sodium bicarb, acidosis, and my BP went up a tad ?? and Sjogrens. :)

[BadBadBear]

Anything containing sodium has the potential to raise blood pressure. It may have nothing to do with pH.

You think if I ingest 4,950 mg. of sodium chloride, as I did yesterday, that it is the 350 mg. from bicarb that is raising my BP? Really? I am having trouble with this idea...

On the other hand pH alters how much oxygen gets released to tissues. Too acidic for too long can be fatal, but too alkaline can greatly reduce energy production capacity. Both effects occur from lack of oxygen, though the mechanisms are different. Direct dumping of oxygen to tissues is higher in acid states, and low in alkaline states. So inducing alkalinity may decrease your oxygen. On the other hand, prolonged acidity suppresses an enzyme needed to release oxygen from blood cells, so again you don't have enough oxygen and can die from lactic acidosis.

Furthermore treating pH does not necessarily correct the underlying problem ... for all we know it might worsen it in some patients. So do be careful, and pay attention to how you feel.

I feel muscle acidity post-exercise is an important area of research. Once we understand the mechanisms better I suspect this may lead to useful treaments.

I agree with what you are saying about micromanaging pH. However, the state I am considering myself to possibly be in is one of bicarb depletion. My blood tests over the last 6 months show anion gap is high and going ever higher. The obvious answer is checking my bicarb level, and I will consider doing that at my next blood test (probably 2-4 weeks). I wish I had a baseline for that number...

 

[BadBadBear]

BadBadBear Yes! the opportunity to discuss bicarb vis-a-vis CFS is great. Plus exercise, too. I have been ramping up exercise a lot lately. Most things are generally getting better all the time. Yesterday, I went on my bicycle up a trail, maybe 20 minutes uphill to get to the top. I'd have been afraid over the past few years that I might not make it back, but I tried and it was no problem.

Sherlock, that is great - I like hearing about the bicycling. My bike is gathering dust in the garage, and I really miss riding it.

Have you tried the KCl as the salt substitute? (NoSalt brand, for one)

My stomach will not tolerate KCl salt substitute. I don't know why, but even a sprinkle of it in my electrolyte drink bothers me. Do you consume that stuff? Does it help?

What's your opinion of the alkalizing drops? That would be great because I could take it throughout the day.

I don't really know... I am trying to consume alkalyzing food for the most part, so hopefully that will cover daytime. For ex. changing out my kefir for plain raw goat milk... Trading out my two cups of decaf for herbal tea. I did mix me up a small portion of buffered e-lyte to carry with me, so I can always add it to water or lemonade if I'm away from home.

What about antioxidants and anti-inflammatories before exercise?

Vitamin E and now N-A-C. What about you? Vitamin E seems to do the most for my muscle recovery (I used it when I ran and for endurance horse riding).

I actually had a really great day yesterday, did a lot more than usual (did a farm clean up project that I was years behind on - hauling off old wood and trash) and felt good. I felt like a bit like the old me. I'm a bit tired today, but still got up early and did some finishing up on that project and got it DONE!! Also went to restorative yoga class last night and felt good.

Honestly, this is doing as much for me as methylation. The question is always will the effect last, and that remains to be seen. But it's lovely that the cheapest supplement I've tried is having this effect.

 

[BadBadBear]

You think if I ingest 4,950 mg. of sodium chloride, as I did yesterday, that it is the 350 mg. from bicarb that is raising my BP? Really? I am having trouble with this idea...

I am going to expand on this slightly.

I have been taking Florinef + salt loading + drinking plenty of water for a couple of months now, with little effect. The Florinef hasn't really touched my blood pressure, but it does seem that I don't have as much pre-syncope which was really bad before Florinef.

IF my own personal issue is renal tube acidosis and my body can't get rid of enough acid => NaCl loading might be making it work even harder and dump more water and salt trying to get rid of the acid, which it can't get rid of because of my naughty renal tubes. I have paradoxical reactions to everything, anyway. If I don't eat a lot of salt, I bloat up, and if I eat too much salt, I deflate too much (my skin, etc. looks terrible and I feel dehydrated). I have never bloated from salt, even in the 10-12 gram per day range.

If that is the case, buffering the acid might be making my body excrete less water, hold more salt, and let the Florinef do it's job better.

