What is a Low-Potassium Diet?

In This Article

Hyperkalemia is the medical term for having too much potassium in your blood. It’s common in people with chronic kidney disease and diabetes. If it goes untreated, hyperkalemia can be fatal. If your potassium levels rise above normal levels, your doctor may prescribe you a low potassium diet.

Benefits

Potassium is a major dietary mineral that is essential for keeping your nervous and cardiovascular systems functioning. Potassium from the food you eat is an important component of blood pressure regulation. It also helps keep your body's pH balance in check.

Your kidneys regulate potassium in your body. Certain health conditions and some medications can affect how well your body gets rid of extra (excretes) potassium, making your levels too high or too low (hypokalemia). 

Normal potassium levels are between 3.5 to 5.0 mmol/L. If your potassium levels are 6.0 mmol/L or higher, you must seek immediate medical treatment.

You’re at risk for hyperkalemia if you have certain medical conditions, including chronic kidney disease, kidney failure, type 1 diabetes, and Addison’s disease. 

If your potassium levels are high for a long time as a result of a medical condition, you may be more likely to have damage to your muscular and nervous systems. One of the reasons this can happen is that it may take months for your potassium levels to get high. During that time, you may not have any symptoms.

Research has shown some negative effects of high potassium may respond to a low-potassium diet. For example, a 2017 study published in the Clinical Journal of the American Society of Nephrology found that patients with stage 3-4 chronic kidney disease were less likely to experience neuropathy on a potassium-restricted diet.  

Taking medications such as renin-angiotensin-aldosterone system (RAAS) inhibitors or angiotensin-converting enzyme (ACE) inhibitors can increase potassium levels. If you are prescribed medication that could affect your kidney’s ability to regulate potassium excretion, your doctor may want you to monitor and limit your dietary potassium intake, as this has been shown to help patients manage their levels. 

How It Works

You may be able to help regulate the levels of potassium in your body by changing what you eat. A low potassium diet is one of the first treatments your doctor may prescribe if you have hyperkalemia. 

The average adult needs between 3500-4500 milligrams of potassium each day. If you have hyperkalemia or are at risk for developing it, your doctor will likely have you limit your intake of potassium to 2,000 milligrams per day.

Going on a low potassium diet presents some unique challenges, as you will need to limit some otherwise healthy foods. Potassium-rich foods, including many fruits and vegetables, are staples of a balanced diet and provide a great deal of nutrition. 

Several research studies have looked at whether potassium-restricted diets are helpful for certain people, such as patients with kidney disease who are on dialysis. A 2016 study cited inconclusive evidence of a strict low-potassium diet’s effectiveness, in part because it’s unclear whether the body considers all dietary sources of potassium (plant and animal) equal. 

The study's findings also suggest potassium-restricted diets may do more harm than good for some patients. However, because there are no other evidence-based dietary treatments for hyperkalemia, most researchers believe doctors should continue to prescribe low-potassium diets. 

The good news is, there are many nutritious low-potassium foods to choose from and you may be able to include small portions of high-potassium foods in your diet.  

You may find it helpful to work with a registered dietitian to create a low-potassium meal plan that’s as individualized as possible. 

Hyperkalemia Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Man

Duration

If your potassium levels are high due to a chronic health condition, you may need to make permanent changes to your diet to keep your levels managed. In some cases, following a potassium-restricted diet may not be enough. If your potassium levels don't respond to changes in your diet, you may need to take medication or have dialysis treatments

What to Eat

Most foods contain some potassium. If you’re on a potassium-restricted diet, you’ll need to avoid foods that are high in potassium (generally over 200 milligrams per serving). You’ll also need to avoid consuming large quantities of any food or drink that contains potassium—even low amounts—as this can also raise potassium levels

Your doctor and a dietician can help determine how many servings of low-potassium foods (generally 150 milligrams or less per serving) you can have each day. 

Compliant

  • Chicken or turkey (3 ounces)

  • Tuna, pork, baloney, or shrimp (1 ounce)

  • Green beans

  • Peppers

  • Eggplant

  • Canned water chestnuts (drained and rinsed)

  • Onions

  • Parsley

  • Snow peas

  • Rhubarb

  • Radishes

  • Asparagus

  • Cauliflower

  • Cucumbers 

  • Corn

  • Kale

  • Iceberg lettuce 

  • Scallions

  • Zucchini

  • Watercress 

  • Cabbage (cooked)

  • Carrots (cooked)

  • Broccoli (raw)

  • Apples, applesauce

  • Blackberries, blueberries, cranberries, raspberries, strawberries, cherries

  • Peaches

  • Grapefruit

  • Plums

  • Grapes

  • Pears

  • Mandarin oranges

  • Tangerines

  • Canned fruit cocktail (drained and rinsed)

