Potassium

Last Updated: March 14, 2024

Potassium is essential for normal bodily function. It is obtained in the diet and found in several foods. Potassium-containing drugs are sometimes used to treat certain conditions. Potassium salts (e.g. potassium chloride) are used in reduced-sodium added-potassium salt substitute interventions and in sodium restriction diets to help treat high blood pressure.

Potassium is most often used for

What is potassium?

Potassium, an element essential for maintaining normal cellular function in the body, regulates electrolyte balance, blood pressure, and electrical impulses in nerves and muscle cells.[5][6] The latter is crucial for maintaining contractile function in muscles, including the heart.

Potassium is obtained in the diet and is found in many foods, including fruits, vegetables, legumes, meat, and animal products (milk, yogurt, etc.).[1][3] In the USA, the adequate intake (AI) for potassium — the amount assumed to ensure nutritional adequacy — in adults without known health conditions is 3,400 mg/day in males and 2,600 mg/day in females, but the AI changes with age and during pregnancy (see the Dosage Information section).[1][3]

The potassium concentration in the blood is tightly regulated within a range of 3.5 to 4.5 millimoles per liter of blood (mmol/L).[5][7][6] Several factors can push blood potassium concentrations outside this range. These include dietary potassium intake, some drugs (e.g., insulin, diuretics, and potassium binders), and certain clinical conditions (e.g., chronic kidney disease and diabetic ketoacidosis).[5][7][6][8][9] Blood potassium concentrations outside the healthy reference range — hyperkalemia (high blood potassium[10]) and hypokalemia (low blood potassium[11]) — are problematic because they’re associated with an increased risk of heart problems (e.g., heart arrhythmias) or dying from a cardiovascular event.[12][13][14][15][16][17]

What are potassium’s main benefits?

Some studies have shown that short-term daily supplementation with a potassium salt (e.g., potassium chloride or potassium citrate) can lower blood pressure in adults without known health conditions[18] and in people with hypertension.[19][20] While early systematic reviews and meta-analyses found that the evidence was mixed and that there was large variability in effects between studies,[21] it now appears that supplementation with a potassium salt can cause a moderate and meaningful effect to lower blood pressure.[22][23] However, the blood-pressure-lowering effect of potassium is likely to be greatest in people with lower potassium intake at baseline, higher sodium intake at baseline, or in people who don’t use a blood-pressure-lowering medication.[23][24]

Observational studies find a correlation between higher levels of daily dietary potassium intake and a reduced risk of stroke and cardiovascular disease.[25][26] [27][28] However, because these studies estimate dietary potassium intake from food recall questionnaires, the direct protective effect of dietary potassium on cerebrovascular or cardiovascular risk cannot currently be proven.

Observational studies also show an association between higher levels of daily dietary potassium intake and better bone health.[29][30] Furthermore, randomized controlled trials show that supplementation with potassium improves aspects of bone metabolism in postmenopausal women with osteopenia[31][32] and in older adults with osteoporosis.[33][34] However, it is currently unclear whether supplementation with potassium prevents bone loss in such people.

Potassium-containing drugs — e.g., potassium chloride, potassium gluconate, potassium bicarbonate, potassium acetate, etc. — are used to treat low blood potassium (hypokalemia). Other potassium-containing drugs are also used clinically. For example, potassium citrate is used to treat some kidney defects, and potassium phosphate is used in the treatment and prevention of low blood phosphorus (hypophosphatemia).

What are potassium’s main drawbacks?

A high blood potassium concentration — hyperkalemia[10] — is associated with an increased risk of heart problems (e.g., heart arrhythmias).[14][15][16][17] Hyperkalemia-related symptoms have been associated with salt substitutes in several case studies,[35][36][37][38][39] but case studies of individual people only show what is possible rather than what is typical.

In people without known health conditions, serum potassium concentrations are between 3.5 and 4.5 millimoles per liter of blood (mmol/L).[5][7][6] A meta-analysis of randomized controlled trials found that daily supplementation with potassium chloride in the range of 22 to 140 mmol/day — equivalent to approximately 0.9 to 5.5 grams/day of potassium — caused a statistically significant but clinically meaningless increase (+0.14 mmol/L) in serum potassium.[4] Therefore, generally, supplementation with potassium is unlikely to cause hyperkalemia. Furthermore, in potassium supplementation studies, adverse effects are uncommon and biomarkers of renal function (urinary and serum sodium and creatinine) are typically unaffected.[4]

While supplementation with potassium salts (e.g. potassium chloride) can improve (i.e., lower) blood pressure,[18][19][20][22][23] some evidence shows that very high doses might increase blood pressure.[24] Consequently, if you use a potassium salt to treat high blood pressure, always use the dose recommended by your doctor.

