Excess potassium is eliminated in the urine. However, people who have chronic kidney disease and those who use certain medications can develop abnormally high levels of potassium in their blood a condition called hyperkalemia.

Examples of these medications are angiotensin converting enzyme inhibitors, also known as ACE inhibitors , and potassium-sparing diuretics. Hyperkalemia can occur in these people even when they consume typical amounts of potassium from food.

Hyperkalemia can also develop in people with type 1 diabetes, congestive heart failure , liver disease, or adrenal insufficiency. People at risk of hyperkalemia should talk to their health care providers about how much potassium they can safely get from food, beverages, and supplements.

The National Kidney Disease Education Program has information about food choices that can help lower potassium levels. Yes, some medications may interact with potassium.

Here are a few examples. ACE inhibitors, such as benazepril Lotensin , and angiotensin receptor blockers , such as losartan Cozaar , are used to treat high blood pressure, heart disease, and kidney disease.

They decrease the amount of potassium lost in the urine and can make potassium levels too high, especially in people who have kidney problems. Potassium-sparing diuretics, such as amiloride Midamor and spironolactone Aldactone , are used to treat high blood pressure and congestive heart failure. These medications decrease the amount of potassium lost in the urine and can make potassium levels too high, especially in people who have kidney problems.

Loop diuretics , such as furosemide Lasix and bumetanide Bumex , and thiazide diuretics , such as chlorothiazide Diuril and metolazone Zaroxolyn , are used to treat high blood pressure and edema.

These medications increase the amount of potassium lost in the urine and can cause abnormally low levels of potassium. Tell your doctor, pharmacist , and other health care providers about any dietary supplements and prescription or over-the-counter medicines you take.

They can tell you if the dietary supplements might interact with your medicines or if the medicines might interfere with how your body absorbs , uses, or breaks down nutrients , such as potassium. Foods contain vitamins , minerals, dietary fiber , and other components that benefit health.

In some cases, fortified foods and dietary supplements are useful when it is not possible to meet needs for one or more nutrients for example, during specific life stages such as pregnancy. For more information about building a healthy dietary pattern, see the Dietary Guidelines for Americans and the U.

This fact sheet by the National Institutes of Health NIH Office of Dietary Supplements ODS provides information that should not take the place of medical advice. We encourage you to talk to your health care providers doctor, registered dietitian, pharmacist, etc. about your interest in, questions about, or use of dietary supplements and what may be best for your overall health.

Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice.

Updated: March 22, History of changes to this fact sheet. Potassium Fact Sheet for Consumers. Consumer Datos en español Health Professional Other Resources.

Table of Contents What is potassium and what does it do? How much potassium do I need? What foods provide potassium? What kinds of potassium dietary supplements are available? Am I getting enough potassium? What happens if I don't get enough potassium?

What are some effects of potassium on health? Can potassium be harmful? Does potassium interact with medications or other dietary supplements? Potassium and healthful eating Where can I find out more about potassium? Magnesium depletion can contribute to hypokalemia by increasing urinary potassium losses [ 1 , 33 , 34 ].

It can also increase the risk of cardiac arrhythmias by decreasing intracellular potassium concentrations. In people with hypomagnesemia and hypokalemia, both should be treated concurrently [ 7 ]. Potassium inadequacy can occur with intakes that are below the AI but above the amount required to prevent hypokalemia.

The following groups are more likely than others to have poor potassium status. Potassium is secreted within the colon, and this process is normally balanced by absorption [ 35 ]. Inflammatory bowel diseases are also characterized by chronic diarrhea, which can further increase potassium excretion [ 36 ].

Certain diuretics e. Potassium-sparing diuretics, however, do not increase potassium excretion and can actually cause hyperkalemia. Large doses of laxatives and repeated use of enemas can also cause hypokalemia because they increase losses of potassium in stool.

Pica is the persistent eating of non-nutritive substances, such as clay. When consumed, clay binds potassium in the gastrointestinal tract, which can increase potassium excretion and lead to hypokalemia [ 5 , 31 , 32 ]. Cessation of pica combined with potassium supplementation can restore potassium status and resolve symptoms of potassium deficiency.

This section focuses on four diseases and disorders in which potassium might be involved: hypertension and stroke, kidney stones, bone health, and blood glucose control and type 2 diabetes. Hypertension, a major risk factor for coronary heart disease and stroke, affects almost a third of Americans [ 2 , 37 ].

According to an extensive body of literature, low potassium intakes increase the risk of hypertension, especially when combined with high sodium intakes [ 16 , ]. Higher potassium intakes, in contrast, may help decrease blood pressure, in part by increasing vasodilation and urinary sodium excretion, which in turn reduces plasma volume [ 1 ]; this effect may be most pronounced in salt-sensitive individuals [ 2 , 3 , 5 , 37 , 41 ].

