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Potassium

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Supplement Forms/Alternate Names :

Potassium Chloride; Potassium Bicarbonate; Chelated Potassium (Potassium Aspartate, Potassium Citrate)

Principal Proposed Uses

Hypertension

Potassium is a mineral found in many foods and supplements. But you will never see pure potassium in a healthfood store or pharmacy—it is a highly reactive metal that bursts into flames when exposed to water! The potassium you eat, or take as a supplement, is composed of potassium atoms bound to other nonmetallic substances—less exciting, perhaps, but chemically stable.

Potassium is one of the major electrolytes in your body, along with sodium and chloride. Potassium and sodium work together like a molecular seesaw: when the level of one goes up, the other goes down. All together, these three dissolved minerals play an intimate chemical role in every function of your body.

The most common use of potassium supplements is to make up for potassium depletion caused by diuretic drugs. These medications are often used to help regulate blood pressure, but by depleting the body of potassium, they may inadvertently make blood pressure harder to control.

Requirements/Sources

Potassium is an essential mineral that we get from many common foods.

True potassium deficiencies are rare except in cases of prolonged vomiting or diarrhea, or with the use of diuretic drugs.

However, in one sense, potassium deficiency is common, at least when compared to the amount of sodium we receive in our diets. It is probably healthy to take in at least five times as much potassium as sodium (and perhaps 50 to 100 times as much). But the standard American diet contains twice as much sodium as potassium. Therefore, taking extra potassium may be a good idea in order to balance the sodium we consume to such excess.

Bananas, orange juice, potatoes, avocados, lima beans, cantaloupes, peaches, tomatoes, flounder, salmon, and cod all contain more than 300 mg of potassium per serving. Other good sources include chicken, meat, and various other fruits, vegetables, and fish.

There is some evidence that, of the different forms of potassium supplements, potassium citrate may be most helpful for those with high blood pressure.1

Research indicates that it is important to get enough magnesium, too, when you are taking potassium.2,3,4 It might be wise to take extra vitamin B12 as well.5

Therapeutic Dosages

When used by physicians, potassium is usually measured according to mEq (milliequivalents) rather than the more common mg (milligrams) measurement. For adults, the typical daily requirement of potassium is 40-80 mEq.20,21

The following table shows the approximate dosage equivalents for the different forms of potassium:20,21

Approximate Equivalents of 40 mEq of Potassium
3.9 g of potassium acetate
4.0 g of potassium bicarbonate
3.0 g of potassium chloride
4.3 g of potassium citrate
9.4 g of potassium gluconate

Therapeutic Uses

Potassium may be mildly helpful for hypertension.6,7,8

What Is the Scientific Evidence for Potassium?

High Blood Pressure

According to a review of 33 double-blind studies, potassium supplements can produce a slight but definite drop in blood pressure.9,10 However, two large studies found no benefit.11,12 The explanation is probably that potassium is only slightly helpful. When a treatment has only a small effect, it is not unusual for some studies to show no effect while others find a modest benefit. It is possible that potassium may only help people who are at least a bit deficient in this mineral.

Evidence suggests that potassium supplements may be most effective for people who eat too much salt.13

Safety Issues

As an essential nutrient, potassium is safe when taken at appropriate dosages. If you take a bit too much, your body will simply excrete it in the urine. However, people who have severe kidney disease cannot excrete potassium normally and should consult a physician before taking a potassium supplement. Similarly, individuals taking potassium-sparing diuretics (such as spironolactone), ACE inhibitors (such as captopril),14-18 or trimethoprim/sulfamethoxazole 19 should also not take potassium supplements except under doctor supervision.

Potassium pills can cause injury to the esophagus if they get stuck on the way down, so make sure to take them with plenty of water.

Interactions You Should Know About

If you are taking:

References

Overlack A, Maus B, Ruppert M, et al. Potassium citrate versus potassium chloride in essential hypertension. Effects on hemodynamic, hormonal and metabolic parameters [in German; English abstract]. Dtsch Med Wochenschr. 1995;120:631-635.

