Vitamins & Supplements · Mineral
Potassium
Potassium (K), an essential mineral and electrolyte · also called K+, potasio
Potassium is a mineral your nerves, muscles and heart need to work. Most people get it from food. The best-supported finding is that more potassium modestly lowers blood pressure in people who already have high blood pressure, and a large trial of a potassium salt substitute found fewer strokes. The main caution is that too much can be dangerous with kidney disease or some medicines.
General information, not medical advice. Last substantive update · Not medically reviewed. A named clinician has not signed off on this page. How this page is made
About Potassium
Potassium is an essential mineral and electrolyte. Most people get it from food. The firmest findings are a modest blood pressure fall in people with high blood pressure and fewer strokes with a potassium salt substitute. Other uses are weak or not tested. The key caution is high blood potassium with kidney disease or some medicines.
What it is
Potassium is a mineral and an electrolyte, an electrically charged mineral in body fluids. MedlinePlus says it helps nerves work, muscles contract and the heartbeat stay regular, and helps move nutrients into cells and waste out. Almost all of it is inside your cells, and the kidneys keep the level in your blood steady.
Supplements and salt substitutes use potassium salts such as potassium chloride and potassium citrate. We read nothing on the history of potassium from a source, so this page does not cover it.
Food sources and amounts (USDA data)
MedlinePlus names leafy greens, fruit from vines such as grapes, root vegetables such as carrots and potatoes, and citrus fruit. The NHS names bananas, broccoli, parsnips, Brussels sprouts, beans and pulses, nuts and seeds, fish, beef, chicken and turkey.
USDA FoodData Central amounts (SR Legacy values, as recorded in our food pages): one medium raw banana (118 g) about 422 mg; raw spinach 558 mg per 100 g (one cup of leaves about 167 mg); cooked white beans 561 mg per 100 g (one cup about 1,004 mg); raw potato with skin 425 mg per 100 g; raw avocado 485 mg per 100 g; plain low-fat yogurt 234 mg per 100 g (one cup about 573 mg). Cooking changes the values.
These numbers describe foods and are not advice on how much to eat. The NHS says adults aged 19 to 64 need 3,500 mg a day and the WHO says at least 3510 mg a day for adults may be beneficial. Those are regulator statements. The NIH Office of Dietary Supplements fact sheet could not be read, so no figure from it is given.
What the research found
A 2013 review of 22 trials found more potassium lowered blood pressure in people with high blood pressure, with no significant harm to kidney function, blood fats or stress hormones in adults. A 2020 review found a U-shape: the fall levelled off, and blood pressure rose again at the highest levels in people on blood pressure medicines.
A large trial in rural China found fewer strokes, heart events and deaths when regular salt was swapped for a salt substitute with 25% potassium chloride. The Cochrane review rates such results moderate certainty. Studies that follow people over time link more potassium in food with lower stroke risk. Prescribed citrate salts reduced new kidney stones in seven small trials, but potassium citrate did not protect bone in healthy postmenopausal women over two years.
Food, salt substitutes and pills are different
The stroke and heart disease links are for potassium eaten in food. The big heart-event trial used a salt substitute that lowers sodium at the same time. The kidney stone trials used prescribed citrate salts. Potassium pills sold for general use were not tested in the large trials we read.
At a glance
Traditional uses history, not proof
- Needed from food by everyone for normal nerve, muscle and heart function
- Normal body roles are not proof that extra pills help
Studied for research
- Blood pressure, moderate certainty (in people with high blood pressure)
- Salt substitutes and stroke or heart events, moderate certainty (not potassium pills)
- Stroke and heart disease links, low certainty (observational)
- Kidney stones (prescribed citrate salts), low certainty
- Bone loss after menopause, low certainty (mostly null)
- Correcting low blood potassium, not rated (no trial read)
Main compounds
- Potassium chloride
- Potassium citrate
- Potassium-sodium and potassium-magnesium citrate
- Potassium bicarbonate and gluconate (evidence not read)
Common forms
- Food sources such as spinach, beans, potatoes, bananas, avocado and yogurt (USDA values as recorded)
- Low-sodium salt substitutes (75% sodium chloride and 25% potassium chloride in the main trial)
- Prescribed citrate salts used in kidney stone trials
- Slow-release potassium chloride tablets (older types linked to gut ulcers)
Research links: 2013 review: potassium intake and blood pressure, stroke (22 trials, 11 cohorts) · 2021 trial: salt substitute and stroke in rural China (20,995 people) · 2022 Cochrane review: low-sodium salt substitutes (26 trials) · 2015 Cochrane review: citrate salts and kidney stones · Research Library · Genes & Biomarkers Library
What it is and its history
- Accepted scientific name
- Potassium (symbol K), an essential mineral and electrolyte. Not a plant, so there is no species name.
- Common names
- Potassium (English); Potasio (Spanish); K+ (ion form) (English)
- Family or group
- Major minerals and electrolytes
- Look-alikes and adulterants
- Name: Sodium; Note: Another electrolyte that works in the opposite direction on blood pressure; it has its own page.; Name: Magnesium; Note: Another mineral involved in muscle and nerve function; it has its own page.
What is inside, and how it may work
What it contains and how those compounds act in cells and animals. Laboratory and animal mechanisms are not proven effects in people.
Main compounds
| Compound | Family | Where it is concentrated | Activity studied | Level of evidence |
|---|---|---|---|---|
| Potassium chloride | mineral salt | In the large salt substitute trial, 25% of the substitute by mass (the other 75% was sodium chloride) | The potassium salt in salt substitutes and slow-release potassium tablets. 9 7 | Human data |
| Potassium citrate | mineral salt | Not stated in the abstracts read | Studied for kidney stones and for bone loss; raised urinary potassium in trials. 10 8 2 | Human data |
| Potassium-sodium citrate and potassium-magnesium citrate | mineral salt | Not stated in the abstract | Prescribed forms studied for kidney stones in 3 trials and 1 trial respectively. 10 | Human data |
| Potassium bicarbonate and potassium gluconate | mineral salt | Not stated in the sources read | Sold as supplement forms; their evidence was not read. 12 | Not verified |
Mechanisms, receptors and pathways
| Target or pathway | Gene or receptor | What was found | Level |
|---|---|---|---|
| Nerve signals, muscle contraction and heartbeat | Not specified in the sources read | MedlinePlus says potassium is an electrolyte that helps nerves function, muscles contract and the heartbeat stay regular, and helps move nutrients into cells and waste out. Low or high blood potassium disturbs these. 12 13 | Human data |
| Sodium and blood pressure | Not specified in the sources read | MedlinePlus and the WHO say a potassium-rich diet offsets some of the harmful effects of sodium on blood pressure. The abstracts read do not test the mechanism. 12 22 | Hypothesis |
| Kidney handling of potassium | Not specified in the sources read | The kidneys remove potassium in the urine to keep the right amount in the blood. A 2026 review describes the kidney adjusting to potassium supply; in advanced chronic kidney disease this is impaired. 13 5 | Human data |
| Citrate in the urine and calcium stones | Not specified in the sources read | The Cochrane review states that oral citrate raises urinary citrate, which binds calcium and inhibits crystallisation. It does not test this in the abstract. 10 | Hypothesis |
Absorption, metabolism and elimination
- Absorption
- Not found in the sources read.
- Distribution
- MedlinePlus: almost all body potassium is inside cells; a small amount is in the blood.
- Elimination
- Mostly by the kidneys in the urine; kidney disease reduces removal (MedlinePlus).
- Bioavailability
- Food versus pill absorption and the differences between potassium salts were not found in the sources read.
Isolated compounds versus whole extracts
Food and pills are not the same thing. Observational links with stroke and heart disease are for potassium from the usual diet. The blood pressure trials mixed diet changes and supplements. The large heart-event trial used a salt substitute that also cuts sodium. The kidney stone trials used prescribed citrate salts. In the one long bone trial, potassium citrate did not help bone while the effect of extra fruit and vegetables is not given in the abstract.