The Dietary Approaches to Stop Hypertension DASH eating pattern, which emphasizes potassium from fruits, vegetables, and low-fat dairy products, lowers systolic blood pressure by an average of 5. The DASH eating pattern provides three times more potassium than the average American diet.

Additional information and sample DASH menu plans are available on the National Heart, Lung, and Blood Institute website. Results from most clinical trials suggest that potassium supplementation reduces blood pressure.

A meta-analysis of 25 randomized controlled trials in 1, participants with hypertension found significant reductions in systolic blood pressure by 4.

The supplements had the greatest effect in patients with hypertension, reducing systolic blood pressure by a mean of 6. Two earlier meta-analyses of 19 trials [ 45 ] and 33 trials [ 46 ] had similar findings.

However, a Cochrane Review of six of the highest-quality trials found nonsignificant reductions in systolic and diastolic blood pressure with potassium supplementation [ 47 ]. In , the Agency for Healthcare Research and Quality AHRQ published a systematic review of the effects of sodium and potassium intakes on chronic disease outcomes and their risk factors [ 48 ].

The authors concluded that, based on observational studies, the associations between dietary potassium intakes and lower blood pressure in adults were inconsistent.

They also found no evidence for an association between potassium intakes and the risk of hypertension. A similar analysis conducted by the NASEM committee that included 16 trials found that potassium supplements significantly lowered systolic blood pressure by a mean of 6.

However, the effects were stronger among studies including participants with hypertension; for studies including only participants without hypertension, the effects were not statistically significant. Based on 13 randomized controlled trials that primarily enrolled patients with hypertension, the AHRQ review found that the use of potassium-containing salt substitutes in place of sodium chloride significantly reduced systolic blood pressure in adults by a mean of 5.

However, reducing sodium intake decreased both systolic and diastolic blood pressure in adults, and increasing potassium intake via food or supplements did not reduce blood pressure any further.

This finding suggests that at least some of the beneficial effects of potassium salt substitutes on blood pressure may be due to the accompanying reduction in sodium intake, rather than the increase in potassium intake.

Higher potassium intakes have been associated with a decreased risk of stroke and possibly other cardiovascular diseases CVDs [ 16 , 49 ]. However, the AHRQ review found inconsistent relationships between potassium intakes and risk of stroke based on 15 observational studies [ 48 ].

Any beneficial effect of potassium on CVD is likely due to its antihypertensive effects. However, some research shows a benefit even when blood pressure is accounted for. These findings suggest that other mechanisms e. FDA has approved the following health claim: "Diets containing foods that are a good source of potassium and that are low in sodium may reduce the risk of high blood pressure and stroke" [ 17 ].

Overall, the evidence suggests that consuming more potassium might have a favorable effect on blood pressure and stroke, and it might also help prevent other forms of CVD.

However, more research on both dietary and supplemental potassium is needed before firm conclusions can be drawn. Kidney stones are most common in people age 40 to 60 [ 52 ].

Stones containing calcium—in the form of calcium oxalate or calcium phosphate—are the most common type of kidney stone.

Low potassium intakes impair calcium reabsorption within the kidney, increasing urinary calcium excretion and potentially causing hypercalciuria and kidney stones [ 16 , 37 ]. Low urinary levels of citrate also contribute to kidney stone development.

Observational studies show inverse associations between dietary potassium intakes and risk of kidney stones. Some research suggests that supplementation with potassium citrate reduces hypercalciuria as well as the risk of kidney stone formation and growth [ 52 , 55 ].

In a clinical trial of 57 patients with at least two kidney stones either calcium oxalate or calcium oxalate plus calcium phosphate over the previous 2 years and hypocitraturia low urinary citrate levels , supplementation with 30—60 mEq potassium citrate providing 1, to 2, mg potassium for 3 years significantly reduced kidney stone formation compared with placebo [ 55 ].

This study was included in a Cochrane Review of seven studies that examined the effects of potassium citrate, potassium-sodium citrate, and potassium-magnesium citrate supplementation on the prevention and treatment of calcium-containing kidney stones in a total of participants, most of whom had calcium oxalate stones [ 52 ].

The potassium citrate salts significantly reduced the risk of new stones and reduced stone size. However, the proposed mechanism involves citrate, not potassium per se; citrate forms complexes with urinary calcium and increases urine pH, inhibiting the formation of calcium oxalate crystals [ 52 , 56 ].

The authors of the AHRQ review [ 48 ] concluded that observational studies suggest an association between higher potassium intakes and lower risk of kidney stones.

However, they also found the evidence insufficient to determine whether potassium supplements are effective because only one trial that addressed this question [ 55 ] met their inclusion criteria.

Additional research is needed to fully understand the potential link between dietary and supplemental potassium and the risk of kidney stones. Observational studies suggest that increased consumption of potassium from fruits and vegetables is associated with increased bone mineral density [ 57 ].

