:Potassium:

:Potassium is needed to regulate water balance, levels of acidity, blood pressure, and neuromuscular function. This mineral also plays a critical role in the transmission of electrical impulses in the heart. People with low blood levels of potassium who are undergoing heart surgery are at an increased risk of developing heart arrhythmias and an increased need for cardiopulmonary resuscitation. 1 Potassium is essential for carbohydrate and protein metabolism.

Sources: Fruit and vegetables as well as beans and milk supply significant potassium.

Well documented uses:

• High blood pressure (for people not taking potassium-sparing diuretics )
• Kidney stones (citrate in combination with magnesium citrate)

Science-supported uses:

• Cardiac arrhythmia
• Congestive heart failure
• Premenstrual syndrome
• Stroke

Deficiency: Primitive diets provide more potassium than modern diets, which may provide too little. Gross deficiencies are rare except in prolonged vomiting, diarrhea, or use of potassium-depleting diuretic drugs. People taking these drugs are often advised to take supplemental potassium. Prescription potassium provides more than the amounts sold over the counter but not more than in several pieces of fruit.

Dosage: The best way to obtain extra potassium is to eat several pieces of fruit per day, as well as liberal amounts of vegetables. The amount of potassium found in the diet ranges from about 2.5 grams to about 5.8 grams per day. The amount allowed in supplements, 99 mg per tablet or capsule, is very low, considering that one banana has about 500 mg. One should not attempt to achieve higher potassium levels by taking large numbers of potassium pills. Concentrated potassium can irritate the stomach, unlike food potassium.

Side-effects: High potassium intake (several hundred milligrams at one time in tablet form) can produce stomach irritation. People using potassium-sparing drugs should avoid using potassium chloride-containing products, such as Morton Salt Substitute®, No Salt®, Lite Salt®, and others and should not take potassium supplements, except under the supervision of a doctor. Even eating several pieces of fruit each day can sometimes cause problems for people taking potassium-sparing drugs, due to the high potassium content of fruit.

Potassium and sodium work together in the body to maintain muscle tone, blood pressure, water balance, and other functions. Many researchers believe that part of the blood pressure problem caused by too much salt (which contains sodium) is made worse by too little dietary potassium.
People with kidney failure should not take potassium supplements, except under careful medical supervision.

Drug-interactions:

• Angiotensin-Converting Enzyme (ACE) Inhibitors (Adverse interaction)
• Albuterol (Depletion or interference)
• Amiloride (Adverse interaction)
• Atenolol (Adverse interaction)
• Benazepril (Adverse interaction)
• Beta-Adrenergic Blockers (Adverse interaction)
• Betaxolol (Adverse interaction)
• Bisacodyl (Depletion or interference)
• Captopril (Adverse interaction)
• Celecoxib (Depletion or interference)
• Cisplatin (Depletion or interference)
• Colchicine (Depletion or interference)
• Oral Corticosteroids (Depletion or interference)
• Digoxin (Depletion or interference)
• Docusate (Depletion or interference)
• Enalapril (Adverse interaction)
• Epinephrine and other stress hormones reduce intracellular potassium. Consume a diet high in vitamin C, potassium, and magnesium, or consider supplemention.
• Etodolac: NSAIDs cause kidney dysfunction and increase blood potassium, especially in older people. Do not supplement potassium without consulting your doctor.
• Felodipine (Depletion or interference)
• Gentamicin (Depletion or interference)
• Haloperidol may cause hyperkalemia (high blood potassium) or hypokalemia (low blood potassium).
• Heparin: may cause hyperkalemia (high blood potassium). Potassium supplements, potassium salt substitutes (No Salt®, Morton Salt Substitute®, etcetera), and high-potassium foods (e.g. fruit) should be avoided unless approved by your doctor.
• Ibuprofen causes kidney dysfunction which increases blood potassium, especially in older people. Do not supplement potassium without consulting your doctor.
• Indapamide (Depletion or interference)
• Indomethacin (Adverse interaction)
• Ipecac (Side effect reduction/prevention)
• Ketorolac (Adverse interaction)
• Labetalol (Adverse interaction)
• Lisinopril (Adverse interaction)
• Loop Diuretics (Depletion or interference)
• Losartan can cause hyperkalemia (high blood potassium). Potassium supplements, potassium salt substitutes (No Salt®, Morton Salt Substitute®, etcetera), and high-potassium foods (e.g. fruit) should be avoided unless approved by your doctor.
• Magnesium Hydroxide: People taking potassium-depleting diuretics and people at risk for potassium deficiency (e.g. chronic diarrhea or vomiting) may have a drop in serum potassium if taking magnesium without additional potassium. This can cause muscle cramps or, in people taking digoxin or digitalis, cardiac arrhythmias. People with a history of potassium deficiency and people at risk for potassium deficiency, as well as people taking digoxin or digitalis, should ask their health practitioner before taking magnesium.
• Metoprolol (Depletion or interference)
• Mineral Oil (Depletion or interference)
• Moexipril (Depletion or interference)
• Nabumetone: NSAIDs cause kidney dysfunction and increase blood potassium, especially in older people. Do not supplement potassium without consulting your doctor.
• Nadolol (Depletion or interference)
• Neomycin (Depletion or interference)
• Oxaprozin: NSAIDs cause kidney dysfunction and increase blood potassium, especially in older people. Do not supplement potassium without consulting your doctor.
• Piroxicam (Adverse interaction)
• Quinapril (Adverse interaction)
• Quinidine (Side effect reduction/prevention)
• Ramipril (Adverse interaction)
• Rofecoxib (Adverse interaction)
• Salsalate (Depletion or interference)
• Senna: Overuse or misuse of laxatives, including senna, can cause water, sodium, and potassium depletion. Limit laxative use, including senna, to one week or less.
  
  Threlkeld DS, ed. Gastrointestinal Drugs, Laxatives. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, May 1991, 318a–9
  
• Sotalol (Adverse interaction)
• Spironolactone (Adverse interaction)
• Sulfamethoxazole (Adverse interaction)
• Sulindac (Depletion or interference)
• Tetracycline (Depletion or interference)
• Thiazide Diuretics (Depletion or interference)
• Thioridazine (Side effect reduction/prevention)
• Timolol (Adverse interaction)
• Tobramycin (Depletion or interference)
• Triamterene (Adverse interaction)
• Trimethoprim (Adverse interaction)
• Trimethoprim/Sulfamethoxazole (Adverse interaction)

References:

1. Wahr JA, Parks R, Boisvert D, et al. Preoperative serum potassium levels and perioperative outcomes in cardiac surgery patients. JAMA 1999;281:2203–10.