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.


79 thoughts to “Understanding potassium”

  1. 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?

  2. 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?

  3. Hi,

    I won’t give you my full story that would take all day….. 😉
    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?

  4. 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.

  5. 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 🙂

    Cheers, Michele

    1. 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.

  6. 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. 🙂

    1. 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

  7. 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?

  8. 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.

  9. 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.

  10. 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).

  11. Potassium Chloride vs Glutonate


    I have developed severe burning pain throughout my body (started in anterior neck area 4 months ago) in the last couple of weeks. My urine pH has been acidic for quite some time. One night I had a horrible bought of body burning pain and narcotics (which I hate taking were not even touching it.) My natural doc is out of town and I’m on my own with this.

    I started a regimen of a fresh lemon juice, 1/2 of baking soda and one tablet of Potassium
    Chloride – 99 mg. (I’ve read from Vernon Johnson, with the baking soda cancer protocol, to always do potassium if you are going to do baking soda.) Within a half hour, the pain went down considerably!

    Yesterday, was day three of my regimen and it’s been going quite well until this morning but I did something different last night.

    I ran out of the Potassium Chloride last night and used the Potassium Glutonate. Well, I woke this morning to crazy burning pain. I decided to do the baking soda, lemon juice and potassium glutonate and the burning pain continues even though my pH is alkaline.

    Can you tell me the big difference between glutonate and chloride?

    The different potassium might not be the issue but at this point, that is the only difference.

    Thank you,

    1. Sorry Christine, I don’t really remember too much about the various potassiums right now – but if you were feeling better with chloride, I’d go back to that and see what happens!

      Hope you feel better soon…

  12. Hi Everyone,
    Wanted to post about some of the experiences I’ve had with magnesium and potassium too. I’ve been reading a lot from Dr. Wilson about how mineral deficiencies can relate to certain personalities/symptoms: http://drlwilson.com/Articles/personality.htm

    He seems to have a unique approach to understanding mineral imbalances without laboratory testing.

    I’ve also noticed that the macrominerals magnesium and potassium oppositely affect water balance in the body. Magnesium tends to dry out a person and potassium hydrates.

    In order to tell which type of person you are, you can rely on symptoms such as: dry mouth, edema, constipation vs diarrhea, etc. Or you can tell by the tongue: swollen and thick with saliva is too moist whereas thin and with horizontal cracks is too dry.

    Just thought I would share my observations.

  13. Hi Eric I’ve read this post over a couple of times as I think potassium is a cornerstone nutrient for me as well. You say you’re not taking any now? And you mentioned you were on it for way too long. What did you experience that made you think you’d been on it too long?

    There’s conflicting info on the web about how much there is in a teaspoon of cream of tartar. I’m currently taking that form which is potassium bitartate – about 3 teaspoons pd which amounts to about 1500 – 2000mg pd – (or on another blog indicates 5000 per teaspoon = 15,000 per day?!)…..do you know whether that’s similar to bicarbonate? And whether its alkalizing? I’m feeling quite spacey and my energy is getting lower which I suspect is low blood pressure kicking in (blood pressure already in the low end).

    I want to keep taking potassium because the good thing is it seems to be releasing a spasming ileocecal/ileum region and reducing my nerve and muscular pain to a degree.

    Do you have any idea what could be a lower effective dose – perhaps 1500 – 2000 and also you suggest using potassium chloride primarily?

    Thanks so much Eric – your site is helping me track through a load of information and find what can work.

    1. sorry Elizabeth but it has been too long since I wrote or thought about potassium and I’m to brain fog to say anything about this now… I’m not taking potassium now but maybe should add a little. I generally take it when I experience muscle cramps – that’s my signal.

  14. Potassium can make fatigue more severe according to Dr. Lam, who does extensive research in adrenal fatigue. Also, potassium can increase pyruvate and uric acid level in the body, which could be a serious problem for people with kidney dysfunction and CBS/SUOX mutation. Have you looked into this Eric?

    1. I’ll take your word for it – I’ve experimented with up to 5 g a day of potassium and currently just taking one half gram. I don’t think it affected my fatigue level one way or the other…

  15. Very nice article. I would add that in the Paleo days, people ate about 11 grams of potassium per day and about 3.5 grams of sodium. Now days we lucky if we get 1 gram of potassium and most people load up on sodium 4-5 grams. If you do alot or cardio you deplete your body of minerals due to acidic blood buffering effect. Besides Potassium bicarbonate you can make and drink Magnesium bicarbonate very easily. Since low potassium and low bicarbonates most likely cause high calcium serum, your arteries are plagued with calcium deposits. You need magnesium to dissolve them. Magnesium bicarbonate is an excellent suppliment for this purpose.

    1. Hi, I can only comment under an existing post. I have spent a lot of time reading this site in the past week and very surprised how supplementing with potassium is such a big focus whenever cramping, pain or salt cravings is noticed….all signs of magnesium deficiency, which is extremely common and potassium is apparently not to be supplemented without first getting magnesium levels high enough as it regulates both low potassium and calcium. By adding the potassium without magnesium, it’s creating further depletion of our most crucial macro-mineral.

      Up until a few weeks ago, the pain in my hands and feet were severe, I felt like I was walking on broken bones and I could barely use my hands due to stiffness, swelling and pain. I thought it was arthritis from so many past injuries of fractures, sprains and other injuries.

      I have had fibromyalgia since childhood (52yrs old now) plus myofascial pain condition which had become so severe that the past year I’ve had chronic muscle spasms in my torso which were excruciating and often had me to scared to breathe deeply in bed, as the spasms were always worse then.

      My balance has always been bad and I often have accidents or fall over but it had become so bad, that I’d fall over for no reason!

      Cognitively, I have spent the past few years terrified I was developing early dementia as I spent so much time forgetting what the hell I was looking for. I couldn’t find words, forgot things as soon as I was told or read them and I was just not ‘me’ any more. I couldn’t really focus 100% on anything.

      I’ve got a long way to go BUT my saving grace has mainly been huge doses of magnesium, spread out through the day. If I slack off the spasms start niggling. I can use my hands with only a little pain now and no swelling even in humid weather. My feet still hurt me but MUCH improved. I wasn’t expecting relief from hands or feet and it’s so exciting!!!

      I haven’t fallen over in 2 weeks and I don’t feel unsteady. My hands no longer have a tremor. I’m not as easily confused or in a perpetual brain fog or as forgetful.

      A wonderful relief was a huge reduction in waking myself up half a dozen times with the noise I made by grinding my teeth. I hardly do that now.

      I take about 8-10 Source Naturals Magnesium Malate, as well as transdermal Magnesium Chloride
      oil but it was better when I was taking my 5000IU of Vit D3 daily as well before I ran out.

      One thing people are never told when taking Vit D3 is that it depletes magnesium and it has to be taken with it for proper absorption. I also take Zinc and B Complex

      I have started to supplement with Methyl B12 5000 transdermal patches but it was the magnesium that made the biggest difference and most notable change if I forget to take as much.

      Happy to provide links for you. It’s one of the recommended treatments that has helped some with CFS and Autism.

      Regards, Michele

      1. glad you are getting such great benefits from magnesium Michelle! I don’t talk much about magnesium because it is so widely reported and I also take large quantities myself. I try to focus my writing on issues that are little-known or difficult to find information about and especially what I’m experiencing personally… I’ve recently cut back a lot on magnesium because I don’t want to take it with meals as it reduces stomach acid and must hinder digestion somewhat. Thanks for the vitamin D/magnesium reminder. Hope you can find out what’s at the root of your magnesium deficiency!

  16. Hi Eric,

    The link you provided to potassium bicarbonate info is no longer available. Do you have any other links that suggest that 1 teaspoon = 2,000mgs potassium? It seems high, and some of that has to be bicarbonate.


    Thanks Eric!

    1. Sorry, I remember that link was hard to find. I can tell you however that potassium bicarbonate is very strong stuff – a small quantity has a big impact on urine alkalinity and also very easily irritated my stomach. I would tend to believe that measure is accurate.

