In most forms, potassium will irritate the mouth/throat, esophagus, stomach & GI tract. Crushed potassium is CAUSTIC to the throat, esophagus and the entire digestive system for that matter. It causes inflammation and a narrowing of the esophagus which will cause mild to moderate dysphagia to become severe.
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Potassium burns
- Thread starter manoj
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Hi @jonathanedwards, I appreciate your concern about potassium supplementation. Based on your knowledge, if a person is supplementing with potassium and there is no history of and no signs of heart or kidney or really any other issues on comprehensive blood tests done through a medical doctor, what are the other concerns regarding supplementing potassium with serum monitoring? (Other than the impact on esophago-gastric lining.) For example, might it tax the liver or kidneys too much? I read that it can impede folate absorption if taken at the same time. Is there something else that it can affect?
Thanks very much.
Thanks very much.
Jonathan Edwards
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None, other than oesophageal stricture, really. But if all the levels are monitored and normal what is the point of taking potassium? The whole point of taking potassium was if it was low as I understood it. It just makes no sense at all.
Thanks very much.
My perception is that people here are not supplementing potassium because there's necessarily an innate problem with getting it inside the cells, but more so when they are replenishing there vitamin B levels to compensate for the depletion of K when making new blood cells and the unpleasant symptoms and dangerous outcome of hypokalemia. I may be wrong. I've only been on these boards for the past several months.
Some folks here including myself have experienced very uncomfortable symptoms when potassium is in the low normal range. The very first time I experienced these symptoms was after starting B vitamins. I had shortness of breath at rest which I'd never experienced before. I saw a medical doctor who tested me revealing a potassium level of 3.4, just slightly below normal and no other abnormalities on comprehensive blood testing. EKG was deemed " slightly flat likely due to mild hypokalemia." Based on lab results from the last 10 years, my serum potassium had never been that low and typically above 4.0.
Since then, serum potassium has been above 3.4, but I've continued to experience symptoms despite being in the normal range. The symptoms I correlate with low potassium are mild shortness of breath, chronically very tight muscles, and cramping in feet and legs. I do not get relief with taking high potassium foods. I was extremely reluctant to supplement with potassium for all the reasons that's been discussed. I am, however, able to get periodic/frequent lab work done allowing monitoring of my level (every 10 days to 3 weeks so far over the past 3 mos). What I have found is that my symptoms are greatly reduced when my potassium level is at 4.3 versus 3.5. I know that my level is up before I test due to consistently diminished symptoms, but the tests have confirmed it 3/3 opportunities. Not a large number, but something.
I don't necessarily think I have ME. My theory is that I have some level of B vitamin based anemia. I am close but do not hit the marker on blood test for enlarged blood cells. My blood work showed normal folate and b12 levels, but I felt significantly better when supplementing both and my potassium dropped dramatically when I did so. It seems plausible that I began forming new blood cells since beginning to replenish the folate and cobalamin levels. You probably saw @Mary post discussing the same. I am very much in the same boat except my labs support the theory re: potassium.
Something else that has been brought up is the intracellular level of potassium which I understand is difficult or cannot be tested for. The notion is that the intracellular level can be low even if serum level is WNL. What are your thoughts on this?
I don't know what variety of testing methods are used to detect megoblastic anemia outside of checking red blood cell size, whether it's a mix of clinical symptoms and blood tests, how accurate testing is believed to be, or if it's known prevalence renders testing unwarranted by docs when perhaps it should be tested for. Could it be possible that folks or a percentage of folks with ME have a component of an undiagnosed anemia, that, when addressed, depletes existing potassium as is seen in the diagnosed population?
As you've undoubtedly come across, it has been suggested that there is a significant percentage of the population who likely have problems properly utilizing folate from food and supplemental synthetic folic acid (MTHFR mutation). Is this notion something that's accepted in the medical community?
Much of the discrepancy between allopathic medicine guidelines and how many folks here are guiding themselves has a lot to do with the established norms that physicians use. The standard labs/tests and norms fail to capture something very real that is going on.
These are some of the reasons why folks are feeling the need to guide themselves by their symptoms and not what a physician says is "normal" or makes sense to them based on what they've learned and what's perpetuated by the medical establishment. This process, inherently requires hypothesizing, estimating, trial and error, etc because there is nothing else one can do if they want to get better.
Apologies if others have already expressed much of this. Again, your thoughts and efforts to improve understanding and attempts to find something plausible to research in this arena is very much appreciated. This is just my opinion, but I think in this process, some questioning of established norms and of traditional medicine as a whole may be necessary to get anywhere. I have found it to be the case for me being wholly engulfed within the traditional medical community and myself resisting what "does not make sense" according to this culture.