I did feel like yesterday that my skin looked better hydrated than normal & DH commented that my skin felt noticably soft last night. Is this hydration? I don't know. At this point, it just has me interested to see some positive changes.

I am planning to trial bumping up my bicarb just a bit in my elyte mix, and possibly decreasing the NaCl just a tad to balance it out (equal amounts of each) and run with that for a while. So maybe for the day total, I would consume 3/4-1 tsp. bicarb. Then try to balance KCl similarly with potassium bicarb => aim for more neutral balance of acid and alkaline.

PS. I did notice the laxating effect of bicarb, but for me that's a plus.

 

[Sherlock]

BadBadBear I have used the KCl, but not lately. I go for things that I instinctively crave, but haven't craved that now - maybe because of all the bananas and potatoes. Funny that you're sensitive to it.

You're saying that I shouldn't make yogurt anymore? That might be going too far

I see vinegar variously stated as pro or anti alkaline. A lot of times, I really love vinegar; but when I'm taking a lot of bicarb, then the craving for vinegar is gone - except with jalapenos. That tells me that vinegar is alkalizing.

For anti-inflammatories, I'm going to finish off my bottle of curcumin and then maybe go to ginger. Maybe I'll also try the vit E PWO. Most supplements do nothing, aside from covering any individual deficiencies; but my tendons have been acting up in my fingers and I can't make myself stop lifting weights so I need an intervention.

Looking back, I know that I have been acidic my whole life. Plus, I've always consumed acid-forming stuff almost exclusively.

Yes, I too am getting "like my old self", plus another thing: I feel like my real self when I'm outdoors.

It's good to hear that you had a great day, Michelle. Yep, 50 cents a pound for a cure! I get a kick out of that These actual experiments trump theories and purported mechanisms.

Have you noticed that you had some conditions pre-CFS that are heightened during CFS? For me, high histamine is the obvious one.

 

[alex3619]

BadBadBear These actual experiments trump theories and purported mechanisms.

Knowledge of mechanisms is still in its infancy, thats part of why we experiment so much. Rule 22: 22. Most treatments for ME are lemons, they don't suit everyone - but you often wont know if it suits you until you suck it and see. If you see a soured look on my face you will know why.

If you don't try it you may never know. http://forums.phoenixrising.me/index.php?entries/28-rules-of-thumb.941/

 

[MeSci]

2 teaspoons at once? You didn't have to build up to that level? AFAIK, that'd be pretty rare and might give you a clue... to something. (I'm assuming you take it on empty stomach.)

What other supplements do you take to akalize? Minerals?

I take it in water in 4 doses about an hour after meals. I started with 5g, which was good, tried increasing to 10g but felt worse (maybe coincidence), compromised with 7.5g for a few months, then upped to 10g again and have kept it there as it seems good.

Also taking l-glutamine to help heal the gut, and cut out gluten and reduced carbs (especially sugar and grains) as these are acid-producing, especially if you have abnormal carb metabolism which it looks as though I have as I am so much better after reducing them.

I do also take a bone mineral supplement but that is more to replace what I am probably losing rather than to alkalise.

It may be significant that I am a vegan, so may need less stomach acid than an omnivore (stomach acid serves mainly to break down insoluble material and proteins, I understand).

 

[MeSci]

I did feel like yesterday that my skin looked better hydrated than normal & DH commented that my skin felt noticably soft last night. Is this hydration? I don't know.

I don't know either, but I have noticed softer, smoother skin a lot lately. I am prone to dehydration, and even taking desmopressin to combat this didn't make my skin smooth. It seems that my diet and supplement regime is helping with that. I certainly don't get as parched as I used to, although I still have polyuria.

 

[Sherlock]

I take it in water in 4 doses about an hour after meals.

Your stomach is emptied by then? The reason I mention this is because I've seen the claim out in the world that it can be taken on a not-empty stomach. But that seems implausible, since it will be annihilated by the stomach acid:
NaHCO3 + HCl → NaCl + H2CO3
H2CO3 → H2O + CO2
Am I missing anything?

I started with 5g, which was good, tried increasing to 10g but felt worse (maybe coincidence), compromised with 7.5g for a few months, then upped to 10g again and have kept it there as it seems good.

