High Potassium levels can cause afib

It has been some time since I have posted, three years since my ablation with Dr Schweikert at Akron General, I did have a short episode this spring while on vacation in Jamaica and the interesting thing about it was that during the episode my Potassium level was slightly over 6, the normal being 3.5 to 5. I always have my Cardymeter with me along with my usual supplements including Magnesium, 600mg. a day works well with me. I no longer take Potassium since I quit eating wheat products and I am normally around 4.5. In addition I always have with me 25 mg. Metaprolol and 100 mg. Flecainide for a PIP just in case, good thing because I needed it now, far away from my home and Dr. Schweikert in Akron, Ohio. So I chewed up the Metaprolol and drank some water, waited half an hour and took 2 Flecainide, the directiions were to take 3, but I thought that was too much. One hour and 45 minutes later I converted back to NSR. The next thing I worked on was getting that Potassium down, that was fairly easy, I just ate some bread and a few other acidic Potassium reducing foods and alot of fluids and by the next day I had come down to my usual levels. After reviewing my diet I was convinced that all of the food I was eating had added to my Potassium levels, coconut juice, lots of fruits, avacodos ect., stuff I don't eat alot at home. I was still avoiding wheat products so there was not much to reduce the Potassium.
While in afib, I searched the internet for causes of afib and a high Potassium level was right there near the top of the list. It could just be my system that is sensative to Potassium, but before I quit the wheat I was taking 3 teaspoons or 1620 mg. of Potassium a day to stay at good levels, now I cannot take it or I will go way too high. I have also noticed that missed beats have been greatly reduced since losing the wheat.
Now, after hearing my story I would hope that if you decide to go wheat-free, you should monitor your levels, especially if you are supplementing with Potassium. Good luck to you all and thank you for the great info provided here.

Hey TomC

Good to hear from you again and that things have been going so well! The one episode on vacation not withstanding which, as you noted, could easily have been from too much K at a level of 6.0!

That's a good reminder for folks here that like in most things nutritional and hormonal there is a broad optimal range where we do our best but when we drp too low or rise too high in that same vital biochemical we can get out of whack and often trigger the same unwanted result.

Best wishes to you and keep in touch from time to time.

Cheers!
Shannon

Hi Tom - Good to hear from you....but sorry about the heart activity.

Definitely too much potassium (just as too little) can cause arrhythmias... especially in the case of high potassium along with low magnesium - inside the cells where it isn't easily measured.

A recent Exatest results indicated that my intracellular potassium was low which probably accounted for some of my previous activity along with the Lyme treatments... so I've been adding more supplemental potassium and I'm noticing that overall, that I'm having more energy which seemed to be diminishing as well. I dusted off my potassium book by Betty Kamen, PhD ... Everything You've Always Wantd to Know About Potassium.... but were too tired to ask!. Reading it was a good reminder that potassium sufficiency is critical to more than just heart function.

I've been totally gluten free (and wheat free) for about 5 years.

The potassium connection to afib is well-documented in CR 72 for new readers who may not yet have visited that Conference Room session.

Be well,
Jackie

Hi Tom,

My diet for the last 5 or so years has generally been < 50 g carbs a day. I almost never eat any grains, legumes or starches. I have maintained keto-adaptation. The diet is mostly lots of non-starchy veggies, fat (mostly saturated) and some meat. It works out to be about 75-80% fat, 15% protein and 5-10% carbs. I also supplement with 2 g/day of potassium as citrate and another 2g/day of potassium as bicarbonate plus what is in my food. This causes me no issue. So there are many varieties of human systems (I also take magnesium to bowel tolerance, between 2-3g/day and 4 g/day of taurine).

I did have issues the last year or so, but they turned out to be related to excess calcium, mostly from dairy. When I removed that Ca source, my very well controlled afib remission returned. <[www.afibbers.org]

The electrolytes are certainly important, but it can be a challenge figuring out which ones are the critical ones for any of us and whether the issue is one of too little or too much.

