Let's Talk About Potassium Supplements


(Failed) #21

This article from the NIH is interesting, especially as to the reason most supplements only contain 99 mg potassium.

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

Many dietary supplement manufacturers and distributors limit the amount of potassium in their products to 99 mg (which is only about 3% of the DV) because of two concerns related to potassium-containing drugs. First, the FDA has ruled that some oral drug products that contain potassium chloride and provide more than 99 mg potassium are not safe because they have been associated with small-bowel lesions [21]. Second, the FDA requires some potassium salts containing more than 99 mg potassium per tablet to be labeled with a warning about the reports of small-bowel lesions [22,23]. In accordance with a ruling by Congress, the FDA may not limit the amount of any nutrient, including potassium, in a dietary supplement, except for safety-related reasons [24]. However, the FDA has not issued a ruling about whether dietary supplements containing more than 99 mg potassium must carry a warning label [17,23].

Also of note from the same article:

DV = Daily Value. The DV for potassium used for the values in Table 2 is 3,500 mg for adults and children aged 4 and older [17]. This DV, however, is changing to 4,700 mg as the updated Nutrition and Supplement Facts labels are implemented [18]. The updated labels and DVs must appear on food products and dietary supplements beginning in January 2020, but they can be used now [19].

I bought some potassium citrate powder and I made my own capsules. Trying to get the 4.7 g per day but working up to it slowly.

Potassium will kill you is apparently one of those things ā€œeverybody knowsā€ that isnā€™t true. Even the manufacturer I bought from is misinformed. Hereā€™s what they have on the page where theyā€™re selling it:

This supplement should be taken in servings of exactly 275mg per day; no more, no less. Too much Potassium has the potential to be fatal, so it is always best to measure out amounts of this supplement on an accurate milligram scale. Do not attempt to use anything other than a milligram scale. This supplement should be stirred into a full glass of water and consumed that way.

The FDA recommends taking no more than 100mg elemental Potassium per day. Since this supplement is made up of 36% elemental Potassium, this means that a single serving of 275mg is equal to 99mg, which comes within the recommended daily dosage. If you have any lingering concerns about taking this supplement or your eligibility to take this supplement, it is best to discuss them with a doctor first, as individual needs for Potassium vary greatly.

This is simply not true.


(Failed) #22

For the past several days, Iā€™ve supplemented with potassium citrate and for the past 3 days ensuring that Iā€™m getting the RDI of 4.7 g and Iā€™m finally not feeling like Iā€™m going to pass out when I stand up. My morning temp is still low, but gets up to normal after I get my 4.7 g of potassium. I take ~1.6 g 3x a day, several hours apart. I hope that as I get adequate potassium every day, my morning temp will normalize. I figure it will take several weeks.

I have a capsule-making machine that I use to make 100 potassium citrate capsules at a time. Each capsule ends up with a little over 1 g of potassium citrate which contains approximately 400 mg of potassium.

I also have a precision .001 mg scale to ensure that the contents of each capsule is consistent. Iā€™m not real concerned about overdosing. The info I found on National Institute of Health says that there is no upper limit established for potassium, but that itā€™s probably safer not to take more than 15 g.

Iā€™m taking 400 mg magnesium (in magnesium glycinate) each day and have not not supplementing salt, only what I get from whatever is in and on my food and pickles. The extra salt was causing the same thing that happens when you are prepping for a colonoscopy to both my husband and myself.

I had minor cramping in my calves & toes last night, so this morning took 1 g sodium.

So,my husbandā€™s & my n=2 is that we need to supplement potassium, and only a bit of salt, at least at the moment.


(Central Florida Bob ) #23

Interesting, Dee.

Iā€™ve been thinking of something to do with capsule making. Is there a link or brand name or something?

FWIW, if I get a cramp anymore, I add some potassium (above my 1/2 or 3/4 teaspoon of KCl a day). The weird part is that itā€™s always my right lower leg and foot. If big toe is #1, itā€™s toes #3 and 4 that cramp. Only 3&4. The muscle is on the right front side of that right lower leg. Itā€™s odd how specific that is.

Also odd is that I donā€™t get swollen ankles as a regular thing, but if Iā€™m going to get a swollen ankle, it will be my right ankle.

Edit to add that I ordinarily take 200 mg of Magnesium Glycinate a day. On my fasting days, I aim for 1 teaspoon of Real Salt - which works out to just over 2 grams of sodium - spread out over the day and I usually mix 1/4 tsp of Potassium Chloride in with the Real Salt either every dose, or most of the time.


