Understanding potassium

Anyone following Freddd’s methylation protocol or any other high dose methylation support should know there’s a risk of creating a potassium deficiency which is potentially lethal. It’s called hypokalemia. Muscle cramping is one of the warning signs and I’ve experienced some of those cramps. I’m currently supplementing with 2.2 g of elemental potassium a day and suspect I still need more, so I’m trying to understand the potassium issue in more depth before taking more potassium.

It’s a complicated subject because both too little and too much potassium is dangerous. For this reason, Andy Cutler recommends you not exceed 1 g of supplemental potassium without “doctor supervision”. While I appreciate the warning and take it seriously, I’m saving this precious oxymoron ‘doctor supervision’ as the title for a new post about my pathetic experience with doctors.

The more I learn, the more I think potassium may be one of those cornerstone supplements for me and for many others. Most of the information on this page comes from Stephanie’s posts on FDC who just happens to be studying and experimenting at the same time as I am:

These observations are all from the book “Potassium Nutrition” ($4 kindle book on Amazon) unless otherwise noted – the author explores all the research relating to dietary potassium deficiency leading to a functional deficiency, and how it applies to many chronic disease processes (he essentially includes chronic fatigue and fibromyalgia as well). In some cases these correlations have not been examined before, in part because conventional medicine overlooks the role of potassium, and the labs that are typically used to assess potassium and electrolyte levels don’t give the entire picture.

There really isn’t a good way to assess the overall level of our potassium status (it is possible but the tests to determine this aren’t really available – it requires special equipment which is very expensive). Even measuring RBC potassium and sodium doesn’t give the complete picture – for one thing, our bodies will lose potassium from muscle cells at a far greater rate than blood cells- and this is why muscle cramps and weakness are common symptoms.

Potassium gluconate (one of the most available supplement forms) goes into solution easily to give potassium ions (which is the electrolyte), and the gluconate part is metabolized in the liver to create bicarbonates. Bicarbonates are also electrolytes. So this is similar to supplementing potassium bicarbonate.

Potassium bicarbonate is alkalizing and it helps to prevent calcium loss that can be caused by a functional potassium deficiency…. which are both desirable for most people – particularly given modern diets. Potassium bicarbonate is also the form most similar to what you get from eating vegetables. However potassium bicarbonate will tend to lower blood pressure.

My sense is that salt cravings are a way to help raise blood pressure – it’s actually the chloride in salt that tastes salty and raises blood pressure. My blood pressure was definitely getting lower after cutting back hugely on salt and supplementing with potassium bicarbonate over the course of a few days. Note that one teaspoon of potassium bicarbonate contains roughly 2000 mg of potassium.

If you have low blood pressure, it’s preferable to supplement primarily with potassium chloride – and use potassium bicarbonate (or potassium gluconate) to help balance pH (if urine pH becomes acidic). Too much bicarb will be too alkalizing and will lower blood pressure so it needs to be balanced with the chloride – which does the opposite.

Chloride is another important electrolyte – it gives the salty taste to salt and tends to raise blood pressure (loss of chloride usually accompanies a potassium deficiency because chloride is secreted to maintain serum pH). So naturally, potassium chloride tends to raise blood pressure, and tends to be acid forming. Potassium chloride will also help to raise the cell levels of potassium faster than potassium bicarbonate. This seems to make sense given their relative effects on electrolyte balance and blood pressure and pH.

An ideal ratio of total daily intake (diet and supplements) of potassium to sodium is said to be something like 5:1. But, a low potassium to sodium ratio is the norm these days – especially if you compare that to the ratio that researchers believe humans evolved on… potassium sources were plentiful and the mainstay of diet, whereas sodium was very scarce. Paleo man probably had at least a 10:1 potassium to sodium ratio in his diet, and many put that estimate much higher. So even people who eat a relatively healthy diet these days aren’t necessarily immune to the effects of a lower ratio – given the availability of sodium, and the relative scarcity of high potassium foods from plant sources…, together with all the other influences that affect our acid-alkaline balance and electrolyte balance in modern life (i.e. toxicities).

