After the release of my book, The Hormone Fix,I received a lot of questions relating to my recommendation for people to measure their urine pH as a marker of their overall health.
I’ve always said, “Test, don’t guess,” when it comes to your health. And testing your urine pH is no different. Low-cost urine pH strips can easily be obtained and used in the privacy of your home. Testing your urine can help you quickly assess if your body is in an alkaline or acidic state, either of which can provide important clues relating to your current and ongoing health.
Note that some urine pH test strips also test for a chemical produced in the body known as ketones, the presence of which has been associated with reduced inflammation in the body, improved insulin sensitivity, and greater weight loss; as well as being supportive of brain health.
I’ll talk a bit more about ketone measurement in the urine, but first let’s focus on the importance of your body’s acid-alkaline pH status.
In a substantial amount of research, a more optimal alkaline pH status in the body has been found to:
And we can test for less than optimal alkaline status. Our urine pH is one easy way to do this.
And the even better news? We can choose to address an overly acidic condition through simple lifestyle interventions, including dietary changes. So let’s get started.
Here’s what you will learn in this 2-part article…
The chemistry behind pH in your body
First, a review of what pH is, and how it is measured in your body and in the foods you eat…if this is familiar information to you, please just skip this “101 on pH” and go directly to the next section, “Diet-induced metabolic acidosis.”
There are actually 3 instances of pH in your body that we will be touching on in this article although there are many aqueous (containing water) systems and organs in the body which also have a pH value. We’ll specifically be talking about:
First, what is pH?
You can measure any aqueous solution and determine its pH (“power of hydrogen”), which measures the total hydrogen ion concentration in a solution. Basically that means measuring whether a solution is acidic or alkaline.
The pH scale ranges from 1 to 14, with 7 considered to be generally neutral. Higher numbers are alkaline (also referred to as base) and lower numbers are acidic (acid). This scale may appear like it is too small or simple to be meaningful, but each change in a point is 10 times greater than the next. So a pH of 8 is 10 times more alkaline than a pH of 7, but is 100 times more alkaline than a measure of 6.
The ocean has a pH of about 8.1 (it has actually become more acidic over time, perhaps due to the input of CO2 due to global warming). Human blood has a very specific “normal” range between 7.35 – 7.45. For urine testing I see a pH of 7 as ideal.
In contrast, on the acidic side, the pH of the vagina is 3.8 – 4.4. The stomach is also acidic, usually at a pH less than 3. This makes sense as the acidic environments keep pathogens and infections at bay. The body attempts to maintain all of its various pH levels based on the optimal levels needed for a given organ or system.
Your body’s pH buffering abilities
A good friend of mine, JJ Virgin, has always said that our bodies are like chemistry labs…and it is so true.
Our body strives to maintain itself in a slightly alkaline pH (in both the urine and blood) for optimal health.This happens through a series of acid-buffering activities involving the kidneys, lungs, bone, skeletal muscle, liver, intestines and a number of buffering fluids (electrolytes). These systems work together to reduce (buffer) acidity and balance the body’s electrolytes to keep it in this healthier alkaline state.
Each system contributes to this balancing act through the production, utilization (sometimes absorbing, converting, or filtering and recycling) and excretion of minerals (electrolytes or ions) such as potassium, sodium, phosphorus, bicarbonate, copper, zinc, chromium, iron, phosphate, manganese, magnesium, citrate, bicarbonate, chloride and calcium. These buffering systems also have to manage the creation, utilization and waste removal of acids such as sulfuric acid, phosphoric acid, hydrochloric acid, carbonic acid, lactic acid, and more.
The electrolytes buffer the body fluids and control the movement of fluids throughout the body. They can take up residence within the body; for example, phosphate and calcium taken in through the digestive tract most often get incorporated into our bones and teeth, basically becoming a storage area for those minerals should the body need them to supply the blood or other tissues with those minerals. Electrolytes can get converted and recycled throughout the body. They can be excreted through urine (via the kidneys), sweat or feces. Vomiting or diarrhea can cause changes in their levels. Automatic adjustments in respiratory and renal (kidney) function continually occur to balance of levels of these buffering substances.