Reports like yours are excellent as it gives people an idea of how varied we are. My motto is if something isn't working, try something else!

George

George:

Your story isn't finished yet---you are being a lab rat, I wish you well.

Liz

Liz,

Of course, I'm well aware & I'm my own control...

Using control in a different sense, if your reference is to my afib, I consider the results excellent. After an initial 2 1/2 month afib episode, I had about 7 1/2 years of very good control (after initiating my supplement program), about 10 episodes during that time, most lasting an hour. Then about a year of poorer control, most likely caused by an excess of calcium, many more episodes most lasting an hour or two. Subsequent to limiting Ca intake, my control is back to what it was for the 7 1/2 years. This is not a bad place to be.

If your reference is to my keto-adapted diet. I assure you I realize I'm completely going against conventional wisdom, but it is not without study and data. In a simple sense, there are significant data that suggest that many of the chronic illnesses of aging (heart disease, cancer, dementia, kidney & of course Type II diabetes) are due to poor glucose control and excessive insulin secretion.

I most likely came to afib by way of chronic fitness. I still like to be very active, but am aware of the risk this entails. So the question to myself is how to be fit enough to participate in many activities and yet not push the afib. My answer is to not train for endurance, but to perform enough bodyweight exercises on a suspension trainer to keep strong (TRX Military Fitness Program).

The keto-adaptation has reduced my need for oxygen fairly dramatically. This is very evident when skiing at 12-13,000' and with my very fit friends and they are breathing hard and I'm not at all. In a technical sense, my respiratory quotient (RQ), the ratio of carbon dioxide you produce to oxygen you consume, has reduced for the same level of activity. This means I'm using more fat for fuel than glucose. When I'm using fat for fuel, I'm also using ketones as they are produced from the fat when keto-adapted. The ketones require 28% less O2 to metabolize, so are more efficient.

So the keto-adaptation allows me to exercise modestly and yet retain the ability to perform at a high level when necessary (and IMHO avoid the chronic illnesses). It is a great trick and I love it.

George

George:

75 to 80% fat is a lot of fat to consume, what kind of fat would that be, seems like all that fat would make your skin oily, sorry. Whatever works is great at least you aren't getting an ablation which seems to be the trend on here lately. I try to eat lots of veggies, fruits and meat and stay away from too many starches, but do think that legumes are ok in moderation. I am in my late seventies and have a very large garden which I rototill and take care of, I have a couple of acres of land to mow which have fruit trees that I take care of, I do get a few episodes of AF once in a while which are mild. I dry and freeze and can my produce so I am sure all of that helps.

Liz

Hi Tom - you said

"The next thing I worked on was getting that Potassium down, that was fairly easy, I just ate some bread and a few other acidic Potassium reducing foods and alot of fluids and by the next day I had come down to my usual levels. "

Can you tell me what other kinds of foods work for getting your potassium down. I am having a very hard time getting mine up, and must be consuming something that is giving me grief.

Ron

PS I'm at bowel tolerance with magnesium, plus using Mg spray plus regular foot soaks of Epsom.

George - Your successes confirm what many have been advising for a long time about the importance of low carb and high fat intake... right fats, of course. (and eating 'clean' foods). This supports the science on the benefits of and critical necessity for keeping cellular membranes healthy and allows for healthy membrane repair. It also goes along with the increasing focus on warding off brain disorders including dementia and Alzheimer's. Getting away from eating foods that produce AGEs (Advanced Glycation End Products) is the best way to get healthy and remain healthy throughout the senior years. Since you aren't eating much to stimulate the production of insulin, you are avoiding all of those pitfalls. As you have done, getting your body to burn fat as fuel as opposed to glucose, is a very healthy thing.

Good for you.

Jackie

Liz,

My fat is mostly saturated - ghee (organic clarified butter from grass fed cows) and organic coconut oil are the most common, and of course the fat from my meat (and I choose fatty rather than lean portions, generally from grass fed animals).