Now, even getting to a ratio of 2:1 or 3:1 is better than the average human who eats a lot of processed foods. Of course, there are many other factors besides this ratio to consider – including the source of potassium in food and whether it forms bicarbonates and is therefore alkalizing (this would be the potassium from plant sources, especially leafy greens) – or whether it makes chloride and is therefore acidifying (from protein sources of potassium), so this relates to our pH balance.

If a person is very deficient (at the cell level), then it can take a long time for general healing to occur… maybe 6 months to a year or more. However, if you’re supplementing – say 1 gram with each meal (~3 grams/day) – then you should be able to correct the deficiency state in a matter of weeks, assuming you lower sodium appreciably and otherwise eat a decent diet and you’re getting enough magnesium, taurine etc (according to Wikipedia, “In cells, taurine keeps potassium and magnesium inside the cell, while keeping excessive sodium out” so, supplementing with taurine – up to 3 grams per day – may be helpful).

Medications, and other things that might cause potassium loss or create acidity (like toxicity from metals and chelating) have to be taken into account as to how much potassium is right for you, and whether you need extra bicarbonate to neutralize acidity. It’s ideal to get our potassium from food of course, but it seems that can be kind of hard to do, especially for someone dealing with toxicities.

Hence, supplementing with potassium chloride and potassium bicarbonate as indicated can help improve our K to Na ratio, and overcome the effects of “poor” dietary influences, medications, toxins etc. It’s worth considering that the author of this book suggests that, “our bodies don’t store potassium”…but we need to continually take in a lot of it for healthy metabolism, nerve function etc.

What becomes pertinent is our ability to regulate the level of potassium in serum and in cells… Which leads to the topic of aldosterone – which is essential for regulating serum potassium… The question being, is it possible one might be low in aldosterone at least in part because we are functionally deficient in potassium? And will slowly improving this ratio of K to Na allow our aldosterone levels to rise along with potassium intake?

The info in this book suggests this is generally this case (short of permanent atrophy of the part of the adrenal gland that produces aldosterone – or I suppose secondary adrenal insufficiency will prevent the appropriate signaling for the release of adrenal hormones, no matter how much potassium is available). Regardless, one shouldn’t drastically increase potassium intake without keeping an eye on our serum potassium to ensure that our body is handling it properly – as Andy has told us.

If we don’t have adequate aldosterone, we can go high on serum potassium… And there are other factors too, certain medications and kidney function factor in. By the way, the same could apply to cortisol – that is, secretion may rise as potassium is increased.

Increasing methylation may have the effect of pulling more potassium into cells that are deficient… at the expense of serum potassium – causing low serum potassium (this is Rich Van K’s theory). According to this theory, people with chronic fatigue caused by methylation block have fewer cells than normal. Ramping up their methylation cycle supplies the missing folate needed to make new DNA and suddenly the body can make new cells. This is what we call ‘healing’:

All of a sudden, the cells now have enough DNA to overcome the arrest of the cell cycle, and their rate of cell division goes up, making new cells more rapidly. These new cells require potassium, and their membrane pumps start pumping it in from the blood plasma. Unfortunately, since the existing cells, which contain 95% of the body’s potassium inventory, are already low in potassium, there is no cushion or buffer for the blood plasma potassium level, and if it is not augmented by increased potassium intake from the diet or supplements, the PWC’s blood plasma potassium level drops, resulting in hypokalemia.

While both the cell and serum levels of potassium are important, it’s the serum level of that can be very dangerous if it goes out of the so-called “normal” range. So, if you are ramping up your methylation cycle, keep a bottle of potassium around and know the symptoms of hypokalemia (weakness, lack of energy, muscle cramps, stomach disturbances, an irregular heartbeat, and an abnormal EKG) and hyperkalemia (muscle weakness, slowed heart rate, and abnormal heart rhythm).

