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B-12 induced Potassium depletion ?

dannybex

Senior Member
Messages
3,561
Location
Seattle
I've heard several folks mention that b-12 can deplete potassium.

A few questions:

What is the basis for this hypothesis?

What are the specific symptoms of b12-induced potassium deficiency?

And how does one know it's from potassium depletion and not another mineral or vitamin co-factor? Do other co-factors have distinctly different symptoms?

THANKS IN ADVANCE,

Dan

p.s. And in general, is there a specific dose of b12 that might create this depletion?
 

determined

Senior Member
Messages
307
Location
USA: Deep South
Dannybex, I'm sorry I can't answer your questions.....

I'm just wondering how you are, in general, with the methylation supplements?

All of this is very complicated indeed. I am continuing to take it very, very slow.
 

Enid

Senior Member
Messages
3,309
Location
UK
dannybex if this relates to your question about b-12 causing potassium depletion - in early days before any supplementation my urine went almost neon orange - on testing my Doc said it had a high potassium content usually seen when eating too many bananas (I didn't). So potassium seemed to be overly released (not absorbed - though diet normal ?) for no apparent reason. I was not on b-12 supplementation.
 

LaurieL

Senior Member
Messages
447
Location
Midwest
Danny,

I seem to experience a whole body weakness and abnormal arrythmias when low on potassium. I know when I doubled my dose, those went away for a while, but now it seems to induce the whole body weakness. And it seems to make only certain muscles flush. No palpitations though. So now, I am just as confused as you are. I posted my recent experiences, and not one reply. :(

Laurie
 

Freddd

Senior Member
Messages
5,184
Location
Salt Lake City
I've heard several folks mention that b-12 can deplete potassium.

A few questions:

What is the basis for this hypothesis?

What are the specific symptoms of b12-induced potassium deficiency?

And how does one know it's from potassium depletion and not another mineral or vitamin co-factor? Do other co-factors have distinctly different symptoms?

THANKS IN ADVANCE,

Dan

p.s. And in general, is there a specific dose of b12 that might create this depletion?

Hi Dan,

What is the basis for this hypothesis?


Research studies. While they point out that hypokalemia is "rare" with hycbl and cyanocbl, it happens when a person has high MCV and the the rate of blood cell maturation increases using more potassium.

With methylb12, methylfolate, adb12 and the other factors needed for cell formation, lack of potassium becomes the only thing holding it up. Hypokalemia is very common with mb12, adb12 and methylfolate because it sets ALL kinds of cells needing replicating on the fast track. SO as skin heals, and muscle forms and nerves heal and blood cells of all types are produced normally lots more potassium is used as it is one of the most common elements in EVERY cell.

As hypokalemia is defined by serum and tissue level, and a serum level of anywhere from 3.5-4.0 might be the lower end of "normal" and people migh be starting to have all sorts of symptoms at around 4.2 or 4.3, a "clinical" finding of hypokalemia might not be made despite you having terrible cry out in pain leg spasms all night, heart palpitations, nausea, mood changes, personality changes, "flu" feeling and many others are potential. It can also cause a "paralyzed ilium" which has been ascribed to mb12. Dangerous it is when unrecognized. Generally low potassium can have all the symptoms and then some generally ascribed to "detox". There is considerable overlap with folate deficiency symptoms of many causes.

I have had my blood measured frequently and am most comfortable at 4.3 and above. By 4.0 I have terrible symptoms.

The problem with this one, hypokalemia, is that it is so common it is hard to recognize because people have symptoms well above the "low cutoff". Also it can be dangerous and even fatal if allowed to continue and yet it is a primary signal flag that methylation has started and cells are being formed where ever needed in the body. Those who don't have effective methylation startup won't generally have low potassium. Those with CFS/FMS have large backlogs of cells that need replacement because that stops when methylation stops.

Many people can find fast relief from low potassium. A 500mg supplemental or prescription dose can provide relief in 30 minutes or less providing a quick test of the hypothesis. However, as it can pass out of ther body quickly or be used quickly, a person needs to titrate their base rate high enough that extra doses don't need to be taken often. I try to keep that at below once a week. High potasium is very rare in the absence of kidney damage.
 

