The potassium supplement that I take with my lasix (80 mg.) is a really HUGE dose of potassium chloride. It's the biggest pill I've ever seen and must approach 2 grams total weight. It's called 20 Meq (millequivalents) of KCl which means 780 mg. potassium often referred to as K-Dur.
My doctor was going to prescribe TWO a day if after the first month my potassium showed low. However, since I came up with 4.6 mmol/L, smack in the middle of the range, there was no need.
I have always suspected that the warnings about the potassium retaining properties of ACEIs and ARBs were WAY overstated. I doubt very few prople have ever wound up with high potassium from anything like Altace.
So, yes, I think you can very easily and cheaply "fix" your low serum potassium and allow yourself to take diuretics. LOTS of people supplement their potasssium and these 800 mg. potassium supplements are available OTC in drug and vitamin stores everywhere EXCEPT IN THE UNITED STATES.
Since dietary minimum requirements are 2000 mg. and most people go between 2 and 4 grams a day, there's nothing fearsome about taking an extra 800 mg. especially when taking a diuretic which throws extra amounts out through the kidneys.
Incidentally, that 3.6 mmol/L minimum translates to 140 milligrams per Liter of blood.
Tell your doctor you'd rather add the 20 Meq. KCl than lose the HCTZ...it's completely rational and I'm SURE he'll comply. They split easily (with a hammer and chisel, they're so big:D) so if you want to ease into it you can take 10 Meq. There really is no downside.
Rigel has truth behind what he says, except the salt substitutes are no good for people who get 100% of their salt from processed food and never add ANY to their cooking...that's me to a T.
I've had 3 jars of Nu-Salt, No-Salt and Salt Substitute for years (over a decade actually) and they are still half full with yellowed labels that are beginning to flake off.
Vitamin store offerings of the 99mg supplements aren't worth the plastic they're bottled in; totally useless.
No side effects from the KCl that I've noticed. I think wisest to take with food because a large dose of "salt" like that can irritate/burn the stomach if taken on an empty stomach...probably like taking a teaspoonful of table salt.
Lasix however takes some getting used to. Water retention goes from water-filled to bone dry to all full up again in half a day! :D
Isn't it silly to hear every doctor preach about the dangers of low potassium and yet see so few willing to take the next logical step and supplement potassium? And that mantra about bananas and orange juice begins to wear thin after the first 20 years...and the 4 million extra calories from Chiquita and Tropicana!