A few words from the author himself, Charles Weber, MS. We asked the author of Potassium Nutrition, to review the summary above for accuracy and this is his response:

I did not see anything in the URL you sent that was obviously invalid. The body is a complicated soup, though, and it is easy to get things wrong. If a personโ€™s kidneys have not been damaged, by poison for instance, that person can do some great nutritional blunders with respect to potassium and still stagger through. Healthy kidneys can handle some bizarre ratios since they have much more capacity than they need. The only circumstance that I know of that is desperately dangerous is the interaction between potassium and thiamin (vitamin B-1). If potassium is supplemented it is essential that vitamin B-1 be adequate (see http://charles_w.tripod.com/kandthiamin.html ). And of course, if the kidneys have been damaged in such a way as to be unable to excrete potassium there is some danger from supplements. This can easily determined by blood analysis.


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  • avatar

    Luis July 8, 2016, 12:53 am

    Hi, I use to tolerate magnesium with no problem. I took mag citrate for a couple 9f months and then switch to mag chloride oral I was ok for about 3 month until I took cod liver oil with it. Now I get a lethargy simptom with nerve debilitating pain all over my body every time I try to take mag. I feel drowsiness like out, fatigue, week, my heart pounds slow and I feel like I need breath when I fall a sleep. And noticed my urination output has decreses. I don’t urinate as often and as much. What could it be?
    Some people tell me that it could be a calcium deficiency. To take calcium and k2. And I read in the internet that a person was having similar symptoms and one night he was feeling his heart pounding very slow he immediatly got up and took some potassium and his heart rate immediatly went up and he felt better.
    Its a bery old post so I can ask whitch type of potassium and what amount did he used.
    Magnesium was what was helping me relax and sleep and now I can take it.
    Anyone has had similar syptoms and has solve the problem?

  • avatar

    Hasina April 10, 2016, 3:27 am

    Hi Troy. Thank you for your insightful article. I too am realizing the value of potassium supplementation in my recovery to health. Joint pain, fatigue, adrenal exhaustion and chronic musculoskeletal pain. I am noticing great improvement with careful supplementation (1-2 grams/day) . My question is, do you know if potassium bicarbonate is absorbed transdermally?

  • avatar

    Samantha McRorie March 21, 2016, 5:04 pm


    I won’t give you my full story that would take all day….. ๐Ÿ˜‰
    But I am having issues with low potassium and low sodium (not by serum testing but my HTMA)
    Unfortunately, I also have issues with lowish magnesium and while trying to rase my magnesium it is my understanding this can do a number on potassium and sodium….

    I have been doing foot baths with sodium bicarb, mag chloride, and epsom salts (for the mag and sulphates)…..and My muscles aren’t feeling very happy – assuming they are doing a number on my potassium.

    I was thinking of adding potassium bicarb to the foot bath (alternating with the sodium bicarb) – but since I lean towards low blood pressure – perhaps I should consider using potassium bicarb with potassium chloride on the foot bath…(the bicarb is important as a co-factor for the mag)

    Do you think this would work?

    • avatar

      Eric April 1, 2016, 5:01 pm

      It’s worth a try Samantha!

  • avatar

    brian jenkins January 5, 2016, 7:03 am

    Great website with so much pertinent health information.And so much pertinent information that I had no knowledge of. I seem to have a natural egomania.And think I know quite a bit.Thank you all for Posting and sharing.

  • avatar

    Michele N November 15, 2015, 8:10 pm

    Hi Joshua,

    Thank you for all that. I stopped taking Vit D many months ago as I believe taking so much is what contributed to going downhill so far by using up the little magnesium I had and would have been increasing unwanted calcium levels as well. I’ve never supplemented calcium, thank goodness!

    I always take magnesium now with other trace minerals, omega 3’s and B complex once daily and when I do take extra mg, I also take boron and taurine which helps to retain it. I’ve also purchased pure cod liver oil which has natural vit A and Vit D but put off starting it due to worrying about gagging on the taste of it.

    After exhaustive research, what I believe now is my biggest issue needing priority healing and that is severe adrenal exhaustion, so I also supplement with active B6 and wholefood Vit C, plus potassium and raw dessicated beef liver and adrenal/cortex glands. Improved my diet as well. Slowly but surely, I have been experiencing at least one, sometimes 2 good days a week. My setbacks don’t last as long.

    Unfortunately, I couldn’t keep up with the amount of mg I was initially taking but still take at least 3 x daily. The pain in feet and occasionally hands have returned but nowhere near as severe and I don’t pay for days on end like I used to after over-exerting myself, which is great.

