Insulin is the hormone released by the pancreas that is key in blood sugar regulation. It acts as a gatekeeper to allow glucose and other nutrients inside the cell. This is insulin’s most important job when it is within healthy levels. However, when insulin is high for a long period of time a dangerous condition known as ‘insulin resistance’ develops. As we saw in our previous blog, the damage that excess insulin can do to the heart, proteins and fats in our body is significant enough to make us want to consider improving this condition.

One clue that tells us insulin resistance is developing is our cravings. Cravings for sugar are a sign that our body is using sugar for energy exclusively (1). Since sugar provides a limited amount of calories to run the body, this fuel source is short lived, which means that one would need to consume many meals a day to get energy. The problem with this is that the act of eating itself raises insulin. Also, because insulin removes excess sugar from the blood after every meal, the body goes from high sugar to low sugar, which will immediately create more sugar cravings in order to raise blood sugar again. This is known as the ‘high sugar low sugar roller coaster’. Both high sugar and low sugar are very stressing to the body. One way to reverse this is to change the body’s fuel source to fat.

In today’s blog we will talk about how to heal insulin resistance with a very specific way of eating known as ‘intermittent fasting’. We will also look at the ‘ketogenic diet’ because of its many benefits in assisting the regulation of sugars and thereby, helping in healing insulin resistance. We will revisit the alkaline diet and see how the ‘Heart and Body Extract’ can help.

Factors that increase insulin

In our previous blog we saw how a diet high in refined carbohydrates can raise insulin to dangerous levels. This is what is known as ‘glycemic index’ and it is probably something most everybody is familiar with. In today’s blog we are learning that the act of eating itself can increase insulin, because this hormone is released into the blood everytime we consume food, even foods that are low in the glycemic index. However, there is another aspect to take into account when it comes to insulin that is known as ‘insulin index’. This refers to all those foods that are not carbohydrates but also increase insulin significantly. These are:

1. Low fat foods: lean meats, consuming egg whites without the yolk, protein without the fat
2. Whey protein
3. Certain food additives: MSG increases insulin by 300%
4. Mixing fat with sugar or protein with sugar, like it is the case hamburger and bun, fries and carbonated drinks in the same meal
5. Excessive protein, more than 3-6 oz per meal (2)

Side effects of high insulin

We have seen how high insulin can damage the body by affecting fat and protein. There are other side effects (3):

1. Cardiac hypertrophy: The heart cells are damaged in such a way that the blood vessels deteriorate, increasing the workload of the heart.
2. Thrombus (clot formation): Too much insulin targets the arteries of the heart, specially the wall of the heart, making it stiff.
3. Lesions and plaquing in arteries: This can create obstructions that eventually will create a clot, stroke or heart attack.
4. Inflammation
5. Diabetes
6. Fatty liver
7. Obesity
8. Cancer
9. Alzheimer’s disease: excess insulin causes something called ‘amyloid plaquing’
10. Metabolic syndrome
11. Retina damage leading to macular degeneration
12. Nerve damage leading to peripheral neuropathy
13. Kidney damage
14. Hunger, cravings, and malnutrition

Healthy insulin levels

One of the most significant problems with insulin resistance is that it reduces and even blocks nutrient absorption into the cells. This means that with high insulin, our cells are starving for nutrients, which increases cravings and hunger. The person will be consuming too many meals but never feel satiated, increasing insulin with every meal. The most logical way to reverse this would be to reduce the number of meals one consumes. How can this be done successfully if nutrients are being blocked from entering the cell? Studies have shown that the ketogenic diet is able to do this by healing insulin resistance (4) .

What is the ketogenic diet?

To answer this question we need to look at the different sources of energy the body uses (4):

1. The aerobic system: Allows the body to use oxygen as energy. This system uses fats for fuel.
2. The glycolytic pathway: Glycolysis is the process by which glucose is split to release energy (5). This pathway uses carbohydrates.
3. Creatine phosphate: It is a molecule that acts as a reserve of energy that recycles adenosine triphosphate(ATP), the energy currency of the cell (6).

All this can be explained more simply by saying that the body uses either sugar (glucose) or fat as energy: either the glucose stored in our muscles and liver, known as ‘glycogen’, or the stored fat found in adipose tissue. In the presence of a small amount of glycogen (stored sugar) the body will prefer to use this as a source of energy rather than the stored fat. The problem with glucose is that it does not last long without having to consume more glucose from the diet. The ketogenic diet allows the body to switch from ‘sugar burning’ to ‘fat burning’ through a process known as ‘keto adaptation’. By this process the body will start making new mechanisms in the cells to obtain energy from fat exclusively. This process of keto adaptation takes a few days to occur, from 3 days to several weeks, depending on how long our body has been using sugar as fuel, our age, how fast our metabolism is, etc. Before we explain the diet in detail, we need to understand what the process of ketosis is.

What is ketosis?

Ketosis is the state the body is under when it has adapted to getting energy from fat rather than glucose. For this conversion to happen, there is an absolute requirement: to starve the body of sugar (glucose). This is because in the presence of just a small amount of sugar, the body will always use this first for energy. However, removing sugars from the diet will force the body to adapt by looking for an alternative source of energy. The good news is that the body is able to store a lot more energy from fat. An average thin person has approximately 77,000 calories stored in adipose tissue.

When the body is fat adapted, it makes something known as ‘ketone bodies’, these are a by-product of fat burning that the body can use for energy.

How are ketones created in the body?

When the body is without a source of glucose from the diet for 10-12 hours , the amount of insulin released goes down (11). Insulin then opens up the gates in the cells for fats to flood in, either from the adipose tissue or from the fat consumed through the diet. Once fats get in the blood stream, they travel through the body, go to the liver and there they get converted into energy or ketones. Ketones are used by the brain as a source of energy.

This process of keto adaptation can be measured with strips that change color according to how many ketone bodies the body is producing. It can also be measured more accurately through breath with a special device (12).

Keto adaptation can take from 3 days to 2-6 weeks, depending on how long our body has been burning sugar fuel.

Ketones are the preferred source of energy for the body, so we could say that our bodies are made to run on fat, especially our brain. Our ancestors consumed a lot more fat and much less processed carbohydrates. The benefits of ketosis are many, one of these benefits is that during ketosis the body protects its own protein, just the opposite of high insulin. Because of this the body will start building muscle, will also protect other proteins in the body like tendons, joints, hair, nails, skin, etc.

Something else that is significant is that with ketosis the body will be able to get rid of fluid retention. This means there will be increased urination, which can cause a loss of electrolytes. Replenishing these with green leafy vegetables is very important.