Different systems and organs in the body (digestive, vagina, whatever…each with their own unique pH requirements) can also affect each other, in particular when we experience hormone fluctuations or imbalances. Each system is also its own little chemical laboratory, filtering, recycling and removing electrolyte and acid wastes…inputting into other systems. It is a very complex overall system to keep each individual system at that system’s own optimal pH levels and yet still maintain the body’s overall alkaline health.
So I mentioned that the “normal” pH for blood is actually a range, between 7.35 and 7.45. This range is maintained by the two most diligent buffering systems within the body, the kidneys and the lungs (using other buffering systems throughout the body as needed). These mechanisms are so sensitive to maintaining the correct pH that fluctuations outside of the normal range rarely occur unless someone is having an emergency health issue and are near dying (blood pH less than 7.35 is referred to as diabetic ketoacidosis or acidemia; less than 7 is likely to be fatal; above 7.45 is referred to as metabolic alkalosis with a blood pH greater than 7.8 to be fatal).
Within the normal range, the body tries to keep to a slightly more alkaline pH of 7.4 as much as possible by using the various buffering mechanisms it has.
When the body’s blood pH shifts slightly lower within the normal range, due to an acidic diet, dehydration, kidney issues, hormone imbalances (such as cortisol or insulin), etc. this condition is called, chronic low-grade metabolic acidosis. This condition stresses the buffering systems within the body and key electrolyte balance can break down.
This condition has been measured and documented in many research studies, in particular as a result of consuming an acidic diet. Blood pH can change, albeit slightly and within the normal range, due to diet-induced acidity.
Those slight shifts are quite meaningful to one’s health. I’ll share some of the research and we’ll talk a lot more about chronic low-grade metabolic acidosis, also sometimes referred to in the research as diet-induced metabolic acidosis, or food-induced metabolic acidosis.
As mentioned above I use 7.0 as the ideal measure we want to see for urinary pH. Most “normal” urine pH levels range from about 4.6 to 8.0, with 6 being viewed as average.(1) In my women’s restorative health programs I find that about 90% of participants have a urine pH of less than 6 at the start.
Long-term occurrence of lower urinary pH is a marker for diet-induced metabolic acidosis. Note that having a urinary pH that is too high (overly alkaline) is also unhealthy and can result in many health conditions such as kidney stones and urinary tract infections.
Numerous studies have shown that urinary pH adjusts to healthier alkaline levels with greater intake of fruits and vegetables (considered foods with the greatest alkaline effect) and reduced intake of more acidic foods such as processed foods and sugar. Too much protein or fat can also impact the body’s ability to maintain a more optimal alkaline status.(2)
Let’s talk more about diet’s impact on the body’s acid-base balance.
The pH of foods we eat
A little more chemistry before we can get into the research.
Foods have pH values that usually mirror the effect that the particular food has on the body’s acid-base balance once consumed. There are a few exceptions (just to confuse things) though, one example being lemon. Lemon is an “acidic” fruit with a pH of 2, but it has an alkalizing effect once consumed. It is actually a wonderful alkalizing secret (nothing better than a hot cup of water with a slice of lemon in it).
Fruits and vegetables generally have the most alkaline effect on the body’s acid-base balance (due to their high mineral content), and meat, poultry, dairy, sugar, soda, processed foods, caffeine, etc. have the more acidic effect. Grains are slightly acidic. Alcohol is also acidic (I always say that most vices are, unfortunately, acidic)!
Note that many of us eat a more acidic diet due to our unhealthy food choices (processed foods in particular), but even those who may eat healthfully may be unaware of the very different mineral profiles that our foods today have versus what our ancestors ate. Today’s farming practices and mineral-poor soils, coupled with the large amount of toxins that foods are now exposed to (including pesticides, antibiotics and hormones) impact the acidic effects of much of what people eat. There has been a significant increase in sodium (Na) and a decrease in potassium (K), for example. In fact the ratio of potassium to sodium has reversed and changed dramatically. K/Na previously was 10 to 1; now in the typical Western diet it has a ratio of 1 to 3!. (3)These changes can impact many of our body’s most important processes.