  • Watermelon

  • Pineapple

  • Hard cheese

  • Cottage cheese

  • Egg whites

  • Refined white flour bread, pasta, and cereals

  • White rice

  • Corn chips, crackers, popcorn

  • Apple, grape, pineapple juice

  • Rice milk

  • Non-dairy creamer

  • Powdered mixed drinks (Kool-Aid)

  • Iced or hot tea (16 fl oz / day) and coffee ( 8fl oz/day)

  • Yellow cake, angel cake, cookies without nuts or chocolate, pies without high-potassium fruit or chocolate

Non-Compliant

  • Most fish (including salmon and halibut)

  • Shellfish, including clams, scallops, lobster

  • Sardines

  • Red meat

  • Spinach (cooked)

  • Greens (except kale), bamboo shoots, cabbage, Swiss chard

  • Artichokes

  • Potato, sweet potato

  • Bok Choy

  • Carrots (raw) 

  • Squash

  • Parsnips

  • Brussels sprouts

  • Mushrooms

  • Pumpkin

  • Broccoli (cooked)

  • Okra

  • Beets

  • Papaya

  • Mango

  • Dried fruit

  • Dates

  • Nectarines

  • Avocado

  • Pomegranate

  • Bananas 

  • Plantains

  • Kiwi

  • Oranges

  • Yams

  • Pears

  • Coconut

  • Cantaloupe

  • Honeydew melon

  • Tomato, tomato products

  • Prunes

  • Apricots

  • All dairy products (except some cheese and sour cream)

  • Pinto, kidney, black, lima, soy, and navy beans

  • Tofu

  • Lentils

  • Bran

  • Granola

  • Oats and oatmeal

  • Whole-grain bread, baked goods, and cereal

  • Nuts and seeds (limited portions may be approved)

  • Peanut butter, other nut butters

  • Molasses

  • Chocolate

  • Figs

  • Fruit and vegetable juice, soy milk, electrolyte-replacement drinks (Gatorade, Powerade)

Fruits and Vegetables: Fresh produce is generally rich in potassium. When eaten raw, many fruits and veggies are too high in potassium for a restricted diet. However, you may be able to have them if you limit portions and/or cook them to reduce the potassium content. Canned fruits and vegetables can also work as long as you drain and rinse them. 

Avoid high-potassium herbs such as alfalfa, dandelion, and nettle which are often used in tea or seasoning blends.

Dairy: Milk products need to be avoided, or at least limited, on a low-potassium diet. You may be able to have a small serving of milk or yogurt each day. Some types of cheese (including cottage cheese) are low enough in potassium that you may be able to include them in your diet.

If you add milk to your tea or coffee, switch to a non-dairy creamer or milk alternative such as rice milk.

Grains: Instead of whole grains and bran, look for rice cereals or bread made from refined flour. White rice, pasta noodles made from refined white flour, and white potato that’s been peeled and boiled are approved on a low-potassium diet. Saltines or soda crackers, unbuttered popcorn, and puffed rice are lower-potassium snack options.

Protein: Most animal and plant-based protein are high in potassium. However, you need to include some protein in your diet. Choose lower-potassium options or have smaller portions of high-potassium sources.

Egg whites are one lower-potassium option. You may be able to have small servings of nuts (one small handful) or peanut butter (a single tablespoon). 

Avoid sausage, bacon, lunchmeats, and any other processed meat with additives that may contain potassium. Whenever you cook meat of any kind, be sure to drain the juices and discard them instead of using for sauces, basting, or gravy. 

Desserts: Many sweets are made with ingredients that are high in potassium, such as nuts, syrups, and chocolate. Be careful when choosing cookies, cakes, and ice cream. Look for plain yellow cakes (such as angel food or sponge cake) with no icing, frosting, toppings, or fillings. 

Clear gelatin, honey, and maple syrup are lower-potassium sweets. If you’re baking, white sugar is a lower-potassium choice than brown sugar. 

Beverages: Dehydration can disrupt the electrolyte balance in your body and lead to hyperkalemia. Water is the best choice for staying hydrated, but other approved beverages on a low-potassium diet include fresh lemonade and juice made from low-potassium fruit or frozen fruit concentrate. 

Tea is also acceptable, as long as you stick to 16 ounces per day. It can be served hot or on ice with lemon and sugar or honey. You can also have one eight-ounce cup of iced or hot coffee with non-dairy creamer.

You may want to avoid drinking alcoholic beverages if you're on a potassium-restricted diet. In fact, consuming large amounts of alcohol is a risk factor for hyperkalemia.

Cooking Tips

If you don't want to completely give up your favorite high-potassium produce, you'll want to learn how to leach vegetables. While this cooking method can make some higher potassium foods safer to eat, talk to your doctor before you add leached vegetables to your diet. Even if you remove some of the potassium from a vegetable, you’ll still want to only have it on occasion. 

