I'm currently reading through Google search results, trying to determine whether iron levels might somehow affect potassium upon B12 supplementation.
So far, I have read partly through this study, which put the person on a high potassium diet, to avoid hypokalemia, when supplementing both B12 and iron:
"Based on these findings, the patient was diagnosed with anemia caused by a combined vitamin B12 and iron deficiency attributable to impaired absorption caused by SBS. Parenteral vitamin B12 and iron treatment was initiated. Vitamin B12, as cobalamin, was administrated via intramuscular injection of 100 µg daily for 14 days, followed by 50 µg every other week. Our patient was also given 3 mg/kg elemental iron (ferric form) intravenously every other day for 14 days, followed by the same dose weekly. He was initially placed on a high potassium diet to avoid the transient hypokalemia that could result from rapid erythropoiesis."
At least they presumed that the hypokalemia would be transient. I'll take that as promising news. What I wish they explained more was: how much potassium on a high potassium diet??? I already eat a high potassium diet bc it's whole food, plant based. I just ate another serving of liver with my otherwise plant based lunch (my lunch included: potatoes, green beans, corn, carrots, quinoa, tomato sauce (just dab), broccoli, ground turkey breast (cooked), and beef liver (obviously cooked). Most veggies have a lot of potassium. Yet I felt tired after lunch.
I did workout today (mostly walking outside for an hour, a few min of running in the mix, then about 45 min indoors on the elliptical bc not as much sweating and the walk was basically like no exercise -- and I'm tired of not being myself). During my workout, I drank one serving of C water, then another after.
Now later in the day, 6 p.m., and I'm feeling twitchy and unusually tired. So now again drinking more water with potassium drops (100 mg).
I might fail. I mean I might die. Holy hell. But right now I am still pretty determined to continue some form of fitness / exercise, listening to my body, and trying like hell to avoid needing to ingest high doses of straight potassium.
Other good news is that I slept for 5.5 hrs last night. Early morning wakening is causing a problem. I read on another forum (recommended by B12 lady) that for whatever reason, B12 increases histamine, which can cause early morning wakening. Not sure what to do there. I can't handle a low histamine diet bc I need nutrients and I'm already low acid. I've never tried DAO supplements and can't imagine taking anything else, but maybe that's something worth considering if nothing else works. Today I took an Ambien at 6 a.m. to get a little more sleep, all the while wondering whether and how that drug might interfere with my healing.
The bad thing about that quote above (from the link) is that they started by giving the patient what look like very small initial, daily doses of both B12 and iron (I have deficiencies in both). And they still gave him a high potassium diet. So maybe injecting 1000 ml at a time is a bad idea. I don't even know how 100 ug equates in mls. But just looking real quick, 100 ug seems pretty low (and only 3 mg per kg of iron) (also interesting that iron was every other day -- something I've seen debated a lot in my recent reading).
"Other common adverse effects are fever, itching or rash, tingling or numbness of joint, shortness of breath, rapid weight gain, polycythemia, hypokalemia, congestive heart failure, pulmonary edema, and vascular thrombosis."
This resource claims that sublingual is okay if the cause was a strict vegan diet.
Why would B12 injections cause heart failure? Weight gain? And the other bad stuff??? Does anyone have any guesses?
That article has a lot of concerning info. Also, apparently you need your platelet count monitored if receiving B12 injections:
"Erythropoiesis significantly increases after treatment with cobalamin that may lead to hypokalemia. Thrombocytosis may occur after anemia correction. So, platelet count and serum potassium level require monitoring during cobalamin therapy."
my guess is its potassium related. b1 and potassium are required in equal good states. if either is too low, heart failure can result from this. its a typical refeeding symptom. thats why b1 and potassium must go hand in hand, especially if severe deficient.
its also shown that a equal deficiency in both b1 and potassium is somewhat protective against the bad effects for the heart in comparison to a normal/high b1 state and a low potassium level is bad. so if b12 increases potassium needs like crazy it might have the same effects like having too much b1 but too less potassium.
http://charles_w.tripod.com/kandthiamin.html
POTASSIUM and THIAMIN (VITAMIN B-1) in HEART DISEASE by Charles Weber, MS
I recommend that you seek additional advice before using any information in this article.
ABSTRACT Insufficient potassium and vitamin B-1 (thiamin) can not damage the heart significantly when both are deficient. This has very important implications when supplementing each during heart disease, hypertension, diabetes, and rheumatoid arthritis.
INTRODUCTION
Cardiovascular disease remains as the #1 cause of mortality. About 50% of heart failure patients will perish in 5-years. At age 40, life time risk of developing heart failure is 1 in 5.Diastolic dysfunction heart failure prevalence has increased to 50% of all heart failure. Most of the heart disease in western societies is probably either caused by or is greatly enhanced by a potassium deficiency. Potassium has been used in heart disease therapy since 1930 [1]. Potassium enriched table salt almost halved the mortality from cardiovascular disease of retired men studied in China over a 31 month period [2]. Permanent damage can be inflicted on the heart and kidneys of animals by potassium restriction [3].
However it is possible for a dangerous imbalance with respect to thiamine (vitamin B-1) can arise from potassium supplements if animal experiments are an indication. If potassium supplements are given during the wet heart disease of beri beri (vitamin B-1 deficiency), the heart disease is made much worse [4][5]. Wet heart disease of beri-beri is impossible if potassium is also deficient [6]. Instead a muscular atrophy similar to that from vitamin E deficiency appears [7][8]. Hove and Herndon suspect that muscular dystrophy is a potassium deficiency since body potassium is low during muscular dystrophy [7]. During a vitamin B-1 deficiency the heart loses potassium [4]. This may be why heart damage in beriberi resembles that in a potassium deficiency. The chemistry of vitamin B-1 in the body is extremely complicated and determining its status by chemical tests is very difficult (this article shows the chemistry in great detail)[36 Wooley]. One symptom of a vitamin B-1 deficiency is lactic acid acidosis [9]. Why the heart should be protected by a deficiency of both potassium and vitamin B-1 is strange, and I know no explanation for it.
Some of the symptoms of heart disease are shortness of breath, swelling of the legs and ankles and occasionally the abdomen, fatigue and weakness, loss of appetite and nausea, reduced urination, and persistent cough which sometimes produces mucus or blood tinged sputum. DISCUSSION
It could be the sulfur dioxide in most wines might be part of the reason why wine statistically protects people from the more prevalent potassium deficient heart disease because sulfites in most wines destroy vitamin B-1 in the intestines. Wine also has a poison in it that interferes with potassium excretion [10], and this would intensify the problem with vitamin B-1 destruction for those who start to take potassium supplements. Please keep in mind that the necrosis of heart tissue discussed here is not the same as cardiovascular disease of blood vessels, which is probably usually from a copper deficiency.
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]. . You may see here the way to acquire a very comprehensive book about potassium supplementation, nutrition and physiology. It is called “POTASSIUM NUTRITION in Heart Disease, Rheumatoid Arthritis, Gout, Diabetes, Metabolic Shock (hyperkalemia), and High Blood Pressure”. The table of contents and the introduction are shown.
Potassium supplements are also called sodium free table salt, Morton’s Lite salt, Stirling’s Half and Half (the above combination salts contain about one atom of potassium to two of sodium as the chloride), sodium free baking powder (potassium bicarbonate or tartrate), oral rehydration therapy (ORT) for diarrhea, glucose-insulin-kalium (GIK) salt, and potassium softened water [11]. Leafy vegetables low in starch are high in potassium, some so much so that they are virtually a supplement. Ammonium chloride is equivalent to a potassium supplement since ammonium interferes with excretion of potassium in the kidneys. Glucosamine is a biological reaction product of fructose-6-phosphate sugar and glutamic amino acid, sold as the sulfate. Glutamic acid breaks down forming ammonium ion in the body, so glucosamine acts to increase body potassium by ammonium interference with excretion. Some commercial glucosamine products are also a direct potassium supplement, since they contain large amounts of potassium chloride. Potassium was considered inert, or largely so in the past but definitely is not. In addition to potassium, ammonium and choline molecules were also used in salt substitutes. These molecules may not be useless. Choline is a biologically active material similar to vitamins but made by the body. Its long-term effects as a supplement are unknown to me. However choline supplements increase memory ability in baby rats when administered either before or after being born, probably from an increase in brain cell size [12]. Ammonium, at least, may interfere with potassium excretion if it is absorbed in the intestines and has been used to protect the kidneys [13]. So far as I know, reasonable amounts of the substitutes above are reasonably harmless for healthy people who have normal blood pressure. Ammonium is even synthesized by the kidneys during a potassium deficiency from glutamine, and this is probably a strategy of the body, the purpose of which is to prevent potassium loss. Eating glutamine increases ammonia excretion and decreases potassium excretion [14]. However, if ammonium chloride is used during a potassium deficiency a dangerous taurine depletion occurs resulting in lethal heart disease in cats [15], so should be avoided by humans until there is more information. Sulfate is an excretory product, so the sulfate as the anion with potassium should be, at the least, useless. I suspect that potassium as the sulfate may have the same effect on high blood pressure (hypertension) as the chloride has in increasing pressure, but I know of no evidence. In patients on adequate potassium and low sodium, there is no significant change of blood pressure from potassium supplements. “Urinary potassium was 77±16, 122±25, and 125±27 mmol/24 hours after 4 weeks on placebo, potassium chloride, and potassium bicarbonate, respectively. There were no significant differences in office blood pressure among the 3 treatment periods, and only 24-hour and daytime systolic blood pressures were slightly lower with potassium chloride. Compared with placebo, both potassium chloride and potassium bicarbonate significantly improved endothelial function as measured by brachial artery flow-mediated dilatation, increased arterial compliance as assessed by carotid-femoral pulse wave velocity, decreased left ventricular mass, and improved left ventricular diastolic function. There was no significant difference between the 2 potassium salts in these measurements. The study also showed that potassium chloride reduced 24-hour urinary albumin and albumin:creatinine ratio, and potassium bicarbonate decreased 24-hour urinary calcium, calcium:creatinine ratio, and plasma C-terminal cross-linking telopeptide of type 1 collagen significantly. These results demonstrated that an increase in potassium intake had beneficial effects on the cardiovascular system, and potassium bicarbonate may improve bone health. Importantly, these effects were found in individuals who already had a relatively low-salt and high-potassium intake.” Potassium citrate should have an affects similar to potassium bicarbonate because citrate is used by the body to provide energy. Potassium citrate has been found to effectively prevent kidney uric acid stones. This is probably related to producing a less acid urine. I suspect that the citrate or the carbonate are the safest long term potassium supplements.
Adding potassium sulfate to a processed food diet should have the same effect as adding sulfuric acid to a normal diet, whatever that is. In any case, sulfate and phosphate increases potassium excretion [16]. Phosphate is probably very dangerous for those with heart disease. Excess phosphate has caused 100 per cent mortality during heart disease [13], so potassium probably should not be provided as the phosphate. Soft drinks often are high in phosphoric acid.
