Potassium - a possible cure for RLS - Restless Legs Syn...

Restless Legs Syndrome

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Potassium - a possible cure for RLS

Oldcolner profile image
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I have a friend with RLS and did some researching based on my pharmacy experience. I found a 2016 report of 68 patients in Bangladesh who took potassium 10meq a day for 45 days after noting an patient with kidney stones got better taking pot citrate. All gradually got better with 37 cured by 15 days, 57 by 30 days and all 68 by 45 days. The article isn’t good but the resultsare medcraveonline.com/PPIJ/PPI...

Has anyone checked this out or used potassium? It’s something that needs medical checks as it can cause problems in some patients eg kidney or heart disease.

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My husband takes potassium citrate every day, It does help, but no cure.

Oldcolner profile image
Oldcolner in reply toSeekingAnswersForRLS

Thanks. How much does he take and when

Simply put, in normal health, the kidneys maintain an optimum level of potassium. Take extra potassium and if you already have enough, your kidney's just get rid of it.

If your kidneys aren't working properly then there may be a build up of potassium, take a supplement then you make it worse. This is dangerous!

Potassium Citrate is good because it makes your urine more acid, which has some benefits. But this is mainly due to the citrate part.

Low potassium can be associated with neuromuscular problems, including the heart.

If some condition, (and there has to be some "condition" ) causes potassium deficiency, it has to be corrected.

The study you refer to isn’t corroborated by other studies and the study shows that Pot Cit was useful for RLS sufferers who were potassium deficient.

It also implies that this refers to “secondary” RLS not idiopathic. In the case of secondary RLS, restoring potassium levels should relieve the RLS.

I would say if you've had a blood test and you're deficient of potassium then something's wrong and you may need treatment. If you've too much, you need treatment. If it's OK then no supplement is needed.

Too little or too much potassium is extremely dangerous.

There is no cure for idiopathic RLS.

Oldcolner profile image
Oldcolner

Thanks Manerva

I’m not a sufferer but have a friend who is and I came across this study In trying to find some light for him. I have tried to contact the authors to see what further information they can provide as it has some gaps .

Regarding your comments

Healthline says a national survey found that approximately 98% of Americans are not meeting the recommended potassium intake (of around 4700mg a day) so this could be a bigger issue than you think.

Potassium regulation is not quite as simple as you suggest, as unlike sodium, blood levels do not reflect the amount in the body. The 5 meq per litre in the blood stream does not reflect the 20 times greater levels of 100 meq/litre inside cells. As the volume of blood and plasma is also several times less than that inside body cells the actual amount of potassium outside the blood is even greater.

Yes excretion is by the kidneys and control of blood levels is partly through thus as you say but is also affected by other factors such as insulin and beta stimulants and exercise which move it into cells from the blood. There is diurnal variation in blood levels too, with lower levels found in the evening.

Healthline says “Potassium helps start and stop muscle contractions. Low blood potassium levels can affect this balance, causing uncontrolled and prolonged contractions known as cramps.“

It might be possible for plasma levels to be ‘normal’ but for levels in nerve cells to be lower.

You are right that giving potassium in renal failure is dangerous and large doses can affect the heart. Supplementation is possible through, diet small amounts can be bought over the counter in the UK. The levels in this study need assessment and a prescription.

Can you point me to the other studies that you refer to as I haven’t found them and it would be great to see further hopefully more detailed reports.

I have seen anecdotes of some patients finding potassium to be beneficial and effective but sadly unlike the study not everyone has.

Thanks

ironbrain profile image
ironbrain

I take about 5 grams of potassium citrate a day which I worked out here:

healthunlocked.com/rlsuk/po...

equates to about 1.8 grams (1800mg) of potassium. (I've swapped the oats for a few rice crispies occasionally, by the way.)

I take it more to make sure my electrolyte balance is good to avoid cramps than for RLS. I think magnesium citrate (which I also take) is much more likely to help RLS, since it possibly dampens the impulses that stimulate the inclination to move – but, of course, RLS is mainly about the dopamine control of those impulses.

