Potassium is an essential mineral and electrolyte. It works in your nervous and skeletal systems, controls the electrical activity of your heart, and is involved in blood pressure control. Potassium bicarbonate is one available form of potassium supplement. Others include potassium chloride, potassium acetate, potassium citrate, and potassium gluconate.1

Most people can receive enough potassium through certain foods, but some health conditions or medications may cause low potassium levels. In this case, potassium bicarbonate may be prescribed by a healthcare provider. Potassium supplements should be taken cautiously since too much potassium can be harmful.

 

Uses of Potassium Bicarbonate

Potassium supplements can be used to treat or prevent low potassium levels. Blood potassium levels can be easily checked with a blood draw to determine if supplementation is needed.

While this article is specific to potassium bicarbonate, the potential uses are related to potassium supplementation in general. Your healthcare provider can discuss which form is most appropriate for your needs.

Below are the potential uses in which potassium supplementation may have a role.

Hypokalemia

Hypokalemia (low levels of potassium in the blood) can lead to serious health problems, such as arrhythmias (irregular heart rhythms) and even cardiac arrest.2 Potassium supplementation helps return potassium to normal levels in the body.

Hypokalemia frequently happens in hospitalized people. They may be prescribed oral (by mouth) or intravenous (IV, into the vein) potassium.3

Certain health conditions or medications can cause persistent hypokalemia. In these cases, you may need potassium supplementation over a longer period.

Blood Pressure

The DASH (Dietary Approaches to Stop Hypertension) diet is designed to help lower blood pressure. It includes many potassium-rich foods. In fact, the DASH diet provides three times the amount of potassium compared to the typical American diet.1

The following research looks at the role of potassium in reducing blood pressure:

• A large meta-analysis found potassium supplementation significantly reduced blood pressure. It was particularly helpful for people with hypertension (high blood pressure) who had a high sodium but low potassium intake in their diet.5
• A second meta-analysis in the Journal of Hypertension also showed that potassium supplementation lowered blood pressure.6
• One study that looked at only six of the strongest studies on potassium supplementation found no significant improvement in blood pressure with potassium supplementation. However, this study is older than the studies mentioned above.7

It is important to note that not all reviews included meta-analyses that used potassium bicarbonate as the supplementation.

However, based on the research, the FDA has approved the health claim that diets containing potassium-rich foods that are low in sodium may reduce the risk of high blood pressure and stroke.1

Bone Health

Potassium may play a role in improving bone health.

In a 2013 study, people received 60 milliequivalents of potassium citrate or a placebo for years. Bone mineral density (BMD) improved significantly with potassium supplementation compared to placebo.8

A meta-analysis of 14 studies reviewed the effects of potassium bicarbonate and potassium citrate on calcium metabolism. The authors found there was a reduction in bone resorption indicating a potential benefit to bone health.9

A 2018 study found potassium citrate supplementation improved the beneficial effects of calcium and vitamin D on bone health in women with osteopenia and documented low potassium and citrate levels.10

Further research is needed to determine the mechanism by which potassium may preserve bone health and whether supplementation should be recommended. Note some of these studies evaluated potassium citrate, not potassium bicarbonate.

Kidney Stones

There is some evidence that higher potassium intake may prevent the development of kidney stones.

Two large studies found that a high intake of potassium was associated with a lower risk of developing kidney stones.1112 It is thought that fruits and vegetables help prevent stone formation because of their high water, potassium, and magnesium content.13

However, it should be noted that this does not establish a cause-and-effect relationship. Additionally, the higher potassium intake was not from supplementation.

More research has suggested that increasing potassium intake may lower how much calcium is excreted in the urine, which in turn helps manage hypercalciuria (excessive calcium in the urine) and kidney stones.11

Further research in the form of clinical trials is needed to determine if potassium supplements can prevent kidney stones.

Stroke

Higher intakes of potassium may help prevent stroke.

Two separate meta-analyses found a reduction in stroke occurrence in those who had higher potassium intake. Higher intakes of potassium (greater than 155 millimoles per day) resulted in a 24% reduction in stroke.1415

Another meta-analysis found an inverse relationship between potassium intake and the risk of stroke. The higher potassium intake was associated with a reduced risk of stroke.16 Approximately 3,500 milligrams (mg) of potassium per day were needed to see the reduced risk.

Again, these studies evaluated potassium intake from the diet and not specifically potassium supplementation.

 

Potassium Deficiency

Generally speaking, nutrient deficiencies (including potassium) occur with too little food intake or a high amount of nutrient loss.

Most Americans get only about half of the recommended amount of potassium in their diets.17 Although this intake isn’t optimal for overall health, it doesn’t mean it will lead to potassium deficiency.

What Causes a Potassium Deficiency?

Potassium deficiency is most often due to increased losses. Potassium losses can occur through diuretic use, laxative use, or the GI tract or kidneys.3

Some diuretics (also known as “water pills”) cause higher amounts of potassium to be excreted. Potassium deficiency can also occur as a result of laxative abuse, which can lead to GI symptoms like diarrhea.1

Groups at Risk of Potassium Deficiency

You may be at risk of potassium deficiency if you:1

• Take diuretics: Discuss with your healthcare provider to find out if you need supplemental potassium. Potassium supplements are frequently prescribed by healthcare providers along with diuretics that increase potassium losses.
• Have GI conditions that make you prone to diarrhea, such as Crohn’s disease and ulcerative colitis
• Have kidney disease, especially in the early stages18
• Abuse laxatives
• Have pica, which is the persistent eating of non-food substances

How Do I Know if I Have a Potassium Deficiency?

