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Potassium Deficiency From Steroid Therapy

I recently suffered from hypokalemia (potassium deficiency) as a result of methylprednisolone therapy for PMR, and required approximately 4500 mg of potassium each day to prevent muscle fatigue and cardiac arrhythmia. In an attempt to achieve this number, I carried a card in my pocket and itemized the potassium content of each food I consumed. If there was a small short-fall, I supplemented with potassium tablets as necessary. This method was tedious, and to achieve my goal, I often had to either overeat, or eat foods that weren’t appetizing.

I also found the labels on over-the-counter potassium supplements to be very misleading. Because potassium is chemically unstable, supplement manufactures commonly bind it to 6 different compounds which contain varying amounts of active elemental potassium by weight. For example: Elemental potassium accounts for 16.7% of the weight of potassium gluconate, 38.3% of potassium citrate, 39% of potassium bicarbonate, 52% of potassium chloride, and 20% of either potassium aspartate or potassium orotate. As a consequence, a product named "Potassium Gluconate 595 mg" will actually contain only 99 mg of active elemental potassium; an important fact which will be missed by many consumers.

Although charts of potassium rich foods are readily available, I discovered two items which were not on the lists I found that made it much easier for me to get the required potassium. They are as follows:

1) Low Sodium V8 Vegetable Juice which contains 1180 mg of potassium per 11.5 oz can and only 70 calories. I found the flavor of this juice to be better when warm and added a lemon wedge and some freshly ground black pepper to make it even better. The original V8 has approximately 600 mg of sodium and must be avoided.

2) Plantation Organic Blackstrap Molasses contains 630 mg of potassium per tablespoon and when added to an 8 oz glass of 1% milk, (370 mg of potassium), provides a 1000 mg cocktail with great flavor and 160 calories. Other brands of blackstrap typically have one half the potassium content of Plantation Organic. It is also important to note that diabetics may be required to use this high sugar product in smaller quantities.

Once I made this discovery, I learned that my normal every day diet, two of the above easy to drink beverages, and 300 mg from supplements safely provided all of the daily potassium I needed and controlled my symptoms. Moreover, this formula eliminated record keeping, selective grocery shopping, and eating the same potassium rich foods over and over.

Because too much potassium from supplements can be dangerous, and different forms of supplementation are required for different causes of deficiency, it is advisable to consult with your practitioner when starting a potassium replacement therapy.

I hope this will be helpful,

5 Replies

Thank you for the information. I'm regularly found to be potassium deficient and am prescribed a supplement. I have also taken Blackstrap Molasses with iron in the past.

I must look for the V8 juice.


Thank you so much for this information! I have been wondering if this was a problem for me as I await bloodwork results to check my potassium levels now that I am on prednisone for PMR. TY for posting.


I had this happen when on methotrexate. Feels terrible like a heart attack is imminent. Thank you for the info. I was prescribed a prescription for potassium which was a huge pill.


....this is good to know as I am often low in potassium, thank you



Bananas are good source of Potassium.


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