Editing Potassium (section)

===Nutrition===

====Dietary recommendations====
===== North America =====
The U.S. [[National Academy of Medicine]] (NAM), on behalf of both the U.S. and Canada, sets [[Dietary Reference Intake]]s, including Estimated Average Requirements (EARs) and Recommended Dietary Allowances (RDAs), or [[Adequate Intake]]s (AIs) for when there is not sufficient information to set EARs and RDAs.

For both males and females under 9 years of age, the AIs for potassium are: 400{{nbsp}}mg of potassium for 0 to 6-month-old infants, 860{{nbsp}}mg of potassium for 7 to 12-month-old infants, 2,000{{nbsp}}mg of potassium for 1 to 3-year-old children, and 2,300{{nbsp}}mg of potassium for 4 to 8-year-old children.

For males 9 years of age and older, the AIs for potassium are: 2,500{{nbsp}}mg of potassium for 9 to 13-year-old males, 3,000{{nbsp}}mg of potassium for 14 to 18-year-old males, and 3,400{{nbsp}}mg for males that are 19 years of age and older.

For females 9 years of age and older, the AIs for potassium are: 2,300{{nbsp}}mg of potassium for 9 to 18-year-old females, and 2,600{{nbsp}}mg of potassium for females that are 19 years of age and older.

For pregnant and lactating females, the AIs for potassium are: 2,600{{nbsp}}mg of potassium for 14 to 18-year-old pregnant females, 2,900{{nbsp}}mg for pregnant females that are 19 years of age and older; furthermore, 2,500{{nbsp}}mg of potassium for 14 to 18-year-old lactating females, and 2,800{{nbsp}}mg for lactating females that are 19 years of age and older. As for safety, the NAM also sets [[tolerable upper intake level]]s (ULs) for vitamins and minerals, but for potassium the evidence was insufficient, so no UL was established.<ref>{{cite book |author=National Academies of Sciences, Engineering and Medicine |editor3-first=Maria |editor3-last=Oria |editor2-first=Meghan |editor2-last=Harrison |editor1-first=Virginia A |editor1-last=Stallings |date=2019 |title=Dietary Reference Intakes for Sodium and Potassium |location=Washington, DC |publisher=The National Academies Press |chapter=Potassium: Dietary Reference Intakes for Adequacy |chapter-url=https://www.nap.edu/read/25353/chapter/8 |isbn=978-0-309-48834-1 |doi=10.17226/25353 |doi-access=free |pmid=30844154 |access-date=2019-05-13 |archive-date=2019-05-13 |archive-url=https://web.archive.org/web/20190513200758/https://www.nap.edu/read/25353/chapter/8 |url-status=live }}</ref><ref>{{cite book |url=http://www.nationalacademies.org/hmd/Reports/2019/dietary-reference-intakes-sodium-potassium.aspx |title=Dietary Reference Intakes for Sodium and Potassium – Publication |date=March 5, 2019 |website=Health and Medicine Division |publisher=National Academies of Sciences, Engineering and Medicine |doi=10.17226/25353 |pmid=30844154 |isbn=978-0-309-48834-1 |s2cid=104464967 |access-date=May 13, 2019 |editor1-last=Stallings |editor1-first=Virginia A |editor2-first=Meghan |editor2-last=Harrison |editor3-first=Maria |editor3-last=Oria |archive-date=May 9, 2019 |archive-url=https://web.archive.org/web/20190509031658/http://www.nationalacademies.org/hmd/Reports/2019/dietary-reference-intakes-sodium-potassium.aspx |url-status=live }}</ref>

As of 2004, most Americans adults consume less than 3,000{{nbsp}}mg.<ref name="iom_panel2005">{{cite book|author=Panel on Dietary Reference Intakes for Electrolytes and Water, Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition|title=DRI, dietary reference intakes for water, potassium, sodium, chloride, and sulfate|date=2004|publisher=National Academies Press|location=Washington, D.C.|isbn=978-0-309-53049-1|url=http://www.iom.edu/Reports/2004/Dietary-Reference-Intakes-Water-Potassium-Sodium-Chloride-and-Sulfate.aspx|url-status=dead|archive-url=https://web.archive.org/web/20111006174858/http://www.iom.edu/Reports/2004/Dietary-Reference-Intakes-Water-Potassium-Sodium-Chloride-and-Sulfate.aspx|archive-date=2011-10-06}}</ref>