Potassium bicarbonate has been shown to be not as quick as the chloride in relieving a deficiency both as to reducing cell sodium content and raising plasma levels of potassium [16][17]. However, potassium as the chloride should have the same affect on heart disease as potassium from unprocessed food coupled with hydrochloric acid supplements, whatever that is. There are times when this might be disadvantageous. However, even so, potassium chloride reduces blood pressure in sodium loaded spontaneously hypertensive rats and protects them from kidney damage [18] (and no doubt from heart disease).This may be because of difficulty in handling hydrogen ion (acid) in some forms of high blood pressure. Support is given to this possibility since sodium bicarbonate lowered blood pressure 5 mm of mercury while sodium chloride had no affect [19], possibly partly because sodium chloride was already high in their diet. Any designation of high blood pressure must be by comparing the pressure to the average among low sodium chloride intake people [20]. Both sodium and chloride are necessary for pressure augmentation [21]. This phenomenon may be involved with 18 hydroxy deoxycorticosterone steroid hormone (18 OHDOC) because that hormone is raised in one of the forms of high blood pressure [22] and that hormone is the hormone used by the body to increase acid excretion. Chloride as the potassium salt increases blood pressure somewhat though. All these complications are arguments to eat only undamaged food and get as much nourishment from food as possible
Even if the patient is eating foods fairly adequate in vitamin B-1, the patient could still possibly have a problem with vitamin B-1 deficiency if also eating foods that have sulfites in them since sulfites degrade vitamin B-1 in the intestines [23] [24] Such foods are wine, vinegar, pickles, olives, salad dressing, canned clams, fresh, frozen, canned, or dried shrimp, frozen lobster, scallops, dried cod, gelatin, pectin jelling agents, cornstarch, modified food starch, spinach pasta, gravies, hominy, breadings, batters, noodle/rice mixes, shredded coconut, vegetable juice, canned vegetables (including potatoes), pickled vegetables (including sauerkraut), dried vegetables, instant mashed potatoes, frozen potatoes, potato salad, corn syrup, maple syrup, fruit toppings, and high-fructose syrups such as corn syrup and pancake syrup, instant tea, liquid tea concentrates, beer, bottled lemon juice, some baked goods, some dried fruits, and some meat in dog and cat food [47]. Extruding wheat flour at temperatures approaching 100 degrees C can cause losses of vitamin B-1 as high as 34%. Using diuretics can cause loss of vitamin B-1 [25], loop diuretics, for instance [36 Wooley]. There is something in tea leaves that antagonizes vitamin B-1 [26]. Phenolic compounds in blueberries [48] and rice bran [49] destroy vitamin B-1. Also, the symptoms of a vitamin B-1 deficiency can materialize even if vitamin B-1 is adequate if magnesium is deficient, say from Chron’s disease [27]. A folate deficiency prevents thiamin absorption in rats. Folate is the most common B vitamin deficiency in the world. [50] Tea leaves and betel nuts destroy vitamin B-1. Consumption of food high in tannins can cause thiamin deficiency. The reaction was biphasic, having a rapid initial phase which was oxygen-independent, followed by a slower phase which was oxygen concentration-dependent. Ascorbic acid completely inhibited the reaction if present at the beginning of the reaction and could partially reverse the reaction if added during the first 30 min. It is possible that low hydrochloric acid in the stomach of diabetics causes destruction of vitamin B-1. The diet can vary widely as to vitamin B-1. Vitamin B-1 deficiency may be suspected in refugee immigrants, critically ill patients and alcoholics. Vitamin B-1 deficiency can result in cardiac failure, neuropathy, or Wernicke-Korsakoff syndrome, which last can not be cured with oral supplements even though classic thiamine deficiency symptoms do not show [28].
Diabetics should keep in mind a new discovery that type 1 diabetics excrete vitamin B-1 four times normal people and type 2 three times, which leads to a vitamin B-1 content in plasma one fourth as high in diabetics. This is due to a malfunction of thiamin absorption in the proximal kidney tubules. Erythrocyte (red blood cells) vitamin B-1 was normal in diabetics, probably because there were increased thiamin transporters THTR-1 RFC-1 in the cell wall. Therefore erythrocyte thiamin can not be used to determine thiamin status [29].
Since diabetics are usually deficient in potassium, it seems that it is highly probable that they should never use potassium unless they correct the vitamin B-1 at the same time and the reverse.
Rheumatoid Arthritis
The reverse is also the case. Vitamin B-1 supplements should be dangerous for people with low potassium. Since cell potassium is always low in rheumatoid arthritis [30], such people should not take vitamin B-1 without potassium. This may be part of the reason why people with rheumatoid arthritis (but not osteoarthritis) have a much higher heart disease rate than others [31]. It is not possible to rely on plasma or serum potassium determinations because when the blood of arthritics is drawn the platelets release potassium into the plasma [32]. Even so, 80% of people with rheumatic heart disease have low blood plasma potassium content [33].
All purpose vitamin capsules contain no potassium but usually contain vitamin B-1. Some contain 1,000% of the recommended daily intake and one even contains 5,000%. This is -dangerous for most heart disease in the absence of potassium supplements, but I do not know what definitive affect it has on rheumatoid arthritis.
CONCLUSION
It is extremely important to determine what kind of heart disease a patient has because of the potassium / vitamin B-1 imbalance. As much of essential vitamins and minerals should be obtained from food as possible in or out of a hospital, because nutrient interactions are complicated and correcting deficiencies is difficult for doctors and sometimes dangerous. For patients it is almost impossible to get it correctly. Food is usually safe and balanced for people with no genetic defect if unprocessed, varied, and free of poison. Food processors have no legitimate excuse for destroying or poisoning the food. They have PhDs in nutrition and food technology.
It is probable that the increased mortality during heart disease from taking non steroid anti inflammatory drugs (NSAIDs) that Mangoni and Knights mention is because of NSAIDs’ affect in inhibiting aldosterone degradation [60], so that the build up in aldosterone causes inappropriate potassium excretion thus an artificial potassium deficiency is created. REFERENCES – see them below at the end
IDEAL POTASSIUM INTAKE If every one had an average intake of potassium equal to his fair share of the as grown potassium, they would receive about 3,500 milligrams per day. After processing losses and uneaten food is subtracted from the total [37 Adelson], my best guess is that the average daily intake is about 2,000 milligrams per day [38 Economic]. Keep in mind that half the people are eating less than the average. Old people have an intake less than the average [39 Dall & Gardner]. [40 Dall, et al], which is no doubt at least partly due to a lower caloric intake. Black people in Georgia average 1,500 milligrams per day, while their white neighbors average 2,000 milligrams [41Grim 1970] [42 Grim 1980]. I say the above is an unacceptably high loss. Anyone taking a pay cut like that would be very, very unhappy.
Low potassium intake is also somewhat implicated in high blood pressure, stroke, osteoporosis [35], and kidney stones. Potassium ingested as the chloride can actually raise blood pressure (hypertension) slightly. Potassium has been found to increase bone density [43 Tucker].
POLITICS of POTASSIUM
The health of people in the USA is abysmal , and a major part of it is poor nutrition. As the 12th century physician, trying to cure by diet before he administers drugs, said; “No illness that can be treated by diet should be treated by any other means" or as Hippocrates expressed it in 460 - 377BC; "If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." It would seem that a healthy life style has been known for a long time. It is my belief that an unprocessed, unfrozen, not canned, high in vegetables diet would keep a large majority of people reasonably healthy and without the need for fad diets. The World Health Organization of the UN agrees with this, and maintains that the majority of deaths are from nutrition preventable chronic diseases. 80% of Americans do not eat adequate vegetables, but even though 72% of Americans take vitamin or mineral supplements daily or sometimes [44 Sardi p148], their health is atrocious, especially old people. Those who don't smoke, eat five servings of fruits and vegetables daily, exercise regularly and maintain a normal weight account for ONLY 3 PERCENT of the adult population in the United States, according to the report in the April 25 issue of the Archives of Internal Medicine. And now people with primitive diets are switching over to up to date destroyed diets world wide with corresponding decline in health.
One third of the world’s children are under weight and malnourished. 20,000 die of hunger each year [45 Gitlin]. We can ill afford to deliberately destroy any of our food by processors.
I would suggest that a partial solution to the problem of poor potassium nutrition would be to place a tax on all food that has had potassium removed by food processors and completely fund all Medicare, Medicaid, and workman’s compensation for injuries and disease that relate to rheumatoid arthritis, gout, heart disease, and high blood pressure. This would also take the onerous tax burden now incurred for them and place it on the shoulders of those who cause the problem. And this tax burden is not the only burden. Half the bankruptcies in the USA are caused by medical bills. Achieving this would be much more likely if the money was removed from politics by public funding of election campaigns and there were runoff elections. It would be the best bargain for use of public funds we would ever have made. The Health Freedom Foundation is currently attempting to solve the problem by lobbying government legislatures to change the laws and agencies organizations. Michael Jacobson and Kelly Brownell of the Center for Science in the Public Interest have proposed a small tax on soft drinks and candy to finance public nutrition education. This would be a small step in the correct direction, but inadequate by itself. Another idea to help the nutrition of our society by Dan O’Keefe is to require all supermarkets to provide a computer that tells a shopper which brands should not be eaten for each of the degenerative diseases (for instance food containing sulfite not to be eaten by those suffering from beri-beri caused heart disease).
REFERENCES ----1. Sampson JJ, Anderson, EM. The therapeutic use of potassium in certain cardiac arrhythmias. Proceedings of the Society of Experimental Biology & Medicine 28: 163, 1930.
----2. Chang HY, Hu YW, Yue CSJ, Wen YW, Yeh WT, Hsu LS. Effect of potassium-enriched salt on cardiovascular mortality and medical expenses of elderly men, l, Am J Clin Nutr, 83(6): 1289-96, 2006.
----3. Rubini ME, Chojnacki RE. Principles of parenteral therapy. Am. Clin. Nutr. 25: 96-113, 1972.
----4. Mineno T. Effect of some vitamins and other substances on K metabolism in the myocardia of vitamin deficient rats - Experiemtal investigation. J. Nagoya Med. Assoc. 92: 80-95, 1969.
----5. Gould SE, ed Pathology of the Heart and Blood Vessels - 3rd ed. Charles C. Thomas, Springfield, Ill p 508 1968.
----6. Folis RH. Myocardial necroses in rats on a potassium low diet prevented by thiamine deficiency. Bulletin Johns Hopkins Hosp.71: 235-241, 1942.
----7. Hove EL, Herndon JF. Potassium deficiency in the rabbit as a cause of muscular dystrophy. J Nutr. 55: 363-374, 1953.
----8. Blahd WH, Cassen B, Lederer M. Body potassium content in patients with muscular dystrophy - body composition part 1. Ann. N. Y. Acad. Sci. 110: 282-290, 1963.
----9. Romanski SA, McMahon MM. Metabolic acidosis and thiamine deficiency. Mayo Clin Proc. 1999 Mar;74(3):259-63, 1999.
----10. McDonald JT, Margen S. Wine vs ethanol in human nutrition. Fluid sodium and potassium balance. American journal of Clinical Nutrition 32: 817-822, 1979.
----11. Williams CL Meck WH Heyer DD Loy R Hypertrophy of basal forebrain neurons and enhanced visuospatial memory in perinatally choline supplemented rats. Brain Research 794: 225-238, 1998.
----12. Weber CE, Potassium supplements as affecting rheumatoid arthritis, diarrhea, hypertension, and heart disease. Available from URL http://charles_w.tripod.com/arthritis11.html
----13. Selye H, Sylvester O, Hall CE, Leblond CP. Hormonal production of arthritis. J. Am. Med. Assoc 124: 201, 1944.
----14. Tannen RL. Relationship of renal ammonia production and potassium homostasis. Kidney International 11: 453-465, 1977.
----15. Dow SW, Fettman MJ, Smith KR, Ching SV, Hamar DW. Taurine Depletion and Cardiovascular Disease in Cats Fed a Potassium-Depleted, Acidified Diet. American Journal of Veterinary Research, 53(3):402-405, 1992.
