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Potassium questions

boo85

Senior Member
Messages
178
Hi all

I've been getting bad muscle pains in my legs at night, along with a bad headache and evenbad delirium (very scary waking up after an hour with extreme anxiety and being 'out of it.') this is after starting regular B12 tablets again to treat depression and nerve pain.

The headache/panicked feeling only comes a few days after starting regular B12 and always from 8pm - 11pm. My suspicion is that is when my body starts making new blood cells. It is pumping out new cells when my body is winding down for the night, because of the B12' but doesn't have enough potassium to draw from which cause hypokalaemia. After I had my first B12 injection in a long time, I felt really sick and panicked and out of my mind that night. This usually only happens in the evenings.

What do you think?

I also have general muscle weakness during the day since starting B12 again.

I take 5mcg (yes, micrograms, a very small amount, I know) B12 in an iron/ B12 multivitamin every 2 days, along with an injection of 1000mg of hydro B12 once per month. So very low and slow because of start up symptoms.

My potassium levels were 4.6 in july 2014 (2 months ago.) this was before any potassium supplementation.

I can also give results to a lot of other recent tests too.

I've also been craving and subconsciously choosing dinners/food high in potassium, like potatoes, bananas, greek yogurt, nuts, cheese, spinach etc I would like to buy coconut water but it's too expensive... I think this is another indicator of low potassium, the cravings.

My description sounds like low potassium, yeah?

So...

1. I have potassium chloride salt and it says that on the back of the container that 1/8 of a teaspoon equals 1 gram of potassium chloride. So if I take that amount, would that equal to 1000mg of the potassium I'm needing.

If so, I'm thinking about spreading out 3 x 1000mg doses of the salt throughout the day with water.

2. What's the maximum dose of potassium per day you've taken yourself or heard of someone on this forum taking? I know there's no real upper limit to potassium RDA, but I'm really scared of overdosing, especially considering the start up symptoms of B12, ironically probably caused by lack of potassium anyway.

3. If my body reacts this strongly to B12, with the start up symptoms, creating new blood cells rapidly and need for potassium, does that mean I was/am very deficient of B12? Does that mean I am on the right track by taking it even if it throws my body out at first?

Thank you everyone!
 
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Mary

Moderator Resource
Messages
17,321
Location
Southern California
There is an upper limit to the potassium RDA - I've read the normal range is 3000 - 4000 mg. a day. I don't think it's a good idea to take 3000 mg. a day - that's a lot. Do a search on this board - Freddd has written about this and is much more knowledgable than me on how to take potassium.

When I started Freddd's B12 protocol (methylcobalamin and methylfolate), initially my energy picked up for a couple of days - it was great - and then it tanked, I became very tired and lethargic, and realized my potassium levels had dropped. I titrated up to 1000 mg. a day over a couple of days, the fatigue and lethargy went away, and after several days I tritrated back down to 400 mg. a day of potassium gluconate which I've been taking for a couple of years with no problem.

It's best to start gradually. If 1/8 tsp. is 1000 mg., then I'd try dividing that in quarters, and take 2 doses, for a total of 500 mg., a day and see how you do. And if that helps but not enough, then add a little more. 1000 mg. in 1/8 of a teaspoon sounds like a lot, but if that's what the package says, then I'd go by that.

Have you read about Freddd's B12 protocol and have you tried methylfolate?

Actually I just did a very brief search for posts by Freddd re potassium, and he's taking a lot more than I am, but he emphasizes you have to titrate up and see what works for you. Here's one link: http://forums.phoenixrising.me/inde...dosage-on-freddds-protocol.32005/#post-494124

and there are many more, so I would do some more reading on Freddd's posts.
 
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ahmo

Senior Member
Messages
4,805
Location
Northcoast NSW, Australia
Here are a few links I have. Sorry, it's a document dump, I can't sort thru it. Also, in my signature I've compiled a Guide to Freddd's Protocol. there's some K+ info there.
http://howirecovered.com/understanding-potassium/

It is obvious that if potassium supplements are given, it is very important that the vitamin B-1 intake must be adequate at the same time, and one third of heart disease patients are deficient in thiamin [34].

