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Avoid hypokalemia: Eat high-potassium foods and take magnesium


Altostrata

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As with magnesium, the body needs sufficient potassium to maintain good functioning, neurological and otherwise.

 

People having difficulty going off drugs or post-acute withdrawal syndrome may be vulnerable to subclinical or more severe hypokalemia, since withdrawal syndrome stresses the adrenals and may cause nausea, excessive urination, and other potassium-wasting reactions. People who are older are also more susceptible to low potassium.

 

Rather than taking a potassium supplement, eating potassium-containing foods every day is the best way to correct mild hypokalemia. To address low potassium, it's best to make sure you're taking enough magnesium as well (see references below).

 

(If you have diagnosed hyperkalemia, or high potassium, you will want to AVOID high-potassium foods.)

 

Your blood test does not have to be markedly abnormal for you to be suffering from low potassium. Even slightly low potassium can cause a wide range of very uncomfortable symptoms, such as
 

Quote

 

Constipation

Feeling of skipped heart beats or palpitations

Fatigue

Muscle damage

Muscle weakness or spasms

Tingling or numbness

 

 

In a nervous system sensitized by withdrawal, these symptoms may be much more severe:

 

https://www.healthline.com/nutrition/potassium-deficiency-symptoms#section5

 

Quote

 

....For example, some evidence shows that a deficiency could impair insulin production, resulting in high blood sugar levels (5)....

 

1. Weakness and Fatigue

 

2. Muscle Cramps and Spasms

 

3. Digestive Problems

 

4. Heart Palpitations

 

5. Muscle Aches and Stiffness

 

6. Tingling and Numbness

Those with potassium deficiency may experience persistent tingles and numbness (18).

This is known as paresthesia and usually occurs in the hands, arms, legs and feet (19).

Potassium is important for healthy nerve function. Low blood levels of potassium can weaken nerve signals, which may result in tingling and numbness.

...

7. Breathing Difficulties

 

8. Mood Changes

...a study found that 20% of patients with mental disorders had a potassium deficiency (24).

 

The very best way is to get potassium from foods like fruits, vegetables, beans and nuts. Many high-potassium foods are delicious. Be sure to eat some every day.

 

Quote

14 Healthy Foods That Are High in Potassium

 

Potassium is an essential mineral that the body requires for a variety of processes. Since the body can’t produce potassium, it has to come from food.

Unfortunately, the majority of Americans don’t get enough potassium from their diets.

 

A national survey found that only 3% of Americans meet the recommendation for potassium intake. This is largely due to a lack of fruits and vegetables in the typical Western diet (1).

....

 

1. White Beans (and lentils)

2. Potatoes and Sweet Potatoes

3. Beets

4. Parsnips

5. Spinach

6. Swiss Chard

7. Tomato Sauce (and tomato juice)

8. Oranges and Orange Juice (note: orange juice is high in sugar, so not as healthy as the whole fruit)

9. Bananas

10. Avocados

11. Yogurt

12. Clams

13. Salmon

14. Coconut Water

 

More food sources of potassium https://health.gov/dietaryguidelines/2015/guidelines/appendix-10/

 

Also see this journal article

 

From the paper:

 

Quote

Certain diseases, injuries, and specific medications have the potential to affect potassium homeostasis. As a result, small alterations in serum potassium levels can lead to detrimental effects within the body.

....

Table 1 reviews the signs and symptoms of hypokalemia. In mild cases of hypokalemia, patients are usually asymptomatic and are often diagnosed incidentally during routine blood testing. Moderate hypokalemia is often associated with cramping, weakness, malaise, and myalgias. In severe hypokalemia, electrocardiogram (ECG) changes often occur, including ST-segment depression or S-T–segment flattening, T-wave inversion, and/or U-wave elevation. These ECG changes can lead to various arrhythmias, including heart block, atrial flutter, paroxysmal atrial tachycardia, and ventricular fibrillation. Musculoskeletal cramping and impaired muscle contraction are other common manifestations of severe hypokalemia.

Hypomagnesemia, which is present in more than 50% of cases of clinically significant hypokalemia, contributes to the development of hypokalemia by reducing the intracellular potassium concentration and promoting renal potassium wasting. While the exact mechanism of the accelerated renal loss remains unclear, it is theorized that the intracellular potassium concentration may decrease because hypomagnesemia impairs the function of the sodium-potassium ATPase pump, thereby promoting potassium wasting. When concomitant hypokalemia and hypomagnesemia exist, the magnesium deficiency should be corrected first; other wise, full repletion of the potassium deficit is difficult to achieve.

