Anyone got information on the Findings of the 2016 Article in MedCrave on 2 June 2016 in relation to the Use of Potassium Citrate in RLS?
The Study in Bangladesh showed a 100% success rate in using Potassium Citrate in RLS in 2012.
Has this been proven wider or was this just another false hope for us servere sufferers?
I don't think it will be a false move, but I did read that it can help as a source of potassium for people suffering potassium deficiency.
If their RLS IS due to potassium deficiency, then potassium supplements will help resolve the RLS. In which case, this may be an example of a treatment for "secondary" RLS.
Similarly, vitamin D has been found to reduce RLS symptoms in people with vitamin D deficiency. Again, perhaps an example of secondary RLS.
Unfortunately. although some things like potassium, vitamin D may be effective for secondary RLS, it doesn't necessarily follow that they will work for idiopathic RLS.
Thanks for identifying the article, I will try to get hold of it.
Here is the study you refer to.
medcraveonline.com/PPIJ/PPI...
A quick glance shows the finding about pot cit is incidental to the study. The study was actually about the prevention of renal calculi. Therefore the study lacks some "rigour" in terms of either indication of the serum levels of potassium before the intervention and any placebo control group.
Serum electrolytes, (including potassium) it is stated, were the same before and after the treatment. Which, even though the treatment was apparently effective, fails to identify why.
The introduction implies that the RLS being referred to, is secondary., but because of the above, it is difficult to confirm or deny this.
The study itself recognises there were only a few other studies to corroborate this study.
This study, on its own is not credible enough to recommend pot cit for idiopathic RLS.
So far unable to find any 2012 study. "100%" success sounds highly unlikely.
There have been other studies SINCE 2016.
Overall, based on what I've read ( to date). my opinion is that RLS is a many factored issue and in view of symptoms in some people affected are due to deficiencies or are relieved by various measures, including vitamin or mineral supplements or diets, then as long as no harm is caused by trying them, it's worth trying them.
Until the cause or causes of idiopathic RLS are tied down completely, I doubt if idiopathic RLS sufferers can expect any more than lessening of symptoms, not total refief and certainly not "cure".
Hi Manerva
Think you have misread the paper. There was an incidental finding in one patient with kidney stones whose RLS symptoms improved on Urokit (probably UroCit-K) containing 1080 mg of potassium citrate in a slow release once a day tablet to give a gradual response and minimise side effects.
NB this is not a potassium dose of 1080g. It is equivalent to 10 milliequivalents (meq) of potassium or 390mg of potassium (the rest 690mg is citrate.)
They then organised a study in 68 RLS patients (16 judged severe) who did not have kidney stones all of whom got better taking the same medicine in the same dose Once a day after meals. All 68 were cured by 45 days.
Can you find any follow up studies using that medicine in that dose. I would be grateful for the references
I have seen some bloggers say they tried potassium and it worked or it didnt but they don’t say how much or for how long and if they do it isn’t in mg potassium or in meq. (The amount in mg divided by 39 - the atomic weight of potassium.) We don’t know their magnesium status or sodium intake, both of which could counteract efforts to raise potassium levels.
Manufacturers say Your doctor may direct you to eat a low-salt (low-sodium) diet and drink lots of fluids. Follow your doctor's directions closely.
We don’t know what Rouf et all did on this.
They also say take them with meals and drink 200ml water - we don’t know if that was bottled or what the mineral content was, some sparkling ones have a lot of sodium in them.
A few comments on it.
Rouf say they monitored electrolytes but don’t say what these were. They do say No significant Electrolyte alteration was observed between pre-treatment and on-treatment. This seems strange given the amounts of potassium given. Low magnesium levels could lead to potassium excretion so I would want to know them also.
It was done in a private clinic, they say it was random but there is no control group
The introduction includes contradictory comments which seem to be because I think they have cut and pasted quotes from the references they cite.
The discussion says little about how they think it works and much of discussion is on on kidney stones which is irrelevant.