Nutritional composition
Food sources (MedlinePlus): leafy greens such as spinach and collards, fruit from vines such as grapes and blackberries, root vegetables such as carrots and potatoes, and citrus fruits. The NHS lists bananas, broccoli, parsnips, Brussels sprouts, beans and pulses, nuts and seeds, fish, beef, chicken and turkey. Potassium amounts from USDA FoodData Central (SR Legacy) as recorded in our earlier food pages: raw banana, one medium (118 g) about 422 mg; raw potato with skin 425 mg per 100 g; raw spinach 558 mg per 100 g (one cup of leaves, 30 g, about 167 mg); cooked boiled white beans 561 mg per 100 g (one cup, 179 g, about 1,004 mg); raw avocado 485 mg per 100 g; plain low-fat yogurt 234 mg per 100 g (one cup, 245 g, about 573 mg). Per-portion values are worked out from the per-100 g figures. Cooking changes the values, and the USDA site itself was not re-opened this session. These numbers describe foods and are not advice on how much to eat. NHS says adults 19 to 64 need 3,500 mg a day and WHO says at least 3510 mg a day for adults may be beneficial; these are regulator statements.
2 moderate certainty3 low certainty1 not enough evidence
What was looked at
The 6 benefits and uses checked for Potassium, each with how strong the evidence is. Tap one to open it.
- Blood pressure (more potassium in the diet or as supplements)Moderate certainty
- Salt substitutes with potassium: stroke and heart eventsModerate certainty
- Stroke, heart disease and early death (observational)Low certainty
- Correcting low blood potassium (hypokalemia)Not enough evidence
- Kidney stones (potassium citrate and related citrate salts)Low certainty
- Bone loss in postmenopausal women (potassium citrate)Low certainty
Lab markers tracked in the studies
Systolic blood pressure (top number)Diastolic blood pressure (bottom number)Potassium in the blood (serum potassium)Urinary NTX (a marker of bone breakdown)Potassium in the urine
What is Potassium good for?
The main studied uses and how strong the human evidence is for each. The strongest findings are for blood pressure in people who already have high blood pressure, and for a potassium salt substitute, not for pills.
Benefits, one by one
Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.
Blood pressure (more potassium in the diet or as supplements)
Moderate certaintyAcross 22 trials, getting more potassium lowered blood pressure by about 3.5 points (top number) in adults. The fall was seen in people with high blood pressure, not in people with normal blood pressure. Taking much more did not lower it further and, in one analysis, very high levels raised it again.
4 studiesTrials raised potassium intake through diet changes and supplements (…
Studies, doses and limits
What the trials found
A 2013 review of 22 randomised trials (1,606 adults) found systolic blood pressure fell by 3.49 mm Hg and diastolic by 1.96 mm Hg with higher potassium intake, in people with high blood pressure but not in those without. A 2020 review of 32 trials of potassium supplements of 4 weeks or longer, mostly in adults with high blood pressure, found a U-shaped curve: the benefit levelled off above a certain rise in potassium and blood pressure rose at the highest levels, in people already on blood pressure medicines but not in untreated people. The authors say few trials tested high intakes.
Results
A real but modest effect in people who already have high blood pressure. Little or no effect when blood pressure is normal. Not a substitute for blood pressure medicine.
Effect sizes as reported
Systolic -3.49 mm Hg (95% CI 1.82 to 5.15); diastolic -1.96 mm Hg (0.86 to 3.06). Raising intake to 90 to 120 mmol a day: systolic -7.16 mm Hg (1.91 to 12.41), with no dose response. In children: -0.28 mm Hg, not significant (-0.49 to 1.05).
Why this rating
Moderate. The 2013 reviewers called the evidence for people with high blood pressure high quality, but the trials mixed food and supplement forms, and the 2020 dose-response review found a U-shape with very few trials at high intakes. No effect shown for normal blood pressure.
Form and dose studied
Trials raised potassium intake through diet changes and supplements (the abstracts do not separate them or name the salt used). This is not a statement about how much anyone should take.
Who was studied
Adults; the 2020 review included mostly adults with high blood pressure. In children the effect was small and not significant.
Limits
The 2020 review pooled trials of 4 weeks or longer, mostly crossover designs. Mixed food and supplement forms. High-intake trials are few. People with kidney problems that affect potassium are outside the authors' conclusion.
Why researchers looked
Sodium pushes blood pressure up and potassium is thought to work the other way, so researchers asked whether eating or taking more potassium lowers it.
Traditional use
Potassium is a mineral everyone needs from food. Its normal jobs in the body are not proof that extra pills help.
Proposed mechanism Hypothesis
Not tested in the abstracts read. MedlinePlus and the WHO say a potassium-rich diet offsets some of the harmful effects of sodium on blood pressure.
A proposed mechanism does not show that the effect happens in people.
Too much potassium is dangerous for people with kidney disease or on certain medicines. See the Safety tab.
Salt substitutes with potassium: stroke and heart events
Moderate certaintyIn a large trial in rural China, older people with high blood pressure or a past stroke who swapped regular salt for a salt that is one quarter potassium chloride had fewer strokes, heart events and deaths over about 5 years. A Cochrane review of 26 trials agrees that such salt substitutes probably lower blood pressure slightly and slightly reduce heart events.
3 studiesA salt substitute of 75% sodium chloride and 25% potassium chloride b…
Studies, doses and limits
What the trials found
The 2021 trial randomised 600 villages (20,995 people, average age 65) to a salt substitute of 75% sodium chloride and 25% potassium chloride or to regular salt, for an average of 4.74 years. Stroke, major cardiovascular events and death were all lower with the substitute, and serious events from high blood potassium were not significantly higher. The 2022 Cochrane review of 26 trials (34,961 adults) rated its main findings moderate certainty.
Results
Fewer strokes, heart events and deaths in the main trial; small blood pressure falls and slight reductions in heart events in the review. It tests a salt substitute, not potassium pills.
Effect sizes as reported
Trial: stroke rate ratio 0.86 (95% CI 0.77 to 0.96); major cardiovascular events 0.87 (0.80 to 0.94); death 0.88 (0.82 to 0.95); serious high-potassium events 1.04 (0.80 to 1.37). Cochrane: systolic -4.76 mm Hg, diastolic -2.43 mm Hg, blood potassium +0.12 mmol/L (0.07 to 0.18), little or no difference in high blood potassium (4 more per 100,000 person-years, -47 to 121).
Why this rating
Moderate, as the Cochrane reviewers graded it. One very large open-label trial dominates the heart-event results. The effect cannot be credited to potassium alone. Evidence is thin for people with normal blood pressure and absent for pregnancy.
Form and dose studied
A salt substitute of 75% sodium chloride and 25% potassium chloride by mass was used in the main trial; other trials used different mixes (3% to 77% of sodium chloride replaced). Not a statement about how much anyone should use.
Who was studied
Mostly older adults with high blood pressure or past stroke, rural China (main trial); 26 trials across many settings, with people at risk of high potassium excluded.
Limits
Open-label trial. All 26 trials excluded people for whom extra potassium is known to be risky, so the results do not apply to people with kidney disease or on potassium-raising medicines. WHO says these products suit people not at risk of high blood potassium.
Why researchers looked
Replacing part of table salt with potassium chloride cuts sodium and adds potassium at once, so it is a cheap way to test the sodium and potassium idea in whole communities.
Traditional use
Potassium is a mineral everyone needs from food. Its normal jobs in the body are not proof that extra pills help.
Proposed mechanism Hypothesis
Not separated. The substitute lowers sodium and raises potassium together, so the trials cannot say which change did the work.
A proposed mechanism does not show that the effect happens in people.
Salt substitutes are potassium chloride and add up with other potassium sources. They can be unsafe in kidney disease and with some medicines. See the Safety tab.
Stroke, heart disease and early death (observational)
Low certaintyIn studies that followed people over time, those who ate more potassium had a lower risk of stroke and of heart disease. These studies show a link, not proof, because people who eat more potassium-rich foods also differ in other ways.
2 studiesUsual food intake in the cohorts, measured by questionnaires or by ur…
Studies, doses and limits
What the trials found
The 2013 review pooled 11 cohort studies (127,038 adults): higher potassium intake went with a lower risk of stroke. A 2024 review of 56 prospective studies found higher potassium intake went with lower risk of cardiovascular disease and of death from any cause. In the same review, higher blood potassium went with a higher risk of death, which is a sign of illness and not of potassium intake, and the abstract gives no diabetes result.
Results
Consistent links with lower stroke and cardiovascular risk. They show an association only.
Effect sizes as reported
Stroke RR 0.76 (95% CI 0.66 to 0.89); cardiovascular disease RR 0.88 (0.70 to 1.11, not significant) in 2013 and RR 0.84 (0.78 to 0.90) in 2024; coronary heart disease RR 0.96 (0.78 to 1.19, not significant); death from any cause RR 0.93 per 1.0 g a day (0.88 to 0.99); blood potassium and death RR 1.23 (1.11 to 1.36).
