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Potassium

Potassium is an essential mineral found predominately in fruits, vegetables, and beans. It is relatively common not to consume enough potassium to meet daily requirements and modifying the diet seems highly protective against circulatory disorders such as cardiac arrest and stroke.

Our evidence-based analysis on potassium features 25 unique references to scientific papers.

Kamal Patel
Research analysis led by Kamal Patel.
All content reviewed by the Examine.com Team. Published:
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Summary of Potassium

Primary Information, Benefits, Effects, and Important Facts

Potassium is an essential mineral in the human diet that is found in relatively high amounts in fruits, vegetables, and legumes. It is commonly seen as the counter-part to sodium when it comes to blood pressure and regulation of water in the body with high potassium diets being associated with reduced blood pressure.

Potassium is relatively unique when it comes to the topic of dietary supplements since it cannot legally be sold in levels high enough to provide much benefit due to safety. As an easily absorbed mineral that influences blood pressure, large doses taken in a powder form can be associated with cardiac arrythmia and in a few cases hospitalization. This has largely prevented wide-scale potassium fortification of foods leading this mineral to be a relatively common deficiency. This risk does not seem to apply to when large amounts of potassium are consumed from the fibrous food it is found in as the foods slow the rate of potassium absorption leading to less of a 'spike' in the blood, known as hyperkalemia.

When it comes to potassium, benefits are seen when it comes to circulatory disorders such as cardiovascular disease and particularly stroke when potassium intake is increased. This benefit is seen when potassium is consumed in minor increases (additional 500 mg a day) or large increases of a few grams over the course of the day, has similar protective effect regardless of the form of potassium consumed (food or supplemental), and shows benefit even if sodium is held constant.


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Caution Notice

Examine.com Medical Disclaimer

  • Large doses (500 mg +) of potassium in supplemental or powder form may cause cardiac arrythmia, a risk that is not present with potassium found in food

How to Take Potassium

Recommended dosage, active amounts, other details

Potassium is not commonly found in dietary supplements in doses above 85 mg tablets due to concerns about hyperkalemia (high blood potassium) from too much potassium being taken at once. It can still be found in grocery and nutrition stores as a 'salt substitute' (usually potassium hydrochloride) but doses should be kept minimal and always with food.

While most benefit with potassium will come alongside a modified diet to include more fruits, vegetables, and legumes increasing intake via a salt substitute around 500-1,000 mg a day seems to be sufficient for most benefits associated with potassium without posing any risk if taken alongside food.

Frequently Asked Questions about Potassium

Is diet soda bad for you?
Research suggests that diet soda is unlikely to be detrimental to metabolic health or body composition. Further controlled trial evidence is needed to explore other possible detriments.
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Scientific Research on Potassium

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1Pharmacology

1.1Peripheral Distribution

A review assessing the effects of high dose potassium supplements on serum potassium, after assessing 20 studies, found that there did not appear to be a significant dose dependent effect of supplementation on serum levels in the average range of 1,950-2,925 mg a day (divided doses) with an overall range of 858-5,460 mg.[1]

2Neurology

2.1Stroke and Tramautic Brain Injury

When looking at reviews on the association between potassium intake and instances of stroke, meta-analyses on the subject find protective effects such as a 21% reduced risk of stroke (RR 0.79; 95% CI 0.68-0.90) associated with increasing potassium intake by 1.64 grams a day[2] and 24% reduced risk of incident stroke (RR 0.76; 95% CI 0.66-0.89) associated with dietary levels of potassium near 3,510-4,680 mg;[3] numerous other meta-analyses find similar effects including the US health professional men[4] and nurses[5] cohorts and one 12-year study which found that an increase in potassium as little as 390 mg a day was associated with 40% less death from stroke in adults aged 50-79 in southern California.[6] This risk reduction appears to be greater in magnitude than the beneficial effects of potassium on cardiac health[2][3] which is thought to be due to potassium not only influencing blood pressure (main risk factor for stroke) but also direct and independent effects of potassium[7] as some studies note a protective effect against strokes even when blood pressure is controlled for.[6]

This beneficial effect does not specifically apply to supplements as a decrease in stroke risk has also been noted with three servings of fruits and vegetable daily, reaching a 22% reduction in the risk of stroke in a manner independent of blood pressure and thought to be due in part due to potassium.[8]

Potassium appears to be highly protective against strokes when consumed in adequate amounts, although the protective effect does not seem dose dependent as both minor and major increases in potassium intake both confer a powerful protective effect

3Bone and Joint Health

3.1Bone Density

Potassium intake has been found to have a relation with calcium retention in otherwise healthy adults, with lower intake of potassium being associated with more calcium loss in urine while increasing potassium intake seems to retain calcium and lessen urine losses.[9]

When supplemented, potassium (as citrate) taken over the course of one year in postmenopausal women with osteopenia appears to be effective in reducing some biomarkers of bone turnover such as u-NTX and P1NP suggesting a protective effect on bone mineral density; no apparent changes were seen in lumbar or hip BMD between the two groups however, thought to be in part due to the relatively short length of the study.[10]

While not overly potent, potassium seems to have a protective effect on bone mineral density thought to be due to helping retain calcium better

4Peripheral Organ Systems

4.1Kidneys

When given to rats sensitive to kidney damage, increasing the potassium concentration of the feed from 0.75% to 2.11%[11] or up to 2.6-3.8% at a level similar to sodium (4%)[12] appears to be highly protective against the subsequent renal damage after stroke when compared to lower potassium concentrations; this effect seems to occur without any apparent changes to blood pressure.[11][12]

