Potassium is essential for preventing strokes, building muscles, breaking down carbs, maintaining body growth and most importantly maintaining fluid balance in the body. Continue to read more about the various other health benefits of this macromineral.

What is Potassium?

Potassium is an essential mineral vital for the proper functioning of all living cells.

It is one of the most abundant positively charged ions (cation) in the human body [1].

Approximately 98% of the body’s total potassium is found within a cell. It is present in high concentrations in muscles, bone, liver and red blood cells [2].

The remaining 2% of potassium is present outside of a cell, and it is important for maintaining a voltage difference between the inside and outside of a cell.

Concentration difference between potassium inside and outside of a cell is maintained by Na-K-ATPase enzyme that actively pumps potassium into the cell while moving sodium out of the cell [3, 2].

The major functions of potassium are the maintenance of the cell’s membrane potential and regulation of the fluid within the cell [4].

Potassium is important for [4, 5]:

  • muscle contraction
  • nerve impulse transmission
  • normal heart functioning
  • prevention of excessive fluid retention
  • maintenance of proper pH within the body
  • normal growth and muscle building

Potassium is required for the production of carbohydrates, proteins, and energy in the form of adenosine triphosphate (ATP) [6].

A large number of enzymes that participate in several major metabolic processes require the presence of potassium to function properly [7].

Western diets with more processed foods and fewer fruits and vegetables are lower in potassium and higher in sodium. Healthier diets consumed by our ancestors are richer in potassium [8].

Therefore, diets higher in potassium is associated with many positive health outcomes. However, this association may be because diets higher in potassium are generally healthier rather than the higher potassium content itself.

Health Benefits

1) Reduces Blood Pressure

Potassium supplementation lowers arterial blood pressure in humans with essential hypertension (hypertension with unknown causes, which affects 95% of hypertensive patients) [9, 10].

Previous studies have found that potassium may lower blood pressure substantially in hypertensive patients who consume a lot of sodium [11, 12].

A high potassium intake does not or only minimally decreases blood pressure in humans with normal blood pressure [10].

An increase in potassium intake of at least 20 mmol (0.78 g) per day was associated with a significant reduction in systolic blood pressure by 4.9 mm Hg and diastolic pressure by 2.7 mm Hg [13].

The DASH (Dietary Approaches to Stop Hypertension) diet, which is also rich in potassium, resulted in reductions in blood pressure by 5 mm Hg systolic and 3 mm Hg diastolic.

This diet also decreased the risk of coronary heart disease by 20% and stroke by 34% [14, 15].

African Americans have a relatively low intake of potassium and a high prevalence of elevated blood pressure and salt sensitivity. Therefore, they would especially benefit from an increased intake of potassium [16].

Blood pressure-lowering effect of potassium may be related to its diuretic activity, and effects on the nervous system, blood vessels, the renin-angiotensin-aldosterone system, and natriuretic hormone.

Increasing dietary potassium intake from natural foods reduces the need for antihypertensive medication in patients with essential hypertension.

38% of hypertensive patients on the high-potassium diet had well-controlled blood pressure without any need for drug therapy [17].

2) May Protect Against Stroke

Human and animal studies have suggested that increased potassium intake may protect against stroke [18, 19].

The study indicated that an average increase of 1.64 g of potassium per day is associated with a 21% reduced risk of stroke [20].

A 10-mmol increase in daily potassium intake was associated with a 40% reduction in stroke-associated mortality among 859 individuals over the span of 12 years [21, 22].

A greater fruit and vegetable intake protects against the occurrence of stroke. More than 5 servings of fruit and vegetables per day are associated with a 26% lower rate of stroke compared with 3 or fewer servings [23].

A lower blood potassium level in both diuretic users and those not taking diuretics was associated with increased stroke incidence among older individuals [24].

3) Might Reduce the Risk of Cardiovascular Disease

A number of animal studies confirmed that increased potassium intake protects against cardiovascular disease [25].

The balance between potassium and sodium is more strongly associated with an increased risk of cardiovascular disease than either sodium or potassium intake alone [26].

Patients with congestive heart failure should routinely be given potassium supplementation, a potassium-sparing diuretic, or an angiotensin-converting enzyme inhibitor, even if their initial potassium measurement is normal (4.0 mmol/l) [22].

The National Health and Nutrition Examination Survey (NHANES) III, a study of 12,267 US adults, showed that higher potassium intake was associated with a lower cardiovascular and all-cause risk of dying [22].

High dietary potassium intake in Japanese men and women is associated with a lower risk of dying from coronary heart disease and total cardiovascular disease [27].

On the other hand, some studies show no association between potassium intake and the risks of coronary heart disease and cardiovascular death [28, 29].

4) May Decrease the Risk of Diabetes

Potassium is important for insulin secretion from the pancreatic cells [11, 30].

Low potassium intake or blood potassium level is associated with an increased risk for insulin resistance and diabetes, especially in African Americans and those on thiazide diuretic treatment [11, 30, 31, 32, 33].

