Questions re: electrolyte replacement

Hello All:
Slowly making my way around the website. On Sept. 30th, I was taken to the hospital when I went into afib. I chemically converted about 5 hours later and am doing well. I've made some minor tweaks to my diet to include more potassium and magnesium. As of last week's blood draw, my serum potassium is 4.0 mmol/L and mag. is 1.9 Both numbers were abysmal when I presented in the ED on Sept. 30th.

I don't have the means to pay for the Exetest technology to measure the cellular levels of electrolytes. I am a low-income person on Medicaid, so it would be difficult to consult a doc outside my provider network. I need to be able to work with the resources that I have, as sad as that may sound.

How do I stay stable on a shoestring budget like mine? I'm taking 100mg mag. glycinate to start, but how much potassium gluconate should I take? My cardiologist agrees that I should watch my electrolytes, but wasn't able to offer specifiics in terms of actual dosing. Slowly increasing the mag; it's rough on my stomach, even when taken with food. I want to build up slowly to the dosing levels mentioned in "The Strategy."

I am also on 25mg. metoprolol, and am miserable due to side effects. I have a follow-up with the cardiologist in two weeks. Echo from hospital was normal. EKG taken in doc's office last week showed NSR.

Any input will be helpful. I don't want to end up in the hospital again.



Edited 1 time(s). Last edit at 10/29/2013 07:19PM by Kittymama.

Hello kitty. The way to tell how much potassium to supplement is to spend a few days to a few weeks using one of the free online nutrient calculators like the one at

www.fitday.com

Be sure to list all food and all drink for whatever time you need to see for yourself what nutrients are provided by the foods you normally eat. Then you can either eat more of foods containing those nutrients you are short of, or use supplements to provide them.

Recently one of my lame old computers died, and this one does not contain my bookmarks file. I will give you my 2 favorite potassium info sites as soon as i relocate them.

PeggyM

Kitty - You can just assume you are low in intracellular magnesium as most afibbers are. Repletion is a slow, deliberate task. You can't just take a generous amount and then expect your levels will be optimal... it takes time and in some cases, people never really become replete on a "permanent" basis, but are called "refractory" to optimizing. The Magnesium Absoption report goes into more detail... and if you read through The Strategy, you'll have an overview of all the nutrients that help support not only magnesium function but energy production to maintain normal heart rhythm.

One key piece of advice is not to overload too quickly with supplemental potassium until magnesium stores are optimal. You can, however, add loads of potassium-containing foods ...usually with no detrimental effects. Your serum potaassium is low. If my potassium gets below 4.1, I'll have some activity.

The 100 mg of supplemental magnesium is a start but no where near enough to see much in the way of changes... try 100 mg three (3) times a day for a week and then if all is well, add another 100 to one of the doses... incrementally, until you have 200 mg taken three times a day... 600 mg is still a very low dose for some individuals, depending on the level of deficiency. Keep pushing the doses upward slowly until you reach bowel tolerance.

If you don't tolerate the ramping up of doses... back off to the last comfortable dose and hold there for a while and then try increasing again. Diarrhea is counterproductive so you want to avoid that. Some people who don't tolerate enough oral magnesium to gain repletion, find that the topical oil or gel of magnesium works well. Or, you can do a foot soak or bathe in magnesium sulfate (Epsom Salts)... that's very economical and generally, very well tolerated.

If you decide to try supplementing with the potassium gluconate...the powder form dose is 1 teaspoon = 540 mg. Start with half a teaspoon and if you tolerate that, then try half a teaspoon several times a day.

The one thing you must keep in mind is that adding too much supplemental potassium if you are severely deficient in magnesium will make arrhythmia worse.

There are other considerations as well but magnesium and potassium are the bare-bones minimum.

Here are the links:

The Strategy - What Metabolic Cardiology Means to Afibbers
[www.afibbers.org]

Magnesium Absorption
[www.afibbers.org]

Conference Room Session 72
Potassium/Sodium Ratio in Atrial Fibrillation (February 7 - June 11, 2011)
[www.afibbers.org]

[lpi.oregonstate.edu] - food lists for sources of potassium-containing foods

Jackie

kitty, here are the 2 best potassium info sites that i know about.


[www.krispin.com]

[lpi.oregonstate.edu]

PeggyM

I found I could only tolerate increases of 50mg magnesium at a time. You might want to split up capsules or tablets.

Even now, I'm only up to about 400mg mag glycinate. Everyone's tolerance differs.

I'd also experiment carefully with potassium supplementation, if I were you.

______________
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.

Thank you all for your replies! Most appreciaited.
Unfortunately, I can only tolerate 100 mg. of Mag. glycinate before I get diarrhea, so I will try the topical and see how I do. Haven't tried the potassium yet; had a major setback last night; I've been weaning off the beta blocker with my doc's OK. Taking it very slowly, but still had some rebound tach with a 5 min. run of a-fib. I also had diarrhea during this bout, so supplements are off the table for today.

Hope to get back on track soon; part of the problem may be a stomach bug I picked up.

Thank you again for all the input!