A. Hyperkalemia, unless severe, is usually asymptomatic. The effect of hyperkalemia on the heart becomes significant above 6 mEq/L. As levels increase, the initial EKG change is tall peaked T waves. The QT interval is normal or diminished.
B. As potassium levels rise further, the PR interval becomes prolonged, then the P wave amplitude decreases. The QRS complex widens into a sine wave pattern. Later P wave disappears, QRS becomes irregular and merges with T waves. This is followed by ventricular fibrillation and ultimately cardiac arrest [Bajusz p 222].
C. At serum potassium levels of greater than 7 mEq/L, muscle weakness may lead to a flaccid paralysis that spares cranial nerve function. Sensory abnormalities, impaired speech, and respiratory arrest may follow.
However you should not be unduly alarmed about the possibility of high blood potassium or hyperkalemia. In a study of hyperkalemia induction caused by supplementation of hospital patients using potassium, the following statistics were obtained: out of 16,000 general patients, 4,900 received potassium chloride (86% to prevent low serum potassium, the rest to treat it) and 176 got hyperkalemia. Of these only 7 died and 21 were threatened with death [Kassirer]. This represents a mortality of only 0.14% among sick people. If diuretics were not being used it is possible that it would be lower yet. Among healthy, active people on an adequate diet it must surely be virtually zero. Contrast this with the large death rate in the past from potassium deficiency especially in cholera and heart disease (heart infarction or necrosis of heart cells). Without supplements or ORT salts many, many more would have died. A tribe of South American Indians routinely eat 8 grams (8 thousand milligrams) or more per day of potassium as well as usually well under 2000 milligrams of sodium without any obvious signs of ill effects and being in good health [Oliver]. Healthy kidneys in people used to a large intake are said to be able to unload 26,000 mg in a day if necessary [Peterson]. In my opinion the plasma potassium must rise 1.0 meq (milliequivalent)/liter or so from 4.8 normal (or perhaps a little less if measured correctly) before one would start to use the word alarm. The electrocardiogram changes at 6.5 meq [Seekles]. I believe the dangerous symptoms of metabolic shock start to materialize after about 7.0 meq. I believe death is possible in the vicinity of 8.0 meq at which point the first clinical symptoms of heart failure appear [Seekles] and that life is impossible beyond 10.0 meq or so.
Periodic paralysis is another circumstance, the cause of which is unknown to me, which requires potassium supplements. The lower limbs become paralyzed by too little serum potassium. However there are two forms, one of which is from too much potassium. It is important to know which is involved and so it is desirable to be under the care of a doctor. If a doctor is unavailable, and the attack was triggered by a meal heavy in carbohydrates, the chances are it is the low potassium version [Dajer]. Even so, it would probably be safest to use very small increments of supplements, certainly at first.
HEART DISEASE
Heart disease is another life threatening situation with which potassium is involved. Potassium has been used in heart disease therapy since 1930 [Sampson]. If the heart disease is the "wet" heart disease as associated with beri-beri (vitamin B-1 deficiency) , potassium supplements will dangerously aggravate the situation [Mineno][Gould]. Therefore it is very important to know which kind it is. If potassium supplements are given during the wet heart disease of beriberi (thiamin deficiency) the heart disease is made much worse [Mineno][Gould]. Wet heart disease of beri-beri 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. 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, since the beri-beri damage to the heart is only possible when potassium is adequate. 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 which have sulfites in them such as wine, vinegar, beer, bottled lemon juice, and some dried fruits (see this site’s appendix for a list of food containing sulfites), since sulfites degrade vitamin B-1 in the intestines [Amerine] [Fitzhugh] or are using diuretics. There is something in tea leaves that antagonizes vitamin B-1. The diet can vary widely as to vitamin B-1 [Dept. of Health]. Also, the symptoms of a vitamin B-1 deficiency can materialize even if vitamin B-1 is adequate if magnesium is deficient, say from Crohn’s disease [Dyckner, Nyhlin, Wester].
Even in the more likely circumstance that the heart disease is largely a potassium deficiency or aggravated by one, potassium should be used with great caution shortly after an attack. Even though the cellular content is low, and some heart cells are actually dying for lack of potassium, the plasma content can be high [Flear][Hurley][White] and so supplements can be dangerous. Raab, in a comprehensive review, suggests that dying cells may not be able to reabsorb potassium during the acute phases and thus cause death from this and the adjacent hyperkalemia. He suggests adopting the words "disionic cardiopathy" in order to avoid the semantic confusion and invalidity inherent in such words as "coronary heart disease" [Raab]. It is imperative to keep total potassium adequate though, because a deficiency causes the heart to lose force [Abbrecht]. The way some doctors in the world get around the impasse is to administer the potassium in conjunction with glucose sugar and insulin [Sodi-Pollares][Iosava][Landman][Hjermann][LaMarche]. Thus much of the potassium enters the cell to be tied up with glycogen (animal starch). This is called a "polarizing solution" or "GIK". It is fairly effective although it must not be used during the "wet" heart disease of beri-beri (vitamin B-1 deficiency) as discussed above. The insulin may be also speeding movement across the cell wall because of its effect on a glucose - potassium pump [Lundman]. The insulin response is similar in both normal and potassium deficient animals. They therefore conclude that potassium deficient animals secrete less insulin [Mondon]. This procedure was originally proposed by Laborit and Huguenard [Laborit & Huguenard]] in France and Sodi-Pollares in Mexico in 1962 [Rackley]. This therapy benefits some patients but is unpredictable [Thadani][Fletcher] probably because the “wet” heart disease of beri-beri is sometimes involved or because some other deficiency predominates. This procedure has fallen into disfavor but is now being restudied. It has been suggested as a way of suppressing the tumor necrosis factor (TNF) of arthritis recently [Das]. The unpredictability for heart disease may be also partly because some of the heart disease is caused or accentuated by copper or magnesium deficiency. It has been proposed that most heart disease is a magnesium deficiency. I suspect that much of the effect of magnesium is operating through the potassium physiology. It has been proposed to add magnesium to GIK and calling the therapy MAGIK [Whang and Flink]. Also see this site about magnesium deficiency. Usually magnesium should be part of heart disease treatment. Its efficacy in heart disease has been documented by numerous studies [Schecter]. Probably reasonable magnesium supplements would never be harmful to the heart, but I have no sure evidence. It is very effective in atrial fibrillation or excessive heart beats. magnesium lowered average heart rate by 25 beats per minute more (130 to 105 for the drug digoxin versus 130 to 80 for magnesium) than the savings from digoxin alone [Brodsky] in 60% of patients. In other words, magnesium helped those patients ‘save’ 36,000 heart beats per day over what they would have saved with the drug alone. (see [Kohvacca] for an experiment involving low serum potassium, in which potassium could not be increased in the body with 1,000 milligrams of potassium supplement without magnesium),
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 (Pyrimidinecarboxylic acid, also known as orotic acid or vitamin B13, Animal Galactose Factor, Oro, Orodin, Oropur, Orotonin, Oroturic, Orotyl, or whey factor. is not really recognized as a vitamin. It is manufactured in the body by intestinal flora.) has been shown to be more readily absorbed than the carbonate [Schlebusch]. Athletes had their swimming, cycling and running times decreased in the magnesium-orotate group compared with the controls and their insulin system markedly affected [Golf]. This may have been partly due to the orotate itself, because orotate is incorporated into RNA, enabled by biotin. People with coronary heart disease had their exercise ability significantly increased by magnesium orotate [Geiss]. Orotic acid is not necessarily always good in excess since it is said to bind zinc to a non-biologically active state and can damage the liver, but I would think that the 50 to 100 milligrams that has been recommended should be safe. Sources of orotate are whey, yogurt, beetroot, carrots, and Jerusalem artichoke, but not human milk.
Part of the unpredictability of heart disease may arise because of the dependence of the sodium/potassium pump on inositol [Charalampous] [Greene](a B complex vitamin or myoinositol), or because of unpredictable huge sodium, chloride, or phosphate (from soft drinks) excess. There is 100% mortality in heart attack during potassium deficiency in the presence of excess phosphate [Selye], say from soft drinks (especially colas [Hall] ), for instance. It has been suggested that diabetics should not be treated with polarizing solution [Rackley]. However, a recent experiment has indicated improved results post operatively for GIK polarizing solution for coronary operations [Szabo]. If whatever nutritional imbalance is not corrected correctly the prognosis is poor for heart disease patients. Potassium is prescribed for 40% of heart disease patients. This percentage should probably be much higher, but not so high as to include patients with beri-beri (vitamin B-1 deficiency) at least. Only 50% of one group survived after 5 years [from a dead site]. Anyone suffering from a vitamin B-1 deficiency would be especially at severe risk if animal experiments are an indication [Follis]. Anxiety often attends a potassium deficiency [Davis], probably because of low aldosterone, so this may serve as a clue as to which kind of heart disease is involved and would bear investigation. The only sure way is with a whole body scintillation counter, although plasma potassium much below about 4.0 meq/L would be a strong indication. The risk of heart disease does not change significantly when the mean serum potassium content of patient groups changes between 4.1 milliequivalents per liter (meq) and 5.3 meq [Walsh], so while it is no doubt desirable to attain the normal 4.8 milligrams per liter (or possibly a little less than 4.8 if correctly measured), the situation does not seem to be desperately dangerous above 4.0. One exception to this would be people who have rheumatoid arthritis, whose platelets release some potassium into the plasma upon blood being drawn [Ifudu] and thus give an incorrect reading. There is also a new procedure using neutron bombardment of cells that may yet show promise. In any case there is no good substitute for whole, unprocessed foods with lots of vegetables either alone or with some supplements to prevent heart disease in the first place. Vegetables and fruit have been established by epidemiological studies to protect against heart disease and in this survey and also by experiments on mice.
Serum potassium of 3.5 mEq or less increases problems in heart surgery and doubles arrhythmias. Below 3.3 mEq doubles the necessity of resuscitation [from a discontinued URL]. These figures maybe should be higher for people with rheumatoid arthritis because such people often get anomalously high readings, especially of serum rather than plasma, as mentioned above.
Judging by the statistics associated with heart disease therapy , potassium and magnesium [Bajusz p 168] must be playing dominant roles in a majority of current cases, because potassium whether in polarizing solutions, GIK (glucose-insulin-potassium), as potassium chloride [Chang], or as potassium and magnesium aspartate [Laborit, et al][Classen] causes a considerable reduction in mortality in the USA and especially abroad. Kadaner found that 3 to 4,000 milligrams of potassium chloride for 3-4 weeks prevented or considerably alleviated vascular crises. Most showed a decrease in blood pressure of 30-40 mm of mercury when taken with reserpine, hydrochlorothiazide, and some other drugs, which by themselves did not give such an effect [Kadaner]. Also people working in potash mines have a lower heart disease rate than others [Waxweiler]. Elderly heart disease patients given potassium supplements usually show an increase in whole body potassium [Potter]. It is impossible to cause heart disease experimentally by any known poison unless the potassium intake is also restricted or the kidneys destroyed [Prioreschi]. The total body potassium parallels the severity of the disease [Pierson].
Wine has been correlated with low heart disease rates. I suspect that this is because wine contains a poison that interferes with potassium excretion [McDonald] or perhaps because sulfites in most wine destroys vitamin B-1. If so, getting enough potassium in the diet would be a much superior strategy for achieving this result for several reasons, even if the wine has been fermented without sulfur dioxide.
Heart disease as caused by blockage of blood vessels by cholesterol has been attributed to cholesterol in the diet. While excessive intakes may contribute to this blockage somewhat, a disruption of normal cholesterol synthesis in the body must be the primary cause and in any case adequate potassium has a protective affect [Young]. Cholesterol in the diet has only risen from 683 milligrams to 734 per day in 1961 since the start of the century and Masai tribesmen have low blood cholesterol in spite of high unsaturated fat in the diet [Brown, et al]. Copper deficiency is a much more plausible explanation for high cholesterol and maybe a vitamin C deficiency. For some side effects of cholesterol lowering drugs see links in this site.
Because the clearance of blood through the liver is reduced in heart disease, partly because of lack of exercise, aldosterone builds up [Cope]. Aldosterone is normally constantly destroyed by liver enzymes as fast as it is produced [Messerli]. As a result it is difficult to restore the body's potassium with food alone [Howard][White][Liddle][Randall]. If supplements are prescribed, probably the safest way to take them would be between meals, in small doses, and dissolved in juice. It should be possible to largely restore the body's potassium with potassium chloride supplements in two weeks or so [Conway]. Using potassium chloride may not be a good idea after repletion for those susceptible to high blood pressure for there is evidence from rats that excess chloride can increase high blood pressure. Also it would be wise to receive as much as possible from food. In addition it is probably advantageous not to supplement one's diet with sodium and chloride from salt, phosphate from soft drinks, or vitamin B1 (thiamin). Death of heart cells from a potassium deficiency is prevented by a thiamin deficiency [Follis 1942], so supplementing vitamin B-1 prematurely could be dangerous unless the heart disease was established as the "wet" heart disease of beri beri. When both are deficient lesions of the muscles occur instead similar to muscular dystrophy (potassium is low in muscular dystrophy [Blahd] ). The danger might be especially present if you have been imbibing wine, vinegar or beer fermented with sulfur dioxide or eating fruit dried with sulfur dioxide because sulfur dioxide and sulfites rapidly destroy vitamin B-1 at the pH of the intestines [Amerine p487] [Fitzhugh]. Some of the symptoms of a magnesium deficiency are also muted by a simultaneous vitamin B-1 deficiency [Hokawa], possibly some because of magnesium deficiency on potassium absorption.
Of course, the most effective lifetime strategy would be to get all the potassium and other nutrients which was originally in the food, no huge excesses, and to eat, drink or smoke no poisons in the first place. Then you will not usually be likely to be forced into a bind in which you must make such dangerous, expensive, and time consuming compromises and unnecessarily tie up medical facilities.
The wide spread of nutritional contents in foods should make it possible for a knowledgeable person to meet all his needs by wise selection and preparation. Celery, for instance, has twenty times the potassium content of wheat per calorie, and eighty times of refined wheat. Bamboo shoots and green coconut water are also said to be very high. Such foods as celery have, in effect, many of the characteristics of a supplement, but with some built in safety. That built in safety is inherent by virtue of other nutrients being present. Also such foods are unlikely to be gorged. The potassium content can probably be increased still further for most vegetables by extracting the liquid and drinking it as a juice or as a broth. The best sources are sufficiently high that they should be treated with some of the respect accorded supplements in the event of illnesses which can cause high blood potassium or which immobilize you.
EPILOGUE
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 .
The health of people in the USA is abysmal (numerous statistics), 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 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 pioneering efforts about potassium for arthritis by Charles de Coti-Marsh enabled him to form a foundation currently active in England that promotes the use of potassium for arthritis and it has helped cure 3500 people.
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 It has been found that borax will cure rheumatoid arthritis. It will also get rid of fluoride in the body.
Fluoride in city water will cause fluorosis discoloration of teeth, weakened bones, damage to the kidneys an immune system, and, worst of all, damage to the nerves resembling Alzheimer’s disease.
There is a site that contains reviews of natural remedies for many diseases
See this site for some links to health articles.
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.
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.
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. All printed rights to this article are reserved. Electronic rights are waived.
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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.
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 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 being used by Dr. Enlander, a New York City doctor, but with limited success using 3 to 4.5 milligram doses for CFS or CFIDS. . 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.
See this site for evidence of a correlation between magnesium deficiency and cancer. The taurate is proposed as the best magnesium supplement. 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 [Eby], but see Dumaine [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.. In animal or clinical studies, taurine lowers elevated blood pressure, retards cholesterol-induced atherogenesis, prevents arrhythmias and stabilizes platelets--effects parallel to those of magnesium [McCarty 1996].
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, so adequate copper may be necessary [Brien Quirk, private communication].
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