This discussion of potassium is presented in the hope that one of its readers will consider performing an experiment
establishing the effect of potassium on rheumatoid arthritis. There is no report in the literature going back to 1914 of such
an experiment. Every essential nutrient should have been explored before this. In view of the way hormones which are
regulated by or regulate potassium, such as cortisol and DOC are involved with rheumatoid arthritis (RA), and the low whole
body potassium content in rheumatoid arthritis (RA), potassium especially should have been investigated before now.
by Charles Weber, MS
INTRODUCTION
Since the most serious aspect of the diarrheas is wasting potassium, cortisol has acquired the attribute of conserving potassium by moving it into the cells when cortisol declines. Cortisol (but not corticosterone) is reduced during a potassium deficiency, and this reduction accounts for many of the symptoms of RA.
Cortisol shuts down most of the copper enzymes when it declines so that excretion of copper is increased and Lysyl oxidase inhibited. These last two attributes are proposed to account for most of the mortality from aneurysms and infections during rheumatoid arthritis (RA). Thus the urgent necessity to survive during virulent diarrhea has set people up in the course of evolution for some of the worst symptoms of rheumatoid arthritis
For a more elaborate discussion of potassium physiology and nutrition see Arthritis as a Chronic Potassium Deficiency and for copper see this site.
DISCUSSION
Judging by the drastic decline of mortality in babies suffering from a virulent strain of diarrhea by potassium supplements,1 potassium loss in those diseases which force cyclic AMP to excrete water into the intestines2 must be the most serious effect of the diarrheas. I suggest that this is the reason why cortisol has acquired the attribute of moving potassium out of cells3 and therefore into the cells upon declining. It is also undoubtedly the reason why the adrenal's cortisol secretion is inhibited by low serum potassium in vitro (in the test tube) but not corticosterone.4 The body thus has a way of signaling for a decrease in cortisol secretion during a serious intestinal disease independently of ACTH. Thus the body inversely mobilizes its defenses. Endotoxin bacterial diseases force the body to secrete cortisol by increasing ACTH5 and this is probably an adaptation by the bacteria to force the body to inhibit the immune system. Glucosteroid response modifying factor (GRMF) secreted by T- cells then prevents the cortisol from having full effect on white cells other than suppresser cells6 and thus raises the set point, as does interleukin-I.6. Interleukin-I also stimulates cortisol secretion,7 as does cachectin (tumor necrosis factor).8 I suspect that this is an adaptation to provide some cortisol maintenance9 when normal ACTH production is later cut off during endotoxin attack.10 In other words, the immune system takes over its own regulation but at a higher set point. The role of GRMF has not yet been demonstrated for physiological processes. GRMF will probably prove to inhibit cortisol for most of those processes as well as the immune cells, surely at least for cortisol's various affects on potassium.
One of the most important of the cortisol controlled immune defenses is the mobilization of the availability of copper to the white cells, an attribute which probably arose because copper is crucial to an adequate immune defense.11 The primary way cortisol does this is by, inversely to its concentration, shutting down production of copper-containing enzymes such as Lysyl oxidase and superoxide dismutase.12 Lysyl oxidase catalyzes the formation of cross links in all connecting tissue including elastin.13 Since elastin makes up the main strength of normal blood vessels12 and has a rapid turnover, this is the most serious problem in arthritis. Ruptured aneurysms along with poor resistance to infection and heart disease are the chief terminal events in arthritis.14
The body uses ceruloplasmin to carry copper to the immune system during infection12. Probably the main reason for this development is that the copper in ceruloplasmin is not in equilibrium with the serum and so is not available to pathogens. However, ceruloplasmin is also used to carry copper to the bile for excretion15. Therefore I submit that the rise in serum ceruloplasmin in RA16 causes an increased excretion in members of a society who, even before this, were receiving less than the minimum daily requirement.
CONCLUSIONS
Evidence can be provided for this proposal in several ways. Arthritic people should have a lower whole body potassium content than normal people. This has been proved.17 Red blood cells have a higher potassium content than normal during RA18. This should not be taken as counter evidence because I suspect that this is an adaptation to help avoid circulatory collapse when dehydration reduces the blood volume during diarrhea.