Why this rating
Low. Observational evidence only. The 2013 reviewers called the stroke finding moderate quality; foods rich in potassium bring fibre and other nutrients, and potassium pills were not tested in these cohorts.
Form and dose studied
Usual food intake in the cohorts, measured by questionnaires or by urine. Not a statement about how much anyone should eat.
Who was studied
Adults in the general population in the cohorts pooled.
Limits
Observational. Intake measured imperfectly. Cannot separate potassium from the rest of the diet. Dietary potassium findings do not show that pills do the same.
Why researchers looked
Potassium-rich foods such as fruit, vegetables and beans are part of heart-healthy eating patterns, so researchers looked at whether potassium itself tracks with outcomes.
Traditional use
Potassium is a mineral everyone needs from food. Its normal jobs in the body are not proof that extra pills help.
Proposed mechanism Hypothesis
Not tested in the abstracts read.
A proposed mechanism does not show that the effect happens in people.
See the Safety tab for kidney disease and medicines.
Correcting low blood potassium (hypokalemia)
Not enough evidenceLow blood potassium causes cramps, weakness and an irregular heartbeat. It is usually caused by water pills, vomiting, diarrhoea, laxatives or hormone and kidney problems, and rarely by diet alone. No trial of potassium pills for this was read, so it is not rated here. It needs a blood test and medical care.
2 studiesNot applicable.
Studies, doses and limits
What the trials found
No trial was read. MedlinePlus lists the symptoms and causes of low and high blood potassium and says test results should be discussed with a provider.
Results
Not rated: no trial evidence was read.
Why this rating
Insufficient. This page read agency descriptions, not trials of potassium treatment.
Who was studied
People with a low blood potassium level, usually from medicines or illness.
Limits
No trial read. Treating low potassium is a medical matter, and too much potassium is dangerous.
Why researchers looked
Low blood potassium is the best-known problem of too little potassium.
Traditional use
Potassium is a mineral everyone needs from food. Its normal jobs in the body are not proof that extra pills help.
Proposed mechanism Health agency
MedlinePlus says nerves, muscles and the heart depend on potassium; low levels disturb them.
A proposed mechanism does not show that the effect happens in people.
Do not self-treat low potassium. Too much can cause dangerous heart rhythm problems.
Kidney stones (potassium citrate and related citrate salts)
Low certaintyIn seven small trials, prescribed citrate salts, mostly potassium citrate, reduced new calcium kidney stones and slowed growth of existing stones. The quality of the trials was moderate to poor, and more people stopped taking the citrate because of side effects.
1 studiesPrescribed citrate salts: potassium citrate, potassium-sodium citrate…
Studies, doses and limits
What the trials found
A 2015 Cochrane review pooled 7 randomised trials (477 adults, mostly with oxalate stones, treated for at least 6 months): 3 of potassium citrate, 3 of potassium-sodium citrate and 1 of potassium-magnesium citrate, against placebo or no treatment.
Results
Fewer new stones and less stone growth in people who already form calcium stones. Side effects (upper gut upset) led to more dropouts.
Effect sizes as reported
New stone formation RR 0.26 (95% CI 0.10 to 0.68); stone size RR 2.35 (1.36 to 4.05); retreatment RR 0.22 (0.06 to 0.89); dropouts for side effects RR 4.45 (1.28 to 15.50).
Why this rating
Low. The reviewers rate reporting as moderate to poor, trials were small and not all used pure potassium citrate. This is a prescribed medical use in people who form stones.
Form and dose studied
Prescribed citrate salts: potassium citrate, potassium-sodium citrate, potassium-magnesium citrate. Not a statement about over-the-counter potassium.
Who was studied
Adults with calcium kidney stones, mostly oxalate stones.
Limits
Small trials (477 people in total). The review authors call for a well-designed multi-centre trial. Does not apply to people without stones.
Why researchers looked
Citrate in the urine binds calcium and may keep stones from forming, and oral citrate raises urine citrate.
Traditional use
Potassium is a mineral everyone needs from food. Its normal jobs in the body are not proof that extra pills help.
Proposed mechanism Hypothesis
The Cochrane review states that oral citrate raises urinary citrate, which binds calcium and inhibits crystal formation. Not tested in the abstract.
A proposed mechanism does not show that the effect happens in people.
Upper gut upset and dropouts were more common with citrate. Kidney disease changes how potassium is handled. See the Safety tab.
Bone loss in postmenopausal women (potassium citrate)
Low certaintyA two-year trial in 276 healthy postmenopausal women found potassium citrate did not reduce bone loss. A 2026 review of five trials found one bone marker lower at one month but no steady effect on others. Bone density and fractures were not shown to improve.
2 studiesPotassium citrate; strengths used are in the studies table. Not a sta…
Studies, doses and limits
What the trials found
The 2008 trial gave 276 healthy women aged 55 to 65 potassium citrate (two strengths), placebo, or 300 g of extra fruit and vegetables a day for 2 years. The 2026 review pooled 5 randomised trials (401 women) of potassium citrate.
Results
No lasting effect on bone turnover or bone density in healthy women; a small early change in one marker in the review.
Effect sizes as reported
Spine bone density loss 1.8% (placebo) vs 2.1% (treatment), P = 0.88. Review: urinary NTX at 1 month mean difference -4.05 nmol BCE/mmol creatinine (95% CI -8.05 to -0.05); no significant effect on CTX at 3 or 6 months or P1NP at 3, 6 or 12 months.
Why this rating
Low. The best long trial was null, and the pooled positive result is one borderline marker. The reviewers call its meaning uncertain. Markers, not fractures.
Form and dose studied
Potassium citrate; strengths used are in the studies table. Not a statement about how much anyone should take.
Who was studied
Healthy postmenopausal women (2008 trial); postmenopausal women in 5 trials (2026 review).
Limits
Healthy women, not women with osteoporosis, in the main trial. Small trials. Short follow-up for the review. No fracture data in the abstracts.
Why researchers looked
Fruit and vegetables seem to help bones, and potassium citrate is an alkaline salt that might explain it.
Traditional use
Potassium is a mineral everyone needs from food. Its normal jobs in the body are not proof that extra pills help.
Proposed mechanism Human data
The trial authors tested whether alkali provision explains the benefit of fruit and vegetables; their result says it does not explain a long-term benefit.
A proposed mechanism does not show that the effect happens in people.
See the Safety tab.
Connections to the rest of health
How Potassium connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.
