Electrolytes are a frequent topic of conversation, and a huge source of confusion in Ketogenic circles. Kimmi Katte is one of our fantastic Ketogenic Lifestyle Coaches, as well as a Clinical Nutritionist in Australia, and she has been kind enough to address the various electrolytes, why we need them on keto, and where to start with supplementation. Take it away, Coach Kimmi!

Why Is Potassium Considered to Be an Essential Mineral?

Like sodium and magnesium, potassium is another essential mineral that can become depleted when we are in a state of ketosis. It is involved in many important processes in the body including, but not limited to:

• Blood pressure control
• Facilitation of hormone production (FSH, ADH, and aldosterone)
• Smooth muscle function
• Muscle contraction, nerve and heart function
• Protein synthesis
• Hydration homeostasis
• Bone mass protection

Pretty important stuff.

What Can Interfere with or Change Potassium Metabolism?

There are several conditions or factors that may alter (increase OR decrease) the demand for dietary potassium:

• Hypomagnesemia (low magnesium)
• Adrenal stress
• Intense physical activity
• Cortisone therapy
• Ketosis
•  Excessive diarrhea and vomiting
•  Aging
• Excess intake of sodium, coffee, tea, alcohol, sugar
• Laxative abuse 
• Liver disease
• Any kind of renal disease
• Cushing’s syndrome
• Heart failure
• Bartter’s syndrome
• Paget’s disease
• Addison's disease

Some common medications and classes of medications affect potassium retention, absorption, and/or utilization. Examples include, but are not limited to:

• Digoxin (Lanoxin)
• ACE inhibitors
• Beta-blockers
• Diuretics
• Pain relievers
• NSAID’s
• Steroids
• Antimicrobials
• Beta2 –receptor agonists
• Insulin
• Mineralocorticoids and glucocorticoids
• Theophylline

How Do I Figure Out My Potassium Requirements?

1. Are you retaining or excreting potassium?
   • The big question when it comes to potassium is not whether you need it (it’s an essential mineral, remember?), but whether you are holding onto it or excreting it. As you can see from the lists above, there are many factors that alter potassium requirements, so how can you tell if you are in a situation where your body is handling potassium in an unusual way? The first step would be to talk to your suitably qualified doctor about any medications you’re currently taking, as well as any you’ve taken in the past that may alter potassium handling in the body. While you’re there, ask about any health conditions you might have that alter potassium metabolism. If your doctor tells you that your body handles potassium differently than the “regular” person, it's time to get individualised advice from him/her about how to ensure your potassium levels don’t drop too low or get too high. Both situations are quite dangerous and can have far-reaching implications for your health. Please consider a visit to your doctor before embarking on potassium supplementation. There. You’ve been warned.
2. What does low potassium look like? Many of these signs and symptoms can be an indication to get a medical evaluation, so if you’re concerned please do that. 
   • Weakness, or cramping of the muscles
   • Myalgia
   • Fatigue
   • Tingling or numbness
   • Nausea or vomiting
   • Abdominal cramping, bloating
   • Constipation
   • Arrhythmias or palpitations
   • Passing large amounts of urine or feeling thirsty most of the time, and this is probably the more common sign of being low on both sodium and potassium. It’s also a huge flag for diabetes, so if you are concerned, please get medical advice
   • Hypotension
   • In some people, unexplained or easy bruising can indicate low potassium
   • A potassium deficiency can also lead to unusual psychological behavior, like a worsening of depression, confusion, or hallucinations
3. How much potassium do people need? (Don't neglect step one!)
   • Most people need to get somewhere between 3500mg and 4700mg of potassium a day, however some individuals may fall outside of that range for a variety of reasons. If you start to experience some symptoms of low potassium, it might be time to think about increasing your intake.
4. How to bump potassium intake? (Don't neglect step one!)
   • Best sources of potassium in fatty foods:
     • Pumpkin seeds – ¼ cup = 236mg
     • Sunflower seeds – ¼ cup = 225mg
     • Hemp seeds – ¼ cup = 480mg
   • Best sources of potassium in protein:
     • Bacon – 3.5oz (100g) = 565mg
     • Powdered egg whites – 1oz (28g) = 322mg
     • Pork – 3.5oz (100g) = 360mg
     • Beef – 3.5oz (100g) = 269mg
     • Salmon – 3.5oz (100g) = 628mg
     • Trout - 3.5oz (100g) = 450mg
   • Best sources of potassium in carbohdyrates are as follows:
     • Beet greens (cooked) – 1 cup = 1309mg
     • Swiss chard / silverbeet (cooked) – 1 cup = 960mg
     • Spinach (cooked) – 1 cup = 839mg
     • Kale (cooked) – 1 cup = 296mg
     • Avocado (mashed) – 1 cup = 807mg
     • Mushrooms (sliced, cooked) – 1 cup = 555mg
     • Fresh raw parsley – 1 cup = 332mg
   • Other sources of potassium:
     • Lite Salt / Lo-Salt (contain sodum chloride and potassium chloride) – ¼ teaspoon = 325mg
     • Morton Salt Substitute (contains primarily potassium chloride) – ¼ teaspoon = 604mg
     • Potassium citrate – ¼ teaspoon = 483mg

Editor's note: Due to the myriad of medications and/or medical conditions that affect potassium retention and utilization, we at Ketogenic Success do not typically recommend potassium supplementation with over the counter remedies without the supervision of a physician, which is why there are a multitude of warnings in the piece above admonishing you to have a proper medical evaluation and assessment of your health and medications before fiddling with this mineral. It is always best to get your potassium from healthy, keto friendly food sources, unless otherwise directed by your doctor.

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