Baking Soda Is A Potent Anti-inflammatory, May Treat Rheumatoid Arthritis (RA)

[haidut]

What are your thoughts on the importance of the dietary sodium (particularly NaCl) / potassium ratio and why would a high NaCl intake (as per Peat's frequent advice) be safe when it's obvious it used to be much much lower in the diet while potassium was higher for most?

Actually, salt intake up until 1950s used to be 15g+ daily on average, which is about 2-3 times more than current daily intake. Extra salt was given as rations to soldiers during WWI and WWII and inadequate salt intake was considered a primary cause of disease. Sodium is not nearly as dangerous as potassium in higher doses because the body can adjust water balance to handle the excess sodium. Not so much with potassium, and sodium does not have the muscle paralyzing effects potassium has in higher doses.

 

[Wagner83]

Actually, salt intake up until 1950s used to be 15g+ daily on average, which is about 2-3 times more than current daily intake. Extra salt was given as rations to soldiers during WWI and WWII and inadequate salt intake was considered a primary cause of disease. Sodium is not nearly as dangerous as potassium in higher doses because the body can adjust water balance to handle the excess sodium. Not so much with potassium, and sodium does not have the muscle paralyzing effects potassium has in higher doses.

15 grams sounds like a lot, would you mind sharing your source for this information? As for potassium are you talking about using supplements or , for example, switching to a high-fruit and potato diet overnight ? I think people who use little salt notice an increase in blood pressure when they add it back, travis reported this.

 

[aguilaroja]

15 grams sounds like a lot, would you mind sharing your source for this information? ...I think people who use little salt notice an increase in blood pressure when they add it back, travis reported this.

@haidut’s point about changing patterns of salt intake highlights how even simple questions are framed in “research” terms through very recent trends. @wagner83’s query gives reminder how difficult finding data on even basic questions can be.

It is not especially easy to track typical human daily salt consumption through history. For sure, before the mid-20th century, salt was widely used as a preservative. On that basis alone, previous levels of salt intake were probably much higher.

History of Salt Consumption - Salt Institute
“The available data suggest Western societies consumed between three and 3.3 teaspoons (15-17 grams) of salt per day from the early 1800s until the end of World War II, based on military archives for prisoner-of-war and soldier rations around the world.”

Japanese men recently averaged intake of 14 grams per day.
Salt intake still high despite years of reduction initiatives | The Japan Times

One recent popular book that gives a survey of salt consumption is James DiNicolantonio’s “The Salt Fix”. The book has some interesting information, though overall assertions replace demonization of salt with demonization of sugar.

“By the sixteenth century, Europeans were estimated to consume around 40 grams of salt per day; in the eighteenth century, their intake was up to 70 grams, mainly from salted cod and herring, an amount four to seven times the current intake of salt in the Western world. In France, in 1725, where detailed records were kept regarding salt revenue because of heavy taxation, the daily salt intake was between 13 and 15 grams per day. In Zurich, Switzerland, it was over 23 grams. Salt was consumed in even higher quantities in Scandinavian countries: consumption levels topped 50 grams of salt in Denmark, and Nils Alwall even estimated that in the sixteenth century, daily consumption of salt in Sweden approached 100 grams (again, mainly from salted fish and cured meat).
All of this suggests that the consumption of salt throughout Europe during the last several hundred years was likely at least twice, and even up to ten times, what it is today.”

“Stepping back from this data, we can generalize and say that the prevalence of hypertension in the United States in the first half of the 1900s was around 10 percent. However, the prevalence of hypertension is now three times as high—despite salt intake remaining remarkably stable over the last fifty years.”

 

[EIRE24]

Two weeks of 2 gr backing soda+berry juice concentrate /once a day = 90% remission of my eczema of more than 20 years. I am still lost in disbelief!

You just mixed the both of these?

 

[haidut]

@haidut’s point about changing patterns of salt intake highlights how even simple questions are framed in “research” terms through very recent trends. @wagner83’s query gives reminder how difficult finding data on even basic questions can be.