Freddd

Senior Member
Messages
5,184
Location
Salt Lake City
Danny,

I seem to experience a whole body weakness and abnormal arrythmias when low on potassium. I know when I doubled my dose, those went away for a while, but now it seems to induce the whole body weakness. And it seems to make only certain muscles flush. No palpitations though. So now, I am just as confused as you are. I posted my recent experiences, and not one reply. :(



Laurie

HI Laurie,

but now it seems to induce the whole body weakness.



What is "it"; potassium or low potassium?

a whole body weakness and abnormal arrythmias when low on potassium


What is abnormal arrythmias meaning?

Needs can vary considerably, getting lower when water is being retained, dropping like a rock when urine is draining quickly.

My requirements went higher than I would have expected. Again, the test; does an extra dose of potassium relieve the symptoms? Then a balance with calcium and magnesium is important. As you get close to being in the right balance and sufficient potassium, the number and frequency of symptoms decreases. When I cease to have any of ther low potassium symptoms and don't for a couple of weeks, I tend to start reducing the potassium tablets by 1 each 3 or 4 days. So far when I do that I have another burst of low potassium symptoms within 2-3 weeks, so I am preety near to an equilibrium. Anther trigger is each bout of paradoxical folate deficiency, from, vegetable food folate only now, so my ability to manage it with timing of Metafolin is increasing. I start putting on water at about 3 pounds a day when I go into the folate deficiency. As soon as it is reversed, after a few days the rate of urine output picks up a lot, sometimes 3-4 pounds of accumulated body water on each of several days pours out and I have low potassium spasms by the end of the first day and for the duration of high volume output. Pay attention to all of what is gfoing on and pin down what is happening.
 

L'engle

moogle
Messages
3,197
Location
Canada
I'm taking potassium everyday on the b-12 protocol. One thing I notice is that if I eat more salt I have to add more potassium. So that could be something to watch for when you're trying to figure out how much to take. Sodium and potassium balance each other out.
 
Messages
94
Location
California
Hi Fredd and Others,
I started AB12, MB12, B6(p5p), B2, mFolate, Calcium, magnesium, and zinc about 2 1/2 months ago. In the past I've have become extremely wired and "toxic" on any supplements (except Vit C, D, olive leaf, and omega 3). Knowing this, I started with separate products rather than combined supplements so that I can adjust dosages and add slowly. I hover now between 1/16- 1/4 of each tablet/capsule. It took about a month to come to an equilibrium and be able to get a good night's sleep. Any changes or additions thrust be back into insomnia and toxic overload in my liver (TMG, l-Carnitine, milk thistle, B-complex). While I have carefully avoided excitotoxicity, I have not had any improvements in energy level or muscles spasms/weakness. In fact, I feel weaker, have more muscles spasms than ever, and now, edema. I couldn't sleep at night due to aching legs. I tried regular potassium, but it increased symptoms. So..................I did some research last night and discovered that people with weak adrenals may actually need more sodium rather than potassium. I started mixing sea salt with lemon in water and drinking it several times a day. I have already noticed a huge difference in my abdominal edema and leg pain. Freddd, can you comment on this strange response to potassium? PS I have been spending many hours in the California sun, which I understand aggravates adrenals.
 

Freddd

Senior Member
Messages
5,184
Location
Salt Lake City
Hi Fredd and Others,
I started AB12, MB12, B6(p5p), B2, mFolate, Calcium, magnesium, and zinc about 2 1/2 months ago. In the past I've have become extremely wired and "toxic" on any supplements (except Vit C, D, olive leaf, and omega 3). Knowing this, I started with separate products rather than combined supplements so that I can adjust dosages and add slowly. I hover now between 1/16- 1/4 of each tablet/capsule. It took about a month to come to an equilibrium and be able to get a good night's sleep. Any changes or additions thrust be back into insomnia and toxic overload in my liver (TMG, l-Carnitine, milk thistle, B-complex). While I have carefully avoided excitotoxicity, I have not had any improvements in energy level or muscles spasms/weakness. In fact, I feel weaker, have more muscles spasms than ever, and now, edema. I couldn't sleep at night due to aching legs. I tried regular potassium, but it increased symptoms. So..................I did some research last night and discovered that people with weak adrenals may actually need more sodium rather than potassium. I started mixing sea salt with lemon in water and drinking it several times a day. I have already noticed a huge difference in my abdominal edema and leg pain. Freddd, can you comment on this strange response to potassium? PS I have been spending many hours in the California sun, which I understand aggravates adrenals.

