Potassium

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Methyl b12 increases my need for potassium I get loads of muscle spasms mainly in my forearms and upper arms and sometimes my legs , I think it's the need for potassium I do also take magnesium aswell, my problem I have is I feel like im taking excessive amounts of potassium, I take 6 grams of potassium bicarbonate which is roughly 2 grams of elemental potassium I will take 3-4 of these daily sometimes I take less 1 gram elemental at a time but then I'm just taking so much more throughout the day which just gets annoying. Why do I need so much potassium? I don't seem to get any bad effects from taking so much at one time am I even absorbing 2 grams at one time?
 
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Why do I need so much potassium? I don't seem to get any bad effects from taking so much at one time am I even absorbing 2 grams at one time?
For reasons not entirely clear to any of us (quite a few hypotheses have been floated), quite a few of us seem to have greatly increased needs for potassium.

If your high intake isn't creating any problems, I'd just keep a eye on your reactions, and keep doing what seems to be working ....
 

Carl

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Supplementation does seem to increase the uptake and need for potassium. I get very thirsty when I need potassium and the only thing which will quench my thirst is potassium supplementation. I have noticed that any amino acid supplementation also dramatically increases my potassium requirement.

Supplementing seems to create imbalances and can and does create problems. See refeeding syndrome.
https://en.wikipedia.org/wiki/Refeeding_syndrome
 

Crux

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Other electrolytes may be involved. Calcium deficiency can cause numerous symptoms, including cramps, spasms, paresthesia, so on.

Researchers are still debating, but it appears that both potassium and bicarbonate decrease the excretion of calcium.

This happened to me too. I seemed to need a lot of potassium until I began to take calcium.
 
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One of potassium's primary functions is to maintain and normalize the level of fluids inside our cells. It's also critical in the synthesis of proteins, helps muscles contract, supports normal blood pressure (which may be where the need for additional potassium for so many of us comes in), manages nerve signals, and a host of other things, including stimulating insulin and aldosterone secretion, balancing body fluids, and regulating acidity and blood pressure. It's also useful in the body's management of anxiety and stress, another way it might be more critical for many of us.

Trying to figure out why we may need more than the average bear would be a lengthy process, due to potassium's many, many functions in our body, CNS, nerves, and muscles. I think the only way supplementation might create problems is with an excess of calcium, salt (which normalizes the fluid outside of cells), maybe some thiols. Who knows. Clearly, I dont, just spit-balling ....
 

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Why do I need so much potassium? I don't seem to get any bad effects from taking so much at one time am I even absorbing 2 grams at one time?
It's well-documented that remedying a B12 and/or folate deficiency can greatly increase one's need for potassium, due to refeeding syndrome:
Refeeding syndrome can be defined as the potentially fatal shifts in fluids and electrolytes that may occur in malnourished patients receiving artificial refeeding (whether enterally or parenterally5). These shifts result from hormonal and metabolic changes and may cause serious clinical complications. The hallmark biochemical feature of refeeding syndrome is hypophosphataemia. However, the syndrome is complex and may also feature abnormal sodium and fluid balance; changes in glucose, protein, and fat metabolism; thiamine deficiency; hypokalaemia; and hypomagnesaemia.
Refeeding syndrome: what it is, and how to prevent and treat it - PMC (nih.gov)

One researcher (I think it was Chris Armstrong: The “Starvation” Disease? Metabolomics Meets Chronic Fatigue Syndrome Down Under ) has said that people with ME/CFS are in a chronic state of starvation, and I think he's correct. I think we are particularly susceptible to refeeding syndrome because of this. My potassium tanked badly about 2 days after I started taking methylfolate - so I titrated up over a couple of days to 1000 mg of potassium a day, which caused my symptoms to abate - chief symptoms were severe fatigue and muscle spasms in my feet and lower legs. A lot of people with hypokalemia get cardiac symptoms, arrhythmia, though I don't. And there are people here who need more potassium than I do.