Explore every connection: goals, body systems, organs, symptoms, genes
A. Wellness goals
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Blood Pressure Support | Demonstrated clinical effect | Moderate certainty | Blood pressure (more potassium in the diet or as supplements): Across 22 trials, getting more potassium lowered blood pressure by about 3.5 points (top number) in adults. The fall was seen in people with high blood pressure, not in people with normal blood pressure. Taking much more did not lower it further and, in one analysis, very high levels raised it again. Salt substitutes with potassium: stroke and heart events: In a large trial in rural China, older people with high blood pressure or a past stroke who swapped regular salt for a salt that is one quarter potassium chloride had fewer strokes, heart events and deaths over about 5 years. A Cochrane review of 26 trials agrees that such salt substitutes probably lower blood pressure slightly and slightly reduce heart events. | 1 6 12 22 9 3 |
| Heart Health | Demonstrated clinical effect | Moderate certainty | Blood pressure (more potassium in the diet or as supplements): Across 22 trials, getting more potassium lowered blood pressure by about 3.5 points (top number) in adults. The fall was seen in people with high blood pressure, not in people with normal blood pressure. Taking much more did not lower it further and, in one analysis, very high levels raised it again. Salt substitutes with potassium: stroke and heart events: In a large trial in rural China, older people with high blood pressure or a past stroke who swapped regular salt for a salt that is one quarter potassium chloride had fewer strokes, heart events and deaths over about 5 years. A Cochrane review of 26 trials agrees that such salt substitutes probably lower blood pressure slightly and slightly reduce heart events. | 1 6 12 22 9 3 |
| Heart Health | Low certainty | Stroke, heart disease and early death (observational): In studies that followed people over time, those who ate more potassium had a lower risk of stroke and of heart disease. These studies show a link, not proof, because people who eat more potassium-rich foods also differ in other ways. | 1 4 | |
| Bone Health | Low certainty | Bone loss in postmenopausal women (potassium citrate): A two-year trial in 276 healthy postmenopausal women found potassium citrate did not reduce bone loss. A 2026 review of five trials found one bone marker lower at one month but no steady effect on others. Bone density and fractures were not shown to improve. | 8 2 |
B. Body systems
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Cardiovascular System | Biological association | Moderate certainty | Studied for: Blood pressure (more potassium in the diet or as supplements) Studied for: Salt substitutes with potassium: stroke and heart events | 1 6 12 22 9 3 4 13 |
| Musculoskeletal System | Biological association | Not enough evidence | Studied for: Correcting low blood potassium (hypokalemia) Studied for: Bone loss in postmenopausal women (potassium citrate) | 13 12 8 2 |
| Urinary System | Biological association | Low certainty | Studied for: Kidney stones (potassium citrate and related citrate salts) | 10 |
E. Health conditions
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| High blood potassium (hyperkalemia) | Adverse effect or risk | Documented risk | Kidney disease and some medicines make high blood potassium more likely; MedlinePlus and a review of ACE inhibitor and angiotensin receptor blocker use describe the risk. Preparation or compound: Potassium supplements and salt substitutes |
13 11 |
| Low blood potassium (hypokalemia) | Documented | Low blood potassium causes cramps, weakness and irregular heartbeat; usually from medicines or fluid loss, rarely diet alone (MedlinePlus). Preparation or compound: Potassium as an essential mineral |
13 | |
| Chronic kidney disease | Contraindication | Documented risk | Kidneys may not remove extra potassium; supplementing or restricting should be individualized. Preparation or compound: Potassium supplements and salt substitutes |
12 5 |
I. Biomarkers
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Systolic blood pressure (top number) | Biological association | Moderate certainty | Measured in trials: lowered. A lab change is not the same as a health benefit. | 1 3 6 |
| Diastolic blood pressure (bottom number) | Biological association | Moderate certainty | Measured in trials: lowered. A lab change is not the same as a health benefit. | 1 3 |
| Potassium in the blood (serum potassium) | Biological association | Moderate certainty | Measured in trials: raised slightly. A lab change is not the same as a health benefit. | 3 9 13 |
| Urinary NTX (a marker of bone breakdown) | Biological association | Low certainty | Measured in trials: lowered at 1 month only. A lab change is not the same as a health benefit. | 2 8 |
| Potassium in the urine | Biological association | Low certainty | Measured in trials: raised. A lab change is not the same as a health benefit. | 2 |
K. Biological pathways
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Sodium | Preliminary mechanism | Human | Works against sodium on blood pressure (MedlinePlus, WHO). | 12 22 |
| Magnesium | Preliminary mechanism | Not verified | Low magnesium is sometimes said to contribute to low potassium. This was not confirmed in any source read. | 12 |
| Calcium | Preliminary mechanism | Human | Citrate salts bind urinary calcium in the kidney stone trials; the bone trial found no effect on bone density. | 10 8 |
L. Active compounds
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Potassium chloride | Biological association | Human | The potassium salt in salt substitutes and slow-release potassium tablets. | 9 7 |
| Potassium citrate | Biological association | Human | Studied for kidney stones and for bone loss; raised urinary potassium in trials. | 10 8 2 |
| Potassium-sodium citrate and potassium-magnesium citrate | Biological association | Human | Prescribed forms studied for kidney stones in 3 trials and 1 trial respectively. | 10 |
| Potassium bicarbonate and potassium gluconate | Biological association | Not verified | Sold as supplement forms; their evidence was not read. | 12 |
Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 26, 2026).
Evidence at a glance: what changed in 3 lab markers
Tap a number to show only those markers. Counts are markers, not people.
The evidence
The research centre for Potassium. Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.
Evidence by outcome
Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).
How we rate evidence
High certainty
Several well-run trials or reviews agree; further research is unlikely to change the picture much.
Moderate certainty
Good trials point the same way, but some doubt remains.
Low certainty
Small, short or inconsistent trials. The finding could change with better research.
Very low certainty
Very little or very weak human data. Treat as a possibility only.
Mixed findings
Trials or reviews disagree with each other.
Not enough evidence
Not enough human research to say either way.
Evidence against
Good research found no benefit, or found harm.
We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We started from our earlier potassium summary, re-read the NHS, MedlinePlus and WHO pages, and re-read PubMed abstracts for reviews and trials. The NIH Office of Dietary Supplements pages could not be opened. USDA values come from our food pages. Items we could not verify are flagged in the research gaps.
Study library: every study we checked 22
| Study | Design | People | Product, dose, length | Result |
|---|---|---|---|---|
| Aburto 2013 Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses. BMJ · PMID 23558164 · DOI |
Systematic review meta analysis |
1606 22 randomised trials (1,606 people) and 11 cohort studies (127,038 people), adults; plus 3 trials and 1 cohort in children |
Higher potassium intake (the abstract does not split food from supplement forms) Mineral (not a plant product) Trials: not stated in the abstract · vs Lower potassium intake or placebo |
Higher potassium intake lowered systolic blood pressure by 3.49 mm Hg and diastolic by 1.96 mm Hg in adults, seen in people with high blood pressure but not in those without. Systolic fell by 7.16 mm Hg when intake was raised to 90 to 120 mmol a day, with no dose response. No significant harm to kidney function, blood fats or stress-hormone levels in adults. In cohorts, higher potassium intake went with a lower risk of stroke (RR 0.76) but not significantly with cardiovascular disease (RR 0.88) or coronary heart disease (RR 0.96). In children the blood pressure effect was small and not significant (0.28 mm Hg). Systolic -3.49 mm Hg; diastolic -1.96 mm Hg; stroke RR 0.76 (Systolic 1.82 to 5.15; diastolic 0.86 to 3.06; stroke 0.66 to 0.89; cardiovascular disease 0.70 to 1.11; coronary heart disease 0.78 to 1.19) Methods, limits and fundingOutcomes: Blood pressure, kidney function, blood fats, stress-hormone levels, death, cardiovascular disease, stroke, coronary heart disease Limitations: Abstract only. Trials mixed food and supplement forms and trial lengths are not given in the abstract; the cohort findings show a link, not proof of cause. People with kidney trouble handling potassium were outside the conclusion, which the authors limit to people without impaired kidney handling of potassium. Funding and conflicts: Three authors received WHO funding to attend guideline meetings; the first author was a WHO staff member when the work was done. Several authors are unpaid members of salt-reduction groups. Read: abstract |
| AlSejari 2026 Effects of Potassium Citrate Supplementation on Bone Turnover Markers in Postmenopausal Women: A GRADE-Assessed Systematic Review, Meta-analysis and Trial Sequential Analysis. Calcif Tissue Int · PMID 42423994 · DOI |