Also taking l-glutamine to help heal the gut, and cut out gluten and reduced carbs (especially sugar and grains) as these are acid-producing, especially if you have abnormal carb metabolism which it looks as though I have as I am so much better after reducing them.

I do also take a bone mineral supplement but that is more to replace what I am probably losing rather than to alkalise.

It may be significant that I am a vegan, so may need less stomach acid than an omnivore (stomach acid serves mainly to break down insoluble material and proteins, I understand).

Also for mineral absorption, as you likely know, and hypothyroid people (with low stomach acid) are prone to having low absorption. Some take betaine hydrochloride to compensate.

Can I ask what is your morning urine pH? I'm at 6.5 and would probably never get higher without the baking soda. You must be much better than me with all the vegetables that you eat.

 

[MeSci]

Your stomach is emptied by then? The reason I mention this is because I've seen the claim out in the world that it can be taken on a not-empty stomach. But that seems implausible, since it will be annihilated by the stomach acid:
NaHCO3 + HCl → NaCl + H2CO3
H2CO3 → H2O + CO2
Am I missing anything?

Also for mineral absorption, as you likely know, and hypothyroid people (with low stomach acid) are prone to having low absorption. Some take betaine hydrochloride to compensate.

Can I ask what is your morning urine pH? I'm at 6.5 and would probably never get higher without the baking soda. You must be much better than me with all the vegetables that you eat.

I don't know how long it takes for my stomach to empty. I'm just following guidelines I found on how to take sodium bicarb:

http://www.mayoclinic.com/health/drug-information/DR601241/DSECTION=proper-use

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For sodium bicarbonate powder:

To relieve heartburn or sour stomach:
Adults and teenagers—One-half teaspoonful in a glass of water every two hours. Your doctor may change the dose if needed.
Children—Dose must be determined by your doctor.
To make the urine more alkaline (less acidic):
Adults and teenagers—One teaspoonful in a glass of water every four hours. Your doctor may change the dose if needed. However, the dose is usually not more than 4 teaspoonfuls a day.

from http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682001.html

If you are using sodium bicarbonate as an antacid, it should be taken 1 to 2 hours after meals, with a full glass of water. If you are using sodium bicarbonate for another reason, it may be taken with or without food. Do not take sodium bicarbonate on an overly full stomach.

Do not use sodium bicarbonate for longer than 2 weeks unless your doctor tells you to.

tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially other antacids, aspirin or aspirin-like medicines, benzodiazepines, flecainide (Tambocor), iron, ketoconazole (Nizoral), lithium (Eskalith, Lithobid), methenamine (Hiprex, Urex), methotrexate, quinidine, sulfa-containing antibiotics, tetracycline (Sumycin), or vitamins. Take sodium bicarbonate at least 2 hours apart from other medicines.
tell your doctor if you have or have ever had high blood pressure, congestive heart failure, or kidney disease or if you have recently had bleeding in your stomach or intestine.

Sodium bicarbonate may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

increased thirst
stomach cramps
gas

If you have any of the following symptoms, stop taking sodium bicarbonate and call your doctor immediately:

severe headache
nausea
vomit that resembles coffee grounds
loss of appetite
irritability
weakness
frequent urge to urinate
slow breathing
swelling of feet or lower legs
bloody, black, or tarry stools
blood in your urine

...................................................

I bridle at the advice "Do not use sodium bicarbonate for longer than 2 weeks unless your doctor tells you to."

If my doctor tells me to do or not do something I will be tempted to tell him/her to get £"!%&&*

They can advise me, and I will decide!

I don't know my urine pH, sorry.

 

[Sherlock]

http://www.mayoclinic.com/health/drug-information/DR601241/DSECTION=proper-use

Oh, you are taking it for heartburn / excesss stomach acid? I just want to alkalise. I keep a glass and spoon and the bicarb on the nightstand, and mix some when I awake before it's time to get out of bed.

I bridle at the advice "Do not use sodium bicarbonate for longer than 2 weeks unless your doctor tells you to."

If my doctor tells me to do or not do something I will be tempted to tell him/her to get £"!%&&*

I never heard a cat talk that way before

I think in that advice, though, they don't want people to keep taking the bicarb for what might be a serious condition, such as an ulcer - they want people to go see a doc instead.

 

[MeSci]

Oh, you are taking it for heartburn / excesss stomach acid? I just want to alkalise. I keep a glass and spoon and the bicarb on the nightstand, and mix some when I awake before it's time to get out of bed.