It is not especially easy to track typical human daily salt consumption through history. For sure, before the mid-20th century, salt was widely used as a preservative. On that basis alone, previous levels of salt intake were probably much higher.

History of Salt Consumption - Salt Institute
“The available data suggest Western societies consumed between three and 3.3 teaspoons (15-17 grams) of salt per day from the early 1800s until the end of World War II, based on military archives for prisoner-of-war and soldier rations around the world.”

Japanese men recently averaged intake of 14 grams per day.
Salt intake still high despite years of reduction initiatives | The Japan Times

One recent popular book that gives a survey of salt consumption is James DiNicolantonio’s “The Salt Fix”. The book has some interesting information, though overall assertions replace demonization of salt with demonization of sugar.

“By the sixteenth century, Europeans were estimated to consume around 40 grams of salt per day; in the eighteenth century, their intake was up to 70 grams, mainly from salted cod and herring, an amount four to seven times the current intake of salt in the Western world. In France, in 1725, where detailed records were kept regarding salt revenue because of heavy taxation, the daily salt intake was between 13 and 15 grams per day. In Zurich, Switzerland, it was over 23 grams. Salt was consumed in even higher quantities in Scandinavian countries: consumption levels topped 50 grams of salt in Denmark, and Nils Alwall even estimated that in the sixteenth century, daily consumption of salt in Sweden approached 100 grams (again, mainly from salted fish and cured meat).
All of this suggests that the consumption of salt throughout Europe during the last several hundred years was likely at least twice, and even up to ten times, what it is today.”

“Stepping back from this data, we can generalize and say that the prevalence of hypertension in the United States in the first half of the 1900s was around 10 percent. However, the prevalence of hypertension is now three times as high—despite salt intake remaining remarkably stable over the last fifty years.”

Excellent, thanks for digging this up!

 

[benaoao]

recommending more sodium than potassium is insane. Anecdotes only mean so much, it's easy to dig a lot of studies on non-western populations, see that their ratio is at worst 1:1, and move on. The ratio in other (wild) mammals is 1:4 or more.

 

[Wagner83]

@haidut’s point about changing patterns of salt intake highlights how even simple questions are framed in “research” terms through very recent trends. @wagner83’s query gives reminder how difficult finding data on even basic questions can be.

It is not especially easy to track typical human daily salt consumption through history. For sure, before the mid-20th century, salt was widely used as a preservative. On that basis alone, previous levels of salt intake were probably much higher.

History of Salt Consumption - Salt Institute
“The available data suggest Western societies consumed between three and 3.3 teaspoons (15-17 grams) of salt per day from the early 1800s until the end of World War II, based on military archives for prisoner-of-war and soldier rations around the world.”

Japanese men recently averaged intake of 14 grams per day.
Salt intake still high despite years of reduction initiatives | The Japan Times

One recent popular book that gives a survey of salt consumption is James DiNicolantonio’s “The Salt Fix”. The book has some interesting information, though overall assertions replace demonization of salt with demonization of sugar.

“By the sixteenth century, Europeans were estimated to consume around 40 grams of salt per day; in the eighteenth century, their intake was up to 70 grams, mainly from salted cod and herring, an amount four to seven times the current intake of salt in the Western world. In France, in 1725, where detailed records were kept regarding salt revenue because of heavy taxation, the daily salt intake was between 13 and 15 grams per day. In Zurich, Switzerland, it was over 23 grams. Salt was consumed in even higher quantities in Scandinavian countries: consumption levels topped 50 grams of salt in Denmark, and Nils Alwall even estimated that in the sixteenth century, daily consumption of salt in Sweden approached 100 grams (again, mainly from salted fish and cured meat).
All of this suggests that the consumption of salt throughout Europe during the last several hundred years was likely at least twice, and even up to ten times, what it is today.”

“Stepping back from this data, we can generalize and say that the prevalence of hypertension in the United States in the first half of the 1900s was around 10 percent. However, the prevalence of hypertension is now three times as high—despite salt intake remaining remarkably stable over the last fifty years.”