Oldcolner profile image
Oldcolner in reply toironbrain

Ironbrain

Thanks that’s helpful as I had been thinking more about magnesium when I came across the potassium article. They seem linked with those with low magnesium levels having low potassium too. It also is involved in the brain in dopamine production. It also is mainly an intercellular ion. I’m on my phone and my original response was overwritten by another reply coming in so I’ll get back when my ipad is charged.

Oldcolner profile image
Oldcolner in reply toironbrain

Ironbrain

I’m back but your response More arrow won’t now open up, so apologies if I miss anything.

I blame Manerva! Lol

I think my reply to him takes in much of what I was going to say.

Found this on healthline

“A national survey found that approximately 98% of Americans are not meeting the recommended potassium intake. A Western diet is likely to blame, as it favors processed foods over whole plant foods such as fruits, vegetables, beans and nuts That said, a low-potassium diet is rarely the cause of potassium deficiency, or hypokalemia.

Potassium is important for healthy nerve function. Low blood levels of potassium can weaken nerve signals, which may result in tingling and numbness. “

On wiki

“About 57% of the US population does not meet the US RDA for dietary intake of magnesium.”

Potassium channel efflux is inhibited by magnesium. Thus hypomagnesemia results in an increased excretion of potassium in kidney, resulting in a hypokalaemia.

Magnesium deficiency (low body magnesium) is hard to measure

Either of magnesium deficiency and hypomagnesemia (Low blood levels) can be present without the other.

Magnesium homeostasis comprises three systems: kidney, small intestine, and bone. In the acute phase of magnesium deficiency there is an increase in absorption in the distal small intestine and tubular resorption in the kidneys. When this condition persists, serum magnesium drops and is corrected with magnesium from bone tissue. The level of intracellular magnesium is controlled through the reservoir in bone tissue.

More to follow..

ironbrain profile image
ironbrain in reply toOldcolner

You can only buy capsules with 100mg of potassium each in the US, so you would need a medic to diagnose you with a low potassium problem to get a prescription for higher doses.

Calcium and magnesium intake should usually be in the ratio of 2:1, the RDA being somewhere around 1g calcium and 500mg magnesium. I think moving outside that proportion is thought to amplify the disproportion (because of competition for binding sites). I suspect this interplay extends to potassium too, though I can't remember categorically reading it. What I believe I did read about potassium was that we need something as near to 4.7 grams as we can get without exceeding that amount. Drinking plenty of water helps the kidneys maintain homeostasis and you should always take potassium with a good amount of fluid.

It sounds as if you appreciate the difference between anecdotal and hard evidence and the unreliability of the former.

Thanks for the information about the greater complexity of potassium metabolism than the simplistic version I gave.

Despite this, it still appears to me that if someone is deficient in cellular potassium, there is probably a reason for it, whether it be as you say lack of dietary intake, lack of exercise and insulin disturbance.

If plasma levels don't exactly reflect cellular levels, I can't think, unfortunately, how it could easily be detected.

Although cellular levels may be low when plasma levels are normal it does at least seem logical to assume that if plasma levels are low, then cellular levels will follow.

I wouldn't exclude potassium supplements for someone who has been identified as having some deficiency, e.g. dietary or as a result of a sedentary lifestyle etc AND RLS.

You have to consider that RLS is both a physical and psychological nightmare and sufferers of severe RLS can become willing to try anything that others might suggest irrespective of whether it has been shown to be effective and in ignorance of the possible dangers. Sufferers are also at risk of being vulnerable to being sold "remedies" that aren't. As example a recent post by a member who described a shop advertising the sale of soap in the shop window claiming it cured RLS. Other members are convinced that putting a bar of soap in the bed cures RLS.

Not quite in the same league as claims that cupping therapy or turmeric can cure cancer so much so that I read of at least one case of a lady ceasing her chemotherapy because she was convinced cupping would cure her breast cancer. Someone has suggested it treats RLS.