How does potassium work?

The potassium concentration in the blood is primarily regulated by the kidneys, where potassium channels (protein structures that pass potassium ions across cell membranes) in the cells of the distal tubules regulate potassium excretion in the urine.[40][5][6] Distribution of potassium within the body’s tissues is regulated by insulin, catecholamines (e.g., noradrenaline and adrenaline), and aldosterone.[5][6]

There is a steep gradient between the potassium concentration in the blood (i.e., the extracellular potassium concentration: 3.5 to 4.5 millimoles per liter, or mmol/L) and the potassium concentration in the cells (the intracellular concentration: 120 to 140 mmol/L). This gradient is critical for maintaining normal function in every cell in the body because it helps potassium ions constantly cross the cell membrane that separates the blood from the cell, generating a membrane potential. This vitally important membrane potential drives electrical impulses in neurons and contractions in muscle cells.[5][6]

This gradient is maintained by the potassium channels found in cell membranes. One of the most important is the sodium-potassium ATPase pump, which is found in every cell in the body and uses energy — adenosine triphosphate (ATP) — to maintain the potassium (and sodium) gradient across the cell membrane.[5][6]

The correlation between higher daily dietary potassium intake and a reduced risk of stroke and cardiovascular disease[25][26] [27][28] is likely explained by the blood-pressure-lowering effect of potassium.[22][23] While some evidence shows that potassium intake causes natriuresis — increased sodium excretion in the urine — and reduces vascular resistance,[6][22][41] it is not precisely understood how supplementation with potassium lowers blood pressure.

What else is Potassium known as?
Note that Potassium is also known as:
  • Kalium
  • K+
Dosage information

The adequate intake (AI) for potassium in people without known health conditions — i.e., the daily amount assumed to ensure nutritional adequacy — is as follows:[1]

AgeMaleFemalePregnantLactating
Birth to 6 months400 mg/day400 mg/day--
Infants 7–12 months860 mg/day860 mg/day--
Children 1–3 years2000 mg/day2000 mg/day--
Children 4–8 years2300 mg/day2300 mg/day--
Children 9–13 years2500 mg/day2300 mg/day--
Teens 14–18 years3000 mg/day2300 mg/day2600 mg/day2500 mg/day
Adult 19–50 years3400 mg/day2600 mg/day2900 mg/day2800 mg/day
Adult 51+ years3400 mg/day2600 mg/day--

Some evidence suggests that dietary potassium insufficiency might be common: the global mean potassium intake has been estimated at 2250 mg/day, with only 35% of adults estimated to be achieving adequate intakes.[2]

Potassium is found in many foods, including fruits, vegetables, legumes, meat, and animal products.[1][3] Consult the FoodData Central database to check the amount of potassium in the foods you eat.

Potassium supplements are generally safe for consumption and are unlikely to cause adverse effects if used within the recommended dosage.[4]