An ideal ratio of total daily intake (diet and supplements) of potassium to sodium is said to be something like 5:1. But, a low potassium to sodium ratio is the norm these days – especially if you compare that to the ratio that researchers believe humans evolved on… potassium sources were plentiful and the mainstay of diet, whereas sodium was very scarce. Paleo man probably had at least a 10:1 potassium to sodium ratio in his diet, and many put that estimate much higher. So even people who eat a relatively healthy diet these days aren’t necessarily immune to the effects of a lower ratio – given the availability of sodium, and the relative scarcity of high potassium foods from plant sources…, together with all the other influences that affect our acid-alkaline balance and electrolyte balance in modern life (i.e. toxicities).

Now, even getting to a ratio of 2:1 or 3:1 is better than the average human who eats a lot of processed foods. Of course, there are many other factors besides this ratio to consider – including the source of potassium in food and whether it forms bicarbonates and is therefore alkalizing (this would be the potassium from plant sources, especially leafy greens) – or whether it makes chloride and is therefore acidifying (from protein sources of potassium), so this relates to our pH balance.

If a person is very deficient (at the cell level), then it can take a long time for general healing to occur… maybe 6 months to a year or more. However, if you’re supplementing – say 1 gram with each meal (~3 grams/day) – then you should be able to correct the deficiency state in a matter of weeks, assuming you lower sodium appreciably and otherwise eat a decent diet and you’re getting enough magnesium, taurine etc (according to Wikipedia, “http://en.wikipedia.org/wiki/Taurine, while keeping excessive sodium out” so, supplementing with taurine – up to 3 grams per day – may be helpful).

Medications, and other things that might cause potassium loss or create acidity (like toxicity from metals and chelating) have to be taken into account as to how much potassium is right for you, and whether you need extra bicarbonate to neutralize acidity. It’s ideal to get our potassium from food of course, but it seems that can be kind of hard to do, especially for someone dealing with toxicities.

Hence, supplementing with potassium chloride and potassium bicarbonate as indicated can help improve our K to Na ratio, and overcome the effects of “poor” dietary influences, medications, toxins etc. It’s worth considering that the author of this book suggests that, “our bodies don’t store potassium”…but we need to continually take in a lot of it for healthy metabolism, nerve function etc.

What becomes pertinent is our ability to regulate the level of potassium in serum and in cells… Which leads to the topic of aldosterone – which is essential for regulating serum potassium… The question being, is it possible one might be low in aldosterone at least in part because we are functionally deficient in potassium? And will slowly improving this ratio of K to Na allow our aldosterone levels to rise along with potassium intake?

The info in this book suggests this is generally this case (short of permanent atrophy of the part of the adrenal gland that produces aldosterone – or I suppose secondary adrenal insufficiency will prevent the appropriate signaling for the release of adrenal hormones, no matter how much potassium is available). Regardless, one shouldn’t drastically increase potassium intake without keeping an eye on our serum potassium to ensure that our body is handling it properly – as Andy has told us.

If we don’t have adequate aldosterone, we can go high on serum potassium… And there are other factors too, certain medications and kidney function factor in. By the way, the same could apply to cortisol – that is, secretion may rise as potassium is increased.

http://forums.phoenixrising.me/inde...entation-needed-in-methylation-treatmt.18670/ Why is Potassium Supplementation needed in Methylation Trtment: Response from Rich VanK

http://forums.phoenixrising.me/index.php?threads/methylation-and-fungal-issues.28756/

whodathunkit: my understanding is that as mitochondria begins producing ATP again and cells start waking up, this becomes a potassium problem because essentially cells start soaking up available potassium. This can tank your potassium levels by increasing the overall demand for the mineral. Essentially, because a lot of cells start waking up and using it, suddenly there isn’t enough to go around. Think about a restaurant that typically serves 100 people per night. They plan for this, because it’s the norm. That restaurant is our underfunctioning bodies, with the typical food plan being the normal amount of potassium we use. But what happens if 300 people suddenly show up at the restaurant demanding food, or even if those 100 regulars suddenly demand double portions (i.e., more cells start needing more potassium)?

