Abstract: 

Potassium is an essential mineral present in all living cells. It is necessary for fluid and electrolyte balance, maintaining a regular heart beat, and supporting nerve and cellular functions. It is found to be a shortfall nutrient for most Americans due to the lack of fruits and vegetable intake. Due to its critical role in cell functioning, pregnant women require an increased recommended intake. 

What Is Potassium And Why Do I Need It? 

Potassium is an essential nutrient, meaning you must get it from your diet. It is required in all cells and tissues throughout the body, meaning a potassium imbalance can lead to severe health consequences. 

This nutrient upholds body homeostasis by maintaining fluid and electrolyte balance, regulating your cardiovascular system, facilitating chemical reactions, assisting in nerve function and muscle contraction, and supporting overall cell integrity.

In this article we will:

• Review potassium’s role in pregnancy 
• Introduce the biology of potassium metabolism in the body
• Explore what prenatal vitamins contain potassium 
• Learn foods high in potassium
• Define recommended intake, toxicity, and deficiency 

How Does Potassium Help In Pregnancy?

Potassium is a critical nutrient for both a healthy mom and baby. Because your blood volume expands when you are pregnant, you need more fluid and electrolytes, including potassium,  to nourish yourself and your baby. 

Since potassium plays an important role in muscular function, it is also found to reduce pregnancy cramps both in the stomach and throughout the body. 

Did you know? Pregnant women who are younger, of African American race, and of low-income socioeconomic class are more likely to be potassium deficient. 

Potassium In Action: What Does It Do In The Body?

Potassium is found in all living cells. 

95-98% of our potassium is located inside of our cells, while the rest is found in the blood. Inside cells, potassium takes the role as the positively charged ion where it acts as an electrolyte. Sodium, potassium, and magnesium are all electrolytes that work with each other to maintain homeostasis, or balance of the body. The balance of all these minerals is important in maintaining health. 

There are specific pumps within your cells that allow potassium to move in and sodium to move out, this is known as the sodium potassium pump.

Different hormones and enzymes keep these pumps active and allow for this transport system to work properly.

One hormone that regulates this pump is insulin. Insulin stimulates the sodium potassium pump. This means those with diabetes have an inhibited activation of these pumps which would keep the potassium out in the blood rather than in the cells.

Another hormone important to potassium balance is aldosterone. Potassium is excreted through the kidneys and filtered by the nephrons. Aldosterone is a hormone that acts on the sodium potassium pump within the nephrons of the kidneys and causes sodium to be absorbed and potassium to be excreted.

Did you know? Low potassium, when combined with high sodium leads to high blood pressure and increased risk of death due to stroke

Is Potassium Common Prenatal Vitamins?

Some prenatal vitamins contain potassium while others don’t so it is important to read the label. Common forms of potassium found in supplements include potassium citrate, potassium chloride, and potassium phosphate. It is important to note that many prenatal supplements contain an active compound called potassium iodide, however this is important for maintaining iodine levels, not potassium.

What foods are high in potassium?

The Dietary Guidelines for America 2020-2025 identifies low potassium as a public health concern for Americans. This aligns with the fact that most Americans also do not meet the recommended intake of fruits and vegetables. Below is a list of foods high in potassium to start incorporating into your diet!

• Bananas 
• Spinach 
• Almonds 
• Cantaloupe
• Butternut squash
• Avocado 

How Much Potassium Should I Take Per Day?

According to the Dietary Guidelines for America, few people in the United States consume enough potassium. It is considered a major shortfall nutrient and poses great public health concerns. 

For adolescent pregnancy it is recommended to intake 2,600 mg of potassium/day. 

For anyone older than 18, recommendations increase to 2,900 mg/day.

Recommendations remain consistent between trimesters. 

Did you know? Some newer evidence is suggesting an increased need of potassium during the 3rd trimester of pregnancy.

How Much Is Too Much Potassium?

Too much potassium is known as hyperkalemia. Although this is not very common, large amounts of supplementation or certain disease states increase this risk. The majority of the time over supplementation typically is not an issue because the body is able to expel large doses by vomiting, however not in all cases.

Certain disease states that affect kidney function are linked to hyperkalemia. These are caused by reduced excretion of potassium, from kidney issues such as those with chronic kidney disease because the body is not able to excrete excess out through urine and so it is cycled back into the blood.

Other causes of hyperkalemia are related to low aldosterone levels. Aldosterone is a hormone that activates the sodium-potassium pump, if there is low aldosterone, potassium would remain out in the blood rather than being pulled back into the cells. 

Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen can also lead to hyperkalemia. 

What Happens If I Don’t Have Enough Potassium?

Low potassium is common in the United States. When there is a severe deficiency it is known as hypokalemia. Low potassium could be caused by low intake, or caused by a dysregulation of hormones or organs needed to regulate potassium levels. 

Common risks of potassium deficiency include dehydration, malnutrition, anorexia, severe diarrhea, higher blood pH or alkalosis, and too much aldosterone.

Symptoms of deficiency include:

• muscle weakness
• cramping
• confusion
• paralysis

Potassium levels also interact with diuretics so it is important to consume more potassium and consult with a dietitian. 

Summary:

Potassium is an essential mineral present in all living cells. It is necessary for fluid and electrolyte balance, maintaining a regular heart beat, and supporting nerve and cellular functions. It is found to be a shortfall nutrient for most Americans due to the lack of fruits and vegetable intake. Due to its critical role in cell functioning, pregnant women require an increased recommended intake. Although some prenatal supplements contain potassium, many do not so it is important to read the labels. 

References:

1. Harper AE. Dietary guidelines for Americans 2020-2025. Am J Clin Nutr.;34(1):121-123. doi:10.1093/ajcn/34.1.121
2. McKeating DR, Fisher JJ, Perkins AV. Elemental Metabolomics and Pregnancy Outcomes. Nutrients. 2019; 11(1):73. https://doi.org/10.3390/nu11010073
3. Strohm D, Ellinger S, Leschik-Bonnet E, Maretzke F, Heseker H; German Nutrition Society (DGE). Revised Reference Values for Potassium Intake. Ann Nutr Metab. 2017;71(1-2):118-124. doi:10.1159/000479705
4. Wolak T, Sergienko R, Wiznitzer A, Ben Shlush L, Paran E, Sheiner E. Low potassium level during the first half of pregnancy is associated with lower risk for the development of gestational diabetes mellitus and severe pre-eclampsia. J Matern Fetal Neonatal Med. 2010 Sep;23(9):994-8. doi: 10.3109/14767050903544736. PMID: 20059438.
5. Yang CW, Li S, Dong Y. The Prevalence and Risk Factors of Hypokalemia in Pregnancy-Related Hospitalizations: A Nationwide Population Study. Int J Nephrol. 2021;2021:9922245. Published 2021 Jun 28. doi:10.1155/2021/9922245