===== Europe =====
Likewise, in the European Union, in particular in Germany, and Italy, insufficient potassium intake is somewhat common.<ref>{{cite journal|last=Karger|first=S.|journal=Annals of Nutrition and Metabolism|year=2004|volume=48|issue=2 (suppl) |pages=1–16 |title=Energy and nutrient intake in the European Union|doi=10.1159/000083041|doi-access=free}}</ref> 

The [[National Health Service]] in the United Kingdom recommends a similar intake, saying that "adults (19 to 64 years) need {{val|3500|u=mg}} per day" and that excess amounts may cause health problems such as stomach pain and [[diarrhea]].<ref>{{cite web | title=Vitamins and minerals | website=[[National Health Service]] (NHS) | date=18 November 2021 | url=https://www.nhs.uk/conditions/vitamins-and-minerals/others/ | access-date=13 November 2022 | archive-date=3 April 2019 | archive-url=https://web.archive.org/web/20190403142101/https://www.nhs.uk/conditions/vitamins-and-minerals/others/ | url-status=live }}</ref>

====Food sources====
Potassium is present in all fruits, vegetables, meat and fish. Foods with high potassium concentrations include [[Yam (vegetable)|yam]], [[parsley]], dried [[apricot]]s, [[milk]], [[chocolate]], all [[nut (fruit)|nuts]] (especially [[almond]]s and [[pistachio]]s), [[potato]]es, [[bamboo shoot]]s, [[banana]]s, [[avocado]]s, [[coconut water]], [[soybean]]s, and [[bran]].<ref>{{cite web| url = http://apjcn.nhri.org.tw/server/info/books-phds/books/foodfacts/html/data/data5b.html|title = Potassium Food Charts|publisher =Asia Pacific Journal of Clinical Nutrition|access-date = 2011-05-18|archive-url=https://web.archive.org/web/20210429215547/http://apjcn.nhri.org.tw/server/info/books-phds/books/foodfacts/html/data/data5b.html|archive-date=2021-04-29}}</ref>

The  [[United States Department of Agriculture]] also lists [[tomato paste]], [[orange juice]], [[beet greens]], [[white beans]], [[Cooking banana|plantains]], and many other dietary sources of potassium, ranked in descending order according to potassium content. A day's worth of potassium is in 5 plantains or 11 bananas.<ref>{{cite news|title=Potassium Content of Selected Foods per Common Measure, sorted by nutrient content |publisher=USDA National Nutrient Database for Standard Reference, Release 20 |url=http://www.nal.usda.gov/fnic/foodcomp/Data/SR20/nutrlist/sr20w306.pdf |url-status=dead |archive-url=https://web.archive.org/web/20081217043521/http://www.nal.usda.gov/fnic/foodcomp/Data/SR20/nutrlist/sr20w306.pdf |archive-date=December 17, 2008 }}</ref>

====Deficient intake====
{{main|Hypokalemia}}
Mild hypokalemia does not cause distinct symptoms acting instead as a risk factor for [[hypertension]]<ref>{{cite journal |vauthors=Whelton PK, He J, Cutler JA, Brancati FL, Appel LJ, Follmann D, Klag MJ |title=Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials |journal=JAMA |volume=277 |issue=20 |pages=1624–32 |year=1997 |pmid=9168293 |doi=10.1001/jama.1997.03540440058033 |s2cid=25937399 }}</ref><ref name=":0">{{cite journal | last1 = Krishna | first1 = GG | last2 = Miller | first2 = E | last3 = Kapoor | first3 = S | title = Increased blood pressure during potassium depletion in normotensive men | journal = The New England Journal of Medicine | volume = 320 | issue = 18 | pages = 1177–82 | year = 1989 | pmid = 2624617| doi = 10.1056/NEJM198905043201804 }}</ref> and [[cardiac arrhythmia]].<ref name=EU2010>{{cite journal|last1=Soar| first1=J|last2=Perkins|first2=GD| last3=Abbas|first3=G|last4=Alfonzo|first4=A|last5=Barelli| first5=A|last6=Bierens|first6=JJ| last7=Brugger|first7=H|last8=Deakin|first8=CD|last9=Dunning|first9=J|last10=Georgiou|first10=M| last11=Handley|first11=AJ|last12=Lockey| first12=DJ|last13=Paal|first13=P|last14=Sandroni|first14=C| last15=Thies|first15=KC|last16=Zideman|first16=DA|last17=Nolan|first17=JP|title=European Resuscitation Council Guidelines for Resuscitation 2010 Section 8. Cardiac arrest in special circumstances: Electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution.|journal=Resuscitation|date=October 2010| volume=81|issue=10|pages=1400–33|pmid=20956045| doi=10.1016/j.resuscitation.2010.08.015}}</ref>
Severe hypokalemia usually presents with [[hypertension]], [[arrhythmia]], [[muscle cramps]], [[fatigue (medical)|fatigue]], [[weakness]] and [[constipation]].<ref name=EU2010/>
Causes of hypokalemia include vomiting, [[diarrhea]], medications like [[furosemide]] and [[steroid]]s, [[Kidney dialysis|dialysis]], [[diabetes insipidus]], [[hyperaldosteronism]], [[hypomagnesemia]].<ref name=EU2010/>

====Supplementation====
Supplements of potassium are most widely used in conjunction with [[diuretic]]s that block reabsorption of sodium and water upstream from the [[distal tubule]] ([[thiazide]]s and [[loop diuretics]]), because this promotes increased distal tubular potassium secretion, with resultant increased potassium excretion.<ref>{{Cite journal |last1=Horisberger |first1=Jean-Daniel |last2=Giebisch |first2=Gerhard |date=1987 |title=Potassium-Sparing Diuretics |url=https://karger.com/KBR/article/doi/10.1159/000173130 |journal=Kidney and Blood Pressure Research |language=en |volume=10 |issue=3–4 |pages=198–220 |doi=10.1159/000173130 |pmid=2455308 |issn=1420-4096 |archive-date=2024-07-12 |access-date=2024-07-19 |archive-url=https://web.archive.org/web/20240712015613/https://karger.com/KBR/article/doi/10.1159/000173130 |url-status=dead }}</ref> A variety of prescription and over-the counter supplements are available.<ref>{{Cite web |last1=Ng |first1=Kimberly |last2=Lee |first2=Chung-Shie |date=February 16, 2017 |title=Updated Treatment Options in the Management of Hyperkalemia |url=https://www.uspharmacist.com/article/updated-treatment-options-in-the-management-of-hyperkalemia |access-date=2024-07-19 |website=US Pharmacist |language=en}}</ref> Potassium chloride may be dissolved in water, but the salty/bitter taste makes liquid supplements unpalatable.<ref name="bitter" /><ref>{{Cite journal |last1=Benge |first1=Cassandra D. |last2=Burka |first2=Abigail T. |date=2020 |title=Oral Liquid Potassium Chloride Dosing Pathway in a Tertiary Care Veteran Affairs Academic Medical Center |url=https://journals.lww.com/10.1097/HPC.0000000000000197 |journal=Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine |language=en |volume=19 |issue=1 |pages=18–21 |doi=10.1097/HPC.0000000000000197 |pmid=31478945 |issn=1535-282X}}</ref>  Potassium is also available in tablets or capsules, which are formulated to allow potassium to leach slowly out of a matrix, since very high concentrations of potassium ion that occur adjacent to a solid tablet can injure the gastric or intestinal mucosa.<ref name=BNF69/><ref>{{Cite journal |last1=Gueta |first1=Itai |last2=Markovits |first2=Noa |last3=Halkin |first3=Hillel |last4=Loebstein |first4=Ronen |date=2021 |title=Concomitant oral potassium chloride and anticholinergic therapy is associated with upper gastrointestinal bleeding: A cohort study |url=https://bpspubs.onlinelibrary.wiley.com/doi/10.1111/bcp.14616 |journal=British Journal of Clinical Pharmacology |language=en |volume=87 |issue=4 |pages=2064–2069 |doi=10.1111/bcp.14616 |pmid=33068044 |issn=0306-5251}}</ref> For this reason, non-prescription potassium pills are limited by law in the US to a maximum of 99{{nbsp}}mg of potassium.<ref>{{Cite web |date=June 2, 2022 |title=Potassium - Fact Sheet for Health Professionals |url=https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/ |access-date=2024-07-19 |website=National Institutes of Health (NIH) Office of Dietary Supplements (ODS) |language=en}}</ref>