The mechanism by which potassium exerts a protective effect against strokes may also influence damage that occurs after a stroke, including kidney damage. It is uncertain if potassium has a direct protective effect outside of stroke-related incidents

Potassium intake is known to reduce calcium loss in urine (via helping the body retain it better)[9] which has been hypothesized[7] to be the reason as to why potassium is associated with reduced risk of kidney stones, with half the relative risk when comparing the highest quintile of intake against the lowest.[13]

5Safety and Toxicity

5.1Hyperkalemia

Hyperkalemia refers to high blood levels of potassium which can cause symptoms such as cardiac arrythmia or brain damage, with numerous case studies recording such events associated with salt substitutes.[14][15][16][17][18] While some of these cases were associateed with doses of potassium greatly exceeding the RDA, at least one case has noted usage of potassium supplements at 2,730 mg was associated with hyperkalemia in one Afro-Caribbean man on an ACE inhibitor,[19] although it should be noted a review on the safety of potassium supplements failed to find an association between safety, race, and concomitant usage of pharmaceuticals.[1]

In a review assessing studies using potassium supplements and whether or not they can induce hyperkalemia, it was found that doses of 50-75 mmol (1,950-2,925 mg) taken in divided doses over the course of the day increased serum potassium in a manner which did not appear dose dependent; no side-effects were reported in the review while biomarkers of renal function (urinary and serum sodium and creatinine) were unaffected.[1]

Large doses of potassium, taken in forms that can be absorbed rapidly (usually powders such as salt substitutes), can pose a risk for hyperkalemia and cardiac complications. Lower doses, and divided doses, carry less of a risk

References

  1. ^ a b c Cappuccio FP et al.. Systematic review and meta-analysis of randomised controlled trials on the effects of potassium supplements on serum potassium and creatinine. BMJ Open. (2016)
  2. ^ a b D'Elia L et al.. Potassium intake, stroke, and cardiovascular disease a meta-analysis of prospective studies. J Am Coll Cardiol. (2011)
  3. ^ a b Aburto NJ et al.. Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses. BMJ. (2013)
  4. ^ Ascherio A et al.. Intake of potassium, magnesium, calcium, and fiber and risk of stroke among US men. Circulation. (1998)
  5. ^ Iso H et al.. Prospective study of calcium, potassium, and magnesium intake and risk of stroke in women. Stroke. (1999)
  6. ^ a b Khaw KT, Barrett-Connor E. Dietary potassium and stroke-associated mortality. A 12-year prospective population study. N Engl J Med. (1987)
  7. ^ a b He FJ, MacGregor GA. Fortnightly review: Beneficial effects of potassium. BMJ. (2001)
  8. ^ Gillman MW et al.. Protective effect of fruits and vegetables on development of stroke in men. JAMA. (1995)
  9. ^ a b Lemann J Jr et al.. Potassium administration reduces and potassium deprivation increases urinary calcium excretion in healthy adults (corrected). Kidney Int. (1991)
  10. ^ Gregory NS et al.. Potassium Citrate Decreases Bone Resorption in Postmenopausal Women with Osteopenia: A Randomized, Double-Blind Clinical Trial. Endocr Pract. (2015)
  11. ^ a b Tobian L. High-potassium diets markedly protect against stroke deaths and kidney disease in hypertensive rats, an echo from prehistoric days. J Hypertens Suppl. (1986)
  12. ^ a b Tobian L et al.. Potassium protection against lesions of the renal tubules, arteries, and glomeruli and nephron loss in salt-loaded hypertensive Dahl S rats. Hypertension. (1984)
  13. ^ Curhan GC et al.. A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones. N Engl J Med. (1993)
  14. ^ Schim van der Loeff HJ, Strack van Schijndel RJ, Thijs LG. Cardiac arrest due to oral potassium intake. Intensive Care Med. (1988)
  15. ^ Hoyt RE. Hyperkalemia due to salt substitutes. JAMA. (1986)
  16. ^ Doorenbos CJ, Vermeij CG. Danger of salt substitutes that contain potassium in patients with renal failure. BMJ. (2003)
  17. ^ Ray K, Dorman S, Watson R. Severe hyperkalaemia due to the concomitant use of salt substitutes and ACE inhibitors in hypertension: a potentially life threatening interaction. J Hum Hypertens. (1999)
  18. ^ Wetli CV, Davis JH. Fatal hyperkalemia from accidental overdose of potassium chloride. JAMA. (1978)
  19. ^ Ray K, Dorman S, Watson R. Severe hyperkalaemia due to the concomitant use of salt substitutes and ACE inhibitors in hypertension: a potentially life threatening interaction. J Hum Hypertens. (1999)
  20. Nettleton JA, et al. Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care. (2009)
  21. Dhingra R, et al. Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community. Circulation. (2007)
  22. Gardener H, et al. Diet Soft Drink Consumption is Associated with an Increased Risk of Vascular Events in the Northern Manhattan Study. J Gen Intern Med. (2012)
  23. Kaplowitz GJ. An update on the dangers of soda pop. Dent Assist. (2011)
  24. Cheng R, et al. Dental erosion and severe tooth decay related to soft drinks: a case report and literature review. J Zhejiang Univ Sci B. (2009)
  25. Shenkin JD, et al. Soft drink consumption and caries risk in children and adolescents. Gen Dent. (2003)

This page is regularly updated, to include the most recently available clinical trial evidence.

Each member of our research team is required to have no conflicts of interest, including with supplement manufacturers, food companies, and industry funders. The team includes nutrition researchers, registered dietitians, physicians, and pharmacists. We have a strict editorial process.

This page features 25 references. All factual claims are followed by specifically-applicable references. Click here to see the full set of references for this page.

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