Systematic review meta analysis |
401 5 randomised trials, 401 postmenopausal women |
Potassium citrate Mineral (not a plant product) Follow-up 1 to 12 months in the outcomes pooled · vs Placebo |
Urinary NTX (a bone breakdown marker) was lower at 1 month (mean difference -4.05 nmol BCE/mmol creatinine). No significant effect on serum CTX at 3 or 6 months or on P1NP at 3, 6 or 12 months. Urinary potassium rose. Urinary and serum calcium, parathyroid hormone and urinary pH did not differ. The authors call the clinical relevance uncertain. Urinary NTX at 1 month: mean difference -4.05 (-8.05 to -0.05) Methods, limits and fundingOutcomes: Bone turnover markers (urinary NTX, serum CTX, serum P1NP), urinary potassium, calcium and pH Limitations: Five small trials; the one positive result is borderline (P = 0.0474) among several outcomes. Markers, not fractures. Trial sequential analysis says the evidence is inconclusive. Funding and conflicts: The authors declare no conflict of interest. Read: abstract |
| Brand 2022 Replacing salt with low-sodium salt substitutes (LSSS) for cardiovascular health in adults, children and pregnant women. Cochrane Database Syst Rev · PMID 35944931 · DOI |
Systematic review meta analysis |
34961 26 randomised trials; 34,961 adults and 92 children; 11 trials only in people with high blood pressure; no trials in pregnant women |
Low-sodium salt substitutes, mostly (23 of 26 trials) with potassium salts replacing part of the sodium chloride Mineral (not a plant product) Share of sodium chloride replaced ranged from about 3% to 77% Two months to nearly five years · vs Regular salt or no active intervention |
In adults, salt substitutes probably lower systolic blood pressure by 4.76 mm Hg and diastolic by 2.43 mm Hg (moderate certainty), probably slightly reduce non-fatal stroke, non-fatal acute coronary syndrome and cardiovascular death (moderate certainty), and probably raise blood potassium slightly by 0.12 mmol/L (moderate certainty). They may make little or no difference to high blood potassium (moderate certainty) or to the rate of high blood pressure (low certainty). Evidence is very uncertain in children. Systolic -4.76 mm Hg; diastolic -2.43 mm Hg; blood potassium +0.12 mmol/L (Systolic -6.01 to -3.50; diastolic -3.50 to -1.36; blood potassium 0.07 to 0.18) Methods, limits and fundingOutcomes: Blood pressure, cardiovascular events, blood potassium, high and low blood potassium Limitations: All 26 trials excluded people for whom extra potassium is known to be risky, so safety in kidney disease or with potassium-raising medicines is not shown. Risk of bias high in 6 trials and unclear in 12. Little evidence in people with normal blood pressure. Funding and conflicts: Authors report support from a UK aid funded research initiative and institutional payments for related Cochrane reviews; no product-company funding is stated in the abstract. Read: abstract |
| Fan 2024 Potassium status and the risk of type 2 diabetes, cardiovascular diseases, and mortality: a meta-analysis of prospective observational studies. Crit Rev Food Sci Nutr · PMID 37788131 · DOI |
Systematic review meta analysis |
56 prospective observational studies of potassium in diet, blood and urine | Observational: dietary, blood and urine potassium (no intervention) Mineral (not a plant product) Studies followed people over time · vs Lowest versus highest groups |
Higher potassium intake went with a 16% lower risk of cardiovascular disease (RR 0.84) and, per extra 1.0 g a day, a lower risk of cardiovascular disease (RR 0.85) and death from any cause (RR 0.93). Higher blood potassium went with a higher risk of death (RR 1.23, nonlinear). Higher urinary potassium (a marker of intake) went with a lower risk of death (RR 0.84). The abstract does not give a diabetes result. Cardiovascular disease RR 0.84; death per 1.0 g a day RR 0.93; blood potassium and death RR 1.23 (CVD 0.78 to 0.90; death per 1.0 g 0.88 to 0.99; blood potassium 1.11 to 1.36) Methods, limits and fundingOutcomes: Type 2 diabetes, cardiovascular disease and death from any cause Limitations: Observational: people who eat more potassium-rich foods differ in other ways, so a link is not proof of cause. Blood potassium is a medical marker, not an intake measure, and its link with death does not mean potassium causes harm. Funding and conflicts: Funding is not stated in the abstract. Read: abstract |
| Ferdaus 2026 Kidney Effects of Potassium Additives in Health and Disease. Semin Nephrol · PMID 42823246 · DOI |
Narrative review n/a |
Narrative review of kidney physiology and potassium intake | Not applicable (review) Mineral (not a plant product) |
The kidney keeps potassium in balance, and both too little and too much are linked with heart and kidney problems. The authors say potassium-rich diets and bicarbonate or citrate supplements may have heart and kidney benefits, but because advanced chronic kidney disease makes high blood potassium more likely, supplementing or restricting potassium should be individualized to kidney function and risk. No numbers in the abstract (Not applicable) Methods, limits and fundingOutcomes: How kidneys handle potassium and what potassium intake does to kidney and heart health Limitations: A narrative review (online ahead of print on 1 October 2026), not a trial. Abstract only. Funding and conflicts: Funding is not stated in the abstract. Read: abstract |
| Filippini 2020 Potassium Intake and Blood Pressure: A Dose-Response Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc · PMID 32500831 · DOI |
Systematic review meta analysis |
32 randomised trials of 4 weeks or longer, mostly in adults with high blood pressure and mostly crossover trials | Potassium supplementation Mineral (not a plant product) Trials used 30 to 140 mmol a day as supplementation Trials of 4 weeks or longer · vs Control arms with lower potassium |
The relationship was U-shaped. The blood pressure fall weakened above a difference of about 30 mmol a day in potassium excretion, and blood pressure rose above about 80 mmol a day. The fall was stronger in people with high blood pressure and at higher sodium intakes. The rise at high potassium excretion was seen in people on blood pressure medicines but not in untreated people. The authors say estimates for high intakes need caution because few trials exist. U-shaped relationship; no single number in the abstract (Not given in the abstract) Methods, limits and fundingOutcomes: Blood pressure against the difference in 24-hour potassium excretion between arms Limitations: Abstract only. The authors warn that few trials tested high intakes, so the rise at the top end is uncertain. Funding and conflicts: Funding is not stated in the abstract. Read: abstract |
| Leijonmarck 1985 Ulceration of the small intestine due to slow-release potassium chloride tablets. Acta Chir Scand · PMID 4013604 |
Case series |
22 22 patients in Stockholm County surgical clinics with small-bowel ulcers probably linked to slow-release potassium chloride tablets |
Slow-release potassium chloride tablets (older products) Mineral (not a plant product) Retrospective study |
Most ulcers narrowed 1 to 2 cm of gut; 4 of these also perforated and 5 more patients had perforation without narrowing. The estimated frequency since 1970 was low, about 3 cases per 100,000 patient-years of slow-release tablet use, but 27% of the patients in the series died. The authors say microencapsulated tablets were reported to be less irritating. About 3 cases per 100,000 patient-years; 27% mortality in the series (Not applicable) Methods, limits and fundingOutcomes: Small-bowel ulceration, narrowing, perforation and death Limitations: A 1985 retrospective case series of older tablet types; it cannot say how common this is with today's products, which this page did not review. Funding and conflicts: Funding is not stated in the abstract. Read: abstract |
| Macdonald 2008 Effect of potassium citrate supplementation or increased fruit and vegetable intake on bone metabolism in healthy postmenopausal women: a randomized controlled trial. Am J Clin Nutr · PMID 18689384 · DOI |
Randomized trial |
276 276 healthy postmenopausal women aged 55 to 65 |
Potassium citrate, two strengths (high 55.5 mEq a day; low 18.5 mEq a day), or 300 g extra fruit and vegetables a day Mineral (not a plant product) High 55.5 mEq/day and low 18.5 mEq/day potassium citrate, as described in the abstract 2 years · vs Placebo |
No difference between groups in most bone turnover markers. One marker (urinary deoxypyridinoline) was lower in the high-dose group at 4 to 6 weeks only. Spine bone density loss in the placebo group (1.8%) did not differ from the treatment groups (2.1%); hip loss was 1.3% with placebo and 2.2% with low-dose citrate (not significant). The authors conclude two years of potassium citrate does not reduce bone turnover or raise bone density in healthy postmenopausal women. Spine BMD loss 1.8% (placebo) vs 2.1% (treatment), P = 0.88 (Not given in the abstract) Methods, limits and fundingOutcomes: Bone turnover markers and bone mineral density at spine and hip Limitations: Healthy women only, not women with osteoporosis. Abstract only; the fruit and vegetable arm result is not given in the abstract. Funding and conflicts: Funding is not stated in the abstract. Read: abstract |
| Neal 2021 Effect of Salt Substitution on Cardiovascular Events and Death. N Engl J Med · PMID 34459569 · DOI |
Cluster randomized trial |
20995 20,995 people in 600 villages in rural China; aged 60 or older with high blood pressure, or with a history of stroke (72.6% had had a stroke) |
