Anne came to see me because she was tired. Her children were grown and her husband had recently passed away, leaving her to cook only for herself. She knew her diet was not as healthy as it had been, but she had no real complaints other than her fatigue and a little extra weight. Basically, she was looking for a weight-reduction program that would give her more energy. But her problem wasn’t her weight. Instead, it was an easy-to-fix deficiency….
Through an exam and examining her health history and current symptoms, I found that Anne had high blood pressure and an irregular heartbeat (arrhythmia). She was chronically tired, had occasional headaches and suffered from leg cramps. All of these symptoms began when her diet took a detour into the land of convenience foods.
Previously, Anne had prepared meals for her family that included fruits, vegetables, grains, and protein. But when she found herself on her own, she ate fewer fruits and vegetables. Fresh produce tended to spoil as she spent more time eating out with friends or making a quick meal of a single food. After eating a chicken breast, she had no desire for anything else. Pasta with tomato sauce was satisfying, and the comfort of salty garlic bread replaced her usual salad. Instead of eating fruit, Anne tended to snack on crackers and potato chips. Her diet had changed from one that was high in potassium (fruits, vegetables, and beans) and low in sodium, to the opposite. And by changing her potassium-sodium ratio, she created her symptoms.
The importance of potassium
I frequently see patients like Anne who have more than one complaint. Invariably, there’s a common thread that runs through all or most of their symptoms. It’s not uncommon for me to see someone with chronic fatigue, headaches, and heart arrhythmias with muscle cramps at night. Or a patient with congestive heart failure accompanied by high blood pressure. These symptoms, along with osteoporosis, can all be linked to a potassium deficiency. When we can correct the “bottom line” cause, like an electrolyte imbalance caused by too little potassium, symptoms and health improve.
Electrolytes (sodium, potassium, chloride) are important minerals for healthy nervous-system functions, but too much sodium or too little potassium can upset the delicate balance and lead to such problems as irregular heartbeat, fatigue, or high blood pressure. These minerals help regulate your body’s fluids by creating low-voltage electricity that helps run your body by sending messages throughout your body.
Potassium combines with magnesium to help your muscles contract and relax, while potassium and sodium help regulate fluids around your cells and keep you from retaining too much water. This is important because you may be holding on to three to five pounds of water weight! Your heart, brain, bone strength, and energy all depend not only on getting enough potassium, but getting it in the proper ratio to sodium. Opinions differ as to what this ratio of sodium to potassium should be, but I want you to understand that you need more potassium than sodium. Anne’s diet was the exact opposite. And low potassium and high sodium can lead to cancer and heart disease.
Where it all began
Most of us need less sodium and more potassium because of the foods that were available to our ancestors hundreds of years ago. At that time, people ate more fruits and vegetables that are naturally high in potassium and low in sodium. Because their diets were so high in potassium, their bodies adapted to any excess by excreting whatever their bodies didn’t need. Since their diet was low in sodium, their bodies learned to hold on to this important mineral.
Unfortunately, your diet may be high in sodium and low in potassium, like Anne’s. A typical modern diet contains salty snacks and processed foods with so much sodium that it’s almost impossible to get enough potassium – even if you eat plenty of fruits and veggies. We eat much more sodium in relation to potassium than our ancestors did. But our kidneys, like theirs, still continue to excrete more potassium and retain sodium.
This is the same situation we talked about in past issues concerning calcium and magnesium. Our ancestors’ diets were high in magnesium (greens and beans) and low in calcium (dairy products). So their bodies – and ours – learned to hold on to calcium but not magnesium. Because our modern diet contains more dairy and less greens and beans, many of us are deficient in magnesium, not calcium. And because magnesium and potassium are both needed for good muscle and nerve function, the foods you eat should emphasize potassium and magnesium, without too much sodium and calcium.
Potassium and disease
There are so many illnesses, and symptoms of illness, that can be attributed to a lack of sufficient potassium. Take a look to see if any of these could apply to you:
Heart disease: Your heart is a muscle that constantly contracts and relaxes, operating from messages that are transmitted through a network of nerves. Electrolytes help get these messages to your heart and regulate your heart rhythm. A mineral imbalance can result in heart spasms or an irregular heartbeat. All minerals need to be present in the proper balance for your electrical system to work correctly. When your magnesium level is low, your heart can’t retain potassium. This means that if you have an irregular heartbeat (cardiac arrhythmia) and you are low in potassium, you may need more magnesium as well as potassium before your heartbeat can become normal. The electrical stability of your heart comes primarily from having enough magnesium and potassium. I can’t tell you how many patients of mine no longer have irregular heartbeats after taking potassium and magnesium supplements.