Hi Therron,

Interesting. I think this just illustrates how critical the mineral balance can be. I got the calcium out of balance once too. Fine tuning, customizing to your needs, is critical. I've seen just about everything be the critical factor to somebody, and sodium chloride to a number of people. Adele Davis said something about salt and adrenals decades ago.

Redmond Real Salt (on the web) is perhaps the finest tasting gourmet salt available. It is sea salt mined in Utah from seas that dried up a couple of hundred million years before man-made pollution. It has a lot of various trace minerals which is what gives it's flavor enhancing characteristics.
 

dannybex

Senior Member
Messages
3,561
Location
Seattle
Thanks everyone...

Thanks all for your replies.

Laurie, please don't think that folks are ignoring you -- many of us can only go online for very short periods of time. I tried to reply this morning, but just could not -- have been getting some 'essential tremors' and stiffness in my left hand when I type lately -- so i reply when I can. Also, I didn't know the answers to your symptoms, so I was hoping someone else could reply, as Fred has now done.

Thanks Fred for your list of potassium depletion symptoms. They seem similar to so many other symptoms, but I suppose if I 'up' my methylfolate and said symptoms worsen, then I can suspect low potassium

Therron makes a great point -- that many folks with ME/CFS have adrenal issues where more salt is recommended, and helps -- especially with folks who don't hold their water very well (like myself -- diabetes insipidus?). I have craved sodium in the past, but not as much in the last 2 weeks, and feel if I salt something too much, then i get a heavy feeling in my legs.

Another thing I'm considering is that ever since I've had to cut way back on high-salicylate foods 3-4 weeks ago, I've felt a little more 'stiff' and less flexible and yes, maybe weaker. Interesting that many high-sal foods are also high in potassium -- very high in potassium -- like dates, cherries, raisins, molasses, and honey. I wasn't eating too much of these, but did on a few days, (and other high salicylate veggies) and had severe reaction: salicylates impair methylation/sulfation...

Determined, Thanks for asking: I've been tolerating 250mcgs -- 500mcgs mb12, along with 250mcgs ad-b12 -- the mb12 seems to be helping me sleep a little deeper -- and will be starting mb12 injections very soon, as I know I'm very depleted in b12. Then if that goes okay, will add small amounts of methylfolate. Hopefully that will go okay.

I've lost 11 lbs in 9 months -- and was too thin 9 months ago, so need to turn this around, and am hopeful I can. I'm trying to raise funds to get the genetic testing. We'll see.

Thanks to all,

Dan

p.s. Fred, do you know what kind of a dose of mb12 might trigger the potassium depletion? I do have potassium chloride powder so can get 700+mgs in 1/4 teaspoon.
 

Freddd

Senior Member
Messages
5,184
Location
Salt Lake City
Thanks all for your replies.

Laurie, please don't think that folks are ignoring you -- many of us can only go online for very short periods of time. I tried to reply this morning, but just could not -- have been getting some 'essential tremors' and stiffness in my left hand when I type lately -- so i reply when I can. Also, I didn't know the answers to your symptoms, so I was hoping someone else could reply, as Fred has now done.

Thanks Fred for your list of potassium depletion symptoms. They seem similar to so many other symptoms, but I suppose if I 'up' my methylfolate and said symptoms worsen, then I can suspect low potassium

Therron makes a great point -- that many folks with ME/CFS have adrenal issues where more salt is recommended, and helps -- especially with folks who don't hold their water very well (like myself -- diabetes insipidus?). I have craved sodium in the past, but not as much in the last 2 weeks, and feel if I salt something too much, then i get a heavy feeling in my legs.

Another thing I'm considering is that ever since I've had to cut way back on high-salicylate foods 3-4 weeks ago, I've felt a little more 'stiff' and less flexible and yes, maybe weaker. Interesting that many high-sal foods are also high in potassium -- very high in potassium -- like dates, cherries, raisins, molasses, and honey. I wasn't eating too much of these, but did on a few days, (and other high salicylate veggies) and had severe reaction: salicylates impair methylation/sulfation...

Determined, Thanks for asking: I've been tolerating 250mcgs -- 500mcgs mb12, along with 250mcgs ad-b12 -- the mb12 seems to be helping me sleep a little deeper -- and will be starting mb12 injections very soon, as I know I'm very depleted in b12. Then if that goes okay, will add small amounts of methylfolate. Hopefully that will go okay.

I've lost 11 lbs in 9 months -- and was too thin 9 months ago, so need to turn this around, and am hopeful I can. I'm trying to raise funds to get the genetic testing. We'll see.

Thanks to all,

Dan

p.s. Fred, do you know what kind of a dose of mb12 might trigger the potassium depletion? I do have potassium chloride powder so can get 700+mgs in 1/4 teaspoon.

Hi Dan,

Fred, do you know what kind of a dose of mb12 might trigger the potassium depletion? I do have potassium chloride powder so can get 700+mgs in 1/4 teaspoon.

As little as 10mcg absorbed can start cell reproduction if methylfolate is also present. As mb12 has dose proportionate characteristics, more triggers it faster. A single 1000mcg sublingual (100-300mcg absorbed) daily is enough to kick potassium need into high gear in 3 days.

Until you are comfortable taking a 5mg Jarrow mb12 I would not suggest an injection. The 5mg sublingual is fully equal to a 1000mcg injection and probably better qualitatively. Also, until all the body startup is out of the way you won't know if a higher dose such as 7.5mg subcutaneous injection is helping the CNS. Of course if you just dive in with the 7.5mg injection daily, all body startup will be done in a few days to weeks and starting to diminish. Anything other than daily is grossly inadequate and inferior.

I've lost 11 lbs in 9 months -- and was too thin 9 months ago, so need to turn this around, and am hopeful I can.

When I was deficient of folate and b12, I put on 85 pounds of water at the same time I was losing muscle so while there was no meat on my bones you would never be able to tell by looking at me I was so bloated. My thigh muscle had shrunk down to the thickness of my thumb. Now it is the full thumb to pinky (octave) span. My muscles did not start recovering until after I had added adb12 to the mb12, and then l-carnitine fumarate. I put on a good 40 pounds of muscle or more in the next several years. I'm not sure of the reasons for your weight loss but if it is muscle loss it could be the same as mine, lack of something needed to make the cells.
 

dannybex

Senior Member
Messages
3,561
Location
Seattle
b12 injections...

Thanks for your reply Fred -- I appreciate it.

I've been able to tolerate 500mcgs of the Jarrow sublingual but can't handle any more because my teeth start to get very sensitive -- hence the shots. Plus, I did very well (in hindsight) with methylb12 shots back in 2003. I remembered doing shots, but had no idea they were methylb12 until I found the receipts about 5 weeks ago.

I just did my first injection yesterday...only 1.5 mg to start, but will increase the dose today, maybe to 3 mg.

I've had the opposite problem regarding water balance from you, for about 30 years or so -- don't hold my water well at all. Diabetes insipidus I presume.

Thanks again,

d.
 

Freddd

Senior Member
Messages
5,184
Location
Salt Lake City
Thanks for your reply Fred -- I appreciate it.

I've been able to tolerate 500mcgs of the Jarrow sublingual but can't handle any more because my teeth start to get very sensitive -- hence the shots. Plus, I did very well (in hindsight) with methylb12 shots back in 2003. I remembered doing shots, but had no idea they were methylb12 until I found the receipts about 5 weeks ago.

I just did my first injection yesterday...only 1.5 mg to start, but will increase the dose today, maybe to 3 mg.

I've had the opposite problem regarding water balance from you, for about 30 years or so -- don't hold my water well at all. Diabetes insipidus I presume.

Thanks again,

d.

Hi Dan,

The biggest thing with the injectable mb12 is exposure to light during mixing or drawing of injection. I wrap the vial with foil that NEVER comes off the body of the vial. I also wrap the syringe in foil and do it all by feel. Just the light exposure during drawing can degrade the mb12. The syringe has approximately 10x the surface area of light exposure per unit volume of mb12 liquid as compared to the vial.
 

Mary

Moderator Resource
Messages
17,335
Location
Southern California
Hi Dan,

What is the basis for this hypothesis?


Research studies. While they point out that hypokalemia is "rare" with hycbl and cyanocbl, it happens when a person has high MCV and the the rate of blood cell maturation increases using more potassium.