The restaurant (our body) runs out of food (potassium).

I have been formally diagnosed with adrenal fatigue by my Dr., and the increased potassium needed for methylation protocol hasn’t had any bad effects on me at all. Quite the opposite...it helped. In adrenal problems it’s not necessarily that we take in too much potassium, it’s that we don’t use it properly and thus develop an imbalance between sodium and potassium. “Salt loading” helps us correct this imbalance. I don’t understand it all completely, but now I do see that correcting the balance by limiting potassium intake and increasing sodium intake is just a “bandaid” that helps cover the dysfunction of the physiologic processes that drive our endocrine systems to work properly.

I’m currently not salt loading any more, although I don’t limit salt, either, because it’s a valuable mineral, as well. I just salt food to taste and all seems well.

Interestingly, salted water used to taste like heaven to me. I’ve been drinking it for several years. Now I’m kind of “meh” about it

http://forums.phoenixrising.me/inde...ssium-deficiency-share-your-experience.25568/

I’ve done a little research, and the potassium thing seems to be unique to ME/CFS patients. Yasko doesn’t mention it, and Rich Vank wasn’t aware of it until Freddd posted about it. A lot of people on here trying Freddd’s protocol have posted about needing potassium supplementation, but I haven’t seen this on Yasko’s forum.

Potassium, glucose(coconut water being sweet because of glucose), and insulin work together. I wanted to link to a site that said this in the google search, “Insulin also increases the permiability of many cells to potassium, ...” but the link didn’t work for me. Potassium has to get inside the cells to do any good. You can google those three together, what an eye opener! It might have something to do with sodium saturated tissue, too.

Carrot juice has twice the potassium of coconut water, if you can get it. And is delicious

Magnesium and potassium. Inter-relationships in cardiac disorders.

Magnesium and potassium are the 2 major intracellular cations. The intracellular concentrations of these 2 ions appear to be closely correlated, but the existence of a relationship between the plasma concentrations of these ions has been controversial. A major function of potassium is to maintain the excitability of nerve and muscle tissue. (maybe this explains my overstimulation?) Alterations in either the intracellular or extracellular potassium concentration affect membrane excitability by alterations in the resting membrane potential. The critical factor is not the actual potassium concentration in either compartment but rather the ratio of the intracellular to the extracellular concentration. The intracellular concentration of potassium is maintained against an electrochemical gradient by active transport involving an ionic pump mechanism. In this metabolically active ion-pump mechanism the inward transport of potassium is balanced by the outward transport of sodium; this active transport mechanism involves magnesium. The plasma concentration of potassium has been reported to be an important factor in the genesis of cardiac arrhythmias. The arrhythmogenic mechanisms of hypokalaemia, particularly in mild degrees, have not been clearly defined. However, evidence has begun to accumulate that magnesium deficiency may be a critical factor in the cardiac arrhythmias associated with hypokalaemia. Diuretic drugs are recognised as primary agents in the treatment of essential hypertension. In patients on antihypertensive treatment evidence has recently been reported that there is a link between the administration of diuretics and sudden death. In addition to their action on the renal tubular handling of sodium and water, diuretic drugs affect the renal tubular handling of other ions. A well-established complication of therapy with diuretic drugs is an increased urinary excretion of potassium resulting in hypokalaemia. Hypokalaemia and hypomagnesaemia can be induced by the same mechanisms and are often clinically correlated with one another. The reported incidence of hypomagnesaemia is greater than that of hypokalaemia; a significant correlation also appears to exist between the plasma concentrations of magnesium and potassium. A significant inter-relationship between the plasma concentrations of magnesium and potassium and the evidence for a critical role of magnesium in the genesis of cardiac arrhythmias would support the proposal that magnesium should be routinely measured in situations, such as diuretic therapy, that are potentially associated with hypokalaemia.