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References
  1. ^Dietary Reference Intakes for Sodium and Potassium(2019-03)
  2. ^Reddin C, Ferguson J, Murphy R, Clarke A, Judge C, Griffith V, Alvarez A, Smyth A, Mente A, Yusuf S, O'Donnell MJGlobal mean potassium intake: a systematic review and Bayesian meta-analysis.Eur J Nutr.(2023-Aug)
  3. ^Potassium: Fact Sheet for Health Professionals; USA: National Institutes of Health (NIH) Office of Dietary Supplements (ODS); last updated June 2022; cited February 2024(2022 June)
  4. ^Francesco P Cappuccio, Laura A Buchanan, Chen Ji, Alfonso Siani, Michelle A MillerSystematic review and meta-analysis of randomised controlled trials on the effects of potassium supplements on serum potassium and creatinineBMJ Open.(2016 Aug 26)
  5. ^Palmer BF, Clegg DJPhysiology and pathophysiology of potassium homeostasis.Adv Physiol Educ.(2016-Dec)
  6. ^Kettritz R, Loffing JPotassium homeostasis - Physiology and pharmacology in a clinical context.Pharmacol Ther.(2023-Sep)
  7. ^O'Donnell M, Yusuf S, Vogt L, Mente A, Messerli FHPotassium intake: the Cinderella electrolyte.Eur Heart J.(2023-Dec-14)
  8. ^Romagnani P, Remuzzi G, Glassock R, Levin A, Jager KJ, Tonelli M, Massy Z, Wanner C, Anders HJChronic kidney disease.Nat Rev Dis Primers.(2017-Nov-23)
  9. ^Dhatariya KK, Glaser NS, Codner E, Umpierrez GEDiabetic ketoacidosis.Nat Rev Dis Primers.(2020-May-14)
  10. ^Krishnan SK, Lepor NEAcute and Chronic Cardiovascular Effects of Hyperkalemia: New Insights Into Prevention and Clinical Management.Rev Cardiovasc Med.(2016)
  11. ^Coca SG, Perazella MA, Buller GKThe cardiovascular implications of hypokalemia.Am J Kidney Dis.(2005-Feb)
  12. ^Farah R, Nassar M, Aboraya B, Nseir WLow serum potassium levels are associated with the risk of atrial fibrillation.Acta Cardiol.(2021-Oct)
  13. ^Sorraya N, Farrokhzad A, Hassani B, Talebi SAssociation between serum potassium and risk of all-cause mortality among chronic kidney diseases patients: A systematic review and dose-response meta-analysis of more than one million participants.Food Sci Nutr.(2021-Sep)
  14. ^Xi H, Yu RH, Wang N, Chen XZ, Zhang WC, Hong TSerum potassium levels and mortality of patients with acute myocardial infarction: A systematic review and meta-analysis of cohort studies.Eur J Prev Cardiol.(2019-Jan)
  15. ^Hoppe LK, Muhlack DC, Koenig W, Carr PR, Brenner H, Schöttker BAssociation of Abnormal Serum Potassium Levels with Arrhythmias and Cardiovascular Mortality: a Systematic Review and Meta-Analysis of Observational Studies.Cardiovasc Drugs Ther.(2018-Apr)
  16. ^Miriam Giovanna Colombo, Inge Kirchberger, Ute Amann, Lisa Dinser, Christa MeisingerAssociation of serum potassium concentration with mortality and ventricular arrhythmias in patients with acute myocardial infarction: A systematic review and meta-analysisEur J Prev Cardiol.(2018 Apr)
  17. ^Yahui Fan, Min Wu, Xiaohui Li, Jinping Zhao, Jia Shi, Lu Ding, Hong Jiang, Zhaofang Li, Wei Zhang, Tianyou Ma, Duolao Wang, Le MaPotassium levels and the risk of all-cause and cardiovascular mortality among patients with cardiovascular diseases: a meta-analysis of cohort studiesNutr J.(2024 Jan 10)
  18. ^Braschi A, Naismith DJThe effect of a dietary supplement of potassium chloride or potassium citrate on blood pressure in predominantly normotensive volunteers.Br J Nutr.(2008-Jun)
  19. ^Feng J He, Nirmala D Markandu, Rosemary Coltart, Jeffrey Barron, Graham A MacGregorEffect of short-term supplementation of potassium chloride and potassium citrate on blood pressure in hypertensivesHypertension.(2005 Apr)
  20. ^S R Smith, P E Klotman, L P SvetkeyPotassium chloride lowers blood pressure and causes natriuresis in older patients with hypertensionJ Am Soc Nephrol.(1992 Feb)
  21. ^H O Dickinson, D J Nicolson, F Campbell, F R Beyer, J MasonPotassium supplementation for the management of primary hypertension in adultsCochrane Database Syst Rev.(2006 Jul 19)