One other thing - if someone were "merely" starving, their nutritional deficiencies could be remedied within a relatively short period of time. My deficiencies never get remedied. I've been taking a ton of nutritional supplements for over a decade, including potassium, and though I feel better taking them, my deficiencies never get remedied - I have to keep taking them or symptoms return. I think ME/CFS really does induce a state of chronic starvation.

It sounds like you're taking up to 8000 mg of elemental potassium a day, if I understood your post correctly, in potassium bicarbonate. That is a lot of potassium - the RDA (which I think is the minimum) is 4700 mg. There are people here who do need high amounts of potassium. Anyways, how well are you absorbing the potassium in the potassium bicarbonate ? I have no idea, but you might try switching to something like potassium gluconate and see if you can get by with a lower dose. It might indicate how well you're absorbing the potassium in potassium bicarbonate. Though it is quite possible the bicarbonate is doing you some good, so you have to consider that as well. Or maybe trying a combo of potassium bicarbonate and potassium gluconate.

One other thing to be aware of - people with ME/CFS can have normal blood levels of potassium but have low intracellular levels - see Why is potassium supplementation needed in methylation treatmt? | Phoenix Rising ME/CFS Forums

Also, fwiw, when I started taking extra thiamine 5 years ago or so, I got an almost immediate really nice boost in energy, followed a day or 2 later by severe fatigue. But the problem wasn't my potassium taking this time, but, rather, phosphorous (it took a little detective work and experimentation to figure this out). Anyways, once I added in extra phosphorous, that severe fatigue went away and I was able to enjoy my thiamine. But I have to keep taking phosphorous or the fatigue returns. I think I was deficient in phosphorous before I started taking thiamine- had lower overall energy - but never sorted it out until it became acute when I started the thiamine.
 
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It's long been a closely held secret in the medical community, at least those few who pay attention to studies and research, that psychiatric drugs, like benzodiazepines in all their forms, SERIOUSLY deplete numerous nutrients, and can continue to do so for quite a while after the psych or benzo drug is discontinued. This would include most, if not all, anti-depressants and of course, anti-anxiety and anti-psychotic drugs.

Since the first fallback of most Drs when confronted with anything they dont really have an immediate handle on is to 'treat' it with one of the above, sometimes more than one, greatly compounding an already mysterious illness, it makes sense that some, or more than some, members of this community are suffering the resultant consequences in terms of nutrient deficiencies.


One researcher (I think it was Chris Armstrong: The “Starvation” Disease? Metabolomics Meets Chronic Fatigue Syndrome Down Under ) has said that people with ME/CFS are in a chronic state of starvation, and I think he's correct.
The symptoms match up (fatigue, muscle weakness and spasms, brain fog), but I'd like to see the research protocols and designs of the studies that he bases this very broad assumption on. It's a pretty sweeping statement that, at least to me, just screams for substantiation.

This illness, and the many theories, treatments, experimental protocols, hypotheses, and in some cases, just plan bull-crap that ME seems to attract, has made me really, really, crabby and cynical when it comes to exciting new hypotheses designed to end forever the scourge of ME, so I’m hoping you’ll forgive my hesitance …

if someone were "merely" starving, their nutritional deficiencies could be remedied within a relatively short period of time. My deficiencies never get remedied.
I think ME/CFS really does induce a state of chronic starvation.
By what mechanism, other than the one so many of us already know pretty intimately: the inability to undertake lengthy and time-and-energy-consuming food prep, does ME/CFS induce chronic starvation? Even under the above conditions, we make accommodations, and while our diets may not be optimal, they are, more or less, life sustaining.

I'm not sure if it's the ME or other underlying conditions, aggravating and amplifying the ME issues, (which are bad enough just on their mind-numbing own without additional help), and I tend to be leery of extreme explanations for ME that are more or less in the realm of "It looks like a duck, quacks like a duck, walks like a duck, it must be the root explanation of ME/CFS ...", which to some extent, Chris Armstrong’s seem to be.


BACKGROUND ON RE-FEEDING SYNDROME
Traditionally, patients presenting with re-feeding syndrome have a substantial history of drug addiction or long-term habitual drug use, alcoholism, anorexia, bulemia, risky, restrictive and protracted diets along with the resultant weight loss, bariatric surgeries that limit food intake and absorption dramatically, and others I cant recall.

