Managing Potassium Deficiency - Share your experience

[Sparrowhawk]

Thanks, I'll check it out. I have a bladder disease, interstitial cystitis, so potassium citrate is generally the only form I should be taking. I tried potassium chloride before I knew any better. Major mistake.

Does anyone take potassium and B12 at the same time? I don't, based on what I'm reading online about absorption, but...

Ah then do only take what you know will work for your circumstances of course!
Very best to you for healing regardless.

 

[whodathunkit]

@LynnJ: if you're taking pills, can you try powder in juice? I can't take potassium pills...they just sit in my stomach like little bombs, dissolving slowly and giving me a major stomach ache. When I tried powder in juice I found that I didn't get a stomach ache, probably because the potassium was diffused over the entire area of my stomach instead of just sitting and getting concentrated in one area (and thus irritating it).

You can probably also control your dosage better with powder in juice...maybe sip it slowly throughout the day instead of taking a big dose several times per day.

Dunno if juices are contraindicated in IC. Just throwing the thought out there as maybe a help. Powder in water would do just as well but not sure how that would taste.

 

[LynnJ]

When I stupidly tried potassium chloride powder, I put it in water. Disgusting. It gives the water this weirdly smooth texture. It was just...wrong. And gross tasting.

Potassium citrate powder doesn't seem as common, but I'm almost positive I saw some available on Amazon. So I'm 99% sure it exists. Just doesn't seem to be the most popular form of potassium.

My only concern then would be whether or not taking potassium over the course of the entire day would have any affect on B12 absorption.

It's definitely worth a try... When I take too much potassium in pill form I get nausea and everything I eat goes right through me, so obviously I need to find a better solution.

 

[whodathunkit]

Potassium chloride powder is vile stuff. Absolutely disgusting. I can't imagine taking it in water. I was just throwing it out there as a last resort, in case you can't drink juice because of your IC.

But with the right amount of it in juice, it just tastes a little salty. The powder is frequently used as a table salt substitute. But even using it like table salt you can't use too much or you get that nasty taste.

What the "right amount" is will likely vary from person to person, according to taste.

I have heard of potassium citrate powder so it probably does exist out there somewhere. Just not sure where. If you get desperate you can try opening some capsules into your juice or dissolving tablets. I suspect the nasty tastes comes from the potassium more than chloride, so anything you use is likely to have some degree of yuck factor. But maybe not.

As far as the B12 absorption...I think I remember reading that issues with B12 may come with really large doses like with IV. But I honestly can't remember. I am sure that some pretty sick people here have managed potassium deficiency without sacrificing progress with B12. I suspect as long as you're taking B12 sublingually and not just swallowing it, you should be okay.

Good luck. Hope you can find a way to take it that works for you.

 

[caledonia]

When I stupidly tried potassium chloride powder, I put it in water. Disgusting. It gives the water this weirdly smooth texture. It was just...wrong. And gross tasting.

Potassium citrate powder doesn't seem as common, but I'm almost positive I saw some available on Amazon. So I'm 99% sure it exists. Just doesn't seem to be the most popular form of potassium.

My only concern then would be whether or not taking potassium over the course of the entire day would have any affect on B12 absorption.

It's definitely worth a try... When I take too much potassium in pill form I get nausea and everything I eat goes right through me, so obviously I need to find a better solution.

I'm taking both potassium gluconate powder dissolved in water and sublingual liquid methylcobalamin and adenosylcobalamin at the same time. I was taking B12 first for a long time, then added the potassium. I haven't noticed any difference in the way the B12 works.

The NOW potassium gluconate powder has a neutral taste, not salty or anything. I can take more without diarrhea if I divide it up into 4 doses throughout the day.

If you're getting nausea and diarrhea, it's possible that you're maxed out on potassium and need to increase magnesium instead. I just went through this is in the opposite direction. The symptoms of over and under dose of both are very similar.

 

[pemone]

Does anyone here have trouble getting their potassium deficiency symptoms to calm down, even with supplementation? I'm finding that too much potassium makes my stomach very upset, but that I need a large amount to combat the issues B12 causes.

My main problems are a fast heart-rate, shortness of breath, chest pain, and pain/tension in my upper back and by my ribs. I also get a little bit of painless twitching in my legs. Sometimes I get so frustrated I take a day off of B12, which is a bad idea; the symptoms I'm taking B12 for come back with a bang.

What are your sodium and potassium numbers on your electrolyte panel? Have you done a Potassium RBC to see what potassium is inside the cell?

Which of these symptoms resolve when you take potassium? For how long do they resolve?

