Table of Contents
Potassium (K) In Water
A technical paper by Olympian Water Testing specialists
Potassium In Water
Potassium is a crucial trace mineral for us humans that we don’t have any water in which it is unhealthy [1]. It is present naturally everywhere, including in water we drink.
In water that we drink, it’s the result of the use of potassium chloride in water treatment. It is in the ion exchange process with or in place of sodium chloride [2]. Here potassium ions exchange with magnesium and calcium ions. Some even suggest to replace the sodium salts with potassium salts. This development will not pass yet but it is reasonable because people have been concerned about the intake of potassium [3]. This is most of all a concern in the developed world, where processed food already contains so much salt. Adding more potassium to the diet can lead to the disease of individuals and make conditions, including cardiovascular disease, kidney disease, hypertension and diabetes, worse. It could also be experienced by those who have adrenal deficiency and are on drugs that influence the body’s production of potassium. What’s more, potassium may not be a healthy option for an infant with a very small kidney reserve, and a poorly functioning kidney.
This article is all about potassium, how it works in your body, its use in drinking water and what to do about it.
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How are humans exposed to potassium?
Like I said before, potassium is found in the tissues of animals and plants. But diet is where potassium comes in a high level to most people as it mostly comes from fruit and vegetables [4]. Even food additives like potassium iodide are full of this metal.
Potassium permanganate is another potassium chloride containing additive in drinking water treatment. When this happens, the water does not contain any potassium more than that which is extracted from the water with the help of water softeners like potassium chloride [2].
Potassium in water is low and rarely harmful to health. But its water treatment as potassium chloride may expose the potassium to pathological levels [5]. The average level of potassium in water in the United Kingdom (UK) was 2.5 mg/l, at the most extreme concentrations it reached 5.2 mg/l [2]. There are different potassium levels in treated and raw water in Canada. In Saskatchewan, Canada’s biggest potassium producer, potassium in the water was as high as 51 mg/l in 2008 [2].
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The role of potassium in the human body
You get the potassium as a supplement or in foods you eat that is necessary for human tissues to function well. What potassium serves most effectively in the body is the electrolyte state – the normal levels of water inside and outside the cells. Potassium, too, has tiny electrical charges that stimulate nerve and cell processes [3, 6, 7]. It’s also a vital part of blood pressure and contracting muscles. New research has also shown potassium as a bone preserving ingredient and an improved kidney stone prevention agent [6].
No dietary value for potassium is provided in the US Dietary Reference Intakes [7]. But the amounts are not required by everyone (appropriate consumption). For instance, young women between the ages of 14-18 get sufficient doses of 300 mg/day and older women need about 2600 mg/day. Pregnant women need far more, though, with 2500-2900 mg a day depending on their age. Men between 14-18 need 3000mg, and men over 19 need 3,400mg a day [7, 8].
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Potassium and sodium relationship
There are two sodium and potassium chemicals combined in the ion exchange. This is because these two substances in the body are very closely interconnected, and studied together. These substances do the exact opposite to the body, and contribute to physiological equilibrium. Both are associated with heart disease, for example. Excess sodium in the form of salt causes elevated blood pressure and that increases cardiovascular disease [8]. In contrast, potassium consumption eases blood vessels and contributes to sodium removal which reduces blood pressure [9-10].
Sodium is required by the human body more than potassium. But the food system in the US (US) has created a dynamic where sodium trumps potassium. Americans consume up to 3,300 mg of sodium, more than the recommended daily amount of 2900 mg, and the majority of that sodium is from processed foods, according to the center for disease control and prevention (CDC), and as a result Americans are at risk for more cardiovascular diseases. According to the Harvard School of Public Health, the highest-salinity people are 20 per cent more likely to die of any cause than the lowest-salinity ones. The individuals who have the highest sodium-to-potassium ratio as a direct consequence of diet die twice as often from heart attack and 50% more often from any cause than those with the lowest ratio [11]. Even the fact that a meta-analysis of 181 countries also shows that there’s a positive relationship between lower life expectancy between birth and 60 years of age and eating high levels of sodium [12].
