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What is the mechanism by which sodium bicarbonate reduces lactic acid build-up?

Discussion in 'Post-Exertional Malaise, Fatigue, and Crashes' started by Basilico, Jun 25, 2017.

  1. Basilico

    Basilico Florida

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    I've been scouring through all the PEM-related threads discussing baking soda as an intervention to reduce PEM but I can't find the answer to a question I have.

    When consuming sodium bicarbonate (which is basic), it will mix with stomach acids (which are acidic) to form a neutral substance. How does having a neutral pH in the stomach cause a 'mopping up' of excess lactic acid?

    I could see this working if a sodium bicarbonate solution were being injected directly into the bloodstream, but since the baking soda gets neutralized in the stomach before it can reach the bloodstream, it seems like there is no way for it to do much of anything. Yet, people have been reporting benefits, so clearly something is happening.

    None of the threads I read through have proposed a mechanism of action (unless I missed something, which is possible). It is simply stated that baking soda neutralizes lactic acid. How could this be possible?

    I'm tagging @Hip because I know you've written extensively about this topic.
     
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  2. Hip

    Hip Senior Member

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    I don't really understand it fully myself, but I think you have to consider the body as a whole, and the overall effect of bicarbonate on the body. Bicarbonate has an overall alkalizing effect on the body, so I think that's how it helps neutralize lactic acid.

    Info on how bicarbonate helps reduce muscle lactic acid in this post.

    Note that the body contains a number of buffer systems that operate to keep the pH fixed to optimum values, in a dynamic equilibrium; so when we talk about a substance like bicarbonate having an alkalizing effect on the body, it does not actually really change the blood or tissue pH that much, but rather the bicarbonate effects the maintenance of the dynamic equilibrium, and helps that dynamic system deal with excess lactic acid.


    As well as bicarbonate, you can also use citrate to create an alkalizing effect on the body, so possibly citrate might work just as well as bicarbonate to counter lactic acid.

    You can buy trisodium citrate powder and tripotassium citrate powder quite cheaply on eBay and other places. I have tried these myself for alkalizing purposes. In my case, I have a built-in "gauge" in my body that can detect an alkalizing effect: because whenever I alkalize, either through an alkalizing diet or through taking daily bicarbonate, I get a certain lightheaded feeling. This is a sure indication that I am alkalizing. And when I tried citrate powders, it caused this lightheaded feeling just the same as bicarbonate does.

    The advantage of citrate over bicarbonate is that you can take citrate with food, and it will not affect digestion (whereas if you take bicarbonate with food, it will act to neutralize your stomach acid, making it harder for you to digest the food).
     
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  3. Hip

    Hip Senior Member

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    There is a list of studies in this post which indicate how supplements like creatine, citrulline, BCAA, Q10, bicarbonate and glutathione can reduce exercise-induced lactic acid, or reduce lactic acid in the blood.

    So all of these supplements will likely help reduce post-exertional malaise (PEM) by reducing lactic acid.

    See also this thread: List of Supplements Which Reduce PEM (Post-Exertional Malaise) Crashes
     
  4. Basilico

    Basilico Florida

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    I think this is where I'm stuck...trying to understand how it can neutralize lactic acid in the bloodstream if before it reaches the bloodstream it encounters hydrochloric acid in the stomach and is no longer basic. Should have the same effect as drinking water.
     
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  5. Hip

    Hip Senior Member

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    Here is my stab at explaining it: since we know an acid is a proton ion donor, and a base is a proton ion acceptor, when the stomach creates hydrochloric acid (to neutralize the bicarbonate), presumably it has to get those proton ions (hydrogen nuclei) from somewhere in the body order to manufacture the HCl. So then there will be a deficit of proton ions elsewhere in the body, thus making the body more alkaline.

    I am not sure if this explanation is scientifically correct though, as it is just my own way of trying to understand how bicarbonate has an overall alkalizing effect in the body.
     
    Last edited: Jun 27, 2017
  6. Basilico

    Basilico Florida

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    Thanks, @Hip - I'm aware there may be no actual published explanation in existence, but this at least gives me something to read about to see if it could explain the 'neutralizing effect'.
     
  7. Valentijn

    Valentijn WE ARE KINA

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    Placebo effect? It's effective in IV form, but no one has any scientific basis for claiming effectiveness when taken orally. And I agree that it really doesn't make sense.
     
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  8. Carl

    Carl

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    I did read that Carnosine is meant to have an effect on lactic acid in the muscles and that supplementation might help. However carnosine taken orally might not be too effective or last long. I have not read too much about it but it might be worth further investigation.

    I have seen CFS people report that their blood ph is higher than normal ie alkaline in which case taking further alkalizing substances might not be a good idea. Detoxing ammonia might be a better idea to lower blood ph. Limiting it's production would be the best idea and large amounts of ammonia can come from the stomach when urease is present.
     