Ketones vs. glucose

The benefits of using fat as fuel are many:

1. Fat burning and weight loss, because the body will use its stored fat as energy.
2. Longer and more stable energy.
3. Better brain performance and cognitive function, more focus and concentration, better mood and memory. The opposite happens when the brain runs on glucose: poor memory and concentration, brain fog, irritability, even depression.
4. Reversal of insulin resistance. The reason why ketosis is able to heal insulin resistance is because fat provides a lot of energy thereby the need for frequent meals is removed. What is more, fat does not trigger the hormone insulin, like sugar does. This in itself, is the main reason why the ketogenic diet is so appropriate for insulin resistance and diabetics. Fat is neutral when it comes to hormones.
5. Fat stabilizes blood sugar because it does not raise blood sugar.
6. Ketosis preserves muscle glycogen more than eating sugar from the diet (which is used up quickly). Studies have shown that during ketosis 75% of muscle glycogen is reabsorbed without having to consume extra carbohydrates. The body will actually collect the glycogen it needs to restore the carbohydrates naturally and keep muscle function. What is more, the body is able to ‘turn off’ its desire to even use that stored glycogen. This is impressive in itself, because it means there is no need to consume glucose from the diet. And this is exactly what we are looking for to heal insulin resistance. The implications for heart health are very significant too because of the fact that the heart is a muscle that requires a constant supply of energy. This means the heart could run on fat energy longer without having to increase insulin.

Ketosis and intermittent fasting

Ketosis allows the body to do ‘intermittent fasting’. Fasting gives the body the opportunity to regenerate itself by concentrating on repair rather than having to work hard to digest food.

Benefits of intermittent fasting:

1. Reduction in the risk of cardiovascular disease
2. Reduction in the risk of diabetes
3. Reduction in the risk of certain cancers
4. Cell protection, especially for neurons
5. Longer life span
6. Fasting allows the digestive system to take a break and heal
7. Hormonally, intermittent fasting triggers the release of ‘human growth hormone’ (HGH). In fact, intermittent fasting is considered to be the most powerful stimulant to HGH, it increases it by 1,300% in women and up to 2,000 % in men.
8. Because it improves insulin resistance, intermittent fasting also increases nutrient absorption, reducing the need to eat frequent meals.
9. Ketosis allows the body to preserve muscle and protein better. High insulin, as we saw, destroys the protein and fats in the body. The great news about this is that the heart is a muscle, making it a great diet for the heart.
10. Autophagy: This is intermitent fasting’s more impressive benefit. Autophagy is a condition by which the body starts to recycle old and damaged proteins, and cells. The body is then able to get these worn out pieces of a cell and recycle them by turning them into new amino acids the body can use to build new tissue. Autophagy also cleans up old microbes, bacteria, candida, yeast, mold, viruses, etc. This could be said to be the ultimate antiaging effect of intermittent fasting, and one that improves immune function greatly. For the body to get into autophagy it takes around 18 hours of fasting. Because the ketogenic diet reduces hunger greatly and nutrient absorption, it is the best and safest way to do fasting. What is more, ketosis provides an amazing amount of energy because it produces ketones. Both intermittent fasting and ketosis produce ketones, therefore, practicing both the ketogenic diet and intermittent fasting doubles the amount of ketones made by the body.

The term ‘autophagy’ is a relatively new term, it was coined in 1963 by a Belgian biochemist. The autophagy genes were identified in the 1990’s and in 2016 a Japanese researcher was awarded the Nobel prize for his discoveries on autophagy.

There is a precaution to be taken into account when doing intermittent fasting, and that is to implement fasting slowly. Only when the body has fully adapted to fat burning and the person has built up nutrient reserves can the body fast safely (14). In this sense, one can start fasting for 12 hours and then slowly increase the number of hours.

Consequences of insulin resistance

When insulin resistance is present, it takes greater amounts of insulin to stimulate proper uptake of glucose from the blood. This elevated blood insulin levels create many problems:

1. High blood LDL cholesterol levels
2. Low HDL cholesterol levels
3. Increased fat storage in the body (obesity)
4. Type 2 diabetes because of the elevated glucose levels in the blood

Hypertension is associated with elevated levels of insulin in the blood. And because insulin stimulates the sodium-acid pump, when insulin is high we can expect this pump to be more active in several types of body cells like white blood cells and the small resistance arteries that control blood pressure, this results in a higher pH inside cells. Since the main underlying factor behind hypertension is decreased dietary potassium and increased sodium, a good diet to heal and/or prevent insulin resistance is one that is high in the sodium-potasium rate.

What can we do to heal insulin resistance?

In order to correct and heal insulin, diet is key. We have seen how an alkaline diet allows the body to function at its best because it lets cells detoxify themselves. In the case of insulin dis regulation, this diet could be considered the best because of the high amounts of potassium it delivers.

The work of Dr. Richard D. Moore, as we saw in our previous blog, already pointed out at the importance of potassium. He hypothesized that lower potassium levels in the body increase insulin in the blood. As we explained, one of the consequences of the cellular imbalance between sodium and potassium is insulin resistance. For this increase in the tendency to develop insulin resistance to occur, there must be a slowing of the sodium potassium pump all through the body, which decreases the levels of potassium inside the cell.

In disease states, including hypertension, that are accompanied by depletion of body potassium, insulin resistance develops. Thiazide diuretics not only have their intended effect of increasing sodium loss through the kidneys , they also cause the body to lose potassium, therefore they lead to insulin resistance. The development of insulin resistance associated with potassium depletion is probably due to the increased levels of intracellular calcium that results from decreased sodium-calcium exchange as a consequence of slowing of the sodium-potassium pump. This is because increased levels of calcium inside cells decreases their ability to remove glucose from blood in response to insulin.

In health challenges like is the case of insulin resistance, we need to be proactive and take responsibility of our own eating.

The normal medical strategy might not be enough because blood sugar is usually only checked once a year via a blood sugar panel. The good news is that we can monitor our blood sugar daily at home with the use of a very inexpensive blood sugar meter. Dr. Ritamarie Loscalzo recommends this method, especially if you have a family history of diabetes or you have abdominal fat. The test anybody concerned about this should be familiar with is called‘ hemoglobin A1C’(HbA1C). A perfect range in this test is 5, which means that around 5% of your red blood cells are glycosylated, this averages to approximately 100. Similarly, other health care professionals like Dr. Douillard recommend this test, and explains this test actually measures the amount of glycation or blood sugar glucose in a blood sample (5).In the medical realm a higher number of hemoglobin is allowed, 5.7, and this is concerning because that translates to a 120-5 reading (4).

Another test that Dr. Douillard recommends is a 2-hour Postprandial Glucose Test that checks blood sugar levels 2 hours after you eat. Ideally, this number should stay below 125 mg/dL.(8)

Because blood sugar dis regulation starts affecting blood circulation first, the‘Heart and Body Extract’ drops can be added to our health protocol, together with a alkaline diet, and the tests we mentioned above.

Concluding

In previous blogs we saw how an acidic pH (metabolic acidosis) produces insulin resistance and systemic hypertension. This is because the right ratio of sodium and potassium is needed to maintain the right pH inside the cell, and this pH allows for the proper blood sugar regulation the body needs. Since just a slight increase in sugar in the blood can be the beginning of great damage in the proteins and fat tissue in our body, a proactive approach is needed on our part to keep this at bay. Blood sugar can be monitored from home on a daily basis. The ‘Heart and Body Extract’ can be a great tool in bringing our sugar back to normal levels as well.

Thank you for reading.

