Potassium supplementation with potassium gluconate solution is superior to blood pressure medication

It is a little-known fact that potassium gluconate solution has a very mild taste.  Four small (45ml) drinks of this a day can provide 2.4 grams of potassium a day, approximately doubling the potassium intake.

When combined with general (not obsessive) avoidance of the saltiest food, the normally very low (below 1.0) dietary potassium to sodium ratio can be doubled or tripled to a level which will reduce or eliminate blood pressure problems for most of the population.  This will also greatly reduce the risk of stroke and other diseases.

I am not a doctor
so my views on the matter should not affect anyone's decisions.  What counts here is the research articles I link to.  Please read the initial section of the COVID-19 page ../ for the Disclaimer and other background information - and see my notes below on the dangers of raising blood potassium levels too quickly.

Robin Whittle rw@firstpr.com.au .   2020-03-21  Last update 2020-06-23 14:20 UTC.

The updates/ page lists all the significant updates to these cv19 pages.

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This page does not involve any suggestion that people stop taking their blood pressure medication, except under their doctor's advice.  My aim here is long-term - to raise awareness among doctors and nurses that there is a practical, palatable, way of solving the low potassium to sodium ratio problem, also referred to as the high sodium to potassium ratio problem.  Almost everyone thinks that all potassium salts are too strong tasting to be used in solution.  They don't know about potassium gluconate.

There is controversy about the potential ill-effects of blood pressure medication on COVID-19 patients:


All blood pressure drugs have undesirable side effects.  It would not be surprising if some of these drugs lead to worse outcomes with COVID-19 or other diseases.

Maximising the potassium to sodium ratio

Most or all hypertension drugs are unnecessary, since for most or all people, the underlying cause of hypertension is dietary: inadequate potassium and excessive salt.  It seems that we become more sensitive to this as we age.

Increasing the potassium to sodium ratio is well-known to be the best way to reduce hypertension, the risk of stroke, cardiovascular disease etc. 

Dozens of widely cited articles confirm this, such as:

Recently, several studies suggested that the ratio of sodium to potassium intakes represented a more important risk factor for hypertension and CVD than each factor alone.

(After converting mols to mass and expressing ratios as K/Na in mass.) 

Prehistoric sodium consumption may have been as low as just 0.17 grams per day, and potassium consumption is thought to have been as high as 7.8 to 11.7 grams per day.  As a consequence, the human genome has been selected, within this environment, to provide an appetite for sodium consumption along with its retention.  However, because of the abundance of potassium in the prehistoric diet, no such mechanisms have evolved in its case.

A large international cross-sectional study performed in the 1980s demonstrated daily sodium excretion to be as high as 4.1 grams daily and potassium excretion to be as low as 0.91 grams in some populations.  [A ratio of 2.2.  Excretion is the same as consumption, and is easier to measure.]

Weighted means of all participating centers yields average daily excretion for sodium and potassium of 2.65 grams and 2.15 grams, respectively. These values give a potassium to sodium ratio 0.81 compared with an estimated value of approximately 46 for the prehistoric diet.

Although rare in the modern world, there are small populations of traditional hunter-gatherer societies subsisting on diets of traditional unrefined foods and which yield potassium to sodium ratios comparable with those of the prehistoric diet. Within such societies, individuals do not exhibit a rise in blood pressure with age and the incidence of hypertension overall is <1%; stroke is similarly rare.

Among the randomized controlled trials reviewed, the sodium-to-potassium ratio appears to be more strongly associated with blood pressure outcomes than either sodium or potassium alone in hypertensive adult populations.

Patients with elevated blood pressure may benefit from increased potassium intake along with controlled or decreased sodium intake.

Dietary Na-K ratio assessed by a 3-day weighing dietary record was a significant risk factor for mortality from haemorrhagic stroke, all stroke, CVD and all causes among a Japanese population.

Na:K intake is an independent predictor of stroke risk.

According to the 2013 article, our bodies evolved with a potassium to sodium dietary ratio (by mass) of about 46, while modern diets on average provide a ratio of 0.81.  No-one is suggesting we need such a high ratio now, since our ancestors struggled to get enough salt.  However, a ratio of 2 or 3 would enable every cell in our body to achieve a much better potassium to sodium balance than is possible with unsupplemented, unaltered, modern diets.