I have no qualms with your approach. From data I've seen there is a benefit to reducing carbs and it is a continuous rather than a stepwise function. Starting with whole food, as you do, is wonderful. For many people, there is a great benefit to just avoiding sugar in all its forms, a non-trivial task. Then going to whole rather than refined carbs. It appears you are doing this. I could easily eat this way, but the benefits to me of being keto-adapted are myriad.

If you think about it from a systems perspective, the limiting need for fuel for the body is glucose for the brain. The rest of the body can easily function on free fatty acids, but not the brain. The fuel stores in the body include glycogen in the muscles and liver (about 1400 calories), protein in the muscles that can be converted to glucose (glycogen) if necessary (about 24,000 calories) and fat (100,000 calories on up, depending on how fat you are). The way most fuel, is to continue to top off the small tank (glycogen). The glycogen in the muscles cannot be used for the brain, only locally for the muscles. When you run out of liver glycogen, your blood sugar drops and your brain gets very unhappy.

When someone is keto-adapted, the body makes significant quantities of ketones from fat, but only when insulin levels are very low. These ketones are actually a preferred fuel for the brain (heart and other body parts). When one is keto-adaped, it allows the body to access the fuel in the large, fat tank to feed the brain. It is this ability that allows people to live for a month or more without food. If one is starving, the body initially uses stored liver glycogen to feed the brain, then it starts using muscle tissue converted to glycogen. This is obviously not a good long term strategy -effectively eating your muscles. After a while it starts making ketones from fat. These ketones dramatically reduce the brain's need for glucose and spare muscle tissue. When one is keto-adapted, their body immediately makes ketones in low insulin situations.

My opinion is that this system was commonly turned on in our ancestors, pre-agriculture, as food was not available continuously. Just as food is not available continuously for most wild animals and you see very few fat wild animals.

It is not common in our society to have this system turned on. It takes a few weeks to get the system out of moth-balls and initially adapted. Complete adaptation takes longer.

Having the connection to the "large tank" turned on is amazing. One never has to eat on any schedule and fasts of 24 - 36 hours are easy.

It is amusing to be out with people who feel like they have to eat all the time to keep their blood sugar levels up.

George



Edited 1 time(s). Last edit at 08/18/2013 04:16PM by GeorgeN.

Ron - if you haven't had a recent kidney function test, that might be in order. Sometimes, as we age, the kidney's lose just slightly their ability to 'hang on to the appropriate amounts of electrolytes.' The basic labs are a good start but it may be necessary to do one that involves a 24-hour urine collection to evaluate what's processed including hormones such as aldosterone.

Jackie

Jackie,

Yes AGEs are a huge issue with aging...

Speaking of kidneys. If someone has reduced kidney function, the standard advice is to eat a low protein diet as that is easier for compromised kidneys. I've read rodent studies and also seen anecdotal human reports where putting the rodent or human with kidney issues on a very low carb and adequate (not high) protein diet reversed the kidney issues. I recall one of the authors of the rodent study said it (a very low carb diet) could mitigate much of the need for dialysis. I've even put my felines on the "Catkins" diet as kidney disease is what ultimately kills many cats. It is difficult to find prepared cat food that is not high in carbs, but I have done so.

George

Thank you all for your response, Ron, acidic foods are meats, carbonated colas, cheese, particularly reduced-fat high protein cheese,wheat, some grains, just to name a few. Alkaline foods would be most of the food in the Produce dept. My source for this is the book Wheat Belly by Dr. William Davis, a cardiologist. These foods have a great impact on your Potassium level as well as your ph level. Both of these levels can be checked at home with a Cardymeter and ph test strips. Elizebeth, at least you are consistent, try to remember that it is always better to consider the glass half full, not half empty.

Tom:

Also, remember, whether you look at the glass 1/2 full or 1/2 empty, the result is the same, don't understand your meaning as to "at least you are consistent".