----16. Giebisch G. 1979 Renal potassium transport, Chapter 5 in; Membrane Transport in Biology. p215-298 Giebisch G editor. Springer Verlag, Berlin, NY
----17. DeLand EC, Villamil MF, Maloney Jr JV. A theoretical and experimental study of ionic shifts induced by K depletion and replacement. Journal of Theoretical Biology 76: 31-51, 1979.
----18. Ellis D, Banner B, Janosky JE, Feig PU. Potassium supplementation attenuates experimental hypertensive renal injury. Journal of the American Society of Nephrology, 2: 1529-1537, 1992.
----19. Luft FC, Zemel MB, Sowers JA, Fineberg NS, Weinberger MH. Sodium bicarbonate and sodium chloride: effects on blood pressure and electrolyte homeostasis in normal and hypertensive man. Journal of Hypertension 8: 663-670, 1990.
----20. Tekol Y. Is systemic hypertension only a sign of chronic sodium chloride intoxication? Medical Hypotheses 67: 630-638, 2006.
----21. Boegshold M, Kotchen TA. Importance of dietary chloride for salt sensitivity of blood pressure. Hypertension 17: (auppl) I 158-I161, 1991.
----22. Melby JC, Dale SL, Grekin RJ, Gaunt R, Wilson TE. 18-hydroxy 11 deoxycorticosterone (18 OH-DOC) secretion in experimental and human hypertension. Recent Progress in Hormone Resarch. 28: 287-351, on p 323 1972.
----23. Amerine MA, Ough CS. Recent advances in enology. CRC Critical Reviews in Food Technology 2: 407-515 1972.
----24. Fitzhugh DG, Knudsen L, Nelson A. The chronic toxicity of sulfites J. Pharm. Exptl. Therap. 86: 37-48 1946.
----25. Suter PM, Vetter W. Diuretics and vitamin B1: are diuretics a risk factor for thiamin malnutrition? Nutr. Rev. 58:319-323, 2000.
----26. Baumgartner TG. What the practicing nurse should know about thiamine. Intraven. Nurs. 14: 130-135, 1991.
----27. Dyckner T, Ek B, Nyhlin H, Wester P.O. Aggravation of thiamine deficiency by magnesium depletion. A case report. Acta Med. Scand. 218: 129-130, 1985.
----28. Thompson AD. Mechanisms of vitamin deficiency in chronic alcohol misusers and the development of the Wernicke-Korsakoff syndrome. Alcohol Alcohol Suppl. 35: 2-7, 2000.
----29. Thornalley P, Babaei JR,-Jadidi R, Al Ali H, Rabbani N, Antonysunil A, Larkin J, Ahmed A, Rayman G, BodmerCW. High prevalence of low plasma thiamine concentration in diabetes linked to a marker of vascular disease. Diabetologia 50:2164–2170, 2007.
----30. LaCelle PL. An investigation of total body potassium in patients with rheumatoid arthritis. Proceedings of the Annual Meeting of the American Rheumatism Association, Arthritis and Rheumatism 7: 321, 1964.
----31. Matsuoka Y, Obana M, Mita S Kohno, M Irimajiri S, Fujimori I, Fukuda J. 1981 Studies of death in autopsied cases with rheumatoid arthritis, p 27. in;
New Horizons in Rheumatoid arthritis, (Shiokawa Y Abe T & Yamauchi. Y, eds.). exerpta Medica International Congress Series #535.
----32. Ifudu O, Markell MS, Friedman EA. Unrecognized pseudohyperkalemia as a cause of elevated potassium in patients with renal disease. American Journal of Nephrology 12: 102-104, 1992.
----33. Sokolov EI. Disorders of electrolyte metabolism in cases of rheumatic valvular heart disease (Russian). VOP. Revmatizma 1: 55-58 from; Arthritis and Rheumatic Diseases Abstracts 3: 526, 96, 1966.
----34. Hanninen SA Darling PB Sole MJ Barr A Keith ME 2008 The prevalence of thiamin deficiency in hospitalized patients with congestive heart failure. Journal of the American College of Cardiology. 47; 354-361.
----35. He and MacGregor 2001 Fortnightly review: Beneficial effects of potassium BMJ. 323; 497-501.
---- 36. Wooley JA 2008 Characteristics of thiamin and its relevance to the management of heart disease. Nutrition in Clinical Practice 27; 487-493.
---- 37. Adelson SF et al 1963 Discard of edible food in households. Journal Home Economics 55; 633.
---- 38. Economic Research Service 1971 Food consumption supplement for 1970 to Agricultural Economic Report #138 USDA, Wash. DC. ---- 39. Dall & Gardner HS 1971 Dietary intake of potassium by geriatric patients. Gerontol. Clinic 13; 119-124.
---- 40. Dall JLC Paulose S & Ferguson JA 1971 Potassium intake of elderly patients in hospital. Gerontol. Clinic 13; 114.
---- 41. Grim CE et al 1970 On the higher blood pressure of blacks: A study of sodium and potassium intake and excretion in a bi-racial community. Clinical Research 18; 593.
---- 42. Grim CE, Luft FC, Miller JZ, Meneely GR, Battarbee HD, Hames CG, Dahl LK 1980 Racial differences in blood pressure in Evans County, Georgia: relationship to sodium and potassium intake and plasma renin activity. J Chronic Dis. 33(2):87-94.
---- 43. Tucker KL Hannan ML Chen H Cupples A Wilson PWF Kiel DP 1999 Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. Am. J. Clinical Nutrition, Apr 1999; 69: 727 - 736.
---- 44. Sardi B 2003 The New Truth About Vitamins and Minerals. Here and Now Books, 457 West Allen Ave. #117, San Dimas, CA 91773.
---- 45. Gitlin JD 2006 Distributing nutrition. Science 314; 1252-1253.
---- 46. Rastmanesh R 2008 A pilot study of potassium supplementation in treatment of hypokalemic patients with rheumatoid arthritis: a randomized, double-blinded, placebo controlled trial. The Journal of Pain 9; 722.
---- 47. Studdert, et. al. 1991 Thiamin deficiency in cats and dogs associated with feeding meat preserved with sulphur dioxide, Australian Veterinary Journal, Vol 68, issue 2, p 54-57.
---- 48. Hilker, et. al. 1958 Antithiamin factors in blueberries. Intern J. Vitamin Res., 38: 387.
---- 49. Chaudhuri DK. 1962 Antithiamine factor of rice-bran. Sci. Cult. 28: 384-5.
---- 50. Howard L Wagner C Schenker S 1974 Malabsorption of Thiamin in Folate-deficient Rats, J. Nutr.
---- 60. Knights KM Mangoni AA 2006 Non-selective nonsteroidal anti-inflammatory drugs and cardiovascular events: is aldosterone the silent partner in crime? British Journal of Clinical Pharmacology 61; 738-740.
---- 61. Vacek LV et al American Journal of Cardiology Volume 109, Issue 3 , Pages 359-363, 1 February 2012
my guess is its potassium related. b1 and potassium are required in equal good states. if either is too low, heart failure can result from this. its a typical refeeding symptom. thats why b1 and potassium must go hand in hand, especially if severe deficient.
its also shown that a equal deficiency in both b1 and potassium is somewhat protective against the bad effects for the heart in comparison to a normal/high b1 state and a low potassium level is bad. so if b12 increases potassium needs like crazy it might have the same effects like having too much b1 but too less potassium.
http://charles_w.tripod.com/kandthiamin.html
POTASSIUM and THIAMIN (VITAMIN B-1) in HEART DISEASE by Charles Weber, MS
I recommend that you seek additional advice before using any information in this article.
ABSTRACT Insufficient potassium and vitamin B-1 (thiamin) can not damage the heart significantly when both are deficient. This has very important implications when supplementing each during heart disease, hypertension, diabetes, and rheumatoid arthritis.
INTRODUCTION
Cardiovascular disease remains as the #1 cause of mortality. About 50% of heart failure patients will perish in 5-years. At age 40, life time risk of developing heart failure is 1 in 5.Diastolic dysfunction heart failure prevalence has increased to 50% of all heart failure. Most of the heart disease in western societies is probably either caused by or is greatly enhanced by a potassium deficiency. Potassium has been used in heart disease therapy since 1930 [1]. Potassium enriched table salt almost halved the mortality from cardiovascular disease of retired men studied in China over a 31 month period [2]. Permanent damage can be inflicted on the heart and kidneys of animals by potassium restriction [3].
However it is possible for a dangerous imbalance with respect to thiamine (vitamin B-1) can arise from potassium supplements if animal experiments are an indication. If potassium supplements are given during the wet heart disease of beri beri (vitamin B-1 deficiency), the heart disease is made much worse [4][5]. Wet heart disease of beri-beri is impossible if potassium is also deficient [6]. Instead a muscular atrophy similar to that from vitamin E deficiency appears [7][8]. Hove and Herndon suspect that muscular dystrophy is a potassium deficiency since body potassium is low during muscular dystrophy [7]. During a vitamin B-1 deficiency the heart loses potassium [4]. This may be why heart damage in beriberi resembles that in a potassium deficiency. The chemistry of vitamin B-1 in the body is extremely complicated and determining its status by chemical tests is very difficult (this article shows the chemistry in great detail)[36 Wooley]. One symptom of a vitamin B-1 deficiency is lactic acid acidosis [9]. Why the heart should be protected by a deficiency of both potassium and vitamin B-1 is strange, and I know no explanation for it.
Some of the symptoms of heart disease are shortness of breath, swelling of the legs and ankles and occasionally the abdomen, fatigue and weakness, loss of appetite and nausea, reduced urination, and persistent cough which sometimes produces mucus or blood tinged sputum. DISCUSSION
It could be the sulfur dioxide in most wines might be part of the reason why wine statistically protects people from the more prevalent potassium deficient heart disease because sulfites in most wines destroy vitamin B-1 in the intestines. Wine also has a poison in it that interferes with potassium excretion [10], and this would intensify the problem with vitamin B-1 destruction for those who start to take potassium supplements. Please keep in mind that the necrosis of heart tissue discussed here is not the same as cardiovascular disease of blood vessels, which is probably usually from a copper deficiency.
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]. . You may see here the way to acquire a very comprehensive book about potassium supplementation, nutrition and physiology. It is called “POTASSIUM NUTRITION in Heart Disease, Rheumatoid Arthritis, Gout, Diabetes, Metabolic Shock (hyperkalemia), and High Blood Pressure”. The table of contents and the introduction are shown.
Potassium supplements are also called sodium free table salt, Morton’s Lite salt, Stirling’s Half and Half (the above combination salts contain about one atom of potassium to two of sodium as the chloride), sodium free baking powder (potassium bicarbonate or tartrate), oral rehydration therapy (ORT) for diarrhea, glucose-insulin-kalium (GIK) salt, and potassium softened water [11]. Leafy vegetables low in starch are high in potassium, some so much so that they are virtually a supplement. Ammonium chloride is equivalent to a potassium supplement since ammonium interferes with excretion of potassium in the kidneys. Glucosamine is a biological reaction product of fructose-6-phosphate sugar and glutamic amino acid, sold as the sulfate. Glutamic acid breaks down forming ammonium ion in the body, so glucosamine acts to increase body potassium by ammonium interference with excretion. Some commercial glucosamine products are also a direct potassium supplement, since they contain large amounts of potassium chloride. Potassium was considered inert, or largely so in the past but definitely is not. In addition to potassium, ammonium and choline molecules were also used in salt substitutes. These molecules may not be useless. Choline is a biologically active material similar to vitamins but made by the body. Its long-term effects as a supplement are unknown to me. However choline supplements increase memory ability in baby rats when administered either before or after being born, probably from an increase in brain cell size [12]. Ammonium, at least, may interfere with potassium excretion if it is absorbed in the intestines and has been used to protect the kidneys [13]. So far as I know, reasonable amounts of the substitutes above are reasonably harmless for healthy people who have normal blood pressure. Ammonium is even synthesized by the kidneys during a potassium deficiency from glutamine, and this is probably a strategy of the body, the purpose of which is to prevent potassium loss. Eating glutamine increases ammonia excretion and decreases potassium excretion [14]. However, if ammonium chloride is used during a potassium deficiency a dangerous taurine depletion occurs resulting in lethal heart disease in cats [15], so should be avoided by humans until there is more information. Sulfate is an excretory product, so the sulfate as the anion with potassium should be, at the least, useless. I suspect that potassium as the sulfate may have the same effect on high blood pressure (hypertension) as the chloride has in increasing pressure, but I know of no evidence. In patients on adequate potassium and low sodium, there is no significant change of blood pressure from potassium supplements. “Urinary potassium was 77±16, 122±25, and 125±27 mmol/24 hours after 4 weeks on placebo, potassium chloride, and potassium bicarbonate, respectively. There were no significant differences in office blood pressure among the 3 treatment periods, and only 24-hour and daytime systolic blood pressures were slightly lower with potassium chloride. Compared with placebo, both potassium chloride and potassium bicarbonate significantly improved endothelial function as measured by brachial artery flow-mediated dilatation, increased arterial compliance as assessed by carotid-femoral pulse wave velocity, decreased left ventricular mass, and improved left ventricular diastolic function. There was no significant difference between the 2 potassium salts in these measurements. The study also showed that potassium chloride reduced 24-hour urinary albumin and albumin:creatinine ratio, and potassium bicarbonate decreased 24-hour urinary calcium, calcium:creatinine ratio, and plasma C-terminal cross-linking telopeptide of type 1 collagen significantly. These results demonstrated that an increase in potassium intake had beneficial effects on the cardiovascular system, and potassium bicarbonate may improve bone health. Importantly, these effects were found in individuals who already had a relatively low-salt and high-potassium intake.” Potassium citrate should have an affects similar to potassium bicarbonate because citrate is used by the body to provide energy. Potassium citrate has been found to effectively prevent kidney uric acid stones. This is probably related to producing a less acid urine. I suspect that the citrate or the carbonate are the safest long term potassium supplements.
Adding potassium sulfate to a processed food diet should have the same effect as adding sulfuric acid to a normal diet, whatever that is. In any case, sulfate and phosphate increases potassium excretion [16]. Phosphate is probably very dangerous for those with heart disease. Excess phosphate has caused 100 per cent mortality during heart disease [13], so potassium probably should not be provided as the phosphate. Soft drinks often are high in phosphoric acid.
Potassium bicarbonate has been shown to be not as quick as the chloride in relieving a deficiency both as to reducing cell sodium content and raising plasma levels of potassium [16][17]. However, potassium as the chloride should have the same affect on heart disease as potassium from unprocessed food coupled with hydrochloric acid supplements, whatever that is. There are times when this might be disadvantageous. However, even so, potassium chloride reduces blood pressure in sodium loaded spontaneously hypertensive rats and protects them from kidney damage [18] (and no doubt from heart disease).This may be because of difficulty in handling hydrogen ion (acid) in some forms of high blood pressure. Support is given to this possibility since sodium bicarbonate lowered blood pressure 5 mm of mercury while sodium chloride had no affect [19], possibly partly because sodium chloride was already high in their diet. Any designation of high blood pressure must be by comparing the pressure to the average among low sodium chloride intake people [20]. Both sodium and chloride are necessary for pressure augmentation [21]. This phenomenon may be involved with 18 hydroxy deoxycorticosterone steroid hormone (18 OHDOC) because that hormone is raised in one of the forms of high blood pressure [22] and that hormone is the hormone used by the body to increase acid excretion. Chloride as the potassium salt increases blood pressure somewhat though. All these complications are arguments to eat only undamaged food and get as much nourishment from food as possible
Even if the patient is eating foods fairly adequate in vitamin B-1, the patient could still possibly have a problem with vitamin B-1 deficiency if also eating foods that have sulfites in them since sulfites degrade vitamin B-1 in the intestines [23] [24] Such foods are wine, vinegar, pickles, olives, salad dressing, canned clams, fresh, frozen, canned, or dried shrimp, frozen lobster, scallops, dried cod, gelatin, pectin jelling agents, cornstarch, modified food starch, spinach pasta, gravies, hominy, breadings, batters, noodle/rice mixes, shredded coconut, vegetable juice, canned vegetables (including potatoes), pickled vegetables (including sauerkraut), dried vegetables, instant mashed potatoes, frozen potatoes, potato salad, corn syrup, maple syrup, fruit toppings, and high-fructose syrups such as corn syrup and pancake syrup, instant tea, liquid tea concentrates, beer, bottled lemon juice, some baked goods, some dried fruits, and some meat in dog and cat food [47]. Extruding wheat flour at temperatures approaching 100 degrees C can cause losses of vitamin B-1 as high as 34%. Using diuretics can cause loss of vitamin B-1 [25], loop diuretics, for instance [36 Wooley]. There is something in tea leaves that antagonizes vitamin B-1 [26]. Phenolic compounds in blueberries [48] and rice bran [49] destroy vitamin B-1. Also, the symptoms of a vitamin B-1 deficiency can materialize even if vitamin B-1 is adequate if magnesium is deficient, say from Chron’s disease [27]. A folate deficiency prevents thiamin absorption in rats. Folate is the most common B vitamin deficiency in the world. [50] Tea leaves and betel nuts destroy vitamin B-1. Consumption of food high in tannins can cause thiamin deficiency. The reaction was biphasic, having a rapid initial phase which was oxygen-independent, followed by a slower phase which was oxygen concentration-dependent. Ascorbic acid completely inhibited the reaction if present at the beginning of the reaction and could partially reverse the reaction if added during the first 30 min. It is possible that low hydrochloric acid in the stomach of diabetics causes destruction of vitamin B-1. The diet can vary widely as to vitamin B-1. Vitamin B-1 deficiency may be suspected in refugee immigrants, critically ill patients and alcoholics. Vitamin B-1 deficiency can result in cardiac failure, neuropathy, or Wernicke-Korsakoff syndrome, which last can not be cured with oral supplements even though classic thiamine deficiency symptoms do not show [28].
Diabetics should keep in mind a new discovery that type 1 diabetics excrete vitamin B-1 four times normal people and type 2 three times, which leads to a vitamin B-1 content in plasma one fourth as high in diabetics. This is due to a malfunction of thiamin absorption in the proximal kidney tubules. Erythrocyte (red blood cells) vitamin B-1 was normal in diabetics, probably because there were increased thiamin transporters THTR-1 RFC-1 in the cell wall. Therefore erythrocyte thiamin can not be used to determine thiamin status [29].
Since diabetics are usually deficient in potassium, it seems that it is highly probable that they should never use potassium unless they correct the vitamin B-1 at the same time and the reverse.
Rheumatoid Arthritis
The reverse is also the case. Vitamin B-1 supplements should be dangerous for people with low potassium. Since cell potassium is always low in rheumatoid arthritis [30], such people should not take vitamin B-1 without potassium. This may be part of the reason why people with rheumatoid arthritis (but not osteoarthritis) have a much higher heart disease rate than others [31]. It is not possible to rely on plasma or serum potassium determinations because when the blood of arthritics is drawn the platelets release potassium into the plasma [32]. Even so, 80% of people with rheumatic heart disease have low blood plasma potassium content [33].
All purpose vitamin capsules contain no potassium but usually contain vitamin B-1. Some contain 1,000% of the recommended daily intake and one even contains 5,000%. This is -dangerous for most heart disease in the absence of potassium supplements, but I do not know what definitive affect it has on rheumatoid arthritis.
CONCLUSION
It is extremely important to determine what kind of heart disease a patient has because of the potassium / vitamin B-1 imbalance. As much of essential vitamins and minerals should be obtained from food as possible in or out of a hospital, because nutrient interactions are complicated and correcting deficiencies is difficult for doctors and sometimes dangerous. For patients it is almost impossible to get it correctly. Food is usually safe and balanced for people with no genetic defect if unprocessed, varied, and free of poison. Food processors have no legitimate excuse for destroying or poisoning the food. They have PhDs in nutrition and food technology.
It is probable that the increased mortality during heart disease from taking non steroid anti inflammatory drugs (NSAIDs) that Mangoni and Knights mention is because of NSAIDs’ affect in inhibiting aldosterone degradation [60], so that the build up in aldosterone causes inappropriate potassium excretion thus an artificial potassium deficiency is created. REFERENCES – see them below at the end
IDEAL POTASSIUM INTAKE If every one had an average intake of potassium equal to his fair share of the as grown potassium, they would receive about 3,500 milligrams per day. After processing losses and uneaten food is subtracted from the total [37 Adelson], my best guess is that the average daily intake is about 2,000 milligrams per day [38 Economic]. Keep in mind that half the people are eating less than the average. Old people have an intake less than the average [39 Dall & Gardner]. [40 Dall, et al], which is no doubt at least partly due to a lower caloric intake. Black people in Georgia average 1,500 milligrams per day, while their white neighbors average 2,000 milligrams [41Grim 1970] [42 Grim 1980]. I say the above is an unacceptably high loss. Anyone taking a pay cut like that would be very, very unhappy.
Low potassium intake is also somewhat implicated in high blood pressure, stroke, osteoporosis [35], and kidney stones. Potassium ingested as the chloride can actually raise blood pressure (hypertension) slightly. Potassium has been found to increase bone density [43 Tucker].
POLITICS of POTASSIUM
The health of people in the USA is abysmal , and a major part of it is poor nutrition. As the 12th century physician, trying to cure by diet before he administers drugs, said; “No illness that can be treated by diet should be treated by any other means" or as Hippocrates expressed it in 460 - 377BC; "If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." It would seem that a healthy life style has been known for a long time. It is my belief that an unprocessed, unfrozen, not canned, high in vegetables diet would keep a large majority of people reasonably healthy and without the need for fad diets. The World Health Organization of the UN agrees with this, and maintains that the majority of deaths are from nutrition preventable chronic diseases. 80% of Americans do not eat adequate vegetables, but even though 72% of Americans take vitamin or mineral supplements daily or sometimes [44 Sardi p148], their health is atrocious, especially old people. Those who don't smoke, eat five servings of fruits and vegetables daily, exercise regularly and maintain a normal weight account for ONLY 3 PERCENT of the adult population in the United States, according to the report in the April 25 issue of the Archives of Internal Medicine. And now people with primitive diets are switching over to up to date destroyed diets world wide with corresponding decline in health.
One third of the world’s children are under weight and malnourished. 20,000 die of hunger each year [45 Gitlin]. We can ill afford to deliberately destroy any of our food by processors.
I would suggest that a partial solution to the problem of poor potassium nutrition would be to place a tax on all food that has had potassium removed by food processors and completely fund all Medicare, Medicaid, and workman’s compensation for injuries and disease that relate to rheumatoid arthritis, gout, heart disease, and high blood pressure. This would also take the onerous tax burden now incurred for them and place it on the shoulders of those who cause the problem. And this tax burden is not the only burden. Half the bankruptcies in the USA are caused by medical bills. Achieving this would be much more likely if the money was removed from politics by public funding of election campaigns and there were runoff elections. It would be the best bargain for use of public funds we would ever have made. The Health Freedom Foundation is currently attempting to solve the problem by lobbying government legislatures to change the laws and agencies organizations. Michael Jacobson and Kelly Brownell of the Center for Science in the Public Interest have proposed a small tax on soft drinks and candy to finance public nutrition education. This would be a small step in the correct direction, but inadequate by itself. Another idea to help the nutrition of our society by Dan O’Keefe is to require all supermarkets to provide a computer that tells a shopper which brands should not be eaten for each of the degenerative diseases (for instance food containing sulfite not to be eaten by those suffering from beri-beri caused heart disease).
REFERENCES ----1. Sampson JJ, Anderson, EM. The therapeutic use of potassium in certain cardiac arrhythmias. Proceedings of the Society of Experimental Biology & Medicine 28: 163, 1930.
----2. Chang HY, Hu YW, Yue CSJ, Wen YW, Yeh WT, Hsu LS. Effect of potassium-enriched salt on cardiovascular mortality and medical expenses of elderly men, l, Am J Clin Nutr, 83(6): 1289-96, 2006.
----3. Rubini ME, Chojnacki RE. Principles of parenteral therapy. Am. Clin. Nutr. 25: 96-113, 1972.
----4. Mineno T. Effect of some vitamins and other substances on K metabolism in the myocardia of vitamin deficient rats - Experiemtal investigation. J. Nagoya Med. Assoc. 92: 80-95, 1969.
----5. Gould SE, ed Pathology of the Heart and Blood Vessels - 3rd ed. Charles C. Thomas, Springfield, Ill p 508 1968.
----6. Folis RH. Myocardial necroses in rats on a potassium low diet prevented by thiamine deficiency. Bulletin Johns Hopkins Hosp.71: 235-241, 1942.
----7. Hove EL, Herndon JF. Potassium deficiency in the rabbit as a cause of muscular dystrophy. J Nutr. 55: 363-374, 1953.
----8. Blahd WH, Cassen B, Lederer M. Body potassium content in patients with muscular dystrophy - body composition part 1. Ann. N. Y. Acad. Sci. 110: 282-290, 1963.
----9. Romanski SA, McMahon MM. Metabolic acidosis and thiamine deficiency. Mayo Clin Proc. 1999 Mar;74(3):259-63, 1999.
----10. McDonald JT, Margen S. Wine vs ethanol in human nutrition. Fluid sodium and potassium balance. American journal of Clinical Nutrition 32: 817-822, 1979.
----11. Williams CL Meck WH Heyer DD Loy R Hypertrophy of basal forebrain neurons and enhanced visuospatial memory in perinatally choline supplemented rats. Brain Research 794: 225-238, 1998.
----12. Weber CE, Potassium supplements as affecting rheumatoid arthritis, diarrhea, hypertension, and heart disease. Available from URL http://charles_w.tripod.com/arthritis11.html
----13. Selye H, Sylvester O, Hall CE, Leblond CP. Hormonal production of arthritis. J. Am. Med. Assoc 124: 201, 1944.
----14. Tannen RL. Relationship of renal ammonia production and potassium homostasis. Kidney International 11: 453-465, 1977.
----15. Dow SW, Fettman MJ, Smith KR, Ching SV, Hamar DW. Taurine Depletion and Cardiovascular Disease in Cats Fed a Potassium-Depleted, Acidified Diet. American Journal of Veterinary Research, 53(3):402-405, 1992.
----16. Giebisch G. 1979 Renal potassium transport, Chapter 5 in; Membrane Transport in Biology. p215-298 Giebisch G editor. Springer Verlag, Berlin, NY
----17. DeLand EC, Villamil MF, Maloney Jr JV. A theoretical and experimental study of ionic shifts induced by K depletion and replacement. Journal of Theoretical Biology 76: 31-51, 1979.
----18. Ellis D, Banner B, Janosky JE, Feig PU. Potassium supplementation attenuates experimental hypertensive renal injury. Journal of the American Society of Nephrology, 2: 1529-1537, 1992.
----19. Luft FC, Zemel MB, Sowers JA, Fineberg NS, Weinberger MH. Sodium bicarbonate and sodium chloride: effects on blood pressure and electrolyte homeostasis in normal and hypertensive man. Journal of Hypertension 8: 663-670, 1990.
----20. Tekol Y. Is systemic hypertension only a sign of chronic sodium chloride intoxication? Medical Hypotheses 67: 630-638, 2006.
----21. Boegshold M, Kotchen TA. Importance of dietary chloride for salt sensitivity of blood pressure. Hypertension 17: (auppl) I 158-I161, 1991.
----22. Melby JC, Dale SL, Grekin RJ, Gaunt R, Wilson TE. 18-hydroxy 11 deoxycorticosterone (18 OH-DOC) secretion in experimental and human hypertension. Recent Progress in Hormone Resarch. 28: 287-351, on p 323 1972.
----23. Amerine MA, Ough CS. Recent advances in enology. CRC Critical Reviews in Food Technology 2: 407-515 1972.
----24. Fitzhugh DG, Knudsen L, Nelson A. The chronic toxicity of sulfites J. Pharm. Exptl. Therap. 86: 37-48 1946.
----25. Suter PM, Vetter W. Diuretics and vitamin B1: are diuretics a risk factor for thiamin malnutrition? Nutr. Rev. 58:319-323, 2000.
----26. Baumgartner TG. What the practicing nurse should know about thiamine. Intraven. Nurs. 14: 130-135, 1991.
----27. Dyckner T, Ek B, Nyhlin H, Wester P.O. Aggravation of thiamine deficiency by magnesium depletion. A case report. Acta Med. Scand. 218: 129-130, 1985.
----28. Thompson AD. Mechanisms of vitamin deficiency in chronic alcohol misusers and the development of the Wernicke-Korsakoff syndrome. Alcohol Alcohol Suppl. 35: 2-7, 2000.
----29. Thornalley P, Babaei JR,-Jadidi R, Al Ali H, Rabbani N, Antonysunil A, Larkin J, Ahmed A, Rayman G, BodmerCW. High prevalence of low plasma thiamine concentration in diabetes linked to a marker of vascular disease. Diabetologia 50:2164–2170, 2007.
----30. LaCelle PL. An investigation of total body potassium in patients with rheumatoid arthritis. Proceedings of the Annual Meeting of the American Rheumatism Association, Arthritis and Rheumatism 7: 321, 1964.
----31. Matsuoka Y, Obana M, Mita S Kohno, M Irimajiri S, Fujimori I, Fukuda J. 1981 Studies of death in autopsied cases with rheumatoid arthritis, p 27. in;
New Horizons in Rheumatoid arthritis, (Shiokawa Y Abe T & Yamauchi. Y, eds.). exerpta Medica International Congress Series #535.
----32. Ifudu O, Markell MS, Friedman EA. Unrecognized pseudohyperkalemia as a cause of elevated potassium in patients with renal disease. American Journal of Nephrology 12: 102-104, 1992.
----33. Sokolov EI. Disorders of electrolyte metabolism in cases of rheumatic valvular heart disease (Russian). VOP. Revmatizma 1: 55-58 from; Arthritis and Rheumatic Diseases Abstracts 3: 526, 96, 1966.
----34. Hanninen SA Darling PB Sole MJ Barr A Keith ME 2008 The prevalence of thiamin deficiency in hospitalized patients with congestive heart failure. Journal of the American College of Cardiology. 47; 354-361.
----35. He and MacGregor 2001 Fortnightly review: Beneficial effects of potassium BMJ. 323; 497-501.
---- 36. Wooley JA 2008 Characteristics of thiamin and its relevance to the management of heart disease. Nutrition in Clinical Practice 27; 487-493.
---- 37. Adelson SF et al 1963 Discard of edible food in households. Journal Home Economics 55; 633.
---- 38. Economic Research Service 1971 Food consumption supplement for 1970 to Agricultural Economic Report #138 USDA, Wash. DC. ---- 39. Dall & Gardner HS 1971 Dietary intake of potassium by geriatric patients. Gerontol. Clinic 13; 119-124.
---- 40. Dall JLC Paulose S & Ferguson JA 1971 Potassium intake of elderly patients in hospital. Gerontol. Clinic 13; 114.
---- 41. Grim CE et al 1970 On the higher blood pressure of blacks: A study of sodium and potassium intake and excretion in a bi-racial community. Clinical Research 18; 593.
---- 42. Grim CE, Luft FC, Miller JZ, Meneely GR, Battarbee HD, Hames CG, Dahl LK 1980 Racial differences in blood pressure in Evans County, Georgia: relationship to sodium and potassium intake and plasma renin activity. J Chronic Dis. 33(2):87-94.
---- 43. Tucker KL Hannan ML Chen H Cupples A Wilson PWF Kiel DP 1999 Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. Am. J. Clinical Nutrition, Apr 1999; 69: 727 - 736.
---- 44. Sardi B 2003 The New Truth About Vitamins and Minerals. Here and Now Books, 457 West Allen Ave. #117, San Dimas, CA 91773.
---- 45. Gitlin JD 2006 Distributing nutrition. Science 314; 1252-1253.
---- 46. Rastmanesh R 2008 A pilot study of potassium supplementation in treatment of hypokalemic patients with rheumatoid arthritis: a randomized, double-blinded, placebo controlled trial. The Journal of Pain 9; 722.
---- 47. Studdert, et. al. 1991 Thiamin deficiency in cats and dogs associated with feeding meat preserved with sulphur dioxide, Australian Veterinary Journal, Vol 68, issue 2, p 54-57.
---- 48. Hilker, et. al. 1958 Antithiamin factors in blueberries. Intern J. Vitamin Res., 38: 387.
---- 49. Chaudhuri DK. 1962 Antithiamine factor of rice-bran. Sci. Cult. 28: 384-5.
---- 50. Howard L Wagner C Schenker S 1974 Malabsorption of Thiamin in Folate-deficient Rats, J. Nutr.
---- 60. Knights KM Mangoni AA 2006 Non-selective nonsteroidal anti-inflammatory drugs and cardiovascular events: is aldosterone the silent partner in crime? British Journal of Clinical Pharmacology 61; 738-740.
---- 61. Vacek LV et al American Journal of Cardiology Volume 109, Issue 3 , Pages 359-363, 1 February 2012
Basically B12 injections, if they cause low potassium, cause heart failure. And I have to admit, I might be being paranoid, but I do have a few symptoms of heart failure. I'm extremely upset right now. B12 injections are obviously not worth what I may have already experienced, after only 4 shots. Again -- this might just be paranoia.
I have a swollen abdomen. I already had this before from ongoing gastro issues. For various reasons, docs told me this was caused by nerve damage. When I started the injections, my stomach briefly got flatter. But it's distended again.
I used to have to urinate often. Now it seems like I'm not very often.
I have had unusual tiredness and fatigue, just here and there, throughout the day. But very very unusual for me.
Oh nausea. Here and there, I've had nausea these last few days. Maybe slight weight gain. I haven't weighed myself bc I don't need more anxiety. But just looking in the mirror -- definitely a little weight gain, which, again, is not normal for me.
I can't remember the others. I don't have them all but I have concerning signs, to the point that I probably need to see a cardiologist.
My husband is adamant that he wants be to stop the shots bc I can't handle them, and try to use smaller doses from the sublinguals, until and unless I can handle more without having this potassium issue.
Low potassium is not an acceptable "side effect," and I'm probably screwed bc I'm too scared to take more potassium without knowing that my levels are low, and how much to take.
My husband is adamant that he wants be to stop the shots bc I can't handle them, and try to use smaller doses from the sublinguals, until and unless I can handle more without having this potassium issue.