As an aside, I found this awesome thread, where the different forms & their effects of potassium are debated for those that are interested:

http://forums.phoenixrising.me/index.php?threads/potassium-citrate-vs-potassium-gluconate.21208/


From above pr thread:

As a cautionary note, the reason that you won’t be able to find a potassium pill in higher doses than 99mg is that there is some risk of potassium eroding the stomach lining if it stays in contact with it too long. So a pill of concentrated potassium sitting in one spot and dissolving over time can put that part of the stomach at risk. There is some debate, I believe, over how much is “safe” in most cases.

Any form of potassium should damage the digestive tract if not diluted enough, since it’s the potassium itself that does it. For the same reason, it’s wise to make sure to drink some water right after taking a potassium supplement (and certain other supplement types) to lower the risk of it being stuck in the esophagus and doing damage, or of residue eating away at things down there. It’s great stuff in the right balance, and we need it greatly, but it isn’t easy on some of the body’s systems.

Citrate is alkaline, gluconate is neutral PH, chloride is acidic. Personally, I prefer citrate.

As I read through your comments about the overlapping symptoms between K+ and Mg deficiency I’m reminded of some of they key tenets of orthomolecular medicine. That Potassium and Magnesium are closely dependant and work synergistically (particularly with Zinc) to create a more efficient cellular environment. I think many of us would be able to save a lot of money on wasted potassium supplements if we incorporated this knowledge of orthomolecular medicine. IIRC taking potassium on its on results in increased aldosterone which then simply causes potassium excretion. The solution? Ensure you take some salt with the potassium. You might still get the potassium losing effects of the aldosterone increase but the salt will be retained to lower the excessive calcium which is the usual problem for the elderly and almost certainly those with CFS/ME. When sodium and potassium are increased in the future this lowers the calcium and speeds up cellular function which is what most (not all) need. It takes your body from being a slow oxidiser to becoming a fast oxidiser...

Oh yes, and this has been on my mind a lot lately, Fredd’s experiments with other Bs, and finding that they seemed to overdrive things and made his need for potassium much more intense.

Just checking the forum I see that http://forums.phoenixrising.me/inde...t-failure-fms-cfs-and-minus-100-pounds.25788/:[ http://forums.phoenixrising.me/inde...-failure-fms-cfs-and-minus-100-pounds.25788/]

Finally I discontinued the b1 and suddenly the need for Metafolin and potassium quieted down. . . . The active b12s and folate and carnitine don’t DRIVE these cycles. Biotin, B1, B2 , B3 and maybe pantithine drive these cycles and determine how the deadlock quartet are used.

So I’m considering trying to move to straight methylfolate . . . but probably should do it in stages . . . not thrilled with idea of more changes though, when I’ve finally gotten to a full capsule of mfolate. Dividing up doses is really annoying after months and months of it.
 

Martial

Senior Member
Messages
1,409
Location
Ventura, CA
Ahmo you are like my favorite poster when it comes to finding very unique or sophisticated questions. We should sticky that!

At OP be sure to adequetely cover both potassium AND magnesium. Talk to your doctor first but the RDV of potassium is 4000mg and Magnesium you can take 1000mg transdermally safely.
 

Gondwanaland

Senior Member
Messages
5,092
Muscle spasms/cramps? Seriously? Take sustained-release magnesium. By Jigsaw Health.

I agree with Paulo. I have no more cramps or night anxiety after taking 600mg of magnesium daily. But for me it was tricky to find a form of magnesium I would tolerate.

As you start to produce more ATP your magnesium needs increase exponetially.

And your food cravings sound like magnesium cravings to me.

izzy
 

boo85

Senior Member
Messages
178
Thanks your responses, everyone.

Just to clear a few things up:

I think I made a mistake with the amount of B12 I said I was taking. It's actually only 5 *mcg* per every second day. A tiny amount, I know, but enough to get a reaction and potassium dump.

But I've also been cooking a bunch of chicken livers in ground beef and making hamburger patties from them which delivers about 10 - 20 mcg per serving. Has anyone tried chicken livers? When hidden in other food they taste quite palatable and make me feel better.

I've been taking 2 x magnesium tablets per day for the past 2 months. The ingredients are per tablet: total magnesium 325mg (from oxide -heavy 507mg, and amino acid chelate 150mg), manganese 6mg (as amino acid chelate) and vitamin B6 60 mg.

Previously, I had regularly taken 1 x the above magnesium tablets per day for 3 -4 *years* now. In the past couple of months I doubled it to 2. It works really well for me for muscle pain. If I stop taking it, my legs hurt, so I know it works for me.

In the past month I've also added in a different magnesium tablet: magnesium chelate 500 mg equivalent to elemental magnesium 100 mg. I find this helps with anxiety.

Is this enough magnesium? How much do you usually take when taking B12? When is the best time of day to take magnesium? I usually take them with dinner.

I don't get any tummy troubles from that amount of magnesium at all so could probably easily take more if I need to.

Does @Freddd still post here?
 

maddietod

Senior Member
Messages
2,859
I take magnesium when I start kicking at night. I take potassium when my upper back and neck get crazy-tight, sometimes with headaches.

I take 3-5 99mg tablets of potassium at a time, and wait maybe 20 minutes to see if the tension eases. Eating a banana has never worked for me. I'm not taking B12, so usually 3 tablets once a day is enough. When I was taking B12, I took as much as 5 tablets 4 times a day to relieve the cramping.

Sometimes I don't get a headache, but my brain feels like it's made of cement. Not fluffy like brain fog; dense. Potassium fixes it.
 

aturtles

Senior Member
Messages
129
Location
Seattle, WA
Dear all: I understand that healing requires potassium, but is it also reasonable to assume that if I am getting potassium deficiency symptoms daily while on the Deadlock Quartet (which I am satisfying with potassium, yes) that healing is happening? Or are there other explanations?
 

ahmo

Senior Member
Messages
4,805
Location
Northcoast NSW, Australia
@aturtles
i-dunno.gif
 

aturtles

Senior Member
Messages
129
Location
Seattle, WA
Dear all: I understand that healing requires potassium, but is it also reasonable to assume that if I am getting potassium deficiency symptoms daily while on the Deadlock Quartet (which I am satisfying with potassium, yes) that healing is happening? Or are there other explanations?

In case anyone was wondering, the answer I got when I asked someone pretty knowledgeable about this biochemistry is "not necessarily. There's a lot going on, and potassium deficit even when working the methylation cycle might or might not imply what you call 'healing'".

Right. So. Maybe. Maybe not. Can't say. :)
 

boo85

Senior Member
Messages
178
In case anyone was wondering, the answer I got when I asked someone pretty knowledgeable about this biochemistry is "not necessarily. There's a lot going on, and potassium deficit even when working the methylation cycle might or might not imply what you call 'healing'".

Right. So. Maybe. Maybe not. Can't say. :)

Thanks for that.

I think Freddd has said before that when you suddenly give your body the B12 it has been deficient in for a long time, it tries to create new cells at a rapid rate and that is why potassium drops.

It happened to me a few days after taking B12. I went to bed with a headache and feeling very "out of it" and woke up not long after with delusions and my heart beating so fast it felt like I was going to have a heart attack (which is actually a warning on my hydrocobalamin brochure.)

So my guess it that if you get low potassium symptoms, then you could guess that healing is happening. If you gave B12 to someone who didn't have a deficiency then nothing would probably happen and they wouldn't get hypokalemia because no healing is happening.

How much potassium do you take per day, @aturtles ?
 

aturtles

Senior Member
Messages
129
Location
Seattle, WA
Thanks for that.

I think Freddd has said before that when you suddenly give your body the B12 it has been deficient in for a long time, it tries to create new cells at a rapid rate and that is why potassium drops.

