DiseasesAre we too acidic? Why can ordinary baking soda help more than a pharmacy?
- Prof. Klaus F. Kopp — Das Bikarbonat-Mangel-Syndrom (BDS): Professor Dr. med. Klaus F. Kopp
- Prof. Klaus F. Kopp — The Bicarbonate-Deficiency-Syndrome (BDS): Professor Dr. med. Klaus F. Kopp
- Andrzej Frydrychowski — Czy mamy wpływ na powstawanie chorób cywilizacyjnych?
- Henryk Różański — Kwas węglowy w dawnej medycynie
- Henryk Różański — Borelioza – Borreliosis – fitoterapia cz. III i trochę narzekania
- Hubert Czerniak — Powstrzymać raka
- Sodium Bicarbonate for Acute Metabolic Acidosis in Critically Ill Adults: A Meta-Analysis of Randomized Clinical Trials. · Crit Care Med 2026
- Sodium Bicarbonate Treatment and Clinical Outcomes in Chronic Kidney Disease with Metabolic Acidosis: A Meta-Analysis. · Clin J Am Soc Nephrol 2024
- Sodium bicarbonate administration for metabolic acidosis in the intensive care unit: a target trial emulation. · Intensive Care Med 2025
- Sodium Bicarbonate for Metabolic Acidosis in the ICU: Results of a Pilot Randomized Double-Blind Clinical Trial. · Crit Care Med 2023
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Prof. Klaus F. Kopp links the acidity attributed to modern society to high protein intake and kidney function.
- Andrzej Frydrychowski presents baking soda as a cheap way to alkalize the body and recommends a teaspoon in the morning on an empty stomach.
- Sodium bicarbonate is also used in medicine for specific indications, especially in people with kidney disease, but the doses have not been precisely defined.
- No direct comparison was presented of the effectiveness of baking soda and pharmacy medicines.
What the authors write
Modern society was said to have a chronic bicarbonate deficiency and acidity, linked to kidney function and high protein intake.
Sodium bicarbonate was presented as a substance that can bring great benefits when taken, but doses for different people have not been precisely defined.
Sodium bicarbonate is used in medicine for specific indications, particularly in the treatment of people with kidney disease.
In this view, taking sodium bicarbonate is meant to support acid-base balance and blood circulation, and low bicarbonate levels were also attributed to older people considered healthy.
No recommended or long-term beneficial pH level was given for the body or its fluids.
Baking soda was described as the cheapest and simplest way to alkalize the body, with a recommendation to take a teaspoon in the morning on an empty stomach.
Sodium bicarbonate with citric and tartaric acids was mentioned as something once used for nausea, vomiting, and stomach problems.
Pharmacies were accused of offering many products unrelated to treatment, and medicines were considered effective in only a limited proportion of cases.
The effectiveness of medicines and products from pharmaceutical companies was questioned, but they were not directly compared with the effects of baking soda.
Research from PubMed · Europe PMC
We selected 4 studies with the best, positive results. This is a selection, not a full review of all research.
Total number of studies on this topic in PubMed: 2 543.
A meta-analysis found that, among critically ill patients with acute metabolic acidosis, sodium bicarbonate reduced the need for renal replacement therapy.
Aim of the study: Acute metabolic acidosis is frequent in critical illness and may be managed with volume replacement therapy, sodium bicarbonate, and renal replacement therapy (RRT). BICARICU-1 and BICARICU-2 trials provided new evidence on bicarbonate therapy. We aimed to systematically evaluate the effects of sodium bicarbonate in critically ill patients.
Results: In critically ill adults with acute metabolic acidosis, sodium bicarbonate significantly reduces RRT requirements, with Bayesian analyses suggesting a possibility of a mortality benefit, although current evidence remains inconclusive. Larger RCTs or high-quality real-world studies are needed to confirm the effect of sodium bicarbonate on mortality.
“Not stated” does not mean nobody paid — the database does not always record it.
A meta-analysis of studies in people with chronic kidney disease and metabolic acidosis found that eGFR improved after sodium bicarbonate treatment.
Aim of the study: In patients with CKD, impaired kidney acid excretion leads to the onset of metabolic acidosis (MA). However, the evidence is not yet conclusive regarding the effects of sodium bicarbonate in treating CKD with MA.
Results: Fourteen RCTs comprising 2037 patients demonstrated that sodium bicarbonate supplementation significantly improved eGFR (standardized mean difference [SMD], 0.33; 95% confidence interval [CI], 0.03 to 0.63; P = 0.03). The group receiving sodium bicarbonate had a lower hospitalization rate (odds ratio, 0.37; 95% CI, 0.25 to 0.55; P < 0.001). Higher mid-arm muscle circumference was observed with sodium bicarbonate treatment compared with those without (SMD, 0.23; 95% CI, 0.08 to 0.38; P = 0.003, I2<0.001). However, higher risk of elevated systolic BP was found with sodium bicarbonate treatment (SMD, 0.10; 95% CI, 0.01 to 0.20; P = 0.03). No significant difference in all-cause mortality was noted. In patients with CKD and MA, sodium bicarbonate supplementation may provide potential benefits in preventing the deterioration of kidney function and increasing muscle mass. However, treatment may be associated with higher BP.
“Not stated” does not mean nobody paid — the database does not always record it.
In an observational study, sodium bicarbonate administration was associated with lower mortality in the intensive care unit.
Aim of the study: Sodium bicarbonate is commonly administered to treat metabolic acidosis in intensive care units (ICUs). There is limited evidence from randomized trials to support this practice, and observational studies show conflicting results. Our aim was to perform a target trial emulation evaluating the effect of bicarbonate therapy on mortality.
Results: We identified 6157 eligible admissions, of which 1764 (29%) received sodium bicarbonate. Bicarbonate therapy was associated with a 1.9% absolute mortality reduction for the primary analysis [risk ratio 0.86, 95% confidence interval (CI) 0.80 to 0.91], and significant benefits were seen across all subgroups evaluated. A similar point estimate of 2.1% was observed in the sensitivity analysis, with a sustained mortality reduction seen at 30 days. In this target trial emulation, bicarbonate administration was associated with a small but statistically significant reduction in mortality for patients with metabolic acidosis. Large sample sizes would be required to demonstrate this effect in a randomized trial.
“Not stated” does not mean nobody paid — the database does not always record it.
In a small pilot study, sodium bicarbonate sped up correction of pH and base deficit in patients with metabolic acidosis in intensive care.
Aim of the study: To identify the best population, design of the intervention, and to assess between-group biochemical separation, in preparation for a future phase III trial.
Results: The primary feasibility aim was to assess eligibility, recruitment rate, protocol compliance, and acid-base group separation. The primary clinical outcome was the number of hours alive and free of vasopressors on day 7. The recruitment rate and the enrollment-to-screening ratio were 1.9 patients per month and 0.13 patients, respectively. Time until BE correction (median difference, -45.86 [95% CI, -63.11 to -28.61] hr; p < 0.001) and pH correction (median difference, -10.69 [95% CI, -19.16 to -2.22] hr; p = 0.020) were shorter in the sodium bicarbonate group, and mean bicarbonate levels in the first 24 hours were higher (median difference, 6.50 [95% CI, 4.18 to 8.82] mmol/L; p < 0.001). Seven days after randomization, patients in the sodium bicarbonate and placebo group had a median of 132.2 (85.6-139.1) and 97.1 (69.3-132.4) hours alive and free of vasopressor, respectively (median difference, 35.07 [95% CI, -9.14 to 79.28]; p = 0.131).
“Not stated” does not mean nobody paid — the database does not always record it.
Perspectives and opinion materials
The content below presents the authors’ opinions, interpretations and hypotheses. It is not treated as equal to scientific studies and systematic reviews.
Pisaczek does not judge who is right. It shows what was written and where to read it. Every sentence above has its source.