Acid Base Balance

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Latest Edit: Hector 2014-02-19 (EDT)

Acid–base balance is one of the homeostatic mechanisms required to maintain health. It refers to the balance between acids and bases, it is also referred to as body pH. pH is the measurement of electrical resistance between negative and positive ions, or electrolytes in the body. Like electrolyte regulation, it is essential that the pH of the body be tightly controlled in order for cellular functions to occur. Acid base reactions are reversible which means that body has the ability to correct imbalances, given the correct nutrient or metabolic support.[1]^

Role of Acid Base Balance

When the pH of the body shifts even a little the impact to health can be significant and can result in:

pH of Body Fluids

The pH scale ranges from 1 to 14 with 7 being neutral. Overall the body is slightly alkaline, but each organ and fluid has its optimal pH range. Blood is the most closely controlled with respect to pH. The following are the optimal pH ranges for specific organs and fluids of the body:

  • Blood pH of 7.35 – 7.45
  • Intracellular Fluid (ICF) pH ~ 7.4
  • Extracellular Fluid (ECF) pH ~ 7.2
  • Stomach acid pH of 1.5 – 1.8
  • Acid excretion limit of the kidneys is 4.0 – 4.4
  • Urine pH of 4.0 – 8.0
  • Heart muscle pH of 6.9
  • Saliva pH of 6.5 – 7.0
  • Connective tissue pH of 7.1 – 7.25
  • Pancreatic juices pH of 8.3
  • Amniotic fluid pH of 8.5
  • Bile pH of 8.8

Buffering Ability

The body's acid–base balance is tightly regulated and is dependent on mineral or alkaline reserves, cellular energy reserves and the body's ability to excrete acids primarily through the kidneys or skin.

  • The organ systems responsible for acid-base regulation include:[2], [1]
  • Blood calcium and other minerals and electrolytes are leached from bone and other tissues such as hair and nails if too acidic.
  • Kidneys are the primary organ responsible for excreting acid and regulating electrolyte balance.
  • Lungs regulate acidity by increasing the rate of respiration which results in excreting higher levels of CO2. This is the most efficient way of maintaining acid/base balance, especially in the short-term.
  • Skin acts as a secondary kidney.

Ideally the waste products of glucose are broken down to carbonic acid by the use of enzymes and then the carbonic acid is broken down to H20 + carbon dioxide (CO2) which is exhaled.

  • Problems arise when there is a deficiency of enzymes and nutrients to fully break-down glucose
  • Enzymes require vitamins and minerals to function such as potassium, magnesium, manganese, copper, iron and vitamins B1, vitamin B2, vitamin B3, vitamin B5, vitamin B6 and CoQ10.
  • Whole foods comes with the required nutrients; processed food is deficient in the required vitamins and minerals.
  • When vitamins and minerals are lacking then enzymes become redundant and the cells accumulate partially metabolized by-products of glucose and fat – which are acids – these acids need to be neutralized or buffered until removed by the kidney.
  • Bones release calcium in exchange for hydrogen ions (H+) hence bones and teeth become deficient of calcium (and magnesium) and soft tissues and fascia harden with calcium precipitates.
  • Filtration and elimination of acidic residues occurs primarily through the kidneys, skin and respiration.
  • Blood acid residues and accumulated toxins are pushed into outer extremities as a storage bin away from vital organs. The wrist, joints, fingers, toes and skin are the major target areas to keep the toxins from saturating internal vital organs like the heart and lungs.
  • When the protection phases are overwhelmed, the end result is accumulated acid residues at the cellular level, which drown out oxygen. With this acidic, low oxygen terrain, the microzyma’s trigger morbid microbe infiltration of fungus, molds and parasites, cancer cells, etc., where they seek the diseased terrain as food.
  • There are both extracellular and intracellular buffering electrolytes
  • The extracellular buffers include bicarbonate and ammonia
  • The bicarbonate is pulled from the pancreas into the blood as an alkalizing agent
  • Protein buffers of glutathione, methionine, cysteine, taurine, act as buffers intra-cellularly to bind or neutralize acids during cellular disorganization.
  • The most important buffering process is the bicarbonate buffering system as it is responsible for shifting carbon dioxide (CO2) through carbonic acid (H2CO3) to hydrogen ions and bicarbonate (HCO3-).

