SubEx

Mineral · K⁺

Potassium

Second name on almost every electrolyte label, and the one with nothing to show for it in sport: measured beside sodium in the cramp studies, equally blank.

Findings
9
Best evidence
★★★
Open questions
2

At a glance

Myth check

Potassium is the other half of the electrolyte story. Get the sodium and potassium balance right and you fix the cramps, the flatness and the poor hydration that water alone leaves you with.

In the cramp studies, potassium does none of that work. Sweat potassium concentration and total potassium lost in sweat were the same in 350 collegiate athletes with and without a history of cramping, across eleven sports. Marathon runners who cramped had the same serum potassium as those who did not, and so did Ironman triathletes. Potassium does matter in a rehydration solution for illness, where it replaces what diarrhoea takes out, and it has its own everyday intake figure. Neither of those is the claim the sports aisle is making.

Potassium has earned its place in a rehydration sachet for illness and on a nutrition label. It has not earned the place the sports aisle gives it, where every measurement that would show it doing something comes back the same in the people who cramp and the people who do not.

The findingsStrongest first
Physical & bodyRehydration by mouth worked about as well as a drip in children

Across 17 trials and 1,811 children with gastroenteritis, drinking a rehydration solution matched an intravenous line, and those treated by mouth went home about a day sooner.

★★★Well replicated — this finding’s sources average out to meta-analyses, systematic reviews or high-powered trials.Children with gastroenteritis, which is nobody in a gym. The trials were graded poor to moderate quality and mostly unblinded, since a drink cannot be disguised as a drip. Each route carries its own complication: vein inflammation with the drip, a stalled gut with drinking, roughly one in 50 and one in 33. The death counts, six against two across four trials, are far too small to read anything into.Click to keep this openRecover faster
Physical & bodyDiluting the rehydration recipe made it work better

In hospitalised children with diarrhoea, a weaker solution left the odds of needing an unplanned drip at 0.59 times the older recipe's, with less stool and less vomiting.

★★★Well replicated — this finding’s sources average out to meta-analyses, systematic reviews or high-powered trials.Hospitalised children with acute diarrhoea, compared against another rehydration solution rather than against water, so nothing here reaches a well person drinking one. This is the 2002 version of a review since updated, cited for the finding that changed the formulation. The trials were mostly unblinded and largely in low- and middle-income hospital settings. Low blood sodium was looked for in only six trials with events in three, so that reassurance rests on thin data.Click to keep this openRecover faster
3
OtherThe daily sodium figure is a committee's estimate, not a measurement

Adults are given 1,500 mg of sodium a day, about 3.8 g of table salt, and 3,400 mg of potassium for men or 2,600 mg for women. No measured requirement exists.

★★☆Single study — solid evidence, such as one good trial or a large observational dataset, but not replicated at the top tier.These are general-population reference values, not sport nutrition, and they describe what a healthy adult is thought to need over a day rather than what anyone should drink during exercise. The salt equivalent is arithmetic from the sodium figure, not a separately measured value. The report's own opening observation is that what you eat does not usually move your blood electrolyte levels, because the kidneys and hormones hold them steady.Click to keep this openRecover faster
Physical & bodyAthletes who cramped had the same blood salts as those who did not

In 210 Ironman triathletes and 88 marathon finishers, the ones who cramped matched everyone else on sodium, potassium and how much weight they had lost.

★★☆Single study — solid evidence, such as one good trial or a large observational dataset, but not replicated at the top tier.One real exception sits inside the largest of these studies: among American footballers alone, sweat measurements did carry a weak signal, and in the other ten sports none did. Beyond that, cramping was self-reported throughout, and serum electrolytes were sampled before and after a race rather than inside the muscle at the moment a cramp struck, which is where the theory actually locates the problem. Forty-three crampers is enough to rule out a dominant effect, not a small one.Click to keep this openRelieve pain
Physical & bodyMarathon runners who cramped showed more muscle damage, not less salt

Twenty of 88 marathon finishers cramped. They matched everyone else on sodium, potassium and hydration, and carried more of the enzymes that leak from injured muscle.

★★☆Single study — solid evidence, such as one good trial or a large observational dataset, but not replicated at the top tier.Twenty crampers is a small group, and the finish-line enzyme gap is borderline at p = 0.034 with spreads wide enough to swallow it. The blood was drawn after the cramp, so muscle damage could as easily follow a cramp as cause one. Crampers and non-crampers only diverged in pace from 25 kilometres onward, which points back at effort. The paper's own abstract calls 20 of 88 a rate of 24 percent; it is 22.7 percent.Click to keep this openRelieve pain
6
OtherNo upper limit has been set for sodium or potassium

The US National Academies could set no upper intake level for either mineral. For sodium it advised adults taking in over 2,300 mg a day to cut back instead.

★★☆Single study — solid evidence, such as one good trial or a large observational dataset, but not replicated at the top tier.This is a reference-intake document for the general population, not exercise guidance, and it says nothing about what to drink during a race. The 2,300 milligram figure is a chronic-disease risk-reduction value introduced in the same 2019 report, not a toxicity threshold, and the child and adolescent versions were extrapolated from the adult one rather than measured. Anyone whose kidneys or medication affect how they handle potassium sits outside all of it.Click to keep this openRecover faster
7
OtherA gram of table salt is 393 mg of sodium, not a gram

Table salt is sodium chloride, and sodium is 39 percent of it by weight. Potassium chloride, the usual salt substitute, is 52 percent potassium.

★★☆Single study — solid evidence, such as one good trial or a large observational dataset, but not replicated at the top tier.A chemical identity record, not a study: it says what these compounds weigh and nothing about what they do in a body. Both percentages were calculated from the retrieved molecular weights rather than read off the record, so they carry that rounding.Click to keep this openRecover faster
Physical & bodySweat testing flagged cramp-prone footballers and nobody else

Among 350 college athletes in eleven sports, sweat rate and sweat saltiness picked out cramp-prone American footballers only, and weakly: 0.65 to 0.72 where a coin toss is 0.5.

★☆☆Contested — the evidence disagrees with itself, or the finding carries a caution. A caution or conflict always shows one star, however strong the sources are.CautionWeak discrimination is not a screening test, and the authors do not offer it as one. Cramp history was self-reported, and sweat was collected during ordinary training, never during a cramp. Forearm patches estimate whole-body sweat sodium indirectly and carry real measurement error. One other significant result among roughly fourteen comparisons, potassium content in women, is what chance produces at that many tests.Click to keep this openRelieve pain
9
OtherOne product sold as a rehydration solution contains no sodium

A rehydration solution works by pairing sodium with glucose. This US-listed sachet declares neither: its active ingredients are potassium, magnesium and zinc.

★☆☆Contested — the evidence disagrees with itself, or the finding carries a caution. A caution or conflict always shows one star, however strong the sources are.CautionA label proves what a company was permitted to print, not that anything printed on it is true, and being listed on the US drug label database is not approval. This is one product, so it shows such a thing exists and is listed rather than that the category behaves this way. Its marketing text, including the three-bottles promise, sits inside the section reserved for safe-handling warnings, while the sections for indications, purpose, active ingredient and precautions are all empty.Click to keep this openRecover faster
Sources8 behind this page

What we don't know

2 open questions