Please note, however, that I am not saying we need to completely avoid acidic foods!
I repeat. We need a balance of HEALTHY (organic, grass-fed, etc.!) acidic foods in our diet.
I know some of my Paleo friends have been initially skeptical when they started hearing about the importance of alkalinity, as some interpreted it as contrary to the positive benefits of having meat and other protein in the diet. But let’s be clear on this, I am not saying veggies and alkaline foods only. Protein is vital for bone health and is important to us for many other nutrients that we need. To me, excluding protein isn’t the healthiest plate for a wide variety of reasons, and that’s how I look at all of this, what’s the healthiest plate consist of. So relating to eating “acid” versus “alkaline” foods, the important thing for your best health is the ratio of alkaline to acid, or what is actually on your dinner plate.
You need to be looking at the net effect of your diet on your acid-base balance. So however you want to approach that, maybe using the 80/20 rule. Consume a diet that is 80% alkaline (a lot of veggies), and 20% acidic (your protein and healthy fats). You just want to reduce acidic foods and also eat meals that have a positive base load. In my women’s restorative health programs we talk about visualizing an actual plate with the healthiest proportion of proteins, healthy carbs (veggies) and healthy fats.
Go organic for higher mineral content and fewer toxins: Non-organic options are likely grown in mineral-depleted soils that are also exposed to toxins. Go organic to optimize your alkalinity benefits.
Alkalinity isn’t just about diet: One last point about what impacts your body’s alkaline or acidic state: your acid-base balance is about much more than the food you eat. The effects of consuming acidic diets – stressing our body’s acid-buffering mechanisms - can be worsened by non-dietary lifestyle influences, such as chronic stress, exposure to environmental toxins, inadequate sleep and circadian rhythm disruptions. Through working with thousands of clients I’ve also seen how powerful holding on to toxic and negative emotions can be in regards to a woman’s ability to get out of an acidic state even when eating the perfect alkaline diet.
All of these non-dietary interrupts impact your own unique chemistry lab! They impact endocrine secretions, your microbiome health and more…disrupting the movement and utilization of important fluids throughout your body at the deepest cellular levels.
Diet-induced metabolic acidosis and its very real health effects
As true with most research, a lot of the studies on acid/alkalinity’s effects on overall health have come from a focus on the prevention and/or treatment of diseases. Kidney disease in particular has been key to understanding the importance of acid/alkaline balance, as has bone and muscle research, blood pressure/hypertension research, along with studies relating to athletic performance and diet.
In a similar manner, much of the initial and ongoing research on ketones has focused on diseases such as Alzheimer’s, epilepsy, diabetes and cardiovascular disease; even though ketones (a result of ketogenic diets, my Keto-Green® diet, and fasting) are popular in the mainstream news for their positive effects on weight loss and overall health.
The kidneys are the primary acid-buffering system in the body, and kidney research tells us that as our body ages there is actual degradation in its buffering abilities; as we age our bodies naturally become more acidic as measured with blood pH. This is important to note as an acidic diet, like the typical Western diet, but also ketogenic (high fat) and high protein diets, sustained over time, can become even more deleterious when our body’s ability to buffer acid is naturally weakening with age.(4,5,6)
Consuming an acidic diet has been shown in numerous research studies to lead to a more acidic urinary pHas well as to shift the blood pH slightly more acidic (while still keeping it in the normal range). This diet-induced metabolic acidosis has been shown to contribute to a wide range of disease states.
Here are just a few references,
In other research, an optimal alkaline state has been found to:
So I hope you can see why we want to maintain an alkaline state in our bodies. And the easiest way to ensure that is by ongoing monitoring.
Part 2 of this article, “What Your Urine pH Says About Your Health” will talk about testing your urine for both alkalinity as well as for ketones, and what you can learn about your health from your results!
