Part 1: Acidic or Alkaline? What Your pH Says About You

July 16, 2021 Dr. Anna Cabeca

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.

Acid or Alkaline: Why Should I Care?

In a substantial amount of research, a more optimal alkaline pH status in the body has been found to:

Support bone health and lean muscle mass,
Reduce pain and inflammation,
Lower risk of disease (cardiovascular disease, hypertension, insulin resistance, diabetes, and metabolic disorders), and
Support the healthy balance of electrolyte levels our bodies require for quality sleep, circadian rhythm control and cortisol management.

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
Diet-induced metabolic acidosis and its very real, research-based health effects
What your urine pH tells you about your overall health!
Testing ketones along with urine pH...why you might want to do both

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:

Blood pH
Urinary pH
The pH affect within the body related to the foods you eat

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.

Blood pH

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.

Urinary pH

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 pH as 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,

“…acidosis is a real phenomenon known to contribute to a wide range of diseases, such as metabolic syndrome, cancer, osteoporosis, kidney stones, and increased susceptibility to environmental toxins—and new research is adding to the list …we can consider acidosis as the constant pressure on the body’s physiology to compensate for all the acid-inducing challenges…the pH in the cells and intracellular space becomes more acidic, causing disruption of enzyme function, loss of insulin sensitivity, and cellular metabolic adaptations…A growing body of research has now clearly documented clinical benefit through diet and alkalinizing supplements…” (2015) (7)

“The available research makes a compelling case that diet-induced acidosis… is a real phenomenon, and has a significant, clinical, long-term pathophysiological effect that should be recognized and potentially counterbalanced by dietary means.” (2010) (8)

“The modern Western diet based on animal products generates an acid load not compensated by the shortage of fruit and vegetables, causing a life-span state of low-grade metabolic acidosis whose magnitude increases progressively with age, probably due to the decline in kidney function occurring with aging. The baseline acidotic state is intensified in obese and overweight persons in whom the intake of fruits and vegetables usually does not compensate for the consumption of acidogenic nutrients. The strongly acidogenic diet consumed in developed countries produces a lifetime acidotic state, exacerbated by excess body weight and aging, which may result in insulin resistance, metabolic syndrome, and type 2 diabetes, contributing to cardiovascular risk, along with genetic causes, lack of physical exercise, and other factors.” (2011) (9)

“If there is an excessive consumption of acid precursor foods, to the detriment of those precursors of bases, volubility of the acid-base balance occurs. If this acid-base balance disorder occurs in a prolonged and chronic way, low-grade metabolic acidosis may become significant and predispose to diseases. Many observational studies have been conducted to evaluate the association between dietary acid load and disease risk. The negative effects to health from low-grade metabolic acidosis are associated with mineral excretion and an imbalance in hormone secretion. Dietary-induced low-grade metabolic acidosis may predispose to various disorders including bone metabolism impairment, kidney stone formation, loss of lean mass, increased systemic blood pressure, and risk of type 2 diabetes mellitus.” (2017) (10)

In other research, an optimal alkaline state has been found to:

Maintain lean muscle mass – important in supporting overall bone health and in fall and fracture prevention.(11)
Reduce pain and inflammation An alkaline diet has been associated with reduced inflammation.(12) In particular, chronic low back pain has been studied relating to acid-alkaline diet; with the administration of alkaline supplements resulting in improvement of pain symptoms in 90% of subjects.(13)
Lower risk of disease (cardiovascular disease, hypertension, insulin resistance, diabetes, metabolic disorders)...here’s just a few of the available studies: (14-25)

Influence a reduced risk of cancer - diet-induced acidosis may be one potential upstream (and indirect) trigger among a cascade of others that are associated with carcinogenesis. Pro-inflammatory states such as obesity, metabolic syndrome and insulin resistance - all associated with acidogenic or “Western” type diets - are known to contribute to cancer risk.(26,27)
Increase diversity within the gut microbiome – additionally, we know that some diets like ketogenic diets reduces diversity; gut microbiome diversity provides greater resilience to our bodies to deal with environmental stressors (bacteria, gut-impacting medications, and more).(28)
Preserve vital mineral levels (magnesium and potassium in particular)
Support bone health (while there is agreement that alkalinity supports overall bone health, there is some controversy relating to direct effects on osteoporosis, more below)
And yes, veggies are also just healthy! Outside of the alkalinity benefits most vegetables are loaded with antioxidants and provide much-needed fiber! Some of these attributes have also been found to be reduce cancer risk.(29)

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!

References

P.S. Test, don't guess!

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!

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Part 1: Acidic or Alkaline? What Your pH Says About You

Acid or Alkaline: Why Should I Care?

P.S. Test, don't guess!

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Dr. Anna Cabeca