Potassium supplementation with potassium gluconate solution

Potassium entering the bloodstream from the intestine is rapidly stored in the cytoplasm of all cells, to maintain a high concentration within the cell and a low concentration outside.  Sodium is pumped out of the cells and into the interstitial fluid and circulating plasma.  The resulting voltage and ionic gradients across the cell membrane of all cells provides the energy for many transmembrane processes.

2.4 grams of potassium is required to approximately double the daily intake.  The US RDA used to be 4.7 grams.  The "adequate" intakes (ods.od.nih.gov/factsheets/Potassium-HealthProfessional/) are now 3.4 grams for men and 2.6 grams for women.  However, this is based on highest median intakes for supposedly "healthy" adults - and most Western adults going into their 50s and 60s suffer from hypertension, while stroke kills lots of people younger than this.   Most people in Western societies (and in many other countries with modern diets) aged 50 and beyond, are not at all healthy.

Salt is hard to avoid, and to maintain potassium to sodium ratios more like those of our ancestors, we need a lot more potassium than is available in most diets.  According to academic.oup.com/ajcn/article/96/3/647/4576899 60% of US adults consumed more than 3 grams of sodium a day, which is twice the recommended maximum, while the median potassium intake was only 2.6 grams.

Potassium can't be ingested as tablets, since there is a limit of about 100mg per tablet due to potential problems with the capsule or tablet becoming stuck.  Therefore, it must be in food and/or a supplemental solution. 

To get sufficient potassium in food would be difficult, since it would involve much more potatoes, bananas etc. than most people want to eat, or could sustain due to their high caloric value.  See: blog.watson-inc.com/nutri-knowledge/what-does-4700-mg-of-potassium-look-like .

It is generally believed that potassium solutions can't be used since all potassium salts have a very strong taste.  However, this is untrue.  Potassium gluconate has a mild taste. 

An 8.2% solution (86 grams per litre) tastes about as strong as 0.5% table salt (sodium chloride).  Seawater is about 3.5%.  This is based on the assessment of my wife Tina and I, and of a few friends.  Its taste is much milder than other potassium salts, as noted here:

Potassium: promising yet problematic (2015)

Achieving a "good source" of potassium, currently at least 350 mg per serving, or even "excellent source," at least 700 mg, is possible in such products as dairy products, fortified beverages, infant formula, nutritional products, prepared foods and baked foods, said Rocio Aramburo, market development manager, health and nutrition, for Jungbunzlauer, Inc., Newton Center, Mass.

"Potassium gluconate displays a slightly bitter taste," she said. "However, it also offers specific taste advantages over other potassium salts, and it is particularly favorable in matrixes and beverages."

The sensory profile of potassium gluconate fits better with fruity flavors.

Four 45 gram drinks per day gives about 2,400mg potassium. (Recipe below.) My wife Tina and I have been taking this for several years.  We avoid the saltiest foods but otherwise do not obsess about it.  We are 64 and 55 and our blood pressure is not elevated, even by recently lowered standards.

This requires about 9kg potassium gluconate per annum for the two of us.  It can be obtained in smaller quantities in Australia (including Now brand via eBay).  We get ours from PureBulk in the USA for about USD$22 per kilogram, ex-freight.  Our most recent annual order, during a sale, with freight to Australia, cost USD$307.

A 2001 book by Richard D. Moore MD PhD contains a comprehensive discussion of potassium and sodium metabolism:  The High Blood Pressure Solution (Amazon).  Hypertension is the cause of some illnesses, but it is also an indicator of cellular potassium - sodium imbalance. 

Dr Moore advocated high potassium foods rather than supplements, but these foods contain a lot of carbohydrates.  He does not mention potassium gluconate, so I think it was not widely available in the late 1990s. 

Some hypertension drugs lower blood pressure by mechanisms which improve the body's potassium-sodium balance, such as by reducing potassium excretion.  Others lower it without fixing the potassium sodium balance at all, by mechanisms such as relaxing blood capillaries.   Increasing potassium and/or decreasing sodium in the diet improves the body's whole potassium - sodium balance, and so enables all systems in the body to work better.

