by Neil Bauman, Ph.D.
A lady asked:
Have you heard about potassium gluconate having ototoxic effects? I have been diagnosed with Meniere’s Disease. My ENT put me on a diuretic and a daily dose of 550 mg of potassium gluconate, Almost as soon as I started on it, my tinnitus started to roar and I was hearing very little. I experienced slight to severe vertigo at least two out of every three days during that time. When I stopped taking the potassium gluconate, I noticed an improvement in my tinnitus after only one day. After 2-3 days it was back to its familiar hiss. The vertigo stopped completely the first day, and has not come back in the week I have been off the potassium gluconate. Also, my hearing rebounded almost back to normal in the week I have been off the potassium, but an audiogram confirmed I have lost a bit more hearing. My ENT doesn’t think there’s a connection. Do you know if there is any evidence beyond my anecdotal experience that potassium gluconate could be the cause?
This same lady, a few weeks later, wrote,
I recently decided (again) that it was time to lose weight, and thought I’d use SlimFast to get a jump start on it. I immediately experienced extreme tinnitus and hearing loss. When I checked the label, I found that it is high in potassium—in fact it contains 550 mg—the same amount I was taking in the supplement that caused me trouble before. I stopped the SlimFast and the problems decreased again. I have not gotten back to where I was before the 30 days on potassium, but at least it’s no longer getting worse.
One reference says that taking potassium gluconate can cause ringing in the ears (tinnitus) and sudden hearing loss so obviously you are not alone. (1)
Also, in the same article it explains “Potassium gluconate can decrease blood flow to the optic nerve of the eye, causing sudden vision loss.”
If potassium gluconate can do this to our eyes, it seems likely that it also does the same to the tiny arteries in our inner ears. This would starve the hair cells of oxygen, causing them to be “sick” (to use a fancy medical term). The result could be instant tinnitus and a temporary sudden hearing loss, as well as balance problems such as vertigo when taking potassium gluconate in higher doses.
When you stop taking potassium gluconate, inner-ear blood flow (hopefully) returns to normal. As a result, some/all hearing returns and the tinnitus goes away or decreases. However, this is only true if the hair cells were “sick” from lack of oxygen. If they actually died (and some may die) then you would be left with some degree of permanent hearing loss. I think the longer you take this medication, the weaker the hair cells become and some begin to die—thus resulting in permanent hearing loss. That is why the sooner you stop taking the drug, the better your chances are for near-normal recovery.
Adequate potassium intake is necessary to a healthy body. However, it seems that the potassium dose you were taking was too high for you. From what I can gather, 500 mg a day is about the safe upper limit. After that, ear damage can begin. A more conservative dose is 100 mg, 3 times a day as the maximum.
You may find you can take potassium gluconate, but at a lower dose. It is something you might want to try if you think the potassium gluconate was helping your body (apart from your ears).
In any case, whenever your tinnitus suddenly increases when you start taking a drug, consider it a warning that the drug is causing ear damage at that dose. You need to pay attention to that warning before other ear damage also becomes apparent. Either reduce the dose or stop taking the drug, but run this by your doctor first of course.
(1) Potassium gluconate.
The foregoing problem with potassium is news to me. On the contrary, it is SALT that gives me the tennitus and that pain of pressure behind my ear drum. Salt is in so many things I love, even the brined fried chicken, and the food store rotisserie chicken, not to mention all the condiments. Immediately after eating canned soup, high BP and roaring ears occurs.
I had read of the imbalance between salt and potassium in the inner ear.
Knowing I was probably already getting more salt in just about everything, I resumed taking potass, (but with calcium and magnesium as I’d read they worked best together.
My ENT had at one time suggested Menieres disease, but I have no vertigo except after fishing off the gulf coast. Just the ringing and ear pain. Because potassium seems to be important to me, (in fact, I think of it as my “brain food”), I’l sure want to look into this further. Certainly grateful for the above article
I just found this article I have Menieres disease also. Back in November I developed it in my Left ear also so now I have it in both. I resumed taking Potassium Gluconate about 4 days ago after not taking it for almost a year. Since then the tinnitus has become extreme to where at times it is a roar and at other times it sounds like im standing right next to one of those giant power transformers. I work at a job where im on the phone all day and noticed today that everyone sounded like the teacher from the Charlie Brown cartoons. I havent taken the Potassium Gluconate since yesterday I forgot this morning to take it. I am planning on staying off of it for a few days and see if my hearing improves. I have been on Hydrochlorothiazide for a few years now to help control blood pressure. So I had started taking the Potassium again to hopefully assist in regulating the sodium and also with my fluid retention and blood pressure.
Hydrochlorothiazide also raises the volume of my tinnitus significantly but Hyperkalemia does as well so I need the medication to lower potassium. I appreciate above comment and will try lowering salt intake too.