  17. Hi Eric. I found this article discussion fascinating because I am about to embark on methylation and wanted to get my potassium up first. However, I feel dizzy, weak and get panic attacks with supplementation, or after sprinkling potassium chloride on my food, and was wondering the reason for this.

    The aldosterone relationship to potassium intrigues me. I recently starting taking maca and wonder how this will effect aldosterone and need for potassium. I am also going to read the book to find more out about B1/potassium relationship.

    At this point, I am trying taurine- also helps me sleep and relax. I am hoping it will help cut back my need for supplementation by facilitating transport of ions in and out of the cell. I see your last post was a year ago: How are you doing on the taurine?

    Best wishes, Helen

    1. hi Helen, I don’t have any complaints about the taurine, I’m still taking it. I wouldn’t take the potassium if you react like that to it. I’ve no idea why. You could also try a different form of potassium like potassium gluconate. Better yet, potassium rich foods… I’ve stopped supplementing potassium myself.

      1. Thanks so much for your response, Eric. May I ask why you believe it is no longer necessary to supplement with potassium? The reason I ask is that I just started detoxing (actually by accident): first with a psylium-herbal supplement, then with Maca root- It was like a weight had been lifted and I was all of a sudden so hungry after having no appetite for a year!

        But with the increased appetite I also felt so low on electrolytes and had a nervous exhaustion. So I tried increasing potassium in my diet (and other minerals) but still felt the nervous exhaustion and started doing literal cookie crumb-amounts of methyl B12 and methylfoalte to complete my the detox I had started because I felt the pslium fiber was too dehydrating and the Maca was too excitatory.

        Now with the cookie crumbs of the B12 and methyl folate I feel more depleted from electrolytes than ever but also many positive effects too. I had read that these nutrients help increase cell reproduction at high levels, increasing demand for potassium and other nutrients. I am hoping that if I keep my dosage low for a long period of time, this demand will level out somehow. I am hoping that was your experience.

        So many other people I read about on these nutrients are supplementing with high doses of potassium that I could NEVER reach or sustain with my sensitivities. But I want to stay on these supplements (at least in tiny amounts) and can only down so much potassium/mineral rich food and supplements a day. Do you feel that some of your mineral needs have leveled off to more managable amounts? Thanks, Helen

        1. yes, I think my need for potassium leveled off – seems to only ramp up when I’m increasing my methylation supplements. I think I took potassium for far too long…

      2. Some individuals with either compromised kidney function or a mutation for Hyperkalemic periodic paralysis should avoid supplementation of potassium. These disorders are very serious but can be managed through diet and emergency levels to lower serum potassium levels. For individuals with Hyperkalemic periodic paralysis even minor shifts in serum potassium levels can go quickly from muscle weakness to paralysis and even cardiac arrythmias. . Serum levels do not have to be extremely high for this to occur. Glucose tabs, juice and even inhaled steroids can quickly bring serum levels down enough to eliminate these symptoms.

    2. Hi Helen, after reading up on this page, I did start the Potassium Gluconate and muscle tested for times and doses. My subconscious was wise and did not have me take a bunch of potassium at one time. For the first couple of weeks, I needed usually one potassium gluconate tab in the am and with meals, then the amount I needed started to decrease. Guess I was getting replete at the cellular level. I am surprised at how few supplements I need to take these days, sometimes none at all, but still with the B12 injections every few days, and/or if I am doing something strenuous, like returning to consecutive 12-hour shifts at age 57. Incidentally, I did receive the potassium bicarb several days after starting on the potassium gluconate, but I never have muscle tested positively for using it after receiving it, even though I think tested positive when ordering it, probably because I did not have the gluconate in my home at the time when I ordered it. Guess my body prefers the gluconate for now. Hope you get your supps sorted out…..