References:

• https://www.youtube.com/watch?v=571H-RPxNNs&t=22s
• https://en.wikipedia.org/wiki/Glycation
• https://en.wikipedia.org/wiki/Advanced_glycation_end-product
• http://drritamarie.com/blog/radio-show-insulin-resistance-demystified/?doing_wp_cron=1480879839.3972439765930175781250
• https://lifespa.com/insulin-two-faced-hormone/
• Boynton, Herb, et al. The Salt Solution. Avery, 2001.
• https://www.youtube.com/watch?v=wrrqw0rs5ok  
• https://lifespa.com/how-to-avoid-high-blood-sugar-spikes-after-meals/

High insulin is becoming a major health problem in our modern day, and one that has major implications for the heart. Our diet, high in refined and heavily processed foods is adding a heavy load of sugar that the body is not able to handle.

According to Dr. Douillard, DC, CAP,“The over-production of insulin is the underlying epidemic of our time, and most doctors rarely test for it.” He estimates 50% of the American population is overweight, one-third obese, another third with pre-diabetes, and 10 percent with type II diabetes. Dr.John Douillard calls insulin ‘the silent killer’ because insulin will quietly creep up into dangerous levels. Not only is excess insulin in the blood linked to weight gain and blood sugar issues, new research is linking it to a variety of cancers. In one study, a high-sugar, insulin-provoking diet increased the risk of breast cancer by 36-41 percent. Another study showed that obese women with the higher percentage of belly and hip fat had a 70 % increased risk of pancreatic cancer. In yet another study involving the evaluations of routine colonoscopies, the patients with the highest insulin levels had a 17-42 % increased risk of a cancerous growth in the colon. (5)

What is more, high insulin is related to heart disease, high cholesterol and high blood pressure. Elevated levels of insulin over a period of time leads to a condition known as ‘insulin resistance’.

In our previous blog we saw how the sodium-potassium pump is present in every cell in the body and the electrical current generated by it is used for so many functions: sugar metabolism, fat metabolism, cell growth and division, and the response to hormones like insulin. In today’s blog we will look at how blood sugar and insulin can become dis regulated in what is known as ‘insulin resistance’. We will look at this health challenge in depth and learn what we can do about it.

The role of the pancreas

To help us understand insulin, we need to first look at the organ that produces and makes this important hormone known as insulin.

The pancreas is a very essential organ that has several key roles in the body: it makes enzymes, bicarbonate and it produces several hormones. One of these hormones is insulin, which is triggered by food. Every time we eat a meal, the pancreas releases insulin into the blood in order to remove this glucose from the blood. The faster a food turns into sugar, the faster the pancreas is triggered to release insulin. This means that some foods will stimulate insulin faster than others. Once this glucose is removed from the blood, it is stored in muscle and liver cells to be used for quick energy. (1)

Removing sugar from the blood quickly after a meal is very important to our health because glucose that is circulating in the blood causes a great deal of damage. The main reason being that this glucose is toxic to our cells. Glucose that is not properly removed and stored inside cells will start accumulating in the blood and start sticking itself to the protein and fatty tissue in our body,impairing their function.This process, ironically called AGEs (advanced glycation end products ) (2) is responsible for the inflammation that can go on in our bodies silently for decades. It can literally turn the protein in our body, like our arteries, into ‘caramelized goo’unable to function properly. If you have ever heated up sugar in your kitchen, you can begin to imagine your own body turning into something like it.

The shocking truth about high insulin

AGEs affect nearly every type of cell and molecule in the body and are thought to be one factor in aging and some age-related chronic diseases.They are believed to be the cause of the vascular complications of diabetes, and kidney disease. In the context of cardiovascular disease, AGEs can induce “crosslinking of collagen which can cause vascular stiffening and entrapment of low-density lipoprotein particles (LDL) in the artery walls.” AGEs can also cause glycation of LDL which can promote its oxidation. Oxidized LDL then is one of the major factors in the development of atherosclerosis. Finally, AGEs can cause oxidative stress as well as activation of inflammatory pathways in our heart’s endothelial cells. (3)

Dr. Ritamarie Loscalzo MS, DC, CCN, DACBN refers to this dangerous accumulation of glucose in the blood as‘glycosylation of hemoglobin, which she explains is a fancy way of saying your red blood cells get ‘sticky and stiff’. This process damages the lining of our blood vessels , the endothelium, causing inflammation and cardiovascular disease, high blood pressure, heart attacks and strokes. She further explains that this will also damage the nerves on the periphery of the body, the hands and feet, the back of the retina and the ears. In this sense, high insulin for a prolonged period of time can cause peripheral neuropathy in hands and feet, blindness and loss of hearing. All of which will start as a impairment of blood circulation. In her research, Dr. Ritamarie Loscalzo has discovered that just a slight increase in blood sugar levels, a reading above 120 mg/dl, can start damage to these areas.

Something alarming about this number is how it is being used to diagnose disease. A diagnosis of diabetes or pre-diabetes is not given until a person has a fasting blood sugar of 120. This number, according to her, means that blood sugar has been elevated for a long enough period to cause damage to our proteins and fatty tissue.

In her opinion, a fasting blood sugar level should be around 75-89 mg/dl. This is the amount of sugar circulating in the blood after a person has been fasting for 10-12 hours. Ideally, this should be our normal blood sugar levels when we wake up in the morning. She explains that after eating a meal our blood sugar spikes but then the body should be able to bring it down by the action of insulin within 2 hours. (4)

This amount of sugar is the equivalent of 1 teaspoon of sugar in the whole blood volume, which is around 1 gallon plus 1/3 of a gallon. Our present diet adds around 31 teaspoons of sugar a day. That is a lot of sugar that has to be processed by insulin, and because it cannot be properly metabolized, the extra sugar is stored in the liver as toxic waste.

The ‘feedback loop’ mechanism

Once this glucose has been removed from the blood, insulin acts like a key that unlocks the receptors in our cells so that this glucose can pass the cell membrane and be stored properly inside liver and muscle cells. Inside the cell, this sugar can be converted into energy. When the cell is filled with glucose there is a signal that goes from the cell back up to the pancreas and tells the pancreas to turn off the production of insulin. This is an on-off mechanism called ‘feedback loop’which acts as a communication between the cells and the pancreas and is very important for the regulation of blood sugar in the body. However, this feedback mechanism can start to malfunction, in this case the pancreas will continue to send insulin even though it is not needed.This will cause a dangerous spike in insulin in the blood.

When we have too much sugar for a long period of time,the receptor in the liver that is supposed to receive insulin becomes blocked. This is what is known as ‘insulin resistance’. It is called ‘resistance’ because the cells in the liver start ignoring this insulin, so the glucose cannot get into the cell. There is no feedback loop to the pancreas either, which causes the pancreas to keep pumping insulin. This rises the insulin in the blood even higher, because the body is still trying to send insulin to drive nutrients into the cell, but because the receptor is blocked this is not happening. The result is high levels of insulin in the blood and low inside the cell, so the person has both the symptoms of high insulin and low insulin at the same time. A person with high insulin has 5 to 7 time more insulin than a normal person, this is known as prediabetes. However, all this insulin is not working because it is not bringing the sugar in the blood down, it is not feeding the cells either and it is going into storage as belly fat, causing fatty liver.

When someone has insulin resistance they are going to be deficient in many nutrients, like the major vitamins. Because the B vitamins are needed to protect the myelin of the nerves, deficiencies in this family of vitamins can cause peripheral neuropathy.

Without insulin other nutrients cannot make it inside the cell either , like protein (amino acids). This is why diabetics have loss of muscle, with general muscle weakness and inability to build muscle. They also experience loss of collagen, joint and disc issues, etc.

