This page about potassium citrate for gout, was last reviewed or updated on 20 May 2013.
Potassium citrate is one of the best vita-nutrients for gout. It can deliver huge benefits but you must do it right.
If you have gout, or are at risk of it due to uric acid levels above about 6.8 mg/dL(0.401 mmol/L), men, and 6.0 mg/dL(0.354 mmol/L),women, there is quite a risk of kidney stones developing. One estimate is that there is about a 20-25% chance that uric acid kidney stones will form in gout patients who have acidic urine. So your urine needs to be alkaline.
Keeping urine alkaline might also – eventually – help you avoid lithotripsy surgery for kidney stones.
Potassium is very alkaline. The citrate form of potassium is best because it is better absorbed in this form. Another good point about potassium, is that it's cheap.
Read on for other benefits of potassium for gout.... But please carefully note the cautions at the bottom of this page. Potassium citrate, like baking soda (bicarbonate of soda/ sodium bicarbonate) MUST be prescribed by a doctor (physician) who knows your medical condition and knows the other medications (pharmaceuticals) you may be taking. And your starting (baseline) serum (blood) level of potassium needs to be known.
How do you achieve alkaline urine? You take potassium citrate, or potassium-magnesium citrate, to raise your urine pH i.e. alkalize (alkalise) urine. Raising pH levels generally will probably raise urine pH, but potassium citrate has been found in studies to be good at raising urine pH.
Test your urine pH levels with pH test strips (stix). Testing tells you whether your urine is becoming more alkaline, and therefore whether what you are eating and drinking and/or the potassium citrate supplementation, is taking you towards the objective. With gout you need all the personal encouragement you can get and good news from the strips - also called stix - is one way of getting a psychological boost.
The testing procedure is easy. Make sure you follow the manufacturer's instructions' leaflet exactly and keep your doctor informed. Have him/her check your results periodically.
Note that pH testing also tests the pH of saliva, but here we are talking about testing the pH of urine.
At what pH level is urine acidic? Acidic urine is a urine pH measurement of about pH 5.0 – pH 5.5. How alkaline should your urine be? Accounts vary. I have read of numbers ranging from pH 6.2 up to pH 7.5. It is probably somewhat individual-specific, which is another reason why you must work with a doctor.
In one study, healthy women who raised their urine pH from 5.9 to 6.5, ( a large amount because this is a logarithmic scale), using an alkaline foods diet, increased their uric acid excretion about 37%. From 302 mg a day to 413 mg a day.(1)
When do you test? The best time to test is probably first thing in the morning before you have breakfast, since breakfast and subsequent foods affect pH levels. And because pH is more acidic in the morning. (The body it's said, becomes more acidic at night). In other words do it early, and always at the same time (more or less), so that comparisons are more accurate. One pH expert says you should test the second urine of the morning, not the first. Or test urine pH before going to bed, but always at this time (more or less) for the same accuracy reason. So when you write a record, note the time, as well as the date, of your test.
Dissolving kidney stones Even if uric acid stones have formed in the kidneys, potassium citrate has been found to be often effective in dissolving uric acid stones. It may also dissolve the more usual kidney stones made from various kinds of calcium. Both kinds of stones can become present in the kidneys in tandem. Usually the calcium ones are more numerous than the uric acid ones, but in gout patients they may be exclusively uric acid stones.
Potassium citrate for gout prevention Potassium citrate is also used to prevent urine acidity rising again and thus the patient's risk of kidney stones (of both kinds) re-forming. And it can reduce the risk of excess uric acid turning into MSU gout crystals and causing a gout attack.
Other causes of low urine pH Low urine pH may be caused by diarrhoea, (diarrhea). Diarrhoea is a common side effect of most gout drugs and especially colchicine, but also allopurinol, febuxostat, benzbromarone, the corticosteroids, and the NSAIDs such as indomethacin, ibuprofen and naproxen. And perhaps, probenecid and sulfinpyrazone.
Low urine pH may also be caused by dehydration i.e. not drinking enough water. That's another reason why you must drink lots of water on any gout treatment.
Dosage Take potassium citrate for gout ONLY as directed by your doctor, (physician). When more is learnt about how well it's working, the dose can be adjusted. Your starting level of blood (serum) potassium needs to be known. The amount in over the counter (OTC), and in for-sale-online potassium citrate tablets (99 mg), is not nearly enough. You need prescription (RX) potassium citrate at a much higher dosage.
On prescription (RX) it may come in liquid form, not as a tablet. If you find it unpalatable, consider mixing it with a fruit juice. Pure 100% cherry juice or 100% pure orange juice, made only from squeezed oranges, are good ideas because both are gout positive.
Potassium citrate does not always work effectively. If so, you could try a more alkaline diet (see the pH foods list). Foods high in potassium are usually alkaline. Potassium-magnesium citrate and potassium-sodium citrate have also been found to be effective and could also be tried.
If you live in a country where you can't obtain potassium citrate, or the other forms mentioned above, try increasing your potassium intake from foods, and a more alkaline diet. As noted above, a more alkaline diet was successful in a study in raising uric acid excretion by about 37%, which is considerable. (1) Also, discuss using chelated potassium (the chelated type is also better absorbed) with your doctor.
Cautions! If you are taking potassium citrate your blood potassium levels should be regularly checked by a doctor. This is even more important if you have any form of kidney disease. Excessively high potassium levels can cause hyperkalemia. Some symptoms of this are nausea (feeling sick), an irregular heartbeat, and kidney failure. It can even be life threatening. Low potassium can cause hypokalemia. Some symptoms of this are muscle weakness and cramps, fatigue, irregular heartbeats, and heart failure. Certain medications increase potassium levels.
(1) Aya Kanbara, Masayuki Hakoda, Issei Seyama Urine alkalization facilitates uric acid excretion. Nutrition Journal 2010, 9:45.
Visit our pH (alkaline gout remedies) testimonials page, where our visitors explain how pH helped them. And where you can learn something about alkaline remedies in the 19th century.
You can download the USDA National Nutrient database free from our free gout resources page. This shows the potassium content of foods. And you can download a list of the foods highest in potassium.
TEST your urine pH, as well as saliva pH, with this product from phionbalance.com. Advanced pH testing. Not expensive - 90 test strips. Used by practitioners.
Click on the image. It doesn't commit you, but takes you to this product's page at www.phionbalance.com