Remember your acid or alkaline state isn’t just about the diet you eat! That’s so important to understand, and I’ll talk more about that in Part 2. You can also learn much more about the Keto-Green diet - and lifestyle - in my book, The Hormone Fix. I devote an entire section of the book on lifestyle elements that can impact your hormone balance, inflammation and overall health.
Now on to Part 2!
In Part 1, I discussed the chemistry behind pH in your body and the differences between blood pH, urine pH and the pH effect that different foods have on your body.
I also provide a lot of research relating to all of the negative effects associated with eating and living an acidic lifestyle. I hope you’ll review some of this, it is very compelling.
Now let’s talk about testing your urine pH. In Part 2 you will learn,
I’m going to focus on the ill effects of having an acidic pH as that is what the majority of people will find when they test their urine pH (due to consumption of the typical Western diet, processed foods, toxin exposures, stress, etc.).
So let’s all put on our Nancy Drew detective caps and test our urine! Testing your urine pH is easy to do...and will look like this. You just look at the color-codes to determine how alkaline or acidic you are and can also measure for ketones.
Note that you really want to have more than one test result. Testing daily, even several times a day, for several weeks in a row can shed light on what’s going on with your body.
And once you are trying to maintain a more net alkaline diet, testing can also provide immediate feedback on the effect your dietary changes are having.
When your urinary pH tests as acidic, it can point to:
A bit more about bone health
We know that an acidic diet may result in lower levels of magnesium, and that magnesium levels affect bone health due to its impact on Vitamin D activation. Many people are already deficient in Vitamin D.(11)
So a more alkaline diet supports this aspect of bone health. As stated earlier an alkaline diet is supportive of maintaining lean muscle mass, important for fall and fracture prevention.
There are also numerous studies that have concluded that acidic diets adversely affect bone health by pulling needed calcium from the bone (referred to as resorption of the bone) as an acid-buffering mechanism (on top of kidney and lung acid-buffering actions).(12) These researchers feel that decades of eating a high acid diet might contribute to the loss of bone mass seen in osteoporosis due to this ongoing bone resorption activity.
But there are also opponents to this thinking. And the many studies relating to the effects of acid diets on osteoporosis appear to support “both sides.”
One recent 2018 study tried to meld both sides of thinking by looking at the age of the subjects. They concluded that additional factors such as age (as well as gender, immobility, and race) impacted whether a high acid diet contributed to the development of osteoporosis, as well as whether alkaline therapy would help treat osteoporosis. (13) In older subjects they found lower buffering capacity due to lower muscle and/or bone mass, as well as diminished kidney buffering ability (remember, our kidney acid-buffering capability declines with age), such that a depletion of bone mineral could occur. For this group they also concluded that alkaline therapies could be beneficial in the treatment of osteoporosis.
Note that the important role of protein (even though it has an acidic pH effect on the body) has been studied as well relating to bone health with the conclusion that adequate protein is necessary for the prevention of osteoporosis and sarcopenia (loss of muscle mass); and that protein should not be excluded from the diet. The recommendation is that alkaline foods such as fruits and vegetables be added versus taking away protein, especially in older people. This is in alignment with my thinking in my Keto-Green diet as well. It is all what’s on the “plate” in achieving a net alkaline load (and yes, there is protein and healthy fats along with those veggies!).(14)
Bottom line is that I feel that bone health can be strengthened with an alkaline diet (along with a moderate amount of healthy, quality protein!) due to its proven acid-buffering role, increased levels of magnesium/Vitamin D, support of muscle mass, and proven anti-inflammatory effects.
Bone health is clearly just one health benefit of an alkaline state. And there are many others. But can we have too much alkalinity? What if our urine pH testing comes back very high?
When your urinary pH tests as overly alkaline, it can point to:
As I mentioned earlier, most women start my programs with an acidic urine pH. Again, when you “Test, Don’t Guess” you will know so much more than you otherwise would, and can measure changes as well. I’ve had many participants in my programs take their urine pH test measurements to their doctors to have a discussion about their findings! Sometimes this has led to more specialized urinary testing or blood tests which have pointed to specific issues. All of that is a good thing!
(A cautionary note: I am not suggesting women abandon regular check-ups and other recommended testing...urine pH testing is simply a great way to self-test and get a “heads-up” as to when something may be out of balance… Should you have symptoms you should always consult with your doctor.)
Testing ketones along with urine pH...why you might want to do both
I won’t spend a lot of time on ketones as you can read more about ketones and ketogenic diets on my blog.
Briefly, though, ketones are substances in your body that are produced when you are on a ketogenic diet or when fasting (both of which put your body in a metabolic state called ketosis). When your body is in ketosis and producing ketones it is burning fat for energy and is providing you many other health benefits such as helping balance your blood sugar (keeping your body from becoming insulin resistant), reducing inflammation, supporting brain health and more. Ketones are being studied for a possible treatment in Alzheimer’s disease and there is a lot of great research on ketones relating to brain health. Ketones also support a very important process in the body called autophagy (kind of like taking out the garbage within our cellular network, a process that is viewed as anti-aging and supportive of longevity).
And as already mentioned, ketones can be measured as easily as urine pH.
The pH and ketone test measurements provide so much information. And the reason I put the two tests (pH and ketones) together on a urine test strip is based on the importance of both measures in regards to your health. This is especially true when embarking on a ketogenic diet or fasting as they both can have a very acidic effect on the body, resulting in negative symptoms known as the “keto flu!”. Many people feel very ill during the initial weeks on ketogenic diets (and many just stop the diet as well!); especially women over 40, who due to hormone imbalances really need to keep our body alkaline. That’s the foundation of my Keto-Green diet, maintaining an alkaline state while getting into ketosis and producing ketones.
Why the Keto-Green® diet and lifestyle
In my book, The Hormone Fix, I discuss many self-tests that women can take to help provide clues to their health. Testing for urine pH and for ketones in the urine are two easy tests - using a single test strip - that can shed light on one’s health as well as measure one’s progress in making positive health changes.
Women in my programs have tested their urine and found,
“I thought I ate a very healthy diet. Imagine my surprise when my initial urine pH was 5.7! And even after adjusting my dietary plate to be more alkaline I still couldn’t seem to move the test marker until I started focusing on my poor sleep and stress…”
“Many of my friends had tried ketogenic diets and felt lousy…quitting after a few days of nausea. Becoming alkaline, and being able to see the results of dietary changes in my urine pH, was incredibly helpful. When I initially started the keto diet part of the program I felt great, and having one urine dipstick that gave me both pH and ketone info was great real-time feedback.”
“I had no idea that I had blood sugar issues. I couldn’t get my urine pH in an alkaline range no matter what I did. I brought this concern to my doctor who tested my blood and found my blood sugar was out of whack….”
“One of the most interesting findings from testing my urine pH was seeing how much that stress and lack of sleep impacted my ability to test alkaline...it took awhile for me to see this connection, but once I did and was able to start addressing these I started to see great results….
“Once I started testing alkaline the hot flashes and joint pain also seemingly vanished…”
Along with easy self-testing my book focuses on techniques that I have developed that are now known as my Keto-Green® approach, which includes the Keto-Green diet, intermittent fasting and lifestyle changes to reduce acidity and lower long-term risk for inflammation and disease. The book also includes a 10-Day Keto-Green Quick Start plan, recipes and many tools to help you measure and monitor your health and progress. I encourage you to order a copy of The Hormone Fix today.
An integral part of my Keto-Green approach is bone broth (or for vegetarians, an alkaline broth). It is so alkalinizing, full of hormone-balancing minerals, and supportive of balanced hormones and overall health. The best part? It’s super easy to make!
*You can substitute this for Bone Broth anytime.
I've found over the years is that the key to real results is keeping track of your progress. Use these Urinalysis Test Strips to start tracking your body's pH so you know for sure if you are on track to healthy fat loss, stable moods and balanced hormones. Get your own here!