As to potassium, ever since I have had blood tests for potassium, my levels have always been on the high end of lab values, I used to eat more pastas, bread, potatoes etc., I eat very little of those items anymore, doesn't make any difference in my potassium levels. It is said on here that one has to get their mag. levels up before their potassium levels come up, that too may not be true, my mag. levels are towards the lower end of the lab values.

Liz

I looked back on my potassium labs, historically, mine have always tended to be 4.0 or higher with no special diet (and I have never been a fan of veggies).

I've been supplementing with magnesium and fish oil for many years, even prior to afib.

Magnesium and potassium (and fish oil) are no doubt part of the puzzle, and supplementing with mag and fish oil has been beneficial to me in other ways, but they do not seem to be the key in my case.

______________
Lone paroxysmal vagal atrial fibrillation. Age 62, female, no risk factors. Autonomic instability since severe Paxil withdrawal in 2004, including extreme sensitivity to neuro-active drugs, supplements, foods. Monthly tachycardia started 1/11, happened only at night, during sleep, or when waking, bouts of 5-15 hours. Changed to afib about a year ago, same pattern. Frequency increased over last 6 months, apparently with sensitivity to more triggers. Ablation 6/27/13 by Steven Hao.

Iatrogenia…. I’ve learned over time and experience that if my serum level of potassium happen to be measured at the time I’m having AF, it will typically be around 4.1 and often lower. I’ve learned that I must keep my levels at or around 4.5 – 4.7 to ensure NSR.

The science behind the potassium relationship to AF is discussed in great depth in CR 72. The minimum requirement for potassium is 4700 mg daily and some recommend 5,000 mg. If dietary intake is scanty at best, then supplementing is in order if missed beats, arrhythmia or hypertension is an issue.

Obviously, people will vary slightly, but the standard lab values list the ‘normal’ range low as 3.9 and typically that’s just too low to maintain a steady heart rate. When potassium levels start to get low, that affects the refractory period (the time between beats) and as that time shortens, it sets the stage for AF as the heart doesn’t have enough energy or voltage to maintain NSR. (see CR 72)http://www.afibbers.org/conference/session72.pdf

Keep in mind that serum values and the Cardymeter values are just snapshots in time. Potassium levels fluctuate continually depending on the requirements of the body for potassium so it’s best not to be in the ‘marginal’ area for your particular biochemical/electrical needs …in other words, keep a comfortable buffer so if potassium gets pulled out or interfered with by.. ie, sodium, it’s not so easy to slide into AF.

Four years after my ablation, I began to have periodic AF breakthroughs… one or two a year.. six or nine months apart and by testing and tinkering, I learned that I needed to optimize continually both magnesium and potassium by supplements because my appetite and food consumption is small and I wasn’t keeping those electrolytes up to my minimal requirements. As a result, I offered The Strategy report which was my success story for reversing the AF rather than consider a second ablation might be in order. Fortunately, that plan still is viable for me….and many others using the basic principles.

I'm just sharing this with you because you are newly ablated and in NSR, but if things ever change, then look to your low potassium levels first.. that and low IC magnesium.

Best to you,
Jackie

Iatrogenia,

As is so often the case, I concur 100% with what Jackie has just posted above. My experience too in using the very handy Cardymeter .. which I highly suggest for every afibber to have handy, even after an ablation, is that 4.1 serum equivalent potassium level on the Cardymeter or on venous blood draw was my tipping point. During the time, I was having all those left atrial flutter episodes from May 2011 through June 2012 before going in for the LAA isolation ablation last Aug 2012.

I had flutter almost like clock work every 3 to 5 weeks ( one or the other in a definite pattern) for 15 months except for a full two month reprieve just before the LAA isolation.