Some deficiencies, such as vitamin or mineral disturbances do cause Restless Legs Syndrome. The key word is "syndrome". Like jaundice, a syndrome is a group of signs and symptoms that consistently appear together, it is not a condition. There are various conditions "underlying" RLS including potassium deficiency, end renal failure, hypothyroidism, vitamin D deficiency, anaemia, some neuropathies etc

Treating the underlying condition will relieve the RLS. If someone tries to relieve RLS by treating an underlying condition they don't have, apart from a placebo effect, it will be ineffective at least.

However, where RLS is due to an identifiable cause it is known as secondary RLS.

Sufferers of severe RLS, (severe because there is no identifiable underlying condition) appear to have "idiopathic RLS."

Idiopathic RLS can occur without potassium deficiency, iron deficiency, vitamin D deficiency, etc because the "underlying condition" is an as yet incompletely defined and complex genetic one variously described as being due to a lack or dysfunction of dopamine receptor sites, possible glutamate disturbance, brain iron deficiency possibly due to dysfunctional mitochondria etc.

There is diurnal variation in potassium levels, but there's diurnal variations in lots of things including the most known effective remedy for idiopathic RLS, i.e. dopamine.

I read recently of a member considering spending several hundred pounds for an iron infusion in the hope that it will relieve their RLS, yet brain iron deficiency is only demonstrated in about 22% of RLS sufferers. Sensibly, at least he is having a ferritin test.

If people want to try and can afford to take regular supplements in the hope of relieving their RLS, that's fine if that's all it was. There are also psychological consequences, the build up of hope that something will work, it appears to, then it doesn't.

There are also possibly idiopathic RLS sufferers, who in desperation and naivity take excessive amounts of potentially toxic minerals or other risky substances that shouldn't be encouraged to do so.

I also find it very annoying that even reputable high street shops are making profit out of purveying "supplements" that are commonly believed to be almost universal panaceas e.g. the current "fad" of CBD oil.

There are 5 criteria for a diagnosis of RLS. Four are descriptive of the syndrome, the fifth is that all other possible explanations for the symptoms are excluded.

Sorry about the bit of a rant. This is only an opinion, I'm not a medical expert. Some of what I say is based on my interpretation of what I've read, but I don't keep a record of what I've read. Some of it is based on my experience of lecturing in human physiology which I haven't done for 10 years and it's getting a bit hazy.

Oldcolner profile image
Oldcolner

Manerva, thanks for the reply, which pinged in just as I was completing my reply to iron and deleted it. Will need to watch my long replies lol.

I will confess I am a retired pharmacist with a hazy memory of physiology and pharmacology. I am trying to help my friend and have time to spend on it. I’m new to RLS and my brain pharmacology is poor as you may see but I’m trying to refresh my brain having left pharmacy clinically in the 80s to become a manager and public health person and academic till I retired.

I sat next to my friend on a long train journey and saw first hand what his symptoms were like. I used to suffer from night cramps and I used to take electrolytes for that. They seemed to due to local rather than central nerve stimulation.

So that made me wonder if there was a local component to some RLS and RLM. I was drawn to Magnesium and Potassium because of their intracellular predominance. Then I found this paper which seemed to good to be true and it looks like it may be. I wonder if there are other papers studying this but I’m stuck with google and nothing else appears. If you have found any please tell me. It’s a poor paper but the results are impressive it’s a pity they don’t cite pretreatment potassium levels or monitor them for example.

I’m drawn to go back to my thinking that the two ions may be linked as low magnesium levels give low potassium ones, the two ions also have brain effects and dopamine production needs magnesium. I see Iron has brain effects too. I found two Parkinson’s patients reporting their symptoms were resolved when given penicillin potassium and returned when the course was completed. Which made me think local actions may be happening.

I’ve found quotes that the majority of the population has in the US and UK have dietary deficiencies of both too. Maybe they don’t in Bangladesh.

Anyway that’s my thinking so far, it’s early days for me, so all comments and ideas are welcome. I’m also thinking about how sensory nerves work as tingling and creeping sensations seem not to work like motor nerves. More research for me may be you can tell me.

Better go as it’s overlong.

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