There should be a lower concentration of potassium in blood plasma during RA. The National Health and Nutrition Survey-III has determined that of 39,695 people selected, there were 840 who said they had been diagnosed with rheumatoid arthritis. Of these, 691 had their serum tested for potassium. Of that number 7.8% had less than 3.6 milliequivalents per liter, 34.7% between 3.6 and 4.0, 40.7% between 4.0 and 4.4, and 18.1% above 4.4. Only 18% appeared to be in the normal range. The samples were refrigerated and sent out to outside contract laboratories [22c]. Refrigerating blood increases the apparent amount when it is serum that is analyzed, especially if there is a delay in the analysis. In addition to that, arthritics lose potassium from the platelets as noted above. If some were misdiagnosed, had a remission since being diagnosed, or there was a longer than usual delay in analysis, it could account for the 18% seemingly normal. So this survey showed at least most arthritics low in potassium. Many others in the survey were low in potassium also. So, unless arthritis is caused by something besides a potassium deficiency and low potassium is a symptom, those other survey people would have to have had arthritis as well. I believe many people die of a potassium caused heart disease without being arthritic, so, if so, the first part of the statement must be in order. In any case, a large proportion of arthritics at least are too low for sure, some dangerously low.
There should be a lower incidence of RA among people on potassium supplementation or who eat Morton's Lite Salt (TM) or Stirling's Half and Half (TM). I know of no epidemiological study showing this. However, people who work in potash mines have a 25% lower incidence of heart disease than the surrounding population19 and heart disease is prevalent in RA. There should be a healing of RA upon starting potassium supplements. No controlled experiment has been reported which would indicate this. However there is a case history of a single arthritic brought up to 3,500 milligrams per day in order to explore the effects of various steroid hormones on the body's mineral balance.20 A total of 3,500 milligrams is about the amount an adult would obtain from unprocessed food. The subject showed consistent improvement throughout the experiment even though potassium was the only consistent change. His total body potassium slowly but consistently rose. There should be a negative correlation between high potassium-caused muscle spasms and RA, but I have no supporting data. Neither do I know of a positive correlation with eating licorice (but not licorice candy, which is made of anise seeds) grapefruit, or potassium losing diuretics, each of which increase potassium loss. There should be a negative correlation between eating acids which have an indigestible anion and RA since the hydrogen ion interferes with potassium excretion21. I know of no good experiment or epidemiologic study. However, it has been suggested from folk custom that eating vinegar22 or cherries is efficacious. The vinegar seems doubtful since it is my understanding that acetate can be metabolized by the body22a. However, it is conceivable that people on a diet high in calories do not utilize all the acetate or even much of it. In any case. RA should not be present much in people who eat predominantly vegetables instead of grains. An experiment has been performed in which RA was healed in a group of people by switching to a vegetable diet23b. Eating bananas would increase potassium somewhat, but it is only a moderate source per calorie, about the same as potatoes.
I suspect that people with rheumatoid arthritis tend to have a poorer ability to conserve or absorb potassium than other people because of damage to their kidneys by a poison such as bromine gas (as happened to me) or long term poisons in plant foods or by a mild genetic defect or by poisons excreted by pathogenic bacteria. Some bacterial infections do trigger RA. Screening some common poisons currently in food might be enlightening. Since GRMFs inhibit cortisol, it is possible that a discordance in the immune response involving GRMF in some people or some infection types (that last does happen) may accentuate RA and thus even cause an auto immune response.
If animals are used for experiments, it is futile to use rats or mice because they rely on corticosterone to regulate the immune response, not cortisol. I suspect that this developed because they have a factor in their intestinal fluid which counteracts cholera toxin.23 They also have the ability to absorb water under cyclic AMP stimulation in part of their colon24 instead of excretion of water, unlike other animals.
Since the disturbance in copper metabolism is proposed as the most serious aspect of RA, evidence for copper's effect should be possible. Supplementing with copper should remove some of the symptoms of RA. I know of no such experiment. However, it is known that Finnish men who work in copper mines have little arthritis or susceptibility to infection.25 The high milk diet along with frequent saunas may be two reasons why other Finns have one of the highest rates of arthritis in the world,26 since milk is the poorest source of copper27, p.92 and perspiration loses potassium.28 Milk has been shown to have a high statistical correlation with cardiovascular disease, said to be as great a risk as smoking,29 which disease in turn is correlated with RA. Laplanders on a meat diet have a lower rate of RA not much further north.26 The Massai of Africa have a higher rate of RA than the surrounding tribes.30, p.768 The Masai also use a lot of milk as well as very few vegetables, which vegetables would have increased potassium intake. Men who work in copper mines must have stronger tissues than other miners because the percentage of injuries which result in lost time is significantly lower31 even though injuries like eye damage and burns which are not affected by strength are part of the data. Eating a lot of shellfish or liver should reduce those symptoms related to copper deficiency since they are the richest sources, but I know of no study. The same is true of drinking acid water out of copper plumbing.
