WHAT IS POTASSIUM CITRATE
We have reached the point in the evolution of this site where the main stone risk factors are introduced and detailed, and the importance of citrate established. I have written about the price of potassium citrate because many patients and physicians have told me that it has risen steeply in recent months, and I would like to be of help.
A LOUD DISCLAIMER
In this post I will mention beverages and medications by name. Let me be clear: I have no financial relationships with the companies that produce or sell the products I write about here. Likewise neither I nor my colleagues at University of Chicago receive any support, financial or otherwise from these companies.
WHAT DOES CITRATE DO FOR PATIENTS?
It Can Reduce Formation of Uric Acid Stones
Some patients produce too acidic a urine which raises risk of uric acid stones, and they need supplemental alkali to make their urine less acidic. The use of potassium citrate to make urine less acidic will prevent uric acid stones in most patients who form them.
It Can Reduce Calcium Stone Formation in Patients with Low Urine Citrate
Some patients form calcium stones because they produce urine that is low in citrate, a valuable inhibitor of crystal formation. Most of the naturally occurring inhibitors in urine are complex molecules about which we can presently do nothing. But citrate is a small and easily measured molecule which we can prescribe and which will increase the urine citrate in at least some patients. Potassium citrate lowers urine calcium excretion. In so doing it reverses a key kidney stone risk factor. In trials potassium citrate reduced stone formation.
Potassium Citrate is Preferable to Sodium Citrate
I have a long list of sodium’s undesirable effects. It can raise blood pressure in large numbers of people, especially with age. It raises the amount of calcium lost in the urine, and that increase of calcium can raise supersaturation and promote calcium kidney stones. High sodium intake can reduce bone mineral retention. But, it may be that the sodium in sodium bicarbonate causes less of these problems than the sodium in sodium chloride – table salt. So I offer sodium bicarbonate as an alternative – with reservations.
Because sodium produces problems of its own, we tend to use potassium citrate as the preferred medication, and generations of stone patients have taken it. In several trials it has reduced new stone formation when given to patients whose urine is citrate deficient.
IS THERE A COST ISSUE?
I am not at all sure why the pricing of potassium citrate has become a topic I often hear about from patients, doctors, and just about everybody in the kidney stone world. Certainly the price must have increased, but I cannot find data on the web to prove the point. I also believe Medicare and perhaps other insurers have altered the status of this drug in their payment schedules. Perhaps some of you know more about the problem than I do and are willing to share what you know by way of a comment.
I did find on inspection of the Medicare lists of drug prices by insurance plan that some plans appear to include potassium citrate pills in their formularies at a preferred level and charge as little as $10 for what appears to be 90 pills. Others do not do this and publish higher prices, often as percentages of the retail cash price. Once again, I hope those of you with experiences in purchasing the drug will share what you know.
CAREFUL SHOPPING LOWERS PRICES
Listening to agitated, and worrisome stories about inflated prices for potassium citrate, I decided to try to be helpful. A Google search for prices of potassium citrate yielded a few promising shopping sites, and on study of the prices I found some much better than others. Note that in the following sections I present a lot of prices and arithmetic. Sometimes, when the message is very clear the results are rounded for simplicity. I give the basis for every calculation if you want absolute exact answers to the nearest penny. Likewise, because we are comparing prices, I have chosen 4 pills daily as my cost basis. The actual range can be from 2 to 6 pills or even more daily, so you will have to adjust costs to your own prescription.
SAM’S CLUB
GoodRx gives what I believe is the clearest list of prices. On their site, Sam’s Club was least expensive at $145 for 180 pills or $0.805 per pill. A typical 4 pills per day treatment option would therefore come to $290/quarter, which is still very pricey. The site gives a long list of other stores whose prices are even higher. Everyday health offers an approximate price for Cytra-K and Polycitra K of $50 – $99, but I could not be sure if this was for a month and likewise how much medication was in a dose.
CANADA
So far as I can tell, importing from Canada will not save you much money. I found Urocit K at $1.10 per tablet, which is higher than Sam’s Club. Another generic, K-Citra 10 was $0.79, which is about the same as Sam’s Club. Another less desirable canadian price was $0.52 per pill if you buy 90 pills, but it was for the 5 mEq size, 1/2 of the usual and therefore the corresponding price for 10 mEq would be $1.04/pill. Given that some costs must accrue for mailing, and there are issues with importing, I cannot see an advantage right now.
WHAT TO DO
Shop Well
Certainly web shopping is a good thing because in my modest and amateurish shopping efforts I found a tremendous range of prices. I am sure that many of you who read this post are far more skilled than I am at shopping for best prices. It is time for you to step forward and share your knowledge with all of us by posting a comment. Everyone will benefit and appreciate your contributions.
But even if you shop better than I did, retail pricing for this medication seems too high for most to afford. At even 4 pills a day, and at the best price I found ($290.00/quarter) we are over $1000.00 yearly for this one product. It seems to me that if your plan does not subsidize this medication, cost could be a serious issue.
Use Beverages
A useful publication reports the alkali content of commercial beverages. The ‘lemonade formula’ referred to on the graph is given as 1/2 cup ReaLemon© mixed with 7-1/2 cups of 
water and sweetened to taste with sugar or artificial sweetener. Diet 7-up was the winner with 10 mEq of citrate in a liter. A single Urocit K tablet contains 10 mEq of potassium citrate, as a comparison, so you would need 4 liters of the beverage daily to match 4 pills.
You Can Do Better
My colleague Dr. John Asplin has measured an additional group of products: Minute Maid Lemonade contains 10.3 mEq/liter of alkali, like Diet 7-up. Gatorade contains only 8.3 mEq/liter. But Crystal Light Lemonade contains 21.7 mEq of alkali, so it is the winner. Each liter substitutes for 2 potassium citrate pills, $1.60 a day, or $144 every 3 months.
We know About Classic Crystal Light
Crystal Light beverages include teas and other drinks. Our measurements refer to the classic or standard lemonade beverage. In what follows all of my remarks at bounded by that limitation. For example, I do not know if liters of the Crystal Light tea might contain excessive amounts of oxalate.
The Prices of Crystal Light
I did not research the price of Crystal Light Lemonade extensively, but Crystal Light Lemonade Pitcher Packs – 3-Pack – are $27.95 at Amazon. Each 3 pack provides 96 quarts of beverage. Each quart is about one liter (0.946 liters to be exact). The cost is therefore $27.95/96 or about $0.29 per 20 mEq (2 pills). This comes to $0.58 daily or $52 every three months. The Amazon site points out that prices might be lower at other stores. Please comment on the best prices you have found so everyone can benefit.
It is Not Just How Much Citrate is in the Beverage
You may have read, on a label or in a scientific paper, that some of the beverages I have listed contain quite a lot of citrate, yet we show them as inferior as an alkali. The reason has to do with the form of the citrate. If the drink is made up in a very acidic manner, much of the citrate is citric acid and will not produce alkali in the body when metabolized. It is only when the molecule is citrate itself, not the citric acid, that it can benefit you as an alkali. The graph and the additions by Dr. Asplin present the true alkali content.