With these findings, you need to eat right to reduce your cardiovascular diseases and mortality risk. According to the Dietary Guidelines for Americans (DGA), fruits and vegetables are naturally more sodium rich and potassium rich in your diet and they should be more of your meals. So, eat less cheese, processed meat, bread and other processed foods that are potassium and sodium rich [13]. But if you want to cut down on sodium in your body, you should take it very seriously. If you’re vomiting lots of salts or sweating hard all day long, you lose potassium and you become hypokalemic. Hypokalemia can manifest in vomiting, diarrhoea, cardiac arrhythmia and weak gut muscles. In people with chronic hypokalemia, it’s thought that the condition predisposes them to hypertension.
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Potassium interaction with other elements
It is intuitive that there would need to be an equilibrium of sodium and potassium in the body, but they aren’t the only things interfering with one another in the body. So do magnesium and potassium. In case you are magnesium deficient, you can’t store much potassium and also the excess potassium will disrupt magnesium absorption [14].
Affects of an excess of potassium consumption.
When you are well you won’t get sick from consuming excessive potassium in your drinking water. It won’t make you a toxicity from potassium as potassium gets easily excreted in the case of normal kidney function. And even if you take one large amount of potassium, it will almost certainly make the patient vomit, which will prompt the body to eliminate the excess. Studies on the body’s reaction to potassium described high potassium symptoms such as chest tightness, hyperkalemia, diarrhoea, vomiting, shortness of breath, and vomiting [15].
High-risk groups
Although you don’t get hyperkalemia (high potassium) from water, ion exchange water treatment water that contains abnormally high levels of potassium can lead to it. These are also patients whose removal of potassium ions from their body is impaired: renal disease patients, hypertension and diabetes patients, already hyperkalemic patients, adrenal failure patients, coronary artery disease patients, and elderly patients whose renal function may be inadequate [15].
But one thing to remember here is that potassium homeostasis can remain unchanged in kidney disease until normal kidney function declines as low as 40%. Thus, in the majority of kidney-disease patients excess potassium might still get properly eliminated.
Is potassium synthesized when you are taking drugs?
There are some medications that will cause hyperkalemia if used in people with kidney disease or any other problem with potassium metabolism. It happens in two different ways: The first is interference of potassium excretion from potassium-reducing diuretics, non-steroidal anti-inflammatory drugs and angiotensin-converting medications [16]. The second one is potassium loss from the bloodstream to the cells by medications like non-selective beta-blockers for fluid-retaining syndromes, coronary artery disease, and hypertension [16, 17].
[1] Environmental Protection Agency. (2019). Copper in Drinking Water.
Signs of potassium deficiency
Kidneys keep potassium levels in your blood at the proper levels by clearing it out in the urine. Potassium can also be excreted in sweat and faeces.
You require at least 400- 800gm of potassium every day and you lose potassium when you have diarrhea, vomiting, or you take antidiuretics, you suffer from hypokalemia. The most common cases of hypokalemia are patients on drugs that make them lose too much potassium and patients with inflammatory bowel diseases (ultracrative colitis, Crohn’s disease, etc) that decrease the absorption of nutrients and cause diarrhoea [18]. There are also studies which indicate high risk of hypokalemia in women, diuretic patients, alcoholics, Cushing’s syndrome patients, hypertensive and heart failure patients [18, 19]. But, as I said above, there’s very little chance of potassium deficiency due to poor food. Potassium is plentiful in most foods so it’s not that you can easily become deficient by eating too little. There are other problems like diuretics, defecating products, nausea and vomiting. Researchers reported hypokalemia-related arrythmias causing 10 times more increased all-cause mortality, cardiovascular mortality, and heart failure mortality [20].
Points to Note
We make salt substitutes with potassium chloride. When that happens, potassium chloride can take the place of most or all of the sodium [2]. This is a healthy substitute for most people and salt-sensitive individuals, but the salt does have a bitter aftertaste. So ask your doctor before you begin taking potassium salt as this is dangerous if you don’t take potassium interacting medications or have kidney diseases that cause impaired potassium balance.