Potassium supplementation can also be combined with other metabolites, such as citrate or chloride, to achieve specific clinical effects.<ref name="pmid38333496">{{cite journal |vauthors=Keller CL, Jones NT, Abadie RB, Barham W, Behara R, Patil S, Paladini A, Ahmadzadeh S, Shekoohi S, Varrassi G, Kaye AD |title=Non-steroidal Anti-inflammatory Drug (NSAID)-, Potassium Supplement-, Bisphosphonate-, and Doxycycline-Mediated Peptic Ulcer Effects: A Narrative Review |journal=Cureus |volume=16 |issue=1 |pages=e51894 |date=January 2024 |pmid=38333496 |pmc=10849936 |doi=10.7759/cureus.51894 |doi-access=free |url=}}</ref>

Potassium supplements may be employed to mitigate the impact of hypertension, thereby reducing cardiovascular risk.<ref>{{cite journal |last1=D'Elia |first1=L. |last2=Barba |first2=G. |last3=Cappuccio |first3=F. |last4=Strazzullo |year=2011 |title=Potassium Intake, Stroke, and Cardiovascular Disease: A Meta-Analysis of Prospective Studies |journal=J Am Coll Cardiol |volume=57 |issue=10 |pages=1210–9 |doi=10.1016/j.jacc.2010.09.070 |pmid=21371638|doi-access=free }}</ref> [[Potassium chloride]] and [[potassium bicarbonate]] may be useful to control mild [[hypertension]].<ref>{{cite journal |vauthors=He FJ, Marciniak M, Carney C, Markandu ND, Anand V, Fraser WD, Dalton RN, Kaski JC, MacGregor GA |title=Effects of potassium chloride and potassium bicarbonate on endothelial function, cardiovascular risk factors, and bone turnover in mild hypertensives |journal=Hypertension |volume=55 |issue=3 |pages=681–8 |year=2010 |pmid=20083724 |doi=10.1161/HYPERTENSIONAHA.109.147488 |doi-access=free }}</ref> In 2020, potassium was the 33rd most commonly prescribed medication in the U.S., with more than 17{{nbsp}}million prescriptions.<ref>{{cite web |title=The Top 300 of 2020 |url=https://clincalc.com/DrugStats/Top300Drugs.aspx |website=ClinCalc |access-date=7 October 2022 |archive-date=12 February 2021 |archive-url=https://web.archive.org/web/20210212142534/https://clincalc.com/DrugStats/Top300Drugs.aspx |url-status=live }}</ref><ref>{{cite web | title=Potassium Chloride - Drug Usage Statistics | website=ClinCalc | url=https://clincalc.com/DrugStats/Drugs/PotassiumChloride | access-date=7 October 2022 | archive-date=8 October 2022 | archive-url=https://web.archive.org/web/20221008035439/https://clincalc.com/DrugStats/Drugs/PotassiumChloride | url-status=live }}</ref> Potassium supplementation has been shown to reduce both systolic and diastolic blood pressure in individuals with essential hypertension.<ref name="pmid38333496"/>

Additionally, potassium supplements may be employed with the aim of preventing the formation of kidney stones, a condition that can lead to renal complications if left untreated. Low potassium levels can lead to decreased calcium reabsorption in the kidneys, increasing the risk of elevated urine calcium and the formation of kidney stones. By maintaining adequate potassium levels, this risk can be reduced.<ref name="pmid38333496"/> 

The mechanism of action of potassium involves various types of transporters and channels that facilitate its movement across cell membranes. This process can lead to an increase in the pumping of hydrogen ions. This, in turn, can escalate the production of gastric acid, potentially contributing to the development of gastric ulcers.<ref name="pmid38333496"/> 

Potassium has a role in bone health. It contributes to the acid-base equilibrium in the body and helps protect bone tissue. Potassium salts produce an alkaline component that can aid in maintaining bone health.<ref name="pmid38333496"/>