Be Wary of Sugar
The beverages are mainly diet so they do not add to your caloric burden. If you sweeten them, or lace them with fruit juice, or add fruit juice or other flavorings to baking soda – see below, you will be adding calories to your diet and that may not be ideal.
But apart from weight gain, sugar has undesirable effects specific to kidney stone formers: It raises urine calcium losses. Even worse, as the article points out, urine flow rate falls as urine calcium increases, so supersaturation rises for two reasons.
What About Sodium Bicarbonate
It Has a Lot of Alkali for the Money
Baking Soda
According to Google, a teaspoon contains 4,500 mg of baking soda (sodium bicarbonate). Given the molecular weight of 84 mg/mEq (each molecule is one mEq of alkali) the teaspoon contains 53 mEq of sodium alkali. In principle, therefore, one can get alkali for nearly nothing by way of price. According to Dr. Asplin, who has – unbelievably – determined such matters, a teaspoon can contain up to 6,100 mg of baking soda depending on packing and whether the teaspoon is level or heaping.
To get 20 mEq of alkali from baking soda would require about 1/3 teaspoon. Given the variability of what a teaspoon holds, and the sheer problems of fractions of a teaspoon for every dose, I strongly recommend we abandon the remarkable cost savings from baking soda and use sodium bicarbonate tablets, which are very inexpensive and measure out the dose for you.
Sodium Bicarbonate Tablets
You can buy sodium bicarbonate tablets OTC and they are cheap. Concord, via Amazon, sells one hundred 650 mg tablets for $14.95 ($0.14 each). Rugby sells 1000 tablets of the same size for $25.77 ($0.026 each). Because each tablet contains only 7.7 mEq of alkali, it takes about 3 to match 2 K citrate pills (I realize 7.7 times 3 is 23.1 mEq but it approximates 20 mEq and the difference is not important). But that is only $0.075 for the three. So the price can come way down with this form of alkali.
It has a lot of Sodium, Too
But, alas, the 1/3 teaspoon, or the three 650 mg pills, deliver 20 mEq of sodium for each 20 mEq of alkali. The extra 20 mEq of sodium is 460 mg, about 20% of a full day’s sodium intake. For the 40 mEq (4 potassium citrate pills) we have used as a benchmark thus far, it is 40% of a full day’s sodium intake.
Whereas I am unconcerned to recommend beverages as replacements for potassium citrate pills, I have considerable reservation about sodium loads for reasons I have already mentioned and repeat here for emphasis. Excess sodium intake can raise blood pressure in those who are sensitive to salt. Although we have not as yet discussed urine calcium losses as a risk factor for stones, sodium loads will raise urine calcium, and are therefore not beneficial in that respect. If you are taking a diuretic to reduce urine calcium for stone prevention, sodium loads will reduce the efficacy of the treatment and promote losses of potassium. People with heart disease may develop worsening heart failure. Always ask your physician before using sodium bicarbonate as an alkali.
Even so, sodium bicarbonate is not sodium chloride – table salt. For physicians I have reviewed a few papers on the subject. If I sound ambivalent, I am. We may need a few more trials on this subject. In the mean time, all of my reservations hold sway. Use sodium bicarbonate sparingly.
How To Put It All Together
Compromise is the best policy, and I offer a general scheme which patients and physicians can use, if they wish, with their personal alterations. Be sure and check that your combinations provide the dosages your physician wants you to have.
Make a List of Equivalent Dosages
Each potassium citrate pill is 10 mEq; 2 are 20 mEq of alkali. Each liter of Crystal Light is just over 20 mEq of alkali. Each OTC 10 grain (650 mg) sodium bicarbonate tablet is 7.7 mEq of alkali so 3 make 23 mEq.
Make A Day’s Menu
Consider dividing the day’s alkali into 3 parts: Beverages; sodium bicarbonate; potassium citrate pills.
To Replace 2 Potassium Citrate Pills
If we only need 2 10 mEq potassium citrate pills (20 mEq), substitute 1 liter of Crystal Light (20 mEq). It is part of the day’s fluids, but also like a medication, so spread its use out over the day and, if possible, night.
To Replace 4 Potassium Citrate Pills
If we need 4 pills (40 mEq) consider 1 liter of Crystal Light and three sodium bicarbonate pills (20 mEq). The beverage and individual pills can be spread out through the day.
To Replace 6 Potassium Citrate Pills
If we need 6 pills (60 mEq), consider 2 liters of Crystal light (40 mEq) and three sodium bicarbonate pills (20 mEq) likewise spread out through the day. Reserve the potassium citrate pills for when you tire of the beverage or if the extra sodium is raising blood pressure or urine calcium.
Use Many Beverage Types But Keep the Dose of Alkali The Same
Crystal Light is convenient because of how much citrate it contains. But the chart shows many alternatives which can be used instead in larger volumes. Just remember to multiply so the total amount of alkali remains about the same. For example, you need 2 liters of Diet 7-Up to equal one liter of Crystal Light.
Be Inventive: Not All Days Need Be The Same
Mixing and matching is perfectly acceptable. Each day need not look like the one before so long as the correct amount of total alkali is used. The only drawback of a mix and match approach is confusion, so make lists and keep track. As a general rule, try to make the sodium component smaller than the beverage component. Keep the expensive potassium citrate pills as a convenience and source of variety. Obviously if sodium is contraindicated medically, and beverages are too tiresome as a source for all the alkali that is needed, potassium citrate pills can be used to replace sodium bicarbonate pills.
Not All Patients Need Potassium Citrate Or Any Other Alkali
This post is for those who have been told by their physicians to use alkali. Nothing I have written here should induce anyone to begin alkali unless their physician has prescribed or recommended it. Stone formation is complicated. Sometimes alkali can worsen stones, or even become a danger. Potassium can itself be dangerous if kidney function is below normal. Sodium loads are a problem for people with high blood pressure, heart disease, and other illnesses. Do not use sodium or potassium alkali or even high volumes of Crystal Light unless the physician who is treating your stones recommends you do so.
Stay Hopeful
Whatever caused the price rise, the changes in how insurers pay for this medication, or both, may be transitory. Millions of people have kidney stones in the US. Prices for 90 days of a standard treatment are so high that few can afford them without serious budgetary concerns. When so many people are affected, hopefully market or even political forces will countervail. In the meantime, between a few potassium citrate pills, a few liters of Crystal Light, and maybe some sodium bicarbonate, physicians can piece together an adequate regime of alkali for those patients who need it. Not every stone former does need alkali, of course.
ANOTHER AND FINAL DISCLAIMER
I have brought Crystal Light to your attention as an inexpensive substitute for some of the medicinal alkali your physicians may have prescribed. As in my initial ‘Loud Disclaimer’ I say here that I receive no financial or other benefits of any kind from the makers of this beverage, have not, in fact, ever tasted it, and do not currently plan to do so. My evidence for the value of Crystal Light comes from the work of Dr. John Asplin, and comparisons to the published work of Dr. Eisner and his colleagues.
Hello,
I found this article very helpful. I am currently battling with my insurance company to cover my urocit k. I am a 28 year old male recently diagnosed with not only a minor kidney stone, but also with having been born with 1 kidney (found out 3 years ago). Long story short, my current insurance does not cover the cost of the urocit script that i’ve been proscribed. I have been told to take 4, 10 MEQ tablets every day, because in addition to only having one kidney and a history of kidney stones myself and within my family, I also have a very low level of citrate in my urine. The 4 pills are to boost my natural levels.
My prescription is currently 483.00 for roughly a 67 day supply (270 pills divided by 4 pills a day), an amount that I can not afford to pay. Do you have any recommendation as to what I can attempt to do to get the cost of my medically necessary medication covered by my insurance company?
Hi Michael, The mass of older comments have a wealth of ideas. I would read through the long string and see which work for you. The article points to some beverage alternatives, as well. It is a real horror, and an example of industry selfishness beyond comprehension. Regards, Fred Coe
Dr. Coe. Were I to follow the Crystal Light Lemonade routine you outline, are there any concerns regarding ingesting the artificial sweetener and/or phenylalanine (as listed on the package) on as regular a basis as you outline? I would be drinking 1.5 liters/day.
I found coupons on line. Goodrx has a coupon $119.23 for 180 tablets of 10meq. Walgreens wanted $200 after insurance for the same.
Dr. Coe. Were I to follow the Crystal Light Lemonade routine you outline, are there any concerns regarding ingesting the artificial sweetener and/or phenylalanine (as listed on the package) on as regular a basis as you outline? I would be drinking 1.5 liters/day.
Hi Owen, I am not an expert on the sweeteners or that amino acid. I must say most warnings about artificial sweeteners arose as propaganda from the sugar industry that did what it could to find reasons they might be unsafe. If I were to weigh out the risks from the beverage against even one stone surgery the beverage would win. Regards, Fred Coe
Thank you Dr. Coe. One other thing. In addition to having passed two kidney stones (calcium oxalate) over the past 4 years, recently I was diagnosed with Barretts esophagus. I was prescribed Omeprezole and Fomotadine to treat it. I am also supposed to avoid acidic foods, which is a concern with the Crystal Light lemonade (although it is not carbonated, which is good since I am also supposed to avoid carbonated beverages). Would it be advisable to find a different alternative to Crystal light lemonade?
Hi Owen, the beverage is not overly acidic, but if it bothers your esophagus perhaps you should use the potassium citrate. Alternatively, given this GI complexity perhaps your physician should reconsider the need for the k citrate and suggest alternatives. At this distance I cannot be particularly helpful in this kind of detail. Regards, Fred Coe
Dr. Coe, I’ll work with my physician as you suggest. Thanks for your insights, both here in the comments, and in what you have published on this site. Best Regards, Owen Rockwell
I found coupons on line. Goodrx has a coupon $119.23 for 180 tablets of 10meq. Walgreens wanted $200 after insurance for the same.
Thanks for all the info. I was going to fill mine today for 90 days and they called and said it was $340.00. The potassium citrate over the counter is only 99mg. Have been taking the 10 meq for five years.
Thanks for all the info. I was going to fill mine today for 90 days and they called and said it was $340.00. The potassium citrate over the counter is only 99mg. Have been taking the 10 meq for five years.
print a Good rx coupon on line
Greetings, Dr. Coe
Thanks so much for posting all this info: for sharing resources and naming names. As with many of these posts, cost for KCit has become an issue for me. I have been taking 1040 mEq for two yrs, as part of tx for CaOxalate stones, as prescribed by nephrologist who monitors a range of urinary parameters, citrate included. I have been doing well — no more stones, yippee! — so am committed to continuing with the KCit.
I had hoped to find an alternative within the veterinary market, but all veterinary products contain other things that I cannot do — or liver flavor, which is just gross!
On the websites linked above, I have found 2 bulk products; the first two links are for the same product — sold on amazon (I thought the comments were helpful) and by manufacturer. A few of the comments alluded to the less-than transparent nature of testing and verification; this does concern me. So I searched for “potassium citrate” and “USP’ and found a second product,; this is the third link above.
I am wondering whether you have any experience with either of these, or any similar products?
I have a digital gram scale, so encapsulating a powder would not be an obstacle for me. And these scales are not expensive nowadays ($25 -$50), so the one-cost purchase could potentially save all these folks who have written you $$$. That is, if indeed you think this scheme is reasonable.
Oops!!! your site won’t let me submit 3 websites — gets an error msg. SO just sending the amazon link. The other product can be found searching the following site:us.vwr.com/
I thank you for your kind consideration.
with Best Regards
Leah Birch Postman
Hi Dr Birchman, Many before you – look at the older posts – have found food grade K citrate and adopted it through measurement and capsules. I have warned all that their physicians should know as large errors in potassium dosing can be dangerous. As you are a trained physician and have had lab experience I am sure you can do this. But even you should let your personal physician know – I would, myself. Regards, Fred Coe
Thanks So Much dr Coe
I so appreciate your speedy response, and plan on spending some time with your back-catalog of thoughtful posts this wkend. Thanks as well for your wise cautionary words of including my nephrologist in whatever changes I hope to make. Absolutely!
with Gratitude & Best Regards,
Leah Birch Postman
Greetings, Dr. Coe
Thanks so much for posting all this info: for sharing resources and naming names. As with many of these posts, cost for KCit has become an issue for me. I have been taking 1040 mEq for two yrs, as part of tx for CaOxalate stones, as prescribed by nephrologist who monitors a range of urinary parameters, citrate included. I have been doing well — no more stones, yippee! — so am committed to continuing with the KCit.
I had hoped to find an alternative within the veterinary market, but all veterinary products contain other things that I cannot do — or liver flavor, which is just gross!
On the websites linked above, I have found 2 bulk products; the first two links are for the same product — sold on amazon (I thought the comments were helpful) and by manufacturer. A few of the comments alluded to the less-than transparent nature of testing and verification; this does concern me. So I searched for “potassium citrate” and “USP’ and found a second product,; this is the third link above.
I am wondering whether you have any experience with either of these, or any similar products?
I have a digital gram scale, so encapsulating a powder would not be an obstacle for me. And these scales are not expensive nowadays ($25 -$50), so the one-cost purchase could potentially save all these folks who have written you $$$. That is, if indeed you think this scheme is reasonable.