Try taking a 1/4 teaspoon of celtic sea salt with 12 to 16 oz of water, no potassium. Do any of the symptoms improve?

Out of curiosity, have you lost a lot of weight right around the time you got CFS?

How much body weight are you losing each night, without going to the bathroom? (In other words, for purposes of this "test" the only loss of weight should be from breathing.) At my worst, I would lose five pounds per night just from breathing.

The fast heart rate and breathing issues were a nightmare for me in the first few months. I'm convinced that - in my case at least - the CFS was brought on by a weight loss, and that this disease is somehow about my body's fluid volumes becoming dysregulated. At first I thought the heart beat was being caused by low sodium, but my electrolyte panels do not support that. My extracellular potassium always comes out okay, but I want to check my intracellular potassium because a biochemist I know told me that in CFS it is not uncommon for the intracellular value to become very high when the serum level suggests a very different picture.

For reasons I do not understand, the heart beat resolves with an electrolyte solution. I started with sea salt, then migrated to sodium bicarbonate, and now my current solution is 12 ounces of water with 1/2 teaspoon of potassium citrate powder and 1/8 teaspoon of sodium bicarbonate. That gives me about 600 mg of elemental potassium and 150 mg of elemental sodium. Because of the bicarbonate, you must take this one hour before a meal, NEVER with a meal. I drink that during night and on rising, and maybe two or three times additionally during the day. I'm starting to gain back water weight I had lost previously, and for a few hours after I take it the heart and breathing issues resolve, so I know this is starting to have some positive effects. I try to keep the potassium in at least a four to one ratio to the sodium, and I don't want to have a huge sodium load overall.

Another key aspect of this disease for me has been the accumulation of some kind of acid in the muscle. So I have focused on alkalinity and supporting the citric acid cycle to clear acids. Sodium bicarbonate makes blood serum more alkaline. Potassium citrate increases alkalinity inside the cell. At this point I do not know where the acidity resides and if either or both of these solutions is acting at the right levels. I need to identify some tests that will make sure I am not creating additional problems.

For citric acid cycle, I am taking a lemon twice a day in 12 oz of water mixed with Ribose to sweeten. In addition, I am taking two tablespoons of vinegar in 12 oz of water mixed with Ribose to sweeten about three times a day. I have no idea how it works, but something in these substances helps to clear the acid from my muscle. Whereas exercise would cause me three days of symptoms before, taking the citric/acetic acids I can usually resolve all symptoms with only one day of downtime. Still experimenting with this.

When it comes to potassium supplements (I'm taking potassium citrate because it doesn't irritate my bladder), I can only seem to take around 400mg at a time. Otherwise I get sick.

Don't take the pills. Get bulk powder, or grind your pills into powder. 1/4 teaspoon of potassium citrate should be 300 mg of elemental potassium.

I'm pretty concerned about getting too much potassium inside my cells. That's a very dangerous condition so I think you need to monitor it if you supplement potassium.

 

[pemone]

Potassium chloride powder is vile stuff. Absolutely disgusting. I can't imagine taking it in water. I was just throwing it out there as a last resort, in case you can't drink juice because of your IC.

But with the right amount of it in juice, it just tastes a little salty. The powder is frequently used as a table salt substitute. But even using it like table salt you can't use too much or you get that nasty taste.

What the "right amount" is will likely vary from person to person, according to taste.

I have heard of potassium citrate powder so it probably does exist out there somewhere. Just not sure where. If you get desperate you can try opening some capsules into your juice or dissolving tablets. I suspect the nasty tastes comes from the potassium more than chloride, so anything you use is likely to have some degree of yuck factor. But maybe not.

As far as the B12 absorption...I think I remember reading that issues with B12 may come with really large doses like with IV. But I honestly can't remember. I am sure that some pretty sick people here have managed potassium deficiency without sacrificing progress with B12. I suspect as long as you're taking B12 sublingually and not just swallowing it, you should be okay.

Good luck. Hope you can find a way to take it that works for you.

Potassium bicarbonate and potassium citrate in the scientific literature are both associated with sparing of calcium from your bones and improvements in bone markers. The body normally eats your bone to create alkaline buffers. Potassium chloride does NOT have that benefit. It's also less alkaline, and I think alkalinity is key to fighting a disease that makes us retain too much acid in muscle tissues.

 

[LynnJ]

If you're getting nausea and diarrhea, it's possible that you're maxed out on potassium and need to increase magnesium instead. I just went through this is in the opposite direction. The symptoms of over and under dose of both are very similar.

