Sodium bicarbonate
Related Terms
- The information in this bottom line is based on studies and reviews of sodium bicarbonate. There are different types of sodium available in the diet, medications, and other sources, but this bottom line focuses on sodium bicarbonate. It does not focus on sodium benzoate, sodium chloride, sodium phenylacetate, sodium ascorbate, sodium acetate, or other sodium salts. There may be uses, safety issues, side effects, and interactions linked to other forms of sodium that are not discussed in this bottom line. For more information, please view the Natural Standard bottom line on sodium chloride.
Background
- Sodium bicarbonate is created from a reaction between sodium chloride, ammonia, and carbon dioxide in water. It easily dissolves in water, but not in alcohol, according to some sources.
- Sodium bicarbonate is also called baking soda and has been used to treat ulcers and upset stomach. There is strong evidence supporting the use of sodium bicarbonate for preventing kidney disease or damage caused by contrast dye used during medical imaging. The use of sodium bicarbonate for relieving pain associated with the injection of anesthesia is also supported by strong scientific evidence. There is good evidence supporting the use of sodium bicarbonate for the removal of earwax. Sodium bicarbonate has also been used to remove dental plaque and treat conditions such as diarrhea, poisoning, and excess acid in body fluids. Strong evidence in support of other uses is lacking. There may be negative side effects associated with sodium bicarbonate when used to revive people from unconsciousness or to treat excess acid in the body fluids.
- Overall, more research is needed on the safety of sodium bicarbonate.
Evidence Table
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. |
GRADE * |
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. |
GRADE * |
Sodium bicarbonate has been used alone and in combination with other agents to help reduce damage or disease to the kidneys caused by the use of a contrast dye during medical imaging. Many studies found positive effects, including significant differences in the rate of kidney problems between people given sodium bicarbonate and those given other agents. There are a number of reviews on the effects of sodium bicarbonate on kidney injury caused by contrast dye.
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A |
Sodium bicarbonate has been used alone and in combination with other agents to help reduce damage or disease to the kidneys caused by the use of a contrast dye during medical imaging. Many studies found positive effects, including significant differences in the rate of kidney problems between people given sodium bicarbonate and those given other agents. There are a number of reviews on the effects of sodium bicarbonate on kidney injury caused by contrast dye.
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A |
Many studies and reviews have looked at the use of sodium bicarbonate as a buffer to prevent excess acid, and, when given with anesthesia, it consistently reduced pain associated with the treatment.
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A |
Many studies and reviews have looked at the use of sodium bicarbonate as a buffer to prevent excess acid, and, when given with anesthesia, it consistently reduced pain associated with the treatment.
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A |
The use of sodium bicarbonate drops has been shown to help remove earwax in many available studies. Benefits include increased removal of wax, reduced need for further removal, and satisfaction with treatment.
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B |
The use of sodium bicarbonate drops has been shown to help remove earwax in many available studies. Benefits include increased removal of wax, reduced need for further removal, and satisfaction with treatment.
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B |
Studies have found that sodium bicarbonate may have a small but positive effect on sprinting performance in men. Other benefits include improved overall exercise performance, time to exhaustion, total work, performance time, and power. More research is needed on the effects of sodium bicarbonate in women.
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B |
Studies have found that sodium bicarbonate may have a small but positive effect on sprinting performance in men. Other benefits include improved overall exercise performance, time to exhaustion, total work, performance time, and power. More research is needed on the effects of sodium bicarbonate in women.
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B |
In general, studies looking at the effects of sodium bicarbonate on acidosis (excess acid in the body fluids) have found mixed or negative results. One review reported that solid evidence is lacking and that sodium bicarbonate may have negative effects on levels of fluid, sodium, and lactate, while other studies suggested that it may negatively affect some aspects of heart health. More research is needed, especially in the elderly, infants, and people who have certain types of acidosis.
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C |
In general, studies looking at the effects of sodium bicarbonate on acidosis (excess acid in the body fluids) have found mixed or negative results. One review reported that solid evidence is lacking and that sodium bicarbonate may have negative effects on levels of fluid, sodium, and lactate, while other studies suggested that it may negatively affect some aspects of heart health. More research is needed, especially in the elderly, infants, and people who have certain types of acidosis.
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C |
Sodium bicarbonate has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of diarrhea with loss of sodium bicarbonate in adults and children. Some studies report that sodium bicarbonate is as effective as sodium citrate for rehydration and treatment of acidosis caused by diarrheal dehydration.
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C |
Sodium bicarbonate has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of diarrhea with loss of sodium bicarbonate in adults and children. Some studies report that sodium bicarbonate is as effective as sodium citrate for rehydration and treatment of acidosis caused by diarrheal dehydration.
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C |
A review reports that sodium bicarbonate is commonly used to treat fluid in the lungs. However, more research is needed in this area.
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C |
A review reports that sodium bicarbonate is commonly used to treat fluid in the lungs. However, more research is needed in this area.
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C |
Sodium bicarbonate may lack significant effects on survival rates before hospital discharge, nervous system disorders, brain disease or disorders, hemorrhage, or seizures in newborn babies. Information is limited, and more research is needed.
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C |
Sodium bicarbonate may lack significant effects on survival rates before hospital discharge, nervous system disorders, brain disease or disorders, hemorrhage, or seizures in newborn babies. Information is limited, and more research is needed.
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C |
In people who have cystinuria (stones in the bladder, kidney, or ureter), the acidity of urine may decrease similarly in those given sodium bicarbonate and those given potassium citrate. More research is needed.
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C |
In people who have cystinuria (stones in the bladder, kidney, or ureter), the acidity of urine may decrease similarly in those given sodium bicarbonate and those given potassium citrate. More research is needed.
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C |
Some studies suggest that toothpaste that contains baking soda may remove plaque more effectively than toothpaste that does not contain baking soda in hard-to-reach places in the mouth. However, further research is needed.
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C |
Some studies suggest that toothpaste that contains baking soda may remove plaque more effectively than toothpaste that does not contain baking soda in hard-to-reach places in the mouth. However, further research is needed.
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C |
A number of studies report mixed results when sodium bicarbonate is used to treat poisoning resulting from antidepressants, pesticides, and other agents. However, information is limited and of poor quality, and more research is needed.
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C |
A number of studies report mixed results when sodium bicarbonate is used to treat poisoning resulting from antidepressants, pesticides, and other agents. However, information is limited and of poor quality, and more research is needed.
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C | * Key to grades
A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
| * Key to grades
A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
| Tradition / Theory
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.
Dosing
Adults (18 years and older)
- According to some sources, the usual dose of sodium bicarbonate taken by mouth in adults is 325 milligrams to two grams four times daily. The maximum daily dose of sodium bicarbonate for people 60 years of age or older is eight grams daily, while the maximum daily dose is 16 grams daily for people aged 18-59 years.
- To treat acidosis, 0.9 grams of sodium bicarbonate has been taken by mouth three times daily. A dose of 40 milliequivalents per liter of sodium bicarbonate has been given through an intravenous injection during dialysis together with one milliequivalent per kilogram of sodium bicarbonate taken by mouth. In some people, dosing may include a first dose of one milliequivalent per kilogram of sodium bicarbonate, followed by dosing as needed. A report states that a dose of 0.5-1 milliequivalents per kilogram of sodium bicarbonate taken by mouth daily to reach a level of 22-24 millimoles per liter of sodium bicarbonate in the blood is a common treatment for acidosis linked to chronic kidney disease. Sources report that the following doses may be taken by mouth: 20-36 milliequivalents daily in divided doses, providing a bicarbonate level of about 18-20 milliequivalents per liter. Higher doses may be needed to reduce symptoms and prevent or stabilize kidney failure in people who have acidosis caused by kidney failure. Depending on the type of kidney-related acidosis, a dose of 0.5-2 milliequivalents per kilogram of sodium bicarbonate may be taken by mouth daily in 4-5 divided doses, based on the person's response and tolerance to this amount and until the acidosis has been controlled, or a dose of 48-72 milliequivalents (about 4-6 grams) may be taken by mouth daily. Additionally, doses of 4-10 milliequivalents per kilogram may be taken by mouth daily in divided doses. In people who have a type of acidosis that occurs as a complication if diabetes, sodium bicarbonate may be given through an intravenous injection if the blood pH falls below 7.2. A steady dose of 400 milliequivalents of sodium bicarbonate through an intravenous injection for 4-6 hours has been given for lactic acidosis (buildup of lactic acid). A dose of 2-5 milliequivalents per kilogram has been given through intravenous injection over 4-8 hours based on how severe the acidosis is. Some sources suggest that less than 33-50 percent of the bicarbonate needed should be given through intravenous injection immediately for people who need it urgently, while 2-5 milliequivalents per kilogram be given over 4-8 hours for less urgent cases, with additional doses given based on response and lab results.
- To reduce the acid level of urine, a dose of 48 milliequivalents (or four grams) of sodium bicarbonate may be taken by mouth, followed by 12-24 milliequivalents (1-2 grams) every four hours or doses of 30-48 milliequivalents (2.5-4 grams) every four hours, up to 192 milliequivalents (16 grams) daily. These doses may be adjusted to maintain the desired pH level of urine.
- To improve exercise performance, single doses of 3.6 millimoles per kilogram of body mass, a single dose of 2.4 millimoles per kilogram of body mass, or single doses of 2.9 or 4.8 millimoles per kilogram of body mass have been taken by mouth. Doses of sodium bicarbonate have ranged from 100 to 400 milligrams per kilogram taken by mouth as a single dose, as well as given through an intravenous injection either all at once or over three hours within three hours of starting exercise.
- To remove plaque, 1.5 grams of toothpaste containing 20-65% baking soda for one minute on a standard toothbrush has been used while brushing the teeth.
- To treat poisoning, sodium bicarbonate has been taken by mouth to reduce the acid level of urine in the following doses: after taking chlorpropamide, 41.5 ? 3.2 grams of sodium bicarbonate for 1-64 hours until a urine pH of 7.1-8.2 was achieved; three grams of sodium bicarbonate four times daily the day before and two days after taking 750 milligrams of diflunisal; one gram of sodium bicarbonate every four hours for one day before taking three milligrams of sodium fluoride; and 10 grams of sodium bicarbonate over 11 hours after taking sodium fluoride.
- To treat an upset stomach, up to one teaspoon of baking soda dissolved in a glass of water has been taken by mouth for up to two weeks.
- During cardiopulmonary resuscitation (CPR), one milliequivalent per kilogram of sodium bicarbonate has been given through intravenous injection. For heart-related emergencies caused by drugs, 1-2 milliequivalents per kilogram of sodium bicarbonate has been given through multiple intravenous injections until a pH of 7.45-7.55 was reached and maintained. An infusion of 150 milliequivalents per liter of sodium bicarbonate, plus 30 milliequivalents per liter of potassium chloride in five percent dextrose, has been given through an injection. A dose of one milliliter per kilogram of 8.4 percent sodium bicarbonate has been given after blood gas analysis.
- To prevent or treat kidney disorders, 80-212.9 milliequivalents per liter or 150-154 millimoles per liter of sodium bicarbonate solution has been given through an intravenous injection at a rate of 1-5 milliliters per kilogram hourly for 1-12 hours before a medical imaging procedure, and 1-3 milliliters per kilogram hourly for 1-12 hours afterward, or hourly throughout the procedure. Sodium bicarbonate solution has been given through an intravenous injection at a rate of 80 milliliters per kilogram hourly or 80 milliliters per hour for six hours. Sodium bicarbonate solution has been given through an intravenous injection along with 2,400 milligrams of N-acetyl cysteine (NAC) taken by mouth, commonly as 600-1,200 milligrams twice daily, before, the day of, and/or after the procedure. Up to 2,400 milligrams of NAC has also been given through an intravenous injection along with sodium bicarbonate.
- To treat bladder and kidney stones, a daily dose of 71.4 millimoles of sodium bicarbonate has been used to reduce acid in the urine.
- To treat pain, 7.5-8.4 percent of sodium bicarbonate has been given through an intravenous injection before injection with anesthesia. A solution of 1.4 percent sodium bicarbonate or five milliliters of 8.4 percent sodium bicarbonate has also been given with anesthesia.
- To treat poisoning from antidepressant use, the following doses have been given through an intravenous injection: 0.5-2.0 milliequivalents per kilogram of sodium bicarbonate; 100 millimoles, 150 millimoles, or 88 milliequivalents followed by 44 milliequivalents of sodium bicarbonate; 50 millimoles; or levels of sodium bicarbonate needed to reach a pH of 7.83 or to raise pH from 7.4 to 7.5 over a 24-hour period or from 7.36 to 7.52. The following doses have been given through an intravenous injection to increase the pH of urine: a single dose of 10-20 grams over three hours or 40-60 millimoles in five percent dextrose, 12 hours before giving methotrexate and continued for 48 hours after methotrexate treatment or after taking phenobarbital; a dose of 500 milliliters of a solution containing 1.25 percent sodium bicarbonate for one hour every four hours until urine pH exceeded 7.5; or a bolus dose of one millimole per kilogram of sodium bicarbonate through an intravenous injection 30 minutes after an infusion with five milligrams per kilogram of phenobarbital, followed by a one-liter infusion of five percent dextrose containing 100 millimoles of sodium bicarbonate at a rate of 2.5 milliliters per minute until urine pH was maintained at 7.5-8.0. After giving 2,4-dichlorophenoxyacetic acid or a mixture of 2,4-dichlorophenoxyacetic acid and mecoprop, 14 liters containing 69.3 grams of sodium bicarbonate has been given over a two-day period beginning 42-51 hours after ingestion of the toxin. A dose of five milliequivalents per kilogram of sodium bicarbonate has been given through an intravenous injection over one hour, followed by an infusion of 5-6 milliequivalents per kilogram over 23 hours, repeated daily until recovery or death.
- To remove earwax, 4-5 drops of sodium bicarbonate solution have been placed in the ear one or two times daily for up to two weeks.
- To clean the bowels, 1-2 moistened sodium bicarbonate suppositories have been placed inside the rectum, repeated as needed every 4-6 hours.
Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Interactions
Interactions with Drugs
- This section focuses on potential interactions with sodium bicarbonate. For more potential interactions based on sodium itself, information is available in the Natural Standard sodium chloride monograph.
- Sodium bicarbonate has been shown to have benefits in reducing acid levels in urine. This may reduce the toxic effects of poisons.
- Sodium bicarbonate may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin?) or heparin, antiplatelet drugs such as clopidogrel (Plavix?), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin?, Advil?) or naproxen (Naprosyn?, Aleve?).
- Sodium bicarbonate may affect blood pressure. Caution is advised in people who are taking drugs that affect blood pressure.
- Sodium bicarbonate may also interact with agents that may affect blood vessel width, agents that may enhance exercise performance, agents that may increase pH, agents that may reduce potassium levels, agents that may treat ear disorders, agents that may treat heart disorders, agents that may treat kidney disorders, amphetamines, antacids, antidiarrheals, antifungals, antiulcer and stomach acid-reducing agents, aspirin, atazanavir, cefpodoxime proxetil, chlorpropamide, corticosteroids, dasatinib, dental agents, ephedrine, flecainide, iron, lithium, mecamylamine, memantine, metformin, methenamine, pain relievers, pseudoephedrine, tricyclic antidepressants (TCA), and Zegerid OTC?.
Attribution
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This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
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