Understanding potassium

[A]nyone 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 person’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.