I believe that it is unwise to give cortisol to any class of people whose immune system is weak, such as arthritic people. If it is felt that cortisol should be raised in the body, why not use something relatively safe, like potassium supplements? If potassium supplements are used, be certain that vitamin B- 1 is adequate because the "wet" heart disease of beri-beri can not materialize when potassium is deficient.32 Obviously the reverse is also true for vitamin B-1 supplementation. For this reason, If the patient has heart trouble, it is very important to determine whether it is caused by vitamin B-1 or potassium.
If potassium chloride is dissolved in fruit juice it tastes good and avoids the danger to the intestines that even slow release enteric tablets may present. The chloride is the most efficacious form33. It would be better and safer yet to provide potassium from food high in potassium such as celery or bamboo shoots as Effinger proposed34. Unboiled, unfrozen, uncanned vegetables low in starch are the richest sources35. However, removing a deficiency will be slower since the potassium is not associated with chloride and would take a few weeks or months longer.
A deficiency can arise from diarrhea, processed food, reliance on grain or fatty foods35, psychic stress stimulation of aldosterone36 p.209 (which is the main regulator of potassium)37, stress stimulation of cortisol (as in an operation, for instance38), diuretics, licorice39 as well as probably grapefruit39a, profuse perspiration28, excessive vomiting40, eating sodium bicarbonate41, hyperventilating42, laxatives43, enemas44 (especially if prolonged), shock from burns or injury45, hostile or fearful emotions36, and very high or very low sodium intake46, All of these increase excretion or decrease intake of potassium and many at once would be very dangerous. and probably even lethal if prolonged.
A chronic potassium deficiency must surely cause a degenerative disease. I believe it materializes in some people as RA. If not, then what is the name of the degenerative disease which attends a potassium deficiency ? It is not hypokalemia. This is only a word which describes low serum potassium, a marker or symptom. It is about time we found such a name.
http://members.tripod.com/~charles_W/potassium.html
by Charles Weber, MS
INTRODUCTION
Since the most serious aspect of the diarrheas is wasting potassium, cortisol has acquired the attribute of conserving potassium by moving it into the cells when cortisol declines. Cortisol (but not corticosterone) is reduced during a potassium deficiency, and this reduction accounts for many of the symptoms of RA.
Cortisol shuts down most of the copper enzymes when it declines so that excretion of copper is increased and Lysyl oxidase inhibited. These last two attributes are proposed to account for most of the mortality from aneurysms and infections during rheumatoid arthritis (RA). Thus the urgent necessity to survive during virulent diarrhea has set people up in the course of evolution for some of the worst symptoms of rheumatoid arthritis
For a more elaborate discussion of potassium physiology and nutrition see Arthritis as a Chronic Potassium Deficiency and for copper see this site.
DISCUSSION
Judging by the drastic decline of mortality in babies suffering from a virulent strain of diarrhea by potassium supplements,1 potassium loss in those diseases which force cyclic AMP to excrete water into the intestines2 must be the most serious effect of the diarrheas. I suggest that this is the reason why cortisol has acquired the attribute of moving potassium out of cells3 and therefore into the cells upon declining. It is also undoubtedly the reason why the adrenal's cortisol secretion is inhibited by low serum potassium in vitro (in the test tube) but not corticosterone.4 The body thus has a way of signaling for a decrease in cortisol secretion during a serious intestinal disease independently of ACTH. Thus the body inversely mobilizes its defenses. Endotoxin bacterial diseases force the body to secrete cortisol by increasing ACTH5 and this is probably an adaptation by the bacteria to force the body to inhibit the immune system. Glucosteroid response modifying factor (GRMF) secreted by T- cells then prevents the cortisol from having full effect on white cells other than suppresser cells6 and thus raises the set point, as does interleukin-I.6. Interleukin-I also stimulates cortisol secretion,7 as does cachectin (tumor necrosis factor).8 I suspect that this is an adaptation to provide some cortisol maintenance9 when normal ACTH production is later cut off during endotoxin attack.10 In other words, the immune system takes over its own regulation but at a higher set point. The role of GRMF has not yet been demonstrated for physiological processes. GRMF will probably prove to inhibit cortisol for most of those processes as well as the immune cells, surely at least for cortisol's various affects on potassium.
