Effect of sodium bicarbonate on [HCO3-], pH, and gastrointestinal symptoms
Abstract
CONTEXT: Sodium bicarbonate (NaHCO₃) is often ingested at a dose of 0.3 g/kg body mass (BM), but ingestion protocols are inconsistent in terms of using solution or capsules, ingestion period, combining NaHCO₃ with sodium citrate (Na₃C₆H₅O₇), and coingested food and fluid. PURPOSE: To quantify the effect of ingesting 0.3 g/kg NaHCO₃ on blood pH, [HCO₃-], and gastrointestinal (GI) symptoms over the subsequent 3 hr using a range of ingestion protocols and, thus, to determine an optimal protocol. METHODS: In a crossover design, 13 physically active subjects undertook 8 NaHCO₃ experimental ingestion protocols and 1 placebo protocol. Capillary blood was taken every 30 min and analyzed for pH and [HCO₃-]. GI symptoms were quantified every 30 min via questionnaire. Statistics used were pairwise comparisons between protocols; differences were interpreted in relation to smallest worthwhile changes for each variable. A likelihood of >75% was a substantial change. RESULTS: [HCO₃-] and pH were substantially greater than in placebo for all other ingestion protocols at almost all time points. When NaHCO3 was coingested with food, the greatest [HCO₃-] (30.9 mmol/kg) and pH (7.49) and lowest incidence of GI symptoms were observed. The greatest incidence of GI side effects was observed 90 min after ingestion of 0.3 g/kg NaHCO₃ solution. CONCLUSIONS: The changes in pH and [HCO₃-] for the 8 NaHCO₃-ingestion protocols were similar, so an optimal protocol cannot be recommended. However, the results suggest that NaHCO₃ coingested with a high-carbohydrate meal should be taken 120-150 min before exercise to induce substantial blood alkalosis and reduce GI symptoms.
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The common or recommended dose of oral sodium bicarbonate supplement is 300 mg/kg body mass.
“The common or recommended dose of oral sodium bicarbonate supplement is 300 mg·kg−1 body mass [23,24,25,26,27,28]”
From Effects of Enteric-Coated Formulation of Sodium Bicarbonate on Bicarbonate Absorption and Gastrointestinal Discomfort (2024) · cites this paper as [25]
Administration of sodium bicarbonate supplements is associated with gastrointestinal symptoms in approximately 30% of athletes.
“However, administration of sodium bicarbonate supplements is associated with adverse effects, i.e., gastrointestinal symptoms, in ~30% of athletes [25,26,27].”
From Effects of Enteric-Coated Formulation of Sodium Bicarbonate on Bicarbonate Absorption and Gastrointestinal Discomfort (2024) · cites this paper as [25]
Ingestion form may alter the ergogenic potential of NaHCO3.
“Given that higher pre-exercise blood [HCO 3 -] is associated with greater performance enhancements (Carr et al., 2011b;Matson & Tran, 1993), ingestion form may alter the ergogenic potential of NaHCO 3 .”
From Enteric-Coated Sodium Bicarbonate Attenuates Gastrointestinal Side-Effects (2020) · cites this paper as Carr et al., 2011b
More participants reached blood bicarbonate concentrations associated with performance-enhancing effects with delayed-release NaHCO3.
“Similarly, more participants reached concentrations that are associated with performance-enhancing effects (Carr et al., 2011b).”
From Enteric-Coated Sodium Bicarbonate Attenuates Gastrointestinal Side-Effects (2020) · cites this paper as Carr et al., 2011b
Gastrointestinal disturbances often occur with bicarbonate use, but can be managed by consuming the dose in a split protocol with intake of a small meal/snack.
“Gastrointestinal disturbances often occur with bicarbonate use, but can be managed by consuming the dose in a split protocol with the intake of a small meal/snack [135].”
From New strategies in sport nutrition to increase exercise performance (2016) · cites this paper as [135]
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MEETING THE NUTRITIONAL DEMANDS OF HIGH-INTENSITY INTERVAL TRAINING
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- Authors
- Carr, A. J., Slater, G. J., Gore, C. J., Dawson, B., & Burke, L. M.
- Venue
- International Journal of Sport Nutrition and Exercise Metabolism
- Publisher
- Human Kinetics
- Published
- 2011-06
- Volume
- 21
- Issue
- 3
- Pages
- 189-194
- ISSN
- 1526-484X (ISSN-L)
- 1543-2742
- OpenAlex
- W2096818215
- Cited by
- 159
- References
- 26
- Citations by year
- 2026: 13 · 2025: 5 · 2024: 14 · 2023: 10 · 2022: 8 · 2021: 18 · 2020: 17 · 2019: 11 · 2018: 14 · 2017: 4 · 2016: 12 · 2015: 10 · 2014: 5 · 2013: 9 · 2012: 4
- FWCI
- 5.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Sport Nutrition and Exercise Metabolism (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Research Bank (Australian Catholic University) (submittedVersion)
- University of Canberra Research Portal (submittedVersion)
- Deakin Research Online (Deakin University) (submittedVersion)
- USC Research Bank (University of the Sunshine Coast) (submittedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Renal function and acid-base balance
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Keywords
- sodium bicarbonate, blood bicarbonate, blood pH, alkalosis, gastrointestinal symptoms, exercise performance, sodium citrate, pre-workout supplements
- MeSH terms
- Sodium Citrate, Adult, Citrates, Dietary Carbohydrates, Drug Administration Schedule, Eating, Female, Gastrointestinal Diseases, Humans, Hydrogen-Ion Concentration, Male, Surveys and Questionnaires, Time Factors, Sodium Bicarbonate, Cross-Over Studies, Gastrointestinal Tract
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