Oops!!! your site won’t let me submit 3 websites — gets an error msg. SO just sending the amazon link. The other product can be found searching the following site:us.vwr.com/
I thank you for your kind consideration.
with Best Regards
Leah Birch Postman
Hi Dr Birchman, Many before you – look at the older posts – have found food grade K citrate and adopted it through measurement and capsules. I have warned all that their physicians should know as large errors in potassium dosing can be dangerous. As you are a trained physician and have had lab experience I am sure you can do this. But even you should let your personal physician know – I would, myself. Regards, Fred Coe
Thanks So Much dr Coe
I so appreciate your speedy response, and plan on spending some time with your back-catalog of thoughtful posts this wkend. Thanks as well for your wise cautionary words of including my nephrologist in whatever changes I hope to make. Absolutely!
with Gratitude & Best Regards,
Leah Birch Postman
Dr Coe
I currently take potassium Citrate 10meq three times a day for kidney stone that were calcium oxalate. This medication is not on my insurance formulary and they want to charge $280.00 for 2 pills a day for a 30 day supply. I have since developed a sore spot in my throat that is painful when swallowing. I see this is a side effect from the medication. Do you have a suggestion for an alternative to the pill. I have ulcerative colitis and have had 4 kidney stones in the past couple years
Thank you
Hi Tom, The article gives all of our present alternatives. But another issue is why you need this medication. Do you have a low urine pH, uric acid stones, low urine citrate as your putative cause of stones. Often, the drug is either not needed or one of several alternatives. Given ulcerative colitis, have you had colon removed? All of this requires your physician to assess your situation and be sure about alternatives. I cannot, being too far from the facts. Regards, Fred Coe
Dr Coe
I currently take potassium Citrate 10meq three times a day for kidney stone that were calcium oxalate. This medication is not on my insurance formulary and they want to charge $280.00 for 2 pills a day for a 30 day supply. I have since developed a sore spot in my throat that is painful when swallowing. I see this is a side effect from the medication. Do you have a suggestion for an alternative to the pill. I have ulcerative colitis and have had 4 kidney stones in the past couple years
Thank you
Hi, I’m wondering if d-mannose as a supplement is an acceptable alternative to raise urine pH? I have found a lot of information on it online, but nothing seems to tie it all together. I’m asking because my cat has Feline Urological Syndrome, and it worked wonders for him. The vet thinks it’s partially because it lowered pH. Thanks for any insight you have, and know that I recommend your site to absolutely everyone – it’s SO helpful.
Best wishes,
Jennifer
Hi Jennifer, I know of no human use for d-mannose in stone formers. Regards, Fred Coe
Hi, I’m wondering if d-mannose as a supplement is an acceptable alternative to raise urine pH? I have found a lot of information on it online, but nothing seems to tie it all together. I’m asking because my cat has Feline Urological Syndrome, and it worked wonders for him. The vet thinks it’s partially because it lowered pH. Thanks for any insight you have, and know that I recommend your site to absolutely everyone – it’s SO helpful.
Best wishes,
Jennifer
Hi Jennifer, I know of no human use for d-mannose in stone formers. Regards, Fred Coe
I read somewhere that potassium citrate is also prescribed for dogs. Maybe the high cost is due to high demand.
My arguement is that dogs don’t require a USP product. Perhaps the potassium citrate for dogs could be made at a lower quality and thus a higher yield. That would increase the supply for human use.
Hi Larry, there is no shortage of potassium citrate. You can buy it, food grade, anywhere. The high price is due to industry gauging. Regards, Fred Coe
EXACTLY. We were told the pharmaceutical company that makes the Uricit k also owns the generic right/patent for it. Therefore, they ARE gouging the public.
I read somewhere that potassium citrate is also prescribed for dogs. Maybe the high cost is due to high demand.
My arguement is that dogs don’t require a USP product. Perhaps the potassium citrate for dogs could be made at a lower quality and thus a higher yield. That would increase the supply for human use.
Hi Fred!
Thank you for writing this article! I myself have a hereditary kidney stone disease, with lots of other absorbing or non absorbing issues in my intestines . My Boston doc just texted me today to tell me to stop taking the potassium citrate pills… it is ironic you wrote this today:) he said my intestines were absorbing to much.. I’m a young female and have experienced the crazy amount of the perscription of $145 a month. Unable to work it was hard to get them but now it seems it may have been a good thing. I had lots of side effects from it also. I’m going to stay positive, meditate and do my energy healing as I’m told! If you have any suggestions I would love to hear them. Thanks
Warmest wishes
Angela
Hi Angela, I presume you have calcium phosphate stones and idiopathic hypercalciuria. Your urine is rather alkaline, your well read physicians read our latest article that women absorb excessive amounts of food alkali and decided the potassium citrate was not ideal. In general you would benefit from prevention, however, and meditation and energy healing might not be as good as the kidney stone diet. I think your physicians sound rather excellent, so speak more with them about prevention. Regards, Fred Coe
Thank you Fred!! I will do, I see them Thursday in Boston . You are amazing!!:)
Hi Fred!
Thank you for writing this article! I myself have a hereditary kidney stone disease, with lots of other absorbing or non absorbing issues in my intestines . My Boston doc just texted me today to tell me to stop taking the potassium citrate pills… it is ironic you wrote this today:) he said my intestines were absorbing to much.. I’m a young female and have experienced the crazy amount of the perscription of $145 a month. Unable to work it was hard to get them but now it seems it may have been a good thing. I had lots of side effects from it also. I’m going to stay positive, meditate and do my energy healing as I’m told! If you have any suggestions I would love to hear them. Thanks
Warmest wishes
Angela
Hi Angela, I presume you have calcium phosphate stones and idiopathic hypercalciuria. Your urine is rather alkaline, your well read physicians read our latest article that women absorb excessive amounts of food alkali and decided the potassium citrate was not ideal. In general you would benefit from prevention, however, and meditation and energy healing might not be as good as the kidney stone diet. I think your physicians sound rather excellent, so speak more with them about prevention. Regards, Fred Coe
Thank you Fred!! I will do, I see them Thursday in Boston . You are amazing!!:)
I buy Potassium citrate in bulk powder. Its available very cheap (1kg or 2.2 pounds for only $30!) from places like https://www.bulksupplements.com/potassium-citrate.html Buying prescription pills with skyrocket price is insane.
Interesting that the bulk supplement website recommends a max of 275 mg. I looked for meq to mg equivalence and found that 10 meq is equal to 1080 mg so about four times the recommended concentration of the supplement website. At $13.96 for 250 grams (which is 250,000 mg), this is a 250 day supply for $20 with shipping. With mg scales between $20 and $50 bucks, the scales pays off in the first month.
Without a scale the best option it on http://www.goodrx.com. Getting a discount card for $51.34 for 60 tablets of 10 meq.
I buy Potassium citrate in bulk powder. Its available very cheap (1kg or 2.2 pounds for only $30!) from places like https://www.bulksupplements.com/potassium-citrate.html Buying prescription pills with skyrocket price is insane.
