When you have kidney disease, maintaining an optimal pH balance is one of the most important things you can do to improve your kidney health, so today I want to talk about what this means and dispel a common misconception about the best supplements to use to help alkalise the body.
The Acid: Alkaline Balance
Every cell, tissue and organ in your body functions at a specific pH. pH is the abbreviation for potential hydrogen and is a rating of acidity or alkalinity. The higher the pH reading, the more alkaline the fluid is and the lower the pH the more acidic it is. The pH range is from 0 to 14, with 7.0 being neutral. Anything above 7.0 is alkaline, anything below 7.0 is considered acidic.
Your bodies physiology operates optimally at a slightly alkaline pH of 7.35 to 7.45, if blood pH moves too much above or below this, enzymes stop functioning properly and illness is inevitable. A blood pH of 7.0 results in death.
What happens when blood pH drops?
Even a slight shift to a more acidic pH decreases your body’s ability to absorb minerals and other nutrients, decreases the energy production in cells, decreases the body’s ability to repair damaged cells, decreases your ability to detoxify, helps tumour cells thrive and makes you more susceptible to fatigue and illness. Research shows that unless the body’s pH level is slightly alkaline, the body can’t heal itself.
But what does this have to do with the kidneys?
Because maintaining blood pH is vital for life, our body has extensive (and pretty impressive) buffer systems to make sure that blood pH is maintained between these very narrow limits. If you become too acidic, the body takes alkalising minerals, such as calcium or magnesium, from your bones and diet (robbing Peter to pay Paul so to speak), and with the help of your kidneys, restores the acid-alkaline balance.
One of the jobs of the kidneys is to keep the right balance of acids in the body; one way they do this is by removing acid from the body through urine.
If the body’s buffer system reaches its limits and renal acid excretion is exhausted, this results in chronic metabolic acidosis.
Chronic Kidney Disease reduces the excretion of acids and therefore people with Chronic Kidney Disease are at a higher risk of metabolic acidosis.
The effect of acidity on the kidneys
Not only are the kidneys one of the primary organs responsible for maintaining optimal pH of the body but their functioning is highly dependent the body’s acid: alkaline balance.
Metabolic acidosis is associated with a faster decline in kidney function and the degree of metabolic acidosis is directly associated with glomerular filtration rate (GFR). What this means is that the more acidic your body is, the worse your kidney function is likely to be and the lower your GFR.
This ends up being a bit of a vicious cycle because:
higher acidity = reduced kidney function = reduced ability to excrete acids = higher acidity
…… I could keep going here!
So, what can you do to reduce acidity?
The primary and number one thing you can do to reduce acidity or make your body more alkaline is by changing your diet.
Typical high animal protein Western diets are highly acidic so changing to a more alkaline diet will (within hours) take off the load from your kidneys and will not only help to improve the function of your kidneys but also give them the opportunity to heal.
Alkaline diets have also shown to be beneficial for numerous other health conditions including:
- Cardiovascular disease
- High blood pressure
- Bladder conditions
- Kidney stones
- Immune deficiency
- Free radical damage
- Hormone damage
- Premature ageing
- Joint pain
- Aching muscles
- Low energy and chronic fatigue
If you’re not currently following an alkaline diet, make sure you check out one of my previous posts which will tell you everything you need to know about implementing an alkaline diet.
So if step one is following an alkaline diet, step two is:
Now I’m going to tell you something that you might not have heard before!
Bicarbonate supplementation might not actually be the best way to alkalise!
When people with kidney disease are advised to use supplements to assist with alkalising the body, they are typically told to use sodium bicarbonate.
The body uses endogenous bicarbonate to buffer acidity, but supply is limited because the body can’t produce an infinite supply of bicarbonate. When buffering mechanisms are overwhelmed due to reduced kidney function, the body gets to the point that it is unable to compensate, which leads to acidosis and negative health effects.
This has led to the practice of increasing bicarbonate stores by supplementing with bicarbonates, such as sodium bicarbonate. Makes sense, right?
On the surface, yes, however, while bicarbonate supplementation may increase your body’s alkalinity in the short term, it’s far from the ideal solution.
So what are the problems with Sodium Bicarbonate Supplementation?
The main issues in supplementing with bicarbonates are the effect on stomach acid and its unpleasant side effects.
Sodium bicarbonate leads to an increase in stomach carbon dioxide, which increases the pH of the stomach acid (making it more alkaline). This is one of the reasons that some people use baking soda to ease heartburn.
We need adequate stomach acid to breakdown, absorb and assimilate amino acids, vitamins and minerals from the food we eat (or supplements we take). When your stomach acid is too alkaline this not only reduces nutrient breakdown and absorption but can also cause imbalances in the gut microbiota, leading to bacterial overgrowth, such as SIBO (small intestinal bacterial overgrowth).
Common side effects that people who take sodium bicarbonate supplements experience include stomach pain, bloating, diarrhoea, nausea and vomiting.
Also, you’re not just supplementing with bicarbonate when taking sodium bicarbonate, you’re also supplementing with……
you guessed it- SODIUM- aka salt!
People with kidney disease need to be particularly careful about their sodium intake because the kidneys may not be able to effectively eliminate excess sodium and fluid from the body which can lead to high blood pressure and fluid retention or oedema.
Also, after taking it, there is a fast increase in bicarbonate in the blood, which is rapidly excreted through the kidneys, losing the bicarbonate through the urine. Therefore, the ingested bicarbonate isn’t actually available to buffer the excess acidity in the blood.
Now that I’ve gone through the problems with using sodium bicarbonate to alkalise, I’m guessing your next question is what should you use instead?
That’s a great question.
So, what should you use to alkalise?
If you have an eGFR over 35 then citrates are an ideal way to alkalise the body. Citrates are always absorbed as a salt, with magnesium, potassium, calcium citrate etc, and are found naturally in fruit and vegetables.
Supplementing with these citrates alkalises the body with the added benefit of increased minerals. Importantly, they have minimal impact on stomach acid so don’t have the same detrimental impact on digestion that bicarbonate supplementation has, and their effect is also longer lasting, giving a steadier overall alkalisation when compared to bicarbonate supplementation.
Citrates are always bound to a mineral such as magnesium or calcium. In later stages of kidney disease, those with an eGFR under 35, high doses of magnesium and calcium should be avoided. So, in these cases, you would use sodium bicarbonate to alkalise. To minimise its effects on stomach acid, it should be taken WITH food and in small, divided doses over the day. Ideally, four small doses of between 0.5 – 1.25gms; each dose is enough to provide benefits.
It’s always wise when beginning any new supplements to consult your health professional beforehand, they can help advise you on the type of mineral citrate that will be most appropriate for you and correct dosage.
eGFR of 35 or more – Take ½ a scoop in water 3 x a day of something like KalmAssure Magnesium Powder
eGFR of 35 or less – Use 0.5 – 1.25gms of sodium bicarbonate 3-4 times a day in water WITH meals
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Don’t forget that using an alkalising supplement DOES NOT take the place of following an alkaline diet.
Hopefully I’ve been able to provide a bit of clarity about the importance of the acid: alkaline balance in the body and its effect on kidney health. If you would like further tools to increase your kidney function, then please head to our Home Page and Download our Free Alkaline Diet & pH Guide for Kidney Disease.
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Have a great weekend, I’ll see you next time!