Sorry this is so long.
Mary
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Gretel - I was very cautious when I first took a potassium supplement after reading about all the dangers that potentially could be associated therewith. But I did a lot of reading, titrated my dose up slowly and carefully (took about 3 days to get up to 1000 mg. a day), and also realized that taking 1000 mg. a day is a little less than 25% of the RDA. It's not a huge amount and I can't eat enough high potassium foods to remedy my potassium depletion. I do drink low-sodium V8 which is very high in potassium, but it's not enough. And I have to be very careful with calories. so cannot eat a ton of bananas and sweet potatoes, etc.
And the proof is in the pudding - I don't get the symptoms of low potassium that I used to. I function better. I would encourage you to try a supplement since you keep dealing with low potassium issues and food alone isn't resolving them, and of course go very slowly and carefully. And maybe try the V8.
Oh, sorry, Mary. I should have made it more clear that I did slowly titrate up on potassium a few months ago and am on quite a lot now. I too don't think I could have continued with folate and B12 without it. I have been monitoring via blood test every 2-3 weeks to keep an eye on things as I proceed through FP.
I can see why you would check in about this. I appreciate that!
I can see why you would check in about this. I appreciate that!
Jonathan Edwards
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The problem that I have with this is that I don't think there is such a thing as 'established norms of allopathic medicine'. Homeopathy invented the term allopathy and homeopathy is based on the idea of vaccination (like with like) which is entirely conventional. The idea is disinformation I think.
The reason for being sceptical about all this stuff I simply that this sort of suck it and see approach is all too familiar to me. When I started medicine in the 1970s we all did this - playing around with medicines thinking we were adjusting things just right for individual patients. That was standard practice in mainstream medicine. But then we learnt through doing careful trials that we were all fooling ourselves. Treatments we and the patients thought were wonderful turned out to be useless - just placebos. The current standard view is just based on realising that doctors and patients fool themselves all the time about these things. From what you say it sounds pretty unlikely that your symptoms have anything to do with potassium, or B12 or folate for that matter. They may do, and you must follow the best medical advice you can get, but it does not sound like anything I ever came across in practice in this context.
And as far as I can see it has nothing whatever to do with ME so I do wonder why it gets discussed much here!
I agree that unless you have a deficiency you do not need to supplement. Potassium as well as B12 is a standatd test. I recently had a test for magnesium. I didn't realize there's a standardized test available nor do I know what other tests for vitamins are valid.
Adjusting your diet if you have concerns is a better way to go as food is absorbed differently than a supplement. For example, I am not supposed to take a calcium supplement but need to make sure I get enough calcium in my diet. My memory is fuzzy but it may have to do with the fact that I frequently have kidney stones and my kidneys leak too much calcium. My serum calcium is normal This is called hypercalciuria not to be confused with hypercalcemia.
I'm not sure if this advice is specific to what I have or advice in general. Probably the former.
The other problem is that the companies who make supplements do not have to prove that a supplement works. There is no quality control so what it says on the bottle may not be what you are actually getting. Prescription drugs go through a rigorous process as well as studies before they are approved. Yet all side effects become known until after marketing as no system is perfect. If there isn't any regulation the chances are even greater for these consequences to occur.
However, there is still personal choice whether someone takes supplements or not.
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ahmo
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I believe I used the same amount by both FB and oral. About 750mg.
Ok, thanks very much for that, Jonathan. I do appreciate all you've said. Good food for thought.
garyfritz
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Very interesting, @Lewis! I have never come across the term dysphagia before, but it appears to be exactly what I suffer from on occasion. From some digging in Wikipedia, I believe I have intermittent esophageal dysphagia. Sometimes when I'm eating, the food just seems to get stuck. It's painful, as if the esophagus is spasming, and sometimes it feels like my stomach/esophagus is going to reject the food and make me vomit. So far that's never actually happened, but it's still very unpleasant. I'm pretty sure it started long before I started supplementing with potassium, but I wonder if the potassium might have made it worse. I normally take potassium tablets, but on occasion (when I was having muscle spasms and needed a quick hit) I have just popped 1/4 teaspoon of potassium chloride in my mouth and washed it down. Maybe I should be more careful with that.
Potassium gluconate would be much milder. Even then you should add some liquid to dilute it.
Trying a little potassium gluconate powder on my tongue was a good test for me when I used to need large amounts of it. If it tasted sweet then I needed it, if it had no flavor then I didn't need it. I tested this effect enough times to have no doubts about whether it was real or imagined. Freddd noticed the same effect.
garyfritz
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Thanks, @PatJ. I just got some gluconate powder but I haven't opened it yet. I'll try your taste test.