(Failed) #24

If youā€™re in the US, Amazon has the one I bought,
Wananfu Capsule Filling Machine 00

When buying a capsule filling machine, you have to decide what size capsules youā€™re going to use because each machine is specific to one size of capsule. In my case, I researched how much potassium citrate or salt would fit in each size of capsule and decided on the 00.

I researched and read reviews before deciding on the machine that I wanted to buy, so make sure to find the one that works best for what you intend. The price is reasonable considering the $ you save by making your own. I figure mine will have paid for itself after just a couple hundred caps more.

I was buying salt tablets and that was costing $1 a day for both my hubby & myself. Making my own costs less than 20Ā¢ a day for the both of us. Iā€™ve tried taking pink salt by the tsp but I cannot do it, and just thinking about ketoaid makes me gag.

Also, the instructions are less Than helpful, to say the least. Watch a couple of YouTube videos before deciding and definitely watch it the first and second and third times you use it.

My first try at filling capsules was a total disaster. The second one was more of a success, and I think now that I had the orange plate upside down.

This is the video I followed the 2nd time

I successfully made 2 sets of 100. I did have to squeeze each capsule manually for the final ā€œclickā€ to close them, but it may just have been the type of capsule I bought: https://www.amazon.com/gp/product/B0050PHIRI/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1

Oh and most importantly, buy the capsules that are separated already and have the body & caps in separate bags. Otherwise you either have to sort them out or take each and every capsule apart. Not fun.


(Failed) #25

Itā€™s the left leg for me. Last night, those calf muscles were ā€œHmmm, I think I might seize up, Iā€™ll think about that for a while. Lets do a test drive on a couple of toes first, though.ā€ I fell asleep while they were deciding, lol.

Today I took a salt capsule, just 1, but that may have been too much, as my gastrointestinal tract is grumbling.


(Failed) #26

I started supplementing to the RDI (4.8 g) of potassium a little over three weeks ago. I stopped supplementing sodium at that time, but did drink pickle juice a couple of times a day. After about two weeks I started feeling energetic and like I was a participant in my own life again.

Iā€™m alert, enjoying life, and in a great mood. I finally see what people are talking about when they say that keto makes you feel great. I never got that in the entire time Iā€™ve been doing keto.

Yesterday I also started supplementing sodium in the form of pink Himalayan sea salt, but at half the amount of the potassium Iā€™m taking because the potassium: sodium ratio is supposed to be 3 to 1 or 2 to 1. So far, I still feel good.


(Henry) #27

@DeeCS and @CFLBob be careful with capsule making with salts, potassium in particular. In concentrated form (like a capsule of pure salt), potassium is very harsh on stomach lining and can cause serious damage. There are some low dose potassium pills on the market, but I think they are formulated to be neutral.

Dissolved in water or lightly sprinkled on food should be ok, but donā€™t swallow it in solid concentrated form.


(Failed) #28

Where did you find this information? Iā€™m taking potassium citrate. Is that a salt?


(Henry) #29

I canā€™t find where I initially read it, but I remember that it was one of the popular keto promoting websites and the guy said ā€œI just took half a teaspoon and put it on my tongue and washed it down and that was a bad ideaā€ followed by gastric distress. He went on to point out that Potassium Chloride (the salt he was using) is a strong gastric irritant and can cause peptic ulcers in concentrated form. He explicitly said ā€œdonā€™t put this in capsulesā€

A little googling found this https://link.springer.com/article/10.1007/BF01070989 which describes patients who took multiple enteric coated potassium chloride pills at the direction of doctors and experienced acute discomfort, vomiting, and later ulcers.

This describes how to take the Extended release pills of Potassium Citrate https://www.webmd.com/drugs/2/drug-8836/potassium-citrate-oral/details

ā€œDo not crush, chew, or suck the tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing. Do not lie down for at least 10 minutes after taking this medication. Do not take this medication on an empty stomach.ā€

The side effects include discomfort (which you mentioned having after your first pill), and then signs of ulcers like tarry stool etc.

Iā€™m sure I could find more info out there. But it seems to me that potassium chloride and citrate both have the potential to badly irritate the stomach, potentially causing ulcers. Taking them in forms where the concentration is low, or the release is slow reduces that risk. Putting powder in a capsule that dissolves shortly after swallowing seems to be the opposite approach.