I thought those were just fairly typical side effects of potassium supplements, especially when you're taking more than, like, two pills a day. Can magnesium deficiency cause an increased heart rate? I know it can cause muscle pains, twitching, etc....

What are your sodium and potassium numbers on your electrolyte panel? Have you done a Potassium RBC to see what potassium is inside the cell?

Which of these symptoms resolve when you take potassium? For how long do they resolve?

Try taking a 1/4 teaspoon of celtic sea salt with 12 to 16 oz of water, no potassium. Do any of the symptoms improve?

Out of curiosity, have you lost a lot of weight right around the time you got CFS?

Never had a Potassium RBC (to my knowledge). I think I just got the regular old potassium test. I can't get into my clinic's website right now to view my old test results, but they've always been "normal" by the lab's standards. Although goodness knows their standards can be garbage (*cough* B12 *cough*)! I'll see if I can get in tomorrow. For some reason I THINK my last potassium blood test might have yielded a 4.3 as the result...?

Celtic sea salt, huh? I've heard of plain old sea salt. Same thing, or is the celtic stuff special?

No weight loss. In fact, I've gained a bit and can't seem to get it off.

The symptoms I get from B12 include painless twitching in toes and calves, occasional aching in the legs, twice now I've gotten bad Charley horse cramps (sometimes I feel one coming on and stretch my leg out to prevent it). Worst is the racing heart and the related shortness of breath. Just a few months ago I would sometimes feel like I was fighting for every breath. MISERABLE and scary. Also occasionally felt nervous for no reason and trembly. I get headaches a lot recently, could be because I'm trying to suck in too much oxygen. The racing heart also caused chest pain, like after you've run a marathon. Right now my worst symptoms are the chest pain and (this is the newest symptom) upper back pain that's sneaking into the rib area, and my heart rate is still a tad too fast. Not as bad as it was a while back, but even minor activity can make it shoot up. The potassium helps these symptoms, although in order to significantly relieve them I have to take so much that it makes me sick (nausea, diarrhea). Even then I don't get TOTAL relief.

What confuses me is that I've seen people here talking about how a high dose of potassium keeps them feeling better for a few days. My relief is SO brief. If I continue taking B12 throughout the day without enough potassium, the symptoms come back pretty quickly. I generally always have these symptoms to some degree. Problem is, if I stop the B12, the burning neuropathy in my feet and debilitating pectoral/clavicular/shoulder pain comes back.

At this point, I just have to choose HOW I want to feel crappy! B12-induced symptoms, the symptoms that the B12 helps/"cures"....the terrible nausea after trying to relieve the B12-induced symptoms.... Pick your poison.

 

[Little Bluestem]

I do not have any potassium deficiency symptoms that I am aware of. (I’m blaming other things for my fast heart rate.) I did test low on my last tissue (hair) mineral test, and most of the previous ones as well.

I take 300 mg pills or powder and more than 4 doses of either/both will upset my stomach. I mix the powder in yogurt or water. With water, I add magnesium powder, salt, and 1 tsp lime juice. The lime juice helps the taste. I was using ¼ cup apple juice, but decided I did not need the calories. I take additional Mg each day. I am currently taking taurine capsules, but have taurine powder on order and will be adding it to the electrolyte mix.

I am having the best luck with food sources of potassium. A cup of tomato juice contains 430 mg K and a cup of vegetable juice 460 mg. The have, respectively, 680 and 640 mg sodium. I need the sodium, but it could be a problem for someone who didn’t. I drink a cup of one or the other 6 days most weeks in addition to the 4 doses/day of pills/powder without any problem.

I only drink coconut water when I am driving out of town because of the expense and sugar. I drink the entire carton over the course of the trip. That provides 840 mg K, 30 mg Na, and a little Mg, P, and Ca. It usually replaces the tomato/veggie juice.

I use sublingual B12 and it is sometimes still in my mouth when I take my first dose of K.

 

[Little Bluestem]

I'm convinced that - in my case at least - the CFS was brought on by a weight loss, and that this disease is somehow about my body's fluid volumes becoming dysregulated. At first I thought the heart beat was being caused by low sodium, but my electrolyte panels do not support that. My extracellular potassium always comes out okay, but I want to check my intracellular potassium because a biochemist I know told me that in CFS it is not uncommon for the intracellular value to become very high when the serum level suggests a very different picture.

Have you had your adrenal function tested? Low aldosterone can lead to an electrolyte imbalance which leads to water loss which leads to low blood volume.

Does this biochemist know anything about ME? PwME sometimes have low intracellular potassium because moving the K into the cells requires energy (active transport) which the pwME does not have in sufficient supply.

