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Potassium and Autoimmune Disease

Plant-based diets appear to decrease inflammation via a variety of mechanisms, including boosting our adrenal gland function due to the consumption of potassium rich foods.

December 21, 2012 |
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Potassium and Autoimmune Disease, 5.0 out of 5 based on 1 rating

Sources Cited

Eaton SB, Konner M. Paleolithic nutrition. A consideration of its nature and current implications. N Engl J Med. 1985 Jan 31;312(5):283-9.

Rastmanesh R. Psoriasis and vegetarian diets: a role for cortisol and potassium? Med Hypotheses. 2009 Mar;72(3):368.

Rastmanesh R, Abargouei AS, Shadman Z, Ebrahimi AA, Weber CE. A pilot study of potassium supplementation in the treatment of hypokalemic patients with rheumatoid arthritis: a randomized, double-blinded, placebo-controlled trial. J Pain. 2008 Aug;9(8):722-31.

Field MJ, Giebisch GJ. Hormonal control of renal potassium excretion. Kidney Int. 1985 Feb;27(2):379-87.

McDougall J, Bruce B, Spiller G, Westerdahl J, McDougall M. Effects of a very low-fat, vegan diet in subjects with rheumatoid arthritis. J Altern Complement Med. 2002 Feb;8(1):71-5.

Turner-McGrievy GM, Barnard ND, Cohen J, Jenkins DJ, Gloede L, Green AA. Changes in nutrient intake and dietary quality among participants with type 2 diabetes following a low-fat vegan diet or a conventional diabetes diet for 22 weeks. J Am Diet Assoc. 2008 Oct;108(10):1636-45.

Acknowledgements

Images thanks to: James Heilman, MD via Wikimedia Commons.

Transcript

Potassium is best known for lowering blood pressure and stroke risk, but “A randomized, double-blinded, placebo-controlled trial of potassium supplementation was tried in patients with rheumatoid arthritis,” published in the Journal of Pain. Rheumatoid arthritis is kind of the classic autoimmune inflammatory arthritis. Sufferers tend to have inappropriately low glucocorticoid levels, which are circulating steroid hormones like cortisol that suppress inflammation, and so low levels may allow for more inflammation. Glucocorticoids also help our kidneys excrete potassium, and so when we eat a lot of potassium, our adrenal glands secrete more glucocorticoids so we don’t build up too much, and so maybe if you gave people with rheumatoid arthritis some extra potassium it would boost steroid levels and help with the inflammation. So they bumped their daily intake up to 6500 a day— still not reflective of our evolutionary heritage, but at least making the cut for adequate intake — and indeed, higher potassium intake was associated with an improvement in rheumatoid arthritis and a lower disease activity and pain intensity reflecting an anti-pain effect for potassium” and so they suggest planning a successful dietary regimen, including much more use of leafy vegetables. Those placed on a plant-based diet experience a significant increase in potassium intake. Though even those eating vegan aren't eating enough greens, maybe this bump in potassium helps explain why plant-based diets are so effective at treating rheumatoid arthritis. If this is the mechanism, though, if potassium rich foods boost natural anti-inflammatory hormones in the body, then should it work for other inflammatory conditions? That’s exactly what was suggested recently. Some studies have shown vegetarian diets to improve psoriasis symptoms maybe this is why, suggesting a “cortisol-potassium” theory as a novel mechanism for the beneficial effects of vegetarian diets.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Ashley Rhinehart, RN.

To help out on the site please email volunteer@nutritionfacts.org

Dr. Michael Greger

Doctor's Note

This is the third of my three video series on potassium this year. Check out Wednesday's 98% of American Diets Potassium Deficient and yesterday’s NutritionFacts.org video-of-the-day Preventing Strokes with Diet. I've got a few other arthritis videos, including Preventing Arthritis and Diet & Rheumatoid Arthritis. Eating healthy doesn't improve everyone's joint pain, but as with all nontoxic treatment modalities, they should always be tried first.

If you haven't yet, you can subscribe to my videos for free by clicking here.

  • Larry L.

    Would more potassium in your diet have an effect on frozen shoulder (adhesive capsulitis)?

    • Ashland Lindy

      Good question! I have suffered twice in both shoulders and would love to be able to prevent another recurrence. Of course, I wasn’t eating vegan at the time.

      • Larry L.

        I was eating vegan when it started, that’s why I am wondering if there is anything I can do diet-wise to help. I know physio is a must with daily excercises but work kind of sucks because of the amount of time I spend on the computer. Moving that mouse and typing all day is killing me.

        • LauraK

          Larry L, Vegan diets can vary in their degrees of healthy versus processed and unhealthy content. If you are eating all the “fake” meats and cheeses and eating from packages rather than the produce section then the vegan diet is probably no more healthy than the standard american diet.

          Grains can also play a dramatic role in the inflammation process for many people. Start by going gluten free but if that still doesn’t help, then I would suggest cutting out all grains. There are theory’s that cross sensitivity with grains can cause problems as well. Focus on plants, legumes, tubers and squash for your diet and see if that makes a difference in how you feel.

          Good luck in your journey.
          Laura K

          • Larry L.

            I follow McDougall’s diet pretty much, very little processed foods, pasta, beans, rice and lots of fruits and vegetables. I eat the occasional bag of potato chips mind you. I have always eaten grains so maybe cutting out gluten, as you say, might help.

          • melanie

            I would strongly recommend massage therapy for adhesive capsulitis, if your RMT or LMT is familiar with treating this. If not, call around and find someone who is. On your own, lie on your stomach and allow your arm to swing like a pendulum to help open up the joint capsule.

          • http://www.DonForresterMD.com/ Don Forrester MD

            Sorry to hear about your condition. Adhesive capsulitis is a tough disorder but given correct treatment and time usually responds. Diet wise it sounds like you are doing great. You should continue to eat a variety of fruits, vegetables and spices… see http://nutritionfacts.org/video/garden-variety-anti-inflammation/ and want to avoid alot of omega 6′s in processed oils especially corn oil… easy to do if you eat whole foods and avoid foods with labels. Lastly you could consider taking a omega 3 supplement daily see… http://nutritionfacts.org/video/plant-based-omega-3-supplements-2/. Your condition is well recognized but the underlying mechanism’s are poorly understood and treatments are evolving. A review article… abstract available through PubMed, Frozen Shoulder in J Bone Joint Surg Jan 2012 by Robinson et al provides an overview. I don’t think potassium will help but by eating a variety of plant foods you will get more potassium. Best wishes.

  • Liz H

    One of the journal screen shots states “more use of leafy green vegetables low in starch and not cooked with boiling water.” Does steaming leafy greens keep more potassium than boiling them? If not, how do we cook leafy greens to prevent loss of potassium. Is all of the postassium lost when boiling?

    • Massimo

      Potassium, as well as other minerals and water-soluble vitamins, leaks into the water you use to boll your vegetables. Thus, unless you consume that water too, you waste a significant part of the mineral and vitamin content of your food if you boil it. Steaming does not present the same problem.

      • EccoLa

        What about washing greens in a very weak vinegar/water bath as my local farmer’s market recommended for all fruits and veggies? That is to clean them and also to reduce e coli related food poisoning (lots of that happening with veggies due to water runoff – or can even be just from unclean hands of pickers and handlers, etc. Does this also leech nutrients? The bath allows the addition of anti-bacterial vinegar. Just running water has no anti-bacterial properties, so the quick bath seems the only way to really clean them. Are they then much less nutritious?

        • Massimo

          This would probably leech no more than what rain would also do. Solubility increases with temperature. When you boil your veggies in hot water, you have high temperature and prolonged contact. When you wash them, you use cold water and for a short contact.

    • Thea

      Some people believe that raw is the way to go with leafy greens. I personally like mine cooked, which makes it tough to follow my doctor’s recent dietary recommendations.

  • john

    I am writing a book about the benefits on a plant-based-diet and needn’t I say more. Michael, there is no need for you to keep putting on any more videos on your site, If people have not realized this by now, then they are either blind or do not want to listen.

    The real problem is that people are either lacking the knowledge or have been brainwashed about the system mankind has adapted about drugs, bad advertisements about food choices, diet and weight loss and not actually focusing about the benefits of diet has upon our over-all health.

    The health care system needs to be changed and more emphasis has to be focus on the real truth about diet ad the influence it has towards our health. Prevention is better than the cure. Diet is the solution and not drugs, politics power nor money.

    There will always be bias toward health in large cooperation’s and food establishments, if they do not open up their eyes and look outside the box towards good natural nutrition towards battling the fight towards disease.

    Do I need to say more on this subject?

    John from Malta

    • http://jolkapolkaskitchen.blogspot.com/ WholeFoodChomper

      True, the issue of food and nutrition is multi-layered and complex but the science in these fields is constantly evolving and uncovering new, interesting, and applicable findings. Therefore, I think there is no need to stop making these videos, as I and others are still interested in what current science has to say on the topic of plant-based nutrition and human health. Yes, I am convinced of the benefits, but I still want to know and learn more. So, please do not stop (although, I don’t think that you were even contemplating doing so.)

