Let's Talk About Potassium Supplements


(Dee In NY, US wasT2D. Started keto June 14, 2019) #1

I had quit taking potassium supplements because so many posts I read made me feel like I would die if I took even a little too much.

Several days ago when I first started getting at least 4 g of salt every day to deal with orthostatic hypotension, I quit supplementing with potassium.

I hadn’t been sleeping well up til then, but slept really well right from the first day of adequate sodium, then in the past couple of days, started not being able to sleep. Last night was the worst and my calf and feet muscles felt like wood.

I gave in when I couldn’t sleep and took 891 mg of potassium. After about 45 mins, my legs felt better and I slept soundly through the rest of the night.

This morning I researched potassium and found that the recommended daily intake is 4.7 g and there is no established upper limit, although 1 study said that more than 13 g per day was probably not a good idea.

Also, the sodium:potassium ratio is listed as 1:2 or 1:3 but that’s based on a recommendation of no more than 2.5 g of salt per day, so I have no idea what the real ratio should be.

https://www.nrv.gov.au/nutrients/potassium

https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/#h8


Potassium and kidneys
New here and need some help troubleshooting
(alex kerss) #2

It seems the common consensus if we can get enough Potassium from our diets naturally then that’s the best way.

Although I’ve found getting 4.7mg of Potassium on a KETO diet seriously difficult, and I’m putting a lot of time and effect into trying to get the correct daily intake of trace minerals.

My wife is pregnant and was getting leg cramps, I upped her daily potassium intake to about 3mg from natural food and the leg cramps disappeared, but it was easy as she is not on KETO and I could just feed here baked potatoes, white beans, bananas, orange juice, etc.

From my research in a per calorie benchmark the following foods are great for Potatssium

food item (Potassium (mg) per calorie)

Broccoli boiled (8.371429)
bell pepper green, raw (8.750000)
spinach, frozen, boiled (8.882353)
mushroom oyster, raw (9.767442)
Broccoli Chinese (11.863636)
romaine lettuce (14.529412)

So if you ate 100 calories worth of spinach, you would get 888mg of Potassium which is about 19% of your daily recommended requirement.

From personal experience getting 4.7mg of Potassium per day on KETO is next to impossible each day, I did do it one day by eating 300g of avocado among other things but its just not realistic. Im managing to get about 2.5mg a day which seems about the best I can hope for.

In terms of good food with Potassium for a Keto diet, here’s the top items in my database (some of these are very high in calories per 100g)

food item (Potassium (mg) per 100g of item)

pecan nut 410.0
mushroom oyster, raw 420.0
walnuts 441.0
avocado 485.0
sunflower seeds 645.0
cashew nuts, raw 660.0
coconut flour 700.0
almonds, raw 705.0
flax seeds 813.0


(Central Florida Bob ) #3

@DeeCS, I’ve been down the same road as you, more or less.

Some time in the past, I started mixing up a salt/potassium mix to have a few times a day while fasting. For the sodium, I use Redmond Real Salt mostly because we already have it around the house and we both think it tastes better than the Himalayan pink salt. A quarter teaspoon of that has 530 mg of Sodium and a bunch of other trace minerals but no potassium (well 1mg in 1/4 tsp). I mix that with the Morton salt substitute, which is pure potassium chloride (not Morton Lite Salt). 1/4 tsp of that has 620 mg potassium. I take magnesium, but not in that mix; I take two 100 mg Magnesium glycinate caplets daily.

I had 1/4 tsp of each in a glass of water pretty much three or four times a day for a year. No problems. It helped with some cramps I’d get on fasting days.

A few months ago, the chorus of people saying too much potassium will kill you started to freak me out. I cut back the amount of potassium I was taking and promptly got some cramps back. I finally said to myself, “look, you drank it every day for a year and nothing ever happened”, and started getting less paranoid. Now I tend to use a bit less than 1/4 tsp of potassium to a heaping 1/4 tsp of Real Salt. I think it’s Close Enough.

Just using 1/4 tsp of each is that isn’t a good Na/K ratio - it works out to be almost exactly 1.25:1 and that’s what I did for a year. Your 1:2 or 3 says to use 1/4 tsp of Real Salt and 1/2 tsp of KCl.