So It’s not a great paper but the results, if true, surely merit proper study. i think that should look at intracellular levels as well as blood levels of electrolytes as these can be low even if plasma levels are normal.
Hope that helps
Thanks, great comments.
Yes the study stemmed out of the kidney stone study in that during the kidney stone study, some subjects in that study had RLS which, incidentally, improved. It was therefore incidental in this respect.
I concur with what you say, particularly I too noted that no change in electrolyte levels before and after. Don't recall if they said what they were at i.e. above, below or IN "normal" range.
I too noted that although an improvement in RLS was claimed, no explanation for the reason for this, i.e. what is the relationship between RLS and potassium.
Even if the difference in RLS symptoms was statistically significantly different because of the above, it's still not clear whether Pot Cit is beneficial for ALL cases of RLS or only secondary RLS.
I think it needs to be recognised that not everybody with the same "condition" responds to the same "medicine" in the same way and although idiopathic RLS might be considered a condition, RLS in general, a syndrome, is not a condition as such, but a group of symptoms that can occur as a result of several conditions.
There seem.to be several lines of enquiry into the underlying mechanisms of RLS currently, iron metabolism, vitamin D, potassium and others
It's a bit like the relationship between cosmological theory. ( "big" things) and quantum theory (sub atomic things) and trying to come up with one theory, (Theory OF Everything), that explains it all!
Manerva
I agree individuals responses to treatment will vary according to their individual make up. Bangladesh genetics, diet, mineral intake may well differ from UK or US
Yes there are differences between primary and secondary forms
Primary RLS is familial in up to two thirds of patients. RLS may also be secondary to a number of conditions including iron deficiency, pregnancy and end-stage renal failure and, perhaps, neuropathy.
Eg Impairment of temperature perception is present in a high percentage of RLS patients.
In secondary RLS the sensory deficits are at least in part caused by small fibre neuropathy. In idiopathic RLS a functional impairment of central somatosensory processing is present.
ncbi.nlm.nih.gov/pubmed/153...
You are right the paper doesn’t identify the two groups. I can’t imagine only one group was selected, so at face value potassium must have cured both groups.
Nerve conduction in both groups will depend on potassium in nerve cells so it may be possible for it to cure both groups in Bangladesh and not here. What I’m still unsure of is how many sufferers here have repeated the study exactly and for those who have, was it effective. As the dose is high and slow release I doubt those taking ordinary potassium tablets would be able to take enough using ordinary supplements.
I’m still hoping you post References to the studies you say repeated this work. If these don’t exist there may be merit in pushing for a proper study here. If one or more have been done and not worked at all then I’ll stop talking about it. If they worked partially then we need to try to explain why.
Best regards
It might be a while before I track down more recent studies! You might have to remind me.
Interesting about temperature perception, I didn't know that. Nor about sensory deficits in RLS, must read . . .
I have sensory deficits due to neuropathy and hypersensitivity due to Apergers, so I'm sort of piggy in the middle.
Paper published in 2016 says
“The study period was from June 2011 to March 2012.”
It’s unusual for a study to take 4 years to be published.
I confess to being very impulsive in saying what I say before fully considering what I've just read, in relation to other things I've read and can't entirely blame Pramipecole for this.
Within the confines of the limited search facilties I have access to I have been unable to come up with the claimed "other studies". Repeated searches come up only with this same study and the other sources referenced in this study.
Perhaps if I had access to the commonly used health related bibliographic databases, I might find more, but as neither student or health employee I don't have such access. I'm not willing to subscribe to services privately.
To correct the inaccuracies in my reflections on the study mentioned as this posts's title, this final comment.
This study was a study based on an incidental finding in a previous study that ONE subject with RLS benefited from taking Pot Cit. It was a study in it's own right.
It claimed that ALL of the subjects had NO RLS symptoms after taking Pot Cit for 45 days. (100%). However, there was no placebo control group.