 

[Little Bluestem]

Potassium bicarbonate and potassium citrate in the scientific literature are both associated with sparing of calcium from your bones and improvements in bone markers. The body normally eats your bone to create alkaline buffers. Potassium chloride does NOT have that benefit. It's also less alkaline, and I think alkalinity is key to fighting a disease that makes us retain too much acid in muscle tissues.

Do you know how potassium gluconate fits into this?

 

[pemone]

Have you had your adrenal function tested? Low aldosterone can lead to an electrolyte imbalance which leads to water loss which leads to low blood volume.

I have the vials and just need to get the time to spit.

Does this biochemist know anything about ME? PwME sometimes have low intracellular potassium because moving the K into the cells requires energy (active transport) which the pwME does not have in sufficient supply.

Agreed, but his point was test test test. Never assume anything about your intracellular potassium based on serum potassium, and his experience was that the intracellular can fluctuate out of range in CFS patients.

 

[Tunguska]

I've gotten most of my potassium through potatoes, mushrooms and orange juice. I think I hit the 4700mg potassium a day mark, but not every day. Requires minimum 150g carbs a day to achieve.

Recently I've discovered a nice product: Sweet potato concentrated flour (Beta-Pro). 100g of the stuff (340 calories) has 2400mg potassium. The only downside is I imagine it probably contains some of the oxalates from sweet potatoes, so am going to use more magnesium citrate alongside it.

 

[pemone]

I
Recently I've discovered a nice product: Sweet potato concentrated flour (Beta-Pro). 100g of the stuff (340 calories) has 2400mg potassium. The only downside is I imagine it probably contains some of the oxalates from sweet potatoes, so am going to use more magnesium citrate alongside it.

That is probably a big carb load in that flour as well. What is the relationship between oxalates and magnesium?

 

[Tunguska]

That is probably a big carb load in that flour as well. What is the relationship between oxalates and magnesium?

Carbs are 75g total, 38g sugar for 100g flour. Also 14g fiber. Roughly same as eating same calories (340) of [sweet] potatoes, which I already do. The orange juice results in more carbs and sugar. Hoping to displace some of the orange juice with it. Personally I've come to embrace carbs (150-200g/day) and depend on them.

The relationship is between oxalates and citrate supplements; potassium/magnesium/calcium citrate help prevent stones.

 

[pemone]

Carbs are 75g total, 38g sugar for 100g flour. Also 14g fiber. Roughly same as eating same calories (340) of [sweet] potatoes, which I already do. The orange juice results in more carbs and sugar. Hoping to displace some of the orange juice with it. Personally I've come to embrace carbs (150-200g/day) and depend on them.

That much carb would bury me 10 ft under pretty quick. Do you measure your glucose one and two hours after meals with a glucometer? You might want to start doing that if you ingest 75 gm of carbs in one meal. You might get an ugly surprise if you are older than 30.

The relationship is between oxalates and citrate supplements; potassium/magnesium/calcium citrate help prevent stones.

Ah, the issue here is that potassium citrate spares bones from releasing calcium carbonates. The body doesn't cannibalize its own bone to build alkaline buffers. So there is less calcium in circulation, and therefore less calcium for kidneys to excrete. Maybe something like that?

 

[Tunguska]

That much carb would bury me 10 ft under pretty quick. Do you measure your glucose one and two hours after meals with a glucometer? You might want to start doing that if you ingest 75 gm of carbs in one meal. You might get an ugly surprise if you are older than 30.

I go for ~50g a meal with fiber, fat, protein. Snack/drink in-between. 25-50g fructose per day (this seems important). Never measured blood glucose after meals, but not worried (never had a bad glucose blood result, no sign of diabetes even when I was obese, and used to do much worse when was careless about health). If I go less than 50g per day I can't function; less than 100g I have trouble; 100g seems non-optimal; higher protein to compensate just gives fog; MCT does nothing. Government recommends nearly 300g/day, brain uses 120g/day, so 150g is mid-point and seems reasonable for main meals, plus snacks; roughly what PHD and Ray Peat diets recommend. Body will have to handle 150g one way or another, so it's mostly pacing digestion.

Ah, the issue here is that potassium citrate spares bones from releasing calcium carbonates. The body doesn't cannibalize its own bone to build alkaline buffers. So there is less calcium in circulation, and therefore less calcium for kidneys to excrete. Maybe something like that?

Don't know. Read it some time ago and forgot it all, but there are articles on ncbi.nlm.nih.gov and stuff linked off the low oxalate diet. I had concerns for awhile one of my problems might be stones, can't afford new problems. Need magnesium anyway; citrate form is cheap; safe bet.