    It took many decades of gradual decline, so I’m prepared for it to take years to gradually improve but I’m determined to follow through and continue what I’m doing and learning more.

    I also believe I’ve always been mg deficient and 100% positive now since I realised why being tickled on the sides of my torso was so painful for me even as a small child. (I remember it vividly as my brother once tickled me mercilessly and for a long time I believed he had deliberately tried to hurt me). The worse pain as an adult was severe spasms along the sides of my torso at night, so bad I was scared to move and sometimes breath – my initial reason for taking so much magnesium and only relief provided. Feel guilty I thought so poorly of my brother after that episode of tickling.

    I shall definitely check out the link provided.

    Thank you again ๐Ÿ™‚

    Cheers, Michele

    • avatar

      SunnySky January 17, 2016, 1:31 am

      Be careful, Michele, of the B6 supplement. I ended up with B6 toxicity and trying to recover from it now. We can get plenty of B6 from our diet.

  • avatar

    Joshua Thomas November 6, 2015, 11:01 pm

    Hey Michele, you probably won’t get this and I know how you said, you’ve had fibromyalgia for most of your life and the other disorder, but you said how everything got worse in the past couple years lately and how magnesium has helped you so much. Based on your symptoms, it sounds like to me that you possibly may be experiencing some hypercalcemia. And perhaps that may be from your D3 intake, and the reason you may be experiencing hypercalcemia from D3 at such a relatively low level may have something to do with you being deficient (or at least initially) in the cofactors of A, K2, magnesium, and zinc (and possibly but probably not boron?).

    Also, perhaps if you were severely deficient in manganese (for whatever obscure reason, maybe copper overload or pyrrole disorder), that may also cause the hypercalcemia, in that, without the needed cofactors in creating the functional K2-dependent proteins, an imbalance of D3 ends up creating an abundance of defective K2-proteins that can’t put calcium where it belongs (in your bones or teeth) and may even promote hypercalcemia in some further way. This is according to Chris Masterjohn from the Weston Price Foundation in pertaining to at least Vitamin A and K-2 working with D3, and supported by some recent studies.

    Perhaps unbalanced with the cofactors, D-3 may even increase bone resorption, adding additional calcium from your bones into your blood, adding to the elevated level of calcium in your blood, that for some reason one’s kidneys does not excrete fast enough to maintain normal calcium levels.

    The reason why magnesium supplementation is part of your saving grace right now is probably mostly because hypercalcemia causes your kidneys to excrete an excessive amount of magnesium, continually depleting your body of it unless you keep amending it as you are doing it.

    Maybe I’m wrong in this theory though as elevated calcium in your blood causes the forgetfulness and sluggish brain you mentioned, but I’m not sure how (or if) magnesium would help remedy it though it seems plausible. But you getting the tingling often if you don’t take it, makes me think that your magnesium (and/or potassium) is constantly being depleted and your having to heavily supplement just to keep up with it, which hypercalcemia would cause.

    As you know most people are somewhat magnesium deficient anyway and D3 uses magnesium in multiple steps in the body’s metabolism of D3, but the big reason you’re probably having to supplement like crazy is because the hypercalcemia is just wasting it like crazy. And as you know as well, your body is losing excess potassium when your magnesium levels aren’t sufficient and magnesium deficiency leads to potassium deficiency, which of course is going to be a bad problem, but according to Kerri Knox RN of Easy Immune Health (which you may have gathered your info from her), just correcting your magnesium deficiency is going to remedy the potassium deficiency (though it may take very long without potassium supplementation as Eric wrote), and I’m thinking you probably always being in some borderline magnesium deficiency (though not severe because of your magnesium supplementation) will slowly deplete your potassium reserves potentially.

    Another possibility is that your hypercalcemia reaction (maybe or maybe not from D3) is from a hyperparathyroid issue, which could be due to multiple reasons, including a tumor on your parathyroid that you can have removed. Check out parathyroid.com for more info. I believe I’ve experienced this hypercalcemia from D3 from a zinc deficiency. I wish you the best! If you wish to know more, just let me know. ๐Ÿ™‚

    • avatar

      Michele April 15, 2016, 8:49 am

      Thank you so much for that info Joshua. Definitely plausible and I now make sure I activated complex B daily and take boron and taurine to keep my magnesium in and also a potassium and wholefood vit c for my adrenals. Slowly but surely improving.