With methylb12, methylfolate, adb12 and the other factors needed for cell formation, lack of potassium becomes the only thing holding it up. Hypokalemia is very common with mb12, adb12 and methylfolate because it sets ALL kinds of cells needing replicating on the fast track. SO as skin heals, and muscle forms and nerves heal and blood cells of all types are produced normally lots more potassium is used as it is one of the most common elements in EVERY cell.

As hypokalemia is defined by serum and tissue level, and a serum level of anywhere from 3.5-4.0 might be the lower end of "normal" and people migh be starting to have all sorts of symptoms at around 4.2 or 4.3, a "clinical" finding of hypokalemia might not be made despite you having terrible cry out in pain leg spasms all night, heart palpitations, nausea, mood changes, personality changes, "flu" feeling and many others are potential. It can also cause a "paralyzed ilium" which has been ascribed to mb12. Dangerous it is when unrecognized. Generally low potassium can have all the symptoms and then some generally ascribed to "detox". There is considerable overlap with folate deficiency symptoms of many causes.

I have had my blood measured frequently and am most comfortable at 4.3 and above. By 4.0 I have terrible symptoms.

The problem with this one, hypokalemia, is that it is so common it is hard to recognize because people have symptoms well above the "low cutoff". Also it can be dangerous and even fatal if allowed to continue and yet it is a primary signal flag that methylation has started and cells are being formed where ever needed in the body. Those who don't have effective methylation startup won't generally have low potassium. Those with CFS/FMS have large backlogs of cells that need replacement because that stops when methylation stops.

Many people can find fast relief from low potassium. A 500mg supplemental or prescription dose can provide relief in 30 minutes or less providing a quick test of the hypothesis. However, as it can pass out of ther body quickly or be used quickly, a person needs to titrate their base rate high enough that extra doses don't need to be taken often. I try to keep that at below once a week. High potasium is very rare in the absence of kidney damage.

Freddd - thanks for this explanation. I've been wanting to ask you why the need for potassium increases so much when taking the methylfolate, methylB12 etc. I'm now taking 1,000 - 1100 mg. a day in divided doses. I find I get quite tired when potassium is low, and also my blood pressure is affected. At first it was going high and now it is going low (it got very low a couple of days ago, was a little scary actually - 85 being the top number - I wasn't sure at this point whether I needed salt or potassium or both so took some of each). After several hours gradually went back up. I wish it weren't all such a guessing game!

But, on the plus side, I am feeling better overall, although I still crash when I over do it, still am limited to 3-4 hours of light activity a day, but hope to see that increase as time goes on.

Mary
 

Sasha

Fine, thank you
Messages
17,863
Location
UK
I've been on Freddd's b12 protocol for about 7 weeks now and have several times had to take a 500mg test dose of potassium to identify low potassium as the reason for feeling extra tired and having slightly sore muscles. Even though I was up to 800mg/day, I was still getting these problems, and even after taking 1,300mg yesterday (my usual 800mg plus the test dose of 500mg) and feeling very much better for it, I feel awful again this morning and am going to take another test dose.

I have been wondering if such high amounts are extraordinary (I know Fredd has mentioned taking about 1,100mg/day) and decided to look at my diet to see if it is providing even the RDA.

I used this USDA National Nutrient Database table to work out how much potassium is in my diet. According to that, I'm getting, on average, 2,030 mg/day - the RDA, according to Wikipedia, is 4,700 mg/day! Argh! Argh!

Wikipedia says:

"Although low dietary intake of potassium does not lead to hypokalemia in healthy individuals, many long-term health risks are related to insufficient dietary potassium.

The 2004 guidelines of the Institute of Medicine specify an RDA of 4700 mg of potassium for adults, based on intake levels that have been found to lower blood pressure, reduce salt sensitivity, and minimize the risk of kidney stones. However, most Americans consume only half that amount per day. Similarly, in the European Union, particularly in Germany and Italy, insufficient potassium intake is widespread."​

I'm a bit surprised I'm alive! Actually, my blood pressure is a bit on the low side, as with many PWME.

Does my apparently low-potassium diet mean I should expect to be taking about 2,000mg/day potassium in supplement form?

Presumably being on the b12 protocol will increase my potassium needs but I wonder if being pretty much housebound/bedbound reduces my needs for potassium.

I also wonder at what point, once I seem to be on a sustainable dose, I should present myself to my NHS GP (ulp) and ask to be tested for high potassium.