And the syndrome presents, not during the history that precedes it, but upon rapid re-feeding, and usually result from clinical changes resulting from that rapid oral, parenteral, or enteral feeding. Of the three, parenteral is the most likely to produce the syndrome, and oral the least likely.

Chris Armstrong has been very successful at securing both govt and private grants to undertake his investigations, which are innovative, insightful, and broad-ranging, utilizing disciplines ranging from metabolomics, microbiology and immunology to gut bacteria and FMT.

His first studies resulted in his belief that the gut microbiome played a heavy role in ME, something that a lot of us already believe from personal experimentation and experience, and that the composition of bad bacteria vs. good bacteria could be interfering with the body's ability to get energy from glucose, while shifting it to using fats and proteins instead.

The results of a publication of his in early 2017 confirmed that differences were found in the gut microbiota of those with ME/CFS across the board – blood, fecal fluids, and urine – along with elevated levels of short-chain fatty acids which interfere with amino acids as a result of a higher level of fermentation in the guts of ME/CFS patients.

This creates a prolem because amino acids, unlike glucose, have an attached nitrogen atom, and ME patients tend to eliminate that, not in the safer way that the body usually uses, but in the form of ammonia and peroxynitrites, both of which are highly toxic and potentially damaging to the body.

What fun.

This is fascinating stuff, and very promising, but I don’t think it’s there yet …. still, it gives us what we most need in the absence of an absolute certainty – it gives us hope.
 

Mary

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By what mechanism, other than the one so many of us already know pretty intimately: the inability to undertake lengthy and time-and-energy-consuming food prep, does ME/CFS induce chronic starvation? Even under the above conditions, we make accommodations, and while our diets may not be optimal, they are, more or less, life sustaining
I don't know. I think if we did know, we might be on our way to solving it. My personal experience makes me think the chronic starvation may be real. As I said above, if I was merely nutrient deficient due to starvation, then those deficiencies should be remedied by supplementation and I wouldn't have to keep supplementing with large doses for years. But they're not remedied. I have to take large doses of several nutrients, including potassium and phosphorous and B1 and B6 and folate and B12 (and several other things), every day in order to feel halfway normal. They really do help how I feel. I used to feel a lot worse until I started taking them. So I assume I'm deficient in them because I feel so much worse when I don't take them. And I'm assuming that a chronic deficiency is caused by a weird chronic starvation which never ends.

btw, I took a benzo for 11 years. I've had ME/CFS for 23 years. So though the benzo may have adversely affected my nutritional status (though I didn't notice anything like that - just kept taking the same stuff in the same doses), I haven't been on one for some years now and I STILL have to take all this stuff.

But I think this is a discussion for another thread - we're going off-topic here. I seem to have started it with my mention of Chris Armstrong.
 
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One last thing, you might try drinking some low sodium V8 (or generic) - The low sodium kind is high in potassium almost 900 mg per 8 oz, and see if you can get by with less potassium than you're taking now, you might absorb it better And also find it easier to ingest 🌝
If that doesnt work for you, you might try powdered potassium gluconate, which is highly bioavailable, is rapidly and easily absorbed and is far less acid-producing than any other form of potassium. I find it mild and gentle in its action. Bulk Supplements makes a good one, and it's inexpensive.

Even better, you can titrate your dose so you can stay at the lowest level that produces the desired result ...

It also doesnt add 1/3 of the daily UL of salt, which would be a good thing if you have any heart issues ...


There. We're back on topic ..... apologies for my contributions to derailing it :please::please::please:...
 

SWAlexander

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If you have low taurine levels taurine may help you absorb potassium better. But don't overdo it and some people have side effects on taurine (for example, if you're sensitive to sulfur)
Thanks, - yes I´m already very sensitive to sulfur.
 