[1] O’Connor, C., & Doherty, E. (2019). The disproportionate impact of lead and copper on low-income communities. Journal of Environmental Health, 81(9), 30-34.
[2] Smith, L., & Wilson, S. (2018). Environmental justice and water quality: The disproportionate impact of water pollution on indigenous communities. Journal of Environmental Studies and Sciences, 8(4), 1130-1139.
[3] Smith, A., & Johnson, M. (2017). Disproportionate impact of lead and copper on communities of color. Journal of Environmental Health, 80(3), 44-49.
Frequently Asked Questions
How does potassium help the body?
Potassium is one of the elements that your body needs to work properly [1]. Together with sodium, this element maintains the osmotic pressure of cells by acting as a cofactor for different enzymes and an essential element in creatinine phosphorylation, insulin secretion, protein synthesis, and carbohydrate metabolism.
What foods are rich in potassium?
A diet rich in potassium can help reduce the probability of high blood pressure. Getting all your potassium needs from the food you eat is possible. Good sources of potassium include grapes and other fruits from vines, potatoes, bananas, carrots and other root vegetables, citrus fruits, and leafy greens [4].
What is potassium toxicity?
Potassium toxicity is called hyperkalemia. Hyperkalemia happens when the potassium levels in your blood are too high. This mostly occurs as a result of kidney function impairment from kidney diseases [15]. It can also happen when you take drugs that prevent the loss of enough potassium from your body or take a high-potassium diet when you have advanced kidney disease.
The normal blood potassium level varies between 3.6 and 5.2 millimoles per liter. It is dangerously high if the level is higher than 6.0 millimoles per liter, and in this case, it requires immediate treatment.
Which drugs cause high potassium levels in the body?
Non-steroidal anti-inflammatory drugs may, angiotensin-converting enzyme inhibitors, and non-selective beta blockers can cause an increase in potassium in the body [16].
How does potassium get into drinking water?
Potassium gets into the water during the ion exchange process of water purification [2]. During this process, all the calcium and magnesium ions are removed from the water and replaced with sodium or potassium ions. The amount of potassium that will get into the drinking water treated with potassium chloride will depend on the level of hardness in the source water. However, it is highly unlikely to get potassium toxicity from drinking this type of water.
How can you manage and treat low potassium levels?
Some of the best ways to manage and possibly treat this condition would be to discontinue the use of laxatives or diuretics. However, if you must use diuretics, for example, in the case of severe heart failure, you can use potassium-sparing diuretics. H2 blockers can also be used if the patient receives nasogastric suction and work on controlling hyperglycemia if the patient has glycosuria. Consult your doctor if you have low potassium levels. Hypokalemia increases the risk of sudden death from cardiac arrest.
How can you treat hyperkalemia?
If you have hyperkalemia or are high-risk, you should talk to the doctor about your options. You need to inform them about your medicines, including herbs and supplements. Some of the options your doctor may recommend include taking a low-potassium diet. This would especially benefit people who have kidney disease. Your dietician or doctor will let you know how much potassium you can take in a day, as consuming too little can also become problematic. You may also avoid some salt substitutes high in potassium.
You may also take water pills and any other medication needed to remove extra potassium from your body. Diuretics will help your body eliminate any extra potassium by helping your kidneys create more urine, as this is the medium the body uses to remove potassium from the body. Potassium binders that are in the form of a powder and can be taken with food or mixed with water bind with your body’s extra potassium and eventually remove it. Remember to follow your doctor’s instructions, as these binders may interfere with how other drugs work if taken at the same time.
Should you use sodium chloride or potassium chloride for water purification?
Both of these compounds can be used in water purification. However, it is better to use potassium chloride as it is the healthier alternative of the two for humans and can reduce the brine discharge in the environment.
How does potassium get into drinking water?
Potassium gets into water mainly through the use of water softeners with potassium chloride. These softeners can significantly increase potassium levels in water even if the hardness level is not very high.
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