    • lottsagreens

      John, I understand your frustration. That being said, let me give you another perspective on the benefits of Dr. Greger’s work (videos and blog posts). I’ve only been eating a vegan diet for four months at this point. The information Dr. Greger shares helps me stay enthusiastic about, and committed to, my nutrition-related goals. I agree with WholeFoodChomper: The scientific community regularly uncovers new, interesting, helpful discoveries about plant-based nutrition. Dr. Greger does more than anyone else I know of to share that information with ordinary people throughout the world.

  • mike

    I agree with John’s comments below, but by all means keep the videos coming. I find them inspirational and with 2 minute segments it makes it easy to stay up to date. I’ve forwarded some of your videos to quite a few friends and find they are receptive to the ideas, partly because they are packaged in the short segments.

    I think part of the problem is education and getting information out. The second part is that it is not easy for people to change when faced with long established habits…. what to buy, how to prepare food, etc. So it takes both knowledge and a path to follow, and you help provide both.

    I like the saying from Toyota: “It is easier to act your way into a new way of thinking than to think your way into a new way of acting”. So just providing a few simple ideas on how to get started and constant reminders is extremely useful.

  • S.B.

    Hi Dr Greger.

    I have some questions not related to potassium. (Sorry, i couldn’t find where to post general questions on your site. Please feel free to move my question or to tell me to post it somewhere else)

    1. Does green tea stain your teeth as much as coffee?
    2. Do you still recommend drinking at least 5 cups of green per day? My doctor told me i should cut down to 2 or 3 caffeinated drinks per day because my blood pressure could be a little lower (It was still in the normal range, but towards the top). However, i do drink mainly coffee.
    3. Would i still get all the benefits if i drank decaf green tea? Or if i drink 3 caffeinated teas and 2 decafs per day?

    Thankyou very much

    • http://www.facebook.com/people/Frank-McGinness/100001157887765 Frank McGinness

      Green tea has less caffeine than coffee so drinking as uch tea as coffee means you’ve cut down caffeine. But what doesn’t have caffeine is Tulsi aka HolyBasil tea. A medicinal beveravsed for thousands of years. See Dr. MERCOLA.COMPUTER

      • http://jolkapolkaskitchen.blogspot.com/ WholeFoodChomper

        Dr. G has a mini-video on Tulsi tea here. And, many many videos and articles on green tea here that may answer some of your questions.

        As for Dr. Mercola, I’d be wary of any advice he has to offer, he does not seem like a very credible source of health advice or information, at least not to me. Stick to what you can learn on Nutritionfacts.org instead.

        • beccadoggie10

          Dr. Joseph Mercola’s education background is:
          University of Illinois at Chicago – (UIC) 1972-1976
          Chicago College of Osteopathic Medicine 1978-1982
          Chicago Osteopathic Hospital 1982-1985 Family Practice Residency. Chief resident 1984-1985
          Board Certified American College Osteopathic General Practitioners July 1985
          State of Illinois Licensed Physician and Surgeon

          He is a Fellow at the American College of Nutrition;
          Member of the International Academy Biological Dentistry and Medicine; Advisory Board member American Nutrition Association; Advisory Board member Price-Pottinger Nutrition Foundation; Advisory Board member Weston A. Price Foundation; Advisory Board member Bio-Solar Proto;

          and was
          Chairman, Department of Family Practice at St. Alexius Medical Center, Hoffman Estates, IL 1988-1993

          You may not agree with him Whole Food Chomper, but he is a credible source!

          • http://jolkapolkaskitchen.blogspot.com/ WholeFoodChomper

            Dr. Mercola is a smart businessman, to be sure. However, regardless of the degrees he has obtained and the positions he has held, I believe that Dr. Mercola is not a credible source and am (and will continue to be) weary of any health/medical advice he has to offer.

