Cleo Libonati, RN, BSN

Correcting Potassium Deficiency in Celiac Disease with a Gluten Free Diet

by Cleo Libonati, RN, BSN on October 18th, 2010


Potassium is a mineral that is easily absorbed by the digestive tract. This micronutrient is essential for life because of the vital functions it performs in our bodies. Normal nerve conduction, muscle contraction, fluid balance, acid-alkali balance, blood pressure regulation, digestion, protein production, and metabolism require the action of potassium. For example, in metabolism potassium is required for the movement of sugars, amino acids, and other molecules into cells.

Potassium is an electrolyte that takes part in electrical conduction and chemical reactions in opposition to the electrolyte, sodium. In bodily fluids, potassium is the major cation (positively charged ion), while sodium is the major anion (negatively charged ion).

About 98% of the body’s potassium is contained within muscle cells, while sodium is found abundantly in the surrounding fluid. Potassium is largely excreted in urine and less so in sweat and stool.

 

Potassium Deficiency

While most of us consume too little potassium and too much sodium in our diet, a deficiency of potassium more commonly results from losses in vomiting and diarrhea. In celiac disease, large amounts of potassium can be lost in chronic vomiting and diarrhea.

A co-existing zinc deficiency will worsen the diarrhea, resulting in more potassium loss.

Potassium deficiency results in an imbalance between potassium and sodium that serves to impair muscle contraction. When muscle cells contract, potassium moves out of the cell while sodium moves into the cell. In the event of too little potassium, this normal exchange is hampered and muscle contraction is affected.

If the level of potassium in the blood drops significantly (hypokalemia), confusion, convulsions, muscle paralysis, intestinal obstruction, life-threatening irregular heartbeats, and respiratory failure can develop. The heart muscle is extremely sensitive to potassium depletion.

 

Deficiency Symptoms

Symptoms of mild to moderate depletion make us feel worn out:

  • Muscle aches and spasms
  • Mild weakness of the lower extremities
  • Fatigue
  • Drowsiness
  • Confusion
  • Decreased blood pressure
  • Poor digestion/ enzyme function/ bowel motility
  • Loss of appetite
  • Bone pain

Severe symptoms:

  • Osteoporosis
  • Premature ventricular and atrial contraction of the heart
  • Tetany
  • Myoclonic jerks
  • Convulsions

 

Food Sources of Potassium

Potassium is found in most foods. Below are some food sources.

Excellent

Carob powder, 1 cup (1,275mg)

Peanuts, 1 cup, roasted (1,019mg)

Potato, medium (845mg)

Figs, 5 (665mg)

Black beans, 1 cup (608mg)

Avocado, 1/2 (600mg)

Dates, 10 (541mg)

Raisins, ½ cup (540mg)

Apricots, 1/3 cup, dried (540mg)

Sardines, 3 oz. (500mg)

Orange Juice, fresh, 8 oz. (500mg)

Lentils, 1 cup (498mg)

Winter squash, ½ cup (475mg)

Chickpeas, 1 cup (475mg)

Banana, medium (450mg)

Skim milk, 8 oz. (406mg)

Very good

Salmon, 3 oz. (305mg)

Sweet potato, medium (397mg)

Good

Chicken breast, 3 ½ oz. (254mg)

Ground Beef, 3 oz. (240mg)

Generally, the small amount included in multimineral supplements is very low, around 90mg. Potassium, as medication, is prescribed by a doctor and must be monitored.

 

Recommended Dietary Allowances for Potassium

There is no specific amount set. Intake of potassium should approximate the recommended sodium intake, which is 2,400 mg a day.

 

Getting Your Daily Intake

Make foods rich in potassium a part of your diet, especially if you sweat a lot on the job or at the gym. Restore your muscle strength, improve your energy level, be more alert, and regulate your bowels with potassium-rich food choices.

  • Eat more fresh fruits, salad and fresh or lightly cooked vegetables.
  • Freely season with potassium-rich parsley, chervil, celery flakes, coriander, basil, dill, tarragon, paprika, spearmint, cumin, caraway, marjoram, and oregano.
  • Enjoy your cup of coffee and cocoa.

 

Form in Dietary Supplements

Dietary supplements of potassium should not be used because of the danger of toxicity.