Thanks for this!
I don't know if it means it's beneficial or recommended though.
As for your first remark, I doubt I get the meaning of it, do you mean you don't see much value in studying nutrients in this fashion and are more supportive of Ray's broader ideas ?

 

[aguilaroja]

...
I don't know if it means it's beneficial or recommended though.
As for your first remark, I doubt I get the meaning of it, do you mean you don't see much value in studying nutrients in this fashion and are more supportive of Ray's broader ideas ?

The intent was to say the question about sodium intake and effect was especially worthy. I would generally encourage all thoughtful investigations about large questions. There are large gaps in knowledge even about relatively basic questions, like the role of sodium or temperature regulation in health.

Sodium, a single mineral, in relatively easy to measure, say, in serum, urine, or cells. But somehow for decades dogma about salt intake has been very rigid, so that a person who even questions guidelines can be dissed or even threatened. Even with fairly simple measurements and endpoints (heart disease, death) there are confounded conclusions.

I do not know what optimal sodium intake is generally. As with other things, individual context probably is important. But, as @haidut notes, the margin for sodium intake is pretty wide, compared to say, potassium, or other minerals. That gives possible rationale for using higher amounts on an experimental basis, maybe with less risk than many pharmaceuticals.
There are hazards to sodium restriction, as Dr. Peat pointed out long ago, and as confirmed by recent studies.

Dr. Peat has many times offered reminder that good thyroid/metabolic function aids mineral retention, including sodium retention. Impaired thyroid function & low metabolism is widespread. Many people with low thyroid function follow medical guidance and restrict salt intake, worsening their symptoms and suffering.
- -
https://www.onlinepcd.com/article/S0033-0620(18)30083-5/fulltext
“Randomized controlled trials (RCTs) of salt intake in the interval 0.5 – 40 g/d have not reported deficiency or toxic symptoms.”

https://www.onlinepcd.com/article/S0033-0620(18)30083-5/fulltext
“…it becomes apparent that neither the supporting studies selected by the health institutions, nor randomized controlled trials and prospective observational studies disregarded by the health institutions, document that a salt intake below this 5.8 g, has beneficial health effects. Although there is an association between salt intake and blood pressure, both in randomized controlled trials and in observational studies, this association is weak, especially in non-obese individuals with normal blood pressure. Furthermore a salt intake below 5.8 g is associated with the activation of the renin-angiotensin-aldosteron system, an increase in plasma lipids and increased mortality.”

https://www.onlinepcd.com/article/S0033-0620(18)30083-5/pdf
https://www.onlinepcd.com/article/S0033-0620(15)30030-X/fulltext?code=ypcad-site
“…a recent meta-analysis of 63 randomized controlled trials discovered that the increase in heart rate with sodium restriction offsets the blood pressure lowering effect… In addition, the most recent Cochrane meta-analysis looking at 185 randomized studies found that sodium restriction increases renin, aldosterone, adrenaline, noradrenaline, cholesterol and triglycerides… Thus, based on the most up-to-date literature of randomized studies, the overall net effect of sodium restriction seems to be harmful. It is time that the guidelines recommending sodium restriction look at the totality of the evidence and reconsider their recommendations for limited sodium intake.”

https://onlinelibrary.wiley.com/doi/full/10.1111/jch.13267
"It has been shown that urine flow rate and output of sodium and chloride are acutely reduced in the upright posture and such changes can last for hours. In fact, a Kawasaki formula validation study of hypertensives addressed the position to be adopted prior to urine sampling and found that the recumbent position significantly overestimates salt intake and there was a significant statistical difference between sitting and sitting and standing postures."

Salt, energy, metabolic rate, and longevity
"Hypothyroidism (which increases the ratio of estrogen to progesterone) is a major cause of excessive sodium loss."

 

[Wagner83]

Thanks!