Salt substitute: 75% sodium chloride and 25% potassium chloride by mass, used in place of regular salt Mineral (not a plant product) Used in place of regular salt (the abstract gives no grams) Average follow-up 4.74 years · vs Regular salt (100% sodium chloride) |
Stroke rate was lower with the salt substitute (29.14 vs 33.65 per 1000 person-years; rate ratio 0.86). Major cardiovascular events (rate ratio 0.87) and death from any cause (rate ratio 0.88) were also lower. Serious adverse events attributed to high blood potassium were not significantly higher (3.35 vs 3.30 per 1000 person-years; rate ratio 1.04). Stroke rate ratio 0.86; deaths 0.88; high-potassium events 1.04 (Stroke 0.77 to 0.96; deaths 0.82 to 0.95; high-potassium events 0.80 to 1.37) Methods, limits and fundingOutcomes: Stroke (main), major cardiovascular events, death from any cause, and serious adverse events from high blood potassium Limitations: Open-label (people knew which salt they used). A salt substitute lowers sodium and raises potassium at the same time, so the result cannot be credited to potassium alone. Rural China, older people with high blood pressure or past stroke. The abstract does not say who was excluded for kidney or potassium-raising medicine reasons. Funding and conflicts: Funded by the National Health and Medical Research Council of Australia (ClinicalTrials.gov NCT02092090). Registration: NCT02092090 Read: abstract |
| Phillips 2015 Citrate salts for preventing and treating calcium containing kidney stones in adults. Cochrane Database Syst Rev · PMID 26439475 · DOI |
Systematic review meta analysis |
477 7 randomised trials, 477 adults with calcium kidney stones (mostly oxalate stones), treated at least 6 months |
Potassium citrate (3 trials, 247 people); potassium-sodium citrate (3 trials, 166 people); potassium-magnesium citrate (1 trial, 64 people) Mineral (not a plant product) At least 6 months · vs Placebo or no treatment |
Citrate salts reduced stone growth (risk ratio 2.35 for stone size, 1.97 for staying the same size) and new stone formation was lower (RR 0.26). Need for retreatment was lower (RR 0.22). Upper gut upset was more common with citrate (not statistically significant, RR 2.55) and significantly more people dropped out because of side effects (RR 4.45). One person reported a rash. New stones RR 0.26; retreatment RR 0.22; dropouts for side effects RR 4.45 (New stones 0.10 to 0.68; retreatment 0.06 to 0.89; dropouts 1.28 to 15.50) Methods, limits and fundingOutcomes: Stone size, new stone formation, need for retreatment, side effects Limitations: The reviewers rate reporting quality as moderate to poor. The salts are prescribed citrate forms, three of which are not pure potassium. This does not show that dietary or over-the-counter potassium prevents stones. Funding and conflicts: No conflict of interest stated. Read: abstract |
| Raebel 2012 Hyperkalemia associated with use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Cardiovasc Ther · PMID 21883995 · DOI |
Narrative review n/a |
Review article on people taking ACE inhibitors or angiotensin receptor blockers | Not applicable (review of drug effects) Mineral (not a plant product) |
Up to 10% of patients on these medicines may have at least mild high blood potassium, especially those with chronic kidney problems. The review advises checking kidney function and baseline blood potassium before starting, and assessing whether the person also has excessive potassium intake from diet, supplements or other drugs. It describes monitoring soon after starting. Up to 10% may develop at least mild high blood potassium (Not applicable) Methods, limits and fundingOutcomes: How these medicines affect potassium handling in the kidney, who is at risk, how often high potassium occurs Limitations: A narrative review, not a trial. Abstract only. It names supplements as one possible extra source of potassium but gives no trial of a potassium pill with these medicines. Funding and conflicts: Funding is not stated in the abstract. Read: abstract |
| s-medlineplus-potassium MedlinePlus: Potassium (topic page) · Source |
Health agency n/a |
Methods, limits and fundingRead: full-text | ||
| s-medlineplus-potassium-test MedlinePlus: Potassium blood test · Source |
Health agency n/a |
Methods, limits and fundingRead: full-text | ||
| s-nhs-others-potassium NHS: Vitamins and minerals - Others (potassium section) · Source |
Health agency n/a |
Methods, limits and fundingRead: full-text | ||
| s-ods-potassium NIH Office of Dietary Supplements: Potassium fact sheets · Source |
Health agency n/a |
Methods, limits and fundingRead: not-read | ||
| s-usda-avocado USDA FoodData Central: Avocados, raw (SR Legacy) · Source |
Food database n/a |
Methods, limits and fundingRead: summary-only | ||
| s-usda-banana USDA FoodData Central: Bananas, raw (SR Legacy) · Source |
Food database n/a |
Methods, limits and fundingRead: summary-only | ||
| s-usda-fdc-168462 USDA FoodData Central: Spinach, raw (FDC 168462) · Source |
Food database n/a |
Methods, limits and fundingRead: summary-only | ||
| s-usda-fdc-170026 USDA FoodData Central: Potatoes, flesh and skin, raw (FDC 170026) · Source |
Food database n/a |
Methods, limits and fundingRead: summary-only | ||
| s-usda-fdc-170886 USDA FoodData Central: Plain low-fat yogurt (FDC 170886) · Source |
Food database n/a |
Methods, limits and fundingRead: summary-only | ||
| s-usda-fdc-175203 USDA FoodData Central: White beans, cooked, boiled, no salt (FDC 175203) · Source |
Food database n/a |
Methods, limits and fundingRead: summary-only | ||
| s-who-healthy-diet WHO: Healthy diet fact sheet · Source |
Health agency n/a |
Methods, limits and fundingRead: full-text |
What we do not know yet
- No trial of potassium pills (rather than salt substitutes or diet changes) on strokes, heart attacks or death was read.
- No trial of potassium supplements for correcting low blood potassium was read.
- The NIH Office of Dietary Supplements fact sheets could not be read (access error), so no official upper limit or adequate-intake table from that source is stated.
- No source on pregnancy or breastfeeding safety, product quality or liver safety was read; the NHS page was last reviewed in 2020.
- Which individual medicines raise or lower potassium beyond ACE inhibitors, angiotensin receptor blockers and diuretics was not confirmed.
- USDA food values were not re-opened on the USDA site; they come from our food pages.
- Only abstracts were read for studies.
How new research is added
New studies are found by a saved PubMed search and placed in a review queue before the page changes.
Lab markers
What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".
Other 5
Systolic blood pressure (top number)
Lowered in trials
The pressure in the arteries when the heart beats.
Moderate certaintyResults and what it means
Why it was measured
The main blood pressure measure in trials.
Statistical vs. clinical meaning
A small fall in people with high blood pressure.
Safety implication
Too much potassium can be unsafe in kidney disease.
| Study | Result | People | Product |
|---|---|---|---|
| 1 | Lower by 3.49 mm Hg (95% CI 1.82 to 5.15) with higher potassium intake, in people with high blood pressure but not without | Adults in 22 trials | Higher potassium intake (diet or supplements) |
| 3 | Lower by 4.76 mm Hg (95% CI 3.50 to 6.01) with low-sodium salt substitutes versus regular salt | 21,414 adults in 20 trials | Mostly potassium-containing salt substitutes |
Diastolic blood pressure (bottom number)
Lowered in trials
The pressure in the arteries between heartbeats.
Moderate certaintyResults and what it means
Why it was measured
Second main blood pressure measure.
Statistical vs. clinical meaning
A small fall.
Safety implication
As above.
Potassium in the blood (serum potassium)
Raised slightly in trials
The amount of potassium in the blood. Almost all body potassium is inside cells; a small amount is in blood.
Moderate certaintyResults and what it means
Why it was measured
The standard test for low or high potassium; part of a routine electrolyte panel.
Statistical vs. clinical meaning
Blood potassium rose slightly with salt substitutes; in the main trial serious high-potassium events were not significantly more common.
Safety implication
A rise matters most for people with kidney disease or on medicines that raise potassium. See the Safety tab.
| Study | Result | People | Product |
|---|---|---|---|
| 3 | Higher by 0.12 mmol/L (95% CI 0.07 to 0.18) with salt substitutes versus regular salt | 784 adults in 6 trials | Potassium-containing salt substitutes |
Urinary NTX (a marker of bone breakdown)
Lowered at 1 month only in trials
A protein fragment released into urine when bone is broken down.
Low certaintyResults and what it means
Why it was measured
A blood or urine marker used in bone trials.
Statistical vs. clinical meaning
One borderline early change among several markers.
Safety implication
None specific.
| Study | Result | People | Product |
|---|---|---|---|
| 2 | Lower by 4.05 nmol BCE/mmol creatinine at 1 month (95% CI -8.05 to -0.05); no significant effect on serum CTX or P1NP | 5 trials, 401 postmenopausal women | Potassium citrate versus placebo |
Potassium in the urine
Raised in trials
Potassium passed in urine; it reflects recent intake in people with working kidneys.
Low certaintyResults and what it means
Why it was measured
Used in trials to check that people took the potassium.
Statistical vs. clinical meaning
Shows the supplement was absorbed and passed out; not a health outcome.
Safety implication
None specific.
| Study | Result | People | Product |
|---|---|---|---|
| 2 | Urinary potassium rose at 3 and 6 months with potassium citrate | 5 trials, 401 postmenopausal women | Potassium citrate versus placebo |
Safety
What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.