    • beccadoggie10

      According to Dr. Andrew Weil, a Harvard trained physician who practices Alternative Medicine, “Any
      food or drink capable of staining clothes or carpets can also stain
      teeth – that includes fruit juices, red wine, blueberries, soy sauce,
      and curry. ‘Good quality green tea that is really green in color’ is less
      likely to stain teeth than inferior grades of “green” tea that looks
      brown when brewed.” Dr. Weil suggests
      “rinsing your mouth with water after you drink tea (or coffee or colas).
      Be sure to brush your teeth twice a day with a whitening toothpaste and
      to floss daily.” More at: http://www.drweil.com/drw/u/id/QAA400151

      “While green tea and coffee both have caffeine, coffee has a significantly greater amount per cup.”

      http://www.livestrong.com/article/288832-caffeine-in-green-tea-vs-coffee/

      “As long as the number of cups you drink remains the same, replacing your morning coffee with a cup of green tea will reduce your caffeine intake by about 70%. One cup of coffee contains 100-150mg of caffeine; a cup of green tea has only about 25mg of caffeine. However, there are many variables affecting these numbers. For example, the caffeine content of different types of green tea can vary; also a longer brewing period can result in more strongly caffeinated tea.”

      Learn more: http://www.naturalnews.com/034227_green_tea_caffeine.html#ixzz2GhEu0Pnw

  • http://twitter.com/Abditalipovna Nurzat

    Dr Greger., which plants prevent or help with psoriasis? although psoriasis is based on genetic skin problem, living on vegetable lifestyle doesn’t fully the problem.. I have only one preventable option, based on my experience is turmeric..some people talk about coconut butter..Any other suggestions?

    • Rph1978

      I don’t think there is one particular plant food which helps
      psoriasis but a vegetarian or plant based diet in general reduces arachidonic acid (in the body) which serves as a precursor to pro-inflammatory substances. As you already know, psoriasis is a genetic disease but it is also triggered by inflammation mediated by T-cells. Some studies (not all) have shown benefits with omega-3 fats, fasting or low calorie diets and vegetarianism. Some people with psoriasis have gluten sensitivity and improve on gluten-free diets.
      Wolters M, Diet and psoriasis: experimental data and clinical evidence, Br J Dermatol. 2005 Oct;153(4):706-14.

    • Joan

      I have had relief with tea tree oil products: shampoo, conditioner, and scalp treatment. This has been much more effective than prescribed topical treatments. One dermatologist recommended black castor oil, but this is not pleasant to use on the scalp.

    • http://www.DonForresterMD.com/ Don Forrester MD

      I have a colleague who is a dermatologist who has had success with a plant based diet with attention to specific oils in his treatment of his patients with autoimmune disorders such as lupus and psoriasis. As a Family Medicine physician I haven’t had experience with diet and psoriasis. I have seen the success of proper diet across a host of chronic diseases including other autoimmune disorders. I imagine that like most chronic conditions genetics is a very small part of the picture. That said, there is literature to show that nutrition is a factor in psoriasis. You need to work with your physicians but it seems to me that a general recommendation might involve starting with a plant based diet with Vitamin B12 supplement and avoidance of GMO foods. Of course finding a physician who is willing to work with you and your diet while prescribing more conventional therapies is always a challenge.

      • http://www.facebook.com/jonathan.carp.752 Jonathan Carp

        Hi Don and all – I am the dermatologist that he is referring to. Here is a basic list of things everyone does.

        1. Dairy Free

        2. Gluten Free (no gluten free junk food like breads made from potato flour or tapioca)

        3. Oil free except very small amounts olive, coconut, or ghee

        4. 1-2 lbs of veggies per day – half cooked half raw

        5. Only 3-4 servings of animal protein per week – vegans do not do any better than those who eat high quality animal protein in small amounts. Just an observation.

        6. Boswellia, ginger, and turmeric

        7. Handful of nuts per day or hemp seed oil 1 tsp twice per day

        8. Level of 25, OH Vit D at around 50

        That is the basics and things get modified as time goes by especially with EFA’s but really if anyone wants other information please contact me on facebook. An environmental toxin discussion is done and we discuss stress reduction techniques as well. I also prescribe meds and light therapy. I practice conventional dermatology but have had great success when people want to do something different. I have offered it probably close to 1000 patients and only around 40 have taken me up on it, of those only one has not responded. Cheers,

        Jonathan

  • Charlene

    can you provide a link to the data on potassium levels of various foods. I want to focus on the ones with the most potassium,

    • http://nutritionfacts.org/ Michael Greger M.D.

      The new USDA National Nutrient Database for Standard Reference is now out! Our tax dollars hard at work to analyze the nutrient content of more than 8,000 foods. I’m so glad you asked this question, Charlene, because I’m surprised more don’t know about this incredible resource. If you’re looking for the most concentrated sources of any particular nutrient in the new 2012 database, click here. Then scroll down to potassium and click on Potassium-Sorted By Nutrient Content and poof! A list of about a thousand foods ranked from the most concentrated source (2,675mg in each cup of concentrated tomato paste) down to zero in “foods” like lard and hard candies. You can also download the list alphabetically to make it easier to look up your favorite foods. And that’s just the beginning!

