Morning fatigue - low potassium connection

[Mary]

I think it is very likely that many people who suffer from morning fatigue which eases gradually throughout the day may have low potassium levels. I used to assume that morning fatigue was probably a symptom of low cortisol but I now think that low potassium is a lot more prevalent than generally recognized. It's been true for me and a friend of mine whose morning fatigue has greatly lessened since she started taking extra potassium.

I think potassium levels tend to be lowest in the morning (that's what I've experienced) and then when you eat etc. you gradually raise your levels. So if low potassium is causing fatigue, it makes sense you would feel better as the day goes on. However, if you never get your levels up to where they should be, you will always be tired in varying degrees - fatigue is a major symptom (among many) of low potassium.

I first started to become aware of potassium and its importance after reading about Freddd's B12 protocol. My potassium levels tanked after a couple of days on methylfolate - I had severe fatigue and lethargy - which went away as I gradually got my potassium levels back up through supplementation. The really interesting thing for me though was that that awful fatigue was very familiar - I had had it before but never knew what it was. It was just another weird awful CFS symptom (or so I thought) that would appear from time to time, and then go away just as mysteriously. On blood tests my potassium levels were always on the low side of the normal range so I think the blood test is almost meaningless unless you could have it done every day (sort of like with a diabetic perhaps, where one blood sugar reading obviously will not be true the next day or even the next hour)

An easy way to find out if you need more potassium is to take extra and see how you do. Low-sodium V8 is a really good source of potassium - an 8 oz. glass has 900 mg. and is only 50 calories. I was taking a lot of potassium gluconate and still having trouble getting enough potassium, but since I started the V8 (2 or 3 glasses a day) plus some extra potassium capsules, my levels are better. For some reason low-sodium V8 has a lot more potassium than regular V8, which has around 500 mg. per 8 oz.

 

[acrosstheveil]

weird. i get more fatigued after i eat.

 

[Mary]

weird. i get more fatigued after i eat.

Maybe it's what you're eating? I'm sure you know that wheat, sugar, dairy are really common causes of fatigue. Or maybe you need HCL to help digest food - low stomach acid is another really common CFS problem. There are other possibilities, these are just what came to mind first.

 

[drob31]

I bet there is a variety of reasons. I think cortisol is still a really big factor here. Your t3/cortisol levels are highest in the early morning, and with too much cortisol, or too little, your cells do not get enough of any hormone, including cortisol itself. High cortisol makes the cells resistant to thyroid hormone, testosterone, estrogen, progesterone, and even cortisol itself. It's similar with low cortisol. So having HPA-axis dysfunction I believe is a huge factor. Cortisol can bind to aldosterone receptors in the kidneys and raise aldosterone, and this would lower potassium.

 

[drob31]

Maybe it's what you're eating? I'm sure you know that wheat, sugar, dairy are really common causes of fatigue. Or maybe you need HCL to help digest food - low stomach acid is another really common CFS problem. There are other possibilities, these are just what came to mind first.

I think this is a big factor as well. Low stomach acid is probably a co-morbid condition of not enough thyroid hormone, which is probably caused by too much/too little cortisol. The cortisol issue is probably caused by inflammation/infection/dysglycemia. (my working hypothesis). All those are caused by immune disregulation/autoimmune/infection(lyme/cfs viruses, etc).

Gluten and dairy should be avoided IMO, it's not worth guessing if they are causing issues or not.

 

[Mary]

I bet there is a variety of reasons. I think cortisol is still a really big factor here. Your t3/cortisol levels are highest in the early morning, and with too much cortisol, or too little, your cells do not get enough of any hormone, including cortisol itself. High cortisol makes the cells resistant to thyroid hormone, testosterone, estrogen, progesterone, and even cortisol itself. It's similar with low cortisol. So having HPA-axis dysfunction I believe is a huge factor. Cortisol can bind to aldosterone receptors in the kidneys and raise aldosterone, and this would lower potassium.

I am sure you're right and it's important to normalize cortisol levels as much as possible. I had problems with high cortisol which got pretty much resolved using Seriphos (phosphorylated serine). But I still have CFS/ME and I'm sure all the dysfunctions you outline.

But I think it's still very important to be aware of the potential for low potassium and its effects which can be quite severe. If we regain our health and sort out all the various dysfunctions, then hopefully the potassium issue would get resolved as well. But in the meanwhile, getting potassium levels up to where they should be can make a huge difference in energy. As I noted above, I'd had low potassium issues for quite awhile but didn't know it - and so at least that's one type of fatigue I can do something about. Also my friend who doesn't have CFS/ME still had low potassium issues. I think it's probably greatly unrecognized. And again, doctors rely on one blood test a year, when levels can vary so much from day to day.

Also, I read once that to have proper potassium levels and utilization, the body needs to move about and be active. Well, with CFS/ME we have horrible enforced inactivity which could also contribute to low potassium.

 

[drob31]

I am sure you're right and it's important to normalize cortisol levels as much as possible. I had problems with high cortisol which got pretty much resolved using Seriphos (phosphorylated serine). But I still have CFS/ME and I'm sure all the dysfunctions you outline.