Some people with impaired kidney function or other medical conditions or who are taking particular drugs (such as spironolactone) should not take potassium supplements.  If you are considering doing so, please check with your doctor first.  They may be opposed to potassium supplementation because it is not a standard part of Western medicine.  For insurance and other reasons, most doctors stick very closely to conventional practices.  I hope this web page will convince them that for most people, potassium supplementation is safe and desirable.   Tina and I take it for general health, and we find ourselves somewhat calmer using it. 

Unlike hypertension drugs, no-one makes much profit from potassium gluconate.  It is produced primarily as a food additive - so you won't see it advertised anywhere.  Meanwhile drugs are constantly promoted to doctors - and many of their patients think that drugs are magic bullets which will fix the intended problem without significant ill-effects.

Making your own potassium gluconate solution at home

Please take responsibility for your nutritional choices after assessing all the information above and all you can find elsewhere.  I am just an electronic technician.  Ideally your doctor or nurse can evaluate this information and advise you reliably.

People taking blood pressure medication should not use potassium supplements except as directed by their doctor.  These drugs interfere with sodium and potassium metabolism in various ways, and the dosage assumes a normal, unhealthily low, potassium intake.

It is best to start with small doses of potassium since the body may not at first be able to store the potassium in the cells, which is where most of it must go.  High potassium levels in the blood can lead to heart problems and death, so it is important not to ingest too large an amount at once.  And all doctors are warned of the dangers of introducing too much potassium intravenously.  Still, raising dietary potassium has profound health benefits without any of the ill-effects of anti-hypertensive drugs. 

600mg potassium (about the same as in two bananas) per drink is probably a safe maximum, but start with 1/3 or 1/4 of this in case your body needs time to adapt to higher potassium intakes.

Potential dangers of raising potassium levels in the blood too quickly - especially for people who have had bariatric surgery

The water solution is instantly available to the intestines and will go into the bloodstream more rapidly than potassium contained in food, such as nuts, sweet potatoes bananas etc.  The drink form, especially on an empty stomach, might raise blood potassium levels too rapidly and so cause potential heart disturbances.

Bariatric surgery is likely to make this worse.  For instance, Roux-en-Y surgery - which is widely used in the USA for weight reduction - removes the sphincter which normally regulates flow from the stomach to the intestines.  The stomach is out of circuit - only a little of it remains as a "pouch".  So drinking 600mg of potassium all at once may be dangerous for people with such surgeries - since it is bound to go straight into the intestines, probably within seconds, and so probably raise blood potassium levels much faster than would be the case for people without such surgery.

If you decide to follow my suggestion (remembering you are reading an electronic technician's ideas, not taking the advice of a doctor who has examined you) the problem of overly-high potassium levels can presumably be reduced by sipping each small drink over some period of time, such as 30 minutes.

Here is our recipe.  Four 45 gram drinks provides a total of about 2.4 grams potassium and 12mg boron (see ../#08-boron).

Place 1kg of potassium gluconate in a plastic food container, add 7 grams of borax and shake well.

Add about 86 grams of this mixture to a 1 litre container.  We use a measuring cup, rather than using scales each time.

Add 200ml or so of water and shake vigorously for a few seconds.  Then add the rest of the water.

Cold water is fine, if you shake it well and allow it to sit in the fridge for a few hours to dissolve.  It dissolves more readily in warm to hot water, but we like to keep the solution in the fridge.

We take four drinks a day - breakfast, lunch, dinner and before bed.  Each drink is about 45 grams, using a small measuring cup, though Tina prefers this diluted 2:1 with an equal amount of water. 

Here are the figures:

The mixture is 0.993 potassium gluconate and 0.007 borax.

The total mass of 1 litre of solution with 86 grams of
the mixture and 961 grams of water to fill the container
is 1.047kg, so the solution has a density of 1.047.

The solution is is 8.21% potassium gluconate and 0.67%
borax.  This is 1.37% potassium and 0.076% boron.

A 45 gram (43ml) drink of the solution is 0.0430
of the total 1 litre solution.

otassium           Boron

Potassium gluconate       16.7%   
Borax                                         11.34%

86 grams of the
mixture contains          14,261 mg          68.3 mg 

Each 45 grams of the
solution contains
0.0430 of this, so:          613 mg           2.94 mg

4 such drinks a day =      2,452 mg          11.76 mg

                          Potassium           Boron

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