Potassium: The Top Electrolyte Everyone Needs!
In the first of this 2-part series on electrolytes I discussed sodium and potassium pumps and their ratios. In this article I’ll be discussing more about potassium and the truth about salt.
Diseases associated with low potassium
Hypertension – A number of studies have shown that people consuming a diet higher in potassium had lower blood pressures. A study done by the National Health and Nutrition Examination survey (NHANES III) indicated that higher potassium is associated with significantly lower blood pressures.1
Raising potassium levels also has endothelial benefits to the cardiovascular system, further protecting the individual from heart disease.2 As you lower your blood pressure, the knock-on effect is lowering your risk of a stroke. Several epidemiological studies have shown that increased potassium intake is associated with a decreased risk of a stroke, this is seen in both men and women3,4. As you get older the need for correct levels of potassium becomes even more important as a study shows it can reduce your risk of developing a thrombus in the brain.5
Osteoporosis is normally associated with a calcium deficiency, but in 4 recent cross-sectional studies levels of dietary potassium has significant influences on the bone mineral densities of pre-menopausal postmenopausal women as well as men.6,7,8
The most positive levels of potassium were in up to the levels of 6000mg/ day, in post-menopausal women, this is getting close the ancestral dietary intakes of potassium as mentioned in my previous article.9 Potassium-rich foods such as potatoes (with skin), squash, avocado, bananas, plums and prunes, are also rich in precursors of bicarbonate ions, which buffer the acids produced in the body coming from protein and fat consumption, and this reduces the net acid content of the diet, which may preserve the calcium in bones. Calcium therefore is not used to buffer against high acidity.
Cholesterol levels and potential heart disease risk is influenced by levels potassium consumption. In a study on animals, higher potassium intake reduced the levels of cholesterol deposition by up to 60% into the arterial walls.11
Measuring Potassium levels
Conventionally, measuring potassium levels is done by conducting a renal function test to understand the function of the kidney in managing the electrolytes sodium, potassium chloride and bicarbonates. Standard ranges for potassium are between 3.5-5.5 mmol/l. However, being on the lower end of 3.5 mmol increases risk of sudden cardiac arrest.10 We need to aim our potassium levels to above 4 mmol at least to be on the safe side. The largest pool of potassium is in skeletal muscle, and only 2% of potassium reserves are outside of the cells, so the most sensitive way of measuring potassium is with an intracellular test. A few international laboratories do intracellular testing and it can really guide an individual on whether to supplement or change the diet.
When measuring and optimizing potassium it should always be read alongside your magnesium levels. Magnesium deficiency will affect the uptake and utilization of potassium within cells.12 This results in the depletion of potassium out of the cell and subsequent excretion through the urine. So the two are intimately connected. Magnesium deficiency is much more common due to modern lifestyle choices and beahaviours and therefore potassium deficiency is more likely to follow.
Salt is it the villain?
Sodium Chloride has been misaligned and misrepresented by modern media as the villain causing high blood pressure, when the facts show that it’s a combination of other more nuanced factors contributing to hypertension. The modern processed food diet which we succumb to hides a lot of the sodium we’re not aware of, therefore we need to look at our diets more closely to optimize the fruits and vegetables for potassium and reduce processed foods. The big elephant in the room that are triggers for hypertension are high blood sugar and high insulin. Sugars cause the body to retain water, as water volume goes up within tissues this raises blood pressure. So the solution here is to minimize sugar intake, which then lowers insulin levels.
Supplementation is only recommended when blood tests indicate a deficiency in potassium or renal function tests are lower than 4 mmol/l. Where deficiency is present the best form of potassium is potassium citrate. Dosages are personalized based upon test results, but typically one can start at around 300mg and it can go as high as 1g/day. Taking higher dosages does require more clinical management to ensure other electrolyte imbalances don’t occur.
For more information regarding electrolyte imbalance, please contact Miles Price, Functional Medicine Specialist (IFM, FMU) at 2881 8131 or firstname.lastname@example.org
Written by Miles Price
- Hajjar IM, Grim CE, George V, Kotchen TA. Impact of diet on blood pressure and age-related changes in blood pressure in the US population: analysis of NHANES III. Arch Intern Med 2001;161(4):589–593
- He FJ, Marciniak M, Carney C, et al. Effects of potassium chloride and potassium bicarbonate on endothelial function, cardiovascular risk factors, and bone turnover in mild hypertensives. Hypertension 2010;55(3):681–688
- Ascherio A, Rimm EB, Hernan MA, et al. Intake of potassium, magnesium, calcium, and fiber and risk of stroke among US men. Circulation 1998;98(12): 1198–1204
- Iso H, Stampfer MJ, Manson JE, et al. Prospective study of calcium, potassium, and magnesium intake and risk of stroke in women. Stroke 1999;30(9):1772–1779
- Larsson SC, Virtanen MJ, Mars M, et al. Magnesium, calcium, potassium, and sodium intakes and risk of stroke in male smokers. Arch Intern Med 2008;168(5): 459–465
- New SA, Bolton-Smith C, Grubb DA, Reid DM. Nutritional influences on bone mineral density: a cross-sectional study in premenopausal women. Am J Clin Nutr 1997;65(6):1831–1839 16. New SA, Robins SP, Campbell MK, et al.
- Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health? Am J Clin Nutr 2000;71(1):142–151 17. Tucker KL, Hannan MT, Chen H, Cupples LA, Wilson PW, Kiel DP.
- Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. Am J Clin Nutr 1999;69(4):727–736
- Zhu K, Devine A, Prince RL. The effects of high potassium consumption on bone mineral density in a prospective cohort study of elderly postmenopausal women. Osteoporos Int 2009;20(2):335–340
- Kjeldsen K. Hypokalemia and sudden cardiac death. Exp Clin Cardiol. 2010 Winter;15(4):e96-9. PMID: 21264075;
- Tobian L, Jahner TM, Johnson MA. Atherosclerotic cholesterol ester deposition is markedly reduced with a high-potassium diet. J Hypertens Suppl. 1989;7(6):S244‐S245.
- Solomon R. The relationship between disorders of K+ and Mg+ homeostasis. Semin Nephrol. 1987;7(3):253‐262.