Potassium, one of the most important electrolytes for heart health won’t go into the cell either when insulin resistance is present. Low potassium will cause:

1. Fatigue
2. High pulse rate
3. High blood pressure
4. Arrhythmia
5. Poor sleep, because potassium relaxes the body
6. Muscle cramps
7. Constipation
8. Gout
9. Kidney stones
10. Edema (swelling in the feet)

So what is insulin resistance? It is the body’s own defense mechanism against excess sugar. Because excess glucose is considered toxic, the body tries to stop its absorption by blocking the receptors that take it into the cells.

Roles of insulin

Insulin has several important roles:

1. Its main role is to remove sugar from the bloodstream after a meal and feed this fuel to the cell
2. Insulin then stores sugar in the liver, muscles, kidneys, white blood cells, etc. This stored sugar is called ‘glycogen’ and it is a long string of glucose molecules. Glycogen is one of the two main energy reserves in the body. But the body can only store a tiny amount of this energy that equals 1,700 calories. This is why there is another source of energy available as an energy reserve: fat. Fat reserves constitute 70,000 calories in an non-obese person.

In the case of obesity, insulin converts excess sugar and carbohydrates into fatty deposits in the liver. This is not a desirable situation because the extra fat in the liver can ultimately lead to cirrhosis. This sugar can also be stored as extra fat in the area around the stomach.

3. Insulin is a detoxifier hormone
4. Insulin is like a key that opens the cell to allow the cell to have fuel, to regulate blood sugar, and to allow amino acids and other nutrients in. It goes into our cells by first removing the sugar from the blood. It also allows the transport of potassium and magnesium into the cell.
5. Insulin is also a growth hormone. This means that it increases cellular division rates (often without normal DNA gene regulation) and the growth of fat cells, most notably belly and hip fat. (5)
6. In 1973 Dr. Richard D. Moore proved that insulin increases the pH inside muscle cells . Together with other doctors, he proved that this effect of insulin is due to the to the stimulation of the sodium-acid exchange pump mechanism causing it to move more acid out of the cell, thus increasing the pH inside the cell. They also proved that this increase in pH is probably the main means by which insulin stimulates glycolysis, the first step in the metabolism of glucose once it enters the cell. (6)

Symptoms of insulin resistance

1. Fatigue after meals
2. Craving for sugar and carbohydrates
3. Excessive urination, due to the body trying to dilute high sugar concentration
4. Brain fog and memory problems
5. Inflammation
6. Hypoglycemia,low blood sugar: can cause dizziness, fatigue and irritability. Inability to go without food for a short period of time.
7. Hyperglycemia, high blood sugar
8. Heart disease
9. High cholesterol
10. High blood pressure
11. Diabetes
12. Obesity
13. Metabolic syndrome
14. Kidney disease (7)

The exchange pumps

The outward sodium current generated by the sodium-potassium pump must move back into the cell to complete a closed circuit. Sodium must do this through what is known as the ‘exchange pumps’. These pumps are also located on the cell membrane and their job is to regulate other functions of the cell: the ‘sodium-acid exchange acid pump (Na+/H+)’ controls the levels of acid inside the cell, and the ‘sodium-calcium exchange calcium pump’ (Na+/Ca2+) controls the amount of calcium inside the cell. This means that every cell in the body takes advantage of the sodium current generated by the sodium potassium pump in order to perform other functions. Like we said before, a slowing down of the sodium-potassium pump will have tremendous consequences on overall health, including these two pumps.

The sodium acid (Na+/H+) exchange acid pump

As we saw in previous blogs, cell detoxification is an essential part of health. We explained that as a normal part of a cell’s life, cells produce acid that needs to be removed on a regular basis; failure to do so would result in the shutting down of the energy machinery and the death of the cell. If there was no mechanism to pump acid out of the cell, since the inside is negative, compared to the outside, this would pull so much acid inside the cell that the pH inside the cell would go down to about 6.0, far too low to be compatible with healthy function. The ‘acid pump’, therefore, has the important job of removing excess acid (H+) out of the cell.

The acid pump gets its energy not from ATP but from the electrical current generated by the sodium-potassium pump (via sodium ions). It works by exchanging sodium for acid across the cell membrane, this means that sodium moves into the cell and an acid is taken out. Its main role is to keep acid from piling up in the cell, but it also has the important function of influencing the pH of the inside of the cell which in turn affects directly how enzymes inside the cell function. In turn, this regulates many cellular functions, one very important example is the hormone insulin.

Dr. Richard D. Moore, together with other doctors, obtained evidence that insulin increases the pH inside the cell via the sodium-acid exchange pump by moving acid outside of the cell and therefore increasing the pH inside the cell. They theorized that through this mechanism insulin stimulates glycolysis, the first step in the metabolism of glucose, as it enters the cell. Dr. Moore discovered that when there is no sodium outside the cell, the sodium-acid exchange pump runs backwards, pumping acid into the cell. Low potassium can also cause sodium to stay inside the cell. This shows once again how an imbalance between sodium and potassium inside and outside the cell can have catastrophic consequences for health.

Other aspects of health that are affected by this imbalance are:

1. Protein synthesis
2. Cell growth
3. The manufacture of new DNA and subsequent cell division

This also explains how diet is crucial in this aspect, eating too many acidic foods can cause electrolyte imbalances, changing pH levels to a state of acidosis (3). A diet high in alkalizing minerals like kelp, garlic, found in the ‘Heart and Body Extract’, and green leafy vegetables can bring our bodies back to the balance it needs to function properly. What is important to remember here is that the pH inside the cell depends on the balance between sodium and potassium.

The sodium-calcium exchange calcium pump (Na+/Ca2+)

Another pump that uses the electrical current produced by the sodium potassium pump is the ‘sodium-calcium exchange calcium pump’ (Na+/Ca2+). This pump removes excess calcium from the inside the cell, by exchanging one calcium ion (Ca2+) for three sodium ions. This means it moves three sodium ions in and takes one calcium out. Since this pump is powered by the sodium-potassium pump, anything that slows this pump will slow the sodium-calcium pump, with tremendous implications for our health. How? Keeping the level of calcium inside the cell low is critical, because small variations in this low level of calcium influence cell function greatly. For example, a small increase in the level of calcium inside muscle cells causes them to contract more than needed, leading to hypertension.

The increase in calcium inside cells results in other imbalances like:

1. Decreased effectiveness of insulin (inability of insulin to remove glucose from the blood, leading to diabetes)
2. Disturbance of fat and cholesterol metabolism
3. Narrowing of the smallest arteries leading to high blood pressure
4. Increased growth and division of cells

All of this creates an increase in the pH inside cells through the body, possibly leading to the development of cancer.

Sodium-potassium imbalances, excess calcium and hypertension

Low potassium slows the sodium-potassium pump increasing sodium inside the cells and decreasing membrane potential across the cell surface. Dr. Moore warns about the ‘deadly’ consequences of a dietary imbalance between sodium and potassium, consequences that have only begun to be understood. This imbalance is seen mostly in people with hypertension, therefore high blood pressure is an indicator of low potassium (hypokalemia).

The level of sodium inside cells of hypertensive lab rats was found to be a 40% higher and the voltage of their membranes was decreased by 3%, compared to rats with normal blood pressure. Thus, high blood pressure can be used as an indicator of low potassium and high sodium inside the cells.