For individuals with diabetes, potassium supplementation may be necessary, particularly for those with type 2 diabetes. Potassium is essential for the secretion of insulin by pancreatic beta cells, which helps regulate glucose levels. Without sufficient potassium, insulin secretion is compromised, leading to hyperglycemia and worsening diabetes.<ref name="pmid38333496"/>

Excessive potassium intake can have adverse effects, such as gastrointestinal discomfort and disturbances in heart rhythm.<ref name="pmid38333496"/>

Potassium supplementation can have side effects on ulceration, particularly in relation to peptic ulcer disease. Potassium channels have the potential to increase gastric acid secretion, which can lead to an increased risk of ulcerations. Medications used for peptic ulcer disease, known as "proton pump inhibitors", work by inhibiting potassium pumps that activate the H/K ATPase. This inhibition helps to reduce the secretion of hydrochloric acid into the parietal cell, thereby decreasing acidic synthesis and lowering the risk of ulcers. Nicorandil, a drug used for the treatment of ischemic heart disease, can stimulate nitrate and potassium ATP channels, and as a result, it has been associated with side effects such as GI, oral, and anal ulcers. Potassium chloride tablets are specifically associated with pill esophagitis.<ref>{{Cite journal |last1=Abdi |first1=Saeed |last2=Masbough |first2=Farnoosh |last3=Nazari |first3=Maryam |last4=Abbasinazari |first4=Mohammad |date=2022-06-20 |title=Drug-induced esophagitis and helpful management for healthcare providers |url=https://doi.org/10.22037/ghfbb.v15i3.2591 |journal=Gastroenterology and Hepatology from Bed to Bench |volume=15 |issue=3 |pages=219–224 |doi=10.22037/ghfbb.v15i3.2591 |issn=2008-4234 |pmc=9589134 |pmid=36311965}}</ref> Prolonged and chronic use of potassium supplements has been linked to more severe side effects, including ulcers outside of the gastrointestinal (GI) tract. Close monitoring is necessary for patients who are also taking angiotensinogen-converting enzyme inhibitors, angiotensin receptor blockers, or potassium-sparing diuretics.<ref name="pmid38333496"/>

====Detection by taste buds====
Potassium can be detected by taste because it triggers three of the five types of taste sensations, according to concentration. Dilute solutions of potassium ions taste sweet, allowing moderate concentrations in milk and juices, while higher concentrations become increasingly bitter/alkaline, and finally also salty to the taste. The combined bitterness and saltiness of high-potassium solutions makes high-dose potassium supplementation by liquid drinks a palatability challenge.<ref name="bitter">{{cite book|author1=Institute of Medicine (U.S.). Committee on Optimization of Nutrient Composition of Military Rations for Short-Term, High-Stress Situations|author2=Institute of Medicine (U.S.). Committee on Military Nutrition Research|title=Nutrient composition of rations for short-term, high-intensity combat operations|url=https://books.google.com/books?id=kFatoIBbMboC&pg=PT287|date=2006|publisher=National Academies Press|isbn=978-0-309-09641-6|pages=287–}}</ref><ref>{{cite book|last=Shallenberger|first=R. S. |title=Taste chemistry|url=https://books.google.com/books?id=8_bjyjgClq0C&pg=PA120|date=1993|publisher=Springer|isbn=978-0-7514-0150-9|pages=120–}}</ref> As a food additive, potassium chloride has a salty taste. People wishing to increase their potassium intake or to decrease their sodium intake, after checking with a health professional that it is safe to do so, can substitute potassium chloride for some or all of the sodium chloride (table salt) used in cooking and at the table.<ref>{{Cite journal |last1=Tsai |first1=Yi-Ching |last2=Tsao |first2=Yen-Po |last3=Huang |first3=Chi-Jung |last4=Tai |first4=Yen-Hsuan |last5=Su |first5=Yang-Chin |last6=Chiang |first6=Chern-En |last7=Sung |first7=Shih-Hsien |last8=Chen |first8=Chen-Huan |last9=Cheng |first9=Hao-Min |date=2022 |title=Effectiveness of salt substitute on cardiovascular outcomes: A systematic review and meta-analysis |journal=The Journal of Clinical Hypertension |language=en |volume=24 |issue=9 |pages=1147–1160 |doi=10.1111/jch.14562 |issn=1751-7176 |pmc=9532913 |pmid=36196475}}</ref>