Hi Eric, many do as you do, and I presume you measure out your doses using a balance scale. But I remind everyone who writes this to include their physician to be sure about potassium dosing and that you have no conditions that would make potassium excess specially hazardous. Your physician is ultimately responsible for you so let her/him know. Regards, Fred Coe
Interesting that the bulk supplement website recommends a max of 275 mg. I looked for meq to mg equivalence and found that 10 meq is equal to 1080 mg so about four times the recommended concentration of the supplement website. At $13.96 for 250 grams (which is 250,000 mg), this is a 250 day supply for $20 with shipping. With mg scales between $20 and $50 bucks, the scales pays off in the first month.
Without a scale the best option it on http://www.goodrx.com. Getting a discount card for $51.34 for 60 tablets of 10 meq.
Hi Pat, The Max is because higher doses require prescription because some people cannot tolerate potassium loads and we needs physicians who can prevent serious side effects. Be sure this is the right drug for you. There are options. I presume you have idiopathic calcium stones. Regards, Fred Coe
I’ve just started this prescription and it feels like Pharma fleecing of America. I noticed that you didn’t mention concentration until your Canada paragraph but it matched my initial experience. I did start at 4 pills of 10 meq/pill (40 meq/day), but just heard that my prescription is now 2 a day. Unfortunately this drop may be the taking cost & insurance into consideration. Currently the pharmacy cost is about $180 for 60 pills of 10 meq/pill (30 day supply of 20 meq/day needed). This is still over $2k per year. On a high deductible plan, I’m soaking this up and only getting the benefit of a HSA tax exempt cost. Way too much for a pill that appears to be generic.
Other than the helpful recommendation of using the powder form, I’ll likely keep motivated for that 2.5 quarts of water I’m supposed to drink a day. That should no doubt impact the required dosage. May even start monitoring my pH. Or maybe look into creating a powder mix equivalent of potassium citrate if that’s possible. Thanks for the helpful insight.
Hi Pat, Perhaps this is not even the ideal medication, and mere water is hardly enough for a disease like stones. Get a prevention plan together for yourself; here is my best starting place. Regards, Fred Coe
I’ve just started this prescription and it feels like Pharma fleecing of America. I noticed that you didn’t mention concentration until your Canada paragraph but it matched my initial experience. I did start at 4 pills of 10 meq/pill (40 meq/day), but just heard that my prescription is now 2 a day. Unfortunately this drop may be the taking cost & insurance into consideration. Currently the pharmacy cost is about $180 for 60 pills of 10 meq/pill (30 day supply of 20 meq/day needed). This is still over $2k per year. On a high deductible plan, I’m soaking this up and only getting the benefit of a HSA tax exempt cost. Way too much for a pill that appears to be generic.
Other than the helpful recommendation of using the powder form, I’ll likely keep motivated for that 2.5 quarts of water I’m supposed to drink a day. That should no doubt impact the required dosage. May even start monitoring my pH. Or maybe look into creating a powder mix equivalent of potassium citrate if that’s possible. Thanks for the helpful insight.
Hi Pat, Perhaps this is not even the ideal medication, and mere water is hardly enough for a disease like stones. Get a prevention plan together for yourself; here is my best starting place. Regards, Fred Coe
Doctor – my urologist told me as a cheap alternative I could drink small amounts of baking soda mixed in water… I’m a bit skeptical. Won’t my stomach acid counteract it? Would this be as good as the pills?
Hi Jerry, The sodium is not ideal. If you have calcium stones and need more urine citrate the sodium will raise your urine calcium and offset the citrate benefits. If you have pure uric acid stones, the sodium will only matter because such patients are often hypertensive. Regards, Fred Coe
I am supposed to take 3 potassium tabs daily but fund the cost too prohibiting. I watch my diet drink 64-72 ounces of lemon or ACV water daily. I also read where vitamin supplements may help. I have a supplement with magnesium 122MG, potassium (potassium aspartate/citrate) 294mg. Would these vits work and how many would I need to take to get my value needed?
Hi Ann, given a standard size potassium citrate pill is 1080 mg of potassium, you would need 1080/294 or 3.6 of the small pills per large pill; since you take 3 large pills this is about 11 of the small ones a day. This is presuming the 294 mg is of potassium not potassium citrate. If the latter, there is just not enough potassium to be useful. If you eat your 5 servings of fruits and veggies a day, which provide 4000 mg of potassium you may not need the pills at all. Try this and get a new 24 hour urine to see the effect. Regards, Fred Coe
I am supposed to take 3 potassium tabs daily but fund the cost too prohibiting. I watch my diet drink 64-72 ounces of lemon or ACV water daily. I also read where vitamin supplements may help. I have a supplement with magnesium 122MG, potassium (potassium aspartate/citrate) 294mg. Would these vits work and how many would I need to take to get my value needed?
Hi Ann, given a standard size potassium citrate pill is 1080 mg of potassium, you would need 1080/294 or 3.6 of the small pills per large pill; since you take 3 large pills this is about 11 of the small ones a day. This is presuming the 294 mg is of potassium not potassium citrate. If the latter, there is just not enough potassium to be useful. If you eat your 5 servings of fruits and veggies a day, which provide 4000 mg of potassium you may not need the pills at all. Try this and get a new 24 hour urine to see the effect. Regards, Fred Coe
Hi Dr. Coe,
I’m using this information in research paper in my Chemistry class. I was wondering when you posted this or last updated it so I can cite it properly. I would go off the oldest comment, but I am afraid of it being inaccurate and I’m not seeing a publishing date anywhere else.
Regards,
Hannah Niemczyk
Hi Hannah, The price of K citrate paper was first published 9/11/14. Regards, Fred Coe
Hi Dr. Coe,
I’m using this information in research paper in my Chemistry class. I was wondering when you posted this or last updated it so I can cite it properly. I would go off the oldest comment, but I am afraid of it being inaccurate and I’m not seeing a publishing date anywhere else.
Regards,
Hannah Niemczyk
Hi Hannah, The price of K citrate paper was first published 9/11/14. Regards, Fred Coe
Hi. Thanks for writing this article. I have been prescribed Potassium Citrate 1080 mg. (10 mEq) by my urologist due to formation of large calcium oxalate kidney stones. I have a fairly rare allergy to red meat, diary and meat byproducts (Alpha Gal Allergy). Many medicines have meat byproducts in them, so I am uncomfortable taking the prescribed version of potassium. I have found a vegan version of Potassium Citrate supplement over the counter. It is 200 mg. per tablet. I am unsure how many I should take per day to try to equal the 1080 mg. (10 mEq) X 2 per day prescribed by my doctor. I know it seems like simple math, but I would like to confirm the conversion before loading up on so many Potassium supplement tablets in one day. Any help you can provide would be greatly appreciated. Thank you!