I think this is one of the major reasons itā€™s so often recommended to get potassium from food sources as much as possible, and why the formulations made for supplementation are limited to such small amounts.


(Failed) #30

Based on this info, Iā€™m going to switch to gluconate. Thank you.


#31

I did some research just today and found this! (the sodium substitute) I have been tracking everything and realized it was mathematically impossible for me to get potassium and magnesium met while meeting all of my others and not going over my calories, etc.

I plan on experimenting with a drink supplement with magnesium, sodium, potassium, and maybe a little stevia or something.

I also was fearful about taking potassium supplements since they come in 2% of your daily value and made it sound so scaryā€¦ but if I am so lowā€¦ why am i worried? lol I am usually barely hitting 40%


(Henry) #32

From everything Iā€™ve read, there are two reasons to be cautious with potassium supplements. Whatever potassium you can get in foods, do that first.

But if you are going to supplement, the two dangers are getting too much and your kidney function not being good enough to flush it quickly enough, and having it cause ulcers if itā€™s too concentrated when you take it.

Disclaimer. Iā€™m not a doctor. This is not advice.

I personally have found that I have no problems when I dissolve up to 1/4 teaspoon of potassium chloride (but usually 1/8th) in about 8 ounces of water and then drink it all at once. This is still no where close to the RDA and could be done several times a day.

My understanding is that most forms of potassium in solid form can be too concentrated when they sit in your gut, and this can lead to ulcers. There are formulations like potassium gluconate that may be ok in pill form, but I donā€™t have any data on this other than that they are sold OTC and donā€™t have a bunch of negative reviews. I also donā€™t have any information on bio-availability in any of the forms out there.

Potassium chloride and probably citrate almost certainly will irritate the stomach if taken as powder in a capsule since it will release the concentrate all at once when the capsule dissolves. But it is my understanding that there is no problem if they are first dissolved in a glass of water. Thatā€™s the way I have been taking potassium chloride with no issues. But N=1 for that, so donā€™t take it as advice.

There are also a bunch of ā€œhalf saltā€ products out there which are half sodium chloride and half potassium chloride. They are intended to be used in the place of regular salt. Sprinkled on food, added to recipes, and so on. But I personally would follow the same caution when using them to ensure no concentrated amount gets to my stomach.


(Omar) #33

I think potasium is bad only in one case. That is when consumed with out consuming any salt. That will cause bad electrolite disturbance.

If you take half a tea spoon of hemalayan salt, then consuming the daily potasium supement is preferable and usefull.


(Failed) #34

I made up some 00 capsules of potassium gluconate today. Iā€™m going to throw them away, along with the bag of potassium gluconate powder I bought to make these up because they contain only 87.7 mg of potassium each and I would have to take 79 of them to get my adequate intake of 4.7 g.

Iā€™ll stick with the potassium citrate capsules I make. I only have to take 10-12 of those per day. I was running low, so for the past 2 days had taken less than half. Yesterday, for the first time since Iā€™ve been taking in 4.7 g a day, I got lightheaded when standing again.

My body definitely needs the potassium at the levels Iā€™ve been taking. I make sure to drink a minimum of 8 oz of water with each set of capsules, 2 (860 mg) or 3 (1.3 g), I take. I donā€™t usually take them with food. I assume that if they were causing stomach problems I would be sick or in pain.


#35

(Alex) #36

So, this post is not aimed at the majority taking sensible doses of potassium in water but just a cautionary tale for those who higher dose pills.

I am a silly person who fell into the trap of thinking some is good so more is better, and had a very unpleasant time (dizziness, nausea and a really errattic heartbeart with palpitations). It happened because I became paranoid that every negative feeling was due to electrolytes, and just made the stupid decision to take a tsp of lite salt in water, and then another one soon after for a total of about 3g, whilst fasting and without any additional sodium than that in the lite salt.

It was one of the most terrifying experiences of my life and I spent about 3 hours convinced my heart was going to stop and doing breathing exercises to keep myself calm.

Whilst researching whether I was about to die I discovered potassium chloride is one of the drugs used in lethal injections to stop the heart, at a dose of 100-200mEq or around 7.5-15g. Obviously the speed and method of processing via the kidneys is not the same as whacking it into your bloodstream. But I strongly disagree with people saying thereā€™s no risk at all. The risk is completely dose dependent, and IV potassium chloride is given in hospitals at around 750-1500mg per hour so the typical recipes I see posted of 1/4tsp in water with sodium a few times a day seem to be at a safe level for the average person.

