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Cited by 92Sports Performance and TrainingMuscle metabolism and nutritionCardiovascular and exercise physiology

Time to Optimize Supplementation: Modifying Factors Influencing the Individual Responses to Extracellular Buffering Agents

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Heibel, André B., Perim, Pedro H. L., Oliveira, Luana F., McNaughton, Lars R., Saunders, Bryan·2018·Frontiers in Nutrition
DOI 10.3389/fnut.2018.00035PMC PMC5951986
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Abstract

Blood alkalosis, as indicated by an increased blood bicarbonate concentration and pH, has been shown to be beneficial for exercise performance. Sodium bicarbonate, sodium citrate, and sodium or calcium lactate, can all result in increased circulating bicarbonate and have all independently been shown to improve exercise capacity and performance under various circumstances. Although there is considerable evidence demonstrating the efficacy of these supplements in several sports-specific situations, it is commonly acknowledged that their efficacy is equivocal, due to contrasting evidence. Herein, we discuss the physiological and environmental factors that may modify the effectiveness of these supplements including, (i) absolute changes in circulating bicarbonate; (ii) supplement timing, (iii) the exercise task performed, (iv) monocarboxylate transporter (MCT) activity; (v) training status, and (vi) associated side-effects. The aim of this narrative review is to highlight the factors which may modify the response to these supplements, so that individuals can use this information to attempt to optimize supplementation and allow the greatest possibility of an ergogenic effect.

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  • Blood bicarbonate levels increased by approximately 5-6 mmol/L are considered sufficient to maintain or improve the buffering and contraction capacity of muscles.

    “Such levels are considered sufficient to maintain or improve the buffering and contraction capacity of muscles [29,31].”

    From Effects of Enteric-Coated Formulation of Sodium Bicarbonate on Bicarbonate Absorption and Gastrointestinal Discomfort (2024) · cites this paper as [29]

    The ‘Increases in circulating bicarbonate’ section says a rise of approximately 5–6 mmol/L should be sufficient to improve exercise capacity and performance through increased extracellular buffering. The ‘Role of pH in skeletal muscle fatigue’ section explains how acidosis can hinder muscle contraction, but the paper does not establish that this bicarbonate rise maintains or improves muscles’ own buffering and contraction capacities. (LLM, conf=0.82)

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  • Sodium bicarbonate increases circulating bicarbonate and delays metabolic acidosis resulting from high-intensity exercise, thereby potentially improving performance in rowing, swimming, running, cycling, combat sports, and resistance training.

    “These effects are achieved by increasing circulating bicarbonate and delaying metabolic acidosis resulting from high‐intensity exercise, thereby potentially improving performance in rowing, swimming, running, cycling, combat sports, and resistance training (Heibel et al. 2018; Grgic, Pedisic, et al. 2021).”

    From Gastrointestinal Symptoms Associated With Sodium Bicarbonate Supplementation Protocols: A Systematic Review (2026) · cites this paper as Heibel et al. 2018

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  • Sodium bicarbonate enhances performance, particularly in high-intensity activities lasting 30 seconds to 10 minutes.

    “Sodium bicarbonate enhances performance, particularly in high‐intensity activities lasting 30 seconds to 10 minutes, by acting as an extracellular buffer and maintaining pH homeostasis within the blood (Heibel et al. 2018).”

    From Gastrointestinal Symptoms Associated With Sodium Bicarbonate Supplementation Protocols: A Systematic Review (2026) · cites this paper as Heibel et al. 2018

    The Exercise task section (page unavailable) supports a performance benefit from sodium bicarbonate in some high-intensity tasks, and The role of pH in skeletal muscle fatigue explains how circulating bicarbonate helps buffer hydrogen ions. But the paper gives the 30-second-to-10-minute range as a finding for beta-alanine, from which it expects comparable results for sodium bicarbonate; it also reports that a 30-second exercise test was unaffected by sodium bicarbonate. The claim presents that range too definitively for sodium bicarbonate. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • 300 mg/kg oral sodium bicarbonate can increase blood bicarbonate concentration by approximately 5-6 mmol/L.

    “which can increase the concentration of blood bicarbonate ions by approximately 5–6 mmol·L−1 [29,30,31].”

    From Effects of Enteric-Coated Formulation of Sodium Bicarbonate on Bicarbonate Absorption and Gastrointestinal Discomfort (2024) · cites this paper as [29]

  • Evidence suggests that athletes may be deterred from supplementing with sodium bicarbonate due to the risk of GI symptoms during training or competition.

    “Evidence suggests that athletes may be deterred from supplementing with sodium bicarbonate due to the risk of GI symptoms during training or competition (Heibel et al., 2018).”

    From Acute enteric-coated sodium bicarbonate has negligible effect on anaerobic performance but affects metabolomics and attenuates the gastrointestinal response (2022) · cites this paper as Heibel et al., 2018

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Authors
Heibel, A. B., Perim, P. H. L., Oliveira, L. F., McNaughton, L. R., & Saunders, B.
Affiliations
  • Universidade de Brasília (BR)
  • Universidade de São Paulo (BR)
  • Edge Hill University (GB)
Corresponding author
Saunders, Bryan
ORCID
Venue
Frontiers in Nutrition
Publisher
Frontiers Media SA
Published
2018-05-08
Volume
5
Pages
35-35
ISSN
2296-861X (ISSN-L)
DOI
10.3389/fnut.2018.00035
PMC
PMC5951986
OpenAlex
W2799465694
Cited by
92
References
107
Citations by year
2026: 8 · 2025: 3 · 2024: 13 · 2023: 8 · 2022: 6 · 2021: 24 · 2020: 17 · 2019: 9 · 2018: 2 · 2017: 1 · 2016: 1
FWCI
2.66
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Nutrition (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Edge Hill University Research Information Repository (Edge Hill University) (publishedVersion, cc-by)
  • Edge Hill University (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Fundação de Amparo à Pesquisa do Estado de São Paulo (2016/50438-0, 2017/04973-4, 2016/17391-0)
  • Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
Keywords
sodium bicarbonate supplementation, sodium citrate, sodium lactate, calcium lactate, bicarbonate, exercise performance, ergogenic aids, monocarboxylate transporters, training status, adverse effects, interindividual variability

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