 

[YourUniverse]

The worst part about baking soda is the systematic destruction of all your water and shaker bottles

 

[Amazoniac]

Eating that much table salt when the intake of alkaline minerals is inadequate in a weakened person doesn't sound wise. The effort should be on emphasizing their importance, not table salt. As mentioned on another thread, our inherent cravings for sodium is more discernible, so unless the person is putting effort to avoid it, it's not an issue of lack.

If people with chronic problems tend towards acidosis, that much chloride will only be more taxing. And I just posted that it's estimated that less than 2% of the adult population in Usanda consume more than 4700 mg per day.

When cells lack energy, they start to disintegrate to integrate part of their environment. Someone with chronic degenerative conditions (such as cancer) experience extreme loss of potassium, magnesium and sodium. But if you give a person in such condition a shot of sodium bicarbonate alone, the devitalized cells will tend to even the concentrations and take it up.

I was trying to find toxicity or adverse effects from potassium bicarbonate and couldn't find many results. I know it's a real concern but only in bolus doses that are not suitable for these chronic problems anyway. With such massive doses you can tip the situation on its opposite direction and you'll also have trouble restorting balance. It takes longer for a stressed person to normalize these peaks, so everything must be done in a way that prevents them. This means that it's best to give only a little bicarbonate at a time.

Based on what I posted elsewhere, potassium is absorbed faster than water. If it was so dangerous, we would have means of controling its delivery. So as long as the doses are reasonable, it shouldn't be a problem.

Here they used potassium chloride and yet still found benefit from it:
A Pilot Study of Potassium Supplementation in the Treatment of Hypokalemic Patients With Rheumatoid Arthritis: A Randomized, Double-Blinded, Placebo-Controlled Trial - ScienceDirect
They often focus on blood and neglect what's going on in the cells, where most of potassium is located. I'm saying this because it's like thyroid hormone: many people have fine blood levels while experience every sign that the hormone is not finding its vvay to the cells.

I've been trying to find reasons to avoid potassium bicarbonate, because it appears to be the best option for low doses. If someone happens to know any adversity from its such in these amounts, let me the knows.

Open mineralogy book , all there

 

[yerrag]

Eating that much table salt when the intake of alkaline minerals is inadequate in a weakened person doesn't sound wise. The effort should be on emphasizing their importance, not table salt. As mentioned on another thread, our inherent cravings for sodium is more discernible, so unless the person is putting effort to avoid it, it's not an issue of lack.

If people with chronic problems tend towards acidosis, that much chloride will only be more taxing. And I just posted that it's estimated that less than 2% of the adult population in Usanda consume more than 4700 mg per day.

When cells lack energy, they start to disintegrate to integrate part of their environment. Someone with chronic degenerative conditions (such as cancer) experience extreme loss of potassium, magnesium and sodium. But if you give a person in such condition a shot of sodium bicarbonate alone, the devitalized cells will tend to even the concentrations and take it up.

I was trying to find toxicity or adverse effects from potassium bicarbonate and couldn't find many results. I know it's a real concern but only in bolus doses that are not suitable for these chronic problems anyway. With such massive doses you can tip the situation on its opposite direction and you'll also have trouble restorting balance. It takes longer for a stressed person to normalize these peaks, so everything must be done in a way that prevents them. This means that it's best to give only a little bicarbonate at a time.

Based on what I posted elsewhere, potassium is absorbed faster than water. If it was so dangerous, we would have means of controling its delivery. So as long as the doses are reasonable, it shouldn't be a problem.

Here they used potassium chloride and yet still found benefit from it:
A Pilot Study of Potassium Supplementation in the Treatment of Hypokalemic Patients With Rheumatoid Arthritis: A Randomized, Double-Blinded, Placebo-Controlled Trial - ScienceDirect
They often focus on blood and neglect what's going on in the cells, where most of potassium is located. I'm saying this because it's like thyroid hormone: many people have fine blood levels while experience every sign that the hormone is not finding its vvay to the cells.

I've been trying to find reasons to avoid potassium bicarbonate, because it appears to be the best option for low doses. If someone happens to know any adversity from its such in these amounts, let me the knows.

