed by the crash, though larger doses do.

As for a lab test, I've had blood tests for other things in the past, and things like potassium were checked as routine, though I didn't pay any attention at the time; I just know the reading couldn't have been too extreme either way or it would have been flagged up. The problem here is that amounts can fluctuate a lot throughout the day, and too often it seems that the level of any substance in the bloodstream does not necessarily reflect what's in the cells. You might be ingesting a lot of nutrients, but if your system can't absorb them, you will still end up with deficiency symptoms. I don't know how true this is for potassium in particular, but I think it's probably best for me personally just to be guided by my symptoms.
 

caledonia

Senior Member
Are you also dividing your mag up into 4 doses and taking it as the same time as the potass? This works well for me.

Mag and potass work together.

At present I can get away with dosing sodium whenever I feel like I need it. Or if my adrenals are stressed and I need a larger amount, I also dose it 4 times a day along with the mag and potass.
 

Eastman

Senior Member
Messages
526
As for a lab test, I've had blood tests for other things in the past, and things like potassium were checked as routine, though I didn't pay any attention at the time; I just know the reading couldn't have been too extreme either way or it would have been flagged up.

This reminded me of the time I had my last blood test, it was for complaint of numbness in my extremities. The result for the blood test came back showing a serum b12 reading of 175, with the reference range being 145-637 PMOL/L. The doctor attending to me looked at my result and sent me home, saying that I was fine.

The problem here is that amounts can fluctuate a lot throughout the day

Do you mean the amount of potassium fluctuates or the symptoms fluctuate?

too often it seems that the level of any substance in the bloodstream does not necessarily reflect what's in the cells. You might be ingesting a lot of nutrients, but if your system can't absorb them, you will still end up with deficiency symptoms. I don't know how true this is for potassium in particular, but I think it's probably best for me personally just to be guided by my symptoms.

Agree that symptoms are probably most important. But as you said, trying to get the right dose has been a problem for you, so you never know, a little more information might prove useful.
 

Kitsune

Senior Member
Messages
136
Are you also dividing your mag up into 4 doses and taking it as the same time as the potass? This works well for me.

Mag and potass work together.

At present I can get away with dosing sodium whenever I feel like I need it. Or if my adrenals are stressed and I need a larger amount, I also dose it 4 times a day along with the mag and potass.

I seem to be able to have quite a lot of sea salt too; I always have a teaspoon in water first thing in the morning, though I'm OK to skip it if I'm away. I tried adding a little salt to the dissolved potassium gluconate I've been taking, but it didn't seem to make any difference.

Thanks for the advice about magnesium. I did happen to come across some mentions of it working in synergy with potassium. By now I've fiddled with dose amounts and timings, and tried taking the potassium at the same time as I take my magnesium citrate, which doesn't really seem to matter one way or the other - but I certainly wouldn't be without the magnesium, and have taken it for years - 200mg with each meal, plus another dose at bedtime.
 

Kitsune

Senior Member
Messages
136
Just for the record, I seem to be 'ticking over' OK on a regime where I take 200mg potassium gluconate 6 times a day. I already take my vitamin C at these times, so it's not a problem to remember to take the two things together.

It would be nice not to have to take so much potassium, though, but deviating from this pattern hasn't worked very well so far. If I miss even one dose, I can feel it. I tried missing out my 10 a.m. one today and had a nap. When I woke up at 11:30, I felt really sluggish, my brain didn't want to function, and I was craving sugar. After taking the potassium dose I missed, I gradually felt better.

I read somewhere that potassium helps regulate blood sugar, so maybe that's what it's doing for me. I do find it a bit easier to resist eating sweets than I used to and don't feel so bad between meals. The thing is, I'm on the Paleo diet; while I don't follow it to the letter, I've always done well on it when I can stick to it, and it tends to heal any blood sugar issues I have. I eat nutrient-dense meals that keep me full - though I suppose breakfast and lunch tend to be on the light side for me, and I cook and eat a nice dinner. But why I am now at a point where I can't miss a dose of potassium mid-morning without feeling so rough, I don't understand. Maybe I should just be grateful that I seem to have found a regime that seems to work for me. I have other symptoms on occasion and I don't know if they're maybe due to the potassium doses, but it looks like I'd better stick to this for now and see where I go with it. Thing is, I don't actually feel that much better than I usually do; just not in crisis anymore.

What I would really like is to not have to worry about any of this and live a normal life. Wouldn't we all :)

Added in edit: Come this evening, I'm reminded that every day, a little more, some old symptoms are creeping back that I haven't seen in a long time. Feeling cold a lot of the time, especially at night (when I first got ill, it was so bad that I'd go lie in the bathtub so that the water would warm me up - I know this is probably thyroid, but I've been down the T3 supplementation route etc). Feeling anxious/jittery when the sun goes down. Evening sleepiness/disrupted circadian rhythms despite taking melatonin at 3 a.m. every night, which usually helps with this. I'm wondering if the potassium supplementation is still stressing my system, and with the adrenal fatigue that's always bad news. I think I'm either going to have to get by with less somehow, or stop taking the 1000mcg tablet of mb12 every morning and remove the need for the extra potassium. (My B-multi still has 500mcg, plus 800mcg methylfolate, which wouldn't leave me completely without). It seems like no matter how you try to balance things with this illness, you end up throwing something out of whack. I guess I'll continue to experiment and then check back in when I've managed to stabilise things again.
 
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Kitsune

Senior Member
Messages
136
It's a bit embarrassing to have played this out in such a public way, but I guess many of us have been here before, publicly or privately. To get back to the title of this thread, I don't think I have a 'need' for extra potassium at all - at least not on a regular basis. Even with doses of 200mg, I seem to have been stimulating my adrenals and then crashing them, and the crashes were the symptom I thought might indicate I needed more potassium. The thing is, when I was on Fredd's protocol, my need was genuine, and I never got those crashes, probably because I could never take enough potassium to satisfy whatever need the methylation protocol was causing.

So while Eastman decided he would not try supplementing potassium, I went there and regretted it. I wish I hadn't, but I hope I'll be wiser for the experience. Maybe supplementing potassium when you have adrenal fatigue just doesn't work, at least in my case. I wish I could find a natural way to stimulate aldosterone production (or cortisol, for that matter), but I've tried to many different things over the years, and I've decided I probably need to be free of some enduring stresses in my life (which will take a long time, if it can ever happen at all), because supplements and diet etc. will only do so much. These are things that don't seem to stress other people quite so much - many actually enjoy them - and I can't understand why they've done this to me. I've had a lot of counselling and done a lot of emotional learning and healing, but I can't be anything other than who I am either. Though I will still carry on wondering if the root of my illness is more emotional or more physical.

I've stopped all potassium supplementation and I'm getting on OK. I've healed from worse; I've been through withdrawal from antidepressants and corticosteroids. I'm back to square one - just trying to get on with life, though part of me is always wanting to hold on to some hope that if I can discover and research some other promising thing, maybe it will help. I need to believe that things will get better.