....

Medications cause hypokalemia through a variety of mechanisms, including intracellular potassium shifting, increased renal loss, and/or stool loss. Table 2 highlights selected medications associated with hypokalemia. Some published cases have reported an association between antidepressant use and the risk for hypokalemia. This adverse effect may put psychiatric patients at risk.,, Further studies are required to elucidate a possible association between selective serotonin reuptake inhibitors and hypokalemia. ....

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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  • Altostrata changed the title to Avoid hypokalemia: Eat high-potassium foods and take magnesium
  • 3 weeks later...

Thank you so much @Altostrata. This could not come at a better time for me. I recently had a blood test, where my result was 3.2mmol/l (lab range: 3.5 to 4.5). 


I eat a diet exclusively of vegetables, nuts, and some fish and fruit. Since the test I now ensure that my choices are as potassium-rich as possible. My mild hypokalemia may have been due to the fact that I fasted more than 30 hours before the test, I was stressed, tired, and had drunk a lot of water (without taking in salt and loading on potassium before this period or during it). I didn't feel different during this period, aside from normal withdrawal (and in my case from hypothyroidism symptoms). I fast daily anyway, eating usually once a day but this was a longer fast. I would consider my result is likely due to my fasting period, which I should probably avoid during withdrawal:-

 

On 3/5/2019 at 6:44 AM, Altostrata said:

The very best way is to get potassium from foods like fruits, vegetables, beans and nuts. Many high-potassium foods are delicious. Be sure to eat some every day.

 

I have no conditions (beyond a possible link with thyroid disease and thyroid hormone replacement) that could cause hypokalemia that I am aware of. I appear to have very little to no insulin resistance (due to low fasting insulin, glucose, and a low HbA1c) and my kidneys are in excellent health. 

 

Once again, I am dismayed but also not surprised to discover that SSRI withdrawal is a likely cause of my blood test result. A week of investigating every possible avenue and here I am again, facing this monster drug category that ruins lives. However, I take comfort in the fact that if it is due to my poorly-planned fasting period (in the context of hypokalemia), my diet did a pretty good job of not letting the potassium drop much lower than it was.

 

Edited by ChessieCat
unbolded and deunderlined

2012: 2 weeks of paroxetine, I cannot recall the dose. Strong side effects, stopped cold turkey, had intense, horrible withdrawal thereafter

2012 to 2016: Fluoxetine 40mg daily, sometimes 20mg daily, a couple of bad tapers under doctor's advisement, increasingly bad withdrawal symptoms with each major dose change

Oct 2016 to June 2017: 10-month reinstatement of 20mg fluoxetine daily to stabilize. A very difficult period but withdrawal gradually improved

July 2017: At 20mg (100%), started a linear tapering regimen using water titration (20mg fluoxetine into 300ml of water).

June 2019: Currently at 0.200mg (1.00%). I have many symptoms, most I attribute to fluoxetine, some to withdrawal, and the rest to hypothyroidism. Continuing to reduce anyway.

July 2019: Jumped from 0.066mg (0.33%) to 0.000mg (0.00%); I'm now free of the poison.

 

My introduction thread: https://www.survivingantidepressants.org/topic/14226-kittygiggles-generic-prozac-fluoxetine-stabilization/

 

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  • Administrator

If you tend to be low in potassium, by all means, eat lots of potassium-containing foods.

 

There may be nothing wrong with your metabolism, your body simply works on low potassium. Your ancestors might have eaten a lot of beans!

 

My sodium is naturally borderline, once I went into hyponatremia and was very, very ill. (This was after a terrible bout of atrial fibrillation, clearly my body was in distress. I have since had that successfully treated.) I do not stint on salt.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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3 hours ago, Altostrata said:

If you tend to be low in potassium, by all means, eat lots of potassium-containing foods.

 

There may be nothing wrong with your metabolism, your body simply works on low potassium. Your ancestors might have eaten a lot of beans!

 

My sodium is naturally borderline, once I went into hyponatremia and was very, very ill. (This was after a terrible bout of atrial fibrillation, clearly my body was in distress. I have since had that successfully treated.) I do not stint on salt.

 

I am impressed profoundly by your insight and perception. I often wonder what our distant Homo Sapiens ancestors' diet and why modern potassium requirements are established at such a level, including serum ranges. Maybe they should be higher, or lower, or they could be just right as they are. I don't know but I am so happy to read someone's words who imply anthropology is an avenue worthy of further consideration when establishing present day eating habits.