This imbalance also has consequences in the other pumps we looked at. The sodium-calcium exchange pump is very sensitive to increased sodium inside the cells. An increase of 5% sodium translates into at least 15-20% increase in the level of calcium, which could cause as much as 50% increase in resting tension of the small resistance arteries. For hypertensive rats this was observed to be much higher, up to 100-200% higher. In kidney cells this meant a 64% increase.

What does this elevated calcium translate into? First of all, in muscle cells this increase means the muscles contract more. In the smaller arteries this increased tone, narrows the artery, increases peripheral resistance and raises blood pressure. An increase in the calcium levels inside sympathetic nerves that regulate blood vessel contraction would also increase the release of transmitting hormones such as epinephrine (adrenaline). This causes further contraction of the smooth muscle cells of the small resistance arteries.

High calcium inside cells also means:

1. Increase in growth and division of cells
2. Increase in the production of collagen
3. Alterations in protein synthesis
4. Alterations on the rate at which proteins are made and the way they are assembled together into larger structures

We are out of balance

Since it is the balance of sodium and potassium that counts, our high sodium and low potassium diets put us at risk. Our bodies are not designed to withstand such an extreme dietary imbalance, especially when it is maintained through the years.

In practical terms, increasing the sodium-potassium ratio should be done always slowly according to Dr. Moore, because a body deficient in potassium takes more time to adapt to increased dietary potassium. The presence of hypertension, diabetes, kidney disease and some drugs can slow the body’s adaptation to increased dietary potassium. In these cases, changes in the potassium to sodium balance may require the advice of a physician.

Because the body has so many complex and interrelated regulatory mechanisms, once they are adapted to a situation they require some time to adapt to another. We should not make changes to the body too quickly, because it may not be able to adapt. Since sodium and potassium are interconnected with so many regulatory systems, changing the dietary level of these two minerals too suddenly, especially if they are changed at the same time, could be dangerous.

What is more, since the kidneys excrete excess potassium, an excessive elevation of potassium could result in kidney disease serious enough to involve an inability to excrete potassium. Therefore, Dr. Moore advises to consult with a doctor to rule out kidney problems before increasing the sodium-potassium ratio.

People with hypertension, on diuretics, with magnesium deficiency or hypokalemia, diabetes, kidney insufficiency, and metabolic acidosis all can have an inability to regulate potassium. This is also the case of users of certain drugs like beta blockers, potassium sparing diuretics, ACE inhibitors, etc. A good idea is to start by slowly reducing the intake of sodium through a period of one week, once it has been decreased significantly, one can start increasing potassium with an alkaline diet.

How out of balance are we?

Our dietary intake of potassium should be at least 4-5 times higher than that of sodium. Our ancestors used to have this ratio, even higher on potassium (16:1 ratio). However, our current dietary sodium is about ten times what it should be, around 4,000 mg/day. To make matters worse the average American diet gets about half the daily potassium necessary. This translates into a ratio of 0.6, much worse than 1:1.

How much sodium and potassium do we need?

Surprisingly, a lot less sodium than we think. Some health care professionals estimate we need from 50 mg to 230 mg per day. This points to a minimum required amount of sodium of not more than 100 mg-300 mg. The ‘National Academy of Sciences’ recommends a minimum daily intake of 500 mg. The FDA recommendation is of 2,500 mg a day. Other health care professionals using ‘hair tissue mineral analysis’ (HTMA) like Dr. Robert Selig, explain that ratios are very personal and should only be recommended based on a study of the person’s mineral ratios on a regular basis (twice a year). This is due to the fact that there are many factors influencing mineral ratios in the body like stress, environmental conditions, etc. For this, a hair sample of the patient is taken in order to study the present levels of minerals inside and outside the cell. Blood tests are not considered reliable according to HTMA practitioners because the blood is only a transport system, therefore it does not show how much is actually being used by the cells.

When it comes to potassium, Dr. Young estimates that healthy adults should consume as much as 10,000 mg/day. According Dr. Eric Berg, a minimum of 4,700 mg is needed, that is 7 to 10 cups of vegetables a day. This recommendation goes along the alkaline diet we discussed in previous blogs.

A simple solution

Decreasing the risk of hypertension, stroke, osteoporosis, and other salt linked health problems can be as simple as decreasing salt intake while at the same time increasing the amount of potassium rich foods. This can be done with a personalized hair tissue mineral analysis to better evaluate mineral levels in the person’s body.

An alkaline diet, together with a good nutritional supplement like the ‘Heart and Body Extract’ can support the body’s own regulatory mechanisms toward a balanced sodium-potassium ratio.

In conclusion

Electrolytes are electrically charged minerals that are significant for providing the infinitesimally small units of life called ‘cells’ with the electrical energy they need to do their work. They exist within cells as well as in the fluid that surrounds our cells, and they create an electrical flow when they are in the right balance. Potassium is a specially important mineral for a healthy heart that is usually missing in our diet. In today’s blog we learned that it is the right balance between sodium and potassium that is key for proper heart function. An alkaline diet and the ‘Heart and Body Extract’ can help you bring your body back to balance.

Thank you for reading.

References:

(1) https://en.wikipedia.org/wiki/Sinus_rhythm

(2)  Boynton, Herb, et al. The Salt Solution. Avery, 2001.

(3) https://www.perque.com/pdfs/Joy_In_Living_TheAlkalineWay.pdf

(4) https://www.youtube.com/watch?v=q2vPQYP0dpI

(5) https://www.backtonaturalhealth.com/blog/

The health of the cell is of utmost importance for the heart. A balance of electrical minerals (electrolytes) both inside and outside the cell provides a flow of energy that allows the heart to beat with the proper rhythm (1). Due to the constant pumping action of the heart, a steady and constant flow of this electrical energy is key for proper heart function. This is made possible by the presence of pumps on the cell membrane that turn each of our cells into a small battery, capable of releasing and storing energy and maintaining an electrical charge.

We saw how an alkaline diet, together with a good nutritional protocol, like the ‘Heart and Body Extract’, are the best sources of these electrolytes, namely, sodium, potassium, calcium and magnesium. We also saw how potassium has a critical role for heart health as pointed out by the ‘National Council on Potassium in Clinical Practice’. Such research represents a new focus in the field of cardiology, and one that is receiving much interest from many health care professionals. One of these health care professionals is Richard D. Moore, M.D., Ph. D., who in his book ‘The salt solution’ (2), goes into deep detail about the importance of balancing sodium and potassium for heart health. He has worked with other doctors and published his research on how the sodium potassium pump influences insulin in the body.

In today’s blog, we will focus on his work. Specifically, we will look at how the sodium-potassium pump works to keep our heart healthy, and how it is needed to keep other important pumps working in the cell, the ‘sodium-acid exchange acid pump’, and the ‘sodium-calcium exchange calcium pump’.

Basics of cell biology 

90% of the potassium in the body is found within cells.This compartmentalization depends on its active transport through the cell membrane by the sodium-potassium pump. Before we look deep into this mechanism, we need to understand something basic in cell biology: all cells consist of a surface membrane called ‘plasma membrane’. Across this plasma membrane there is a voltage difference, with the inside of the cell being negative with respect to the outside. This voltage difference is made possible by the presence of the sodium-potassium pump, which acts as a microscopic electric generator of current carried by positive sodium ions.