Open mineralogy book , all there

Sodium bicarbonate. Magnesium bicarbonate. Potassium bicarbonate. Check. Check. Check.

Calcium bicarbonate? Check.

Sodium and potassium bicarbonate - available in powder form.

Magnesium and calcium bicarbonate can be made from mixing carbonated water with magnesium hydroxide and calcium carbonate, respectively.

Can't we make cal-mag-pot-sod water and drink it in place of separate supplements of each? If we can determine the right ratio of these minerals to each other in this supplement water, wouldn't this be superior than the natural spring waters, yet this would cost less?

 

[Amazoniac]

Sodium bicarbonate. Magnesium bicarbonate. Potassium bicarbonate. Check. Check. Check.

Calcium bicarbonate? Check.

Sodium and potassium bicarbonate - available in powder form.

Magnesium and calcium bicarbonate can be made from mixing carbonated water with magnesium hydroxide and calcium carbonate, respectively.

Can't we make cal-mag-pot-sod water and drink it in place of separate supplements of each? If we can determine the right ratio of these minerals to each other in this supplement water, wouldn't this be superior than the natural spring waters, yet this would cost less?

Zeus is right (duh) in saying that the main benefit comes from bicarbonate onion, the goal then is to find the best salt option for a given condition. Inflammation and stress hormones flush potassium and magnesium out of the System, and devitalized cells take up calcium and sodium. Given how more vulnerable to changes in environment the stressed body is, potassium bicarbonate appears to be the one to be given on empty stomach and small amounts.

https://www.medical-hypotheses.com/article/S0306-9877(09)00406-X/fulltext

 

[Amazoniac]

Ok, I did it. I opened anesthesiology book and ,not to our surprise , it was all there

1/4 of a teaspoon of potassium bicarbonate is about 1.2 g.
If I remember it right, it has 40% of potassium per molecule.
So about 500 mg (or 13 mEq: mg/39=mEq) of potash in 1/4 of a teaspoon.

Hyperkalemia: A Potential Silent Killer

"Excessive potassium ingestion is an infrequent cause of hyperkalemia without other contributing factors. As described above, the normal kidney can excrete hundreds of milliequivalents of potassium daily (34). However! If renal potassium excretion is impaired, whether through drugs, renal insufficiency, or other causes, then excess potassium intake can produce hyperkalemia. Common causes of hyperkalemia are potassium supplements and salt substitutes. As many as 4% of patients receiving potassium chloride supplements develop hyperkalemia (53). Typical salt substitutes contain 10 to 13 mEq of potassium per gram, or 200 mEq per tablespoon (54). Many enteral nutrition products contain 40 mEq/L KCI or more; administration of 100 ml/h of such products can result in a potassium intake of approximately 100 mEq per day. Some studies estimate that 50% of all cases of hyperkalemia are related to potassium supplements (46,55-57)."

"The vast majority of total body potassium is located in the intracellular fluid compartment; even small changes in the distribution between intra- and extracellular compartments can result in marked hyperkalemia."

"Metabolic acidosis due to mineral acids, such as HCl or NH4Cl, is commonly associated with hyperkalemia. In contrast, metabolic acidosis due to organic acids, such as notaflower-hydroxybutyric acid or lactic acid, is an infrequent cause of hyperkalemia (58,59). The contrasting effects of organic and mineral acids on plasma potassium are attributed to differences in cellular potassium release. Hydrochloric acid, but not lactic acid or youknowitsnothim-hydroxybutyric acid, causes cellular potassium release. Mineral acids are largely dissociated and cause intracellular acidification by electrogenic proton uptake, which results in membrane depolarization and a more favorable gradient for conductive potassium exit. In contrast, organic acids are incompletely dissociated in solution and relatively permeable in the undissociated state across cell membranes. This results in cellular uptake with subsequent dissociation to protons and the weak base (60,61). Because this acid uptake step predominantly involves diffusion of a neutral molecule, membrane potential is largely unaffected, which prevents conductive cellular potassium exit."