On eating days, I don’t care and don’t supplement with the Morton potassium and I’ve never gotten my leg cramps on the day after eating. I make an effort to salt my food because I’ve never been a big salt lover and I’m trying to get enough sodium every day. Since we haven’t dumped veggies, I’m not concerned about potassium. First off, I still eat greens with one or two meals a day. An avocado has more than twice the potassium of a banana and meat contains potassium as well.


(Michael - When reality fails to meet expectations, the problem is not reality.) #4

I’m with you, Bob. I mix Real Salt, French’s No Salt (potassium chloride) and plain Epsom Salt. My current proportions are: 50 grams Real Salt, 40 grams No Salt, 10 grams Epsom Salt. That makes a 10 day supply at 10 grams per day. I put 2 grams in my morning coffee, 5 grams on my main meal and 3 grams on my evening smaller meal. If I eat a late meal before bed I’ll usually add 1 gram. On work days I also consume a liter of water with about 7 grams of table salt dissolved in it.

I should mention that I used to grind all three salts to powder, but I only do that with the Epsom salt now.

I started this routine to combat night cramps in feet and legs. It has helped enormously. I still get cramps occasionally, but not nightly and not as severe. Many times when a cramp starts I can simply stretch the leg of foot and stop it. I was never able to do that before.

I also find the hysteria over potassium from some members of the forum ridiculous.


(Doug) #5

If one doesn’t have high blood levels of potassium and has decently healthy kidneys (and is getting enough sodium) then I don’t think a little extra potassium is to be feared.

On the other side, if one’s not demonstrably low on it, then often supplementation won’t be required. The kidneys are really good at recycling it if need be, i.e. one can take in about 10% of that “4.7 grams” per day and be fine - it’s not like we’re actually losing that 4.7…

If one gets cramps, try adding more and see, all other things being equal.


(Give me bacon, or give me death.) #6

You are right on the first point, and I’m a big believer in that, but there will always be a few people who need the supplements, as Dee seems to have found out. It’s hard to find the right tone to urge people to do without supplementation if they can, but not to avoid supplementing when they need it.

Something that may help with your second point is that, as I understand it, the requirement for dietary potassium is not as high on a ketogenic diet, especially when salt intake is between 10-15 g/day. (This helps the body keep its potassium better-regulated, which is partly why we don’t need so much in the diet.) I would suggest that if you are not seeing any symptoms of potassium deficiency (hypokalaemia), then you are getting it right and don’t need to worry.

It is easy to get too much potassium, so people do need to be careful. Hyperkalemia can be toxic and even fatal. Not a reason to avoid supplements when they are needed, but a good reason to be careful when increasing the dose.

This is indeed true, but an amount that is just enough to relieve the symptoms of deficiency won’t. Just don’t go hog wild, is all. Some people get the idea that if 10 mg is good, 10000 mg ought to be better. That is not always true, and this is one of those cases where people want to be careful.


(Dee In NY, US wasT2D. Started keto June 14, 2019) #7

Can you please cite something to support that statement? In the research I did, I could not find anything that gave a safe upper limit and at least one that said that 13 g might possibly be too much.

Mayo Clinic’s article on hyperkalemia


(Give me bacon, or give me death.) #8

You may find these two reviews of interest. Apparently, a great deal depends on the context and the clinical setting.



(Michael - When reality fails to meet expectations, the problem is not reality.) #9

I think concerns about potassium are overblown. Like @CFLBob I’ve been using NoSalt for years with no issues other than my night cramps have gotten progressively less frequent and severe. People drown in the bathtub every day but we don’t advise people not to take baths.

Phinney does not seem to have any qualms about potassium:

In short, 3000-5000 mg of sodium and 3000-4000 mg of potassium on average are needed as part of a well-formulated ketogenic diet… Muscle cramps are our best indicator of depletion…


(Trish) #10

How can one know though if muscle cramps are caused by mineral deficiency or simply due to a job where one is on one’s feet for 10 hours a day?


(Central Florida Bob ) #11

The way I’d think about it is if the job caused the cramps, they wouldn’t be a new thing. Unless the job was a new thing. The first thing that someone trying fix something usually asks is, “what changed?”

If you changed over to keto or to fasting and started to have problems, something changed about your life and that would make some experimenting worthwhile.