H+(aq) + HCO3-(aq) ↔ H2CO3(aq) ↔ H2O(l) + CO2(g)

  • A change in breathing or rate of ventilation is how the body compensates for acid-base imbalances in the short-term.
  • The ability for the kidneys to compensate for acid-base imbalances is slower, but can be more effective in the long-term.

Role of Minerals

  • Alkaline Forming Minerals
  • Acid Forming Minerals
  • It is the balance and ratio of minerals that is important. Not just their presence or absence.
  • High acidity arises when the amount of minerals and vitamins fail to meet the requirements for energy production. This results in the inability to neutralize toxins and acids and hence metabolic breakdown.

Causes of Imbalance

Generally speaking, acid-base imbalance occurs for the following reasons:

  • Dehydration
  • Ingestion or exposure to acidic forming substances and energies including:
  • Carbohydrates burn cleanly leaving only carbonic acid as the break-down product which is removed by the lungs. Proteins and fats leave acids that have to cleared by the kidneys. The kidneys are much slower at removing acids than the lungs.
  • Increased production of carbon dioxide due primarily to exercise or serious infection.[2]
  • Exercise increases nutrient requirements especially for zinc, magnesium and the B Vitamins. Heavy exercise regimes will deplete all nutrients unless supplied by the diet or through supplementation.
  • Adolescents are the most vulnerable group as demands for nutrients are high for physical and sexual maturation.
  • From a metabolic perspective:
  • Increased production of hydrogen ions.
  • The storage of partially metabolized by-products of glucose and fat which are acidic due to the fact that they can not be properly metabolized or excreted.
  • Waste products that are not eliminated are reabsorbed primarily from the colon to the liver to the circulation and then to the tissues.
  • Impaired excretion of acids by the kidneys.
  • Loss of buffering ability.
  • Diseases such as kidney disease, diabetes, almost all chronic disease can disrupt acid-base balance.

Impact of Imbalance

When the acid-base balance is disrupted the following physiological responses occur:

  • Hyperventilation
  • Hypoxia
  • Weakness
  • Headache
  • Increases in body temperature
  • Disproportionate systemic circulation
  • Changes in levels of potassium and other electrolytes
  • Calcifications in the joints and tissues
  • Infections
  • Increased aging
  • Destruction of protective barriers or tissues
  • Higher than normal acid levels in body fluids and tissues result in hardening and erosion within the system.
  • Cells do not utilize oxygen efficiently
  • Prolonged alkalosis associated with convulsions, muscular weakness, coma or death

Associated Conditions

It is the tissue residue that reflects the impact of acid-base balance and the degree to which any acid-base imbalance contributes to disease.

  • Alkalosis refers to higher than normal base levels in body fluids.
  • Acidosis refers to higher than normal acid levels in body fluids.

The four main processes associated with an acid base imbalance are[3]

  • Metabolic acidosis
  • Is related to processes that transform food into energy and body tissues.
  • Results in decreased amounts of bicarbonate (HCO3) due to loss or to increased acid.[4]
  • Associated with alcoholic keoacidosis, diabetic ketoacidosis, lactic acidosis, chronic diarrhea, diabetes, renal failure, chronic diseases, cancer and poisoning or overdose of aspirin, methanol, ethylene glycol.
  • Diabetic ketoacidosis is a condition where excess glucagon and a lack of insulin contribute to the production of ketoacidosis in the liver. This condition is often due to chronic alcoholism and poor carbohydrate utilization.[2]
  • Respiratory acidosis
  • Is caused by the lung's failure to remove excess carbon dioxide from the body.
  • Results in decreased breathing rate due to drugs or central nervous system disorders.
  • May be due to certain prescription medications, trauma to the chest or airway obstruction.
  • Associated with respiratory muscle/nerve diseases (myasthenia gravis, botulism, amyotrophic lateral sclerosis (ALS), Guillain-Barre syndrome).
  • Metabolic alkalosis
  • Results in increased bicarbonate (HCO3), due to loss of acid or gain or bicarbonate.
  • Associated with sodium bicarbonate overdose, drugs, severe dehydration or prolonged vomiting, nasogastric drainage.
  • Respiratory alkalosis

Common Bodily Acids

Some bodily acids are essential for health, others are part of the normal healthy metabolic processes.[1]

Healthy Acids

  • Linoleic Acid and linolenic acids are essential for health.
  • Arachidonic acid is required by the human body as staring material in the synthesis of prostaglandins and leukotrienes.
  • Gallic or tannic acid is found in black tea, coffee and wine.
  • Component of tannins which are used to make leather and ink.
  • Oxalic acid is found in many vegetables and fruits such as cocoa and chocolate, spinach and rhubarb.
  • Malic acid is found in fruits such as apples. Component of citric acid cycle which controls cellular energy production.
  • Tartaric acid is found in grapes.
  • Citric acid is found in lemons, oranges and other citrus fruit. It is a component of the citric acid cycle.

Metabolic Acids

  • Sulphuric acid
  • One of the most manufactured products in the chemical industry
  • One of the most important strongly acidic solvents
  • Many acids and compounds (water, alcohol, ethers, ketones, nitro compounds, carbonic acid, etc) act as a base in the presence of sulphuric acid.
  • Sources include pork and eggs. It is also created from the breakdown of protein.
  • Lactic acid
  • Produced in muscle tissue during exertion as a result of the anaerobic breakdown of glucose.
  • Formed when milk turns sour
  • Not used as a fuel by the body
  • Can causes pain, irregular pulse or arrhythmia
  • Rate limiting step is dependent on the the production of lactic acid versus VO2 max threshold
  • Management of lactic acid is key with sports trainers

Uric acid

  • Both antioxidant and pro-oxidant depending on level; maybe a marker for oxidative stress.
  • Increased with stress and over-exertion
  • Excessive consumption of proteins containing purine or decrease in excretion of acids by the kidneys
  • Released in hypoxic conditions
  • Final oxidation product of purine metabolism
  • Secreted in the urine
  • Over ½ of antioxidant capacity of blood plasma comes from uric acid
  • High levels associated with gout and maybe kidney stones
  • Excessive accumulation associated with cardiovascular disease
  • Putative role or uric acid with strokes
  • Associated with higher risk of Type II diabetes, obesity, dyslipidemia and hypertension
  • Due to increase levels of fructose (and sucrose), sea salt and high alcohol
  • High ferritin and low copper results in higher urate levels; high copper levels associated with decreased urate
  • Low uric acid associated with MS and a deficiency of zinc
  • Acetic Acid
  • Compound that gives the sourness to vinegar and is produced by the bacterial oxidation of ethanol in wine. Household vinegar contains about 5% acetic acid.
  • Is increased in the body due to consumption of sugar, white flour and sweets.
  • Found in a number of cleaning agents.
  • Important in the metabolic processes of humans. The acetyl group of acetic acid binds to Coenzyme A to produce energy and carbon dioxide (via citric acid cycle and oxidative phosphorylation). Some of the acetyl group of acetyl coenzyme A is used to synthesize fatty acids, terpenes, steroids, and other molecules.
  • Hydrochloric acid
  • A naturally occurring acid in the body
  • Secreted by the stomach to assist with digestion
  • Impacted by stress and over-exertion
  • Sodium bicarbonate (baking soda) is made in specialized stomach cells and is broken down to sodium chloride, carbon dioxide and water – HCL is the byproduct.
  • Carbonic acid
  • A weak acid
  • A natural by-product and waste product of energy production - glucose conversion (via enzymes) to carbonic acid – CO2 + H2O
  • Bad air, flat breathing, lack of exercise, as well as from over-exertion and beverages containing carbonic acid
  • Red blood cells contain carbonic anhydrase which both increases the reaction rate and dissociates a hydrogen ion from the carbonic acid, leaving bicarbonate. This reaction is reversed in the lungs.
  • Contributes to the acidification of the oceans.

