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What happens if you have too much sodium bicarbonate in your body?

4 min read

Excessive ingestion of sodium bicarbonate, often used as a home remedy antacid, can lead to serious metabolic issues, including metabolic alkalosis, hypokalemia, and hypernatremia [1.2.1]. So, what happens if you have too much sodium bicarbonate in your body?

Quick Summary

Having too much sodium bicarbonate disrupts the body's acid-base balance, leading to metabolic alkalosis. This can cause severe electrolyte disturbances, neurological symptoms, and cardiac issues, requiring immediate medical attention.

Key Points

  • Metabolic Alkalosis: Excessive sodium bicarbonate leads to metabolic alkalosis, a condition where the blood pH rises above 7.45 due to excess bicarbonate [1.7.1, 1.7.6].

  • Electrolyte Imbalance: Overdose causes critical electrolyte disturbances, including low potassium (hypokalemia), high sodium (hypernatremia), and low calcium (hypocalcemia) [1.2.1, 1.2.2].

  • Severe Symptoms: Symptoms can range from mild gas and thirst to severe neurological issues like seizures, cardiac arrhythmias, and slow breathing [1.2.3, 1.3.5, 1.2.2].

  • High-Risk Groups: Individuals with kidney disease, heart failure, high blood pressure, and pregnant women should avoid using sodium bicarbonate as an antacid [1.6.2, 1.8.6].

  • Stomach Rupture: A rare but lethal risk is stomach rupture from the rapid production of carbon dioxide gas when baking soda reacts with stomach acid [1.2.5, 1.6.5].

  • Emergency Treatment: Medical treatment involves IV fluids, correcting electrolyte imbalances (especially potassium), and monitoring vital functions [1.4.2, 1.4.5].

  • Safer Alternatives: Over-the-counter antacids like calcium carbonate are generally safer for managing indigestion than household baking soda [1.2.5, 1.6.3].

In This Article

The Role of Sodium Bicarbonate in the Body

Sodium bicarbonate, commonly known as baking soda, is a salt that plays a crucial role in maintaining the body's pH balance [1.8.3, 1.8.4]. It acts as a natural buffer, neutralizing excess acids in the blood and other bodily fluids [1.8.4]. The bicarbonate buffer system is a primary chemical equilibrium system in the body that prevents the blood from becoming too acidic [1.7.6]. The kidneys and pancreas produce bicarbonate to regulate pH, with the kidneys reabsorbing it from urine as needed to counteract acidity [1.8.4]. Medically, it is used to relieve heartburn and acid indigestion by neutralizing stomach acid and can also be prescribed to make the blood and urine more alkaline in specific conditions [1.8.2, 1.8.5]. While it's effective for occasional indigestion, its use must be carefully managed due to its high sodium content and potential for disrupting the body's delicate balance [1.8.3, 1.6.3].

What is Metabolic Alkalosis?

Having too much sodium bicarbonate in the body leads to a condition called metabolic alkalosis. This is a primary acid-base disorder characterized by an increase in blood pH to a level greater than 7.45, resulting from an excess of bicarbonate (HCO3−) in the blood [1.7.1, 1.7.6]. A normal bicarbonate level is typically between 22 and 29 milliequivalents per liter (mEq/L) [1.5.1, 1.5.6]. When bicarbonate levels rise above this range due to excessive intake or impaired kidney excretion, the body's pH becomes too alkaline [1.5.3, 1.2.2].

The development of metabolic alkalosis involves two key steps: the initial generation of excess bicarbonate and the maintenance of this imbalance [1.7.1]. Generation occurs through the loss of acid (e.g., from vomiting) or the gain of alkali, such as ingesting too much baking soda [1.7.5]. The condition persists when the kidneys fail to excrete the excess bicarbonate, a failure often exacerbated by factors like dehydration (volume contraction), chloride depletion, and low potassium levels (hypokalemia) [1.7.2, 1.7.3].

Symptoms of Sodium Bicarbonate Excess

The clinical presentation of sodium bicarbonate toxicity is highly variable, ranging from mild discomfort to life-threatening emergencies [1.2.1]. Symptoms are often related to the resulting electrolyte imbalances, such as hypokalemia (low potassium), hypernatremia (high sodium), and hypocalcemia (low calcium) [1.2.2, 1.3.5].

Early and Mild Symptoms

  • Increased thirst [1.2.3]
  • Gas and abdominal bloating [1.2.3, 1.2.4]
  • Stomach cramps [1.2.3]
  • Nausea and vomiting [1.3.1, 1.4.2]
  • Diarrhea, as the body attempts to correct the high sodium concentration by pulling water into the digestive tract [1.2.5]

Severe Symptoms and Complications

As the imbalance worsens, more severe symptoms can develop, requiring immediate medical attention:

  • Neurological Effects: Confusion, irritability, lethargy, lightheadedness, and hand tremors are common [1.3.1, 1.4.2, 1.2.4]. Severe cases can progress to muscle twitching, prolonged muscle spasms (tetany), seizures, and even coma. These are often linked to a decrease in ionized calcium [1.3.5, 1.2.2].
  • Cardiovascular Effects: The electrolyte disturbances, particularly hypokalemia, can cause dangerous cardiac dysrhythmias (irregular heartbeats) and QT interval prolongation [1.2.2]. The high sodium load can worsen hypertension and lead to fluid retention, causing swelling in the feet and lower legs [1.2.3, 1.8.6]. In rare instances, cardiopulmonary arrest has been reported [1.2.1].
  • Respiratory Effects: To compensate for the high pH, breathing may become slow and shallow as the body tries to retain carbon dioxide to restore acidity [1.2.3, 1.2.5].
  • Gastrointestinal Rupture: A rare but potentially lethal complication is spontaneous gastric rupture. This occurs when a large amount of baking soda reacts with stomach acid, producing a massive volume of carbon dioxide gas, especially if taken when the stomach is full [1.2.2, 1.2.5].
  • Kidney Issues: High sodium levels can lead to dehydration and kidney failure [1.2.5, 1.2.7]. People with pre-existing kidney disease are particularly at risk [1.6.2].
Feature Mild to Moderate Alkalosis Severe Alkalosis
Neurological Lightheadedness, irritability, muscle twitching [1.3.1, 1.3.4] Confusion, seizures, tetany, stupor, coma [1.3.1, 1.3.3, 1.3.5]
Cardiovascular Dizziness, fast or irregular heartbeat [1.3.2] Dangerous arrhythmias, cardiopulmonary arrest [1.2.1, 1.2.2]
Gastrointestinal Nausea, vomiting, gas, cramps [1.2.3, 1.3.1] Vomit resembling coffee grounds, potential stomach rupture [1.2.3, 1.2.5]
General Increased thirst, weakness, frequent urination [1.2.3] Slow breathing, swelling of feet/legs, loss of appetite [1.2.3]

Populations at Risk

Certain groups are more vulnerable to the dangers of sodium bicarbonate overuse:

  • Individuals with Chronic Indigestion: People who frequently self-medicate with baking soda for dyspepsia are at high risk [1.2.1, 1.6.1].
  • Patients with Comorbidities: Those with hypertension, heart failure, or kidney disease should avoid sodium bicarbonate due to the high sodium load and risk of fluid retention [1.6.2, 1.8.6].
  • Older Adults: People over 60 are advised to take a lower maximum dose [1.2.2, 1.2.7].
  • Pregnant Women: Sodium bicarbonate use may lead to fluid buildup and is generally not recommended [1.2.7, 1.8.3].
  • Children: Baking soda should not be given to children under 12 unless directed by a doctor due to reports of seizures and respiratory depression [1.8.5, 1.2.2].

Treatment for Sodium Bicarbonate Overdose

If an overdose is suspected, it is critical to seek medical help immediately or call Poison Control at 1-800-222-1222 [1.2.5, 1.4.7]. Treatment in an emergency room setting typically involves:

  • Monitoring Vital Signs: Healthcare providers will measure and monitor temperature, pulse, breathing rate, and blood pressure [1.4.2, 1.4.4].
  • Blood and Urine Tests: These are performed to assess electrolyte levels, kidney function, and blood pH [1.4.2, 1.4.4].
  • Intravenous (IV) Fluids: Isotonic saline (0.9 NaCl) is often administered to help correct volume depletion and promote the excretion of excess bicarbonate [1.7.1, 1.4.5].
  • Electrolyte Correction: IV potassium chloride is given to treat hypokalemia, a common and serious complication [1.2.2, 1.7.1].
  • Supportive Care: Other medicines may be given to treat specific symptoms, and in severe cases, airway intubation may be necessary [1.4.5]. Dialysis may be required if kidney function is severely impaired [1.7.1].

Conclusion

While sodium bicarbonate is a common household item used to relieve occasional heartburn, having too much in the body can cause a dangerous cascade of metabolic disturbances. The resulting condition, metabolic alkalosis, along with severe electrolyte imbalances like hypokalemia and hypernatremia, can lead to serious neurological, cardiac, and renal complications. It is crucial to use this substance in moderation, adhere to package warnings, and avoid it altogether if you have underlying health conditions like heart or kidney disease. Safer over-the-counter antacids are available and recommended for managing indigestion [1.2.5, 1.6.3]. If symptoms of an overdose occur, seeking immediate medical attention is essential for a safe outcome.


For more information on poison control, you can visit Poison Control.

Frequently Asked Questions

The primary condition caused by too much sodium bicarbonate is called metabolic alkalosis, where the blood becomes excessively alkaline (pH > 7.45) [1.7.1, 1.7.6].

Yes, it is possible to overdose on baking soda (sodium bicarbonate), especially when using it as a home remedy for indigestion. This can lead to serious metabolic derangements, electrolyte imbalances, and in severe cases, life-threatening complications [1.2.1, 1.6.5].

Early symptoms of ingesting too much baking soda often include increased thirst, stomach cramps, gas, bloating, nausea, and vomiting [1.2.3, 1.2.7].

A sodium bicarbonate overdose can cause low potassium levels (hypokalemia), which may lead to serious heart rhythm disturbances (arrhythmias). The high sodium load can also increase blood pressure and cause fluid retention, straining the heart [1.2.2, 1.6.5].

Treatment is administered in a hospital and typically includes IV fluids (isotonic saline) to restore volume and help the kidneys excrete the excess bicarbonate, as well as correction of electrolyte imbalances like low potassium [1.4.5, 1.7.1].

While occasionally drinking a small amount of baking soda (e.g., half a teaspoon) dissolved in water for indigestion may be safe for some adults, it is not recommended for long-term use. Overuse carries significant risks, and safer over-the-counter antacids are available [1.6.3, 1.2.5].

People with high blood pressure, heart failure, liver disease, or kidney problems should avoid sodium bicarbonate. It is also not recommended for children under 12 or pregnant women unless directed by a doctor [1.6.2, 1.8.3, 1.8.6].

References

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Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice.