Wednesday, February 27, 2013

Potassium Citrate Supplementation Can Improve Skeletal Health

The typical Western diet, high in sugar, processed food, red meat and cheese, and low in fruits and vegetables, is very acidic. This is not good when it comes to the health of your bones. A diet high in acidic animal protein and low in vegetable protein increases urine calcium loss and contributes to the development of osteoporosis and increases the risk of fracture. Potassium, an alkaline mineral that is plentiful in fruits and vegetables, is perfect for neutralizing acids.

Just how good is potassium at alkalinizing the body? Well, according to the March 2013 issue of the Journal of Bone and Mineral Research, supplementing with potassium citrate has the potential to substantially benefit bone health. In a study by Moseley et al., researchers looked at 52 men and women who were randomly assigned to take potassium citrate 60 mmol/day, 90 mmol/day or placebo. The researchers found that after 6 months the subjects who were taking potassium citrate had reduced 24-hour urine calcium losses and significant reduction in CTX, a biomarker for bone resorption. "Potassium citrate was well-tolerated at doses as high as 90 mmol/d with demonstrably positive effects on the calcium economy." "We show that potassium citrate positively and definitively benefits the calcium economy, relieving the skeleton of its role as a source of base reservoir."

There is often concern that potassium supplementation can lead to elevated blood potassium levels (hyperkalemia) which can cause dangerous heart arrhythmias. It is true that individuals predisposed to hyperkalemia, such as those with type 1 diabetes or kidney disease, should use extra caution when considering the use of supplements with extra potassium (i.e. it is always good to talk with your doctor). But what is amazing about this study (in addition to confirming that supplemental potassium is beneficial to bone health) is that supplementing with potassium appears to be quite safe even in high doses. The researchers report "there was only 1 study participant who became mildly hyperkalemic on a dose of potassium citrate 40 mmol/d. That result was surprising given that an extensive literature review and studies performed by our group have never before demonstrated even mild hyperkalemia with escalating doses of potassium salt administration." It is important to note that they used huge doses of potassium citrate in this study (approximately 2,300 to 3,500 mg/d of potassium)...safely. Of course, the best way to get your potassium is through diet but it's not always that easy to get 5 to 9 servings of fruits and vegetables every day. Supplemental potassium, either by way of potassium citrate and/or potassium bicarbonate, is a great way to ensure a balanced body pH.

The authors concluded that "potassium citrate administration has the potential to mitigate age-related declines in bone density and strength associated with the Western diet. Readily available, safe, and easily administered in an oral form, potassium citrate also has the potential to reduce fracture in at-risk populations."

Our Osteo-pHBalance and OsteoMineralWhey both provide healthy doses of potassium and are perfect for helping to alkalinize the body, reduce urine calcium losses and improve skeletal health. By checking the pH of your urine first thing in the morning, it is possible to get an estimate of your body's pH. If your urine pH is consistently below 6.2 to 6.4, you are more than likely acidic and losing calcium. One of my (almost daily) horrors is seeing new patients who have already been to their medical doctor for their osteoporosis and have been prescribed a thiazide diuretic because they tested high in their 24-hour urine calcium test. The maximum loss of calcium in the urine that is considered to be normal for a 24 hour period is 250 mg for women, and 300 mg in men. When losses are higher, it can be extremely detrimental to bone health and patients are commonly prescribed a thiazide diuretic which acts to limit these losses. Unfortunately, diuretics can disturb electrolyte balance, create havoc in the hemodynamics of blood flow, and cause losses of important minerals such as zinc, magnesium, and manganese. Simply supplying these individuals with with some extra potassium (I typically recommend 300 to 1,000 mg of supplemental potassium/day plus vitamin K2, magnesium and boron) can stop this loss of calcium and reduce bone loss...without any of the potential adverse side-effects of diuretics. The sad thing is that doctors don't even try this regimen before resorting to a diuretic. 

Moseley et al. 2013. Potassium citrate supplementation results in sustained improvement in calcium balance in older men and women. JBMR 28(3):497-504.
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