It takes a lot more bulk to get the potassium from the gluconate. I started filling some gelatin capsules with chloride powder, to reduce any esophageal irritation (and the taste!), and one capsule had about 500mg elemental potassium. But it tended to upset my stomach so I haven't used it much. (I've been taking 99mg gluconate tablets morning & night so the capsules were an attempt to step up my dosage a bit.) It takes about 2-3x more volume for equivalent potassium, if I remember right, so I don't know how well the capsules would work. Gluconate is milder, but is it wise to take it directly, even mixed with liquid? Or would it be better to avoid contact with the esophagus, especially given my occasional dysphagia?
It takes a lot more bulk to get the potassium from the gluconate. I started filling some gelatin capsules with chloride powder, to reduce any esophageal irritation (and the taste!), and one capsule had about 500mg elemental potassium. But it tended to upset my stomach so I haven't used it much. (I've been taking 99mg gluconate tablets morning & night so the capsules were an attempt to step up my dosage a bit.) It takes about 2-3x more volume for equivalent potassium, if I remember right, so I don't know how well the capsules would work. Gluconate is milder, but is it wise to take it directly, even mixed with liquid? Or would it be better to avoid contact with the esophagus, especially given my occasional dysphagia?
I used to take it mixed in with water or an electrolyte drink (8 oz). For many months I needed roughly 3.5 grams (elemental) potassium per day split into multiple small doses. Maybe the small but frequent dose size and liquid dilution helped to avoid stomach upset or other problems that some people encounter.
garyfritz
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Wow. That is a LOT of K. May I ask, what symptoms were you suffering that required so much potassium?
Thanks for the info!
Thanks for the info!
I was on Freddd's treatment for 9 months. It's known to ramp up potassium demand like crazy. I got to be very familiar with low potassium symptoms and how quickly they were relieved by taking potassium gluconate. My low potassium symptoms would arise within 2-5 hours if I didn't supplement frequently throughout the day (including a dose in the middle of the night.)
For me, the combination of B12 + Acetyl-l-carnitine spikes my potassium demand. B12 alone is fine.
ahimsa
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I don't know anything about the various methylation (sp?) treatment plans.
However, potassium supplementation is often discussed by folks with ME/CFS who also have some kind of Orthostatic Intolerance (POTS or NMS/NMH) because several patients take fludrocortisone. Fludrocortisone makes your body hold on to salt (sodium) and get rid of other salts such as potassium. My cardiologist has prescribed a time-released potassium supplement for me (some generic version of Klor-con, 10 mEq). I also take some other over the counter supplements.
I've also discussed electrolyte drinks (eg., unflavored Pedialyte) with this doctor. I asked whether they would be a problem for me since those drinks can have as much or more than the prescription amount of potassium that I'm taking. He told me that he didn't think the extra potassium would cause any problems.
I get a blood test yearly to check my levels of sodium/potassium/etc.
I am not an expert in any of this. And to be frank I don't think my cardiologist is, either. But it does not seem to be some huge red flag - otherwise, wouldn't he have been more concerned about it?
Edit - I forgot to mention that I've also had a couple discussions with my primary care physician as well, not just with cardiologist.
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@ahimsa
You are doing this the smart way. Under a doctor's supervision.
What I find concerning is when others take supplements without a known deficiency or by tests that are not valid. Otherwise, you're making expensive urine and IMHO, wasting money.
If supplements have any medicinal value then they need to be treated as medicine with the same requirements and rigorous testing required for these medications. Nothings a guarantee but this ups the odds towards optimal health.
You are doing this the smart way. Under a doctor's supervision.
What I find concerning is when others take supplements without a known deficiency or by tests that are not valid. Otherwise, you're making expensive urine and IMHO, wasting money.
If supplements have any medicinal value then they need to be treated as medicine with the same requirements and rigorous testing required for these medications. Nothings a guarantee but this ups the odds towards optimal health.
ahimsa
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It's a tricky thing.
On the one hand, I don't think a lot of doctors have been trained to think about when supplements are helpful (e.g, review the studies and understand when patients need them). They are trained mostly about prescriptions. [And even then I often like to talk with the pharmacist whenever I have a new prescription!] This means doctors might not be recommending supplements when they could be helpful for the patient. Which means a missed opportunity for the patient.
On the other hand, most patients (I include myself!) probably don't have the necessary training or information to make the right choices about supplements, either. So the supplements chosen may either be a waste of money or potentially harmful.
No easy answers.