The visual anaalogue scale, the tool used for "measuring" severity of symptoms, ignoring the validated tools available I would describe as facile.
Possible explanations for the finding were offered, but nothing to support the explanations i.e. may be due to
I. Neutralization of acidosis and or
II. Potassium influx into muscle cells thereby hyperpolarizing
the muscles resulting in decreased contraction.
There is reference in the study to evidence that low potassium levels can lead to problems with muscle contraction, (in people with deficiency). However, I can find no mention whatever in THIS study about if any of the subjects had potassium deficiency.
Due to poor English grammar, it is left a bit ambiguous if the subjects had secondary or primary RLS.
Some of the references cited are a bit dubious in supporting the credibility of this study e.g. Wikipedia!
This study in itself lacks any credibility. As in other studies I've read there is an implication that because some people suffering RLS symptoms due to some deficiency are relieved of symptoms, then everybody with RLS irrespective of any deficiency can benefit.
A positive for this paper is that a simple self experiment could be to try the dose of Pot Cit identified for 45 days and hope for the 100% relief achieved in this study.
It would be a good idea to undergo a renal function test first.
Thanks Manerva, I agree with what you say, the only real positive is the result. I haven’t had a reply from the authors 2016 cited email address yet, maybe it’s discontinued. I’m hoping to see a reply from them to another blogger.
I am trying to interest a few academics that I’m still in touch with in a repeat study but so far responses haven’t been positive with comments like, there is speculation like ADHD over whether it’s real and it doesn’t fit our research team study areas coming up. Urocit K slow release tablets are only available by import from Canada to the UK.
UK pot cit formulations for cystitis are liquids with adult doses of 3G three times a day. at least one contains an unspecified amount of sodium.
medicines.org.uk/emc/files/...
A lot of cautions though.
It is a little odd that there haven't been follow up studies or attempts to replicate. It would appear to suggesdt that it isn;t generally thought worth pursuing, I'm not sure why except that the quoted study is pretty bad!
I haven;t looked into the dosage aspect yet, side effects, interactions, counterindications, warnings etc
Pot Cit IS available in the UK as a liquid with 300mg of the citrate salt per mL. This provides 28 mmol K+ per 10 mL.
That is, as K+ is monovalent 28 meq. ( 0.93 meq per mg?). Hope my maths is right!
Also an effervescent tablet with 3.5 grams salt. Again, not sure how much of that is K. Also not yet discovered if a prescription is needed. for the tablets. Tablets about £0.30p each.
According to the Bangladesh study that's less than a third of a tablet or 3 and a bit mLs fluid a day.
Will try and do maths later!
Side effects. Hyperkalaemia, nausea, vomiting.
Cautions - heart disease, elderly
Contraindication - severe renal impairment. Addisons disease.
Proprietary brands on sale OTC as a urinary alkalising agent. May be liquid only.
Can buy tablets from Asda/Ebay, doesn't say what form K is in, only 200mg, no indication of bioavailability.
There a few previous posts I came across, not sure if this person in the video is a medical doctor, but he doesn’t warn of issues for heart and kidney disease.
He mentions vitamin B1 to reduce lactic acidosis and insulin affecting potassium. One happy customer.
healthunlocked.com/rlsuk/po...
There are no medical doctors on this site, or if there are, they are not on this site in this capacity. The post you linked to appears to be an advert or similar thing. Adverts are against the community rules.
This is a link to UK Nationally approved information on Potassium Citrate published by the UK National Institute for Health and Care Excellence Care (NICE) and found in the British National Formulary (BNF) which UK doctors refer to when prescribing medications
If you're in the US and can't acccess it, I copy in the relevant parts.
the link -
bnf.nice.org.uk/drug/citric...
The copy -
Indications and dose
Relief of discomfort in mild urinary-tract infections,
Alkalinisation of urine
By mouth using oral solution
For Adult
10 mL 3 times a day, diluted well with water.
