Potassium is an essential mineral that is needed by all tissues in the body. It is sometimes referred to as an electrolyte because it carries a small electrical charge that activates various cell and nerve functions. Potassium is found naturally in many foods and as a supplement. Its main role in the body is to help maintain normal levels of fluid inside our cells. Sodium, its counterpart, maintains normal fluid levels outside of cells. Potassium also helps muscles to contract and supports normal blood pressure.
The U.S. Dietary Reference Intakes state that there is not enough evidence to establish a Recommended Dietary Allowance (RDA) for potassium. However, the National Academy of Medicine has established an Adequate Intake (AI) for potassium. 
- For women 14-18 years of age, the AI is 2,300 mg daily; for women 19+, 2,600 mg. For pregnant and lactating women, the AI ranges from 2,500-2,900 depending on age.
- For men 14-18 years of age, the AI is 3,000 mg; for men 19+, 3,400 mg.
It is estimated that the average daily intake of potassium in adults is about 2,320 mg for women and 3,016 mg for men. 
Potassium and Health
The functions of sodium and potassium in the body are closely related and often studied together.
- Observational studies of large groups of people show that sodium and potassium in the diet are associated with blood pressure.  Many Americans tend to eat too much salt or salty foods and not enough potassium, a dietary pattern that places some people at risk for hypertension, or high blood pressure. A review of randomized controlled trials found that the DASH diet (Dietary Approaches to Stop Hypertension) that is low sodium and high potassium was effective at lowering blood pressure in those with existing hypertension.  This same review found that potassium also had a blood-pressure-lowering effect in people with normal blood pressure, either from a higher intake of fruits and vegetables, or with a potassium supplement.
- The Agency for Healthcare Research and Quality issued a report on the effects of sodium and potassium on chronic disease risk based on clinical trials and cohort studies.  They found that potassium supplements (containing 782 to 4,692 mg taken daily) and replacing table salt with potassium salt substitutes significantly decreased blood pressure compared with a placebo, especially in those with hypertension. However there was not enough evidence or there was conflicting evidence of their effects on lowering overall risk of hypertension, kidney stones, cardiovascular diseases including stroke, and kidney disease.
- A meta-analysis of randomized controlled trials and cohort studies looking at increased potassium intake on cardiovascular risk factors found that higher potassium intakes (from food and supplements) reduced blood pressure in people with hypertension, and was associated with a 24% lower risk of stroke.  Another meta-analysis of cohort studies found a dose-response inverse association between potassium intake and stroke risk, meaning that the higher the intake, the lower the risk; potassium intakes of at least 3,500 mg daily were associated with the lowest risk of stroke. 
- Dried fruits (raisins, apricots)
- Beans, lentils
- Winter squash (acorn, butternut)
- Spinach, broccoli
- Beet greens
- Oranges, orange juice
- Coconut water
- Dairy and plant milks (soy, almond)
- Cashews, almonds
Signs of Deficiency and Toxicity
The kidneys work to maintain normal blood levels of potassium. They will flush out excess potassium through urine, stool, and sweat. At least 400-800 mg daily from food is needed because of normal daily losses. Any conditions that increase fluid losses beyond normal such as vomiting, diarrhea, and certain medications like diuretics can lead to a deficiency, called hypokalemia. Hypokalemia is most common in hospitalized patients who are taking medications that cause the body to excrete too much potassium. It is also seen in people with inflammatory bowel diseases (Crohn’s disease, ulcerative colitis) that may cause diarrhea and malabsorption of nutrients.