 

Impact of Storage, Processing, and Cooking

Limit the use of canned and frozen foods because these processes cause large losses of potassium in foods. Potassium is lost from food in cooking, so be sure to consume the leftover juices as broth and gravy.

 

Nutrient Interactions

Potassium status is strongly affected by sodium intake. Too much sodium causes fluid retention and loss of potassium in urine.Interactions with MedicationsCertain diuretics cause loss of potassium in urine that may require potassium replacement. Potassium levels must be monitored to avoid hypokalemia in people taking digitalis preparations for the heart, asthmatics taking beta agonists, and in those with non-insulin diabetes.

Toxicity

Potassium overdose can cause ventricular fibrillation leading to death.

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Author Information: Cleo Libonati, RN, BSN
Cleo Libonati is president/CEO and co-Founder of Gluten Free Works, Inc. She is the author of Recognizing Celiac Disease.
She can be reached by E-mail.


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5 Responses to “Correcting Potassium Deficiency in Celiac Disease with a Gluten Free Diet”

  1. Katie G. says:

    Cleo:

    This is an excellent list but I’m having a problem with the ingredient on the top of the list. The carob powder is a bit over the top, isn’t it? How could someone sit down and eat a cup of carob powder? Maybe if you listed carob chips… It just seems a bit unrealistic. Maybe if it were reduced down to 1/4 or 1/8 of the amount. Sorry, maybe I’m missing something… :/

  2. Tina says:

    I have been fighting a real battle the last 8 months. I take diuretics for fluid build up. This depletes my potassium(K+), making it necessary to suppliment with oral K+. I recive 160meq (a big dose)a day, yet my K+ would continue to drop to critical levels. 2.0 was the lowest, arrythmias,serious confusion, cramping muscles and low oxygen levels. Several days in ICU to get my level back up to near normal. This happened every 2 weeks, for several months. Finally a new hospitalist mentioned malabsorption syndrome…un able to absorb potassium orally. So only recieving IV potassium brought my levels back up only to slowly fall back to critical levels. He suggested a gluten allergy. My celiac test was normal but I have followed a glutenfree diet for 6 months and now I can go from 2 weeks to 9 weeks before I have to go into hospital for more potassium. I hope that I contine to heal. Anyone else have this? Could I be allergic to something else that is slowing my healing?

  3. Aleka says:

    I’ve been up and down with potassium and have needed prescribed supplements at times. Through experience of bouts of lightheadedness, muscle aches and spasms, mild weakness of the lower extremities, fatigue, drowsiness, and confusion at times of dehydration I have learned the the quickest way to correct my problem, especially when bowels are involved is 12-16 oz of Low Sodium V8. The low sodium variety is especially high in potassium. It works 10x better than Gatorade or any other drink to regain lost electrolytes.

    In other vitamin news, I have a normal low BP and orthostatic hypostasis. When I stand up/bend over, I feel faint or I do. I take medication to elevate it. It seems I have to take less of it when my B12 level is over 600, although no medical professional has ever heard of any connection. We have seen a correlation due to monitoring my B12 while getting regular injections of B12. I don’t absorb B12 due to a resection of my terminal small bowel.

  4. Mark says:

    Since last year I increased my potassium citrate intake to help prevent Calcium Oxalate kidney stones and then I also noticed that my heartbeat became much more regular.
    No more skipping and jumping. I attribute this to my increased potassium intake.
    Beats taking pills with side effects.

    I get my potassium citrate from 1 glass of orange juice in the morning and 1 glass of low salt tomato juice in the afternoon and 1 glass in the evening.

    I also eat a banana with yogurt, and LOTS of raisins.
    Though these don’t have potassium citrate but they are loaded with potassium!

  5. Caryn says:

    Cleo,
    Thanks for a very informative article. When my son was dxd three years ago he had a major zinc deficiency and was exhibiting neuro symptoms. The neurologist never even suggested food allergies or celiac as a possible trigger for him even though he had diarrhea and stomach complaints. We were told his neuro was due to a major magnesium deficiency. His recovery took almost two years. You make a very important point about a lesser known mineral deficiency. I can see it in one of my adult diagnosed relatives. Muscle weakness and bone pain. I will pass along this link to her.

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