This evidence, combined with evidence from metabolic studies and a few clinical trials, suggests that dietary potassium may improve bone health. The underlying mechanisms are unclear, but one hypothesis is that potassium helps protect bone through its effect on acid-base balance [ 37 ].

Diets that are high in acid-forming foods, such as meats and cereal grains, contribute to metabolic acidosis and might have an adverse effect on bone. Alkaline components in the form of potassium salts potassium bicarbonate or citrate, but not potassium chloride from food or potassium supplements might counter this effect and help preserve bone tissue.

In the Framingham Heart Study for example, higher potassium intake was associated with significantly greater bone mineral density in elderly men and women [ 58 ]. In another study, the DASH eating pattern significantly reduced biochemical markers of bone turnover [ 59 ].

This eating pattern has a lower acid load than typical Western diets and is also high in calcium and magnesium, in addition to potassium, so any independent contribution of potassium cannot be determined.

Only a few clinical trials have examined the effects of potassium supplements on markers of bone health. Potassium supplementation significantly increased bone mineral density at the lumbar spine and bone microarchitecture compared with placebo.

Conversely, a clinical trial in postmenopausal women age 55—65 years found that supplementation with potassium citrate at either Overall, higher intakes of potassium from diets that emphasize fruits and vegetables might improve bone health.

adults [ 64 ]. Although individuals with obesity have an elevated risk of type 2 diabetes, other metabolic factors also play a role. Because potassium is needed for insulin secretion from pancreatic cells, hypokalemia impairs insulin secretion and could lead to glucose intolerance [ 2 ].

This effect has been observed mainly with long-term use of diuretics particularly those containing thiazides or hyperaldosteronism excessive aldosterone production , which both increase urinary potassium losses, but it can occur in healthy individuals as well [ 2 , 10 , 16 , 65 ].

Numerous observational studies of adults have found associations between lower potassium intakes or lower serum or urinary potassium levels and increased rates of fasting glucose, insulin resistance, and type 2 diabetes [ ]. These associations might be stronger in African Americans, who tend to have lower potassium intakes, than in whites [ 68 , 71 ].

For example, one study of 1, adults age 18—30 years without diabetes found that those with urinary potassium levels in the lowest quintile were more than twice as likely to develop type 2 diabetes over 15 years of follow-up than those in the highest quintile [ 68 ]. Among 4, participants from the same study with potassium intake data, African Americans with lower potassium intakes had a significantly greater risk of type 2 diabetes over 20 years of follow-up than those with higher intakes, but this association was not found in whites.

Serum potassium levels were inversely associated with fasting glucose levels in 5, participants age 45—84 years from the Multi-Ethnic Study of Atherosclerosis, but these levels had no significant association with diabetes risk over 8 years of follow-up [ 70 ].

Although observational studies suggest that potassium status is linked to blood glucose control and type 2 diabetes, this association has not been adequately evaluated in clinical trials. In a small clinical trial in 29 African American adults with prediabetes and low to normal serum potassium levels 3.

The findings from studies conducted to date are promising. In healthy people with normal kidney function, high dietary potassium intakes do not pose a health risk because the kidneys eliminate excess amounts in the urine [ 1 ].

Although case reports indicate that very large doses of potassium supplements can cause heart abnormalities and death, the NASEM committee concluded that these reports do not provide sufficient evidence to set a UL [ 11 ].

In addition, there is no evidence that high intakes of potassium cause hyperkalemia in adults with normal kidney function or other adverse effects.

Therefore, the committee did not set a UL for potassium. However, in people with impaired urinary potassium excretion due to chronic kidney disease or the use of certain medications, such as angiotensin converting enzyme ACE inhibitors or potassium-sparing diuretics, even dietary potassium intakes below the AI can cause hyperkalemia [ 11 ].

Hyperkalemia can also occur in people with type 1 diabetes, congestive heart failure, adrenal insufficiency, or liver disease [ 7 ]. Individuals at risk of hyperkalemia should consult a physician or registered dietitian about appropriate potassium intakes from all sources.

Information on low-potassium diets is also available from the National Kidney Disease Education Program. Although hyperkalemia can be asymptomatic, severe cases can cause muscle weakness, paralysis, heart palpitations, paresthesias a burning or prickling sensation in the extremities , and cardiac arrhythmias that could be life threatening [ 1 , 7 ].

Potassium supplements can cause minor gastrointestinal side effects [ 48 ]. Chronic ingestion of doses of potassium supplements e. The use of potassium salts in certain medications has been associated with small-bowel lesions, causing obstruction, hemorrhage, and perforation [ 20 , 74 ]. For this reason, FDA requires some oral drugs providing more than 99 mg of potassium to be labeled with a warning.