I think this is a hard problem because cramps can be caused by more than one electrolyte. You may find magnesium helps yours and you may find potassium does. I think that’s why electrolyte drinks or supplements have all three (the third is sodium).

Hope that’s helpful.


(Central Florida Bob ) #12

@PaulL - I’ve come to think of the hyperkalemia warnings as being like, “keto will kill your kidneys”. It’s a warning for a small subset of people that gets applied in general.

Keto being bad for your kidneys is only true for a small fraction of people who already have kidney disease. Hyperkalemia warnings are true in people with chronic kidney disease and a few other conditions.

That’s one of those ideas that has an absolutely flawless, perfect record of never being right. Too much oxygen kills you, too much water kills you. Everything has the “Goldilocks zone”. Not too big, not too small, and just right. Too high a blood sugar is bad, too low a blood sugar is bad (if you’re not really solidly fat adapted) and on and on.

Instead of “if a little is good, a lot is better”, people should remember, “the dose makes the poison” - the toxicologists First Law.


(Trish) #13

Keto start date July 15. Job start date September 3. Lots of nighttime calf cramps the last few weeks. Job or lack of potassium catching up 2 months into keto? LOL. Reading through this thread though it seems like it would be hard to overdo electolyte supplements so I think I’ll up my K, Na, and Mg for a bit and see what happens.


(Central Florida Bob ) #14

If I had to guess, which is all I can do, there’s about six weeks from July 15 and September 2. Six weeks is ordinarily long enough to get fully fat adapted (assuming no big mistakes that drove you out of ketosis - if you’re new to this, one of those can set you back a full month). That leads to guessing it’s really electrolytes rather than just the job. Maybe the job is adding to it and making it worse?

When we’re keto, our bodies treat electrolytes differently and there’s an argument that we need more salt than people on the SAD. A lot of people around here strive for 5 grams a day of sodium, so about 10 grams of salt. I still have a hard time with that much.

Good luck!


#15

My salt mix for backpacking is 5 part sodium to 1 parts potassium. It’s in salt and I take a teaspoon full a day and half of that when not exercising. That’s a supplement of about 5g to 1g of actual sodium/potassium. If I still get cramps I wash down a half teaspoon as soon as I feel one.

It’s just a mixture of Table Salt and Lite Salt. And I take magnesium as well in pill form.


(Dee In NY, US wasT2D. Started keto June 14, 2019) #16

I take potassium gluconate. Does anyone know how much glucose that has in it?

The label says the caplet contains 99 mg potassium. The weight of the caplet on my scale weighs 667 mg. Does that mean that every caplet I’m taking contains 568 mg of glucose?

I hope so, because that would explain why my BGs are going up every day. I’m taking 9 of these 3x a day, so still only 2.6 g of the recommended 4.7 g potassium a day. But, if the glucose is 568 mg for each caplet, I’m ingesting over 15 g of glucose with the potassium.

I’ve got potassium citrate powder, but was waiting to use it until after the potassium gluconate was gone.

Is the citrate in the potassium citrate going to do anything detrimental? Don’t want to go from the frying pan into the fire.


(Central Florida Bob ) #17

If there’s glucose in it, that should be listed separately. Gluconate isn’t glucose, it’s the form of gluconic acid that results when you react it with a strong positive ion like potassium. It’s a salt in the chemical sense, a positive ion (the potassium) and the negative (gluconate) ion. This site implies that they think it might metabolize to some amount of glucose, but describe the mechanism as “God knows what happens”.

No. The whole 568 is not going to be the gluconate because all caplets like this have binders and other junk that make it stay in a capsule form, or control the release of the active ingredients. I’m rusty at the arithmetic of taking the atomic weights of all the carbons and oxygens in the gluconate and turning those into scale weights, so my apologies for not being more helpful.


(Michael - When reality fails to meet expectations, the problem is not reality.) #18

Why not just use No Salt? Nothing but potassium and chloride and you have 100% control over dose. It’s probably a lot cheaper, too.


(Dee In NY, US wasT2D. Started keto June 14, 2019) #19

Thank you, much appreciated.


(Jack Bennett) #20

Also see: salt may have adverse effects for hypertensive middle aged men, therefore everyone needs to cut salt below 2g per day…:grinning: