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What Does Sodium Bicarbonate Do in the Body?

Key Takeaways

  • Sodium bicarbonate helps regulate acid-base balance by neutralizing excess acids in the body.
  • It is commonly used short term as an antacid for heartburn, acid reflux, and acid indigestion.
  • In medical settings, sodium bicarbonate may be used to treat metabolic acidosis, especially in chronic kidney disease.
  • Because it contains high sodium, improper or excessive use can lead to side effects such as bloating, fluid retention, high blood pressure, or electrolyte disturbances.
  • You should use it with caution if you have kidney disease, heart failure, or other medical conditions.

What Is Sodium Bicarbonate?

Sodium bicarbonate, also known as baking soda or NaHCO₃, is a naturally occurring alkaline compound. In the body, it plays an important role in maintaining acid-base balance, which is essential for normal cellular function.

Sodium bicarbonate is available over the counter and it is also used intravenously in hospitals for specific medical conditions. Although it is widely accessible, its effects on the body depend heavily on dose, route of administration, and individual health status.

How Sodium Bicarbonate Works in the Body

Sodium bicarbonate acts as a buffer. This means it helps neutralize acids by binding hydrogen ions. When sodium bicarbonate encounters acid, such as stomach acid (hydrochloric acid), a chemical reaction occurs that forms carbonic acid, which then breaks down into carbon dioxide and water.

This buffering action helps:

  • Reduce acidity
  • Raise pH levels
  • Maintain normal acid-base balance

The kidneys and lungs normally regulate bicarbonate levels very closely. Introducing extra sodium bicarbonate can temporarily change this balance.

Effects on the Digestive System

Stomach acid and heartburn

One of the most common uses of sodium bicarbonate is as an antacid. When taken orally, you should take within 1 to 2 hours after meals with a full glass of water. It will neutralize stomach acid and can relieve heartburn, acid reflux, and upset stomach symptoms.

Because this reaction produces carbon dioxide gas, bloating and belching are common side effects.

Acid indigestion and reflux symptoms

Sodium bicarbonate can provide quick, short-term relief of acid indigestion. However, it does not treat underlying conditions such as gastroesophageal reflux disease or stomach ulcers, and repeated use may worsen symptoms over time.

Metabolic acidosis

In metabolic acidosis, excess acid builds up in the blood. This can occur in conditions such as:

  • Chronic kidney disease
  • Severe dehydration
  • Certain poisonings
  • Uncontrolled diabetes

In these cases, sodium bicarbonate may be given intravenously under medical supervision to restore normal pH levels. Oral sodium bicarbonate supplementation may also be prescribed in chronic kidney disease to help manage ongoing acid retention.

Metabolic alkalosis

Too much sodium bicarbonate can have the opposite effect, causing metabolic alkalosis. This condition occurs when the blood becomes too alkaline and may lead to muscle twitching, confusion, and abnormal heart rhythms.

Effects on the Kidneys and Electrolytes

Sodium bicarbonate affects electrolyte balance, particularly sodium levels. Each dose adds sodium to the body, which can contribute to fluid retention and edema.

Kidney disease considerations

People with chronic kidney disease may be prescribed sodium bicarbonate to help reduce acid buildup. However, dosing must be carefully monitored because excess sodium can worsen kidney problems, increase blood pressure, and strain the heart.

Blood tests may be used to monitor bicarbonate levels, measured in milliequivalents (mEq), along with other electrolytes.

Cardiovascular Effects

Because sodium bicarbonate contains high sodium, it can affect the cardiovascular system.

Potential effects include:

  • Increased blood pressure
  • Fluid retention
  • Worsening heart failure
  • Swelling in the legs or ankles

These risks make sodium bicarbonate inappropriate for regular use in people with heart failure or those on sodium-restricted diets unless directed by a healthcare professional.

Side Effects and Adverse Effects

Side effects depend on dose, frequency, and individual health conditions.

Common side effects of sodium bicarbonate include:

  • Bloating
  • Gas
  • Upset stomach
  • Nausea

More serious adverse effects may include:

  • Metabolic alkalosis
  • Electrolyte imbalance
  • Edema and fluid retention
  • High blood pressure
  • Toxicity with large amounts

Excessive intake can also interact with certain drugs and supplements.

Drug Interactions

Sodium bicarbonate can alter how medications are absorbed or eliminated by the body.

Possible drug interactions include:

  • Salicylates
  • Barbiturates
  • Certain supplements containing calcium or magnesium

By changing stomach acidity or urine pH, sodium bicarbonate can affect drug levels and effectiveness. Always discuss use with a healthcare provider if you take prescription medications.

Sodium Bicarbonate in Exercise and Supplements

Sodium bicarbonate supplementation has been studied for exercise performance, particularly in high-intensity activities. The idea is that it buffers acid buildup in muscles.

Systematic review data suggest possible performance benefits in select athletes, but side effects like bloating and gastrointestinal distress are common. This use should be guided by a healthcare professional or sports dietitian.

Pediatric and Special Populations

Children should not use sodium bicarbonate without medical advice. Pediatric dosing differs significantly, and misuse can quickly lead to electrolyte imbalances.

During breastfeeding, occasional use may be acceptable, but regular use should be discussed with a healthcare provider.

Dosage Forms and Routes

Sodium bicarbonate comes in several dosage forms:

  • Powder (baking soda)
  • Tablets
  • Intravenous solutions (medical use only)

Each route has different effects and risks. Intravenous use is reserved for hospital settings.

Evidence-Based Perspective

Evidence-based guidelines generally recommend sodium bicarbonate for:

  • Short-term antacid use in select situations
  • Treatment of metabolic acidosis under medical supervision

It is not recommended as a long-term wellness supplement due to safety concerns.

When to Talk to a Healthcare Provider

You should seek medical advice if:

  • You have kidney problems or chronic kidney disease
  • You experience frequent heartburn or acid reflux
  • You have swelling, high blood pressure, or heart failure
  • You are considering sodium bicarbonate supplementation

A healthcare provider can determine whether sodium bicarbonate is appropriate and safe for your situation.

Bottom Line

Sodium bicarbonate helps neutralize acids and plays a key role in acid-base balance, but adding extra sodium bicarbonate to the body can have unintended effects. While it can provide short-term relief from heartburn and is used medically for metabolic acidosis, excessive or frequent use may lead to serious side effects. This is especially true in people with kidney disease, heart failure, or high blood pressure. Always use it cautiously and seek guidance from a healthcare professional when needed.

FAQs

What does sodium bicarbonate do in the body?
It buffers acids, helping regulate pH and acid-base balance. It is commonly used as an antacid for acid reflux, heartburn, and acid indigestion.

Is sodium bicarbonate safe to take every day?
No. Daily use can cause electrolyte imbalances and high sodium intake. Do not use sodium bicarbonate every day unless directed by your provider.

Can sodium bicarbonate help with kidney disease?
In some cases, it is prescribed for metabolic acidosis in chronic kidney disease, but only under medical supervision.

Why does sodium bicarbonate cause bloating?
It produces carbon dioxide when reacting with stomach acid, leading to gas buildup.

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