I never heard a cat talk that way before

I think in that advice, though, they don't want people to keep taking the bicarb for what might be a serious condition, such as an ulcer - they want people to go see a doc instead.

I'm alkalising too. I was just trying to get a general idea of safe dosage.

You've never heard a cat swear...? I have! Growl..hiss...spit

I take your point though, but whatever my condition, I do not expect anyone to order me about! The doctors I have seen have been so ignorant that I never assume that they know what they are talking about now.

One example of advice from a consultant regarding my nighttime polyuria which was leaving me dehydrated and thirsty (which no doctors would even BELIEVE): don't have a sip of water when you are thirsty at night...suck a sweet.

?????????

 

[Sherlock]

You've never heard a cat swear...? I have! Growl..hiss...spit

You reminded me of when I learned that you can not feed just one stray cat, and two will eventually meet up at the food bowl. With lots of swearing involved.

One example of advice from a consultant regarding my nighttime polyuria which was leaving me dehydrated and thirsty (which no doctors would even BELIEVE): don't have a sip of water when you are thirsty at night...suck a sweet.

?????????

Silly as that is, I did try not drinking from an afternon onward because I was trying everything. I was too thirsty to fall asleep but nevertheless the polyuria didn't stop.

Benadryl maybe helped (or it was a co-incidence). Baking soda helped (or it is a co-incidence). I am down to 300ml a night, which seems about normal? My worst was a liter overnight, but I get the idea some might be much worse.

 

[Sherlock]

Something just occurred to me: maybe for alkalising the gut lumen itself, baking soda is superior to any kind of alkalising drops.

That's almost akin to how there are a few antibiotics which can't be absorbed. Their job is to act in the lumen only.

But with the baking soda, you get the added benefit of being absorbed.

 

[alex3619]

Oh, you did already say that, sorry.

Out in the world, there is a lot of work on cardiomyocytes and pH, especially in reperfusion after MI, so maybe that's something for me to look into for the meantime.

Have you personally tried post workout bicarbonate? I've noticed a benefit.

I haven't looked at reperfusion injury in many years. What I was reading all that time ago was fascinating. During reperfusion the mitochondria is surrounded by free arachidonic acid, and through an as then unknown mechanism this is associated with a massive oxidative stress burst, which can damage the mitochondria and surrounding tissues. If we experience something similar, though the cause may be different, it can damage our energy production severely.

I have not tried bicarbonate much except as antacid. One of the issues that concerns me is that it might make us feel better but will lower oxygen availability post exercise. I want as much O2 as possible. This needs more science, not generalized from the population but specific to ME. While I am concerned about O2, it may be the case that by assisting a rapid return to normal pH we can modify the resulting alkaline swing. Getting normal pH is the key, and its neither easy to do nor measure from home - its muscle pH that matters, and probably the brain as well, not blood pH.

 

[alex3619]

Something just occurred to me: maybe for alkalising the gut lumen itself, baking soda is superior to any kind of alkalising drops.

That's almost akin to how there are a few antibiotics which can't be absorbed. Their job is to act in the lumen only.

But with the baking soda, you get the added benefit of being absorbed.

The stomach should be acid, the instestines should be alkaline. Too much antacid disturbs digestion and can lead to nutritional deficiency. However so can too much acid. The intestine is where we absorb nutrients, and if its too acidic this will again lead to poor nutrition. I do not know of an easy way to be sure of getting this balance right. It seems to come down to the only way to find out is to try it.

 

[MeSci]

I have not tried bicarbonate much except as antacid. One of the issues that concerns me is that it might make us feel better but will lower oxygen availability post exercise. I want as much O2 as possible. This needs more science, not generalized from the population but specific to ME. While I am concerned about O2, it may be the case that by assisting a rapid return to normal pH we can modify the resulting alkaline swing. Getting normal pH is the key, and its neither easy to do nor measure from home - its muscle pH that matters, and probably the brain as well, not blood pH.

Yes, physiological pH is so complex - so many different reactions going one way and the other.

I have improved significantly since starting my alkalising diet and supplements including bicarb. I have had the occasional relapse which has usually resolved when I have reduced carbs or had another short course of grapefruit seed extract (GSE), the latter being intended to reduce gut bacteria to facilitate recolonisation with the 'right' ones via the alkalising diet and supplements.

