I’ve already spoken at least somewhat about how potassium deficiency is so widespread, and in particular, how it impacts type 2 diabetes, and as it turns out, it may play a much bigger role than we generally think in our disease.
Dr. Ray Peat even thinks that potassium is more important in insulin action than insulin is, and it very well may be. This isn’t even about the role that potassium plays in insulin secretion, which is by the way a fundamental one, but its role in insulin sensitivity may be an even bigger one. So to say it plays a bigger role than insulin in insulin action is to say that the role it plays in the effectiveness of insulin, as far as its glucose regulatory properties are concerned, may be even more important than levels of insulin.
Now we do know that, as type 2 diabetics, we tend to have an excess of insulin, which means basically that all of our issues, not just some of them but all of them, when it comes to insulin action, has to do with a lack of insulin sensitivity. We may not even want to secrete more insulin, and in most cases we actually want to secrete less, not more, believe it or not, because our levels tend to already be too high, and going even higher just worsens things.
This is because our problem is insulin resistance, a lack of insulin sensitivity in other words, and anything that can significantly improve that can definitely make an impact, and therefore is a bigger deal than, say, insulin levels, unless we’re talking about bringing down insulin levels, and in fact becoming more sensitive to insulin is one of the best ways to achieve that.
So, you might think, well I probably get plenty of potassium in my diet, so that is probably not an issue with me, but the truth is, most people don’t. Most people in fact fall well short of the minimum requirements for potassium, and these are requirements that are set not at optimal levels but minimal ones, ones that everyone needs to make sure they get.
I get inspired for topics for posts and articles here from several different sources, and what got me wanting to do this one in particular is my being refused potassium by a pharmacist at the pharmacy which I go to.
I’ve been taking supplemental potassium off and on for over 30 years now, and to be honest, even though I know better, I haven’t been as diligent at this as I should have over the years, and this may indeed be the main reason, if not the sole one, that I ended up becoming diabetic.
Here in Canada, fortunately we can get over the counter potassium supplements at 600 mg strength, the same stuff as doctors prescribe for low potassium, and the kind I prefer is called Slow K. So I’ve been getting this off and on over the years, I used to also work at getting more from my diet, drinking quite a bit of fruit juice in particular, but really still didn’t get the RDA as I was still too slack.
As I was saying, most people are deficient, even people living in rural areas, but people in urban areas are worse off, due to their consuming less fruit and vegetables. Then there’s the fact that we eat more salt these days, compared to historically, which increases the need.
Now with me, when you add in I’ve always eaten what could be considered a kids diet, with a ton of salt added, and now that I have diabetes that’s gotten even further away from things. I used to love potatoes for instance, but I can only consume this in limited quantities, and that’s the only vegetable I like to eat. I do eat some berries but my fruit intake is now limited as well, I need to worry about my diabetes of course and adding potassium while overwhelming your glucose metabolism isn’t a good idea at all.
So there was this one time back in the 1980s where a rather stern pharmacist seemed reluctant to give me some Slow K, he just told me to eat more bananas, I told him I don’t like bananas and I get fatigued when I don’t get enough potassium and just don’t get it in the diet, and he ended up giving in and selling me some.
Now pharmacists do reserve the right to refuse people this, and I will say that potassium isn’t something that you want to give to anyone, as it must be taken with responsibility, you can’t just take it by the handful and that would be dangerous.
Other than taking this to correct hypokalemia, low serum potassium, this is also used as a preventative, and a preventative dosage is suggested in the product monograph, although apparently not all pharmacists are either aware of its being used as a preventative or agree with it being used that way.
So this particular pharmacist, a nice lady really, told me she wasn’t going to be selling me any that night, as she said that one needs blood tests in order to be taking this and therefore implied that diagnosed hypokalemia was the only valid use of this, in other words having a doctor’s prescription.
That’s a lot like saying someone needs a prescription for a potato though. I think this shocked me so much that I didn’t even bother arguing, and the other pharmacists would be in the next day and I’d just pick it up from them, so there was no point in that anyway.
However, this did reveal the way that a lot of people think about potassium supplementation, being something reserved for when you actually do get that bad off, and let me tell you, if your serum potassium is outside the range of 2 standard deviations, you are in trouble indeed.
Perhaps we do want to try to avoid this happening to people though? Perhaps we should strive to consume the recommended amounts, or at least try to get in the neighborhood at least, which is the most I’ve ever done actually. I will settle for almost enough actually, where I don’t get weak and tired and have other symptoms.
Serum electrolyte levels are, by the way, not a very good indicator of sufficiency, as you can have adequate levels in the blood but suffer deficiency at the cellular level, where this matters. This is why they use the RBC magnesium test for instance, at least doctors with a clue do, because by the time serum magnesium falls outside the range, you’re pretty sick indeed, and we want to prevent functional deficiency here.
The same is true with potassium and all electrolytes actually, and with potassium in particular, especially when done fasting, as is typical, as this primarily will measure rates of excretion in this case, as potassium functions inside cells, not in the blood, but when excreted from the cells it will show up there.
What is clearly first and foremost here though, regardless, is that our goal needs to be to pay attention to our bloody intake of this mineral, and try to get what we are told, by conservative authorities I might add, to get.
Now here’s where the real confusion lies. They will tell you to get that much in your diet. What if you don’t? Well you are, for the most part, out of luck, because a lot of people discourage supplementation. This is simply a retarded view though, as potassium is potassium, and while one may need to be careful to avoid potentially inflammatory side effects in salt substitutes, where people shake away with no regard to dosage by the way, Slow K is meant to dissolve more gradually to minimize this.
Other than that, potassium is potassium. It is stupid to stand by and make wistful comments such as deficient people should be getting more in their diet, when they don’t, well screw them then, that’s the attitude, sadly enough.
In addition, there’s an equally retarded view that somehow, dietary potassium is safe in any amounts you could possibly eat, but even small amounts of supplementary potassium is somehow dangerous, or potentially so, even though the total amount ingested may still be a deficient one. This is the stupidity behind the U.S. FDA limiting potassium supplements to 99 mg, somehow 100 mg scares them, when the average person is about 20 of these pills short of an adequate load each day.
I cannot think of any reason why this is all the case, the people behind all of this thinking are either very smart or very stupid. They are either smart enough to realize that they will sell a whole lot more meds if people are kept deficient, or stupid enough to think that it’s actually dangerous to risk a potassium overdose in amounts still below adequacy.
We do need some real education here, and there is very little good education out there on potassium, there’s plenty of info on how much we should get, but when one does not get a sufficient amount from one’s diet, as is typical, we are left to rot. So we need to seize the reigns ourselves and go out and learn about this on our own if we want to try to avoid seeing our health and our diabetes go all to hell.
So thank you Lisa the pharmacist for helping remind me of all of this.