One of the most important of the cortisol controlled immune defenses is the mobilization of the availability of copper to the white cells, an attribute which probably arose because copper is crucial to an adequate immune defense.11 The primary way cortisol does this is by, inversely to its concentration, shutting down production of copper-containing enzymes such as Lysyl oxidase and superoxide dismutase.12 Lysyl oxidase catalyzes the formation of cross links in all connecting tissue including elastin.13 Since elastin makes up the main strength of normal blood vessels12 and has a rapid turnover, this is the most serious problem in arthritis. Ruptured aneurysms along with poor resistance to infection and heart disease are the chief terminal events in arthritis.14
The body uses ceruloplasmin to carry copper to the immune system during infection12. Probably the main reason for this development is that the copper in ceruloplasmin is not in equilibrium with the serum and so is not available to pathogens. However, ceruloplasmin is also used to carry copper to the bile for excretion15. Therefore I submit that the rise in serum ceruloplasmin in RA16 causes an increased excretion in members of a society who, even before this, were receiving less than the minimum daily requirement.
CONCLUSIONS
Evidence can be provided for this proposal in several ways. Arthritic people should have a lower whole body potassium content than normal people. This has been proved.17 Red blood cells have a higher potassium content than normal during RA18. This should not be taken as counter evidence because I suspect that this is an adaptation to help avoid circulatory collapse when dehydration reduces the blood volume during diarrhea.
There should be a lower concentration of potassium in blood plasma during RA. The National Health and Nutrition Survey-III has determined that of 39,695 people selected, there were 840 who said they had been diagnosed with rheumatoid arthritis. Of these, 691 had their serum tested for potassium. Of that number 7.8% had less than 3.6 milliequivalents per liter, 34.7% between 3.6 and 4.0, 40.7% between 4.0 and 4.4, and 18.1% above 4.4. Only 18% appeared to be in the normal range. The samples were refrigerated and sent out to outside contract laboratories [22c]. Refrigerating blood increases the apparent amount when it is serum that is analyzed, especially if there is a delay in the analysis. In addition to that, arthritics lose potassium from the platelets as noted above. If some were misdiagnosed, had a remission since being diagnosed, or there was a longer than usual delay in analysis, it could account for the 18% seemingly normal. So this survey showed at least most arthritics low in potassium. Many others in the survey were low in potassium also. So, unless arthritis is caused by something besides a potassium deficiency and low potassium is a symptom, those other survey people would have to have had arthritis as well. I believe many people die of a potassium caused heart disease without being arthritic, so, if so, the first part of the statement must be in order. In any case, a large proportion of arthritics at least are too low for sure, some dangerously low.
There should be a lower incidence of RA among people on potassium supplementation or who eat Morton's Lite Salt (TM) or Stirling's Half and Half (TM). I know of no epidemiological study showing this. However, people who work in potash mines have a 25% lower incidence of heart disease than the surrounding population19 and heart disease is prevalent in RA. There should be a healing of RA upon starting potassium supplements. No controlled experiment has been reported which would indicate this. However there is a case history of a single arthritic brought up to 3,500 milligrams per day in order to explore the effects of various steroid hormones on the body's mineral balance.20 A total of 3,500 milligrams is about the amount an adult would obtain from unprocessed food. The subject showed consistent improvement throughout the experiment even though potassium was the only consistent change. His total body potassium slowly but consistently rose. There should be a negative correlation between high potassium-caused muscle spasms and RA, but I have no supporting data. Neither do I know of a positive correlation with eating licorice (but not licorice candy, which is made of anise seeds) grapefruit, or potassium losing diuretics, each of which increase potassium loss. There should be a negative correlation between eating acids which have an indigestible anion and RA since the hydrogen ion interferes with potassium excretion21. I know of no good experiment or epidemiologic study. However, it has been suggested from folk custom that eating vinegar22 or cherries is efficacious. The vinegar seems doubtful since it is my understanding that acetate can be metabolized by the body22a. However, it is conceivable that people on a diet high in calories do not utilize all the acetate or even much of it. In any case. RA should not be present much in people who eat predominantly vegetables instead of grains. An experiment has been performed in which RA was healed in a group of people by switching to a vegetable diet23b. Eating bananas would increase potassium somewhat, but it is only a moderate source per calorie, about the same as potatoes.