Potassium depletion studies show that low serum potassium decreases glucose tolerance associated with reduced insulin secretion [34], and lead to marked alterations in glucose metabolism [35].

Studies show that high potassium intake is associated with a 39% reduced risk of metabolic syndrome in both men and women [36].

5) May Benefit the Kidney

Studies in hypertensive rats showed that a high potassium intake prevented vascular, glomerular, and tubular damage of kidneys [37, 38].

Study of 13,917 participants from NHANES, suggested that higher dietary intake of potassium is associated with la ower incidence of chronic kidney disease [39].

The beneficial effects of dietary potassium on vascular lesions are not only through decreases in blood pressure but also through non-blood pressure pathways.

Potassium supplementation can reduce kidney inflammation leading to a regression of chronic kidney disease [40].

Chronic potassium depletion causes kidney functional and structural changes, interstitial nephritis (inflammation of the kidney), or cyst formation in animals and humans [41, 42, 43, 44].

Concurrent supplementation with potassium and magnesium protects kidneys from cyclosporine-induced kidney damage [45].

6) Reduces the Risk of Kidney Stones

Studies have shown that both men and women taking higher doses of potassium had a 50% lower risk of developing symptomatic kidney stones [46, 47].

Increasing dietary or supplemental potassium intake has been found to decrease calcium excretion in urine. Low levels of calcium in the urine decrease the risk of developing kidney stones [48, 49].

Potassium citrate is effective in reducing the stone size and symptoms of kidney stones not only in adults but also in children on a ketogenic diet [50, 51, 52].

7) Decreases the Risk of Osteoporosis

Increased intake of food rich in potassium, mainly fruits, and vegetables, is associated with a higher bone mineral density and prevents osteoporosis [53, 54, 55].

Supplementation with potassium is associated with an increased rate of bone formation and decreased bone degradation [56, 57].

In postmenopausal women, treatment with potassium bicarbonate for 18 days [56] and combined treatment with potassium citrate and calcium citrate for 3 months reduces bone loss, especially in women on a high salt diet [58, 59].

8) Defends Against the Loss of Muscle Mass

Higher intake of foods rich in potassium may favor the preservation of muscle mass in older men and women [60].

In elderly with dietary deficiency of potassium, increased intake had anti-aging effects [61].

Potassium-rich foods relieve an acidic environment in the body caused by eating the typical Western diet that is rich in meat, dairy, and processed food, and protect from loss of bone density and muscle wasting [60].

9) Has an Antioxidant Activity

Increase in potassium concentration blocks dangerous oxygen species formation by blood vessel cells or white blood cells.

Dietary potassium may protect against cardiovascular damage through its antioxidant effects [62].

Potassium supplementation prevents the development of autoimmune and inflammatory diseases. It has a blocking effect on interleukin IL-17A production in T lymphocytes [63].

10) May Reduce Adverse Effects of Lithium

Lithium is widely used for the treatment of manic-depressive psychosis. The most common toxic side effects are kidney-related, such as [64]:

  • nephrogenic diabetes insipidus – excessive urination and thirst due to a kidney problem
  • distal tubular acidosis – increased acidity in the body to a malfunction in part of the kidney
  • impairment of the kidney’s ability to concentrate urine

Studies suggest that potassium supplementation protects against nephrogenic diabetes insipidus by decreasing the reabsorption of lithium from the kidneys [65].

Potassium also increases the elimination of lithium from the tissues, protecting against the potentially toxic accumulation of lithium [65].

11) May Prevent Alzheimer’s Disease Onset

An increase in potassium intake may be important in the prevention of Alzheimer’s disease onset as a non-pharmacological therapy [66].

Increased potassium intake leads to a change in the aggregation of the amyloid-beta peptide in brain tissues, improvement in the cognitive performance, and a decrease in markers related to inflammation and oxidative stress [66].

12) Might Decrease Severity of Gum Disease

High consumption of potassium might decrease periodontitis (gum disease) severity.

The beneficial effect of the intake of potassium-rich fruit and vegetables on periodontitis might be related to their roles in inflammation or oxidative stress [67].

An alcohol-free mouth rinse containing 1.4% potassium oxalate significantly reduced tooth sensitivity [68].

13) Helps with Rheumatoid Arthritis Pain

High-level potassium supplementation helps reduce pain from rheumatoid arthritis (69).

Nearly half of those who took 6,000 mg of potassium daily for 28 days reported a 33% reduction in their arthritis pain intensity. Another one-third of the participants reported a moderate decrease in pain [69].

Higher potassium intake leads to elevated blood cortisol production and secretion, which alleviates rheumatoid arthritis symptoms [70].

14) Reduces Risk of Death from Severe Protein Deficiency

The high potassium supplementation reduced the risk of death in kwashiorkor (a form of severe protein malnutrition).

This may be due to an improved heart and immune function from earlier depletion of potassium [71].