Main points to know 5
- Too much potassium in the blood (hyperkalemia) is dangerous, especially with kidney disease. MedlinePlus says healthy kidneys keep potassium in balance, but with chronic kidney disease the kidneys may not remove extra potassium, and some medicines can also raise it. High blood potassium can cause an irregular heartbeat, fatigue, muscle weakness, nausea, and numbness or tingling. MedlinePlus also says eating very large amounts of potassium-rich foods or taking potassium supplements can lead to health problems. Other causes of high blood potassium it lists include Addison disease, injuries, burns or surgery, and poorly controlled type 1 diabetes. Authoritative guidance 12 13
- Some medicines raise potassium. A review reports that up to 10% of people on ACE inhibitors or angiotensin receptor blockers (common blood pressure and heart medicines) may have at least mild high blood potassium, particularly with chronic kidney problems, and says excess potassium from diet, supplements or other drugs should be considered. If you take these medicines, ask your prescriber or pharmacist before adding potassium pills or a potassium salt substitute. Review article 11
- Salt substitutes are potassium too. Low-sodium salt substitutes replace part of the sodium chloride with potassium chloride. The Cochrane review says all 26 trials excluded people in whom extra potassium is known to be harmful, so safety in kidney disease or with potassium-raising medicines is not shown. The WHO says these products suit people not at risk of high blood potassium. Systematic review 3 22
- Older people. The NHS says older people may be more at risk of harm from potassium because their kidneys may be less able to remove it, and that they should not take potassium supplements unless advised by a doctor. The NHS page was last reviewed on 3 August 2020. Authoritative guidance 14
- Slow-release potassium chloride tablets and gut ulcers. A 1985 Swedish review of 22 cases linked slow-release potassium chloride tablets with small-bowel ulcers, narrowing and perforation. The estimated frequency was low (about 3 cases per 100,000 patient-years) but 27% of the patients in the series died. It concerns older tablet types and was not checked against current products. Case series 7
Side effects 4
| Effect | How often | Severity and recovery | Evidence |
|---|---|---|---|
| Stomach pain, feeling sick and diarrhoea from taking too much The NHS lists these as what can happen if you take too much potassium. | No frequency given. | mild to moderate Not described in the source read. | Authoritative guidance 14 |
| High blood potassium with irregular heartbeat, weakness and tingling The trial screened out people at risk; the figures do not apply to kidney disease. | In the 21,000-person salt substitute trial, serious events attributed to high blood potassium were 3.35 vs 3.30 per 1000 person-years (rate ratio 1.04, 95% CI 0.80 to 1.37). Up to 10% of people on ACE inhibitors or angiotensin receptor blockers may have at least mild high potassium. | can be severe (heart rhythm problems) Not described in the sources read. | Randomized trial 9 11 13 |
| Upper gut upset and treatment stopping with citrate salts for kidney stones Prescribed citrate salts in 7 small trials. | More gut adverse events with citrate (RR 2.55, 95% CI 0.71 to 9.16, not significant); significantly more dropouts for side effects (RR 4.45, 1.28 to 15.50); one report of rash. | mild to moderate Not described in the abstract. | Systematic review 10 |
| Small-bowel ulceration and perforation with older slow-release potassium chloride tablets From 1985; today's tablets were not reviewed here. | About 3 cases per 100,000 patient-years of slow-release tablet use; 27% mortality among the 22 patients in the series. | can be life-threatening Not described in the abstract; the cases were found through surgical clinics. | Case series 7 |
Liver
No liver injury from potassium was found in the sources read. A liver-safety source such as LiverTox was not checked.
How often. No frequency was found.
Monitoring. No agency monitoring advice was found.
This is a safety connection. It is not evidence that Potassium supports liver health.
Medicines and supplements 5
| With | Why it matters | Importance | Evidence | What to do |
|---|---|---|---|---|
| ACE inhibitors and angiotensin receptor blockers (blood pressure and heart medicines) prescription | These medicines reduce potassium loss through the kidney, so potassium can build up. The review says to consider extra potassium from diet, supplements or other drugs. | Up to 10% of people on these medicines may have at least mild high blood potassium, more with kidney problems. No trial of a potassium pill with these medicines was read. | Review article Low certainty 11 | Ask your prescriber or pharmacist before adding potassium pills or potassium salt substitutes, and tell them about any you already use. |
| Water pills (diuretics) prescription | MedlinePlus lists side effects of prescription diuretics among the causes of low blood potassium and diuretics ("water pills") among the causes of high blood potassium. It does not say which kinds of diuretic do which. | Which direction applies depends on the medicine. The sources read do not name individual diuretics. | Authoritative guidance Low certainty 13 | Ask your prescriber or pharmacist which way your own medicine pushes potassium before using a supplement. |
| Other potassium sources, including salt substitutes supplement | Potassium from foods, salt substitutes and pills adds up in the body. | The Cochrane review found salt substitutes probably raise blood potassium slightly (0.12 mmol/L) in people not at risk; trials excluded people at risk. | Systematic review Moderate certainty 3 | Tell your doctor or pharmacist about every potassium-containing product you use. |
| Natural black licorice food | MedlinePlus says natural black licorice may lower blood potassium and should be avoided for at least two weeks before a potassium blood test. Most licorice products in the US do not contain natural licorice. | A reason for a misleading test result and for low potassium, not an interaction with a potassium pill. | Authoritative guidance Low certainty 13 | Check the label if you eat licorice and tell the person ordering your blood test. |
| Potassium-sparing diuretics, aldosterone blockers and antibiotics prescription | These groups are commonly named as raising potassium, but that was not confirmed in the sources read. They say only that some medicines, including diuretics and antibiotics, can raise potassium. | Not confirmed for individual medicines in the sources read. | Not verified Not enough evidence 13 | Ask a pharmacist whether any medicine you take raises potassium. |
Who should check first 5
| Situation | Advice | Evidence |
|---|---|---|
| Kidney disease (especially chronic kidney disease) | MedlinePlus says kidneys may not remove extra potassium and a special low-potassium diet may be needed. A kidney review says supplementing or restricting potassium should be individualized to kidney function and risk. Ask a kidney doctor before using any potassium product. | Authoritative guidance 12 5 |
| Taking medicines that raise potassium (such as ACE inhibitors or angiotensin receptor blockers) | Ask your prescriber or pharmacist before using potassium supplements or salt substitutes. See the interactions above. | Review article 11 |
| Older people | The NHS says older people should not take potassium supplements unless advised by a doctor. | Authoritative guidance 14 |
| Pregnancy and breastfeeding | No trial in pregnant women was found in the Cochrane salt substitute review, and no pregnancy or breastfeeding statement on potassium supplements was read (LactMed was not checked). Ask your midwife or doctor before using potassium supplements or salt substitutes. | Gap 3 |
| Children | Trials in children are few: the blood pressure effect of more potassium was small and not significant, and the Cochrane review calls the evidence on salt substitutes in children very uncertain. Ask a paediatrician before giving a child a potassium product. | Systematic review 1 3 |
Overdose, product quality and regulators
Summary. Potassium is essential and toxic only in excess, mainly through high blood potassium, which disturbs the heart rhythm. For healthy people with working kidneys the sources read describe stomach upset from too much. For people with kidney disease or on certain medicines, excess can be dangerous.
Animal. Not reviewed.
Human doses studied. Amounts used in trials are in the studies table; they are not advice. The 2020 dose-response review found blood pressure rose at the highest potassium intakes, in people on blood pressure medicines.
High dose or long term signals. The 2020 dose-response review found a U-shaped curve for blood pressure, with a rise at the highest intakes in treated people; the authors call the high-intake estimates uncertain.
Overdose response. Seek urgent medical care for signs of high blood potassium; see urgent signs.
Genotoxicity. Not researched.
Product quality for potassium supplements (label accuracy, contaminants, tablet type) was not researched in the sources read.
Tablet type. A 1985 review says microencapsulated potassium chloride tablets were reported to be less irritating to the gut than older slow-release types. Current products were not reviewed. 7
| Body | Action | Date |
|---|---|---|
| NHS (UK) (United Kingdom) | Potassium section of the Vitamins and minerals - Others page: adults aged 19 to 64 need 3,500 mg of potassium a day, obtainable from a varied diet; too much potassium can cause stomach pain, feeling sick and diarrhoea; 3,700 mg or less of supplements a day is unlikely to have obvious harmful effects; older people should not take potassium supplements unless advised by a doctor. The Department of Health and Social Care figures are given as a regulator statement, not as advice to take any amount. source | 2020-08-03 |
| World Health Organization (International) | Healthy diet fact sheet: a potassium intake of at least 90 mmol a day (3510 mg) for adults may be beneficial; lower-sodium salt substitutes can help people not at risk of high blood potassium where health systems can detect and manage kidney disease. Stated as the WHO position, not as advice to take any amount. source | 2026-01-26 |
| MedlinePlus (US National Library of Medicine) (United States) | Potassium topic: many people get all the potassium they need from food and drink; with chronic kidney disease, kidneys may not remove extra potassium; some medicines can raise potassium. source | |
| MedlinePlus (US National Library of Medicine) (United States) | Potassium blood test: symptoms and causes of high and low blood potassium; natural black licorice may lower levels; very large amounts of potassium-rich foods or potassium supplements can lead to health problems. source | 2024-11-12 |
When to get medical help
- Irregular or very fast or slow heartbeat, chest pain, fainting, or sudden severe muscle weakness, especially if you have kidney disease or take blood pressure medicines or potassium products: call your local emergency number or seek urgent care
- Numbness or tingling with weakness, nausea or fatigue after starting a potassium product: contact a doctor promptly (these are listed signs of high blood potassium)
- Severe or lasting stomach pain, repeated vomiting, black stools or vomiting blood after starting potassium tablets: contact a doctor urgently (gut ulcers were reported with older slow-release tablets)
Stop using the product and contact a clinician or emergency service. In the US, Poison Control is 1-800-222-1222.