Potassium works along with calcium to help your heart muscle contract, and it works with sodium to help normalize your heart rate. Without sufficient potassium, your heart simply can’t function properly. A 12-year study published in the New England Journal of Medicine found that just one extra helping of fruits and vegetables reduced the incidents of stroke by 40%.
High blood pressure: Vegetarians tend to have low blood pressure, probably because they eat more fruits, vegetables, and beans – high-potassium foods. In a study of nearly 100 vegetarians and a similar number of non-vegetarian controls, both groups had the same amount of dietary sodium, but the extra dietary potassium lowered blood pressure in vegetarians. Potassium seems to have the greatest blood pressure-lowering effect for people with severe hypertension, but if you have high blood pressure, you should lower your sodium and increase potassium-rich foods. You don’t have to be a vegetarian to lower your blood pressure. Just add more potassium-rich foods.
Osteoporosis: Several studies have shown a connection between bone density and potassium. A study in the American Journal of Clinical Nutrition suggested that acid-producing foods like meat increase the production of cells that break down bone. The potassium in fruits and vegetables are alkaline-producing and counteract this effect. So you can protect your bones by eating more fresh fruits and vegetables.
But there’s more. As we age, the more we risk falling and breaking bones. One reason people fall is due to a condition called postural hypotension. This is a condition where your blood pressure drops too low when you suddenly stand up, producing a feeling of dizziness. When this type of low blood pressure has no medical cause, potassium is often marginally low. Getting enough potassium and eliminating this type of temporary low blood pressure could help you prevent falls.
Aging: You need sufficient potassium for all of your cells to work and live. When we’re talking about one dying cell out of trillions, this is insignificant. Betty Kamen, PhD, explains this in her excellent book, Everything You Always Wanted to Know About Potassium But Were Too Tired to Ask. “But another cell is compromised,” she explains, “and you are two cells older. Then three! Four! And more! Eventually, tissue is affected. Finally, an organ. Now it matters. Now your body notices. As you lose cellular efficiency, you age.”
One big issue few people consider is the relationship between potassium and human growth hormone, a hormone that may well be the fountain of youth. This hormone decreases with age and affects how old you look and feel. Dr. Kamen found a correlation between lowered levels of human growth hormone and reduced potassium levels. That means to slow down the aging process of all your organs, you need plenty of potassium.
Lower sodium – raise potassium
Eat some vegetables with every lunch and dinner, even if it’s “only” a handful of baby carrots. Buy pre-washed vegetables and keep frozen vegetables handy. Eat unsalted sunflower seeds instead of salty nuts or chips. Read labels on all convenience foods you buy, even those in health food stores, and buy those with the lowest sodium. In time, your taste buds will adjust to them.
Before you supplement....
It’s smarter to get most of your potassium from food rather than from supplements. You need around 4,500 mg of dietary potassium a day. As we age, especially if we are wanting to help prevent bone loss, we may consider 200 mg of potassium citrate daily. There is significant research associating 200 mg daily of potassium citrate with reduced bone loss.
Increase your dietary potassium by eating more fresh vegetables and fruits and decreasing your sodium intake. If you suspect that you have low potassium, ask your doctor to run a RBC (red blood cell) potassium test. The usual serum potassium blood test is not accurate because most potassium is in the red blood cells. Don’t take extra supplemental potassium if your kidneys are not functioning properly, if you’re taking the type of diuretic that retains potassium rather than depleting it, or if you’re on NSAIDs (non-steroidal anti-inflammatory drugs).
Anne is a good example of someone who lacked sufficient potassium and ate too much sodium. She modified her diet and within two months she had much more energy. She also dropped most of her excess weight, her leg cramps decreased greatly, and her heart arrhythmias were almost non-existent. Getting more potassium and less sodium was Anne’s answer to most of her health problems. Don’t be surprised if it’s an answer for you, too.
Freudenheim, J.Ll, N.E. Johnson, E.L. Smith. “Relationship between usual nutrient intake and bone mineral content of women 35-36 years of age.” Am J Clin Nutr, 1986:44:863.
Gaby, Alan R., MD. Preventing and Reversing Osteoporosis, Rocklin, CA, Prima Publishing, 1994.
Haas, Elson M., MD. Staying Healthy With Nutrition, Celestial Arts, 1992.
Kamen, Betty, PhD. Everything You Always Wanted to Know About Potassium, Nutrition Encounter, Inc., Box 2736, Novato, CA 94948, 1992.
Khaw, K.T. and E. Barrett-Connor. “Dietary potassium and stroke- associated mortality. A 12-year prospective population study,” New England Journal of Medicine, 316(5), 1987.
Ophir, O., et al. “Low blood pressure in vegetarians: The possible role of potassium,” Am J Clin Nutr, 37, 1983.