The main job of this pump is to move sodium out of the cell and move potassium in. The purpose of this distribution is to generate a voltage between the inside and the outside of the cell: With each cycle, the sodium-potassium pump moves more sodium ions out than potassium ions in. The sodium pumped out is positively charged while the inside of the cell is negatively charged.This movement of electric current out of the cell leaves the inside more negative. In this manner, the sodium-potassium pump generates an electrical current, creating a powerful electric field across the cell membrane. The negative charge, and the lower concentration of sodium inside the cell, create a very strong ‘tug’ which makes sodium ‘want’ to leak back into the cell. This acts like a ‘sodium battery’ that is capable of performing work in a manner similar to a car battery.

The energy this battery creates is so crucial, that life could not be possible without it. This is proven by the astonishing number of pumps the body has: each of our 100 trillion cells have between 800,000 and 30 million of these pumps on the cell membrane (4). This great amount of electricity the human body is capable of generating also means that just a slight slowing down of these pumps can mean a tremendous decline in overall health.

It was originally thought that only nerve, muscle and kidney cells made use of the sodium-potassium pump. The reason for this might have been the fact that nerve and muscle cells have the largest potential (70 and 90 Volts respectively). However, it is now known that all cells in the body use the sodium-potassium pump. A nerve impulse, for example, consists of a 1 millisecond switching of the membrane potential from a negative value to a positive value and then back to the negative. This is accomplished by sodium ions rushing into the cell: as sodium rushes into the cell, the positive charge it carries makes the inside more positive. As the inside becomes positive potassium rushes outside the cell. All this process provides the signal for muscles and nerves to contract. When this happens several times, it is the equivalent of ‘running down’ of a battery, which is thought to be responsible for the fatigue we experience when we exercise. The sodium-potassium pump has the key job of restoring the cell’s energy by pushing the extra sodium back out and pulling the missing potassium back into the cell.

The obligatory link between sodium and potassium

Too much focus has been put on just limiting sodium for improving heart health, however, the sodium-potassium pump proves that it is not possible to isolate either sodium or potassium. It is the right ratio of the two that brings cells back into a healthy balance. This is because in the body sodium and potassium oppose one another, when one goes up the other goes down. Increasing potassium causes sodium to be excreted through the kidneys and vice versa. According to Dr. Moore, it makes no sense to talk about one without mentioning the other. He explains that there is a reciprocal relation between the levels of sodium and potassium inside the cell: anything that decreases sodium will increase potassium and vice versa, because the sodium-potassium pump moves sodium and potassium in different directions. In practical terms, without enough potassium, excess sodium cannot be lowered within the cells, in other words, to lower sodium in the cell, it must be replaced by potassium. This is one of the reasons why low salt diets don’t work for people with high blood pressure.

The teeter-totter rule

Dr. Moore refers to this as the ‘teeter-totter rule’. He explains that in the body it is not possible to affect sodium without affecting potassium. Not getting enough potassium and lowering salt intake cannot possibly restore the normal level of potassium and sodium within the cells. This is because sodium and potassium work together: When potassium goes into the cell, sodium must come out and vice versa, because the pressure inside the cells and the pressure outside must remain constant. An indicator of a healthy sodium-potassium pump is a ratio of around 14 to 1 of potassium to sodium inside the cell, and outside the cell the fluid should contain 30 times more sodium than potassium.

We could therefore say that heart health is not a matter of how much sodium or potassium one gets from the diet, but a matter of balance between the two. However, our present diet contains much more salt than our ancestors used to consume, and this has brought an imbalance to the body. Too much salt, without potassium to balance it out, can damage the heart, blood vessels and even bones. Only the right sodium-potassium ratio can reverse this damage.

More roles of the sodium-potassium pump

As we mentioned earlier, the sodium-potassium pump is present in all the cells of the body. Therefore, it has many different and important functions. So far we have explained that the job the sodium-potassium pump has is to move sodium out of the cell while moving potassium in for cells to be able to conduct electricity. But the sodium-potassium pump could do this without generating electricity, and since the body always works to conserve energy, there must be a very important reason for this. What is the purpose for generating electricity?

First of all, this pump helps maintain order in the body, by keeping sodium on one side of the cell and potassium on another side.

Secondly, the strength of this electric field also influences the structure and function of many proteins in the cell, and these proteins, in turn, play an important role in:

1. Transporting substances into and out of the cell
2. Transmitting hormonal signals, and
3. Carrying out a host of enzymatic reactions

Thirdly, the sodium-potassium pump affects a number of functions which in turn influence:

1. Cholesterol levels
2. How well the heart pumps
3. It influences fat metabolism
4. It allows nerves and muscles to conduct electrical signals
5. It allows sodium to be reabsorbed into the kidneys
6. It provides the power for regulation of levels of acid, calcium, and sugar inside the cell (sugar metabolism)
7. It governs cell growth and division, which makes it significant for cancer prevention
8. It regulates the response to hormones, including insulin

A minor slowing of the sodium potassium pump can affect all of these aspects of health.

Implications for heart energy

Nowhere in the body is the sodium-potassium pump best exemplified than in the heart. Not only because of the number of sodium-potassium pumps heart cells contain, but because the heart is a pump. A pump can be defined as a device that uses energy to move something in a direction opposite to the direction the substance would naturally move if left alone. For any pump to work, energy is required. Both the sodium-potassium pump and the heart use ATP as a source of energy (for more information on ATP please refer to previous blogs). This is the equivalent of a quarter of the energy our body obtains from the food we eat. In this manner, the heart uses energy to move blood against the potential energy force of blood pressure. In the case of the sodium-potassium pump, it also takes energy to move sodium out of the cell, generating an electric current also requires energy. A malfunction of the sodium-potassium pump can mean high blood pressure, stroke, but also osteoporosis, peptic ulcer, stomach cancer, and asthma.

Consensus guidelines for the use of potassium replacement in clinical practice

Low serum potassium concentration is perhaps the most common electrolyte abnormality encountered in clinical practice. According to the ‘National Council on Potassium in Clinical Practice’, in order to maintain normal levels of potassium several factors must be take into account such as:

1. Baseline potassium values
2. The presence of underlying medical conditions (such as CHF)
3. The use of medications that alter potassium levels (eg, non–potassium-sparing diuretics) or that lead to arrhythmias in the presence of hypokalemia (eg, cardiac glycosides)
4. Patient variables such as diet and salt intake, and
5. The ability to adhere to a therapeutic regimen

Because of the multiple factors involved, guidelines should be directed toward patients with specific disease states, such as those with cardiovascular conditions, and toward the general patient population. The following list encompasses the guidelines developed at the 1998 meeting of the National Council on Potassium in Clinical Practice. This council has also called for the continued research on potassium to determine specific recommendations.

General Guidelines

1. Dietary consumption of potassium-rich foods should be supplemented with potassium replacement therapy.
2. Potassium replacement is recommended for individuals who are sensitive to sodium or who are unable or unwilling to reduce salt intake; it is especially effective in reducing blood pressure in such individuals. A high-sodium diet often results in excessive urinary potassium loss.
3. Potassium replacement is recommended for individuals who experience nausea, vomiting, diarrhea, bulimia, or diuretic/laxative abuse. Potassium chloride has been shown to be the most effective means of replacing acute potassium loss.

