[reverett123]

I have been coming at this from various directions for a year now. Lately I have been working with my GP as well. I'm still working on control (how much, how often, etc) but I have gotten to the point that I want to pass on what I have learned.

This is important to all of us but I particularly want those in the "advanced" stages to have the info. It has reduced my freezing by 75% and my off's by a similar amount! I don't think it is just me and I especially want to encourage those on levodopa to look at it because hypokalemia (low potassium) is one of the known possible side effects of sinemet and her sisters.

Before I get technical about this, a word on safety. Anytime the subject of potassium supplements comes up people get nervous. After all, too much can kill you, can't it? The short answer is yes, under a tight range of conditions too much potassium can stop your heart. But you would have to try pretty hard even to do it on purpose.

Some important guidelines-
1- Certain drugs commonly used for high blood pressure can cause high levels to build up. These include beta blockers, ACE inhibitors, angiotensin inhibitors, and potassium sparing diuretics. If you are taking anything like these, talk to your doctor. You can probably still take it but have your levels checked regularly at first until you get a feel for your situation.
2- Kidney function. This is where your body gets rid of excess potassium. If your bladder works well it would be near impossible to reach dangerous levels so long as the drugs in number one aren't a factor. Also, that active bladder not only protects you, it also causes part of the problem as potassium is washed out with the urine.
3- Supplemental dosage is specified in units called mEq which allows different types of potassium to be compared. For example, the prescription of potassium chloride from my GP comes in at 20 mEq per one gram tablet. The potassium glyconate that I buy at the health food store provides about 5 mEq per 99 mg tablet. I have to take five of the latter to equal one of the former. And researchers speak in terms of oral doses in excess of 100 mEq. You don't have to master these numbers, simply be aware that there is a large safety margin so long as your kidneys work and certain drugs are not in the picture.

It is worth a little risk because of the large reward. Two things can happen to your potassium. As mentioned above, it can be literally flushed away. Second, it can be temporarily moved from the blood into the individual cells. Both of these can be a problem because the thing that makes nerves and muscles work is the difference in potassium levels on the inner and outer surfaces of the cell wall. Both a loss through the kidneys or a temporary relocation from serum to cell mess things up. Supplementation can help that and stabiloize things.

At present I am taking a single tablet of potassium gluconate (99 mg) each time I take PD meds and will probably cut that back soon.