The Role of Potassium in Rheumatoid Arthritis

In this episode of research round up Naturopath Ananda Mahony looks at the role of potassium in rheumatoid arthritis, a highly debilitating condition in which pain and reduced mobility are strongly linked to an overall reduced quality of life.

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Hello this is Ananda Mahony and in this episode of research round up I am looking at the role of potassium in rheumatoid arthritis, a highly debilitating condition in which pain and reduced mobility are strongly linked to an overall reduced quality of life.

I will take you through some recent research highlighting the importance of potassium in managing rheumatoid arthritis, the impact low potassium can have on those living with rheumatoid arthritis, and what you can do to ensure your potassium levels are helping and not hindering you”

As a highly inflammatory condition there are systemic consequences in other systems such as an increased risk of CVD and depression, so effective treatment is critical.

The currently medications are aimed at pain relief, as a factor of utmost importance, using analgesics, steroids and NSAIDS for inflammation and biologic medication, which act via the immune system to reduce inflammation.

All of these medications are associated with side effects and risk so it is important to look for non-pharmaceutical approaches to allow for the reduction in overall medication use. Diet based approaches are an important non-pharmaceutical approach not currently included in treatment guidelines for RA nor many other chronic pain treatment approaches. Something I am of the opinion is a significant oversight.

However the paper I am looking at today by Kanifaid and Chopra suggests that people with rheumatoid arthritis often have low levels of potassium in their blood. Why is that relevant? Because potassium is a key nutrient in cell health, conducting nerve impulses and is involved in cardiovascular health. The findings indicated that supplementing dietary intake of potassium might help reduce joint pain and inflammation and reduce the risk of CVD co-morbidities.

There are two obvious reasons why potassium may be low:

1. Low intake and this was shown in an Indian study. Women with rheumatoid arthritis had diets very low in potassium, which the author suggested could be due to fad diets or increased Westernisation of diets. The standard Australian diet is generally low in potassium.
2. The second reason may a higher demand for potassium in rheumatoid arthritis. This condition is associated with a raised metabolic state meaning more use of critical nutrients specifically potassium. It is also associated with a high acid load and disturbed pH of the blood again leading to increased use of potassium as a compensatory mechanism. This overutilisation thus resulting in a deficiency of potassium. It is important to note that too much or too little potassium is a medical emergency however early abnormal levels can be asymptomatic or result in vague symptoms such as low energy and muscle pain.

Other reasons for low potassium in rheumatoid arthritis may be due to low cortisol. This is one of our stress hormones and has a critical role in the body helping to modulate inflammation. Rheumatoid arthritis is considered a low cortisol state disorder. Why is this important? Low cortisol leads to low potassium in the body, and low potassium can further exacerbate low cortisol states. Overall this means more inflammation.

Finally I want to make note of the role of potassium in chronic pain generally, chronic pain is associated with abnormal sensory never excitation generally: a state of nociceptive hyperexcitability. Low potassium levels can lead to increased nerve stimulation and irritability resulting in more danger signals being sent to the brain thus potentially contributing to or facilitating the development of chronic pain.

So of course the question is does increasing potassium status improve rheumatoid arthritis symptoms /outcomes. Well there is limited specific research about this however,

One double-blind placebo controlled study in 36 seropositive women with rheumatoid arthritis supplemented with potassium over a 28-day period. Participants stayed on pre-trial medication and ate a routine diet. The results were a significant reduction in pain and inflammation in the treatment group compared to the placebo arm.

So this sounds positive however there are some caveats to potassium supplementation specifically around cardiovascular disease, kidney disease and blood pressure medications so it is important to check with your health care professional, naturopath or nutritionist before supplementing.

There are other ways to improve Potassium status that don't involve supplementation and this brings me back to non-pharmaceutical diet based approaches. A Mediterranean diet approach has been shown to reduce inflammation in rheumatoid arthritis, and while it has many positive aspects including lots of healthy olive oil, the other factor of this diet is the significant proportion of vegetables and fruit. And guess what, potassium is found in vegetables and fruit, particularly vegetables so upping your intake is key to increasing levels. And by this I don't just mean a few serves a day...actually I mean more like 7-10 serves a day to really improve levels with rheumatoid arthritis. How? Ensure that at least two meals a day are 3/4 vegetables, add in a few pieces of fruit and a vegetable juice...my favourite for rheumatoid arthritis specifically is cucumber and celery. Give it a go - a savoury juice for morning tea may just help reduce pain and inflammation for the day.