I suspect that people with rheumatoid arthritis tend to have a poorer ability to conserve or absorb potassium than other people because of damage to their kidneys by a poison such as bromine gas (as happened to me) or long term poisons in plant foods or by a mild genetic defect or by poisons excreted by pathogenic bacteria. Some bacterial infections do trigger RA. Screening some common poisons currently in food might be enlightening. Since GRMFs inhibit cortisol, it is possible that a discordance in the immune response involving GRMF in some people or some infection types (that last does happen) may accentuate RA and thus even cause an auto immune response.
If animals are used for experiments, it is futile to use rats or mice because they rely on corticosterone to regulate the immune response, not cortisol. I suspect that this developed because they have a factor in their intestinal fluid which counteracts cholera toxin.23 They also have the ability to absorb water under cyclic AMP stimulation in part of their colon24 instead of excretion of water, unlike other animals.
Since the disturbance in copper metabolism is proposed as the most serious aspect of RA, evidence for copper's effect should be possible. Supplementing with copper should remove some of the symptoms of RA. I know of no such experiment. However, it is known that Finnish men who work in copper mines have little arthritis or susceptibility to infection.25 The high milk diet along with frequent saunas may be two reasons why other Finns have one of the highest rates of arthritis in the world,26 since milk is the poorest source of copper27, p.92 and perspiration loses potassium.28 Milk has been shown to have a high statistical correlation with cardiovascular disease, said to be as great a risk as smoking,29 which disease in turn is correlated with RA. Laplanders on a meat diet have a lower rate of RA not much further north.26 The Massai of Africa have a higher rate of RA than the surrounding tribes.30, p.768 The Masai also use a lot of milk as well as very few vegetables, which vegetables would have increased potassium intake. Men who work in copper mines must have stronger tissues than other miners because the percentage of injuries which result in lost time is significantly lower31 even though injuries like eye damage and burns which are not affected by strength are part of the data. Eating a lot of shellfish or liver should reduce those symptoms related to copper deficiency since they are the richest sources, but I know of no study. The same is true of drinking acid water out of copper plumbing.
I believe that it is unwise to give cortisol to any class of people whose immune system is weak, such as arthritic people. If it is felt that cortisol should be raised in the body, why not use something relatively safe, like potassium supplements? If potassium supplements are used, be certain that vitamin B- 1 is adequate because the "wet" heart disease of beri-beri can not materialize when potassium is deficient.32 Obviously the reverse is also true for vitamin B-1 supplementation. For this reason, If the patient has heart trouble, it is very important to determine whether it is caused by vitamin B-1 or potassium.
If potassium chloride is dissolved in fruit juice it tastes good and avoids the danger to the intestines that even slow release enteric tablets may present. The chloride is the most efficacious form33. It would be better and safer yet to provide potassium from food high in potassium such as celery or bamboo shoots as Effinger proposed34. Unboiled, unfrozen, uncanned vegetables low in starch are the richest sources35. However, removing a deficiency will be slower since the potassium is not associated with chloride and would take a few weeks or months longer.
A deficiency can arise from diarrhea, processed food, reliance on grain or fatty foods35, psychic stress stimulation of aldosterone36 p.209 (which is the main regulator of potassium)37, stress stimulation of cortisol (as in an operation, for instance38), diuretics, licorice39 as well as probably grapefruit39a, profuse perspiration28, excessive vomiting40, eating sodium bicarbonate41, hyperventilating42, laxatives43, enemas44 (especially if prolonged), shock from burns or injury45, hostile or fearful emotions36, and very high or very low sodium intake46, All of these increase excretion or decrease intake of potassium and many at once would be very dangerous. and probably even lethal if prolonged.
A chronic potassium deficiency must surely cause a degenerative disease. I believe it materializes in some people as RA. If not, then what is the name of the degenerative disease which attends a potassium deficiency ? It is not hypokalemia. This is only a word which describes low serum potassium, a marker or symptom. It is about time we found such a name.
http://members.tripod.com/~charles_W/potassium.html
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