Potassium: benefits, dosage, contraindications
Other name(s)
Potassium Acetate, Potassium Bicarbonate, Potassium Chloride, Potassium Citrate, Potassium Gluconate
Scientific name(s)
potassium, K
Family or group:
Minerals and trace elements
Indications
Rating methodology
EFSA approval.
Potassium Deficiency ✪✪✪✪✪
Oral potassium can prevent and treat potassium deficiencies. Most hypokalemic patients have serum potassium levels of 3.0 to 3.5 mEq per liter and are asymptomatic. Occasionally, mild fatigue and muscle weakness may be reported. Moderately hypokalemic patients (serum potassium levels of 3.0 to 2.5 mEq per liter) may exhibit significant proximal muscle weakness. Other vague symptoms, including constipation, can also be reported. Severely hypokalemic patients (serum potassium levels below 2.5 mEq per liter) may develop rhabdomyolysis, myoglobinuria, symmetrical ascending paralysis, and even respiratory arrest. Hypokalemia has been shown to be associated with an increased risk of essential hypertension, ischemic and hemorrhagic strokes, arrhythmia issues, and cardiovascular events. The etiology of hypokalemia may be insufficient potassium intake, transcellular movement of potassium from extracellular to intracellular compartments, or excessive loss of potassium. Renal and gastrointestinal systems are the main sites of excessive potassium loss from the body. To prevent hypokalemia, 20 mEq of potassium (about 780 mg of elemental potassium) is typically taken once per day. To treat hypokalemia, 40-100 mEq of potassium (about 1560-3900 mg of elemental potassium) is generally taken in 2 to 5 doses per day. Potassium supplementation should be individualized and based on a person's serum potassium level, which should be maintained between 3.5 and 5 mEq/L.
Posologie
Oral
780 - 3900 mg
Adults
Acid-base Balance ✪✪✪✪✪
Potassium is a mineral salt that, together with sodium, helps maintain acidity (pH) and fluid balance within cells. During hypokalemia, persistent metabolic alkalosis may occur due to reduced renal capacity to excrete bicarbonate and citrate, increased ammoniogenesis, and increased proton secretion in the collecting ducts. Hypokalemia may also contribute to persistent metabolic alkalosis by increasing urinary chloride excretion and causing serum hypochloremia.
Posologie
Oral
3.5 g
Adults
High Blood Pressure ✪✪✪✪✪
Most clinical research shows that potassium, taken orally as part of a diet or as a supplement, reduces systolic blood pressure by about 3 to 9.5 mmHg and diastolic blood pressure by about 2 to 6.4 mmHg in patients with or without hypertension. In most of these studies, daily potassium intake generally ranged from about 1,500 to 7,800 mg, with the most common intake ranging from about 2,340 to 2,540 mg per day. While both potassium supplements and dietary potassium appear beneficial, guidelines recommend obtaining potassium from food sources. Foods providing at least 350 mg of potassium per serving and low in sodium, saturated fats, and cholesterol may help reduce the risk of developing high blood pressure.
Posologie
Oral
1500 - 7800 mg
Adults
Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials.
Does potassium supplementation lower blood pressure? A meta-analysis of published trials.
Daily potassium intake and sodium-to-potassium ratio in the reduction of blood pressure: a meta-analysis of randomized controlled trials.
Potassium treatment for hypertension in patient with high salt intake: a meta-analysis.
Stroke ✪✪✪✪✪
Population research has shown that increasing dietary potassium intake by 1 to 1.5 grams per day is associated with up to a 20% reduction in stroke risk. Foods containing at least 350 mg of potassium and low in sodium, saturated fats, and cholesterol may reduce the risk of high blood pressure and stroke. Higher supplemental potassium intake also appears to be associated with a lower stroke risk, but findings are still preliminary. Some population research has shown that higher supplemental potassium intake is associated with a 29% reduction in ischemic stroke risk. However, additional potassium intake is not associated with a lower risk of hemorrhagic stroke. To prevent strokes, a dietary intake of about 75 mEq (approximately 3.5 g of elemental potassium) per day has been used.
Posologie
Oral
3.5 g
Adults
Association between intakes of magnesium, potassium, and calcium and risk of stroke: 2 cohorts of US women and updated meta-analysis.
Potassium-rich diet and risk of stroke: updated meta-analysis.
Are low intakes of calcium and potassium important causes of cardiovascular disease?