I drink Glaceau Vitamin Water. I drink about 3 bottles per day. The label says it contains 880 mg of Potassium (25% of the bottle). Is this too much and could it make my Tinnitus worse?
Thanks.
Hi Don:
You’re the best person to know since you’re the only person that can hear your tinnitus. If you’ve been drinking 3 bottles a day you should know by now whether your tinnitus is worse or not.
Personally, I think you’d be better off drinking plain water. That is what I do.
Furthermore, you don’t want to take a lot of one element such as potassium and not the corresponding balancing amounts of other elements. Your body is a complex organism that requires many different minerals–all in the correct proportion to each other. Taking too much of one throws everything out of balance and that causes health problems.
The formulation you are taking gives you a lot of Potassium and no other minerals–so you know you must be throwing your body out of whack when you drink it–not a good idea.
Regards
Neil
Thank you all for this insight, wow I have been on a weight loss program and was prescribed potassium 4 blue pills per day and seem to have gotten sudden tinnitus in the right ear. It is the only different thing other than working with autism and one individual jumped crashing to the floor 5 times beside the right of me. I thought maybe it was that noise but its been 6 days now and I went to the doctor who prescribed me antibiotics for a possible ear infection but after 3 days of antibiotics no change to the tinnitus.
Hi Tanya:
It’s stupid to prescribe antibiotics unless there is clear evidence of an infection and you have given no indication of that. So many antibiotics can CAUSE tinnitus and other problems so should only be taken when really needed.
If you lose weight too fast, you can get tinnitus too. People describe this as a loud buzzing in their ears. If this is your problem, just slow the weight loss down to lose no more than 2 pounds a week or so.
If your tinnitus is the result of taking too much potassium, cut down on the dose to a more reasonable level as I explained in my article and see how it goes. Run it by your doctor too of course.
Cordially,
Neil
I took potassium after I got out of Hospital from heart failure. I took with a multi vitamin for leg cramps. It worked great. I only took 250mg though. Last year I laxed on both and my hair is thinner and I am heavier by 20 lbs. Back on the vitamines, and potassium now.
The article said:
“From what I can gather, 500 mg a day is about the safe upper limit”
The daily recommended value is roughly 3,000mg. 3oz of salmon for example contains 534mg potassium. One serving of french fries (116g) contains 677mg potassium. People are consuming way above 500mg everyday. Seems pretty safe to me.
It’s the gluconate that’s the problem.
Maybe better to use potassium chloride or potassium bicarbonate as a supplement
I was diagnosed with Minere’s Disease 2 weeks ago. Upon taking the diuretic, the noise lessened, but major foot, leg, and groin cramps started. I asked the doctor about potassiym. He said to stop the diuretic. I did and the roaring came back. I don’t know what to do about potassium because he never answered my question even after I called back to ask. The cramps are awful, but so is the roaring. Please advise, since he did not.
Hi Tamara:
Which diuretic were you taking. It helps to tell me this kind of information if you want help.
Some diuretics deplete your body of potassium and this leaves you open to cramps as you experienced. However, there is a special class of diuretics called potassium-sparing diruretics that don’t eliminate your potassium like the others do. So if you take one of these, maybe you won’t get cramps. They include Amiloride, Spironolactone and Triamterene.
Of course, you could always beef up your potassium on your own by eating foods high in potassium such as avocados, acorn squash, spinach, sweet potatoes, wild salmon, dried apricots, pomegranates, coconut water, white beans and bananas in that order.
And even better, if you want to get rid of your Meniere’s, instead of just “managing” it, I suggest you investigate treatment from a special kind of chiropractor that specializes in the upper cervical spine (UCS). These people are able to work wonders for certain ailments and they are very gentle–not the bone cracker kind. They focus mostly on your top two vertebra (C1 (Atlas) & C2 (Axis). If this joint is “off” then you could have some of the symptoms you are experiencing such as the ear problems and headaches.
You can find a chiropractor specializing in UCS by going to the following URL and entering your location. You can also read about the things these special chiropractors can do for you at this same website. Here is the URL.
http://www.upcspine.com/
Choose the “Practitioners” link along the top to find the one closest to you.
There is a lot of good information on UCS chiropractic on this page also.
Also, read my comprehensive article on Meniere’s and how to get rid of it at http://hearinglosshelp.com/blog/atlas-adjustments-alleviate-menieres-disease/. So far, everyone that has tried this and reported back to me has had success–so I know it works.
Cordially,
Neil
Hi, I have fluid retention and get puffy ankles but the biggest problem is that I have a blocked ear with tinnitus and I can feel fluid running from under my skin on my head and face which seems to pool in my inner ear. I can feel it draining down and when it does, the noise stops. I have a high potassium level, could this be linked? What can I do about it? Any ideas really helpful.
Hi Sue:
I wish I could help you, but I don’t have any insight into this problem of yours. You need to go to a specialist and find out what is really going on.
Cordially,
Neil
Hi Sue
I have the same problem, did you ever find relied. I’ve have this for over a yeae
Hi DR Niel
I’m 58 years old, prediabetic, high colesterol over weight, I have had hepatitis B for more then 30 years. I’m taking Entercavier for the liver. This is my question. My ears ring every time I eat food high in potassium, I feel tire all the time, I have a sharp pain in the righ shoulder come and goes, and I get cramps at night on both calfves
Thank you Doctor
Hi Lina:
I’m not a medical doctor so I am just giving you some information that you can talk over with your doctor. I suspect you are not getting the right balance of some prime minerals–namely calcium, magnesium, potassium and sodium. If these are out of balance, you can have problems.
For example, if you are too low on magnesium (and I suspect you are) you can have the muscle cramps you are experiencing. Too much potassium (or maybe out of balance with these other minerals) can cause the tinnitus you are experiencing. My first thought is that if you boost your magnesium intake, you may fix both problems as low magnesium levels also affects your ears.
Cordially,
Neil
Hello,
About a month ago, I started taking potassium supplements to naturally treat my blood pressure. About 3 or 4 weeks ago, I had an unusual sore throat that lasted 1.5 weeks. I’ve also had major neck pain on my left side, same side as my Tinnitus.
I have had Tinnitus back in 2005 (3 months, resolved by acupuncture and herbs), again in 2015 (8 months, resolved with acupuncture and high magnesium intake) and about a week ago, it came back. This time, instead of ringing /high pitched frequence and eustachian tube dysfunction, I have the clicking noise.
Should I remove the potassium intake altogether? I’m thinking yes, but what could I use to treat my blood pressure outside of pharmaceuticals?
Also, I’ve been taking magnesium for quite some time w/out calcium, as I eat dairy and other calcium-rich food. I hear that taking too much calcium will cause artery calcification. Would this be alright? Thank you!
Hi Ana:
It wouldn’t hurt if you cut back on the potassium and see what happens. If your tinnitus goes away then maybe that’s a good indication that you’re taking too much potassium.
It’s good that you’re taking magnesium. Normally you would want your magnesium and calcium to be in a one to one ratio. But at the same time, you also need to have adequate vitamin D3. Are you taking a vitamin D3 supplement? most people are very low in vitamin D3. Your blood level of vitamin D3 should be somewhere between 60 and 80 ng/mL. If you are taking vitamin D3 in high doses, say more than 2000 IU per day, then you also need to take vitamin K2. This is very important, as vitamin K2 makes sure that the vitamin D3 doesn’t put the calcium in your blood vessels causing artery calcification, but in your bones where it belongs. So you always want to keep these in the proper ratios–calcium, magnesium, vitamin D3 and vitamin K2. when you do this, you don’t have to worry about artery calcification.
Cordially,
Neil
Is it just potassium gluconate that can cause tinnitus or any type? In order to boost my Iodine, I began taking Potassium Iodine and this week I increased to 775 mg/day and today – the fourth day – I’m experiencing a tremendous increase in my tinnitus accompanied by marked hearing loss in my left ear. And can I remedy this by increasing my salt? (I’ve experienced tinnitus w sudden hearing loss at least 2 times from overdoing my salt).
I just checked the bottle and I was mistaken in what I wrote above. It’s only 750 mcg daily of potassium iodide that I’m taking. Could such a tiny amount cause tinnitus? It’s true that I’ve been supplementing with 1/2 tsp of salt every day for decades to make up for extremely low aldosterone, so, in my unusual case, could just a tiny bit of potassium like this make such an imbalance to throw off my hearing? Much thanks in advance for your response.
Hi Shulamis:
If it’s only 750 mcg of potassium, I’d say the potassium is not the problem. Perhaps the iodine is the problem as it too can be ototoxic under the right conditions.
Rather than increasing your salt intake, just stop the potassium iodide for a few days and see what happens to your tinnitus and hearing loss. Maybe it is related, and then you’ll know. But on the other hand, maybe it isn’t related, and you’ll have to look elsewhere for the culprit.
Cordially,
Neil
Under what conditions would iodine be ototoxic? ( My doctor wrote to me that my iodine is VERY LOW [she added the caps}, and wants me to increase.)
Your responses are a treasure. So few web-experts answer questions from individuals. Much thanks
Hi Shulamis:
Iodine is only very mildly ototoxic according to my information. It mostly affects balance–dizziness and ataxia. I don’t think you have much to be worried about unless you are particularly sensitive to iodine.
Cordially,
Neil
Thank you, Dr. Bauman! Can I trouble you with one more question? Next week, I’m supposed to have an infusion of Zometa, a bone drug. I searched the internet and didn’t see any evidence of ototoxicity for Zometa. Would you know of any? The infusion is a big step for me, and I’d appreciate any help you’d like to offer. Much thanks, Shulamis
Hi Shulamis:
Actually, Zoledronic acid (Zometa) is quite ototoxic. Hearing loss is quite common, tinnitus about a third as much as hearing loss. And then there are all the balance problems too. I’d be careful about this drug, but if you need it, you need it.
Cordially,
Neil
Do you do phone or email consults?
Hi Susan:
Yes. You can reach me by phone or email. My contact information is given at the bottom of any page on the Center’s website.
Cordially,
Neil
Thank you for the information for Zometa. My hearing and tinnitus as been so volatile this summer that I can’t imagine risking the Zometa. Would an ibandronate infusion be any safer? Much thanks again!
Hi Shulamis:
Ibandronate (Boniva) has far fewer ototoxic side effect reports than has Zometa so it would seem a better choice–but both of these are fairly ototoxic. If these two are my choices, I’d opt for the Ibandronate.
Cordially,
Neil
Hi Dr. Bauman,
I have noticed a sudden hearing loss and ringing only in one ear within the last month. I saw a specialist that suggested a steroid injection in the ear drum. I did not mention this to him as I thought about it later but my very recent blood test showed a high leve of potassium. Could this be related ? Also, could lowering the potassium levels reduce the ringing or help to improve the loss of hearing? Thank you for your feedback!
Hi Mary:
High or low levels of potassium can indeed affect your hearing and tinnitus. So can getting your potassium/sodium ratio out of whack.
If the potassium levels in your inner ear are too high and thus causing hearing loss, getting the potassium levels down to the correct level can certainly make a difference.
How is your sodium level? Remember, you want to keep it in proper balance with your potassium level too.
I’m not an expert in this so find yourself a doctor that really understands the correct levels of these two elements and see how you ears do then.
Cordially,
Neil
Thank you Dr. Bauman for your feedback. My potassium level is 6.0 and sodium is 142.
I stopped eating banana and avocado and drinking more water so I hope this help with lowering the potassium level and eventually improve my hearing.
Thank you again for answering my question.
Dr. Bauman, I recently entered the hospital with irregular heartbeat, nothing much showed on blood tests other than Anion Gap being low and all previous Anion Gap chart numbers also always being near the bottom. My potassium level really dipped on this last test, but the doctors didn’t clue in on any of this. I’m a 56 year old male, average height and weight, non smoker, non drinker and eat a health conscious diet. I am often very pale, no color in face whatsoever and have a poor appetite, I’ve had long standing issues with a sensitive stomach and low iron, though am able to maintain a good number with supplementing of iron. My issues are chronic and I’ve had adrenal insufficiency in the past, which I had required cortisol replacement, but thankfully was able to wean off it a good ten years ago and no longer seem to experience the previous adrenal symptoms. I’m just wondering what might cause the low Anion Gap in the first place and associated low potassium, possibly a slight adrenal issue may remain? Chest xrays were normal as well as echocardiogram. Oh, yes, I also do have moderate tinnitus that developed over a year ago. Thank you kindly!
Hi Terry:
You have several issues that are well outside my areas of expertise. If I were in your shoes, I’d go to a naturopathic doctor (ND) and work with him to get your body into proper balance.
Cordially,
Neil
Primary put me on Triamterene HCTZ 75-50 which is what my Menieres Specialist at the House Ear Clinic had me on years ago. My last visit with primary put me on Potassium 20 meq 2x a day because my labs from 2 months earlier showed my potassium to be 3.0 (low). Since starting the potassium I have been having problems with my muscles feeling tight, cramping feeling, & heaviness. My hearing also dropped & lots of fullness in ear. I cutback potassium to just once a day because I thought maybe it was too much. Same problem with heaviness and cramp feeling. A few days ago I stopped taking it for a few days. Ears cleared up, I had more energy and no problem with walking. Last night I took one again after dinner because I felt like my muscles were cramping again. This morning woke up and my leg & arm feel like dead weight, some numbness, uncomfortable when walking. Not sure if potassium level is too high or still low. Primary just graduated from Residency program & new one not assigned yet. Hearing was also back to being fullness again.
Hi Jen:
From what you say, it appears that the potassium you are taking (in the way you are taking it)–pills and not from food–isn’t working for you and is, in fact, working against you.
Why not try eating foods high in potassium and forget the pills and see what happens. Maybe that is the trick.
If your muscles are cramping up, that is often a sign that you are low in magnesium. Maybe try some magnesium supplements. The most bioavailable form of magnesium is magnesium threonate. This is what I take daily.
Cordially,
Neil