 

I want to express so much gratitude to you but I don't know how not to sound like I'm toadying or being irrational. Thank you for your words. I am a skeptic almost to a fault and I will criticize everything (including myself and my own words) to exceptional detail if I have doubts.

 

As you imply, after all this, it could just be that my potassium can sometimes go low in this period of my life and that is perfectly okay. Maybe my body wants it at that level for some reason, or it was just because I fasted for a longer period than usual. As I am not at risk of hyperkalemia, I'll keep eating a lot of potassium-rich foods, as they are mostly very healthy. I never want to steer into pseudoscience though, and as a lay person, I could easily end up doing that unwittingly. Perhaps I should address my own case on my own thread. 

 

I think your original post is comprehensive. Your second post about your sodium issue is interesting and I tend to think that the threshold for excess sodium consumption is set too low at present for the majority of people; we would probably be much better off adding salt to taste and listening to our bodies. In light of this, I will post these links if you deem them appropriate. It addresses how people on the ketogenic diet, low carbohydrate diets, or people who fast may address balancing electrolytes (with sodium being a major factor):-

 

https://www.reddit.com/r/keto/comments/40mjo6/how_are_you_getting_enough_potassium_during_keto/

https://www.reddit.com/r/keto/comments/91k6pv/low_potassium_er_visit_heart_still/

 

PS Sorry if you consider that I've derailed the thread or have been selfish in my responses, I try to take forum etiquette seriously. Please feel free to edit, move, or delete my posts if they detract from the thread :)

 

Edited by ChessieCat
unbolded

2012: 2 weeks of paroxetine, I cannot recall the dose. Strong side effects, stopped cold turkey, had intense, horrible withdrawal thereafter

2012 to 2016: Fluoxetine 40mg daily, sometimes 20mg daily, a couple of bad tapers under doctor's advisement, increasingly bad withdrawal symptoms with each major dose change

Oct 2016 to June 2017: 10-month reinstatement of 20mg fluoxetine daily to stabilize. A very difficult period but withdrawal gradually improved

July 2017: At 20mg (100%), started a linear tapering regimen using water titration (20mg fluoxetine into 300ml of water).

June 2019: Currently at 0.200mg (1.00%). I have many symptoms, most I attribute to fluoxetine, some to withdrawal, and the rest to hypothyroidism. Continuing to reduce anyway.

July 2019: Jumped from 0.066mg (0.33%) to 0.000mg (0.00%); I'm now free of the poison.

 

My introduction thread: https://www.survivingantidepressants.org/topic/14226-kittygiggles-generic-prozac-fluoxetine-stabilization/

 

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Not sure about keto for all metabolisms -- but thanks!

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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3 hours ago, Altostrata said:

Not sure about keto for all metabolisms -- but thanks!

 

I am not promoting any diet at all and I wouldn't dream of it; I try not to talk about what I eat because diet is so emotive and many people draw conclusions on too little evidence, myself included. It just happened to be an interesting discussion about hypokalemia, meeting daily potassium requirements, and sodium, from a group of people who are on keto, LCHF, or fast. It could apply to anyone really: managing sodium and potassium intake appears to be more complex than it needs to be but so goes anything these days where diets are concerned.

 

Edited by ChessieCat
unbolded

2012: 2 weeks of paroxetine, I cannot recall the dose. Strong side effects, stopped cold turkey, had intense, horrible withdrawal thereafter

2012 to 2016: Fluoxetine 40mg daily, sometimes 20mg daily, a couple of bad tapers under doctor's advisement, increasingly bad withdrawal symptoms with each major dose change

Oct 2016 to June 2017: 10-month reinstatement of 20mg fluoxetine daily to stabilize. A very difficult period but withdrawal gradually improved

July 2017: At 20mg (100%), started a linear tapering regimen using water titration (20mg fluoxetine into 300ml of water).

June 2019: Currently at 0.200mg (1.00%). I have many symptoms, most I attribute to fluoxetine, some to withdrawal, and the rest to hypothyroidism. Continuing to reduce anyway.

July 2019: Jumped from 0.066mg (0.33%) to 0.000mg (0.00%); I'm now free of the poison.

 

My introduction thread: https://www.survivingantidepressants.org/topic/14226-kittygiggles-generic-prozac-fluoxetine-stabilization/

 

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  • 3 years later...

Hello, I’ve been eating a lot of watermelon lately. Because of the sugar would this be bad for withdrawals? Hoping natural sugar is different from processed sugar 

1993 started 20mg Prozac.

2008 switched to 10mg of lexapro.

2015 added 50mg of Wellbutrin. Between 2015 and 2020 raised and lowered dosage of both. 2021 moved to Zoloft for one month then back to lexapro for one month. Then switched to 60mg cymbalta for four months. Then Basically cold turkeyed off cymbalta in two weeks using Prozac as a crossover med to reduce withdrawals. Not good. Then had Nortriptylene added to Prozac. Was on 20mg Prozac and 50mg of Nortriptylene for four months. Then did a four month ween off Nortriptylene. To date have been off cymbalta for approximately 11 months and Nortriptylene 7 weeks.  Presently taking 12.5 mg Prozac. Also taking 10 mg of bystolic for BLood Pressure. I’m not sure how the Prozac makes me feel. It does nothing to make me feel not sad and anxious at times. I finally figured out the meds are not what I need. What I need is to get off the 12.5mg of Prozac and continue to work on my stuff. Any help is deeply appreciated thank you. Reduced from 12.5 to 10 then from 10 to 7.5. Too much of a drop. Bought a scale and went to 9. Stabilized and went to 8.2 oct 1, 2022. Just got hit with wicked low mood, high anxiety, fatigue, chills. The anxiety is high in the AM and  lessons throughout the day. Hoping to stabilize soon 

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2 hours ago, Mezzer said:

Hello, I’ve been eating a lot of watermelon lately. Because of the sugar would this be bad for withdrawals? Hoping natural sugar is different from processed sugar 

Fructose raises insulin levels and causes insulin resistance.  80% of Americans are insulin resistant, it's common and responsible for many health ailments.  It makes it tougher to utilize glucose as fuel and it's implicated in dementia.  It's a good reason to limit sugar and not overdue the fruit.  It's a bummer this time of year.  I'm on keto and miss my sugar and carbs

Recent 2018 Zoloft 150mg  (20 years taking at various times, no real issues before stopping)

2019 Risperdal one month low dose (forget amount) stopped bad reaction

2019 Remeron 7.5 mg sleep  (discontinued in mid 2019) on for six months (tapered for a few weeks)

Zoloft 100 mg Summer 2020/Zoloft 75 mg Summer 2021

Zoloft 50 mg November 2021/ Zoloft 25 mg First two weeks January 2022: Reinstated 50 mgJanuary Last week)

Crash in February - on and off doses as doctors conflicted over serotonin syndrome/withdrawal - stopped all for two week & resumed:\

Other drugs tried in hospitals (Abilify, 1mg, 1 dose, Zyprexa 1 dose 1mg, Klonopin .25 4 doses in 2 hospitalizations)

March 1 titrated Zoloft up from 0 to 65 from February to Early May

Severe vision problems at 65 mg (improved depression)

Taper to 55 6/15, 45mg 7/15/ 35mg 8/1, 25mg 8/15, 10 mg, 8/31 OFF 9/2022 Omg  Improved with drops from August to September - November crash ONE dose Zoloft 3mg 11/17 - worsened symptoms - Remain off Zoloft

Mirtazapine -3.5 mg six weeks mid march to end april, occasionally for sleep

Supplements: Fish oil, magnesium, lions mane, cytokine suppress, MCT Oil

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Thank you my friend. That’s pretty much my only fruit besides bananas. I was eating a lot of it. Only meat and veggies after that. I love it. Quite the bummer 

1993 started 20mg Prozac.

2008 switched to 10mg of lexapro.

2015 added 50mg of Wellbutrin. Between 2015 and 2020 raised and lowered dosage of both. 2021 moved to Zoloft for one month then back to lexapro for one month. Then switched to 60mg cymbalta for four months. Then Basically cold turkeyed off cymbalta in two weeks using Prozac as a crossover med to reduce withdrawals. Not good. Then had Nortriptylene added to Prozac. Was on 20mg Prozac and 50mg of Nortriptylene for four months. Then did a four month ween off Nortriptylene. To date have been off cymbalta for approximately 11 months and Nortriptylene 7 weeks.  Presently taking 12.5 mg Prozac. Also taking 10 mg of bystolic for BLood Pressure. I’m not sure how the Prozac makes me feel. It does nothing to make me feel not sad and anxious at times. I finally figured out the meds are not what I need. What I need is to get off the 12.5mg of Prozac and continue to work on my stuff. Any help is deeply appreciated thank you. Reduced from 12.5 to 10 then from 10 to 7.5. Too much of a drop. Bought a scale and went to 9. Stabilized and went to 8.2 oct 1, 2022. Just got hit with wicked low mood, high anxiety, fatigue, chills. The anxiety is high in the AM and  lessons throughout the day. Hoping to stabilize soon 

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