With the last relapse I tried cutting out the bicarb as an experiment, thinking that maybe I didn't need it any more. I got worse, and improved again after restarting it and taking GSE for a week.

 

[Blasted]

I'm toying with the idea that the 'burning' arms, leg, face I get during my post-exertional flare ups are due to low ph/high anions.

I find it interesting that the burning sensation is the first symptom I experience preceding the brain fog, myalgia and muscle tenderness. If this burning sensation is in fact indicative of a low ph level then I'm wondering if perhaps it's this transient dip in ph which causes the other symptoms such as myalgia to arise.

I think that many CFS sufferers experience something similar in their bodies but not all of us experience the burning as badly as I do. Perhaps my acidity level is higher or maybe my neurons are hypersensitive to it, I suspect it's the latter.

I find the possible relationship between ph and CFS fascinating. As someone who has suffered from respiratory alkalosis due to anxiety (years ago) I see a similarity in symptoms. When I had bouts of respiratory alkalosis I would be bed ridden for a couple of days feeling extremely weak and dehydrated until my ph corrected itself. I also seem to recall not being able to think clearly or be able to fall asleep easily. If I compare that experience to the flare ups I experience now following exertion, I do see some crossover. So it would make sense that what I'm experiencing now is again a ph issue albeit at the opposite end of the scale.

Fwiw I plan on getting my anion gap and l-lactate tested when I'm flared up and also to experiment with the bicarbonate.

 

[MeSci]

Not sure if I mentioned this earlier, but according to this site respiratory alkalosis can arise as a result of metabolic acidosis:

A respiratory alkalosis is a primary acid-base disorder in which arterial pCO2 falls to a level lower than expected.

If there was no compensation and no other acid-base disorder present, then this must necessarily lead to an increase in arterial pH.

If there is no metabolic acid-base disorder present, then the actual measured arterial pCO2 is compared against the standard reference value of 40mmHg.

If there is a co-existing metabolic acidosis, then the expected pCO2 used for comparison is not 40mmHg but a calculated value which adjusts for the amount of change in arterial pCO2 which occurs due to respiratory compensation. (The formula used is discussed in Section 9.3). This decrease in pCO2 that occurs as compensation for a metabolic acidosis is not a respiratory alkalosis as it is not a primary process.

As said earlier, it is very complex!

Are you sure that your respiratory alkalosis was due to anxiety? Health professionals are over-ready to diagnose anxiety. Anything that causes breathing difficulty causes anxiety.

My own illness, which turned out to be near-life-threatening hyponatraemia, was dismissed the first time as a 'panic attack' despite my having no history of these. It had almost certainly been caused by sodium loss in urine following over-exertion.

 

[Blasted]

Hi MeSci, yes I'm sure it was anxiety driven in my case. It was years before I got CFS (if that's what I have) and I was going through a hard time and I'd head to University, get over-anxious, over-breathe and then become over alkaline. Ofc I had no clue what was going on at the time, I was just fortunate enough to meet a great doctor who made the suggestion 'alkalosis' and with that one word I was able to isolate the problem and take corrective action.

Just had a gander at hyponatremia, hyponatremic encephalopathy sounds particularly scary . Were you running marathons or just doing light exertion?

 

[MeSci]

Hi MeSci, yes I'm sure it was anxiety driven in my case. It was years before I got CFS (if that's what I have) and I was going through a hard time and I'd head to University, get over-anxious, over-breathe and then become over alkaline. Ofc I had no clue what was going on at the time, I was just fortunate enough to meet a great doctor who made the suggestion 'alkalosis' and with that one word I was able to isolate the problem and take corrective action.

Just had a gander at hyponatremia, hyponatremic encephalopathy sounds particularly scary . Were you running marathons or just doing light exertion?

I was just doing essentials, but there were a lot of essentials to do at the time, such as having to move stuff for builders and cleaning up after them. If they only knew how ill they can make us. I tell them that exertion makes me ill but they don't get it (does anyone?).

The second time I got it (this time I got to hospital and was eventually admitted after initially being sent home) I had been exhausting myself scavenging firewood during a freezing winter, unable to afford to have my heating on, and nursing a terminally-ill cat.

My blood sodium was 115.