 

[pemone]

I go for ~50g a meal with fiber, fat, protein. Snack/drink in-between. 25-50g fructose per day (this seems important). Never measured blood glucose after meals, but not worried (never had a bad glucose blood result, no sign of diabetes even when I was obese, and used to do much worse when was careless about health). If I go less than 50g per day I can't function; less than 100g I have trouble; 100g seems non-optimal; higher protein to compensate just gives fog; MCT does nothing. Government recommends nearly 300g/day, brain uses 120g/day, so 150g is mid-point and seems reasonable for main meals, plus snacks; roughly what PHD and Ray Peat diets recommend. Body will have to handle 150g one way or another, so it's mostly pacing digestion.

This is a pretty common fallacy about fasting blood glucose. Fasting glucose tells you almost nothing about your post pandrial responses. The number that matters is A1C. In my case I had 95 to 105 on my fasting number, but only after I tested did I see I had pretty serious problems. Testing for four months constantly is what it took for me to finally understand what was a safe level of carbs for me.

Like you, I become dysfunctional on 50 gm of carbs per day. I seem to do well at 100 gm. I would like to do more but my post pandrial responses are not good enough. This CFS disease seems to penalize us for low carbing.

Keep in mind that carbs from starch are like liquid rocket fuel and send glucose soaring. Carbs from veggies are much slower to digest. Carbs from fruit in form of fructose are probably harmful because they metabolize to the most dangerous form of VLDL cholesterol in the liver.

 

[Tunguska]

This is a pretty common fallacy about fasting blood glucose. Fasting glucose tells you almost nothing about your post pandrial responses. The number that matters is A1C. In my case I had 95 to 105 on my fasting number, but only after I tested did I see I had pretty serious problems. Testing for four months constantly is what it took for me to finally understand what was a safe level of carbs for me.

I believe you. I haven't put much stock in blood tests at all, but a few doctors now wanted to pin my problems on diabetes but had to look elsewhere since it looked great to them. The only time I've felt bad from carbs was from eating a whole large pizza, things like that, but that's obviously confounded with many factors. I would do that testing if given the chance but I very much doubt it's a serious problem for me and have much more pressing issues. If I had to cut carbs I think it would do more harm than good for me at the moment.

Like you, I become dysfunctional on 50 gm of carbs per day. I seem to do well at 100 gm. I would like to do more but my post pandrial responses are not good enough. This CFS disease seems to penalize us for low carbing.

It sure seems to... Seems particularly bad for hypothyroiders, which made me wonder if that isn't what I've had instead, but no immediate evidence of it.

Keep in mind that carbs from starch are like liquid rocket fuel and send glucose soaring. Carbs from veggies are most slower to digest. Carbs from fruit in form of fructose are probably harmful because they metabolize to the most dangerous form of VLDL cholesterol in the liver.

The fructose is where I divert a bit. I believe it's good if used judiciously, so I aim for 25-50g a day , closer to 50g these days (100g sugar). It has advantages over starch (one being blood glucose) and nothing I've found would lead to believe the liver effects matter with this kind of consumption, and if anything I think a substantial proportion of total carbs as fructose is superior for someone in my situation. The worst issues with fructose actually seem to be not liver but gut-related, but you mitigate those with fruit/fiber/resistant starch and probiotics. Also vitamin C, ALA, etc.

 

[kraken]

I have trouble supplementing Potassium since starting and qutting methylation and wonder if somebody could give me some advice based on my recent blood test. I've stopped like 2 months ago as I got too much side effects which might be related to my gut/something else).

Magnesium level before starting methylation: 0,77 mmol/L
Potassium level before starting methylation: 3,8 mmol/L
Potassium level after 3 months of methylation: 3,7 mmol/L

Now i'm not sure if 3,7 mmol/L would be considered low for a guy in mid 20s/180/75kg?

During methylation, I supplemented Potassium (almost) daily in dose ranges of 500-2000 mg / day. This included Gluconate, also tried Citrate and Chloride (Chloride gave me a horrible reaction).

As of today, i'm very stiff in my muscles (especially upper-back and neck), not very flexible and a lot of cracking/tense muscles. I have pain as well throughout my body (mostly upper-back) and a lot of other stuff that I might think could be attributed to low potassium. I had this before but not this pronounced.

Some other levels from my recent test:

Sodium: 138 mmol/L
Calcium: 2,34 mmol/L
Zinc: 14,1 umol/L
Magnesium: 0,83 mmol/L



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