  22. ^Jalal Poorolajal, Fatemeh Zeraati, Ali Reza Soltanian, Vida Sheikh, Elham Hooshmand, Akram MalekiOral potassium supplementation for management of essential hypertension: A meta-analysis of randomized controlled trialsPLoS One.(2017 Apr 18)
  23. ^Filippini T, Violi F, D'Amico R, Vinceti MThe effect of potassium supplementation on blood pressure in hypertensive subjects: A systematic review and meta-analysis.Int J Cardiol.(2017-Mar-01)
  24. ^Filippini T, Naska A, Kasdagli MI, Torres D, Lopes C, Carvalho C, Moreira P, Malavolti M, Orsini N, Whelton PK, Vinceti MPotassium Intake and Blood Pressure: A Dose-Response Meta-Analysis of Randomized Controlled Trials.J Am Heart Assoc.(2020-06-16)
  25. ^D'Elia L, Barba G, Cappuccio FP, Strazzullo PPotassium intake, stroke, and cardiovascular disease a meta-analysis of prospective studies.J Am Coll Cardiol.(2011-Mar-08)
  26. ^Marco Vinceti, Tommaso Filippini, Alessio Crippa, Agnès de Sesmaisons, Lauren A Wise, Nicola OrsiniMeta-Analysis of Potassium Intake and the Risk of StrokeJ Am Heart Assoc.(2016 Oct 6)
  27. ^Fan Y, Wu M, Ding L, Ji H, Zhao J, Li X, Li Z, Liu S, Jiang H, Shi J, Lei H, Wang M, Wang D, Ma LPotassium status and the risk of type 2 diabetes, cardiovascular diseases, and mortality: a meta-analysis of prospective observational studies.Crit Rev Food Sci Nutr.(2023-Oct-03)
  28. ^Nancy J Aburto, Sara Hanson, Hialy Gutierrez, Lee Hooper, Paul Elliott, Francesco P CappuccioEffect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analysesBMJ.(2013 Apr 3)
  29. ^Kong SH, Kim JH, Hong AR, Lee JH, Kim SW, Shin CSDietary potassium intake is beneficial to bone health in a low calcium intake population: the Korean National Health and Nutrition Examination Survey (KNHANES) (2008-2011).Osteoporos Int.(2017-May)
  30. ^Ha J, Kim SA, Lim K, Shin SThe association of potassium intake with bone mineral density and the prevalence of osteoporosis among older Korean adults.Nutr Res Pract.(2020-Feb)
  31. ^Gregory NS, Kumar R, Stein EM, Alexander E, Christos P, Bockman RS, Rodman JSPOTASSIUM CITRATE DECREASES BONE RESORPTION IN POSTMENOPAUSAL WOMEN WITH OSTEOPENIA: A RANDOMIZED, DOUBLE-BLIND CLINICAL TRIAL.Endocr Pract.(2015-Dec)
  32. ^Granchi D, Caudarella R, Ripamonti C, Spinnato P, Bazzocchi A, Massa A, Baldini NPotassium Citrate Supplementation Decreases the Biochemical Markers of Bone Loss in a Group of Osteopenic Women: The Results of a Randomized, Double-Blind, Placebo-Controlled Pilot Study.Nutrients.(2018-Sep-12)
  33. ^H Lambert, L Frassetto, J B Moore, D Torgerson, R Gannon, P Burckhardt, S Lanham-NewThe effect of supplementation with alkaline potassium salts on bone metabolism: a meta-analysisOsteoporos Int.(2015 Apr)
  34. ^Dawson-Hughes B, Harris SS, Palermo NJ, Gilhooly CH, Shea MK, Fielding RA, Ceglia LPotassium Bicarbonate Supplementation Lowers Bone Turnover and Calcium Excretion in Older Men and Women: A Randomized Dose-Finding Trial.J Bone Miner Res.(2015-Nov)
  35. ^Schim van der Loeff HJ, Strack van Schijndel RJ, Thijs LGCardiac arrest due to oral potassium intake.Intensive Care Med.(1988)
  36. ^Hoyt REHyperkalemia due to salt substitutes.JAMA.(1986-Oct-03)
  37. ^C J Doorenbos, C G VermeijDanger of salt substitutes that contain potassium in patients with renal failureBMJ.(2003 Jan 4)
  38. ^K Ray, S Dorman, R WatsonSevere hyperkalaemia due to the concomitant use of salt substitutes and ACE inhibitors in hypertension: a potentially life threatening interactionJ Hum Hypertens.(1999 Oct)
  39. ^Wetli CV, Davis JHFatal hyperkalemia from accidental overdose of potassium chloride.JAMA.(1978-Sep-22)
  40. ^Palygin O, Pochynyuk O, Staruschenko ADistal tubule basolateral potassium channels: cellular and molecular mechanisms of regulation.Curr Opin Nephrol Hypertens.(2018-Sep)
  41. ^Buemi M, Senatore M, Corica F, Aloisi C, Romeo A, Tramontana D, Frisina NDiet and arterial hypertension: is the sodium ion alone important?Med Res Rev.(2002-Jul)