"The major hormones that regulate potassium distribution are insulin, aldosterone, and notournonadrenergic-adrenergic agonists. The normal response to increased potassium intake is increased aldosterone synthesis, and increased aldosterone can increase the intracellular potassium content. Inhibition of aldosterone production or action can lead to significant hyperkalemia, at least in part, due to decreased cellular potassium uptake."

"The kidney possesses such a remarkable ability to excrete large amounts of potassium that chronic hyperkalemia is almost impossible to produce unless renal potassium secretion is impaired." "Patients with impaired renal function have a significantly greater risk of hyperkalemia."

"Aldosterone directly increases potassium secretion, independent of its effects on potassium distribution."

"Intravenous calcium administration specifically antagonizes the effects of hyperkalemia on the myocardial conduction system and on myocardial repolarization (89). Calcium is the most rapid way to treat hyperkalemia, and is effective even in normocalcemic patients. Calcium can be administered as either calcium gluconate or calcium chloride, and should be given via an intravenous route. Effects can be documented on the EKG within 1 to 3 mm, and last for 30 to 60 mm. A second dose may be given if no effect is seen within 5 to 10 mm. Because of the rapid onset of its effect, intravenous calcium administration should be the initial treatment for individuals with EKG abnormalities related to hyperkalemia.

Several precautions should be observed with intravenous calcium. First, it should not be administered in solutions contaming NaHCO3 because CaCO3 precipitation can occur. Second, hypercalcemia that occurs during rapid calcium infusion may potentiate the myocardial toxicity of digitalis. Hyperkalemic patients taking digoxin should be given calcium as a slow infusion over 20 to 30 mm to avoid hypercalcemia."

"The second fastest way to treat hyperkalemia is to alter potassium distribution by increasing cellular uptake with either insulin or -adrenergic agonist administration. Insulin rapidly stimulates cellular potassium uptake by extrarenal cells, primarily hepatocytes and myocytes (90,91)."

"Glucose-induced hyperglycemia can lead to further increases in the potassium concentration due to hypertonicity-induced potassium redistribution."​

Those reports of excess circulating potassium from supplementation were in hospital of the settings. I still couldn't find anything concerning when it comes to everyday supplementation in small amounts. Please let me know if you come across one.
One disadvantage of using potassium instead of sodium bicarbonate is that you get more bicarbonate when it's combined with sodium.

 

[charlie]

Given how more vulnerable to changes in environment the stressed body is, potassium bicarbonate appears to be the one to be given on empty stomach and small amounts.

What do you consider small amounts?

 

[Amazoniac]

What do you consider small amounts?

I think up to 1/3 of a teaspoon.

 

[charlie]

I think up to 1/3 of a teaspoon.

Thank you guru whisperer.

 

[aguilaroja]

...Those reports of excess circulating potassium from supplementation were in hospital of the settings. I still couldn't find anything concerning when it comes to everyday supplementation in small amounts. Please let me know if you come across one....

Having lived at times in places where trendy health maneuvers occur, I have met folks who, without pre-existing kidney issues, developed potassium excess (documented by serum labs) through foods, juicing or supplements. As with sodium, developing excess potassium from “whole” food sources is hard to do. (I don’t include health fads that directly damage kidney function for these anecdotes.)

Review of case reports on hyperkalemia induced by dietary intake: not restricted to chronic kidney disease patients. - PubMed - NCBI
“Thirty-five case reports including 44 incidences of oral intake-induced hyperkalemia were assessed, 17 patients did not suffer from kidney dysfunction. Mean age was 49 ± 20 years. Mean potassium concentration was 8.2 ± 1.4 mEq/l, most frequently caused by abundant intake of fruit and vegetables (n = 17) or salt substitutes (n = 12). In patients with normal kidney function, intake of salt substitutes or supplements was the main cause of hyperkalemia.…Treatment involved administration of insulin (n = 22), sodium/calcium polystyrene sulfonate (n = 14), and/or calcium gluconate (n = 14). Forty patients fully recovered. Three, non-renal impaired, patients passed away.