The thing is, it can be very hard for some of us to maintain a stable serum potassium and IC mag levels. I agree wholeheartedly that everyone should give a very dedicated effort toward getting enough Magnesium and potassium in the cells as that is the one thing we can all do to go hand in hand with the major benefits provided by a skilled ablationist as well to give is the best chance for the greatest amount of NSR long term.

But just like it's often not enough to rely only on an ablation and then run wild with old triggers and bad dietary and life style habits .. it can be just as true as well that solely relying on a solid nutritional protocol is not always enough to insure the peace long term either. The best results most often include 'the hybrid approach' of getting the best quality ablation(s) that your heart requires AND do your part long term not to return to too many of those trigger issues that we all know about and to make good eating, good rest and stress release as well as learning and implementing a solid anti-inflammation, anti-oxidant, and well balanced mineral supplemental program a constant part of your new post ablation life. I would add too a good bio-identical hormone replacement protocol as well with a skilled physician in this area and all of this in an effort to improve cellular and mitochondrial restoration across the board.

That will help on all levels and not just for AFIB control and can really transform how you feel and respond to life each day.

The key thing with the nutritional protocols is to really dedicate oneself to learning about it .. and Jackie, Hans, PC, Erling and others have made getting started on the right track very easy for afibber.com readers. Its not enough to take a little magnesium and potassium for 6 months with no testing and without really knowing if your are assimilating those vital nutrients properly and then throwing in the towel simply because you are still having a few AFIB breakthroughs.

Even when the nutrients proof insufficient to gain real control over the beast, as proved true in my case, they are still incredibly valuable in helping to keep things quiet as well as so many other improvements in my overall health. So many of us in the AFIB age range have poor to mediocre absorption from food. And without discovering if that is true and without adjusting for that lack of assimilation of those supplements , we will never find out just how much help those protocols could have really provided.

It can become a fine line though in not stretching it too far and depending solely on trying to control it all nutritionally, if and when you are still having significant activity in spite of heroic efforts and plenty of testing to confirm where you are with all this, in getting this under control naturally.

I did drag that part on too long in my case by about a year, but I know now that with that open flutter circuit in my LAA there was no way to stop that periodic flutter without eliminating that driver with that isolation ablation. I haven't had a single twitch of arrhythmia of any kind for over a year now since that LAA isolation and no AFIB at all for five years from yesterday ( outside of some occasional PACs that are almost always controllable and short lived with some more potassium) and I still continue with all my supplements each day.

What I learned from my experience is to respect the wide variation in AFIB severity in different people and not to put too strong an emphasis on just having to control it all naturally alone or else judging it a failure. This should be a team approach where we incorporate all the tools that can help us to win the battle. If you are still getting activity, after a dedicated year of effort on nutritional control, then get the best ablation you can while also redoubling your efforts going forward to improve and sustain your diet and supplement program.

Going this route with dedication insures that you will discover if you are one of the lucky ones that can achieve satisfactory control naturally and can avoid an ablation, while at the same time not getting stuck in the game of feeling a failure if your nutritional efforts aren't successful at keeping the beast at bay and perhaps you delay longer than is in your best interest adding in that critical ablation that may make all the difference in the world and also help you get more benefit out of the natural protocols as well.

The main thing is not to look at it as an 'ablation or natural' question. Its often both for many of us who really want the best possible outcome long term.

Shannon

Shannon,

Well said!

George

Y'all probably don't recall, but the last time I tried supplementation with potassium, I developed hyponatremia. I was very ill.

Please keep this in mind: One size does not fit all with supplementing to manipulate electrolytes.

______________
Lone paroxysmal vagal atrial fibrillation. Age 62, female, no risk factors. Autonomic instability since severe Paxil withdrawal in 2004, including extreme sensitivity to neuro-active drugs, supplements, foods. Monthly tachycardia started 1/11, happened only at night, during sleep, or when waking, bouts of 5-15 hours. Changed to afib about a year ago, same pattern. Frequency increased over last 6 months, apparently with sensitivity to more triggers. Ablation 6/27/13 by Steven Hao.