by Charles Weber, MS.

CONTENTS of other chapters: Back to INTRODUCTION chapter -- II. Arthritis Research -- III. Arthritis and Potassium -- IV. Roles of Potassium in the Body -- V. Electrolyte regulation (sodium and potassium) -- VI. Purpose of cortisol -- VII. Copper nutrition and physiology -- VIII. Nutritional Requirements -- IX. Potassium in Foods -- X,cont. Losses in the kitchen -- XI. Supplementation -- Side Effects and Heart Disease -- XIV Potassium and thiamin in heart disease -- Strategies for CFS and fibromyalgia

POTASSIUM NUTRITION (a book by Charles Weber) Potassium losses from perspiration, in urine, during diarrhea, from stress, poisons, and disease states are discussed in the book available here, as well as methods to supplement potassium safely, especially as involved in heart disease, gout, high blood pressure, and rheumatoid arthritis, and indirectly in diabetes. It is published by iUniverse publishing company and it is a very comprehensive book about potassium, probably much more so than any other. You may see the table of contents with chapter summaries and the introductory chapter by clicking here.P>Do not rely solely on this discussion of nutrients, but seek other medical consultation if you are sick.

INTRODUCTION

Potassium is the most dangerous of the essential nutrients. While mild chronic overdoses are probably not damaging, because of the efficiency of the kidneys in clearing excesses, a very large acute overdose can be extremely dangerous if not cleared in time. As little as 8 to 10 thousand milligrams of potassium taken suddenly can give nausea. A teaspoonful of potassium salt contains about 3300 milligrams of potassium. As little as 14,000 milligrams of potassium taken suddenly can cause death in some replete people, especially those who normally have a low intake for long periods prior. Therefore, one may not use supplements without regard to any caution. However the reason I do not recommend supplements for healthy people is because normally it is quite possible to receive all the potassium you need from food, and this source is inherently safe [Sebastian], inexpensive, and with reasonable wisdom, balanced with respect to other nutrients. Food as a source usually results in shorter hospital stays than supplements [Norris]. My recommendation against supplements is based primarily on concern of an imbalance with other nutrients rather than any likely chance of an acute overdose. The Institute of Medicine does not set an upper limit from food because there is no evidence of chronic excess potassium in healthy individuals. If supplements are used, potassium bicarbonate is probably the safest form, and is essential for gout, because gout requires an alkaline urine for uric acid to be soluble.

The status of magnesium is especially important because potassium can not be absorbed efficiently if magnesium is deficient [Petersen][MacIntyre][Manitius][Dawson]..

One person reports getting red cell magnesium up to normal with magnesium orotate and Epsom sulfate foot baths every other day, along with choline citrate supplement in the hope the last helps with absorption. Magnesium as the orotate has been shown to be more readily absorbed than the carbonate [Schlebusch]. Atheletes had there swimming, cycling and running times decreased in the magnesium-orotate group compared with the controls and their insulin system markedly affected [Golf]. The orotate is probably having an affect physiologically in its own right, and is most likely not making the magnesium more soluble or acting as a chelating agent. 400 milligrams of magnesium per day is the amounts usually recommended. See this article for a further discussion of magnesium supplementation and Rude’s article for safe use of magnesium clinically [Rude].

The imbalance that I know of which is probably most dangerous is the imbalance with thiamine (vitamin B-1) if animal experiments are an indication. If potassium supplements are given during the wet heart disease of beriberi (thiamine or vitamin B_1 deficiency) the heart disease is made much worse [Mineno][Gould]. Wet heart disease is impossible if potassium is also deficient [Folis]. Instead a muscular atrophy similar to that from vitamin E deficiency appears [Hove][Blahd]. During a vitamin B-1 deficiency the heart loses potassium [Mineno]. This may be why heart damage in beriberi resembles that in a potassium deficiency. Hove and Herndon suspect that muscular dystrophy is a potassium deficiency since body potassium is low during muscular dystrophy [Hove]. Why the heart should be protected by a deficiency of both potassium and vitamin B-1 is strange, and I know no explanation for it. If potassium supplements must be used, it is imperative that vitamin B-1 status be known or adequate wheat germ be eaten.

It could be the sulfur dioxide left in wine might be part of the reason why wine statistically protects people from the more prevalent potassium deficient heart disease because sulfites destroy vitamin B-1 in the intestines. It is obvious that if potassium supplements are given, it is very important that the vitamin B-1 intake must be adequate at the same time. Even if you are eating foods adequate in vitamin B-1 you could still possibly have a problem with vitamin B-1 deficiency if you are also eating foods that have sulfites in them since such sulfites degrade vitamin B-1 in the intestines [Amerine] [Fitzhugh]. Sulfites are often present in wine, vinegar, pickles, olives, salad dressing, canned clams, fresh, frozen, canned, or dried shrimp, frozen lobster, scallops, dried cod, gelatin, pectin jelling agents, cornstarch, modified food starch, spinach pasta, gravies, hominy, breadings, batters, noodle/rice mixes, shredded coconut, vegetable juice, canned vegetables (including potatoes), pickled vegetables (including sauerkraut), dried vegetables, instant mashed potatoes, frozen potatoes, potato salad, corn syrup, maple syrup, fruit toppings, and high-fructose syrups such as corn syrup and pancake syrup, instant tea, liquid tea concentrates, beer, bottled lemon juice, some baked goods, and some dried fruits. Also using diuretics depletes vitamin B-1. There is something in tea leaves that antagonizes vitamin B-1. Also, the symptoms of a vitamin B-1 deficiency can materialize even if vitamin B-1 is adequate if magnesium is deficient, say from Crhon’s disease [Dyckner, Nyhlin, Wester]. The diet can vary widely as to vitamin B-1 [Department. of Health].

The use of benfotiamine, as is sometimes used during fibromyalgia, would probably be dangerous during potassium supplementation, since it is said to deplete the body of vitamin B-1. Vitamin B-1 deficiency may be suspected in refugee immigrants, critically ill patients, and alcoholics. Vitamin B-1 deficiency can result in cardiac failure, neuropathy, or Wernicke-Korsakoff syndrome (from alcoholic beverage over use), which last can not be cured with oral supplements even though classic thiamine deficiency symptoms do not show [Thompson]. Diabetics should keep in mind a new discovery that diabetics excrete vitamin B-1 at a much higher rate than other people, which leads to a vitamin B-1 deficiency in them. Type 1 diabetics excrete vitamin B-1 four times normal people and type 2 three times, which leads to a vitamin B-1 content in plasma one fourth as high in diabetics. This is due to a malfunction of thiamine reabsorption in the proximal kidney tubules. Erythrocyte vitamin B-1 was normal in diabetics, probably because there were increased thiamine transporters THTR-1 RFC-1 in the cell wall. Therefore erythrocyte thiamine can not be used to determine thiamine status [Thornalley]. Since diabetics are usually deficient in potassium, it seems that it is probable that they should not use potassium unless they correct the vitamin B-1 at the same time and the reverse.

The reverse is also the case. Vitamin B-1 supplements should be dangerous for people with rheumatoid arthritis. This may be part of the reason why people with rheumatoid arthritis (but not osteoarthritis) have a much higher heart disease rate than others. This information should be especially pertinent for those who drink much alcoholic beverages or vinegar fermented with sulfur dioxide with their meals or use foods mentioned above, given that this destroys vitamin B-1 in the intestines but have an adequate potassium intake. Wine also has a poison in it that interferes with potassium excretion [McDonald], and this would intensify the problem with vitamin B-1 destruction for those who then take potassium supplements. One symptom of a vitamin B-1 deficiency is lactic acid acidosis [Romanski].

All purpose vitamin capsules contain no potassium but usually contain vitamin B-1. Some contain 1000% of the recommended daily intake and one even contains 5000%. This is probably dangerous for most heart disease in the absence of adequate potassium in food or supplements.

Arthritics are deficient in pyridoxine, zinc, and magnesium versus the recommended daily allowance and copper and folate versus the typical American diet, [Kremer] (which itself is not sensational). They also have inadequate calcium, vitamin E and selenium [Stone]. So it is quite possible that other imbalances besides the one above are possible. The recent discovery that something in vegetables, especially onions, prevents bones from losing density [Muhlbauer & Li] is just one more hint that we can not use supplements instead of food with complete assurance that there is no other advantage from good food. I am also concerned about liability were I to recommend supplements and someone were to have real or imagined difficulties.

However there are a few times when supplements would be desirable, sometimes even life saving. Severe diarrhea is one such a time. Cholera is an especially lethal diarrhea and oral rehydration therapy (ORT salts) is in order. ORT salts are a mixture of salts containing sodium, chloride, potassium, and bicarbonate. The Lancet journal has stated that ORT therapy is the most important medical advance of the 20th century. Diarrhea causes more deaths to children than any other infectious disease. It has been suggested that supplementation with potassium would be in order for cirrhosis of the liver also [Conn]. Potassium bicarbonate has been used to correct the acidic serum associated with diabetes [Soler]. It has been found to increase the density of bone [Sebastian] [Jehle]. Potassium citrate also increases the density of bone, almost certainly by the same mechanism. Severe emotional stress and stress of surgery might be two other occasions when supplementation would be in order. Also a low potassium to sodium ratio has been shown to be a risk factor for cancer [Jansson], increases the incidence of calcium kidney stones [Stamler], and bronchitis [Schwartz]. Potassium supplements decreases the risk of stroke [Green].

Rarely acute hypokalemic paralysis afflicts people and can be life threatening. The symptoms are weakness, low plasma potassium, progressing to paralysis. Most cases are due to familial hypokalemic paralysis; however, a few cases are associated with diverse underlying causes including thyrotoxic periodic paralysis from hyper active thyroid, barium poisoning, renal tubular acidosis, primary hyperaldosteronism, licorice ingestion, and gastrointestinal potassium losses. Immediate potassium replacement is in order coupled with an aggressive search for the underlying cause [Stedwell].

If urine potassium is low in the above syndrome, correction must be with small amounts of potassium chloride to avoid rebound hyperkalemia because this is an indication that urine is low because of inappropriate movement of potassium into cells [Lin].

More than 20 % of the people who are hospitalized have a plasma potassium content lower than 3.6 milliequivalents per liter (which they define as hypokalemia) [Gennari]. It would no doubt be considerably higher a percentage if an accurate figure could be obtained for people with rheumatoid arthritis, who lose potassium from their platelets when blood is withdrawn, and if there never was a delay in analyzing the blood. So such people would probably be better off with reasonable supplementation since hospital food is usually low in potassium and that low a potassium content in plasma is very dangerous. Potassium replacement recommended in medical texts (a maximum rate of infusion of 0.3-0.5 milliequivalents per killigrams of body weight per hour and a maximum daily replacement of 3-5 miliequivalents per kilogram of body weight may be inadequate for profound hypokalaemia ( 1.5 millequivalents per liter of plasma) Maybe it should be 3-4 times as great [Welfare].

SODIUM FREE TABLE SALT

Sodium free table salt is the means usually used for supplementation of heart disease patients. The original justification for this was to provide for the psychic dependence on a salty taste without providing sodium. So medical men said in effect, since people will satisfy their craving for salty flavor whether we warn them against it or not, we will give them the salty flavor without the sodium. Since the chloride provides the salty taste this was easy. Just substitute another positively charged atom for sodium. This philosophy carried to its logical conclusion led them even to use lithium as a substitute atom. It was then that lithium's pronounced properties as a tranquilizer became evident.

Potassium was considered inert, or largely so. In addition to potassium, ammonium and choline molecules were also used. These molecules may not be useless. Choline is a biologically active material similar to vitamins but made by the body. Some men may require more than others since six out of twenty six suffered muscle damage and increased liver lipid content when receiving inadequate choline [Penry p192]. Betaine is derived from choline in the body, which betaine furnishes a methyl group to convert homocysteine to methionein [Penry p 197]. It is thought to be adequate in unprocessed food. Coffee, beer, potatoes, and oranges have significant amounts.

There is an article that gives concentrations of choline and betaine in common foods [Zeisel]. They say that choline is important for normal membrane function, acetylcholine synthesis and methyl group metabolism; the choline requirement for humans is 550 mg/d for men (Adequate Intake). Betaine, a choline derivative, is important because of its role in the donation of methyl groups to homocysteine to form methionine. In tissues and foods, there are multiple choline compounds that contribute to total choline concentration (choline, glycerophosphocholine, phosphocholine, phosphatidylcholine and sphingomyelin). In their study, they collected representative food samples and analyzed the choline concentration of 145 common foods using liquid chromatography-mass spectrometry. Foods with the highest total choline concentration (mg/100 g) were: beef liver (418), chicken liver (290), eggs (251), wheat germ (152), bacon (125), dried soybeans (116) and pork (103). The foods with the highest betaine concentration (mg/100 g) were: wheat bran (1339), wheat germ (1241), spinach (645), pretzels (237), shrimp (218) and wheat bread (201). A number of epidemiologic studies have examined the relationship between dietary folic acid and cancer or heart disease. It may be helpful to also consider choline intake as a confounding factor because folate and choline methyl donation can be interchangeable.

Choline is said to enhance the salt (chloride) taste. Short term it is said to enhance memory in young people and in babies from choline adequate mothers. Choline supplements increase memory ability in baby rats when administered either before or after being born, probably from an increase in brain cell size [Williams 1998]. Its long-term effects as a supplement are unknown to me.

Ammonium, at least, may interfere with potassium excretion if it is absorbed in the intestines and has been used to protect the kidneys [Selye 1945]. So far as I know the substitutes above are reasonably harmless for healthy people who have normal blood pressure. Ammonium is even synthesized by the kidneys during a potassium deficiency from glutamine, and this is probably a strategy of the body, the purpose of which is to prevent potassium loss. Eating glutamine increases ammonia excretion and decreases potassium excretion [Tannen, p458]. However, if ammonium chloride is used during a potassium deficiency a dangerous taurine depletion occurs resulting in lethal heart disease in cats [Dow] so it would be a good idea to avoid it for humans until more is known.

Potassium enriched table salt almost halved the mortality from cardiovascular disease of retired men studied in China over a 31 month period [Chang] so potassium deficiency must be a cause of or is considerably accentuating some other cause in half the heart disease in China. I suspect the fraction would be found to be higher yet in the USA if whole body potassium were ever determined routinely here.

Sulfate is an excretory product, so the sulfate as the anion with potassium should be, at the least, useless. I suspect that potassium as the sulfate should have the same effect on high blood pressure as the chloride has in increasing pressure (see below), but I know of no evidence. Adding potassium sulfate to a processed food diet should have the same effect as adding sulfuric acid to a normal diet, whatever that is. In any case, sulfate and phosphate increases potassium excretion [Giebisch]. Phosphate causes 100% mortality in people suffering from heart disease.

GLUCOSAMINE

This synthesis of ammonium just mentioned may be part of the reason that glucosamine has shown evidence of being useful for arthritics, especially osteoarthritis. Glucosamine is a biological reaction product of glutamine and glucose. The rationale usually given is that this provides a molecule which is incorporated in connecting tissue. Glucosamine is a combination of fructose-6-phosphate sugar and glutamic acid and is provided in supplements as the sulfate. Glucosaminec breaks down forming ammonium ion in the body, so it is possible that it is getting part of its beneficial results by virtue of providing ammonium ion in the kidneys as well as hydrogen ion from the sulfate, which interferes with potassium excretion (but keep in mind that I have no evidence yet that osteoarthritis is caused or accentuated by a potassium deficiency, and probably is not directly involved). If so, glucosamine could be considered a potassium supplement of sorts, also. Glutamine or glutamic acid is a major transporter of nitrogen, transporting one third of nitrogen [Labow p1503]. Labow claims that the less than 10 grams per day usually eaten should be increased to 20 to 40 grams for those under stress, and that it considerably increases survival of hospital patients and should in addition be part of intravenous feeding [Labow p 1503,1510]. Conserving potassium may be part of its efficacy. It is apparently used to help excrete acid since glutaminase and glutamine consumption are both increased by acidosis [Labow p1504]. Glutaminedipeptide is more soluble and has a longer shelf life than glutamine [Labow p1509]. Some commercial glucosamine products are also a potassium supplement, since they contain large amounts of potassium chloride.

You can tell which materials are present in a product by the list of ingredients. The materials of highest concentration are supposed to be placed at the beginning of the list. Select the substitute, which has potassium nearest the beginning of the list in order to avoid the small chance of side effects of the other ingredients should you decide to use supplements unless you are sure you need the other ingredients also. Ingredients of some clinical supplements are given in a book by Friedberg [Friedberg p348].

VEGETABLE LIQUERS

Green coconut milk has been proposed as a potassium supplement for cholera patients [Carpenter]. I assume that celery or bamboo shoot juice would have a similar value. If used for diarrhea it is important that salt and perhaps bicarbonate of soda be eaten at the same time in amounts approximating ORT salts. Such a juice strategy would probably be not quite as effective or at least able to be controlled as potassium chloride or ORT salts, but might be all that is available at times.

TABLETS and LIQUIDS

There is a liquid supplement in which the bitter taste of potassium is masked by cherry extract. It is conceivable that a child could get a fatal overdose in this form. Non of the above concoctions are substantially more dangerous than other household items like aspirin, for instance. I would recommend against storing potassium in an easy to eat form in general, however. Liquids containing more than 390 milligrams of potassium must have a prescription in order to be sold in the USA. 100 milligrams is the limit for tablets.

Enteric tablets are also available. These are tablets that will not dissolve until they reach the intestines. Since there are no pain nerves in the intestines as in the stomach, you are not distracted by the commotion that ensues when they suddenly create a saturated potassium chloride solution near the intestine wall, as you would be if they dissolved in the stomach, which has pain nerves. Gastric release tablets give a bad stomachache on an empty stomach. There have been cases [Baker] reported of enteric tablets becoming caught in the fold of the intestines and causing ulcers, some even fatal, when the enteric coating dissolved. You can eat these tablets with safety so far as ulcers are concerned by chewing them while drinking a glass of juice. The bitter taste is largely eliminated also. Of course tablets are an expensive way to increase potassium.

A new enteric tablet has been developed which is prescribed by 99% or more of the doctors today. It is called "slo-release". It is designed to release its potassium slowly so that no portion of the digestive tract is overwhelmed with a concentrated solution. It is probably as reasonably safe as anything is in this dangerous world [Palva][Block]. The safest of all would be to also chew these tablets with juice. The American law prevents more than 100 milligrams of potassium in each one, so that seven or more must be taken with each meal to double the potassium intake of a junk food diet in order to bring it up to a very healthy diet. At least two at each meal would be necessary to bring junk food to a passable intake.

There is also a liquid that contains tiny enteric particles containing potassium chloride. This is only available by prescription. It should be similar to Slo release enteric tablets and should be inherently safe against ulceration, but not against overdose.

Potassium gluconate comes in a tablet that can be chewed with juice also. Since gluconate is metabolized in the body, this form should be similar in effect to potassium from plants or from the bicarbonate (bicarbonate to be discussed later with sodium free baking powder). Women afflicted by premenstrual syndrome were cured within 4 cycles by 800 milligrams per day of potassium as the gluconate [Takacs]. Potassium has been prescribed as the aspartate usually with magnesium for heart disease. I do not know what the rationale for using the aspartate anion is, although the ammonium excretion system may be involved. Also potassium moves into the cell more easily as the aspartate. However both magnesium and potassium are absorbed more effectively as the chloride than as the aspartate [Classen]. Healthy people are probably best advised to get amino acids for endurance from food [Williams]. Indeed as much as possible of all essential nutrients should be gotten from unprocessed food.

Processing removes 75% of the magnesium, which, combined with sugar, phosphates, alcohol, stress and high fat diets that increase magnesium deficiency, is said to cause a deficiency in 80% of the population [Rogers]. Magnes ium is needed in order to power the ATPase [Hamil-Ruth] because potassium can not be absorbed effectively during a magnesium deficit [Kohvakka]. It takes six months for the sodium/potassium pumps to return toward normal after a magnesium deficiency is corrected [Anonymous], so the magnesium must be an integral part of the pumps.

A test for magnesium deficiency is to inject 2.4 milligrams of magnesium per kilogram of body weight over 4 hours and urine collected for 24 hours. If 25% of the magnesium is retained a deficiency is probable. If 50% of the magnesium is retained a deficiency is certain [Rude].

JUICE

There is a safety advantage in keeping your taste in touch with potassium supplement. Potassium chloride dissolved in fruit juice gives it a fine, rich flavor in reasonable amounts. When too much is put in, the flavor becomes nauseating and bitter. Thus you have a built in safeguard. Another inherent safeguard is the presence of adequate water. Potassium supplementation is especially dangerous during dehydration, as was mentioned in Regulation of Electrolytes because of a drastic decline of aldosterone. The use of juice reduces danger during dehydration somewhat. Even so, supplements should not be taken until at least an hour after dehydration has been largely corrected using some a sodium salt supplement to avoid dangerous low blood sodium, in order to give aldosterone a chance to be resecreted. An additional advantage of juice in conjunction with potassium is that it can be more readily taken between meals. Potassium can be more readily absorbed then because it does not tend to form an overload combined with potassium in food. That also probably makes it less dangerous for people with weak hearts or kidneys. People with very weak kidneys should be under a doctor’s care and should not take potassium supplements on their own, or at all. In addition, between meals probably provides minimum interference with other nutrient absorption, such as that of magnesium. For a similar reason it is probably advantageous to divide meals into more than three per day when recovering from a deficiency [Fabry].

SODIUM FREE BAKING POWDER

Sodium free baking powder is a supplement also, including those times when used for baking. It is potassium as the bicarbonate or tartrate. Dissolved in fruit juice, the bicarbonate gives it a delightful tang like soda pop soft drinks. The bicarbonate has been shown to be not as effective as the chloride in relieving a deficiency both as to reducing cell sodium content and raising plasma levels of potassium [Giebisch][DeLand]. However, potassium as the chloride has the same affect as potassium from unprocessed food coupled with hydrochloric acid supplements. There are times when this might be disadvantageous. High blood pressure may be one time , for potassium chloride has been shown to increase blood pressure in rats. However potassium chloride reduces blood pressure in sodium loaded spontaneously hypertensive rats and protects them from kidney damage [Ellis] and lowers blood pressure in sodium loaded humans.. This may be because of difficulty in handling hydrogen ion (acid) in some forms of high blood pressure. Support is given to this possibility since sodium bicarbonate lowered blood pressure 5 mm of mercury while sodium chloride had no affect [Luft], possibly because sodium chloride was already high in their diet. Any designation of high blood pressure must be by comparing the pressure to the average among low sodium chloride intake people [Tekol]. Both sodium and chloride is necessary for pressure augmentation [Boegshold]. This phenomenon may be involved with 18 hydroxy deoxycorticosterone steroid hormone (18OHDOC) because that hormone is raised in one of the at least three forms of high blood pressure and that hormone is the hormone used by the body to increase acid excretion. However, kidney lesions are prevented by potassium chloride supplements by an unknown mechanism, [Ellis] and such lesions are the most important affect of high blood pressure. Aneurysms are important also, but these are almost certainly will not appear if copper is adequate in the diet, for healthy blood vessels take ten times as much pressure as normal in order to rupture. While potassium chloride raises blood pressure somewhat, if potassium is low it would still be desirable to raise potassium if deficient with that supplement or some other supplement because 3% of white people with 4.1 milliequivalents of potassium in blood plasma have high blood pressure while this goes down progressively to 1% for4.8 [Walsh]. Diets low in sodium and high in potassium, magnesium and calcium are associated with freedom from high blood pressure [He]. Actually it is the chloride associated with the sodium that is the problem as mentioned above, not the sodium itself. Sodium alone has no affect, or causes blood pressure to fall. For a review of the affect of numerous nutrients on blood pressure, see Houston [Houston].

If any kind of baking powder is used, it is important that it not contain aluminum. Aluminum is a poison and is suspected to cause a disease similar to Alzheimer’s disease [Masters]. It is synergistic with (reinforce each other) the poisonous fluoride [Varner] often put into municipal water. It also causes surface bone resorption in mammals and navicular disease in horses.

Fluoride in city water will cause fluorosis discoloration of teeth, weakened bones, damage to the kidneys and immune system, low thyroid secretion, and, worst of all, damage to the nerves resembling Alzheimer’s disease.

The phosphate is probably similar to the bicarbonate in regard to being absorbed. Phosphate is probably very dangerous for those with heart disease. Excess phosphate has caused 100 per cent mortality during heart disease [Selye 1958]. Soft drinks often contain phosphoric acid.

I have taken potassium as the bicarbonate for several weeks when I was young without any obvious great difficulty. I did have the strong feeling during that time that I was more susceptible to muscle cramps. However this was probably a function of too little calcium or vitamin D at the same time or more even more likely a low cell potassium since potassium as the bicarbonate should not be substantially different from potassium in food unless food anions temporarily prevent plasma alkalosis. If the bicarbonate should prove in the future to be not, on balance, be a desirable method, then it follows that it may be desirable to go back to the use of yeast for leavening bread. The bicarbonate should be equivalent to potassium acquired from food, though. Sodium bicarbonate is very undesirable for leavening because it is basic. Potassium is extremely sensitive to hydrogen ion, and sodium bicarbonate can triple excretion, as discussed in Chapter IV. Even hyperventilating (breathing too hard) will have an equivalent effect (this would probably make a good emergency procedure in the case of high potassium shock if a hospital can not be reached). The overall effect of potassium tartrate in baking powder would probably depend on whether the tartrate is metabolized or not and this I do not know.

The bicarbonate may be indicated in renal tubular acidosis [Morgan]. It is also said to be desirable to have either part of the sodium as the bicarbonate in ORT salts during diarrhea and dehydration or an equivalent amount with the potassium.

WATER SOFTENING SALTS

When potassium salts are used to soften water, significant amounts of extra potassium will be added to one’s intake if the water is hard and much of the water is used. It may be that water softener potassium salt would provide an inexpensive supplement. However it would be difficult to control the amount ingested. Such salts must be kept guarded from children because of severe scarring of the stomach, including obstruction of the outlet, and metabolic acidosis from eating the salts. I assume this is true for other potassium salts containing chloride also.

COMBINATION TABLE SALTS

For some time now the main table salt suppliers have placed on the market a table salt that contains both potassium and sodium. Two brands which I am familiar with are Morton's "LITE" salt and Sterling's "LO-SALT" or “HALF and HALF”. There is also "HALF SALT" from Canadian Salt Co., a sister company to Morton Salt Co. There is a potassium chloride table salt on the market that contains lysine to mask the potassium flavor. I do not know what the long term affects of lysine would be, but it should be marvelous when suffering from the viruses, since lysine helps to mute the effects of the virus, significantly reducing the occurrence (when taken routinely during the disease), severity, and healing time of herpes simplex virus [Griffith]. You can recognize the shingles virus by large patches of a painful rash that appears on one side of the body in people under emotional stress , older people, or people whose immune system has been compromised. If you must have the salty taste of the chloride these brands would be a fairly reasonable way to go. In the case of diarrhea they would, I suspect, be the best way next to the ORT salts mentioned above. In many areas of the undeveloped countries they may be the only way. They have not caught on much in the developed countries, I suppose because the diarrheas are not often fatal in the temperate regions, probably because potassium is less often lost in perspiration or because the tropical diarrheas are more virulent in the tropics. That greater virulence of tropical diseases is no doubt the main reason why tropical countries are often referred to by the euphemistic term “developing”. The table salts containing sodium are more intrinsically safe from an overdose than pure potassium salts. On balance, though, the possible long term effect of the sodium chloride on hypertension would be sufficiently disadvantageous to make their routine use undesirable except in moderate amounts for there is evidence from rat experiments that excess chloride can increase high blood pressure. Sodium must be combined with chloride to raise blood pressure. Sodium alone, as the bicarbonate or probably as citrate also, lowers blood pressure [McCarty]. Also I have a suspicion based on personal experience that potassium chloride can accentuate pain from some other cause (but I have no proof). It may be eventually shown that the best way would be a salt that contains many essential minerals, including magnesium, calcium, potassium and trace elements and other anions, including bicarbonate and especially iodide (scroll down), in addition to chloride. Currently I am aware of no supporting theory nor of anything in supermarkets or health food stores similar to this last, although Cardia contains magnesium and lysine. Research should be performed to shed light on this. The above combination salts contain about one atom of potassium to two of sodium.

It is possible that combination table salts should also be kept out of the reach of children in view of the affect that water softener salts had on the child mentioned above.

SEA SALT

Sea salt is not a source of potassium. Even if the salt is obtained by evaporating seawater to dryness, it will still only contain about 4% of potassium salts. Sea salt is really only a sodium table salt no matter how it is made. In addition it has the potential of retaining all the mercury and other poisons contained in seawater which could be a slight disadvantage.

DEAD SEA SALT

The Dead Sea water has a reputation for healing arthritis and has been successfully investigated with healing lasting up to three months [Sukenik]. It has two and a half to ten times as much potassium chloride by weight as sodium chloride and an even greater ratio of magnesium chloride. That last link is a commercial source of salts which are both a potassium and magnesium supplement. However it is possible that it seems to be more useful than it is as a bath because it also contains bromide, which I believe can mute pain somewhat. Bromide is mildly poisonous and an antidote is iodide (scroll down) Magnesium chloride as analytical grade can probably be acquired inexpensively from a chemical supply house.

FERTILIZER

Potassium is sold for fertilizer under the designation "muriate of potash". I have no reason to suspect that it contains any bad poisons. Ultimately it came from the same original source as sea salt, but was the last to evaporate in ancient inland seas. It is without a doubt the least expensive source of potassium. A bag would probably last a life time. I have used it both before and after decanting the sediments it contains for several weeks with no obvious bad effects. It may be a reasonable way to go for people too poor to acquire ORT salts if it were decanted. Decanting may be necessary because its red sediments may be high in iron, which is poisonous in large amounts, especially for people with hemochromatosis.

DE COTI MARSH’S SALTS

In 1957 de Coti Marsh of England wrote a book advocating various potassium salts as a treatment for arthritis. He proposed many negative ions to be associated with the potassium. He was the first to definitively propose potassium as an arthritis remedy. The pioneering efforts about potassium for arthritis by Charles de Coti-Marsh enabled him to form a foundation currently active in England that encourages people to use of potassium supplements in order to increase cell potassium and it has helped more than 3500 people cure arthritis..

ATHLETIC DRINKS

There are several artificial drinks on the market catering to athletes who exercise in the hot weather. They are in effect, supplements. All but one of those known to me are really sodium chloride supplements. "Brake-Time" put out by Johnson and Johnson is a sodium supplement, but it also has small amounts of potassium, about equal to the potassium in blood fluids, in addition to vitamin C, phosphate, chloride, and a somewhat lower sugar content than the other athletic fluids. The reason given for lower sugar is to decrease the retention time in the stomach [from Johnson and Johnson brochures].

These drinks are designed to prevent four types of disorders that are associated with heat, as follows:

1. Heat cramps are caused by large sodium chloride losses in sweat. The symptoms are headache, dizziness, fatigue, nausea vomiting, muscle cramps and circulatory failure in late stages. It can occur from any sweating, even shoveling snow. Muscle cramps are thought to be possible even when cell potassium is low, and may even be more likely then from too high a serum potassium relative to the cell.
2. Water intoxication can occur if a body low in sodium is inundated with pure drinking water. The symptoms are cramps, fever and confusion. The symptoms are similar to alcohol intoxication. You should not suddenly drink enormous amounts of pure water with no salt when very thirsty. Taken to extreme it can even be fatal.
3. Heat exhaustion is caused by loss of body salts in general, but with strong overtones of potassium loss. Symptoms include muscle weakness, lassitude, nausea, vomiting, and fainting when the body's weight loss is 5% (10% of the water). Treatment can be accomplished with fluids containing sodium and potassium chloride, rest, and cooling. Lane, et al maintains that the minimum daily requirement for potassium on a hot day is over three grams [Lane]. I suspect that it should be considerably higher than that. If a potassium-depleted person who is dehydrated is suddenly supplied with large amounts of pure water, dangerous low blood serum potassium can develop causing respiratory distress [Ellison].
4. Heat stroke is the worst disability because of high death rates. It is a MEDICAL EMERGENCY and is the result of high body temperatures in the vicinity of 105-16 degrees F. The whole heat regulatory mechanism has broken down by this time due partly to damage to brain cells, which damage may be permanent if not corrected immediately. The symptoms are headache, weakness, vertigo (dizziness), and dry skin. Cooling by dousing with water, especially on the head, is imperative. The situation is sufficiently dangerous that medical help should be called immediately, because intravenous fluids may be necessary to prevent death. The body continues to generate heat so time is of the essence so far as cooling the affected person is concerned. Heat stroke is the extreme of heat exhaustion and is also thought to be largely a potassium deficit [Coburn]. Babies can suffer from heat stroke and is at least as serious to them. Too warm clothes or an overheated car can trigger it. Treatment is the same as adults except it is possible to remove clothing in addition.

A potassium deficiency can cause cramps (also called spasms). A potassium deficiency causes severe titanic muscle seizures in chicks. Such chicks were near death when those seizures occurred. Some people have what is probably a genetic defect whereby large supplements are required to prevent spasms.

You would think that the athletic drinks fill a real need, at least those containing reasonable amounts of potassium. For the general population they may. I address myself to healthy people who presumably are eating a diet that is moderate in sodium and at least adequate in potassium, and reasonably adequate in other nutrients. Such people should rarely be affected by the disorders above if they behave with reasonable common sense. Given that we are discussing such people, water or dilute fruit juice imbibed often in moderate increments should be sufficient and possibly preferable. Vegetable juice is really a food and would probably be inappropriate during strenuous exercise in the absence of a break in the activity.

Paradoxically, low sodium intake probably protects people from sodium losses on a hot day. I have no documentation, but I strongly suspect that the time it takes a one gram of sodium per day person is much shorter to become acclimatized than the week or so it is known to take a four gram per day person. The time may be instantaneous or virtually so. I strongly suspect that the high sodium intake of our society is a fair part of the regulatory difficulties of the summer time. A well-fed normal person should be a tough, adaptable person well able to tolerate even fairly unreasonable assaults of temperature and exertion.

In addition to dietary protection against environmental distress, it should be usually possible to solve some of these assaults by planning your activities, by wearing shorts to make use of the considerable heat dissipating area of the legs, using shaded areas, using wide, loose fitting hats, and most effective, dousing with water. Wet clothes would be preferable to damage to your body and brain, and perspiration would probably make you wet anyway. It is possible that moderate perspiration would be advantageous to people whose kidneys have reduced function provided adequate water is available since perspiration glands behave similarly to kidneys.

Therefore I tentatively recommend against drinks high in sodium. It is conceivable that you could get an inadequate sodium intake if you were to happen to select only vegetables low in sodium or only garden vegetables in a low sodium area and at the same time ate no or small amounts of meat. Such a situation could conceivably introduce dangers. So watch what you eat and consider the possibility of salt supplements, but not necessarily athletic drinks. Salt is much more useful to enhance food flavor than as athletic drinks and in addition is required to assist in absorbing some of the other nutrients. Also extremely low sodium intakes actually make it more difficult to retain potassium than moderate intakes [Dluhy].

Dr. Reza Rastmanesh from Iran has recently performed a large controlled clinical trial testing potassium supplements against rheumatoid arthritis with dramatic decreases in pain in all subjects and increases of cortisol [Rastmanesh]. He would now like to continue his clinical research testing potassium in conjunction with other nutrients, especially magnesium, in an English speaking country. His credentials are impressive. If you know of any rheumatology department able to employ him, please contact him with the email address = r.rastmanesh at nnftri.ac.ir . >

Continue to SUPPLEMENT SIDE EFFECTS and HOW to AVOID THEM, Chapter XII.

or; Back to Chapter I

REFERENCES are below at the end.

EPILOGUE

The health of people in the USA is abysmal, and a major part of it is poor nutrition. As the 12th century physician, trying to cure by diet before he administers drugs, said; “No illness that can be treated by diet should be treated by any other means" or as Hippocrates expressed it in 460 - 377BC; "If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." It would seem that a healthy life style has been known for a long time. It is my belief that an unprocessed, unfrozen, not canned, high in vegetables diet would keep a large majority of people reasonably healthy and without the need for fad diets. 80% of Americans do not eat adequate vegetables, but even though 72% of Americans take vitamin or mineral supplements daily or sometimes [Sardi p148], their health is atrocious, especially old people..

I would suggest that a partial solution to the problem of poor potassium nutrition would be to place a tax on all food that has had potassium removed by food processors and completely fund all Medicare and workman’s compensation for injuries and disease that relate to rheumatoid arthritis, heart disease, and high blood pressure. This would also take the onerous tax burden now incurred for them and place it on the shoulders of those who cause the problem

The author, Charles Weber, has a degree in chemistry and a masters degree in soil science. He has researched potassium for 45 years, primarily a library research. He has cured his own early onset arthritis (33 years old). He has published articles on allied subjects in; The Journal of Theoretical Biology (1970, 1983), The Journal of Applied Nutrition (1974), Clinical and Experimental Rheumatology (1983), and Medical Hypotheses (1984, 1999).

All printed rights to this article are reserved. Electronic rights are waived.

Email to; isoptera at att.net or 1 828 692 5816 (USA)

SOME LINKS TO HEALTH ARTICLES

There is an an article discussing cashew nuts to cure a tooth abscess Which might prove useful.
There is also an article which proposes some speculation about diabetes. There is a site that contains reviews of natural remedies for many diseases .

It has been found that borax will cure rheumatoid arthritis. It will also get rid of fluoride in the body.

See this site for some links to health articles.
For a procedure that discusses tetrathiomolybdate for removing copper and thus preventing further solid cancer growth and Hodgkin’s, see this site. This might buy some time until you can persuade a doctor to try tumor necrosis factor or interferon or an opioid antagonist drug called Naltrexone (Naltrexone in the large 50 mg size, originally manufactured by DuPont under the brand name ReVia, is now sold by Mallinckrodt as Depade and by Barr Laboratories under the generic name naltrexone) that blocks some endorphin receptors. Said blockage is thought to cause the body to temporarily secrete more endorphins, especially after midnight at night. These endorphins are thought to stimulate the immune system, and in particular to stimulate the TH-1 or type 1 antiviral response by decreased interleukin-4 and with increased gamma interferon and interleukin-2 and a simultaneous decrease of type 2 anti bacterial response [Sacerdote]. It appears to be especially effective for minimizing symptoms and retarding progression of multiple sclerosis (MS) There are drugs listed in this site that should not be taken with low dose Naltrexone, including cortisol. Advice how to proceed if you have been taking cortisol may be seen here. (also see these sites; this site and this site and a trial) . A few doctors have had encouraging results in Crohn's Disease, and even to some extent in cancer. Low doses of Naltrexone (LDN), 1.5 to 4.5 milligrams, at bedtime is used (timing is important, and it is important not to buy slow release forms). It is said to have no known bad side effects at those doses other than insomnia the first week or two in some. There is also reports from an extensive survey in this site. and an extensive discussion at this site. I think some clinical studies on Naltrexone are in order, and it should not be a prescription drug (I have a petition to make Naltrexone an over the counter drug with the Center for Drug Evaluation and Research FDA Rockville MD 20857, Re; Docket No. 2006P-0508-CPI. Perhaps if enough people wrote supporting the petition it could be enacted). Though side effects appear unlikely, it is not proven over longer periods. If you try it (it is a prescription medicine in the USA), it seems likely that you should discontinue if you get a bacterial infection in view of its inhibition of antibacterial response Naltrexone is currently. It is also being explored for AIDS by Dr. Bernard Bihari, 29 W 15th St. New York, NY 10011, 212) 929-4196 who is still prescribing Naltrexone for HIV/AIDS. (and currently Executive Director of the Community Research Initiative). Dr. Gale Guyer of Advanced Medical Center located in Zionsville, Indiana also is using it for cancer. Dr. Bihari has shown promising results for a large percentage of his cancer patients.

Olive leaf extract has shown clinical evidence of effectiveness against a wide range of viruses, including AIDS [Bihari], herpes, and cold viruses. It sometimes produces a Herxheimer or pathogen die off symptoms (from effectiveness against bacteria?). There is evidence that it is synergistic (reinforce each other) with Naltrexone. There have been a few case histories of improvement in what were probably arthritis patients and CFIDS patients. The active ingredient is said to be oleuropein or enolate. There has been very little follow up research done on it.

Also it has been found that curcumin in turmeric or curry powder will inhibit several forms of cancer, including melanoma. People who live in India where these spices are eaten, have one tenth the cancer elsewhere. Here is an article with anecdotal evidence for pressurized oxygen, zinc, vitamin B6, and vitamin C after head injuries. They also claim a fair percentage of prison inmates from psychiatric disorders after head injuries.
See this site for evidence of a correlation between magnesium deficiency and cancer. The taurate has been proposed as the best magnesium supplement, although there are no long term studies. Taurine or 2-aminoethanesulfonic acid is an acidic chemical substance sulfonated rather than carboxylated found in high abundance in the tissues of many animals (metazoa), especially sea animals. Taurine is also found in plants, fungi, and some bacterial species, but in far less abundance. It is an amine with a sulfonic acid functional group, but it is not an amino acid in the biological sense, not being one of the twenty protein-forming compounds encoded by the universal genetic code. Small polypeptides have been identified as containing taurine, but to date there has been no report of a transfer RNA that is specifically charged with taurine [from Wikipedia]. It is essential to babies. It has been found that supplements of the amino acid, taurine, will restore the abnormal electrocardiogram present during a potassium deficiency by an unknown mechanism, but see Dumaine’s article [Dumaine] This information has been used in several case histories by George Eby to control a long standing type of cardiac arrhythmia called pre atrial contractions (PACs), a benign but irritating and nerve racking heart problem, with 2.5 grams of taurine with each meal. . Taurine is said to be low in the diets of vegetarians. The 2.5 grams recommended by the American Heart Association causes diarrhea in some people and should probably be reduced in those people. Taurine has been used for high blood pressure, migraine headache, high cholesterol, epilepsy, macular degeneration, Alzheimer’s disease, liver disorders, alcoholism, and cystic fibrosis, and depression. Keep in mind that some people may have a genetic defect that limits the amount of taurine tolerated and that adequate molybdenum may desirable. Also taurine may make a copper deficiency worse, based on a single case history [Brien Quirk]. So adequate copper may be necessary.

A site is available which shows. foods which are high in one nutrient and low in another (including calories). This last site should be especially useful for a quick list of foods to consider first, or for those who must restrict another nutrient because of a genetic difficulty with absorption or utilization

If you use medication ffor arthritis, you may see technical evaluations and cautions of drugs at the bottom of this site.

The very extensive USDA Handbook #8 may be seen here. To access the information you must press "enter" to search, and then divide Kcal into milligrams of potassium. This last table is very comprehensive, is used in search mode, and even lists the amino acids. There are also links in it to PDF types of printouts from the table for individual nutrients available here Just click on the “A” or “W” button for the nutrient you desire. A table that has already done the potassium calculation is here in descending concentration or in alphabetical order. There is a free browser called Firefox, which is said to be less susceptible to viruses or crashes, has many interesting features, imports information from Iexplore while leaving Iexplore intact. You can also install their emailer. A feature that lists all the URLs on a viewed site can be useful when working on your own site.

If you have Iexplore, there is a tool bar by Google that enables you to search literature articles only, search the internet from the page viewed, mark desired words, search the site, give page rank, etc. It is also available for Firefox.

There is a free program available which tells on your site what web site accessed you, which search engine, statistics about which country, statistics of search engine access, keywords used and their frequency. It can be very useful.

All printed rights to this article are reserved. Electronic rights are waived.

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This article has been updated in April. 2014.