      Regards, Michele

  • avatar

    Anne October 29, 2015, 4:04 pm

    Any thoughts about combining potassium bicarb with potassium chloride in order to keep it at a neutral pH? I tried taking potassium bicarb and became too alkaline (constipated/sluggish thyroid, tired). I’m thinking that if I add potassium chloride to the potassium bicarb, it won’t be alkaline OR acidic and maybe that would be best. Also wondering if combining potassium bicarb with lemon juice would make it neutral pH.
    Any thoughts on this?

    • avatar

      Eric November 1, 2015, 3:25 pm

      I think I did that for a while myself…

  • avatar

    D. Smith August 25, 2015, 11:08 pm

    You could try potassium aspartate. The kind I use is from Vitacost.com and has just a little magnesium aspartate in it, as well. I’ve only been using it for a short time but it seem to be working well to lower my BP. I would also like to try the potassium recommended by the author for my BP issues.

    I wish someone somewhere would do more research on the potassium aspartate to see if the same issues exist with the B vitamins, and what medications it might have an interaction with, etc. If that info is out there, I’ve yet to find it.

  • avatar

    Helen Winter August 14, 2015, 3:17 pm

    Hi Troy! (Helen Winter now to differentiate myself from another poster named Helen). I was taking potassium to offset bad response to methylfolate / methyl B12 side effects with scary mega-tight muscles, excitability, cold sweat, etc. At the time my body couldn’t take in minerals very well. My body is better at that now and I attribute that to phosphotidyl choline, carnitine, glutathione to balance phase 2 detox with the phase 1 from the folate, calming my adrenals by limiting green tea and caffeine, and yes the taurine helps too. I only take 200 mcg of folate / day in a special formula that also includes a little sam-E and 400 mcg of foiinic acid. And it took me a while to get that high on the folate. Apparently my double DHFR mutation may keep me from going up on folate. Any more than that and the symptoms come back. I also take hydroxycobalmin with methylcobalamin B12 so I don’t methylate too fast. As far as potassium is concerned, supplementing to offset these methylation symptoms doesn’t help much. I have to keep my folate low at least for now. So I think to answer your question, supporting cell wall with phosphitidyl choline and supporting phase 2 detox with glutathione helped me get minerals and I don’t have too much reaction with potassium but then I don’t try to take more than 300 mg’s at a time because I’m done attempting Fred’s protocol, God bless him- its just not for me- can’t take high folate/methyl B12 yet. So I don’t need mega doses of K. My favorite source though is through emergenC sport packets- 300 mg of K-bicarbonate. I also like cheap K glucanate 99’s and coconut water too. Good luck.

  • avatar

    Troy August 13, 2015, 9:09 pm

    Helen, did you ever get to the bottom of your problems with supplementing potassium? I seem to be having similar problems. I definitely have low potassium, but seem to react adversely to it (panic is especially troubling).


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"...nothing ever goes away
until it has taught us
what we need to know.
-Pema Chodron

"God, whose law it is that all who learn must suffer. And even in our sleep pain that cannot forget, falls drop by drop upon the heart, and in our own despair, against our will, comes wisdom to us by the awful grace of God."


My name is Eric - Iโ€˜m 46 and saw a doctor for fatigue at 17. I lived fairly normally if a little subdued by lack of endurance at times. But then, 12 years ago I fell into a nosedive after moving to South Florida. Now, I know heavy metal toxicity is a significant source of my troubles along with genetic methylation cycle dysfunction. I spent 18 months chelating the metals out and starting up methylation but stopped when I felt myself circling the drain. Currently doing liver, colon, kidney and parasite cleanses. More about me here.

Timeline and current dosing:

Rounds completed: 29
Total chelation days: 125
Dose: 25 mg DMSA and 25 mg ALA every 3 hrs

* supplements
* hair test
* genetics
* lessons learned

"Battles are won in their darkest hours. Wars are won by learning something from each battle."

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