Basically B12 injections, if they cause low potassium, cause heart failure. And I have to admit, I might be being paranoid, but I do have a few symptoms of heart failure. I'm extremely upset right now. B12 injections are obviously not worth what I may have already experienced, after only 4 shots. Again -- this might just be paranoia.
Oh nausea. Here and there, I've had nausea these last few days. Maybe slight weight gain. I haven't weighed myself bc I don't need more anxiety. But just looking in the mirror -- definitely a little weight gain, which, again, is not normal for me.
this is absolutely normal. you have been very sporty and active your life, now you have reduced sport activity. your body is super sensitive to insulin due to your life long sports.
professional sports folks often gain a lot of weight after stopping profi sports.
Low potassium is not an acceptable "side effect," and I'm probably screwed bc I'm too scared to take more potassium without knowing that my levels are low, and how much to take.
imho, you are really overcatastrophizing this. i really do not think you have any permanent damage or even heart failure in such a short time. just slow down, give your body time to heal, then take your time get at it again and try to find the levels / dosages you tolerate (better).
if you feel better, let a cardiologist have a routine check.
my guess is its potassium related. b1 and potassium are required in equal good states. if either is too low, heart failure can result from this. its a typical refeeding symptom. thats why b1 and potassium must go hand in hand, especially if severe deficient.
its also shown that a equal deficiency in both b1 and potassium is somewhat protective against the bad effects for the heart in comparison to a normal/high b1 state and a low potassium level is bad. so if b12 increases potassium needs like crazy it might have the same effects like having too much b1 but too less potassium.
http://charles_w.tripod.com/kandthiamin.html
POTASSIUM and THIAMIN (VITAMIN B-1) in HEART DISEASE by Charles Weber, MS
I recommend that you seek additional advice before using any information in this article.
ABSTRACT Insufficient potassium and vitamin B-1 (thiamin) can not damage the heart significantly when both are deficient. This has very important implications when supplementing each during heart disease, hypertension, diabetes, and rheumatoid arthritis.
INTRODUCTION
Cardiovascular disease remains as the #1 cause of mortality. About 50% of heart failure patients will perish in 5-years. At age 40, life time risk of developing heart failure is 1 in 5.Diastolic dysfunction heart failure prevalence has increased to 50% of all heart failure. Most of the heart disease in western societies is probably either caused by or is greatly enhanced by a potassium deficiency. Potassium has been used in heart disease therapy since 1930 [1]. Potassium enriched table salt almost halved the mortality from cardiovascular disease of retired men studied in China over a 31 month period [2]. Permanent damage can be inflicted on the heart and kidneys of animals by potassium restriction [3].
However it is possible for a dangerous imbalance with respect to thiamine (vitamin B-1) can arise from potassium supplements if animal experiments are an indication. If potassium supplements are given during the wet heart disease of beri beri (vitamin B-1 deficiency), the heart disease is made much worse [4][5]. Wet heart disease of beri-beri is impossible if potassium is also deficient [6]. Instead a muscular atrophy similar to that from vitamin E deficiency appears [7][8]. Hove and Herndon suspect that muscular dystrophy is a potassium deficiency since body potassium is low during muscular dystrophy [7]. During a vitamin B-1 deficiency the heart loses potassium [4]. This may be why heart damage in beriberi resembles that in a potassium deficiency. The chemistry of vitamin B-1 in the body is extremely complicated and determining its status by chemical tests is very difficult (this article shows the chemistry in great detail)[36 Wooley]. One symptom of a vitamin B-1 deficiency is lactic acid acidosis [9]. Why the heart should be protected by a deficiency of both potassium and vitamin B-1 is strange, and I know no explanation for it.
Some of the symptoms of heart disease are shortness of breath, swelling of the legs and ankles and occasionally the abdomen, fatigue and weakness, loss of appetite and nausea, reduced urination, and persistent cough which sometimes produces mucus or blood tinged sputum. DISCUSSION
It could be the sulfur dioxide in most wines might be part of the reason why wine statistically protects people from the more prevalent potassium deficient heart disease because sulfites in most wines destroy vitamin B-1 in the intestines. Wine also has a poison in it that interferes with potassium excretion [10], and this would intensify the problem with vitamin B-1 destruction for those who start to take potassium supplements. Please keep in mind that the necrosis of heart tissue discussed here is not the same as cardiovascular disease of blood vessels, which is probably usually from a copper deficiency.
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]. . You may see here the way to acquire a very comprehensive book about potassium supplementation, nutrition and physiology. It is called “POTASSIUM NUTRITION in Heart Disease, Rheumatoid Arthritis, Gout, Diabetes, Metabolic Shock (hyperkalemia), and High Blood Pressure”. The table of contents and the introduction are shown.
Potassium supplements are also called sodium free table salt, Morton’s Lite salt, Stirling’s Half and Half (the above combination salts contain about one atom of potassium to two of sodium as the chloride), sodium free baking powder (potassium bicarbonate or tartrate), oral rehydration therapy (ORT) for diarrhea, glucose-insulin-kalium (GIK) salt, and potassium softened water [11]. Leafy vegetables low in starch are high in potassium, some so much so that they are virtually a supplement. Ammonium chloride is equivalent to a potassium supplement since ammonium interferes with excretion of potassium in the kidneys. Glucosamine is a biological reaction product of fructose-6-phosphate sugar and glutamic amino acid, sold as the sulfate. Glutamic acid breaks down forming ammonium ion in the body, so glucosamine acts to increase body potassium by ammonium interference with excretion. Some commercial glucosamine products are also a direct potassium supplement, since they contain large amounts of potassium chloride. Potassium was considered inert, or largely so in the past but definitely is not. In addition to potassium, ammonium and choline molecules were also used in salt substitutes. These molecules may not be useless. Choline is a biologically active material similar to vitamins but made by the body. Its long-term effects as a supplement are unknown to me. However choline supplements increase memory ability in baby rats when administered either before or after being born, probably from an increase in brain cell size [12]. Ammonium, at least, may interfere with potassium excretion if it is absorbed in the intestines and has been used to protect the kidneys [13]. So far as I know, reasonable amounts of the substitutes above are reasonably harmless for healthy people who have normal blood pressure. Ammonium is even synthesized by the kidneys during a potassium deficiency from glutamine, and this is probably a strategy of the body, the purpose of which is to prevent potassium loss. Eating glutamine increases ammonia excretion and decreases potassium excretion [14]. However, if ammonium chloride is used during a potassium deficiency a dangerous taurine depletion occurs resulting in lethal heart disease in cats [15], so should be avoided by humans until there is more information. Sulfate is an excretory product, so the sulfate as the anion with potassium should be, at the least, useless. I suspect that potassium as the sulfate may have the same effect on high blood pressure (hypertension) as the chloride has in increasing pressure, but I know of no evidence. In patients on adequate potassium and low sodium, there is no significant change of blood pressure from potassium supplements. “Urinary potassium was 77±16, 122±25, and 125±27 mmol/24 hours after 4 weeks on placebo, potassium chloride, and potassium bicarbonate, respectively. There were no significant differences in office blood pressure among the 3 treatment periods, and only 24-hour and daytime systolic blood pressures were slightly lower with potassium chloride. Compared with placebo, both potassium chloride and potassium bicarbonate significantly improved endothelial function as measured by brachial artery flow-mediated dilatation, increased arterial compliance as assessed by carotid-femoral pulse wave velocity, decreased left ventricular mass, and improved left ventricular diastolic function. There was no significant difference between the 2 potassium salts in these measurements. The study also showed that potassium chloride reduced 24-hour urinary albumin and albumin:creatinine ratio, and potassium bicarbonate decreased 24-hour urinary calcium, calcium:creatinine ratio, and plasma C-terminal cross-linking telopeptide of type 1 collagen significantly. These results demonstrated that an increase in potassium intake had beneficial effects on the cardiovascular system, and potassium bicarbonate may improve bone health. Importantly, these effects were found in individuals who already had a relatively low-salt and high-potassium intake.” Potassium citrate should have an affects similar to potassium bicarbonate because citrate is used by the body to provide energy. Potassium citrate has been found to effectively prevent kidney uric acid stones. This is probably related to producing a less acid urine. I suspect that the citrate or the carbonate are the safest long term potassium supplements.
Adding potassium sulfate to a processed food diet should have the same effect as adding sulfuric acid to a normal diet, whatever that is. In any case, sulfate and phosphate increases potassium excretion [16]. Phosphate is probably very dangerous for those with heart disease. Excess phosphate has caused 100 per cent mortality during heart disease [13], so potassium probably should not be provided as the phosphate. Soft drinks often are high in phosphoric acid.
Potassium bicarbonate has been shown to be not as quick as the chloride in relieving a deficiency both as to reducing cell sodium content and raising plasma levels of potassium [16][17]. However, potassium as the chloride should have the same affect on heart disease as potassium from unprocessed food coupled with hydrochloric acid supplements, whatever that is. There are times when this might be disadvantageous. However, even so, potassium chloride reduces blood pressure in sodium loaded spontaneously hypertensive rats and protects them from kidney damage [18] (and no doubt from heart disease).This may be because of difficulty in handling hydrogen ion (acid) in some forms of high blood pressure. Support is given to this possibility since sodium bicarbonate lowered blood pressure 5 mm of mercury while sodium chloride had no affect [19], possibly partly because sodium chloride was already high in their diet. Any designation of high blood pressure must be by comparing the pressure to the average among low sodium chloride intake people [20]. Both sodium and chloride are necessary for pressure augmentation [21]. This phenomenon may be involved with 18 hydroxy deoxycorticosterone steroid hormone (18 OHDOC) because that hormone is raised in one of the forms of high blood pressure [22] and that hormone is the hormone used by the body to increase acid excretion. Chloride as the potassium salt increases blood pressure somewhat though. All these complications are arguments to eat only undamaged food and get as much nourishment from food as possible
Even if the patient is eating foods fairly adequate in vitamin B-1, the patient could still possibly have a problem with vitamin B-1 deficiency if also eating foods that have sulfites in them since sulfites degrade vitamin B-1 in the intestines [23] [24] Such foods are wine, vinegar, pickles, olives, salad dressing, canned clams, fresh, frozen, canned, or dried shrimp, frozen lobster, scallops, dried cod, gelatin, pectin jelling agents, cornstarch, modified food starch, spinach pasta, gravies, hominy, breadings, batters, noodle/rice mixes, shredded coconut, vegetable juice, canned vegetables (including potatoes), pickled vegetables (including sauerkraut), dried vegetables, instant mashed potatoes, frozen potatoes, potato salad, corn syrup, maple syrup, fruit toppings, and high-fructose syrups such as corn syrup and pancake syrup, instant tea, liquid tea concentrates, beer, bottled lemon juice, some baked goods, some dried fruits, and some meat in dog and cat food [47]. Extruding wheat flour at temperatures approaching 100 degrees C can cause losses of vitamin B-1 as high as 34%. Using diuretics can cause loss of vitamin B-1 [25], loop diuretics, for instance [36 Wooley]. There is something in tea leaves that antagonizes vitamin B-1 [26]. Phenolic compounds in blueberries [48] and rice bran [49] destroy vitamin B-1. Also, the symptoms of a vitamin B-1 deficiency can materialize even if vitamin B-1 is adequate if magnesium is deficient, say from Chron’s disease [27]. A folate deficiency prevents thiamin absorption in rats. Folate is the most common B vitamin deficiency in the world. [50] Tea leaves and betel nuts destroy vitamin B-1. Consumption of food high in tannins can cause thiamin deficiency. The reaction was biphasic, having a rapid initial phase which was oxygen-independent, followed by a slower phase which was oxygen concentration-dependent. Ascorbic acid completely inhibited the reaction if present at the beginning of the reaction and could partially reverse the reaction if added during the first 30 min. It is possible that low hydrochloric acid in the stomach of diabetics causes destruction of vitamin B-1. The diet can vary widely as to vitamin B-1. Vitamin B-1 deficiency may be suspected in refugee immigrants, critically ill patients and alcoholics. Vitamin B-1 deficiency can result in cardiac failure, neuropathy, or Wernicke-Korsakoff syndrome, which last can not be cured with oral supplements even though classic thiamine deficiency symptoms do not show [28].
