High Blood Pressure and Proper Potassium/Sodium Ratios

Q I recently had a physical and was found to have elevated potassium levels. Not dangerously so. But just higher than “normal.” Is the primary issue potassium/sodium balance? I understand Terry Schiavo went into her vegetative state as a result of a potassium imbalance.

Is it true that hundreds of generations ago mankind took in six times as much potassium as sodium, but now the ratio is four times as much sodium as potassium? I know I have evolved, along with my contemporaries, to have higher sodium, but what is the proper balance?

ANDRE, Dickinson, ND

A On admission to the hospital, Terry Schiavo’s serum potassium level was noted to be very low, at 2.0 mEq/L. For analysis of what the appropriate ratios should be, see “Potassium Bicarbonate Supplementation” and “Potassium Bicarbonate for Reduced Blood Pressure and Increased Muscle Mass,” both in the April issue. In the first article, Durk Pearson and Sandy Shaw report that “the Stone Age human potassium intake averaged 400 ± 125 mEq/d [about 15 grams per day!], which exceeds the NHANES III [Third National Health and Nutrition Examination Survey, 1988-1994] age-grouped averages (~60-85 mEq/d) [2.3–3.3 grams/d] by factors greater than 4.”1-2

Furthermore, this amount also “exceeds the 120 mEq/d set for adequate intake by the Food and Nutrition Board of the Institute of Medicine in 2004 and 2006 and the same value, 120 mEq/d recommended by the U.S. Department of Agriculture in 2005 [4.7 grams per day].”1 Thus, “the potassium content of the average American adult diet is only 50% to 70% of the amount recommended. This means that most American diets are officially deficient in potassium. Worse yet, we believe that the official RDA is too low.”2


  1. Sebastian et al. The evolution-informed optimal dietary potassium intake of human beings greatly exceeds current and recommended intakes. Semin Nephrol 26:447-53 (2006).
  2. Pearson D, Shaw S. Potassium Bicarbonate Supplementation. Life Enhancement, April, 2009.

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