Patients with hypertension

1. Patients with drug-related hypokalemia (therapy with a non–potassium-sparing diuretic) should receive potassium supplementation.
2. In patients with asymptomatic hypertension, an effort should be made to achieve and maintain serum potassium levels of at least 4.0 mmol/L. This can be achieved with a diet high in potassium-rich foods as well as potassium supplementation.

Patients with CHF

Potassium replacement should be routinely considered in patients with CHF, even if the initial potassium levels appear to be normal (eg, 4.0 mmol/L).The majority of patients with CHF have an increased risk of hypokalemia. In patients with CHF or myocardial ischemia, mild-to-moderate hypokalemia can increase the risk of cardiac arrhythmia. In addition, diuretic-induced hypokalemia can increase the risk of life-threatening arrhythmias.

The risk of hyperkalemia secondary to drug therapy with ACE inhibitors or angiotensin II receptor blockers, makes the regular monitoring of serum potassium level a life saving strategy for these patients. Stress is something also to be considered in these patients as it can trigger the secretion of aldosterone, and therefore a loss of potassium levels.

Patients with cardiac arrhythmias

Maintenance of optimal potassium levels (at least 4.0 mmol/L) is critical in these patients and routine potassium monitoring should be mandatory. Patients with heart disease are often susceptible to life-threatening ventricular arrhythmias. In particular, such arrhythmias are associated with heart failure, left ventricular hypertrophy, myocardial ischemia, and myocardial infarction. Magnesium supplementation should be considered too in order to facilitate the cellular uptake of potassium.

Patients prone to stroke

In patients at high risk for stroke, including those with a history of atherosclerotic or hemorrhagic cerebral vascular accidents, achieving optimal levels of potassium should be a priority. Although the effectiveness of potassium supplementation in reducing the incidence of stroke in humans has not been demonstrated in randomized controlled trials, prospective studies suggest that the incidence of fatal and nonfatal stroke

correlates inversely with dietary potassium intake. In addition, the association of stroke with hypertension is well known.

Patients with diabetes

Patients with diabetes show a marked decline in the levels of potassium, accompanied by a high incidence of cardiovascular and renal complications. Potassium levels should be closely monitored in patients with diabetes and potassium replacement therapy should be administered when appropriate.

Patients with renal impairment

Data suggest a link between potassium levels and lesions of the kidneys in patients with renal disease or diabetes. Animal studies have demonstrated that potassium may offer a protective effect on the renal arterioles. The clinical implications of these findings are not yet clear.

In conclusion

Electrolytes are electrically charged minerals that are significant for providing the infinitesimally small units of life called cells with the electrical energy they need to do their work. Electrolytes exist within cells as well as in the fluid that surround our cells, and can create an electrical flow when they are in the right balance. One of these electrolytes is potassium, which has been shown to have a great positive effect in heart health. A diet rich in potassium, paired with the many benefits of supplemental potassium, like the ‘Heart and Body Extract’ will ensure your heart is well taken care of. Get your bottle today!

Thanks for reading.

Resources:

(1) https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/485434

(2) https://www.backtonaturalhealth.com/blog/am-i-potassium-deficient

(3) Wilson, Lawrence D. “Nutritional Balancing and Hair Mineral Analysis.” Nutritional Balancing and Hair Mineral Analysis, Center for Development, Inc., 2010, pp. 316–317.

(4) https://drjockers.com/6-major-health-benefits-of-sea-kelp/

When it comes to the health of the cell, we have seen that the right balance of electrolytes inside and outside of the cell is key to allow energy into the cell. For heart health this is important because the proper flow of electrolytes into and out of the heart cells is required to keep the heart from filling up with water (cardiac edema) and to keep the electrolytes present that allow the heart to beat properly. This is made possible by the presence of pumps on the cell membrane, called ‘sodium-potassium pumps’, that turn each of our cells into a little battery capable of releasing and storing energy and maintaining an electrical charge.

We also saw how the ‘Heart and Body Extract’, and an alkaline diet are the best sources of these electrolytes, namely, sodium, potassium, calcium and magnesium. In today’s blog, we will focus on the role of potassium in heart health, as observed by the ‘National Council on Potassium in Clinical Practice’. According to this council, low potassium is the most common electrolyte abnormality encountered in clinical practice, a condition known as ‘hypokalemia’ (1).

The ‘National Council on Potassium in Clinical Practice’ 1998 meeting

The critical role potassium has for heart health was studied in depth at a 1998 meeting of the ‘National Council on Potassium in Clinical Practice’. The Council was a multidisciplinary group comprising specialists in cardiology, hypertension, epidemiology, pharmacy, and compliance.

The main focus of this meeting was to study how maintaining normal levels of potassium in the body could help reverse challenging heart conditions. The evidence accumulated confirmed the crucial role potassium has for reducing the risk of life-threatening cardiac arrhythmias, high blood pressure and stroke. As a result of this meeting and its findings, new guidelines for potassium replacement therapy in clinical practice were established.

This initiative represented a new approach to the field of cardiology as, so far, potassium had not been the focus of treatment in any cardiological conditions. Quite the contrary, the many health challenges caused by hypertension and heart failure, had mandated the introduction of drugs that, according to the authors, disrupt electrolyte homeostasis, a fact that emphasizes the serious role of potassium.

The sodium-potassium pump

In their research, the authors were able to prove that, in healthy circumstances, potassium is one of the most abundant electrolytes in the body. Of the total body potassium content (about 3500 mmol), 90% is sequestered within cells, where it does all its work. This compartmentalization depends on its active transport through the cell membrane by the sodium-potassium pump, which maintains an intracellular positively charged ion ratio of 1:10. The smallest percentage of potassium can be found in the blood, as the blood is the main carrier for potassium to the cells. The loss of just 1% (35 mmol) of total body potassium content would seriously disturb the delicate balance between intracellular and extracellular potassium and would result in profound physiologic changes.

Clinical implications of potassium depletion

Potassium depletion, hypokalemia, is one of the most common electrolyte abnormalities encountered in clinical practice. More than 20% of hospitalized patients have this deficiency, and up to 40% of patients treated with thiazide diuretics.

The kidneys, being the major regulators of potassium levels, account for approximately 80% of potassium transit from the body; this is reason why kidney dysfunction can result in low levels of potassium.

But potassium homeostasis also depends to a large extent on the acid-alkaline balance in the body. Acidosis causes the cells to lose potassium. What is more, increases in insulin or glucose, and type 2 diabetes can affect potassium homeostasis as well.

Drugs like decongestants and bronchodilators can temporarily reduce potassium and increase sodium. Other potential causes include diuretic therapy, inadequate dietary potassium intake, high dietary sodium intake, and low magnesium. In most cases, hypokalemia is secondary to drug treatment, particularly diuretic therapy. Diuretics inhibit sodium reabsorption in the kidneys, creating a favorable electrochemical change toward potassium loss.

Hypokalemia occurs less frequently in patients with uncomplicated hypertension who take a diuretic but is more common in patients with congestive heart failure (CHF), nephrotic syndrome, or cirrhosis of the liver, who take an equivalent dose of a diuretic and consume approximately the same amount of potassium from food.