But I think it's still very important to be aware of the potential for low potassium and its effects which can be quite severe. If we regain our health and sort out all the various dysfunctions, then hopefully the potassium issue would get resolved as well. But in the meanwhile, getting potassium levels up to where they should be can make a huge difference in energy. As I noted above, I'd had low potassium issues for quite awhile but didn't know it - and so at least that's one type of fatigue I can do something about. Also my friend who doesn't have CFS/ME still had low potassium issues. I think it's probably greatly unrecognized. And again, doctors rely on one blood test a year, when levels can vary so much from day to day.

Also, I read once that to have proper potassium levels and utilization, the body needs to move about and be active. Well, with CFS/ME we have horrible enforced inactivity which could also contribute to low potassium.

Yes, I think in this situation you have to treat the symptoms, unfortunately. Since vegetables like sweet potatoes have so much potassium, I think it's good to get potassium from vegetables as much as possible. Unless you need to avoid the nigh shade family because of food allergies or autoimmune.

One thing I don't see talked about often is diet. Infact, some people I have talked to still eat gluten and dairy, and maybe it's not a factor for them, but I still avoid it...

 

[Mary]

@drob31 - I think anyone with almost any sort of health issue should try cutting out wheat and dairy, and gluten (and sugar, course!). One of my sisters (who doesn't have CFS/ME) recently cut out all wheat and sugar for a couple of weeks, and then had pasta and some treats at work. And she said that the next day she was very tired and spacey - she could see really clearly how badly they affected her!

I was really glad when I discovered the low-sodium V8 with its high potassium content but only 50 calories per glass. I avoided sweet potatoes etc because of the high sugar content so was relying mainly on supplements for potassium.

 

[drob31]

I just looked up the nutrtion info on low sodium v8. 95 mg of sodium and 700 mg of potassium. Looks good to me. The only complaint I could make is that it has nightshades in it, and possibly GMO's, but I guess that is being nitpicky.

 

[Tunguska]

They fortify the low-sodium V8 with potassium chloride.

 

[Unduki]

I've been taking prescription potassium and getting my blood levels checked every 3 months for the past 25 years. My body just doesn't make it. Are you attributing a low potassium level to ME/CFS? Very interesting... My deficiency became known a few years after my CFS dx.

 

[Gondwanaland]

IME fatigue = high ammonia. I think the reason why potassium helps is by increasing urine output, therefore somehow stimmulating conversion of ammonia into urea.

 

[Gondwanaland]

Since vegetables like sweet potatoes have so much potassium, I think it's good to get potassium from vegetables as much as possible. Unless you need to avoid the nigh shade family because of food allergies or autoimmune.

Sweet potato is not a nightshade (but still related though). But it's a potent goitrogen for those with hypothyroidism (impairs conversion of T4 into T3).

 

[ukxmrv]

My morning symptoms (which could be the low cortisol) improve over the day even if I don't eat.

 

[Mary]

I've been taking prescription potassium and getting my blood levels checked every 3 months for the past 25 years. My body just doesn't make it. Are you attributing a low potassium level to ME/CFS? Very interesting... My deficiency became known a few years after my CFS dx.

I'm not attributing low potassium to ME/CFS, though there very well may be a correlation. All I was trying to do was to make people aware that if they had morning fatigue, there's a very good possibility they may have low potassium. I had it for years without knowing it. And it is very easily remedied. Drink some low-sodium V8 or have some other high-potassium food, or take potassium capsules and see what happens. Right now I seem to need a lot of potassium. And maybe if the riddle of CFS ever gets solved, I won't need so much - I just don't know.

http://www.medicinenet.com/low_potassium_hypokalemia/page2.htm - here's the basic symptoms (which I'm sure you know!) I never had heart palpitations - my main symptoms are muscle aches and fatigue when my potassium gets low.

 

[Mary]

IME fatigue = high ammonia. I think the reason why potassium helps is by increasing urine output, therefore somehow stimmulating conversion of ammonia into urea.

You could be right. I just don't know. This article explains briefly why low potassium makes one tired:
http://www.medicinenet.com/low_potassium_hypokalemia/page2.htm

With Freddd's B12 protocol, specifically methylfolate, my potassium levels tanked quite badly, I had severe fatigue after a couple of days, and the reason is that the methylfolate was causing cells to multiply and start working how they were supposed to, which increased my need for potassium, thus causing a deficiency. It happened very quickly. And I will be eternally grateful to Freddd who first made me aware of low potassium and all its ramifications.

 

[Mary]

My morning symptoms (which could be the low cortisol) improve over the day even if I don't eat.

Your morning symptoms very well could be due to low cortisol, which improves over the day. And they could still be due, even in part, to low potassium. As I stated before, our bodies need to move and be active to utilize potassium properly, so it would make sense that as the day wore on, your levels would get better, even if you didn't eat.