Cautions
Cardiac disease; elderly
Interactions
Individual interactants:
Potassium citrate
Side-effects
Frequency not known
Hyperkalaemia; nausea; vomiting
Renal impairment
Avoid in severe impairment.
Monitoring
Close monitoring required in renal impairment—high risk of hyperkalaemia.
Prescribing and dispensing information
When prepared extemporaneously, the BP states Potassium Citrate Mixture BP consists of potassium citrate 30%, citric acid monohydrate 5% in a suitable vehicle with a lemon flavour. Extemporaneous preparations should be recently prepared according to the following formula: potassium citrate 3 g, citric acid monohydrate 500 mg, syrup 2.5 mL, quillaia tincture 0.1 mL, lemon spirit 0.05 mL, double-strength chloroform water 3 mL, water to 10 mL. Contains about 28 mmol K+/10 mL.
Exceptions to legal category
Proprietary brands of potassium citrate are on sale to the public for the relief of discomfort in mild urinary-tract infections.
Medicinal forms
There can be variation in the licensing of different medicines containing the same drug.
Oral solution, Effervescent tablet
I have personally witnessed someone die from excess potassium due to renal failure.
His heart stopped and neither me nor the medical team were able to resuscitate him.
Potassium is a vital and sensitive electrolyte without which muscles, including those of the heart and lungs and nerves cannot work . If potassiumj levels are too high or low, it can be fatal.
Manerva
I’m not sure what you are trying to do, I’m trying to be constructive and Hami is looking for comments from those who used potassium on their experience.
I don’t understand why you would say other studies showed potassium didn’t work, then say you couldn't find any. That was most unhelpful.
You have put forward responses which espouse alternative treatments, your counter theories or involve the cosmos. Now it’s a placebo effect.
How does that help answer Hamis question. Have you used potassium in the doses in the study.? Did it work?
There’s a risk you are discouraging genuine replies to hami from experienced potassium users and that genuine responses get lost in a morass of irrelevant text. I’m probably responsible for some of that too!!
Yes you are quite right, this thread has wandered off course and I accept responsibility for this.
Otherwise, I 'm sorry if you've misunderstood what I've written or misinterpreted my intentions.
I see you have only recently joined this community. It is brillant!
I hope you haven't gained a bad first impression and get lots of benefit from it in the future.
healthunlocked.com/rlsuk/po...
Tami is another reporting success on this thread.
This is someone describing the same study report that started this thread a year ago.
The member simply copies selected text from the study without any comment.
There are comments above on the dubious credibilty of this study. You have to read the WHOLE report.
After two days of looking for more studies on the efficacy of Pot Cit for RLS, I have found none. It appears to be the only one and most probabaly describes a placebo effect.
Manerva
I have never heard of a 100% cure placebo effect in any therapeutic area and assessing new medicinal products used to be my job.
It’s either a real effect or a made up one in my view.
Thanks for this fascinating exchange and very helpful to have the Report from Bangladesh exposed to this level of scrutiny. Thank you for taking the time and trouble to give your comments in such detail.
If anyone else in the Community Form has any good/bad experiences of using potassium citrate for RLS, I would be delighted to hear from them. Especially if they experienced a permanent relief of RLS. Thank you.
I just posted a random use of potassium citrate last night that relieved my moderate but insane RLS. Almost immediately. I had a bag as I take a very tiny amount in my food in the morning. Last night I took about 1/2 a teaspoon in water (ugh on the taste but who cares?) and worked to my surprise almost immediately. I did find the same study this morning Manerva posted above which heartens me greatly and will continue to update. I did just have a neurologist who did blood tests after negative nerve testing say I was low in vitamin D even though I take 10,000 units a day. I’ve doubled down on the D.
What a miracle if it continues to work. I’ve had RLS moderately since 2019 and occasionally (did not know what it was) lightly for some years before that if I drank coffee at dinner when out. I still cannot drink coffee after noon and only 1/2 decaf at that. Right now I am very happy. No morning buzz except from the coffee I’m drinking!
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