Hi Renee, if it is 200 mg of potassium (not of the potassium salt) then the math is indeed simple: 1080/200 = 5.4 tabs – round to five. The 1080 is actual potassium as the citrate salt. I am not sure the binders in the OTC size is more free of meat byproducts than is the prescription size. Regards, Fred Coe
I have had an ileostomy for 30+ years, and now, at 72 years old have had my fourth (separated by 2-4 years) kidney stone issue. I’ve learned from you that I should expect (though I don’t know) my kidney stones to be uric, and I am just now learning to understand my 24-hour test results. Can you recommend some reading specific to those of us with an ileostomy?
Hi David, I have really failed you in that I have yet to write an article on the ileostomy stone problem. But I can say the problem is volume and alkali loss that causes uric acid and calcium oxalate stones. You are most likely sodium and bicarbonate depleted and will benefit from sodium bicarbonate vs potassium citrate but that depends on your 24 hour urine values and your physician to read them with you. Oxalate will not be a problem if there is no colon. Maybe I should get busy on the article! Regards, Fred Coe
I have had an ileostomy for 30+ years, and now, at 72 years old have had my fourth (separated by 2-4 years) kidney stone issue. I’ve learned from you that I should expect (though I don’t know) my kidney stones to be uric, and I am just now learning to understand my 24-hour test results. Can you recommend some reading specific to those of us with an ileostomy?
Hi David, I have really failed you in that I have yet to write an article on the ileostomy stone problem. But I can say the problem is volume and alkali loss that causes uric acid and calcium oxalate stones. You are most likely sodium and bicarbonate depleted and will benefit from sodium bicarbonate vs potassium citrate but that depends on your 24 hour urine values and your physician to read them with you. Oxalate will not be a problem if there is no colon. Maybe I should get busy on the article! Regards, Fred Coe
Thank you so much for your website….. What do you think of No salt a substitue that is potassium base. Thank you
Thank you so much for your website….. What do you think of No salt a substitue that is potassium base. Thank you
Hi Danielle, I believe the product is potassium chloride, so it will not substitute for potassium citrate. Regards, Fred Coe
Hi Dr. Coe,
I found your website informative and helpful.
Price gouging on Potassium Citrate has almost doubled due to recent insurance changes and deductibles.
Some of the best pricing without insurance and a Help RX online coupon is at Walmart. Perscription 1620 MG 90 day supply $92.00. Shop around hope that helps everyone.
Thanks, Joe; all advice on this topic is very welcome. Fred
Hi Dr. Coe,
I found your website informative and helpful.
Price gouging on Potassium Citrate has almost doubled due to recent insurance changes and deductibles.
Some of the best pricing without insurance and a Help RX online coupon is at Walmart. Perscription 1620 MG 90 day supply $92.00. Shop around hope that helps everyone.
Thanks, Joe; all advice on this topic is very welcome. Fred
A friend bought me some over the counter potassium citrate. They are 99mg tablets. Are these a good cheaper option vs a prescription? How many should be taken to be equivalent to 10mEq tablets? Thank you in advance for answering me and also for sharing your knowledge via this article. I love the Crystal Light information.
Hi Sharon, the 10 mEq tabs are 1080 mg, so you would need 1080/99 or 11 for one. Not a good deal, though no doubt cheaper. The comments – look back some – have many better ideas in them. Regards, Fred Coe
Hmmm… does ’99mg’ apply to potassium citrate, or only potassium in the pill (regulation for OTC potassium supplements)? …
https://www.swansonvitamins.com/swanson-ultra-potassium-citrate-99-mg-120-caps
Potassium (from potassium citrate): 99mg .
$3 for 120 pills, close to 2,5 mmol of potassium in each, so 10 mmol = 4 pills –> 1 cent per 1 mmol, 10 cents per 10 mmol
Hi ANdre, it is 99 mg of the potassium citrate salt. So about 10 of these gives one 1080 potassium citrate pill. Regards, Fred Coe
Hmmm
*potassium* (from potassium citrate) 99mg.
Looks like there is an emphasis on *potassium*. Also, that 99mg suggest it is maximum US allowed dose.
I’ve sent a question to Swanson about it. If I am right, taking 10 tablets as 10 mEq tablet equivalent (pun not intended) would result in serious overdose!
Hi Andre, 99 mg of potassium from potassium citrate would be 275 mg of potassium citrate salt. A standard 10 mEq tab has 1080 mg of that salt, so the 99 mg pill has 2.5 mEq and one would need 4 to make one 10 mEq tab equivalent. Usual dosage of the 10 mEq tabs is 1 2 or three times a day making 20 to 30 mEq, a safe and common range. But your physician is in charge of this, so be sure with him/her that you need this med, and that you have your dosing right if you switch to an OTC pill. Regards, Fred Coe
I’ve got reply from Swanson Customer Support:
“Hello Andre,
I understand the concern. The SWU395 Potassium Citrate has 99 mg of potassium. This comes from potassium citrate.”
So it’s 99 mg of *potassium*. AFAIK ’99 mg’ in potassium citrate supplements will be most of the time the potassium content (due to regulations for OTC potassium supplements).
It’s important – someone who took 10 pills as 10 mEq wopuld get 2,5 times more potassium citrate!
Hi Andre, I answered this in my prior comment. The 99 mg potassium pills have 2.5 mEq of potassium citrate; also of potassium as the atomic weight of potassium is 40 (99/40 = 2.475) Regards, Fred Coe
A friend bought me some over the counter potassium citrate. They are 99mg tablets. Are these a good cheaper option vs a prescription? How many should be taken to be equivalent to 10mEq tablets? Thank you in advance for answering me and also for sharing your knowledge via this article. I love the Crystal Light information.
What about other minerals w/ citrate?
Such as Magnesium Citrate? Or would we need to take too much of it to get the equivalent dosing of citrate found on Potassium Citrate? Sort of hard to overdose on Magnesium (well, one could, but I think bathroom issues would be sort of an obvious sign)… safer than too much Potassium, anyway.
Hi Mike, Magnesium citrate would not prove useful for stone prevention because of what you mention. Increased bowel fluid losses could increase stone risk. Regards, Fred Coe
What about other minerals w/ citrate?
Such as Magnesium Citrate? Or would we need to take too much of it to get the equivalent dosing of citrate found on Potassium Citrate? Sort of hard to overdose on Magnesium (well, one could, but I think bathroom issues would be sort of an obvious sign)… safer than too much Potassium, anyway.
Hi Mike, Magnesium citrate would not prove useful for stone prevention because of what you mention. Increased bowel fluid losses could increase stone risk. Regards, Fred Coe
I do not have stone but gout issues. I have no idea what is the cause. Based on your research Crystal light seems to be a solution. I am concerned about OTC potassium citrate because I am on a statin and have high blood pressure. Does any of your findings show that crystal light can impact my BP?