  9. Keela Too

    Keela Too Sally Burch

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    I haven't read the full thread, but here are my thoughts - as someone who actually using bicarb to good effect :

    The stomach is mostly acid around the time you eat, so it will have less acid if you take bicarb away from meal times. This way, even if some bicarb gets neutralised on the way through the stomach, much of it will pass through the empty stomach to reach the rest of the intestine where it can be absorbed into the blood stream.

    The levels of bicarb are then elevated in the blood stream for a period of time that will gradually reach a peak (as it is absorbed) and then gradually decline (as it is either used in neutralising acids, or is removed from the blood stream by the kidneys etc.)

    My daughter has just finished a Sport & Exercise Science degree and she tells me that 45 mins in advance of an exertion episode is the time athletes use to take bicarbonate. They take quite a lot all at once, but I find for ME symptoms I'm better with a lower dose spaced through the day. (With more on more active days ;) ).

    Weirdly when I told my daughter the daily amount I was taking (self regulated to that level), it tallied with the grammes of bicarb per body mass in kg, that she had found in her notes!!! (Sorry can't locate the ref she sent me.)

    I have also found that taking bicarb improved my tendency to low blood pressure and so enabled me to remain upright for longer periods when that was a problem last year. I imagine that is just because of the added salt factor. (Being upright is less of a problem now, so I use bicarb now only when I either anticipate lactic acid burn, or when I am experiencing it after a busier than expected day.)

    Hope some of that is sorta useful.. :)
     
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  10. Hip

    Hip Senior Member

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    Oral sodium bicarbonate is routinely used as a medical treatment for metabolic acidosis, so I don't think there is any issue about whether it works. Oral bicarb does effectively lower body acidity.

    On examine.com, they detail numerous studies on the effects of sodium bicarbonate supplementation on blood acidity, lactate, exercise performance, etc.

    Though whether oral sodium bicarbonate can reduce PEM is another issue.

    In terms of the anecdotal evidence presented by patients on this forum (evidence found in the threads listed at the top of this post), it seems that very high dose Q10 (800 mg to 1800 mg daily) was quite effective in treating PEM, at least in one patient.

    Perhaps the best results might be obtained by taking a cocktail of several of the anti-PEM supplements listed in that post.



    The question posed by @Basilico is more about how can sodium bicarbonate work in situations where it is neutralized by stomach acid. My guess is that the alkalizing effect of bicarbonate will not be impeded even if bicarbonate is taken on a full stomach (when stomach acid is high), because you have to look at the body system as a whole.

    But in any case, it is not advisable to take bicarbonate is taken on a full stomach, as you don't want to neutralize stomach acid when you are digesting. So you would want to take the bicarbonate on an empty stomach, where there is not much stomach acid around.

    Or you can take oral citrate instead of bicarbonate, because you can take citrate on a full stomach, and it will not neutralize your stomach acid.

    Here is a paper showing that oral potassium citrate is also effective in reducing acidity in metabolic acidosis.
     
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  11. PennyIA

    PennyIA Senior Member

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    I'm having my lipomas issue again. Which seems to be a form of a relapse with major PEM from the slightest activities. With the PEM comes burning sensation immediately below the skin. Although I can't contribute to scientific discussion, I can state that within about 20 minutes of taking bicarbinate, there's a bit of a 'buzzing' sensation which I can feel where the burning sensation was, and within another 20 minutes those muscles in that area still hurt, but the BURN is gone.

    This leads me to believe that it's lactic acid from anaerobic energy that's being neutralized.
     
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  12. Basilico

    Basilico Florida

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    Thanks to everyone for your insights, it's starting to make much more sense how sodium bicarbonate could still act as a neutralizing agent when taken orally.
     
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  13. voner

    voner Senior Member

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    I find this interesting. also from examine.com:

    anyone with experience in dosing at the levels they describe in examine.com??
     
  14. Valentijn

    Valentijn WE ARE KINA

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    Nearly all of those studies involve less than 10 people, with a maximum of 25. Some involve infusions, and most don't mention lactate levels in the summaries. None of them seem to involve any unhealthy participants, which could be very relevant regarding the body's ability to adjust pH or lactate levels.

    Given 3-4 comparison groups in each trial, the extremely small sizes, and quite a few outcome measurements, I also have trouble believing there was any statistically significant outcomes.
     
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  15. Hip

    Hip Senior Member

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    You might be right, @Valentijn, to be a bit skeptical about the benefits of bicarbonate in treating acidosis, as although bicarbonate therapy is routinely used in clinical settings, the evidence base is not that strong:

    In this Wikipedia article on lactic acidosis, it says:
    And this article on bicarbonate therapy in lactic acidosis says:


    This article is interesting:
     
    Last edited: Jun 28, 2017
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  16. Valentijn

    Valentijn WE ARE KINA

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    That's almost certainly referring to the IV form. The use of oral forms in research seem primarily related to sports performance, and longer-term use. I haven't seen anything about it being used orally for acute lactic acidosis.
     

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