Effect of Stacked Sodium Bicarbonate Loading on Repeated All-out Exercise
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The purpose of this study was to evaluate whether NaHCO3, administered via a 9-h stacked loading protocol (i.e. repeated supplementation with small doses in order to obtain a gradual increase in blood [HCO3 -]), has an ergogenic effect on repeated all-out exercise. Twelve physically active males were randomly assigned to receive either NaHCO3 (BIC) or placebo (PL) in a double-blind cross-over design. NaHCO3 supplementation was divided in three identical 3-h cycles: a 6.3 g bolus at the start, followed by 2.1 g doses at +1-h and +2-h, yielding a total NaHCO3 intake of 0.4 g·kg−1 BM over 9-h. At the end of each cycle, participants performed 2-min all-out cycling. Capillary blood samples were analyzed for [HCO3 -], pH and [La-]. Pre-exercise blood [HCO3 -] in PL decreased from 25.6±0.2 mmol·L−1 in bout 1 to 23.6±0.2 mmol·L−1 in bout 4, while increasing from 25.5±0.2 to 31.2±0.4 mmol·L−1 in BIC (P<0.05). Concomitantly, pre-exercise pH values gradually decreased in PL (from 7.41±0.00 to 7.39±0.01) and increased in BIC (from 7.41±0.01 to 7.47±0.01; P<0.05). Mean power output of the four bouts was higher in BIC (428±20 W) than in PL (420±20 W; P<0.05). The ergogenic effect on repeated all-out exercise occurred in the absence of gastrointestinal distress.
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Gastrointestinal symptoms associated with sodium bicarbonate include nausea, vomiting, bloating, abdominal cramps, flatulence, and diarrhea.
“Of note, doses around and above 0.2–0.3 g/kg have been linked to reports of gastrointestinal symptoms (GIS) (Grgic, Pedisic, et al. 2021), which include, but are not limited to, nausea, vomiting, bloating, abdominal cramps, flatulence, and diarrhea (Dalle et al. 2019; Driller et al. 2012; Miller et al. 2016; Saunders et al. 2014; Varovic et al. 2023).”
From Gastrointestinal Symptoms Associated With Sodium Bicarbonate Supplementation Protocols: A Systematic Review (2026) · cites this paper as Dalle et al. 2019
The Introduction identifies stomach cramping and diarrhea as gastrointestinal problems associated with sodium bicarbonate; the Discussion also describes abdominal pain and flatulence. The paper does not identify nausea or bloating, and the vomiting reported in its Results occurred in the placebo group, not the sodium-bicarbonate group. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe greater GIS with placebo may be related to the composition of the placebo, which has in other studies shown non-zero presence of GIS.
“possibly related to the composition of the placebo, which has in other studies shown non‐zero presence of GIS”
From Gastrointestinal Symptoms Associated With Sodium Bicarbonate Supplementation Protocols: A Systematic Review (2026) · cites this paper as Dalle et al. 2019
The Results report greater, non-zero GI distress with placebo than with bicarbonate. But the Discussion says sodium in the placebo was very unlikely to explain the difference and instead favors exercise-induced acidosis; it does not support the proposed link to placebo composition. No page numbers are available in our copy. (LLM, conf=0.87)
Experimental — accuracy not yet measuredIn one of these five studies, GIS were greater with placebo.
“though in one of these instances, GIS were greater with placebo (Dalle et al. 2019).”
From Gastrointestinal Symptoms Associated With Sodium Bicarbonate Supplementation Protocols: A Systematic Review (2026) · cites this paper as Dalle et al. 2019
Five of 28 studies reported statistical differences in GIS between conditions.
“Five of 28 studies reported statistical differences in GIS between conditions (Dalle et al. 2019; J. C. Siegler et al. 2022; Ferragut et al. 2024; Montalvo‐Alonso et al. 2024; W. H. Gurton et al. 2025)”
From Gastrointestinal Symptoms Associated With Sodium Bicarbonate Supplementation Protocols: A Systematic Review (2026) · cites this paper as Dalle et al. 2019
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Grgic, J., Pedisic, Z., Saunders, B., Artioli, G. G., Schoenfeld, B. J., McKenna, M. J., Bishop, D. J., Kreider, R. B., Stout, J. R., Kalman, D. S., et al. (2021) · Journal of the International Society of Sports Nutrition · doi:10.1186/s12970-021-00458-w · Cited by 138 · see citing works
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Winter, I. P., Sarac, P., & Wilson, P. B. (2026) · European Journal of Sport Science · doi:10.1002/ejsc.70225
- Authors
- Dalle, S., De Smet, S., Geuns, W., Rompaye, B. V., Hespel, P., & Koppo, K.
- Affiliations
- KU Leuven (BE)
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
- Ghent University (BE)
- Corresponding author
- Koppo, Katrien
- Venue
- International Journal of Sports Medicine
- Publisher
- Georg Thieme Verlag KG
- Published
- 2019-08-21
- Volume
- 40
- Issue
- 11
- Pages
- 711-716
- ISSN
- 0172-4622 (ISSN-L)
- 1439-3964
- OpenAlex
- W2969708954
- Cited by
- 11
- References
- 6
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2022: 2 · 2021: 3 · 2020: 2
- FWCI
- 1.86
- Type
- journal article
- Language
- en
- Open access
- green
- lirias.kuleuven.be
- Licence
- other-oa
- Locations
- International Journal of Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- Lirias (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Keywords
- sodium bicarbonate, ergogenic aids, blood bicarbonate, blood pH, lactate, cycling power output, exercise performance
- MeSH terms
- Double-Blind Method, Drug Administration Schedule, Exercise Test, Gastrointestinal Diseases, Humans, Hydrogen-Ion Concentration, Male, Sodium Bicarbonate, Cross-Over Studies, Lactic Acid, Athletic Performance, Young Adult, Performance-Enhancing Substances
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