Tracking my efforts to beat Myalgic Encephalomyelitis (ME), aka CFIDS, aka CFS

Tracking my efforts to beat Myalgic Encephalomyelitis (ME), aka CFIDS, aka CFS

Sunday, February 12, 2012

What is the best dosage & brand of potassium?

*This is the next is a series of posts summarizing my research of common ME/CFS supplements and trying to determine the consensus best dosage, maximum dosage, and best brands.  Keep in mind, I have no medical background or training, so the goal here is to sort out conflicting information and find a common nexus.

In my February 3rd post, I recounted how an apparent potassium deficiency caused me to crash, even though I had only just begun to dabble in a half-baked vitamin B12 protocol.  Notably, I began experiencing twitches all over my body, and later, pain in both thighs.  As I started taking potassium supplements, the  twitching slowly faded (although a small amount still remains).  Yet I was still experiencing a strange aching in both of my thighs, which can also be a sign of low potassium.  That aching remained even after I began supplementing potassium, and didn't go away until I switched forms of potassium: from potassium chelate to potassium citrate.

Based on my review of medical websites and ME/CFS message boards, this is what I've determined regarding the best dosage, maximum dosage, and best brand of potassium:

Maximum Dosage / Best Dosage

The recommended daily allowance (RDA) of potassium for adults is 4,700 mg.  Frankly, if you look at the amounts of potassium in even the highest potassium foods, it's amazing that any of us ever meets our RDA.  Apparently, the diets of our evolutionary ancestors contained about 4 times more potassium than those of modern man.  

Ask most people to name a food that's high in potassium, and almost everyone cites the banana.  And it's true, the banana is near the top of the list with about  500 mg.  But that means, if you ate nothing else, it would take over 9 bananas per day to meet your requirements.  

It seems that even with supplements, it is difficult to ingest enough potassium.  In the U.S., potassium is sold in tablets with a maximum of only 99 mg.  So, if you didn't get any potassium from food, it would take about 47.5 pills per day to meet the RDA - that's more than half of a typical bottle of 90 pills.  

So, all of the above tells me, when in doubt, err on the side of popping a few extra potassium pills.

On the other hand, it is slightly concerning that the side effects of overdose are basically the same as deficiency: irregular heartbeat, muscle weakness, confusion, numbness/tingling of the hands/feet, and chest pain.  So, without blood tests, there's really no way of knowing whether you're deficient or overdosing!  

But the consensus from this 8 page thread on Phoenix Rising seems to be that, as long as you have healthy kidneys, the risk of overdose is much less concerning than the risk of deficiency, because the kidneys usually filter excess potassium.  Put another way, it usually takes years of overdosing on potassium to trigger kidney failure, but a potassium deficiency can cause serious trouble (like heart failure) right away.  

I wasn't able to find any studies that listed a maximum daily dosage of potassium, but some sources said that any more than 1,800 mg in any one meal can tax the kidneys.  But if you only eat three means a day, you have to average over 1,500 mg per meal to meet your RDA.  So we're shooting for between 1,500 and 1,800 mg per meal?  Sheesh.  That seems to require some pretty careful planning.

I've also read that one should ingest about twice as much potassium as sodium, but who can keep track of it so precisely?  It seems to me it's simply better to increase potassium intake gradually until I no longer experience twitching or muscle pain. 

My conclusion from all this is that it is best to try to obtain most of my potassium from foods (yogurt, bananas, and plantains have about 500-800 mg per serving), and then to supplement another 200-300 mg per meal in pill form.  Theoretically, the rest of my RDA will be met with snacks and the occasional 99 mg pill without a meal.  If I still experience symptoms of deficiency, I'll gradually increase the after-meal doses to a maximum of about 600 mg.  

Best Brands / Forms

Potassium supplements come in all varieties: including potassium chloride, citrate, gluconate, bicarbonate, aspartate, chelate and orotate.  The chelate, aspartate and citrate seem to be the most common.  Personally, I found that the citrate form worked better for me.

Searching the internet far and wide, I wasn't able to find any consensus brand recommendations, but based on my experiencing with a staggering amount (two!) of brands, I'll say that Twin Labs Potassium Citrate works fairly well for me.  I'll update this if I find something that works better.  

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