Hi Herb, I presume you form uric acid stones – given gout – and potassium citrate pills are warranted for their prevention. Whereas beverages are reasonable for calcium oxalate stones prevention as a way of raising urine citrate, as are vegetables and fruits, uric acid stones require considerable alkali to raise urine pH to 6 or higher and medications should be used. As for blood pressure, potassium supplements are part of treatment as is lower diet sodium, weight loss, and aerobic exercise. Regards, Fred Coe
Amazon sells Potassium Citrate powder at $21/500g, which, at 4 daily doses of 1.08g (10 Meq or 1,080 mg to match your examples) would come to about $65/year. This seems a good tradeoff for the trouble of measuring, especially since precision isn’t required for this drug. One could add it to seltzer (my beverage of choice) with other flavorings, or buy gelcaps and mix it with baking soda? If the latter, what ratio do you recommend? Thanks so much for your thoughtful and detailed exposition!
Hi Peter, Potassium citrate can be measured out into gel capsules using a balance that can weight to the mg or so. It would be wise to keep dosing to within 10 mg or so of the 1080. I believe seltzer water is acidic – pH around 4 – so it will protonate some of the citrate to citric acid that will no longer be available as a drug. Therefore I would take it in capsules. Regards, Fred Coe
Hello Dr. Coe.
I can’t understand this:
Seltzer water is carbonated, but its acidity comes mostly from carbon dioxide… so for each citrate ion converted to hydrocitrate (and dihydrocitrate), there will be a hydrocarbonate produced from CO2…
Hi Andre, yes, you will convert some citrate into citric acid and a corresponding amount of dissolved CO2 into bicarbonate. Do you want to do this? Citrate is metabolized and so offers the blood a steady supply of bicarbonate from the liver; bicarbonate is just that. Potassium bicarbonate is also available but usually the citrate is prefered. Regards, Fred Coe
Amazon sells Potassium Citrate powder at $21/500g, which, at 4 daily doses of 1.08g (10 Meq or 1,080 mg to match your examples) would come to about $65/year. This seems a good tradeoff for the trouble of measuring, especially since precision isn’t required for this drug. One could add it to seltzer (my beverage of choice) with other flavorings, or buy gelcaps and mix it with baking soda? If the latter, what ratio do you recommend? Thanks so much for your thoughtful and detailed exposition!
Hi Peter, Potassium citrate can be measured out into gel capsules using a balance that can weight to the mg or so. It would be wise to keep dosing to within 10 mg or so of the 1080. I believe seltzer water is acidic – pH around 4 – so it will protonate some of the citrate to citric acid that will no longer be available as a drug. Therefore I would take it in capsules. Regards, Fred Coe
Hello Dr. Coe.
I can’t understand this:
Seltzer water is carbonated, but its acidity comes mostly from carbon dioxide… so for each citrate ion converted to hydrocitrate (and dihydrocitrate), there will be a hydrocarbonate produced from CO2…
Hi Andre, yes, you will convert some citrate into citric acid and a corresponding amount of dissolved CO2 into bicarbonate. Do you want to do this? Citrate is metabolized and so offers the blood a steady supply of bicarbonate from the liver; bicarbonate is just that. Potassium bicarbonate is also available but usually the citrate is prefered. Regards, Fred Coe
Found 1080mg tabs at Sam’s club for 50 cents per tablet.
Rick, you are a superb shopper. Can US people get these?? Fred
Found 1080mg tabs at Sam’s club for 50 cents per tablet.
Rick, you are a superb shopper. Can US people get these?? Fred
Crystal Light also has sodium citrate and aspartame. Would you comment on those potential negative ingredients? I have kidney stones with several ER admissions in the last year. The pill form of potassium citrate gives me cramps and digestive problems. Looking for alternatives.
Hi Larry, sodium citrate is without risk, aspartame the same – big sugar is mostly responsible for the bad name of synthetic sweeteners. But of greater import, the proper prevention of your stones may not require the beverage or the pharmaceutical form of potassium citrate. Get a full evaluation of stone cause, and plan treatment from that. Here is a good article to start with. Regards, Fred Coe
I really appreciate all your articles. As for the using Crystal Light to replace Potassium Citrate Pills, I like the taste of Crystal Light straight from the packet. In theory, could I just take the powder form to make up for not drinking another liter of it? In other words; if I was required to take four Potassium Citrate pills, could I take one pill, drink one Crystal Light packet with water, and eat (dissolve in my mouth) two Crystal light packets throughout the day to equal four Potassium Citrate pills?
Hi Don, Sure – you can use the beverage or pills and interchange. Be sure the citrate is right for you. Take a look. Regards, Fred Coe
Does anyone use potassium citrate powder to replace pills. I take 6 pills of 1620mg – 15meq per day. Now switching to 7.5ml of liquid potassium citrate 3 times a day, its cheaper. I have just found 907mg of powder citric acid for $10.00. Does anyone use it instead?
Hi Vince, many have used commercial powder. But potassium is hazardous so you would need to weight out your dosages and be sure your physician agreed with what you were doing. Take a look back into the many comments on this page and your will find lots of suggestions. Regards, Fred Coe
Does anyone use potassium citrate powder to replace pills. I take 6 pills of 1620mg – 15meq per day. Now switching to 7.5ml of liquid potassium citrate 3 times a day, its cheaper. I have just found 907mg of powder citric acid for $10.00. Does anyone use it instead?
Hi Vince, many have used commercial powder. But potassium is hazardous so you would need to weight out your dosages and be sure your physician agreed with what you were doing. Take a look back into the many comments on this page and your will find lots of suggestions. Regards, Fred Coe
I am in the hospital as I write this, waiting for a surgery go-ahead for a stent and lithotripsy. 2 mm and 6 mm stones, one per side, so kidneys are not emptying properly. I have been taking potassium citrate, very inexpensive, less than .05 per pill. A few different brands on Amazon. Anyway, I’ve been taking 1/day of 99 mg. Urology doc just said I should be taking 3.
Hi Zachw, the 99 mg of potassium citrate at 3 daily is so little as to be of no medical use. One needs at least 2 of the 1080 mg pills for even an initial dose. But whether to use this med is not always clear. While waiting take a look at a better approach. Regards, Fred Coe
Thanks for the followup. Stones were 65% calcium oxalate. The 99 mg x 3 of K citrate was recommended by both my nephrologist and urologist. I’ll forward the info on this site to them. Drinking lots of water every day, about a quart of which has lemon juice (no sugar). This article (probably linked on your site but I didn’t see it) suggests lemon solution can be more effective than K citrate (maybe I’ll start measuring out the lemon juice?): https://journals.lww.com/jbisrir/Fulltext/2011/09481/The_Effectiveness_of_Lemon_Solution_versus.8.aspx
Also upping my calcium from dairy. But I just GOTTA have my dark chocolate!