Osteoporosis ✪✪✪✪✪
In a cross-sectional study involving 994 healthy premenopausal women aged 45 to 49 years, the bone mineral density of the lumbar spine and femoral neck increased with higher potassium intake. A study involving 62 healthy women aged 45 to 55 years showed that a high potassium intake was associated not only with higher bone mass but also with lower excretion of pyridinoline and deoxypyridinoline. [9](https://www.bmj.com/content/323/7311/497#ref-9) The administration of potassium bicarbonate to 18 postmenopausal women for 18 days reduced urinary excretion of calcium and hydroxyproline and increased serum osteocalcin concentration, indicating reduced bone resorption and increased bone formation rate.
Posologie
Oral
3.5 g
Adults
Dietary potassium intake is beneficial to bone health in a low calcium intake population: the Korean National Health and Nutrition Examination Survey (KNHANES) (2008-2011)
Improved mineral balance and skeletal metabolism in postmenopausal women treated with potassium bicarbonate
Nutritional influences on bone mineral density: a cross-sectional study in premenopausal women
Kidney Stones ✪✪✪✪✪
Increasing potassium intake reduces urinary calcium excretion and results in a positive calcium balance. By reducing calcium excretion, a high potassium intake may also reduce the risk of kidney stones.
Posologie
Oral
3.5 g
Adults
Properties
Cardiovascular
The relationship between intracellular and extracellular potassium is important for determining the electrophysiological properties of cardiac conductive tissue. Hypokalemia can cause prolonged repolarization, a pathogenic factor for torsades de pointes (a specific type of ventricular tachycardia), especially in patients with ischemic heart disease, heart failure, and left ventricular hypertrophy. In heart failure patients, potassium balance is often disrupted. The reduction of serum potassium concentrations can increase the likelihood of arrhythmias. Correcting serum potassium concentrations can reduce the frequency and complexity of ventricular arrhythmias and may prevent sudden cardiac death.
Essential
Potassium is an essential element in physiological processes, including nerve impulse transmission, contraction of cardiac, smooth, and skeletal muscles, gastric secretion, renal function, tissue synthesis, and carbohydrate synthesis. European health authorities (EFSA, European Food Safety Authority and the European Commission) have assessed that dietary supplements containing potassium could contribute to the normal functioning of the nervous system, normal muscle functioning, neuromuscular transmission, and maintenance of normal blood pressure.
Usages associés
Antihypertensive
Sodium intake restriction along with an increase in potassium intake has been recommended to prevent hypertension and cardiovascular diseases. The extensive international study on electrolytes and blood pressure (Intersalt) showed that potassium intake, as judged by 24-hour urinary potassium excretion, was a significant independent determinant of population blood pressure. An increase of 30 to 45 mmol in potassium intake was associated with an average reduction in population systolic blood pressure of 2 to 3 mm Hg.
Usages associés
Neurological
European health authorities (EFSA, European Food Safety Authority and the European Commission) have assessed that dietary supplements containing potassium may contribute to the normal functioning of the nervous system. On the other hand, the main risk factor for stroke is increased blood pressure. As increased potassium intake lowers blood pressure, it is difficult to separate the effects of potassium on strokes that are mediated by blood pressure from those that might be mediated by a direct effect of potassium.
Usages associés
Bone Density
Increased potassium intake reduces calcium excretion and results in a positive calcium balance, which can be associated long-term with higher bone mass.
Usages associés
Safety dosage
Infant up to 1 month: 750 mg
Child from 1 to 3 years: 800 mg
Child from 4 to 6 years: 1100 mg
Child from 7 to 10 years: 1800 mg
Child from 11 to 14 years: 2700 mg
Child from 15 to 17 years: 3500 mg
Adult from 18 years: 3500 mg
Pregnant woman from 18 years: 3500 mg
Breastfeeding woman from 18 years: 4000 mg
Interactions
Médicaments
Antihypertensive: moderate interaction
Angiotensin-converting enzyme inhibitors reduce potassium excretion, and concomitant potassium intake may increase the risk of hyperkalemia.
Diuretics: moderate interaction
The concomitant use of potassium-sparing diuretics with potassium supplements increases the risk of hyperkalemia. Additionally, loop and thiazide diuretics increase urinary potassium excretion.
Amphotericin B: strong interaction
Amphotericin B increases urinary potassium losses due to toxic effects on renal tubular epithelium. Hypokalemia may occur in up to 50% of patients.
Plantes ou autres actifs
Potassium: moderate interaction
In some individuals, potassium supplementation may decrease vitamin B12 absorption, potentially leading to a deficiency.
Contraindications
Digestive disorders: prohibited
Oral potassium tablets and capsules are contraindicated in individuals with gastrointestinal motility disorders.
Renal failure: prohibited
Potassium supplementation can be dangerous in patients with renal failure due to the risk of potassium accumulation, leading to hyperkalemia.