Signs of a possible potassium deficiency include:1

• Constipation
• Fatigue
• Muscle weakness
• Malaise, or feeling of general discomfort

Your potassium level can be checked in your blood. Potassium levels are part of a basic chemistry panel. Normal blood potassium levels are 3.6 to 5 millimoles per liter, but potassium levels can change significantly from day to day.1

 

What Are the Side Effects of Potassium Bicarbonate?

There may be some side effects from supplementing with potassium bicarbonate (and potassium in general). Talk to a healthcare provider about the risk of side effects.

Potassium bicarbonate increases potassium levels. Having high potassium levels (hyperkalemia) is a health concern and can cause serious symptoms such as:19

• Muscle weakness
• Nausea
• Numbness or tingling in the hands or feet
• Vomiting

More serious side effects of consuming too much potassium can include:19

• Chest pain
• Confusion
• Excessive weakness (especially in the legs)
• Irregular heartbeat or palpitations
• Severe abdominal cramps
• Trouble breathing

Contact a healthcare provider and stop taking the supplement right away if any of these side effects occur.

 

When to Avoid Potassium Supplementation

If you have kidney disease, talk to your healthcare provider before taking potassium supplements. People with kidney disease often have high blood levels of potassium. Your healthcare provider may instruct you to avoid high-potassium foods and limit your intake to less than 2,000 milligrams (mg) daily.20

Addison’s disease (a disorder that affects your adrenal glands) can also lead to high potassium levels.21 Therefore, potassium supplementation is not recommended.

If you are pregnant or nursing, discuss with your healthcare provider if you need potassium and weigh the risks and benefits to you and your baby.

Potassium bicarbonate may interact with some medications that affect potassium levels. These include ACE inhibitors, beta-blockers, diuretics, NSAIDs, and steroids. If you take any of these medications, talk to your healthcare provider before taking potassium bicarbonate.1

 

Dosage: How Much Potassium Bicarbonate Should I Take?

There is no Recommended Dietary Allowance (RDA) for potassium bicarbonate. However, there are Adequate Intakes (AIs) of potassium. AI refers to the recommended average daily nutrient level in healthy people.22

The recommended daily dosage limit for potassium bicarbonate is 200 milliequivalents (mEq) per day in people up to 60 years old and 100 mEq in people 60 years and older.23

Potassium bicarbonate is safe to eat if you are generally healthy, but you don’t want to overdo it. The FDA limits potassium bicarbonate supplements to less than 100 milligrams per serving.1 You should not take potassium bicarbonate along with other sources of potassium. Taking too much potassium can cause serious heart complications.

 

What Happens if I Take Too Much Potassium Bicarbonate?

If you take too much potassium bicarbonate, you are more likely to experience side effects such as nausea, vomiting, stomach pain, or diarrhea. Although not as common, some may experience an irregular heartbeat.1

It is possible for death to occur from too much potassium intake, but it is rarely reported. The kidneys regulate potassium balance in the body. Assuming normal kidney function, excess potassium will be filtered through the kidneys and excreted in the urine.1

 

Interactions

There are several different medications that can affect the amount of potassium in your body.

Talk to a healthcare provider about taking potassium bicarbonate if you are also taking one of the following medications:

• Angiotensin-converting enzyme (ACE) inhibitors such as quinapril, Altace (ramipril), Lotensin (benazepril), and more1
• Beta-blockers including Betapace (sotalol), Bystolic (nebivolol), Coreg (carvedilol), and more24
• Diuretics (also called water pills) including Aldactone or Aldactazide (spironolactone), Diuril (chlorothiazide), Dyrenium (tramterene), and more1
• Non-steroidal anti-inflammatory drugs (NSAIDs) including aspirin, Advil, Midol, or Motrin (ibuprofen), Naprosyn (naproxen), and more25

Food Interactions

Some people use salt substitutes in food to lower their overall sodium intake. Most salt substitutes replace sodium with potassium. The potassium content of salt substitutes ranges from 440 to 2,800 mg of potassium per teaspoon.1

This should be included in the total potassium intake. Salt substitutes should be avoided while taking a potassium supplement.

 

How to Store Potassium Bicarbonate

Potassium supplements should be stored in a tightly closed container. Keep them protected from heat, moisture, and light.

As with all medications and supplements, store out of reach of children and pets.

 

Sources of Potassium and What to Look For

Potassium is widely available in a variety of foods that we eat. It is also available as an individual supplement or in multi-nutrient supplements.

Food Sources of Potassium

High-potassium foods include:26

• Fruits and vegetables, such as bananas, oranges, cantaloupes, Swiss chard, potatoes, yams, acorn squash, and spinach
• Beans, especially lima, adzuki, white, soy, pinto, and black beans
• Some fish, such as salmon, flounder, and cod

Potassium Supplements

Potassium supplements are available as pills or tablets, liquids, and powders.

Several forms of potassium supplements are available, including potassium chloride, potassium bicarbonate, potassium acetate, potassium gluconate, and potassium citrate. All forms are absorbed in the body equally as well.1

The Supplement Facts label should include the amount of elemental potassium. Potassium is often referred to in amounts of milliequivalents (mEq) or milligrams. For conversion, 1 milliequivalent is equal to 39.09 milligrams of potassium.

Potassium supplements will come with a warning if they provide greater than 99 milligrams of potassium. This is because some potassium salts have led to small-bowel lesions.1