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
Scoring methodology
EFSA approval.
Potassium deficiency ✪✪✪✪✪
Oral potassium is used to 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. Patients with moderate hypokalemia (serum potassium 3.0 to 2.5 mEq per liter) may have significant proximal muscle weakness. Other vague symptoms, including constipation, may also be reported. Severely hypokalemic patients (serum potassium below 2.5 mEq per liter) may develop rhabdomyolysis, myoglobinuria, ascending symmetric paralysis, and even respiratory arrest. Hypokalemia has been shown to be associated with an increased risk of essential hypertension, ischemic and hemorrhagic strokes, arrhythmias, and cardiovascular events. The etiology of hypokalemia may be inadequate potassium intake, a transcellular shift of potassium from extracellular to intracellular compartments, or excessive potassium loss. The 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 generally taken once daily. 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 the 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 inside cells. During hypokalemia, a persistent metabolic alkalosis may occur because of decreased ability of the kidney to excrete bicarbonate and citrate, increased ammoniagenesis, and increased proton secretion in the collecting ducts. Hypokalemia can also contribute to persistent metabolic alkalosis by increasing urinary chloride excretion and causing serum hypochloremia.
Posologie
By mouth
3.5 g
Adults
High blood pressure ✪✪✪✪✪
Most clinical research shows that potassium, taken orally as part of the 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 being about 2,340 to 2,540 mg per day. Although potassium supplements and dietary potassium both appear to be beneficial, guidelines recommend obtaining potassium from food sources. Foods that provide at least 350 mg of potassium per serving and are low in sodium, saturated fat, 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 the risk of stroke (CVA). Foods that contain at least 350 mg of potassium and are low in sodium, saturated fat, and cholesterol may reduce the risk of high blood pressure and stroke. A higher supplemental potassium intake also appears to be associated with a lower risk of stroke, but the results are still preliminary. Some population studies have shown that higher supplemental potassium intake is associated with a 29% reduction in the risk of ischemic stroke. However, supplemental potassium intake is not associated with a lower risk of hemorrhagic stroke. To prevent strokes, a dietary intake of about 75 mEq (about 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 of 994 healthy premenopausal women aged 45 to 49 years, lumbar spine and femoral neck bone mineral density increased with higher potassium intake. A study of 62 healthy women aged 45 to 55 years found 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) Administration of potassium bicarbonate to 18 postmenopausal women for 18 days reduced urinary excretion of calcium and hydroxyproline and increased serum osteocalcin concentration, indicating a reduction in bone resorption and an increase in 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 leads to a positive calcium balance. By reducing calcium excretion, a high potassium intake may also reduce the risk of kidney stones.nn
Posologie
Oral
3.5 g
Adults
Properties
Cardiovascular
The relationship between intracellular and extracellular potassium is important for determining the electrophysiological properties of the cardiac conduction tissue. Hypokalemia can cause prolonged repolarization, a pathogenic factor for torsades de pointes (a particular type of ventricular tachycardia), particularly in patients with ischemic heart disease, heart failure, and left ventricular hypertrophy. In heart failure patients, potassium balance is often disturbed. A reduction in serum potassium concentrations can increase the likelihood of arrhythmias. Correction of 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 concluded that food supplements containing potassium can contribute to the normal functioning of the nervous system, to the normal functioning of muscles and neuromuscular transmission, and to the maintenance of normal blood pressure.
Usages associés
Antihypertensive
A restriction of sodium intake accompanied by an increase in potassium intake has been recommended to prevent hypertension and cardiovascular disease. nnThe large international study of electrolytes and blood pressure (Intersalt) showed that potassium intake, as assessed by 24-hour urinary potassium excretion, was an important independent determinant of population blood pressure. An increase of 30 to 45 mmol in potassium intake was associated with an average reduction in the population's systolic blood pressure of 2 to 3 mm Hg. nn
Usages associés
Neurological
The European health authorities (EFSA, European Food Safety Authority and the European Commission) have concluded that dietary supplements containing potassium can claim to contribute to the normal functioning of the nervous system. nnOn the other hand, the main risk factor for stroke is elevated blood pressure. Since 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. nn
Usages associés
Bone density
Increasing potassium intake reduces calcium excretion and results in a positive calcium balance, which may be associated in the longer term with higher bone mass. nn
Usages associés
Safe 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 (18 years and older): 3500 mg
Pregnant woman (18 years and older): 3500 mg
Breastfeeding woman (18 years and older): 4000 mg
Interactions
Médicaments
Antihypertensive agents: moderate interaction
Angiotensin-converting enzyme inhibitors reduce potassium excretion; concomitant potassium intake may increase the risk of hyperkalemia.
Diuretics: moderate interaction
Concurrent use of potassium-sparing diuretics with potassium supplements increases the risk of hyperkalemia. In addition, loop and thiazide diuretics increase urinary potassium excretion.
Amphotericin B: strong interaction
Amphotericin B increases urinary potassium losses due to toxic effects on the renal tubular epithelium. Hypokalemia can occur in up to 50% of patients.
Plantes ou autres actifs
Potassium: moderate interaction
In some individuals, potassium supplementation may decrease vitamin B12 absorption and consequently lead to a deficiency.
Contraindications
Digestive disorders: contraindicated
Oral potassium tablets and capsules are contraindicated in people with disorders of gastrointestinal motility.nn
Renal insufficiency: contraindicated
Potassium supplementation can be dangerous in patients with renal insufficiency due to the risk of potassium accumulation leading to hyperkalemia.nn