  42. ^Bruce Neal, Yangfeng Wu, Xiangxian Feng, Ruijuan Zhang, Yuhong Zhang, Jingpu Shi, Jianxin Zhang, Maoyi Tian, Liping Huang, Zhifang Li, Yan Yu, Yi Zhao, Bo Zhou, Jixin Sun, Yishu Liu, Xuejun Yin, Zhixin Hao, Jie Yu, Ka-Chun Li, Xinyi Zhang, Peifen Duan, Faxuan Wang, Bing Ma, Weiwei Shi, Gian Luca Di Tanna, Sandrine Stepien, Sana Shan, Sallie-Anne Pearson, Nicole Li, Lijing L Yan, Darwin Labarthe, Paul ElliottEffect of Salt Substitution on Cardiovascular Events and DeathN Engl J Med.(2021 Sep 16)
  43. ^Tsai YC, Tsao YP, Huang CJ, Tai YH, Su YC, Chiang CE, Sung SH, Chen CH, Cheng HMEffectiveness of salt substitute on cardiovascular outcomes: A systematic review and meta-analysis.J Clin Hypertens (Greenwich).(2022-Sep)
  44. ^Yu J, Thout SR, Li Q, Tian M, Marklund M, Arnott C, Huffman MD, Praveen D, Johnson C, Huang L, Pettigrew S, Neal B, Wu JHYEffects of a reduced-sodium added-potassium salt substitute on blood pressure in rural Indian hypertensive patients: a randomized, double-blind, controlled trial.Am J Clin Nutr.(2021-Jul-01)
  45. ^Zhou B, Webster J, Fu LY, Wang HL, Wu XM, Wang WL, Shi JPIntake of low sodium salt substitute for 3years attenuates the increase in blood pressure in a rural population of North China - A randomized controlled trial.Int J Cardiol.(2016-Jul-15)
  46. ^Zhao X, Yin X, Li X, Yan LL, Lam CT, Li S, He F, Xie W, Sang B, Luobu G, Ke L, Wu YUsing a low-sodium, high-potassium salt substitute to reduce blood pressure among Tibetans with high blood pressure: a patient-blinded randomized controlled trial.PLoS One.(2014)
  47. ^Hao Sun, Bing Ma, Xiaomei Wu, Hailong Wang, Bo ZhouLong-Term Effect of Salt Substitute on All-Cause and Cardiovascular Disease Mortality: An Exploratory Follow-Up of a Randomized Controlled TrialFront Cardiovasc Med.(2021 May 17)
  48. ^Maria Lukács Krogager, Kristian Kragholm, Jesper Qvist Thomassen, Peter Søgaard, Basil S Lewis, Sven Wassmann, Iris Baumgartner, Claudio Ceconi, Thomas Andersen Schmidt, Juan Carlos Kaski, Heinz Drexel, Anne Grete Semb, Stefan Agewall, Alexander Niessner, Gianluigi Savarese, Keld Per Kjeldsen, Claudio Borghi, Juan Tamargo, Christian Torp-PedersenUpdate on management of hypokalaemia and goals for the lower potassium level in patients with cardiovascular disease: a review in collaboration with the European Society of Cardiology Working Group on Cardiovascular PharmacotherapyEur Heart J Cardiovasc Pharmacother.(2021 Nov 3)
  49. ^Kardalas E, Paschou SA, Anagnostis P, Muscogiuri G, Siasos G, Vryonidou AHypokalemia: a clinical update.Endocr Connect.(2018-Apr)
  50. ^Murray D, Miller KC, Edwards JEDoes a Reduction in Serum Sodium Concentration or Serum Potassium Concentration Increase the Prevalence of Exercise-Associated Muscle Cramps?J Sport Rehabil.(2016-Aug)
  51. ^FoodData Central: Bananas, ripe and slightly ripe, raw; U.S. Department of Agriculture, Agricultural Research Service; updated 1 Apr 2020; cited Feb 2024(2020 April)
  52. ^FoodData Central Search Results for Potassium; U.S. Department of Agriculture, Agricultural Research Service; updated 1 April 2020; cited Feb 2024(2020 April)
  53. ^Miller KCPlasma potassium concentration and content changes after banana ingestion in exercised men.J Athl Train.(2012)
Examine Database References
  1. Bone Mineral Density - H Lambert, L Frassetto, J B Moore, D Torgerson, R Gannon, P Burckhardt, S Lanham-NewThe effect of supplementation with alkaline potassium salts on bone metabolism: a meta-analysisOsteoporos Int.(2015 Apr)
  2. Blood Pressure - Filippini T, Violi F, D'Amico R, Vinceti MThe effect of potassium supplementation on blood pressure in hypertensive subjects: A systematic review and meta-analysis.Int J Cardiol.(2017-Mar-01)
  3. Blood Pressure - Jalal Poorolajal, Fatemeh Zeraati, Ali Reza Soltanian, Vida Sheikh, Elham Hooshmand, Akram MalekiOral potassium supplementation for management of essential hypertension: A meta-analysis of randomized controlled trialsPLoS One.(2017 Apr 18)