General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.
Frequently asked questions
What is potassium?
Potassium is a mineral and electrolyte that helps nerves work, muscles contract and the heartbeat stay regular. Most people get it from food, and the kidneys keep the level in the blood steady.
Does potassium lower blood pressure?
In 22 trials, higher potassium intake lowered systolic blood pressure by about 3.5 mm Hg in people with high blood pressure, but not in people with normal blood pressure. It is not a substitute for medicine your doctor prescribed.
Are potassium salt substitutes safe and do they work?
In a trial of 20,995 older people with high blood pressure or past stroke, a salt substitute with 25% potassium chloride lowered strokes and deaths without significantly more serious high-potassium events. All 26 trials in the Cochrane review excluded people at risk of high potassium, and the WHO says these products suit people not at risk. They are unsafe for many people with kidney disease.
Can you have too much potassium?
Yes. High blood potassium (hyperkalemia) can cause an irregular heartbeat, weakness, nausea, fatigue, and numbness or tingling. Kidney disease and some medicines make it more likely. MedlinePlus says very large amounts of potassium-rich food or potassium supplements can lead to health problems.
Is potassium safe with kidney disease?
Which medicines does potassium interact with?
A review says up to 10% of people on ACE inhibitors or angiotensin receptor blockers may have at least mild high potassium and that extra potassium from diet, supplements or other drugs should be considered. MedlinePlus says diuretics can both lower and raise potassium. Ask a pharmacist about your own medicines.
What are the signs of low potassium?
MedlinePlus lists an irregular heartbeat, muscle cramps, weak or twitching muscles, fatigue, nausea and constipation. It is usually caused by water pills, vomiting, diarrhoea, laxatives, adrenal or kidney problems or alcohol use disorder, and rarely by diet alone. Only a blood test can tell.
Do I need a potassium supplement?
Does potassium help kidney stones?
Prescribed citrate salts, mostly potassium citrate, reduced new calcium kidney stones in seven small trials (477 adults), though more people stopped treatment because of side effects. That is a prescribed medical use, and the trials were of moderate to poor quality.
Does potassium protect bones?
Is potassium safe in pregnancy, breastfeeding or for children?
Which foods are high in potassium?
MedlinePlus names leafy greens such as spinach, grapes and blackberries, root vegetables such as carrots and potatoes, and citrus fruit. The NHS adds bananas, broccoli, beans, nuts, fish and poultry. USDA lists about 422 mg in a medium banana and about 1,004 mg in a cup of cooked white beans.
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Editorial transparency
- Written by
- AlternativeMed editorial team. Research compiled with AI assistance, then checked against the sources listed.
- Medical review
- None. This page has not been reviewed by a physician or pharmacist.
- First published
- 2026-10-26
- Last substantive update
- 2026-10-26
- How we research
- We started from our earlier potassium summary, re-read the NHS, MedlinePlus and WHO pages, and re-read PubMed abstracts for reviews and trials. The NIH Office of Dietary Supplements pages could not be opened. USDA values come from our food pages. Items we could not verify are flagged in the research gaps.
- How we rate evidence
- See "How we rate evidence" in the Evidence tab.
- Independence
- No product is promoted on this page. No affiliate links are shown. Authors of the cited blood pressure review disclose WHO funding for guideline meetings and unpaid roles in salt-reduction groups; the salt substitute trial was funded by an Australian government research council. This is stated where each study is used.
Sources 22
Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.
- Aburto NJ, Hanson S, Gutierrez H, Hooper L, Elliott P, Cappuccio FP. Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses.. BMJ. 2013. PMID 23558164. DOI 10.1136/bmj.f1378. (abstract)
- AlSejari N, Alkhulaifi NS, Alenezi RS, Alharran AM, et al.. Effects of Potassium Citrate Supplementation on Bone Turnover Markers in Postmenopausal Women: A GRADE-Assessed Systematic Review, Meta-analysis and Trial Sequential Analysis.. Calcif Tissue Int. 2026. PMID 42423994. DOI 10.1007/s00223-026-01569-9. (abstract)
- Brand A, Visser ME, Schoonees A, Naude CE. Replacing salt with low-sodium salt substitutes (LSSS) for cardiovascular health in adults, children and pregnant women.. Cochrane Database Syst Rev. 2022. PMID 35944931. DOI 10.1002/14651858.CD015207. (abstract)
- Fan Y, Wu M, Ding L, Ji H, et al.. Potassium status and the risk of type 2 diabetes, cardiovascular diseases, and mortality: a meta-analysis of prospective observational studies.. Crit Rev Food Sci Nutr. 2024. PMID 37788131. DOI 10.1080/10408398.2023.2262584. (abstract)
- Ferdaus MZ, Delpire E, Terker AS. Kidney Effects of Potassium Additives in Health and Disease.. Semin Nephrol. 2026. PMID 42823246. DOI 10.1016/j.semnephrol.2026.151729. (abstract)
- Filippini T, Naska A, Kasdagli MI, Torres D, et al.. Potassium Intake and Blood Pressure: A Dose-Response Meta-Analysis of Randomized Controlled Trials.. J Am Heart Assoc. 2020. PMID 32500831. DOI 10.1161/JAHA.119.015719. (abstract)
- Leijonmarck CE, Raf L. Ulceration of the small intestine due to slow-release potassium chloride tablets.. Acta Chir Scand. 1985. PMID 4013604. (abstract)
- Macdonald HM, Black AJ, Aucott L, Duthie G, et al.. Effect of potassium citrate supplementation or increased fruit and vegetable intake on bone metabolism in healthy postmenopausal women: a randomized controlled trial.. Am J Clin Nutr. 2008. PMID 18689384. DOI 10.1093/ajcn/88.2.465. (abstract)
- Neal B, Wu Y, Feng X, Zhang R, et al.. Effect of Salt Substitution on Cardiovascular Events and Death.. N Engl J Med. 2021. PMID 34459569. DOI 10.1056/NEJMoa2105675. (abstract)
- Phillips R, Hanchanale VS, Myatt A, Somani B, Nabi G, Biyani CS. Citrate salts for preventing and treating calcium containing kidney stones in adults.. Cochrane Database Syst Rev. 2015. PMID 26439475. DOI 10.1002/14651858.CD010057.pub2. (abstract)
- Raebel MA. Hyperkalemia associated with use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers.. Cardiovasc Ther. 2012. PMID 21883995. DOI 10.1111/j.1755-5922.2010.00258.x. (abstract)
- . MedlinePlus: Potassium (topic page). . . (full-text)
- . MedlinePlus: Potassium blood test. . . (full-text)
- . NHS: Vitamins and minerals - Others (potassium section). . . (full-text)
- . NIH Office of Dietary Supplements: Potassium fact sheets. . . (not-read)
- . USDA FoodData Central: Avocados, raw (SR Legacy). . . (summary-only)
- . USDA FoodData Central: Bananas, raw (SR Legacy). . . (summary-only)
- . USDA FoodData Central: Spinach, raw (FDC 168462). . . (summary-only)
- . USDA FoodData Central: Potatoes, flesh and skin, raw (FDC 170026). . . (summary-only)
- . USDA FoodData Central: Plain low-fat yogurt (FDC 170886). . . (summary-only)
- . USDA FoodData Central: White beans, cooked, boiled, no salt (FDC 175203). . . (summary-only)
- . WHO: Healthy diet fact sheet. . . (full-text)
Where to buy
Check the label first. Whatever you buy, look for these:
- The amount of the active ingredient per serving, not just the front-label claim
- A third-party testing mark (USP, NSF or ConsumerLab)
- Other ingredients and allergens
- Ask a pharmacist about interactions with your medicines
Talk to a pharmacist or doctor before you start any supplement, especially if you take medicines. See the Safety tab for interactions.
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