Diabetics should keep in mind a new discovery that type 1 diabetics excrete vitamin B-1 four times normal people and type 2 three times, which leads to a vitamin B-1 content in plasma one fourth as high in diabetics. This is due to a malfunction of thiamin absorption in the proximal kidney tubules. Erythrocyte (red blood cells) vitamin B-1 was normal in diabetics, probably because there were increased thiamin transporters THTR-1 RFC-1 in the cell wall. Therefore erythrocyte thiamin can not be used to determine thiamin status [29].
Since diabetics are usually deficient in potassium, it seems that it is highly probable that they should never use potassium unless they correct the vitamin B-1 at the same time and the reverse.
Rheumatoid Arthritis
The reverse is also the case. Vitamin B-1 supplements should be dangerous for people with low potassium. Since cell potassium is always low in rheumatoid arthritis [30], such people should not take vitamin B-1 without potassium. This may be part of the reason why people with rheumatoid arthritis (but not osteoarthritis) have a much higher heart disease rate than others [31]. It is not possible to rely on plasma or serum potassium determinations because when the blood of arthritics is drawn the platelets release potassium into the plasma [32]. Even so, 80% of people with rheumatic heart disease have low blood plasma potassium content [33].
All purpose vitamin capsules contain no potassium but usually contain vitamin B-1. Some contain 1,000% of the recommended daily intake and one even contains 5,000%. This is -dangerous for most heart disease in the absence of potassium supplements, but I do not know what definitive affect it has on rheumatoid arthritis.
CONCLUSION
It is extremely important to determine what kind of heart disease a patient has because of the potassium / vitamin B-1 imbalance. As much of essential vitamins and minerals should be obtained from food as possible in or out of a hospital, because nutrient interactions are complicated and correcting deficiencies is difficult for doctors and sometimes dangerous. For patients it is almost impossible to get it correctly. Food is usually safe and balanced for people with no genetic defect if unprocessed, varied, and free of poison. Food processors have no legitimate excuse for destroying or poisoning the food. They have PhDs in nutrition and food technology.
It is probable that the increased mortality during heart disease from taking non steroid anti inflammatory drugs (NSAIDs) that Mangoni and Knights mention is because of NSAIDs’ affect in inhibiting aldosterone degradation [60], so that the build up in aldosterone causes inappropriate potassium excretion thus an artificial potassium deficiency is created. REFERENCES – see them below at the end
IDEAL POTASSIUM INTAKE If every one had an average intake of potassium equal to his fair share of the as grown potassium, they would receive about 3,500 milligrams per day. After processing losses and uneaten food is subtracted from the total [37 Adelson], my best guess is that the average daily intake is about 2,000 milligrams per day [38 Economic]. Keep in mind that half the people are eating less than the average. Old people have an intake less than the average [39 Dall & Gardner]. [40 Dall, et al], which is no doubt at least partly due to a lower caloric intake. Black people in Georgia average 1,500 milligrams per day, while their white neighbors average 2,000 milligrams [41Grim 1970] [42 Grim 1980]. I say the above is an unacceptably high loss. Anyone taking a pay cut like that would be very, very unhappy.
Low potassium intake is also somewhat implicated in high blood pressure, stroke, osteoporosis [35], and kidney stones. Potassium ingested as the chloride can actually raise blood pressure (hypertension) slightly. Potassium has been found to increase bone density [43 Tucker].
POLITICS of POTASSIUM
The health of people in the USA is abysmal , and a major part of it is poor nutrition. As the 12th century physician, trying to cure by diet before he administers drugs, said; “No illness that can be treated by diet should be treated by any other means" or as Hippocrates expressed it in 460 - 377BC; "If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." It would seem that a healthy life style has been known for a long time. It is my belief that an unprocessed, unfrozen, not canned, high in vegetables diet would keep a large majority of people reasonably healthy and without the need for fad diets. The World Health Organization of the UN agrees with this, and maintains that the majority of deaths are from nutrition preventable chronic diseases. 80% of Americans do not eat adequate vegetables, but even though 72% of Americans take vitamin or mineral supplements daily or sometimes [44 Sardi p148], their health is atrocious, especially old people. Those who don't smoke, eat five servings of fruits and vegetables daily, exercise regularly and maintain a normal weight account for ONLY 3 PERCENT of the adult population in the United States, according to the report in the April 25 issue of the Archives of Internal Medicine. And now people with primitive diets are switching over to up to date destroyed diets world wide with corresponding decline in health.
One third of the world’s children are under weight and malnourished. 20,000 die of hunger each year [45 Gitlin]. We can ill afford to deliberately destroy any of our food by processors.
I would suggest that a partial solution to the problem of poor potassium nutrition would be to place a tax on all food that has had potassium removed by food processors and completely fund all Medicare, Medicaid, and workman’s compensation for injuries and disease that relate to rheumatoid arthritis, gout, heart disease, and high blood pressure. This would also take the onerous tax burden now incurred for them and place it on the shoulders of those who cause the problem. And this tax burden is not the only burden. Half the bankruptcies in the USA are caused by medical bills. Achieving this would be much more likely if the money was removed from politics by public funding of election campaigns and there were runoff elections. It would be the best bargain for use of public funds we would ever have made. The Health Freedom Foundation is currently attempting to solve the problem by lobbying government legislatures to change the laws and agencies organizations. Michael Jacobson and Kelly Brownell of the Center for Science in the Public Interest have proposed a small tax on soft drinks and candy to finance public nutrition education. This would be a small step in the correct direction, but inadequate by itself. Another idea to help the nutrition of our society by Dan O’Keefe is to require all supermarkets to provide a computer that tells a shopper which brands should not be eaten for each of the degenerative diseases (for instance food containing sulfite not to be eaten by those suffering from beri-beri caused heart disease).
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----5. Gould SE, ed Pathology of the Heart and Blood Vessels - 3rd ed. Charles C. Thomas, Springfield, Ill p 508 1968.
----6. Folis RH. Myocardial necroses in rats on a potassium low diet prevented by thiamine deficiency. Bulletin Johns Hopkins Hosp.71: 235-241, 1942.
----7. Hove EL, Herndon JF. Potassium deficiency in the rabbit as a cause of muscular dystrophy. J Nutr. 55: 363-374, 1953.
----8. Blahd WH, Cassen B, Lederer M. Body potassium content in patients with muscular dystrophy - body composition part 1. Ann. N. Y. Acad. Sci. 110: 282-290, 1963.
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----16. Giebisch G. 1979 Renal potassium transport, Chapter 5 in; Membrane Transport in Biology. p215-298 Giebisch G editor. Springer Verlag, Berlin, NY
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----21. Boegshold M, Kotchen TA. Importance of dietary chloride for salt sensitivity of blood pressure. Hypertension 17: (auppl) I 158-I161, 1991.
----22. Melby JC, Dale SL, Grekin RJ, Gaunt R, Wilson TE. 18-hydroxy 11 deoxycorticosterone (18 OH-DOC) secretion in experimental and human hypertension. Recent Progress in Hormone Resarch. 28: 287-351, on p 323 1972.
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----24. Fitzhugh DG, Knudsen L, Nelson A. The chronic toxicity of sulfites J. Pharm. Exptl. Therap. 86: 37-48 1946.
----25. Suter PM, Vetter W. Diuretics and vitamin B1: are diuretics a risk factor for thiamin malnutrition? Nutr. Rev. 58:319-323, 2000.
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----27. Dyckner T, Ek B, Nyhlin H, Wester P.O. Aggravation of thiamine deficiency by magnesium depletion. A case report. Acta Med. Scand. 218: 129-130, 1985.
----28. Thompson AD. Mechanisms of vitamin deficiency in chronic alcohol misusers and the development of the Wernicke-Korsakoff syndrome. Alcohol Alcohol Suppl. 35: 2-7, 2000.
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----30. LaCelle PL. An investigation of total body potassium in patients with rheumatoid arthritis. Proceedings of the Annual Meeting of the American Rheumatism Association, Arthritis and Rheumatism 7: 321, 1964.
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---- 38. Economic Research Service 1971 Food consumption supplement for 1970 to Agricultural Economic Report #138 USDA, Wash. DC. ---- 39. Dall & Gardner HS 1971 Dietary intake of potassium by geriatric patients. Gerontol. Clinic 13; 119-124.
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---- 42. Grim CE, Luft FC, Miller JZ, Meneely GR, Battarbee HD, Hames CG, Dahl LK 1980 Racial differences in blood pressure in Evans County, Georgia: relationship to sodium and potassium intake and plasma renin activity. J Chronic Dis. 33(2):87-94.
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your husband is a wise man, follow his suggestion.
maybe do a shot once every 2-4 weeks and in between sublingual.
i really doubt you have heart failure after just 2 weeks.
this is absolutely normal. you have been very sporty and active your life, now you have reduced sport activity. your body is super sensitive to insulin due to your life long sports.
professional sports folks often gain a lot of weight after stopping profi sports.
why not just add some thiamin?
imho, you are really overcatastrophizing this. i really do not think you have any permanent damage or even heart failure in such a short time. just slow down, give your body time to heal, then take your time get at it again and try to find the levels / dosages you tolerate (better).
if you feel better, let a cardiologist have a routine check.
Thank you. I owe you a huge thank you either way. I just didn't understand the level of risk that was happening with the low potassium.
The only catch is that I believe I was close to catastrophe with the B12 deficiency, it's the only thing that has helped at all with the reflux that was destroying in life, and the books at least say that you need aggressive and high dose to recover from Neuro.
But my body chemistry at the moment is what it is.
I really appreciate, seriously, really appreciate how caring and supportive you have been.
I just woke up with a jolt, BP top number right now 134, pulse right now 64 but was 87 when I woke up (I was wearing my Garmin watch; thank you for the suggestion), and my muscles were twitching and I was extremely thirsty. I'm 100% that is low potassium. I can't imagine it's good even to have a temporary drop that low. And it's only night two after the fourth shot! Tomorrow and the next day will be worse. The Cleveland clinic website says that extreme thirst is a sign of severely low potassium (the other things are signs of moderately low).
I made an appt last night with my primary care for Friday morning. There are a lot of tests they can run. But there is one blood marker that would show heart failure.
And as healthy as I was 3 years ago, you don't understand. I've been through absolute complete hell for 3 years, including catastrophic and absolutely chronic insomnia. I have had some stretches of good sleep, for sure, but also many many many stretches of near total or total insomnia. That is *not good* for the heart, regardless of exercise or nutrition. I've known this and been devastated bc I've been totally powerless to stop it. Now I'm adding this assault?
I think it definitely could just be too much.
During this time, I've had plenty of several week long stretches where I couldn't run (mostly bc I keep getting sick). I've never gained weight bc of my diet. I am drinking way too much C water and that definitely could be the reason I'm gaining some weight (along with eating more meat and protein powder). But the other symptoms, the weird tiredness and fatigue (these are momentary, usually before I drink more C water bc I realize what's happening)... totally abnormal and really concerning.
I'm not sure whether I shared somewhere but if you Google refeeding syndrome, which I don't think there's any question I have, it says that it's very dangerous and needs hospitalitization, multiple specialties following, and constant cardiac monitoring.