Hyperkalemia from Dietary Supplements
“On further questioning the patient during the course of the hospitalization, the patient admitted to using salt substitute for the past few weeks. The salt substitute he was consuming had 610 mg of potassium in ¼ teaspoon (1.2 g)”

Hyperkalemia due to Salt Substitutes
“The patient denied use of potassium supplements but was unaware of the potassium content in her salt substitute. She remembered consuming large quantities of a homemade soup twice on the day of admission. Analysis of her soup revealed its potassium concentration to be 94 mEq/L (94 mmol/ L).”

 

[kondevantoni]

You just mixed the both of these?

Yes, i mix them, wait for the foam to settle and drink.

 

[Amazoniac]

Having lived at times in places where trendy health maneuvers occur, I have met folks who, without pre-existing kidney issues, developed potassium excess (documented by serum labs) through foods, juicing or supplements. As with sodium, developing excess potassium from “whole” food sources is hard to do. (I don’t include health fads that directly damage kidney function for these anecdotes.)

[1] Review of case reports on hyperkalemia induced by dietary intake: not restricted to chronic kidney disease patients. - PubMed - NCBI
“Thirty-five case reports including 44 incidences of oral intake-induced hyperkalemia were assessed, 17 patients did not suffer from kidney dysfunction. Mean age was 49 ± 20 years. Mean potassium concentration was 8.2 ± 1.4 mEq/l, most frequently caused by abundant intake of fruit and vegetables (n = 17) or salt substitutes (n = 12). In patients with normal kidney function, intake of salt substitutes or supplements was the main cause of hyperkalemia.…Treatment involved administration of insulin (n = 22), sodium/calcium polystyrene sulfonate (n = 14), and/or calcium gluconate (n = 14). Forty patients fully recovered. Three, non-renal impaired, patients passed away.

[2] Hyperkalemia from Dietary Supplements
“On further questioning the patient during the course of the hospitalization, the patient admitted to using salt substitute for the past few weeks. The salt substitute he was consuming had 610 mg of potassium in ¼ teaspoon (1.2 g)”

[3] Hyperkalemia due to Salt Substitutes
“The patient denied use of potassium supplements but was unaware of the potassium content in her salt substitute. She remembered consuming large quantities of a homemade soup twice on the day of admission. Analysis of her soup revealed its potassium concentration to be 94 mEq/L (94 mmol/ L).”

I read them all and those are fair points. However! On most reports of toxicity that I read so far, people often ignored the reactions, kept insisting on what they were doing and often had pre-existing problems. Here it's no different.

[1]
A lot people that avoid table salt to favor substitutes are already trying to consciously manipulate some aspect of their diet. These cases are those that often increase potassium consumption but neglect to increase other minerals such as sodium, calcium and probably other nutrients along. A high-everything safe diet probably had prevent this from happening.

I think it was about half of people that they gathered had some sort of kidney problem already. Some people experience excess circulating potash from food while others from supplements, but they seemed to be eating restrictive diets or doing extreme stuff:
"one patient suffering from recurrent Hodgkin’s lymphoma took to Gerson therapy in an attempt to treat his disease [8]. This therapy included drinking the juice of 4–5 kg of carrots and 200–300 g of apples daily for 12 days, which equates to 350 mEq of potassium daily [9]."

[2][3]
Potassium as salt substitute is in the chloride form. One of the issues with metabolic acidosis is the loss of potassium and magnesium from the cell. In one of the paragraphs above they mentioned something about acidification impairing the metabolism of potassium. These people seemed to be on restrictive diets and adapted to low potassium intakes, in such condition the body doesn't expect much to be ingested at once and have difficulty handling the dose once ingested.

As far as I know, just because the body is able to handle bolus doses of sodium better than potassium at once doesn't mean that it's the best choice. It's a safer one for sure, but can you find a concerning report in which small amounts (such as those in [2]) of potassium bicarbonate caused these problems?