Saito N, Kuchiba A. The changes of magnesium under high salt diets and by administration of antihypertensive diuretics. Magnes Bull. 1987;9:53.

Dorup I, Skajaa K, Thybo NK. Oral magnesium supplementation restores the concentrations of magnesium, potassium and sodium-potassium pumps in skeletal muscle of patients receiving diuretic treatment. J Intern Med. 1993;233:117-123.

Whang R, Whang DD, Ryan MP. Refractory potassium repletion: a consequence of magnesium deficiency (Review Article). Arch Intern Med. 1992;152:40-45.

Drug Evaluation Annual. Vol 3. Milwaukee, WI: American Medical Association; 1993.

Whelton PK, He J, Cutler JA, et al. Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA. 1997;277:1624-1632.

Whelton PK, Buring J, Borhani NO, et al. The effect of potassium supplementation in persons with a high-normal blood pressure. Results from phase I of the Trials of Hypertension Prevention (TOHP). Trials of Hypertension Prevention (TOPH) Collaborative Research Group. Ann Epidemiol. 1995;5:85-95.

Gu D, He J, Wu X, et al. Effect of potassium supplementation on blood pressure in Chinese: a randomized, placebo-controlled trial. J Hypertens. 2001;19:1325-1331.

Whelton PK, He J, Cutler JA, et al. Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA. 1997;277:1624-1632.

Gu D, He J, Wu X, et al. Effect of potassium supplementation on blood pressure in Chinese: a randomized, placebo-controlled trial. J Hypertens. 2001;19:1325-1331.

Whelton PK, Buring J, Borhani NO, et al. The effect of potassium supplementation in persons with a high-normal blood pressure. Results from phase I of the Trials of Hypertension Prevention (TOHP). Trials of Hypertension Prevention (TOPH) Collaborative Research Group. Ann Epidemiol. 1995;5:85-95.

Davis BR, Oberman A, Blaufox MD, et al. Lack of effectiveness of a low-sodium/high-potassium diet in reducing antihypertensive medication requirements in overweight persons with mild hypertension. TAIM Research Group. Trial of Antihypertensive Interventions and Management. Am J Hypertens. 1994;7:926-932.

Whelton PK, Buring J, Borhani NO, et al. The effect of potassium supplementation in persons with a high-normal blood pressure. Results from phase I of the Trials of Hypertension Prevention (TOHP). Trials of Hypertension Prevention (TOPH) Collaborative Research Group. Ann Epidemiol. 1995;5:85-95.

Stoltz ML, Andrews CE Jr. Severe hyperkalemia during very-low-calorie diets and angiotensin converting enzyme use. JAMA. 1990;264:2737-2738.

Good CB, McDermott L, McCloskey B. Diet and serum potassium in patients on ACE inhibitors. JAMA. 1995;274:538.

Warren SE, O'Conner DT. Hyperkalemia resulting from captopril administration. JAMA. 1980;244:2551-2552.

Grossman A, Eckland D, Price P, et al. Captopril: reversible renal failure with severe hyperkalaemia. Lancet. 1980;1:712.

Burnakis TG, Mioduch HJ. Combined therapy with captopril and potassium supplementation: a potential for hyperkalemia. Arch Intern Med. 1984;144:2371-2372.

Alappan R, Perazella MA, Buller GK. Hyperkalemia in hospitalized patients treated with trimethoprim-sulfamethoxazole. Ann Intern Med. 1996;124:316-320.

Potassium supplements. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated April 11, 2011. Accessed December 7, 2011.

AHFS Drug Information 2004. McEvoy, GK, ed. Potassium Supplements. Bethesda, MD: American Society of Health-System Pharmacists; 2004:2517-2523.

Last reviewed July 2012 by EBSCO CAM Review Board

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Copyright © EBSCO Publishing. All rights reserved.

 
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