Sources, Bioavailability, Dosage, Deficiency & Side Effects

Major food sources containing potassium are fruit (bananas, dried apricots, prunes, dates, avocados, cantaloupe, citruses), vegetables (dark leafy greens, potatoes, tomatoes, squash), legumes (especially beans), mushrooms, dairy, nuts, and fish [72, 6].

Potassium-containing supplements are available in the form of salts: gluconate, citrate, chloride, bicarbonate, and acetate.

They are commonly used to treat low levels of potassium in patients who do not have enough potassium in their regular diet or have lost potassium due to illness or treatment with certain medication.

Supplemental potassium should be provided under medical supervision due to potential toxicity [73, 74].


Approximately 90% of dietary potassium is absorbed in the small intestine by passive diffusion [4].

The potassium is primarily balanced by kidney excretion in urine. Approximately 80 – 90% is excreted in urine, while the remainder is excreted mainly in feces, with much smaller amounts being lost in sweat [75].

Because it is easily excreted by the kidneys rather than stored in the body, humans need constantly consume potassium.


Recommended adequate intake of potassium for adults is set at 4.7 g/day [76].

In individuals whose kidney function is impaired, a potassium intake below 4.7 g/day is appropriate because of irregular heart rhythm from the resulting elevated blood potassium concentration [76].


Even though the Western diet has led to a diet low in potassium, potassium deficiency rarely occurs through the inadequate intake of dietary potassium [8].

Presently, less than 3% of the population have total potassium intakes that exceeded the adequate intake of potassium. The average intake by adults is approximately 2.2 – 3.3 g/day [77].

Potassium deficiency can develop as a consequence of increasing losses through the gut (prolonged vomiting or diarrhea) or kidneys (Fanconi syndrome, Cushing’s syndrome, Conn’s syndrome, treatment with diuretics, amphotericin B, cisplatin, theophylline) [6].

Symptoms of potassium deficiency include muscle weakness and cramps, fatigue, irritability, abdominal pain, and constipation. Mental disturbances, e.g. depression and confusion, can also develop.

Severely decreased potassium levels may lead to muscle injury, paralysis, abnormal heart rhythms and impaired respiration that can be fatal [78].

Side effects

There are no reports of adverse effects associated with potassium naturally occurring in food in healthy individuals [79].

Abdominal discomfort has been reported with slow-release and wax matrix formulations as well as oral solutions of potassium salts, but not with potassium from the diet [80].

Potassium chloride irritates upper digestive tract especially in association with delayed stomach emptying. Lesions and ulcerations of the gut lining have been seen [81, 82].

In patients with impaired kidney function or those who take potassium-sparing diuretics, angiotensin receptor blockers, or angiotensin-converting enzyme inhibitors, high potassium intakes from diet and potassium-containing salt substitutes may lead to high potassium in the blood and life-threatening abnormal heart rhythms [83].


In patients with chronic kidney failure, potassium supplementation must be considered carefully because kidneys are the major regulator of potassium balance [6, 84].

Patients with a previous history of ulcers and bleeding must be considered carefully for oral potassium supplementation because some potassium salts can be irritating to the gut lining [6, 84].

Serum Potassium

Serum potassium is the amount of potassium in the fluid portion of the blood (serum).

The normal range for serum potassium is narrow (3.5 to 5.5 mmol/L), and minor departure from this range (by less than 1.0 mmol/L) is associated with a significant risk of disease and dying [85].

The distribution of potassium between the intracellular and extracellular fluids can markedly affect the serum potassium level without a change in total body potassium [86].

Hypokalemia is defined as a serum potassium concentration of less than 3.5 mmol/L.

It may be caused by the entry of potassium into cells (regulated by insulin, acid-base status, aldosterone, and catecholamines), and a total body depletion of potassium due to kidney, gut, or sweat losses.

Although poor intake is an uncommon cause, patients with extremely poor dietary intake (alcoholics) and patients on severe weight-reduction programs are in danger of developing severe potassium deficiency [86, 2, 85, 87].

Hyperkalemia is defined as a serum potassium concentration above 5.5 mmol/L. Serum potassium above 6.5 mEq/L is associated with a significant risk of death and should be handled as an emergency.

It occurs in kidney failure, adrenal gland insufficiency, and massive tissue damage such as in trauma, marked destruction of red blood cells, and in the tumor lysis syndrome [86, 2, 85, 87].

Pseudohyperkalemia is a rise in serum potassium concentration with actual normal plasma potassium concentration.

In pseudohyperkalemia, no toxic manifestation of hyperkalemia is present and no emergency therapy is required because the elevation of serum potassium concentration does not reflect the actual level of plasma potassium in the body.

It is caused by the destruction of red blood cells in the blood sample, prolonged application of a tourniquet or excessive fist clenching when drawing venous blood. Thrombocytosis (elevated platelets) and extreme leukocytosis (elevated white blood cells) can cause pseudohyperkalemia in serum [2, 88].

Both hypokalemia and hyperkalemia may cause asymptomatic changes in electrocardiogram, abnormal heart rhythms, muscle weakness, and death [2].


Irregular Potassium Levels?

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