      WARNING: browsing the Nutrient Database can be addictive for nutrition geeks–like me! (though if you were a true nutrition geek you’d already be sleeping with the entire database under your pillow :).

      So the next time you see me do a video on fiber, for example, (like Relieving Yourself of Excess Estrogen) you can look up to see which foods have the most.

      See Fat Burning Via Flavonoids and wonder where the heck you can find them? They’ve got the answer.

      Amazed by Egg Industry Blind Spot or intrigued by Prevent Glaucoma and See 27 Miles Farther and want to know where to find those critical eyesight saving nutrients lutein and zeaxanthin? Look no further.

      What foods have the most sugar? The most trans fats? The most cholesterol or the most vitamin C? It has it all!

      A consumer friendly version available in PDF form of some of the most common nutrients in some of the most common foods can be downloaded here. And for more depth you can browze through individual reports on each of the 36 food groups.

      • Jessica

        Wow, I can see that the database is addictive! Thanks for sharing, Dr. Greger. We just put up a chart on the fridge of potassium-rich foods with a one- to five-smile rating (each smile ~ 200 mg), with the goal that adults get 24 smiles and kiddo 20 smiles per day. Thanks to the list, I was able to add tomato sauce, bok choy, black beans, pumpkin, artichokes, cucumber, and kale, which weren’t on my original list.

        One question though: I generally avoid white potatoes because I thought they were devoid of nutrition, but I notice that baked potatoes are surprisingly high on the list. Do you recommend occasional potato consumption for people seeking to boost their potassium intake, or is it better to stick with the other foods?

  • John

    To totally agree with Mikes below comment. Yes! Please Dr, Greger, keep up the good work and keep showing the videos you truly work very hard in showing and producing. If was not for people like you then most people who be blind to the truth about the health benefits of a plant-based-diet in the reduction of the leading causes of death and disease.

    the hardest part of health is actually trying to convince people to change their eating habits and lifestyle.

    John from Malta

  • Dr.Dan

    I love how Greger based his video on the estimated daily intake of paleolithic diet (that included a lot of meat: 87mg of iron!) to promote a meat free diet. This website is one big contradiction.

    • http://jolkapolkaskitchen.blogspot.com/ WholeFoodChomper

      Actually, Dr. Greger, cited 6 sources for the basis of this video and not just the 1 you refer to. I’m not sure how this one incident you found equals a “website [that] is one big contradiction.” How so? Could you please explain?

    • d1stewart

      Gee, which paleolithic diet? There is no such thing as a “paleolithic diet” that is based on any paleolithic population to be used as a reference point. And there are dozens of paleolithic diets among late-20th and early-21st century theoreticians, with widely varying composition.

    • EccoLa

      Iron abundant in dark leafy green vegetables, which don’t run as fast as animals and whose iron is more bio-available to humans. So there is a very high likelihood that much of the iron in early human diets came from dark leafy greens. When diagnosed with serious anemia, I spent 2 months as directed by doctors w/iron supplements & putting red meat back into my daily diet and felt like hell — different from the anemia, but yet another source of unwellness. So I told the docs I’d researched & found this high quality source of bio-available iron in dark leafy greens, would continue the iron supplements but wanted to swap out the dark leafies for the meat. Doc approved. I went hardcore vegan w/emphasis on the dark leafies, and saw immediate improvement in how I felt day to day as well as in the underlying health problem. Dr. Dan, your comment together with your embedded skepticism suggests a very un-scientific mindset.

  • Melissa

    Hello Doctor,

    I became vegetarian and then vegan when I was first diagnosed with RA. I also did a food challenge to eliminate any food sensitivities. I responded extremely well and although not symptom free, I looked and felt so much better. UNTIL I had my first child. He is now 3 and my daughter 1 and my RA is worse than ever. I still eat a vegan diet and I eat lots of potassium rich foods (ie beans greens, dried fruit, banana) although I do not eat potatoes or tomatoes. What can I do now? I am now taking Sulphasalazine and considering adding Hydroxychloroquine. I have been on 10mg prednisone almost continually throughout my pregnancies and breastfeeding but am now slowly coming off 1 mg per month (currently at 5mg.) Any advice appreciated as I am only 38 and I’ve seen my hands and feet rapidly changing in the past year. Thank you.

    Melissa

    • Tessa

      Have you went Gluten Free? I have RA and I feel so much better (still struggling with symptoms….) but less miserable, especially with my stomach.

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