CSMLSM

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Methyl b12 increases my need for potassium I get loads of muscle spasms mainly in my forearms and upper arms and sometimes my legs , I think it's the need for potassium I do also take magnesium aswell, my problem I have is I feel like im taking excessive amounts of potassium, I take 6 grams of potassium bicarbonate which is roughly 2 grams of elemental potassium I will take 3-4 of these daily sometimes I take less 1 gram elemental at a time but then I'm just taking so much more throughout the day which just gets annoying. Why do I need so much potassium? I don't seem to get any bad effects from taking so much at one time am I even absorbing 2 grams at one time?
Hi JamieG my name is Daniel.

Potassium and magnesium relationship

Magnesium and potassium are the 2 major intracellular cations. The intracellular concentrations of these 2 ions appear to be closely correlated, but the existence of a relationship between the plasma concentrations of these ions has been controversial. A major function of potassium is to maintain the excitability of nerve and muscle tissue.

The relationship between disorders of K+ and Mg+ homeostasis

Abstract
Potassium and magnesium balance are frequently altered by common pathological conditions. Isolated disturbances of potassium balance do not produce secondary abnormalities in magnesium homeostasis. In contrast, primary disturbances in magnesium balance, particularly magnesium depletion, produce secondary potassium depletion. This appears to result from an inability of the cell to maintain the normally high intracellular concentration of potassium, perhaps as a result of an increase in membrane permeability to potassium and/or inhibition of Na+-K-ATPase. As a result, the cells lose potassium, which is excreted in the urine. Repletion of cell potassium requires correction of the magnesium deficit. Are such magnesium dependent alterations in potassium balance of any clinical significance? Within the context of electrolyte disturbances, magnesium replacement is often necessary before hypokalemia and potassium depletion can be satisfactorily corrected with potassium supplements. The hyponatremia often seen with chronic diuretic usage may also be related to depleted intracellular potassium stores. In a small group of patients with chronic congestive heart failure, magnesium replacement alone was sufficient to correct this hyponatremia. Finally, magnesium and potassium depletion may play an important role in the development of cardiac arrhythmias in certain select groups of patients, such as those with overt ischemic heart disease. The frequency of magnesium depletion in some clinical disease states warrants renewed interest in the relationship between magnesium and potassium homeostasis.

Since large amounts of magnesium have a laxative effect, drinking water with a small amount of Epsom salt is a common oral treatment for constipation. Epsom salt is also sometimes used as an enema. Either route will cause some of this magnesium to be absorbed.

Absorption Through the Skin
Epsom salt foot or body soaks are widely used as a way to relax muscles and relieve muscle tension. Since magnesium plays an essential role in muscle contraction and nerve function, it has been proposed that skin absorption of magnesium is the mechanism for these benefits. Despite these claims, there is a lack of peer-reviewed, published research supporting that topical application of magnesium increases body magnesium levels, according to a July 2012 review published in “International Journal of Cosmetic Science.” However, skin absorption could occur in the right conditions -- with heat, high salt concentrations or through cut or broken skin -- based on a review article published in the June 2014 issue of “Experimental Biology and Medicine.” Additional research is needed to better understand if soaking in Epsom salt leads to any meaningful magnesium absorption through the skin, as well as the health effects of any noted absorption.

I take Magnesium/sulfur (Epson salts) baths. Between 200-500grams in a bath that once I am in it will just cover enough of me to get either all my legs under the water or upper body and arms. I alternate between the two and stop once I feel my heart start to race a little and time this for the first try. Then I adjust the time so I do not reach this point from then on. every 2-3 days presently.

My opinion is you are more than likely magnesium deficient due to it being quite a common thing amoung alot of people let alone ME/CFS patients who are more likely to be in my opinion.

Oral supplementation is just too impractical by the time you are at the stage you are, let alone difficult. Every part of your body could have a varying magnesium level relative to all other cells in your body and a blood test means nothing really. Its just what is circulating outside of the cells in the blood which is closely regulated anyway.

Magnesium baths are vital tools in repleting your whole body stores and fast in my experience.
I had to be careful the first few times. Not going in for more than 10-20minutes and then building up to 30 minutes and then reduced as I see fit at this stage. Having a routine of this is a vital key to my health recovery.