Aside from potassium-wasting drugs, hypokalemia is most commonly caused either by abnormal loss through the kidney due to metabolic alkalosis or by loss in the stool secondary to diarrhea.

According to other healthcare professionals, potassium deficiency is caused by the ‘improper processing of food over the last 100 years, complicated by the fact that the food industry has used super phosphate fertilizers’ (2).

Because potassium is a major intracellular positively charged ion, the tissues most severely affected by potassium imbalance are muscle and kidney cells. Manifestations of hypokalemia include generalized muscle weakness, paralytic ileus, and cardiac arrhythmias. Severe untreated hypokalemia, may progress to acute renal failure.

Protective effect of potassium

Data gathered from animal experiments and epidemiologic studies suggest that high potassium may reduce the risk of stroke. Part of the protective effect of potassium may be due to the fact that potassium lowers blood pressure. Other protective mechanisms include:

1. Reduction of free radical formation, and oxidative stress
2. May reduce macrophage adherence to the vascular wall, an important factor in the development of arterial lesions

In 1987, the results of a 12-year prospective population study showed that the relative risk of stroke-associated mortality was significantly lower with higher potassium intake. In fact, the study demonstrated that just a 10-mmol higher level of daily potassium intake was associated with a 40% reduction in the relative risk of stroke mortality. This apparent protective effect of potassium was independent of other nutritional variables, including caloric intake, dietary levels of fat, protein, and fiber, intake of calcium, magnesium, and alcohol. The authors also noted that the effect of potassium was greater than that which would have been predicted from its ability to lower blood pressure.

Similarly, an 8-year investigation of the association between dietary potassium intake and subsequent risk of stroke in 43,738 US men, aged 40 to 75 years, without previously diagnosed cardiovascular disease or diabetes was conducted. During the study follow-up, only 328 strokes were documented. The association between low potassium intake and subsequent stroke was more marked in hypertensive men.

Other investigators also found that the use of potassium supplements was inversely related to the risk of stroke, particularly among hypertensive men. They speculated that this relationship might be due, at least in part, to a reduction in the risk for hypokalemia.

Clinical implications in hypertension

Studies have shown a strong relation between potassium depletion and essential hypertension. Increasing the intake of potassium appears to have an antihypertensive effect that is evident in effects like vasodilation, and lower cardiovascular reactivity to norepinephrine or angiotensin II.

Similarly, correction of diuretic or laxative abuse can also raise potassium level and lower blood pressure.

The large-scale Nurses’ Health Study found that dietary potassium intake was inversely associated with blood pressure. Specifically, intake of potassium-rich fruits and vegetables was inversely related to systolic and diastolic pressure.

Similarly, 24-hour urinary potassium excretion, and the ratio of urinary sodium to potassium were found to be independently related to blood pressure in the ‘Intersalt’ study, a 52-center international study of electrolytes and blood pressure.

Additional information was provided by the ‘Rotterdam Study’, which evaluated the relationship between dietary electrolyte intake and blood pressure in 3,239 older people (age ≥55 years).

Another recent meta-analysis evaluating the effects of oral potassium supplementation on blood pressure, included 33 clinical trials involving 2,609 participants. The results demonstrated that potassium supplementation was associated with a significant reduction in systolic and diastolic blood pressure. The greatest effects were observed in participants who had a high sodium intake. This analysis suggests that low potassium intake may play an important role in the genesis of high blood pressure.

Clinical Implications in ‘Congestive Heart Failure’ (CHF)

Potassium depletion is commonly seen in patients with CHF, a condition that is characterized by electrolyte disturbances. CHF is linked to renal dysfunction and neurohormonal activation, both of which stimulate aldosterone, sympathetic nervous tone, and hypersecretion of adrenaline.

The researchers have observed a common misperception regarding angiotensin-converting enzyme (ACE) inhibitor therapy is that these drugs enhance potassium retention, thereby eliminating the need to add potassium or potassium-sparing diuretics to ACE inhibitor therapy. What they observed is that, in many cases, the prescribed dosages of ACE inhibitors in patients with CHF are insufficient to protect against potassium loss. Their recommendation is that potassium levels must be closely monitored in all patients with CHF, even those taking ACE inhibitors, to minimize the life-threatening risk of hypokalemia.

Clinical implications in patients with arrhythmias

Mild-to-moderate hypokalemia can increase the likelihood of cardiac arrhythmias in patients who have cardiac ischemia, heart failure, or left ventricular hypertrophy. This is not surprising taking into account the important role that potassium plays in the electrophysiologic properties of the heart. The resting membrane potential (RMP) (the difference in electrical charge inside and outside the cell) is determined by the ratio of intracellular to extracellular potassium. Changes in potassium levels modifies the amount of electricity able to pass the cell membrane and can have profound effects on impulse generation and conduction throughout the heart. Changes in this ratio, such as those induced by diuretic therapy, can alter cardiac conduction greatly.

Something significant observed during this research is that patients with hypertension who were prescribed non–potassium-sparing diuretics had approximately twice the risk of sudden cardiac death compared with users of potassium-sparing therapy.

To prove the link between hypokalemia and clinical heart arrhythmia and to determine the relationship of diuretic-induced hypokalemia, 17 hypertensive men receiving diuretics were studied. These patients had increased frequency and complexity of ventricular ectopic activity during diuretic therapy. However, oral potassium supplements or potassium-sparing agents reduced the complexity and frequency of arrhythmias by 85%, even after discontinuation of diuretic therapy.

There is also evidence that hypokalemia can trigger sustained ventricular tachycardia or ventricular fibrillation, particularly in the case of acute myocardial infarction.

Potassium supplementation strategies

All this evidence has led the authors to suggest that increasing potassium is necessary in the case of cardiac arrhythmias, such as heart failure, myocardial infarction or ischemic heart disease.

Repletion strategies should include eating foods high in potassium, potassium salts substitutes, and supplements. Potassium salts include potassium chloride, potassium phosphate, and potassium bicarbonate. Potassium phosphate is found primarily in food, and potassium bicarbonate is typically recommended in the case of metabolic acidosis (pH <7.4).

In our blog covering the alkaline diet we saw how fresh fruits and vegetables are a great source of alkalizing minerals, especially potassium. This includes kelp and garlic (3) found in the ‘Heart and Body Extract’; but also food sources like avocados, peas, beans, nuts, cocoa, seafood, and dark green vegetables.

According to Dr. David Jockers, “Kelp is extraordinarily rich in alkaline buffering nutrients such as sodium, potassium, magnesium and calcium. It is also a phenomenal source of chlorophyll to boost blood cell formation and purify the blood” (4).

The role of magnesium in potassium repletion

Magnesium is an important cofactor in potassium absorption and necessary for the maintenance of intracellular potassium levels. Research has demonstrated that long term magnesium deficiency could lead to the inability to replete potassium. It has been observed that many patients with potassium depletion most frequently also have magnesium deficiency. This is especially the case of patients on diuretics, which cause a substantial loss of intracellular potassium and magnesium. Some diuretics accelerate the excretion of magnesium by reducing its reabsorption in the kidneys.

It is thereby recommended considering the repletion of both magnesium and potassium for patients with hypokalemia.