Also, when I don't get an updated shot right away, my reflux starts coming back. And that's up and down but a few times really bad. I could get to the point that I would have to start back the pepsid, without shots.
I am receiving hydroxy and can control the dose, so I can experiment. The B12 woman (who actually was really good -- you would have liked her -- she believes in eating red meat and saturated fat -- still don't agree but she seemed like more of an expert on B12 than any doc I've met). Anyway she said I might have a totally different and better reaction to hydroxy. And to consider a lower but daily dose, or just waiting until I recover, then take folonic acid with iron for several days before the next injection. Basically to play around with things and see how my body reacts.
That's the best plan I can do. I just want to make sure that I'm not in the beginning stages of heart failure already. I am definitely planning to call a cardiologist first thing tomorrow. I just know that it will take a couple of months, at least, to get an appt. And my primary will usually only approve the most basic testing. There is one blood marker that, from reading last night, I think should be a good indicator. Of course what the hell do I actually know??? I'm sure it's more complicated than that. But that would at least make me feel a little better. Maybe also some kind of basic scan like CT or something.
I fear damage can happen quickly -- otherwise why the warnings on the refeeding study about needing so much observation? And even that study above. He was in the hospital and it looks like they have him daily, low dose B12 and iron, plus a high potassium diet.
This is unreal. I drank a TON of C water last night ending at 11:45. Tonight I was awakened with this "episode" at 3:45. So that's how fast my levels are dropping overnight. And again -- tomorrow night and the next 2-3 (or 4) after will be worse. For sure.
Just finished about 450 mg of potassium (350 from C water and another 100 added in). HR back down to 57 but should be 49 for me, laying in bed.
I searched last night and found that the half life of potassium is 1.5 to 2 hrs. So that would make sense.
There aren't any easy answers but thank you. Very much.
Do you know how many ml in 100 ug? That's how much B12 they gave that guy by IM injection every day, for two weeks, in the hospital. I have to keep reminding myself that they said they expected the low potassium to be transient. The question is... How much damage is the low potassium doing in the meantime?
Of course what the hell do I actually know??? I'm sure it's more complicated than that. But that would at least make me feel a little better. Maybe also some kind of basic scan like CT or something.
you do not need CT. usually doctor does a ECG in calmness and under stress , like on a bike. he draws blood before the bike test and after. also heart docs use ultrasonic instead of CT.
so for you its bike + ultrasonic.
This is unreal. I drank a TON of C water last night ending at 11:45. Tonight I was awakened with this "episode" at 3:45. So that's how fast my levels are dropping overnight. And again -- tomorrow night and the next 2-3 (or 4) after will be worse. For sure.
you really need to check your sugar! this sounds like hypoglycemic episodes.
try to eat something instead of c-water, if that helps you have your answer.
as is for sugar and insulin... well not exactly but almost.
btw a good indicator for CFS is, to do such tests twice. usually results for the first come back normal. but if you repeat the test like 2-3 days after, normal people have same results as with the first test, but cfs people will have much lesser capacity on the second, because they do not regenerate to baseline after 2 days.
medical literature is always about the extremes. we are talking about people who are on the brink of death.
they do not handle somewhat chronic or functional deficiencies at all. freddds protocol does.
you can run 5 miles... if you were in such a condition that potassium might kill you... you wont do it. (i dont know, thats my logic)
you really dont owe me anything!
this is a place for desperate people like you and me. we help each other out.
you are right now in a lot of desperation and panic and helplessness by that situation, i know how that feels and it just helps if somebody is here to listen and take it serious and maybe have one or two good suggestions/ideas.
dont trust me, trust her! she knows what she is talking about.
you do not need CT. usually doctor does a ECG in calmness and under stress , like on a bike. he draws blood before the bike test and after. also heart docs use ultrasonic instead of CT.
so for you its bike + ultrasonic.
you really need to check your sugar! this sounds like hypoglycemic episodes.
try to eat something instead of c-water, if that helps you have your answer.
as is for sugar and insulin... well not exactly but almost.
btw a good indicator for CFS is, to do such tests twice. usually results for the first come back normal. but if you repeat the test like 2-3 days after, normal people have same results as with the first test, but cfs people will have much lesser capacity on the second, because they do not regenerate to baseline after 2 days.
medical literature is always about the extremes. we are talking about people who are on the brink of death.
they do not handle somewhat chronic or functional deficiencies at all. freddds protocol does.
you can run 5 miles... if you were in such a condition that potassium might kill you... you wont do it. (i dont know, thats my logic)
what is C-water? coconnut water?
you really dont owe me anything!
this is a place for desperate people like you and me. we help each other out.
you are right now in a lot of desperation and panic and helplessness by that situation, i know how that feels and it just helps if somebody is here to listen and take it serious and maybe have one or two good suggestions/ideas.
My husband returned the $70 worth of sugar testing stuff.
But I had these episodes before I started drinking the C water.
And, again, my diet hasn't otherwise charged much at all since the shots. And low potassium is a known risk. B12 deficiency groups are filled with ppl complaining about potassium, not glucose. Most of them are drinking straight potassium (in water). I'm just not yet comfortable without the mix. Plus, I looked up the symptoms of high glucose, and they didn't really match. But low potassium does.
I definitely haven't gained weight. If anything, I'm going to the bathroom less often. I don't have blurred vision.
And most importantly -- no mention of the high and low blood pressure (seems low when it's worse -- I have read Mayo clinic docs saying BP can be variable and that is an emergency if caused by potassium). Also no mention of spikes in pulse rate. No mention of very noticeable and intense muscle twitching. No mention of constipation. I might be forgetting something. But these are all symptoms of low potassium, which symptoms I'm sure are either caused by the shots, or possibly other supplements like iron (constipation, but I only take every other day -- and those weren't causing constipation before the shot).
So basically the low potassium symptoms line up much better. And the high glucose would not explain the most concerning symptoms related to my heart, BP, pulse rate, etc.
Still definitely don't agree with either of you re red meat. She had some reflux opinions that I know are incorrect too (take ACV ). But her opinions about B12 line up with what I've read, but went further and were more in depth. She's has much more experience specifically with B12 than, for example, reflux.
Also red meat doesn't have that much B12. Many meat eaters are deficient, unless they regularly eat organ meat, which she thought sounded really bad. But it's the best for both iron and B12.
And, again, my diet hasn't otherwise charged much at all since the shots. And low potassium is a known risk. B12 deficiency groups are filled with ppl complaining about potassium, not glucose. Most of them are drinking straight potassium (in water). I'm just not yet comfortable without the mix. Plus, I looked up the symptoms of high glucose, and they didn't really match. But low potassium does.
i wasnt talking about Hyperglycemia (too much) .. i was talking about TOO LESS (hypOglycemia).
and there are people complaining about hypOglycemia in context with b12 deficiency. it also makes sense, b12 increases metabolism, improves insulin sensitivity and might cause episodes of too less.
this doesnt have to do anything with diabetes. its completely different.
if we do not test and see we will need to believe. things look similiar, but they can be something completely different than what our actual knowledge makes us believe it is.
so do i depending on the day. as long as you did not collect your urine and measure volume this is just subjective input. maybe b12 improved your muscles down there therefore no need to go that often, but maybe volume is increased.
i have days where i do pee a lot but its rather small volume... and then i do have days were i pee not much but huge amounts. and it didnt even feel that way on the toilet... until i actually measured. i was shocked as reality hit me.
Also red meat doesn't have that much B12. Many meat eaters are deficient, unless they regularly eat organ meat, which she thought sounded really bad. But it's the best for both iron and B12.
Also I do respect many things you have said, and I have learned several key things from you, which I really appreciate.
But as far as "eating meat is good for you, especially saturated fat," I just know that I'll never agree. I've read way too many studies myself on the benefits of plant based eating, and the serious negatives of eating meat (as long as you supplement B12). You say those studies are bogus but I don't agree. I'm very confident that the literally countless studies are legit.
So it's just not worth the time to debate. I know I'm not going to change my mind in that, and you know that you aren't. Long ago, I stopped trying to convince even some good friends that they might benefit from plant based eating. I'm just really not interested in the debate. At the moment, I'm trying to resolve what I feel very confident are B12, iron, folate, potassium, and other co factor issues. With emphasis at the moment on potassium and B12 bc I believe that they are causing the biggest problems.
@linusbert okay these are low glucose symptoms (sorry I actually looked up both before, just posted only one):
blood sugar levels become too low, hypoglycemia signs and symptoms can include:
Looking pale
Shakiness
Sweating
Headache
Hunger or nausea
An irregular or fast heartbeat
Fatigue
Irritability or anxiety
Difficulty concentrating
Dizziness or lightheadedness
Tingling or numbness of the lips, tongue or cheek
As hypoglycemia worsens, signs and symptoms can include:
Confusion, unusual behavior or both, such as the inability to complete routine tasks
Loss of coordination
Slurred speech
Blurry vision or tunnel vision
Nightmares, if asleep
Severe hypoglycemia may cause:
Unresponsiveness (loss of consciousness)
Seizures
I'm not sweating at all. No headache. I have had nausea but usually after iron pill, not when these episodes occur. I haven't had difficulty concentrating. And no tingling in my lips, tongue or cheeks.
That does line up better than high glucose. But still, critically, no mention of BP or constipation or these very distinct full body twitches.
@linusbert also the reason I think I can run during the day but am falling apart at night is bc I'm extremely conscientious about eating and drinking lots of potassium during the day. But esp bc of reflux, which causes problems if you ingest any calories within 3 hrs before sleeping, and bc potassium leaves the body quickly, and bc B12 is always hard at work reducing potassium, my levels fall too much at night.
And again hospital study quoted above where patient had B12 and iron deficiencies (which is what I have), and their concern with refeeding even at low daily doses was potassium. Only potassium...
no need to debate.
just do the tests.
- test your blood to see if you are hypOglycemic in the moment
- eat something without potassium like a mars bar, bread, a cracker or plain glucose and see if it also helps
- do a fat blood panel, omega 6:3 ratio, transfats and other fatty acids.
- pee in a bottle, collect your urine, see if you objectively pee more or less amounts.
you always come back with this topic, idk why. you seam to interpret my texts as if i have any emotional importance to make you believe meat are better... but i assure you, i really do not care if you eat meat, plants or whatever.
i just provide my knowledge what i've read over countless hours the last 7 years. it can be wrong, it can be right. its up to you to evaluate it in your context.
i just want people to know this information is out there, and have their thoughts.
do whatever you want, like, and feel is right for you.
(in this regard i am emotionally dry as bread no need to apologize)
And last thing. @linusbert
I
'm drinking a C water from powder recommended by nutritionist. It has low sugar and calories compared to most coconut water.
I can't eat overnight. That's why I need to stop the coconut water esp overnight. My reflux reactions are getting worse after drinking. I'll try during the day, but food like bread also has potassium. I can't eat sugar bc of reflux.
I don't eat enough omega 6 to worry about that. I do eat omega 3 from plants. Transfats are nasty.
And I can't compare pee in bottle since this has already started and I don't have a baseline.
Also on my second waking this morning, I had zero calorie potassium high trace minerals in water. That helped reduce my heart rate. Calmed the twitching. It just didn't fully stop those. So I think I need a higher dose but I'm scared to try more than the RDA. Probably much more on the first awakening with more intense symptoms. C water plus potassium is over 500 mg. The trace mineral potassium is only 99.
). But her opinions about B12 line up with what I've read, but went further and were more in depth. She's has much more experience specifically with B12 than, for example, reflux.