Other Acids

  • Formic acid
Formic acid is the toxic metabolite responsible for the metabolic acidosis oberserved in methanol poisoning.[5]
  • Ricinoleic acid – occurs in castor oil.
Breaks down to undecylenic acid and n-heptaldehde.
Zinc salt of undecylenic acid is used to treat fungal infections of the skin.
Esters of this acid are used in perfumery.
  • Sorbic acid
Used as a preservative in many food products as well as in their packaging materials.
Inhibits the growth of molds and other fungi.
  • Benzoic acid
Sodium benzoate is used as a preservative in many food products
  • Butyric acid – component of cow’s milk
  • Capryic (caproic and capric) acid – component of goat’s milk
  • Lauric, myristic, palmitic and stearic acids – present in the fats and oils of animals and plants
  • Keto-acids – acetone, processed fat and from incomplete fat burning as in the case of diabetes.
  • Tannic acid – black tea, coffee and wine
  • Phosphoric acid – from soft drinks, energy drinks
  • Nitric acid – from cured meats, artificial cheese products
  • Acetylsalicylic acid – painkillers
  • Many plastics are produced from acids


No test can accurately gauge pH due the many buffering mechanisms of the body.

  • Overall tissues residue determines sickness or health.
  • Most measurements of electrolyte concentration are of the extracellular fluid such as blood or urine.
  • Rise in serum potassium is a sign of high acidity. This can occur when a large number of cells are severely injured or die – spilling potassium ions – which may affect heart function or other systems.
  • Primary metabolic acid-base disorders are determined by measuring bicarbonate and serum electrolytes.
  • A faster pulse rate at rest is typically associated with more acidic.
  • Saliva pH assessment
  • First morning assessment of the saliva pH (using pH paper) can give an indication of the overall state of health of the body. It reflects a person's alkaline reserves and is an indicator of intracellular pH. The most accurate saliva pH measurement is taken right after a person rises from at least five hours of sleep. Prior to eating or even brushing your teeth.In a healthy state the salivary pH will be above 6.8.
  • The pH of your saliva after you eat gives an indication of what the mineral reserves of your body are.
  • The ideal salivary pH reading is 6.8 upon waking, 7.0 before eating and 8.5 following breakfast.
  • By taking a base-line saliva pH reading and then eating a lemon or drinking pure lemon juice and taking salivary pH readings every minute you can assess your mineral reserves.
  • It is impacted by what a person eats.
  • Urine pH assessment
  • The first morning urine pH (using pH paper) is a reflection of the detoxification of the body at night and is not a good indicator of overall pH status of the body.
  • The second morning urine pH reflects how well your digestive system dealt with what you ate or did the night before.
  • The pH of urine between meals ideally will be in the range of 7.0 to 8.5 if the digestive system is functioning optimally and the body has the mineral reserves to digest what has been eaten.
  • Urine pH is affected by body stores, recent diet, alkalizing steps such as herbs, homeopathics or other supplements, overall health status, hydration status, activity level, stress levels and any medications that you are taking.

To assess overall pH range you can do the following 5 tests:

  1. Test your saliva pH upon waking (before food, drink or brushing your teeth).
  2. Test the pH of your second urine of the morning.
  3. Test the pH of your saliva five minutes after eating.
  4. Test your urine pH between breakfast and lunch.
  5. Test your urine pH between lunch and dinner.


Steps to decrease the acidity of the body include:

  • Increase body’s stores of buffering minerals
Article Acid-alkaline balance: The third dimension of fruit and vegetables, IHP, September 2009
  • Food: Adopt the 80:20 rule and consume 80% alkaline foods and 20% acidic.
  • Consider mineral powders or supplements
  • Choose alkalizing herbs
  • Decrease the inputs and increase the excretion before increasing mobilization of stored acids.


  1. 1.0 1.1 1.2 Britannica Online Encyclopedia Acid-base reaction [1]
  2. 2.0 2.1 2.2 Kaczkowski Crystal Heather Acid-Base Balance [2]
  3. Pagana KD, Pagana TJ (1997) Mosby's Diagnostic and Laboratory Test Reference Mosby.
  4. Peters John P, Bulger Harold A, Eisenman Anna J (1926) Total Acid-Base Equilibrium of Plasma in Health and Disease, High Serum Bicarbonate in the Heart Failure. Asphyctic Anoxemia. Depart of Internal Medicine, Yale University;pg511-523.
  5. Muthuvel A, Rajamani R, Sheeladevi R (Feb 2006) Therapeutic response to single intravenous bolus administration of formate dehydrogenase in methanol-intoxicated rats. Toxicology Letters;161(2):89-95'