In conclusion I would urge caution and think we should stick to mixing up electrolyte water in a sensible ratio and drinking it throughout the day to spread the dose, and avoid the urge to believe more is always better as has been astutely mentioned above :slight_smile:


(Henry) #37

Everyone is different, but 4.7g taken in supplement form seems like a huge amount to me.

Here are some related, but maybe disjointed things Iā€™ve learned about potassium in the last few weeks.

Potassium is mostly present in cells. So I think the build up can take some time. On the other hand itā€™s got to go into the blood first when you ingest some. So the serum levels will fluctuate with consumption and water intake.

Sodium/potassium balance is key to proper cell function. Sodium in the blood, potassium in the cells. If sodium gets too low in blood to balance, the kidneys will take water out of the blood to concentrate the sodium. This lower blood volume can induce lower blood pressure. Potassium can also slow the heart rate. Both can be good things at appropriate levels. But taken too far can make for difficulty keeping effective blood flow to head, and thus feeling lightheaded.

Recent studies have been showing that the RDA for sodium of 2300mg is way low for many people who donā€™t have high blood pressure. The book ā€œThe art and science of low carbohydrate performanceā€ suggests getting 4 or 5 grams a day if I remember right. If you sweat a lot, you might benefit from more still.

That same book has no suggestions at all for taking potassium in supplemental form. It does suggest eating foods with high potassium to get enough, but never mentions pill or powder form. Salt on the other hand is something it suggests to use liberally everywhere to make sure you get enough. It also suggests magnesium rich foods and supplementation if needed. Neither sodium or magnesium carry much risk when taking too much because they both will typically get flushed quickly by kidneys, or bowels. Potassium at high intakes on the other hand can be more dangerous.

It could be that you needed to get your cellular potassium levels up by taking higher doses for a while. And maybe youā€™ve done that and are now hitting a new situation where there isnā€™t enough serum sodium to keep your blood volume high enough for optimal function. Maybe. Maybeā€¦ I donā€™t know much of anything about your situation and even doctors seem to have a hard time figuring out electrolyte issues since blood tests donā€™t indicate cellular levels. So donā€™t take any of this as an indication to change anything or everything.

But do please consider that potassium can cause serious problems when it builds up too much. If you are taking 4.7g a day of elemental potassium, I think you are taxing your system. There are reasons that the pills are limited to just 79mg each.

When I was writing about damage to stomach, it wasnā€™t about quantity of potassium so much as concentration. The pills (and presumably powder in capsules) can sit on the stomach lining and cause peptic ulcers. Maybe you wonā€™t be susceptible to this. Maybe the powder dissolves with the water quickly. Maybe ulcers take some time to form. But the concentrations you say you are taking make me concerned.

This is anecdotal, but until about 10 days ago I was taking potassium chloride around 1/8t a few times a day, dissolved in water. I was also taking regular salt with it most of the time, but not always. Sometimes Iā€™d use the 50/50 Lite salt. For a while it seemed to make me feel better. It stopped the feeling of my heart beating forcefully. But then I got to a point where it didnā€™t help anymore.

After reading a lot more info on keto and electrolytes, I decided to decrease potassium, and increase sodium. I have been feeling a lot better since that change. Very few periods of heart palpitations, and they consistently go away when I drink a glass of water with 1/4t of salt. I also started taking 400mg magnesium consistently instead of the fluctuating amounts I was taking before.

For me, I think it started months ago as a sodium deficiency due simply to the fact that keto took a lot of water out of my tissues and I didnā€™t increase my sodium intake as is usually recommended for keto. I just ate very low carb and lost weight as expected.

After some time being deficient in sodium, I think my body also dropped my cellular potassium levels to keep balance. That went on for a couple months and I started to get problems with my heart beating forcefully more often.

I went into this in more detail in another thread here. The short version is that increasing my sodium intake has probably been the most important part of getting back to balanced cell and heart function. Potassium may have been too low for a while, but without increasing sodium, trying to make it higher was just causing problems for me. Now with the higher sodium and small amounts potassium together things seem to be working much better.

Again, thatā€™s me.

Hesitating to give ā€œadviceā€ here, but please take a closer look at your levels of potassium intake and the balance of sodium intake. Kidneys can flush both out on a regular basis. But there are limits. And the potential for intestinal damage from taking potassium in concentrations like that is something to consider also.