      1. Thanks so much for relating your experience and insight, Beverly. I think you are right- there may be a form of potassium out there that I can tolerate. I find it interesting that you too feel your need for it varies from day to day agree it is best to let the body determine daily needs for this nutrient. And always starting very low is a great idea. Thanks for the encouragement! Helen

  18. Trying to figure out my potassium needs, since trying to bring down blood pressure. Have some potassium bicarbonate on order per your suggestion. Just picked up some potassium gluconate. Had been using potassium citrate, but that just made me feel odd in higher doses, and I don’t think it even began to bring down my blood pressure. On the aggressive B12/folic acid protocol. Thanks for all this info. I knew to increase potassium with the B12 protocol, after being on the Pernicious Anemia/B12 Deficiency FB page for a while, but I was curious about the pathology and the reasons for it. Thanks for explaining that…..makes sense….do eat mostly fruit, meats, kefirs, veggies (usually from own garden.)

  19. I’m having such a hard time understanding how everything works together! About 2 weeks ago my B12 lab came back at 182. My doctor told me to start with 2000mcg a day. I happened to have cyanocobalamin 1000mcg pills and started on that twice a day. At first it made me very tired. I ordered what I THOUGHT was methylcobalamin and when I got it it was only “sublingual cobalamin”. I started on that twice a day, didn’t have the fatigue issue but now the faint heart palpitations with the other kind were getting worse with every pill I took. About a week into supplementing it was terrible. It started with muscle tightness in my neck, where it felt like they would cramp up if I just moved the wrong way. Then muscle weakness, heart palpitations, tightness in my chest and a general unwell feeling. That was 3 days ago and I am still trying to recover. Someone told me that it may be a potassium issue and so I started eating potassium rich foods as much as possible. Feeling slightly better over all, my heart still feels off and now I have a monster headache. My serum potassium level was 3.6 in May, I can only imagine what it is now.
    I don’t quite understand how the other things correlate, my chloride was 108 (high range 107), and sodium normal low.
    I tried to call my doctor to talk about it but she seems completely unconcerned and simply said to stop taking the B12. I called again later to see if I could add potassium to other labs she had ordered and spoke with her nurse who basically said, “if you feel so uncomfortable, you should go to the ER”. Thanks for the help, lady.
    This is all so confusing to me, I don’t know what the real issue is or how to fix it!

    1. your experience with MDs sounds like mine, no surprise there! you might try potassium gluconate. For a long time I was taking 23 potassium gluconate pills per day. Total of around 3 g of potassium… No doctor is helping me. Just be very careful to make small changes each day.

  20. ps – should I also ditch the “Intrinsic Factor with follinic acid” and TMG?


  21. The signs of ‘hypokalemia’ are almost identical to ‘hyperkalemia’. How do you tell the difference??


      1. Thanks very much for your response.

        I get constant neck spasms (I guess you could call them ‘cramps’) – all the time from fibromyalgia. I am taking Enzymatic Therapy Krebs Mag-Pot Chelates: has 250 of mag/ 100 of potassium. Do you think that’s enough potassium, or do you think I may need more?

        I’m doing the B12 protocol, but got pretty confused; there was so much to read through and process. I thought that you & Freddd took large amounts of the 2 forms of B12 – right? Can you tell me how many MG’s you took?

        I had begun on Jarrow 5,000 mcg and took 5 sublingually with Source Naturals Dibencozide 10 mgs. 4 sublingually for 45 minutes.

        However, the protocol summary gives low amounts. I WANT TO HEAL AND WILL DO WHAT IT TAKES. I am past the end of my rope with this.

        I am also trying to help cure doctor-induced nerve damage, and read where B12 helps to heal that in large amounts (saw in a study on ProHealth).

        I would sincerely appreciate any guidance.

          1. May God truly bless you and Fredd for sharing your stories, and for helping those of us trying to find our way through this maze. Your story provides hope; something I think those of us sick for so long with these disorders need. I printed out your list of supplements, so I can go through it carefully.

            I sat all day today and read through your story (have to re-read many times, and highlighted important points, and didn’t reach the end). I had no idea that B12 was involved in 600 processes in the body, as well as many other facts I was unaware of.

            I had read up on nutrition for years, but never had I heard of “methylation” – and the importance of it. I am so adamant that my family never goes through what I have, that I bought each of them a bottle of mb12 & adb12. I printed out the first page of your story to give to each of them, as well as my father, who has foot-drop.

            I am hoping this will work, as I’ve tried almost everything else. But the symptoms seem to fit. I had a lot of mercury fillings removed, (after having them for years) but the dentist didn’t do the removal properly, so I’m certain I inhaled & swallowed all the dust. I am doing Andy Cutlers ALA protocol, and implemented things like lipid replacement therapy that Radio from ProHealth uses. He sent me the link to your article, which I am very thankful for.

            I really appreciate you taking the time to answer.

  22. I had severe headaches tingling almost 4 months back and after a month of wasting time doctors figured out B12 Def. I was given Mb12 many times along with gram doses of folic acid.  My headaches went within 4 days and my mood became better. But within 2 weeks I started developing joint pain etc… It has worsened since and I hurt my back also… Now its 3 + months and all my original symptoms of Nerve/headache is gone but my back muscles and other join weakness (Without pain) has worsened. I have stopped all folic acid 15 days back and my B12 Injections were stopped almost 1.5-2 months back… It has similarities to potassium / electrolyte… depletion since taking pot supps helps .. I have not tried potassium supps more than 1 G per day… I am at loss and depressed not able to go to work…  Can someone help… Can weakness due to potassium depletion persist even after stopping B12/Folate. If so what is the best mechanism to increase…it… What is the best way to get out of this weakness… I am not diagnosed with CFS etc. I am not sure if I have any…. May be my body was already on low Potassium and the B12 treatment + Multi gram Folic Acid might have triggered Potassium deplesion… But even after discontinuing …it is still there.. Some one please help

    1. Well, I take around 5g of potassium gluconate per day and still getsome muscle cramps… I would try titrating up your potassium very slowly and carefully. Take it with meals to avoid hurting your stomach and try to split it up across meals as best as you can. Watch carefully for any symptoms of too much potassium. Ideally, you don’t want to take large doses of b12/folate and then suddenly quit. You’ll be better off increasing slowly and steadily so you can work out your potassium issues over time so that you are doing everything in a sustainable way.

      1. As you suggested I will slowly increase potassium and watch. I am very glad and thankful that you replied. Wish you and everyone including me heal well. I will post based on my experience so that someone with similar symptoms could possibly take better decisions. Life…has become a big game… but I am sure one day at least our next generations will be able to lead a better life due enhancements in techs. Just need to at-least hold on till then and do everything to get betters..(doctors as you said are not helping..No one here in my area knows anything about methylation block, potassium need etc)…and people like you aid in that.. Thank you.

          1. In the few days I tried… Few things I noticed. When I increase potassium the symptoms improve in the short term, but need of potassium keeps growing to keep up with the same level of muscular strength. Also peeing has increased… Weakness starts with a pee typically and then potassium ..pee potassium pee this goes on… till I get afraid at 2 g of elemental potassium (Dissolved KCL powder with food). Overall strength has improved but something is tricky with this potassium. Do you take elemental Potassium 5g or Potassium gluconate 5g. My problem is  I dont have any lever to control methylation (Assuming my symptoms are due to methylation)  Since I am not taking any supplements….Only Potassium.. My B12 levels are very high and so is my folate level. Any similar experience ? Any ideas on how to manage. Also I have relative weakness half day and then more strength the rest of the day (All this started only after taking B12 injections with folates)…

            1. “Do you take elemental Potassium 5g or Potassium gluconate 5g.”
              Elemental 5g

              “My problem is I dont have any lever to control methylation”
              Niacin (not flush-free type) will turn down your methylation – I take 100 mg at bedtime.

              I don’t do any blood testing because I think the tests are fairly meaningless. So what if you have high levels of something in your blood that should be getting into your cells and isn’t. You can have a deficiency of something that a blood test shows high. That’s one of the main issues with potassium deficiency I believe, that some people have trouble getting it into the cells where it’s needed.

  23. Eric,  Thanks so much for mentioning chloride.  I just checked my most recent labs: my chloride was 101 and the reference range was 101-111.  
    According to: 

    A test for chloride may be done to:

    Check your chloride level if you are having symptoms such as muscle twitching or spasms, breathing problems, weakness, or confusion.

    I guess it’s time for me to up my intake of salt. I don’t really eat out at all, and am pretty strict paleo.  I’ve been gluten free for the last 40 days.  I never realized it, but baked goods contain lots of sodium.  In fact, a dunkin donuts muffin contains twice as much salt as large french fries at mcDonalds. 
    I’m very excited to do some diet tweaks with sodium chloride in mind!  I will get some Now Foods potassium chloride as well.
    Thanks again for such a great resource!

  24. My recent light-bulb moment was when I realized that after 3 days of mega-doses of methyl b12, I’d get grinding tension headaches and muscle cramps. 
    I’m day 3 into taking NO b12. high potassium foods, and low salt.   The only supplement I’m taking is jigsaw magnesium.  However, based on what I’ve read today, I’m upping my salt intake. 
    I have a new-patient visit with a functional medicine doc in 2 weeks. 
    Any tests you can suggest I ask about pertaining to this whole potassium thing, given my methylation issues?

  25. How common is potassium deficiency?  I suspect more common than you think!
    I was chatting with a 53 year old woman who has rheumatoid arthritis. For years now, she has suffered from some muscle twitching and some muscle cramping.  Her doctor said her blood potassium level was normal. End of discussion.  That’s pretty much identical to what happened to me with my primary care doctor. 
    What tools are available to normal doctors pertaining to low potassium?

  26. What a great thread!
    1. Could someone have potassium induced muscle cramping and/or muscle twitching if blood potassium levels are at 4.1-4.3?  
    2. I’m on paleo and have a very very low sodium intake.  Is this a bad idea as I bump of the qty of potassium foods?
    Thanks for any thoughts,

    1. My impression is that blood potassium levels are not very meaningful, so that would be a yes… and also that the low sodium intake is a very good thing. At times in the past I have used saltwater because my adrenal function is low but that’s a separate issue. If your blood pressure is low you may also need the chloride from salt but you could get that by supplementing with potassium chloride instead.

      1. I started a thread over at:
        I got an interesting comment there: “Over-restricting salt is a prime reason for getting low potassium because it leads to excessive aldosterone production (which retains sodium while over-excreting potassium, magnesium and calcium). You won’t fix the problem by eating more potassium (this will make it even worse), you have to salt more. Also ensure that you got enough calcium in your diet (i.e. from dairy)..
        I responded: “Funny you mention “aldosterone” While researching my 23andme methylation results, I came across this: “ACE Gene: This enzymes leads to high levels of angiotensin II which causes an increase in aldosterone. High aldosterone leads to increase potassium loss in the urine and increased sodium retention.” My doctor dismissed this saying if this were relevant, I’d have high blood pressure, which I don’t. An MAO-A mutation makes this worse. (which I have). I am hetero for ACE and homo for MAO-A.

        1. That’s pretty interesting Mike! I also have the the same exact pattern you do for those two genes. However, a 24-hour urine collection test by Meridian Valley showed my aldosterone levels to be normal. Now that you mention it, I think my cramping has gotten worse since reducing my salt intake and increasing potassium supplementation. However, I was boosting methylation at the same time so I don’t think there’s any way for me to know without doing experiments.

          After doing more research and thinking I’ve been wondering if my cortisol supplementation is to blame for my potassium troubles. I’ve been tapering my cortisol so maybe I’ll have an answer soon.

          As for salt intake, unless you eat nothing at all from restaurants or prepared food from grocery stores like Whole Foods (in my experience) it’s pretty hard to get salt intake way way down.

        2. Thanks for posting this Mike. It rings a bell for me as well, as I’ve been upping my potassium using potassium salt (chloride) and also increasing magnesium, because my blood pressure has been erratic, despite reluctantly taking a half-dose BP med.

          The day I went back for a followup I limited my salt intake big time, and increased my potassium (and a little magnesium), and I could hardly walk because the spasms and cramps were so bad. And on top of that, my blood pressure was the highest it’s ever been! Part of that is the ol’ white-coat’ phenomenon, as it dropped almost 50 points a few hours later, but still…

          And since then, just in the last couple of days, I’ve cut back on the potassium salt, and despite my severe muscle loss (like Freddd’s on the PR forum), I’ve been able to “walk”, at least move around the apartment, a little easier.

  27. Any word on Potassium Citrate?  My oldest went on that when he had kidney stones at age 11.  He’s been on it several years now, long before a doc diagnosed him with B-12 def and MTHFR.  I’ve been trying to think through how it’s related.

    1. I’ve been taking 3 g of potassium citrate every day for about a week. I’m happy with it except for the fact that my urine pH is way too alkaline. I’m trying to balance with vitamin C but not having much success. Not sure what to do next…

      1. I accidentally discovered the solution for the pH imbalance. It turns out that D-ribose is strongly acidifying, so, with 15 to 20 g – problem solved! Also discovered that I need this much to keep my energy and body warmth up.

        Discovered this accidentally when I started forgetting to take it, and one evening had low energy, so I took 15 g and immediately my body warmed up and I could feel my methylation cranking again…


        1. Wow – that’s a lot of D-Ribose Eric! I get what you mean though, that there seem to be any number of possible rate limiting factors when it comes to methylation. Adding NAC has been hugely helpful for me. I tried D-Ribose many years ago and didn’t notice any effect. Most likely I would notice now, given that my entire system has been “upregulated” 🙂 Perhaps I’ll get some…

          I have to wonder though, exactly what’s happening merely from tweaking our pH (presumably urine pH?) by adding stuff like bicarbonate or more acid… I suppose that’s better than having our pH be way out of range but it’s also possible that it’s not really doing much to adjust our intracellular pH and mostly it’s being eliminated in the urine. At least for myself, I haven’t figured that out to my satisfaction as yet. At the very least, if our pH is apparently “normal” (whatever that is), but if we feel yucky and fatigued, then I have to figure that into my interpretation. I’ve found that I know rather intuitively whether I’m trending towards over-acidity or not… and testing pH tends to confirm that.

          1. At first I thought that was a lot of ribose also, and if you look at the cost, it definitely is. However, if you look at it in terms of the amount of sugar in a cup of juice or an “energy” bar, it’s not that much.

            The reason I felt it important to pay attention to urine pH is because Revici found that urine pH was typically all acidic or all alkaline in cancer patients. Healthy people start the day acidic and become alkaline. That crossover used to happen before I started taking large quantities of potassium, so I wanted to correct for that… also worried I might damage my kidneys or some other system if I didn’t.

  28. After reading the book “The doctor who cures cancer” and seeing Revici’s potassium patent, I’m thinking of making liposomal potassium. Also an interesting mention of encapsulated potassium here:

    “In all cases, autoimmune diseases are preceded by breakdown in cellular anabolic performance, and consequently, cellular potassium deficiency is guaranteed in autoimmune disorders. The critical oversight in research literature is that cellular potassium is a by-product of anabolic metabolism.

    Dietary potassium sources weakly influence cellular potassium levels because the cellular potassium channels are one way out, not in.

    Modest exceptions occur when dietary potassium is encapsulated, chelated into aspartate, orotate forms, or lipid structures that integrate with the cell membrane.

    1. Have you ever tried potassium aspartate or orotate?  After reading the quote you mentioned, about aspartate and orotate forms perhaps having stronger influence on cellular potassium, I wondered about it.  Especially as these two forms are easier to acquire than making liposomic potassium would be (I don’t think anyone sells liposomic yet premade).  The tiny dose per capsule is a problem though, and I haven’t seen them in powder form.  Swanson’s sells the orotate capsules (cheaply, too, looks like), Amazon has them for somewhat higher cost/different brands. Maybe these forms haven’t been on the market long though, there aren’t many user reviews on either of those sites for them.

      1. hi Mary, I haven’t tried the potassium chelates… I thought the first step would be for me to try liposomal vitamin C to see if I can tolerate lecithin and to see if the liposomal trick works well for me. In theory, I don’t mind making my own because I might be making the vitamin C anyway.

        Will look for that comment you mentioned…

  29. Hi Eric,
    I’m glad you added Charles’ comments and the caution about adequate B1. I left that out of the original post on FDC to avoid making the topic more confusing… in part because I found it confusing. At least in his book, there is a case where he says one should not take supplementary B1. But it seems that caution applies if there is an existing potassium deficiency.  I suppose the upshot is to supplement both, presuming one is starting from a deficiency state. 