I had a friend who complained for years of morning fatigue. Her cortisol levels are low in the morning so we both assumed that was the issue, though she didn't seem to be able to raise them. and then on my recommendation she increased her potassium, and voila! her energy picked up.

It would be very simple to find out whether or not potassium will help you - get some V8 or other food high in potassium (more than just a banana), or get a potassium supplement and see what happens.. It just made such a huge difference for me - I wish I had known this years ago.

 

[Gondwanaland]

With Freddd's B12 protocol, specifically methylfolate, my potassium levels tanked quite badly, I had severe fatigue after a couple of days, and the reason is that the methylfolate was causing cells to multiply and start working how they were supposed to, which increased my need for potassium, thus causing a deficiency.

I totally chrashed after taking 800mcg of mFolate. My symptoms were high uric acid and high ammonia. I finally understood what happened after I saw how folate interacts with the urea cycle in this diagram.
There are several threads about ammonia here, but I never saw one linking it to folate directly.

About morning fatigue, I distinctly had it (unrelated to ammonia) when my T3 was low (probably due to low cortisol/insulin). Now that I am taking T4+T3 and consistently supplementig with selenium, it is much easier to get up in the morning.

I am intrigued as to why potassium supplementation doesn't help me much. I think b/c it's very hard for me to detox ammonia. I find that magnesium really helps me to clear uric acid and sodium bicarbonate to clear ammonia.

 

[Mary]

I totally chrashed after taking 800mcg of mFolate. My symptoms were high uric acid and high ammonia. I finally understood what happened after I saw how folate interacts with the urea cycle in this diagram.
There are several threads about ammonia here, but I never saw one linking it to folate directly.

About morning fatigue, I distinctly had it (unrelated to ammonia) when my T3 was low (probably due to low cortisol/insulin). Now that I am taking T4+T3 and consistently supplementig with selenium, it is much easier to get up in the morning.

I am intrigued as to why potassium supplementation doesn't help me much. I think b/c it's very hard for me to detox ammonia. I find that magnesium really helps me to clear uric acid and sodium bicarbonate to clear ammonia.

Interesting, @Gondwanaland - How did you know you had high uric acid and high ammonia? Did you have to go to a lab to get testing done?

I know it was my potassium levels which tanked (as Freddd predicted could happen) because my energy came back with potassium supplementation. But maybe your body manages to maintain adequate potassium levels, or you get enough in your food or something. I don't know.

It makes sense you would have morning fatigue (and I'm guessing fatigue in general) when your T3 was low. I've been taking Naturethroid or Armour thyroid for probably 15 years.

I do take a lot of magnesium and also have taken selenium for quite awhile, and just a couple of days ago started taking sodium bicarbonate on pone's recommendation, to help with PEM - it's amazing, it really does help. The theory is that PEM is caused by excess lactic acid which results from anaerobic energy production through glycolysis (instead of through the folate pathway) - I don't know all the chemistry by any means, just have learned this in the last couple of days. So baking soda draws the lactic acid out of the cells and neutralizes it. And so have just been reading how it helps athletes with endurance and recovery. I've been crashing faithfully for 16 years and this is only the 2nd thing I've come across which helps with PEM. The first is BCAAs. I'm going to do a separate post about that with more info.

I do find that with the baking soda, I need even more potassium! I know they work synergistically - levels of one affects the other. I just bought a roll of Ph paper to help with this balancing act. pone also recommended this electrical conductivity meter: http://www.amazon.com/gp/product/B0038QTQZ8 when supplementing with baking soda. Here is his reasoning which makes a lot of sense::

"The reason this is important is it is doing an implicit measurement of electrolyte levels in your urine, which you then use as a guide to how much water you drink, and how much sodium bicarb and potassium bicarb you take.

"The risk you now run is that you will start taking too much sodium and you will end up with very high electrolyte levels, possibly dehydrated. Aim on the conductivity meter to stay between 4000 and 5000. Above 5000 you need to dilute your electrolytes and drink water (that is the signal for dehydration). Below 4000 you need to start taking more electrolyte.

"The body should self-regulate these things, but part of my disease was that it did NOT! The conductivity meter is a true life saver in helping me to see when I am extremely dehydrated."

I think we need to be chemists to deal with this illness!

 

[Gondwanaland]

The only mineral supplementation that really helped me so far without disturbing other electrolyes was magnesium.

When I take potassium, I get brain fog or some strange endocrine disturbance (pituitary), same for sodium. I do ok with electrolyte capsules (Ca+Mg+K+Na+Zn+Cr+vit C)

A few months ago sodium bicarbonate baths (and Mg oxide oral supplementation) saved me from high ammonia, uric acid, lactic acid, dehydration, frequent urination.

I get in serious trouble when I try supplementing aminoacids. Strangely Selenomethionine gives me brain fog and I do well with Selenium chelate (I don't know to which amino it's chelated though).

I don't understand the biochem in deep either.

I know I have high uric acid when I have very acidic urine (test at home with pH paper). Sometimes when it gets worse I feel "glass shatters" between my toe bones and have some painful bumps in my finger joints. My father had gout at some point (under control now).