It is rare for a potassium deficiency to be caused by too low a food intake alone because it is found in so many foods; however an inadequate intake combined with heavy sweating, laxative abuse, or severe nausea and vomiting can quickly lead to hypokalemia. Another reason is a deficiency of magnesium, as magnesium helps to maintain normal potassium levels in cells. Symptoms of hypokalemia:
- Muscle cramps or weakness
- Muscle paralysis and irregular heart rate (with severe hypokalemia)
Too much potassium in the blood is called hyperkalemia. In healthy people the kidneys will efficiently remove extra potassium, mainly through the urine. However, certain situations can lead to hyperkalemia: advanced kidney disease, taking medications that hold onto potassium in the body, or people who have compromised kidneys who eat a high-potassium diet (more than 4,700 mg daily) or use potassium-based salt substitutes. Symptoms of hyperkalemia:
- Weakness, fatigue
- Nausea, vomiting
- Shortness of breath
- Chest pain
- Heart palpitations, irregular heart rate
The interplay of potassium and sodium
A study in the Archives of Internal Medicine found that:
- People who ate high-sodium, low-potassium diets had a higher risk of dying from a heart attack or any cause. In this study, people with the highest sodium intakes had a 20% higher risk of death from any cause than people with the lowest sodium intakes. People with the highest potassium intakes had a 20% lower risk of dying than people with the lowest intakes. But what may be even more important for health is the relationship of sodium to potassium in the diet. People with the highest ratio of sodium to potassium in their diets had double the risk of dying of a heart attack than people with the lowest ratio, and they had a 50% higher risk of death from any cause. 
- People can make a key dietary change to help lower their risk: Eat more fresh vegetables and fruits, which are naturally high in potassium and low in sodium, but eat less bread, cheese, processed meat, and other processed foods that are high in sodium and low in potassium.
Did You Know?
- The chemical symbol for potassium is “K,” not to be confused with vitamin K.
- Salt substitutes are sometimes made from potassium chloride, which replaces some or all of the sodium chloride in table salt. Although those on salt-restricted diets may benefit from its much lower sodium content, potassium salt has a bitter aftertaste when heated so it is not recommended for cooking. Check with your doctor before trying a potassium salt, because extra potassium can be dangerous for people who have trouble eliminating excess amounts or who are taking medications that can increase potassium levels in the bloodstream.
- National Academy of Medicine. Dietary Reference Intakes for Sodium and Potassium. Washington (DC): National Academies Press (US); 2019 Mar.
- National Institutes of Health; Office of Dietary Supplements. Potassium: Fact Sheet for Health Professionals. https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/. Accessed 5/20/2019.
- Aaron KJ, Sanders PW. Role of dietary salt and potassium intake in cardiovascular health and disease: a review of the evidence. InMayo Clinic Proceedings 2013 Sep 1 (Vol. 88, No. 9, pp. 987-995). Elsevier.
- Newberry SJ, Chung M, Anderson CA, Chen C, Fu Z, Tang A, Zhao N, Booth M, Marks J, Hollands S, Motala A. Sodium and Potassium Intake: Effects on Chronic Disease Outcomes and Risks. Rockville (MD): Agency for Healthcare Research and Quality (US); 2018 Jun. Report No.: 18-EHC009-EF.
- Aburto NJ, Hanson S, Gutierrez H, Hooper L, Elliott P, Cappuccio FP. Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses. BMJ. 2013 Apr 4;346:f1378.
- Vinceti M, Filippini T, Crippa A, de Sesmaisons A, Wise LA, Orsini N. Meta‐analysis of potassium intake and the risk of stroke. Journal of the American Heart Association. 2016 Oct 6;5(10):e004210.
- Brown IJ, Tzoulaki I, Candeias V, Elliott P. Salt intakes around the world: implications for public health. International journal of epidemiology. 2009 Apr 7;38(3):791-813.
- Dietary Guidelines for Americans Scientific Advisory Committee. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010, to the Secretary of Agriculture and the Secretary of Health and Human Services. 2010.
- Yang Q, Liu T, Kuklina EV, Flanders WD, Hong Y, Gillespie C, Chang MH, Gwinn M, Dowling N, Khoury MJ, Hu FB. Sodium and potassium intake and mortality among US adults: prospective data from the Third National Health and Nutrition Examination Survey. Archives of internal medicine. 2011 Jul 11;171(13):1183-91.
The contents of this website are for educational purposes and are not intended to offer personal medical advice. You should seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The Nutrition Source does not recommend or endorse any products.