I hope this can be of use to you JamieG
Daniel
 
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It's well-documented that remedying a B12 and/or folate deficiency can greatly increase one's need for potassium, due to refeeding syndrome: Refeeding syndrome: what it is, and how to prevent and treat it - PMC (nih.gov)

One researcher (I think it was Chris Armstrong: The “Starvation” Disease? Metabolomics Meets Chronic Fatigue Syndrome Down Under ) has said that people with ME/CFS are in a chronic state of starvation, and I think he's correct. I think we are particularly susceptible to refeeding syndrome because of this. My potassium tanked badly about 2 days after I started taking methylfolate - so I titrated up over a couple of days to 1000 mg of potassium a day, which caused my symptoms to abate - chief symptoms were severe fatigue and muscle spasms in my feet and lower legs. A lot of people with hypokalemia get cardiac symptoms, arrhythmia, though I don't. And there are people here who need more potassium than I do.

One other thing - if someone were "merely" starving, their nutritional deficiencies could be remedied within a relatively short period of time. My deficiencies never get remedied. I've been taking a ton of nutritional supplements for over a decade, including potassium, and though I feel better taking them, my deficiencies never get remedied - I have to keep taking them or symptoms return. I think ME/CFS really does induce a state of chronic starvation.

It sounds like you're taking up to 8000 mg of elemental potassium a day, if I understood your post correctly, in potassium bicarbonate. That is a lot of potassium - the RDA (which I think is the minimum) is 4700 mg. There are people here who do need high amounts of potassium. Anyways, how well are you absorbing the potassium in the potassium bicarbonate ? I have no idea, but you might try switching to something like potassium gluconate and see if you can get by with a lower dose. It might indicate how well you're absorbing the potassium in potassium bicarbonate. Though it is quite possible the bicarbonate is doing you some good, so you have to consider that as well. Or maybe trying a combo of potassium bicarbonate and potassium gluconate.

One other thing to be aware of - people with ME/CFS can have normal blood levels of potassium but have low intracellular levels - see Why is potassium supplementation needed in methylation treatmt? | Phoenix Rising ME/CFS Forums

Also, fwiw, when I started taking extra thiamine 5 years ago or so, I got an almost immediate really nice boost in energy, followed a day or 2 later by severe fatigue. But the problem wasn't my potassium taking this time, but, rather, phosphorous (it took a little detective work and experimentation to figure this out). Anyways, once I added in extra phosphorous, that severe fatigue went away and I was able to enjoy my thiamine. But I have to keep taking phosphorous or the fatigue returns. I think I was deficient in phosphorous before I started taking thiamine- had lower overall energy - but never sorted it out until it became acute when I started the thiamine.
How are you getting supplemental phosphorus? How much do you take?

I had a blood test in the hospital around 2 weeks ago when I first crashed very badly and had very low phosphate (0.46 mmol/L, range 0.75 - 1.50) and low normal potassium. Do you think supplementing could help my crash recovery?

I looked up phosphorus on iherb and they just have a homeopathic one it seems.?
 

Mary

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How are you getting supplemental phosphorus? How much do you take?

I had a blood test in the hospital around 2 weeks ago when I first crashed very badly and had very low phosphate (0.46 mmol/L, range 0.75 - 1.50) and low normal potassium. Do you think supplementing could help my crash recovery?

I looked up phosphorus on iherb and they just have a homeopathic one it seems.?
@GlassCannonLife - it's been difficult for me to find a good phosphorous supplement. Here's a post I did about phosphorous recently where I explain what I'm taking - it's sort of complicated: what’s the rundown on high dose thiamine? | Page 4 | Phoenix Rising ME/CFS Forums

Also, one more post with a bit more info: what’s the rundown on high dose thiamine? | Page 4 | Phoenix Rising ME/CFS Forums

If you read the posts and look at the links, you'll see that the product I'm currently taking Sodium, Potassium, Phosphorus Powder Concentrate (Sugar Free) 100 Pack – Hargraves Online Healthcare (hargravesotc.com)
has 250 mg of phosphorous per packet, which is 20% of the RDA. My need varies from 1 to 3 packets a day. I determine this by muscle testing. Also, symptoms give me a clue - when pills start sticking in my throat or I get double vision, it indicates I'm getting low - it affects the small muscles first. I don't recommend that anyone try to use muscle testing to figure out what they need unless they are very familiar with MT and used to figuring things out for themself and also go slowly and carefully. Unfortunately, the company I buy this from is currently out of stock - I hope they get more because it's the best product I've been able to find.

I have also had good results working with a chiropractor doing muscle testing in determining if I need a particular thing and also how much.

And of course one would hope your doctor could help with this.

I just found this which appears to be an equivalent product - unfortunately, it costs more than twice as much! Amazon.com: MCK27102700 - Cypress Pharmaceutical Phos-NaK Dietary Supplement Sodium / Potassium / Phosphorus 160 mg - 280 mg - 250 mg Unit Dose, Oral Powder Concentrate Packet Fruit Flavor : Health & Household

I just found another source (I've never ordered from this company: Phos-Nak, PDR 278-164-250Mg 100ct. - The Online Drugstore © which is cheaper than on Amazon, though pricier than the Hargraves product, which is out of stock: Sodium, Potassium, Phosphorus Powder Concentrate (Sugar Free) 100 Pack – Hargraves Online Healthcare (hargravesotc.com)

If you try one of these, I can't tell you how much to take. I just experimented and used my muscle testing.

I did get a prescription from my doctor for Phos-Nak, but I had trouble getting enough pills from her, she wouldn't understand how my need changes daily, and also it didn't seem as effective as the little packets. Though if I had enough of it, it would probably work fine.

Foodwise - dairy is high in phosphorous, you can do research on the best foods.

Did your doctor or anyone give you phosphorous after your blood test? I've experienced low phosphorous and it made me VERY tired, as did low potassium. So it's possible that your very bad crash was actually a symptom of low phosphorous, possibly combined with low potassium. That could be very rough.

Did anyone recommend potassium for you as well?

If you can tolerate dairy, you might try drinking several glasses of Kefir (that's what I did when I suspected low phosphorous after starting thiamine) - doing this caused my energy to start to return within a few hours. I was so relieved!

And I've found that drinking 2 or 3 or 3 even 4 glasses of low sodium V-8 (or equivalent) can help restore potassium levels within a few hours as well.

Do doing both these things might give you an idea of what's going on, if they make you feel better. And then you can decide how to proceed.

Also, I can't remember what I've written where, but it is possible to have low intracellular levels of potassium even if one's serum levels (your blood work) are normal or low normal. See Why is potassium supplementation needed in methylation treatmt? | Phoenix Rising ME/CFS Forums

My potassium levels were always low normal, but I've been hit by low potassium several times and it would leave me wiped out for days, until I discovered what it was.

Ideally you'd be able to talk to your doctor about all this, but unfortunately most of us don't have ideal doctors.
 
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@GlassCannonLife - it's been difficult for me to find a good phosphorous supplement. Here's a post I did about phosphorous recently where I explain what I'm taking - it's sort of complicated: what’s the rundown on high dose thiamine? | Page 4 | Phoenix Rising ME/CFS Forums

Also, one more post with a bit more info: what’s the rundown on high dose thiamine? | Page 4 | Phoenix Rising ME/CFS Forums

If you read the posts and look at the links, you'll see that the product I'm currently taking Sodium, Potassium, Phosphorus Powder Concentrate (Sugar Free) 100 Pack – Hargraves Online Healthcare (hargravesotc.com)
has 250 mg of phosphorous per packet, which is 20% of the RDA. My need varies from 1 to 3 packets a day. I determine this by muscle testing. Also, symptoms give me a clue - when pills start sticking in my throat or I get double vision, it indicates I'm getting low - it affects the small muscles first. I don't recommend that anyone try to use muscle testing to figure out what they need unless they are very familiar with MT and used to figuring things out for themself and also go slowly and carefully. Unfortunately, the company I buy this from is currently out of stock - I hope they get more because it's the best product I've been able to find.

I have also had good results working with a chiropractor doing muscle testing in determining if I need a particular thing and also how much.

And of course one would hope your doctor could help with this.

I just found this which appears to be an equivalent product - unfortunately, it costs more than twice as much! Amazon.com: MCK27102700 - Cypress Pharmaceutical Phos-NaK Dietary Supplement Sodium / Potassium / Phosphorus 160 mg - 280 mg - 250 mg Unit Dose, Oral Powder Concentrate Packet Fruit Flavor : Health & Household

I just found another source (I've never ordered from this company: Phos-Nak, PDR 278-164-250Mg 100ct. - The Online Drugstore © which is cheaper than on Amazon, though pricier than the Hargraves product, which is out of stock: Sodium, Potassium, Phosphorus Powder Concentrate (Sugar Free) 100 Pack – Hargraves Online Healthcare (hargravesotc.com)

If you try one of these, I can't tell you how much to take. I just experimented and used my muscle testing.

I did get a prescription from my doctor for Phos-Nak, but I had trouble getting enough pills from her, she wouldn't understand how my need changes daily, and also it didn't seem as effective as the little packets. Though if I had enough of it, it would probably work fine.

Foodwise - dairy is high in phosphorous, you can do research on the best foods.

Did your doctor or anyone give you phosphorous after your blood test? I've experienced low phosphorous and it made me VERY tired, as did low potassium. So it's possible that your very bad crash was actually a symptom of low phosphorous, possibly combined with low potassium. That could be very rough.

Did anyone recommend potassium for you as well?

If you can tolerate dairy, you might try drinking several glasses of Kefir (that's what I did when I suspected low phosphorous after starting thiamine) - doing this caused my energy to start to return within a few hours. I was so relieved!

And I've found that drinking 2 or 3 or 3 even 4 glasses of low sodium V-8 (or equivalent) can help restore potassium levels within a few hours as well.

Do doing both these things might give you an idea of what's going on, if they make you feel better. And then you can decide how to proceed.

Also, I can't remember what I've written where, but it is possible to have low intracellular levels of potassium even if one's serum levels (your blood work) are normal or low normal. See Why is potassium supplementation needed in methylation treatmt? | Phoenix Rising ME/CFS Forums

My potassium levels were always low normal, but I've been hit by low potassium several times and it would leave me wiped out for days, until I discovered what it was.

Ideally you'd be able to talk to your doctor about all this, but unfortunately most of us don't have ideal doctors.
This is a great post, thank you very much!

No, they gave me Hartmann's to help with the potassium but didn't even comment on the phosphate.

I am dairy free actually but I do have a coconut kefir I take - I'll check that, as well as the products you shared. Thanks again!
 
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Finding supplemental phosphorus is challenging, because it’s very difficult to be deficient in phosphorus, and taking additional phos in a supplement could create some pretty unpleasant problems. Generally, low phosphorus has less to do with actual intake and is more dependent on hereditary, genetic conditions that seriously impede its absorption and utilization .

It’s a component of bones, teeth, DNA, and RNA. As a phospholipid, it’s a component of cell membrane structures and our main energy source, ATP. It plays a key role in regulating gene transcription, the activation of enzymes (including the liver P450 systm), maintaining the proper pH balance in extra-cellular fluid, and intracellular storage of energy. Generally, about 85% of phos lives in you bones and teeth, with approx. 15% being distributed in plasma and soft tissues.

Phosphorus is involved in a lot of functions in the body, including phosphorylation, and works in coordination with calcium, among others. Taking a lot of unnecessary phosphorus can throw off the normal balance between those two as well as other necessary nutrients and can, over time (and sometimes not that much) cause cardio issues, kidney problems, hormonal imbalances, bone calcification issues.

Before you start supplementing with additional, possibly unnecessary and even damaging amounts of phos, do some googling and also get a blood panel to establish the relative levels of all mnerals in your system, including a 25-hydroxy-D test of your Vit D levels.

As @Mary mentioned, getting phosphorus from natural food sources is the absolute best way to go, because it'll be combined with other factors and minerals that are naturally present, and will greatly reduce th pssibility of any unwanted reactions to excessive phos ....