    Your readers might also be interested to know that in addition to magnesium and taurine, inositol can help raise cell levels of potassium. However in my further reading on the topic, the limiting factor when it comes to cellular uptake of of potassium, is largely about the integrity of the cell membrane. Supplemental potassium may simply be lost in the urine (or cause serum levels to rise if there is poor kidney function or insufficient aldosterone) when the potassium pumps on the cell membrane are not functioning efficiently, as it likely the case for CFS sufferers, or those who are otherwise poisoned by mercury. This does relate to methylation status, but I think there’s more to it than that.

    In Amalgam Illness, Cutler states: “Mercury selectively catalyzes the oxidation of cell membranes. This destroys essential fatty acids and membrane constituents like phyospatidylserine and phosphatidylcholine at an accelerated rate. The alternation in membrane components interferes with cellular signaling, interferes with cell function, renders the cells more susceptible to oxidative stress, and favors other pathological processes.”

    Cutler also discusses potassium in the Hair Test book: “Hair potassium does not reflect dietary intake or body burden even when mineral transport is normal and orderly. Low hair potassium suggests the possibility of low thyroid function. Urine potassium generally correlates with dietary intake, and red blood cell potassium generally correlates with body inventory. Serum potassium is primarily a marker of adrenal/kidney interactions. High hair potassium may reflect excessive aldosterone activity. Low body potassium can cause general weakness, fatigue, thirst, constipation, weak reflexes and heart beat irregularities, the most common of which is a racing heart (tachycardia). Low potassium can be due to certain types of diuretic medications or to a diet low in vegetable matter. Mercury deranged mineral transport often causes functionally low body potassium levels by interfering with the concentration of potassium into cells by cell surface pumping proteins. However this is not reflected by the hair potassium level – red blood cell potassium is the relevant measure.”

    Note that Mr. Weber states that the body will selectively keep potassium levels in red blood cells above that of muscle cells in the event of a deficiency (I think I mentioned that in the original post)… so measuring RBC potassium doesn’t tell the whole story either. But it can still provide some indication.
    In the next section in the hair test book about key mineral ratios as they appear in hair test results, Cutler mentions the concept of metabolic typing and so-called “fast” and “slow” oxidizers, and that some practitioners suggest that certain nutrients are helpful or will increase dysfunction, depending on your oxidation type, but he doesn’t necessarily agree with these theories. I mention this because in my further reading, I’ve found that potassium is one of the nutrients that theoretically should not be supplemented by fast oxidizers. However, it would be indicated for slow oxidizers. The distinction has to do with the rate that the cell uptakes and utilizes glucose and other nutrients like potassium. I think this would be analogous to methylation rates, and it also has to do with adrenal function. Early stages of adrenal fatigue that are characterized by high cortisol, as well as over-methylation, can push too much potassium into the cell. However, I would guess that most of your readers (i.e. CFS sufferers) are probably experiencing the opposite – impaired adrenal function, impaired methylation and low cell levels of potassium. This also implies that the cells likely have a lower pH level – meaning excess acidity and therefore toxicity.   

    For myself, these added insights have led me to up my dosages of antioxidants and essential fatty acids. This should better protect cell membranes and therefore increase potassium uptake. 🙂

    1. Thanks Stephanie, very nice summary! I’m also doing what I can for the membrane integrity with fish oil and egg. I also take inositol, fortunately.

  30. This process of figuring out potassium has become a little messy for me. In a short time period, I reduced my salt intake and increased taurine and potassium by adding potassium chloride and subtracting some potassium gluconate.

    Then I started getting very spacey. Not lightheaded as I do with methylation and not brain fog, but spaced out. It seems to come on and go away rather quickly which should make it easy for me to figure out what’s causing it, but so far I can’t pin it down.

    I think it’s the taurine, so I’ve reduced that and to be safe, reduced my potassium gluconate a little as well. What a nuisance when I was hoping for a miracle right out of the gate, lol.


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