It happened to me a few days after taking B12. I went to bed with a headache and feeling very "out of it" and woke up not long after with delusions and my heart beating so fast it felt like I was going to have a heart attack (which is actually a warning on my hydrocobalamin brochure.)

So my guess it that if you get low potassium symptoms, then you could guess that healing is happening. If you gave B12 to someone who didn't have a deficiency then nothing would probably happen and they wouldn't get hypokalemia because no healing is happening.

How much potassium do you take per day, @aturtles ?

Right. That's what I asked the doctor: does potassium deficit symptoms mean new cells are being created? His answer, above: not necessarily. It could mean any number of things. Certainly, though, it means I need more. :)

I take 4-5 grams a day. Yes, GRAMS. I started with a mix of citrate & gluconate, but i have come to feel that potassium gluconate is better absorbed, so am moving toward that entirely. I buy the NOW brand in powder, put it in a nalgene bottle with good water, shake it, and drink as it occurs to me. When I get foggy-headed, or my heartbeat goes heavy.

I used to worry that taking K+ as needed leading me to this much was too much. I don't worry about that any more. This kidney specialist doctor told me he wouldn't even blink at this amount.
 

boo85

Senior Member
Messages
178
I take 4-5 grams a day. Yes, GRAMS. I started with a mix of citrate & gluconate, but i have come to feel that potassium gluconate is better absorbed, so am moving toward that entirely. I buy the NOW brand in powder, put it in a nalgene bottle with good water, shake it, and drink as it occurs to me. When I get foggy-headed, or my heartbeat goes heavy.

I used to worry that taking K+ as needed leading me to this much was too much. I don't worry about that any more. This kidney specialist doctor told me he wouldn't even blink at this amount.

I have also taken about 4 grams per day of potassium salts. I'm not sure if I noticed any difference or not in terms of low potassium symptoms. It's hard to know. Only if I took big amounts of B12 would I know whether or not 4 grams of potassium salt is enough for me. I haven't regularly taken beyond 60 mcg of B12 daily for a long time. Only if I started taking > 100mcg per day would I really know whether 4 grams of potassium salt is truly enough.

I haven't really read that many people taking that much potassium every day, so it's good to know that you are as well.

When I entered in my kidney test results into an online calculator it said that I have around 97% kidney function, so I'm not going to worry about high potassium, or, I'll try not to. At the same time I don't want to force my kidneys to work too hard. It's a matter of balancing the possible low potassium symptoms thanks to B12 making my body repair itself to quickly versus possibly straining my kidneys...
 

aturtles

Senior Member
Messages
129
Location
Seattle, WA
I have also taken about 4 grams per day of potassium salts. I'm not sure if I noticed any difference or not in terms of low potassium symptoms. It's hard to know. Only if I took big amounts of B12 would I know whether or not 4 grams of potassium salt is enough for me. I haven't regularly taken beyond 60 mcg of B12 daily for a long time. Only if I started taking > 100mcg per day would I really know whether 4 grams of potassium salt is truly enough.

Not sure I understand you, @boo85 . I take that much K+ because I feel the deficit symptoms after every round of L-MTHF & MeCbl. I take it to remove the symptoms. I wouldn't take this much if I didn't need it.

If you're not taking it for symptoms, how do you know how much you need?
 

boo85

Senior Member
Messages
178
Not sure I understand you, @boo85 . I take that much K+ because I feel the deficit symptoms after every round of L-MTHF & MeCbl. I take it to remove the symptoms. I wouldn't take this much if I didn't need it.

If you're not taking it for symptoms, how do you know how much you need?

I get mild - severe low potassium symptoms when taking B12.
 
Messages
3
I have been trying to bring Potassium on board. I've tried the Now Brand Potassium Gluconate that I believe Freddd recommended. Has anyone else experienced IBS with potassium supplements? I even tried Seeking Health's electrolyte drink and have the same issue. Right now, in order to follow Freddd's protocol I've been eating a lot of bananas and drinking coconut water. Any tips for tolerating potassium supps would be much appreciated. Thanks!