How to Leach Vegetables

  1. Wash veggies in cold water (carrots, potatoes, squash, etc.)
  2. Peel and thinly slice veggies, then rinse under warm water.  
  3. Add unsalted warm water to a pot or bowl (you’ll need a ratio of about 10 parts water to one part vegetable). 
  4. Soak vegetables for at least two hours. You can soak for up to 12 hours just be sure to change the water every four hours. 
  5. Remove vegetables from the soak, rinse in warm water.
  6. Cook in unsalted water using a ratio of about five parts water to one part vegetable.
  7. Be sure to drain the cooking water when finished, as that’s where the leached potassium has collected.

Considerations

Making changes to your diet can affect other areas of your life—and vice versa. Your day to day routine, responsibilities at home and work, and your social life can influence how easy (or difficult) following a specific diet will be.

Understanding how each aspect of your life affects the decisions you make about the food you eat will help you prepare to make changes and stick with them.

Safety

Hyperkalemia is usually caused by an illness or medication. In rare cases, it can happen if you take large doses of supplemental potassium. If you have hyperkalemia, do not take potassium supplements or nutritional supplements that contain potassium unless directed by your doctor. 

Flexibility

It's possible to dine out on a low-potassium diet, but you may need to exercise extra caution when evaluating your options.

Just as you would when preparing meals at home, choose low-potassium foods and keep an eye on portions. When you’re eating at a restaurant or hitting the drive-thru for fast food, remember that relatively low-potassium foods may be served in large portions. 

As you’re shopping for groceries, carefully read nutritional labels on all store-bought food items. The upcoming 2020-2021 updated FDA food labeling guidelines require potassium quantities to be displayed, but until then you'll need to check the ingredients list for potassium-rich foods. 

Dietary Restrictions

You may have other dietary needs and preferences to consider along with your low-potassium diet. For example, you may need to avoid gluten due to Celiac disease, or you may prefer to follow a plant-based diet. 

Proper nourishment is essential for your overall health, but it can be hard to maintain when you're on a limited diet. You'll need to work with your doctor and nutrition experts to figure out how to meet all your dietary needs. 

Additionally, if you have another health condition that can be affected by your diet, such as high blood pressure (hypertension) or diabetes, your doctor may have you make other changes to what you eat and drink. 

If you’re overweight or have other risk factors (such as a family history of heart disease) your doctor may suggest you limit your fat intake. High-fat, high-cholesterol foods not only put stress on your kidneys, but they can also contribute to obesity and conditions such as atherosclerosis

Side Effects

The most common side effect of a low-potassium diet is constipation. If you’re not able to increase your intake of fiber-rich foods, your doctor may suggest a fiber supplement

You should also be aware of the signs of an acute spike in your potassium levels, which can be dangerous. A sudden rise in potassium can affect your heartbeat. 

More subtle symptoms of hyperkalemia include general fatigue and nausea, but acute hyperkalemia can cause trouble breathing, a racing heart, and chest pain. If you have these symptoms, seek immediate emergency medical care. 

Low Potassium Diet vs. Other Diets

Renal Diet

If you have hyperkalemia due to chronic kidney disease, your doctor may put you on a renal diet. Sodium-restricted diets and restricted fluid diets may also be prescribed separately, depending on your needs. 

On a renal diet, you will reduce your intake of sodium, phosphorus, protein, and sometimes fluid, in addition to limiting your potassium intake. 

Your potassium levels are related to your body’s sodium levels. If your potassium levels are high because your kidney function is poor, your doctor might tell you to watch your salt intake to make sure you don’t put too much stress on your kidneys. 

Your doctor might tell you to mind your sodium intake, as salty foods can make you thirsty. If you have high blood pressure, you may be prescribed a sodium-restricted diet. However, if you are also on a low-potassium diet, you would need to avoid popular salt substitutes, as they are often made with potassium. 

Drinking a lot of water or other fluids makes your kidneys work hard. If your kidney function is impaired, your doctor may ask you to restrict your fluid intake. Proper hydration is essential to your overall health, so you will need to closely follow your doctor’s orders to avoid dehydration. They will help you determine your individual fluid needs. 

A Word From Verywell

Potassium is an essential mineral the body needs to function properly, but sometimes too much builds up in the blood. Usually, this happens because of a medical condition. Your doctor will likely want you to try eating less potassium-rich foods to help lower your levels. You may also need to take medications or restrict other elements of your diet, such as sodium or fluid, to get your potassium levels back to normal. Having dangerously high potassium levels (6 mmol/L or above) is a medical emergency. While high potassium doesn’t always cause symptoms, if you experience chest pain, trouble breathing, or heart palpitations, go to the emergency room. 

Was this page helpful?

Article Sources