Hi Zachw, The article is a proposal for a meta analysis to be done at a future time – it is not a completed study. Lemons contain citate, so do many beverages as noted in the article. In fact, five servings of fruits and veggies will get you 100 mEq of potassium much of it as metabolizable anions like citrate. So lemons have no special properties, and do contain considerable fructose if used on a regular basis. One can do better – see the article and the many suggestions by other readers. Most important, be sure low citrate is your problem; lots of people have plenty of citrate in their urine. Potassium citrate is not rarely recommended just so, and not to remedy a deficit. Regards, Fred Coe
24 hour urine results were quite alarming. Extremely low Ca (30) and citrate (20). On my own I have increased 99×3 K citrate to twice a day (which is about 15 mEq, no?). Ca supplement twice a day, both with meals at least one of which includes dairy. In the past, I had a super high oxalate diet (veggies, taters, nuts, tofu, whole wheat, brown rice, dark chocolate), in short one that is quite healthy for most people! I have dramatically changed my consumption of these very high oxalate foods.
Regarding adding lemon to water, lemon juice is only about 1% fructose. I don’t add any sweeteners. Besides that & regular water, I pretty much only drink OJ (but not too much, all that sugar), milk, coffee, and little else. Not a fan of the ingredients in Crystal Lite but we don’t need to go there!
Next stop, nephrologist.
I very much rely on the resources of this website and appreciate the efforts that you and others expend here.
Hi Zachw, I cannot find your original comments – made on another article, but infer your urine oxalate was very high. The low calcium and citrate are unclear to me; is your kidney function normal? Do you have intestinal disease or perhaps an obesity weight loss surgery? The dose of potassium citrate is too tiny for any benefit, and lemons are all nonsense when urine citrate is essentially null. I have so little to go on here, I cannot say much more, but I am sure your nephrologist will easily figure out the problem. Regards, Fred Coe
Dr. Coe
I was perfectly happy drinking Crystal Light. however, there has been much recent data that artificial sweeteners may increase the risk for Type 2 diabetes as much as actual sugar. Alas, I starting drinking water spiked with ReaLemon juice instead. Since the goal as I understand it is to alkalanize the urine, I wondered if you had any opinion on the pH of water. Bottled water pH runs anywhere from 3-9 depending on the brand. Would you hypothesize that there is benefit to drinking a more alakline water? (Which I am guessing getts that way by the bottler adding hCO3)
Hi Randy, I imagine we are seeing once again the efforts of Big Sugar to sponsor and proliferate fake science. Here is a recent meta- analysis showing no trend at all between artificial sweetener drinks and diabetes. Another such indicated that associations between artificial sweeteners and diabetes were likely due to bias. A news article about rats given these sweeteners needs to be discounted until real evidence is found. A very long and tedious but rigorous review indicates that the link between diabetes and artificially sweetened beverages lacks significance, arises from publication bias, and that the underlying data are too thin to rely on. Juices have a real relationship to diabetes, though smaller than sweetened beverages, so the lemon juice is perhaps a slight increase in risk. Water lacks enough buffering power to be of real help. The Crystal Light is probably the least objectionable option, presuming you need supplemental potassium citrate in the first place. I should point out that 5 servings of fruits and veggies a day will provide 110 mEq of potassium mostly as organic anions that raise urine citrate. Regards, Fred Coe
Dr. Coe
I was perfectly happy drinking Crystal Light. however, there has been much recent data that artificial sweeteners may increase the risk for Type 2 diabetes as much as actual sugar. Alas, I starting drinking water spiked with ReaLemon juice instead. Since the goal as I understand it is to alkalanize the urine, I wondered if you had any opinion on the pH of water. Bottled water pH runs anywhere from 3-9 depending on the brand. Would you hypothesize that there is benefit to drinking a more alakline water? (Which I am guessing getts that way by the bottler adding hCO3)
Hi Randy, I imagine we are seeing once again the efforts of Big Sugar to sponsor and proliferate fake science. Here is a recent meta- analysis showing no trend at all between artificial sweetener drinks and diabetes. Another such indicated that associations between artificial sweeteners and diabetes were likely due to bias. A news article about rats given these sweeteners needs to be discounted until real evidence is found. A very long and tedious but rigorous review indicates that the link between diabetes and artificially sweetened beverages lacks significance, arises from publication bias, and that the underlying data are too thin to rely on. Juices have a real relationship to diabetes, though smaller than sweetened beverages, so the lemon juice is perhaps a slight increase in risk. Water lacks enough buffering power to be of real help. The Crystal Light is probably the least objectionable option, presuming you need supplemental potassium citrate in the first place. I should point out that 5 servings of fruits and veggies a day will provide 110 mEq of potassium mostly as organic anions that raise urine citrate. Regards, Fred Coe
I was diabetic for 13 years and was taking metformin 1000 mg twice daily. Last A1C was 15. My symptoms have always been stomach and bowels. I am a 54 year old male. the metformin wasn’t really working so this year, our family doctor started me on Natural Herbal Gardens Diabetes Disease Herbal mixture, With the help of Natural Herbal Garden natural herbs I have been able to reverse my symptoms using herbs, my symptoms totally declined over a 7 weeks use of the Natural Herbal Gardens Diabetes disease natural herbal formula. My diabetes is totally reversed!
Hi James, I am happy for you, but would not personally support the use of this preparation in someone with so high an A1C as yours. Be sure and keep your care at least partly with a reliable endocrinologist who specializes in diabetes and the disease can have terrible long term consequences. Regards, Fred Coe
I was diabetic for 13 years and was taking metformin 1000 mg twice daily. Last A1C was 15. My symptoms have always been stomach and bowels. I am a 54 year old male. the metformin wasn’t really working so this year, our family doctor started me on Natural Herbal Gardens Diabetes Disease Herbal mixture, With the help of Natural Herbal Garden natural herbs I have been able to reverse my symptoms using herbs, my symptoms totally declined over a 7 weeks use of the Natural Herbal Gardens Diabetes disease natural herbal formula. My diabetes is totally reversed!
I have Crohn’s disease…multiple surgeries with bowel resection…2 reversals, no more bags. I am afraid of potassium citrate because of 3rd stage kidney disease that I have. I have to drink 10 ml three times a day. my specialist feels the liquid form mixed with water will be more beneficial than a pill. Question: Is the potassium bad for my kidneys? Are protein, salt and sugar bad for m kidneys at this stage? I form alot of oxalate and calcium stones because of the Crohn’s disease and past surgeries. In remission now, with a subtotal colectomy and ileo sigmoid anastamosis. I get small bowel obstructions periodically. Thank You
Hi Jane, Stage 3 CKD poses no real problems for potassium citrate in most people. Often, diarrhea from bowel disease causes enough sodium loss one can use plain sodium bicarbonate that is far more tolerable. The main issues with small bowel obstruction are low urine volume from diarrhea, high urine oxalate, and sometimes low urine pH. The former often responds to beverages with glucose in them that are absorbed well in the jejunum – ask your GI specialist. The high oxalate can respond to extra calcium with your main meals, or may require oxalate binders. Because the underlying disease is complex how to use these will also be complex and I can make only general comments. Regards, Fred Coe