There are many health benefits to following an alkaline diet. Research has shown that inflammation in the body decreases and disease is less likely to develop when a person’s diet includes a healthy balance of acid-forming and alkaline-forming foods.
The terms alkaline and acid are defined by a scale called a pH scale, which is the abbreviation for the term potential of hydrogen. This gives us a clue that pH has to do with chemistry, and for this article specifically our body’s chemistry.
The pH scale starts with 0 (most acidic) and ends with 14 (most alkaline). In the middle is 7, which is neutral. Numbers below 7 are considered acidic, while numbers above 7 are considered alkaline.
Everything in liquid form can be tested to determine its potential of hydrogen, or pH. The pH of blood in a healthy human body is between 7.35 and 7.45. Outside of that range disease and even death can occur.
Fortunately, our body has 3 main mechanisms to keep the pH of our blood inside that range. Without delving too deeply into the chemistry and physiology of those mechanisms, I will briefly state what they are.
The first mechanism is chemical buffers. This is the body using proteins and phosphates existing in the body to adjust pH up or down. The second mechanism is CO2 being expelled from the lungs. The third mechanism is bicarbonate being removed by the kidneys. This is an extremely simplified description of these 3 mechanisms but it is enough for this discussion.
Clinically, the term acidosis is used when blood pH is below 7.35. Similarly, the term alkalosis is used when blood pH is above 7.45. Although we like to speak about a person’s body being too acidic or alkaline, in reality the pH of blood is rarely outside of the normal range.
In fact, doctors don’t give it much consideration unless there are major health issues. Blood pH may or may not be checked with a basic metabolic panel, depending on the doctor’s preference. More often, a urine test is what is used to check a person’s pH.
A urine pH test is not as accurate as a blood pH test because the pH of urine changes throughout the day and is affected by what food and drink is consumed. Also, the normal range for urine pH is different than the normal range for blood pH. The normal range for urine pH is 6.5 to 7.5.
The advantage of a urine pH test is that it can be done at home and anytime with pH strips commonly available at health food stores and some pharmacies. To check blood pH, blood must be drawn by your doctor and analyzed by a laboratory.
So, what is the point of being concerned about whether what you eat and drink is acid or alkaline-forming? If your body is going to keep your pH inside the normal range most of the time, why even worry about it? Well, there are several good reasons.
Let me simply start with quality of life. Most body processes have a range for what is normal; somewhere in the middle is the point of optimal functionality. When systems run at optimal function, they are more efficient with less wear and tear, and less problems in the long-run. This generally equates to more energy, less sickness, and increased wellness because your body is less stressed.
If you have kidney or lung disease, or have restrictions that keep you from exercising to the point of which you are breathing hard, an alkaline diet may aggravate existing health problems, and even induce others. I will explain why.
Recent years have seen an increase in interest in alkalizing the body. Magazines are filled with trendy alkaline diets, and the market is flooded with different types of alkaline water. Many times, the promoters of these products all but promise that if your body is alkaline enough, you will never get cancer or any other disease.
This kind of thinking is misleading. To put your odds in favor of never developing disease, the entire body needs to be considered. When systems are working properly and working together properly, then you will realize the best health of your life.
While it is true that the standard American diet and lifestyle is unhealthy by causing the body to be too acidic, so is being too alkaline unhealthy. Let me explain.
When the body has to compensate for a low pH, it uses minerals such as calcium, potassium, magnesium, and bicarbonate already in the body. These minerals (also called electrolytes) are critical for proper nutrition and to keep your body’s electrical system functioning normally (including normal heart rhythm).
Calcium is so important for proper body function that it is stored in your bones and teeth. When your body needs extra calcium, it gets taken from your bones. When the need is over, calcium will be put back until needed again. This is a natural and ongoing process.2
However, if your body is constantly in need of calcium to raise your pH level your bones will become weak. Additionally, you may develop kidney stones as your kidneys try to filter your blood of excess calcium. Uric acid may also be high so there is also a risk of developing uric acid stones. Over time, kidney disease may also develop because they kidneys are working extra hard and do not have time to properly cleanse themselves.
Since the parathyroid glands play a large role in storing and withdrawing calcium from your bones, they may also become overworked and diseased. Risk of other diseases such as type 2 diabetes, heart disease, and obesity increases due to elevated inflammation in the body directed related to blood pH being more acidic.
Adrenal glands are also stressed which can lead to adrenal fatigue, and feeling wired but tired at the same time.
There are also health risks associated with the blood being too alkaline. When blood is too alkaline, there is a decreased ability for the blood to carry oxygen. Lightheadedness, muscle spasms and cramps, dehydration, and insomnia may also occur. There is also a decreased immune function. 
Most often, there is elevated levels of bicarbonate in the blood. This can lead to calcium phosphate kidney stones because the body is using sodium bicarbonate to try to lower blood pH. The sodium binds to calcium, creating stones in the kidneys.6
Being too alkaline can also be detrimental to those already suffering from hypothyroidism or low blood pressure, as these conditions may worsen.6
Let’s review the mechanisms that the body uses to regulate blood pH. First is chemical buffers. Sweating can lower electrolyte levels, primarily sodium, which can cause blood pH to become more acidic. Strenuous exercise can cause a build up of lactic acid which also lowers blood pH.
Secondly, during heavy breathing, the lungs help to raise blood pH by removing excess carbon dioxide. And third, the kidneys help balance blood pH by removing bicarbonate to lower blood pH.
Regular exercise is important for helping your body to balance blood pH. Along with a healthy balance of acid-forming and alkaline-forming foods, it is easy for your body to maintain the proper blood pH with little stress on your organs.
However, if you have lung or heart disease which prevents you from engaging in strenuous exercise, hypothyroidism, low blood pressure, or take a diuretic medication7 an extremely alkaline diet (to include alkaline water) may not be the best choice. Watch for signs such as fatigue, sluggishness, diarrhea, lightheadedness, dehydration, and muscle spasms and cramps.5,6 As a side note, prolonged vomiting and diarrhea will raise blood pH.
Also, if you have kidney disease, it is extremely important that you are not too alkaline or too acidic. Kidneys have to work extra hard to remove the chemical buffers used in balancing pH. The less chemical buffers are necessary to achieve balance, the less your kidneys will have to work.
Signs of being too acidic include anxiety and agitation, candida, cancer, adrenal fatigue, being physically tired but mentally keyed up, rapid and shallow breathing, shortness of breath, and sleepiness. People with diabetes often have low blood pH and are considered acidic.5,
Eating according to the season (seasonal eating) is always recommended, but is especially important for those who have heart, kidney or lung disease, and anyone who is inactive due to other health restrictions.
In the winter months, seasonal eating dictates eating more animal protein and fats, more whole grains, and only eating cooked vegetables. Since the body is working harder to stay warm, more protein and fat is required. The body will naturally become more acidic due to increased protein and fat, and due to less physical activity which is typical in winter.
It is recommended that everyone take a break from “alkalizing” in the winter. Having said that, it is still important to eat a balanced diet of organic foods and avoiding junk food. Eating seasonally in the winter means cooking vegetables that have been harvested in the fall, along with nuts, seeds, and meats. Click here for a list of recommended foods for winter.
Always talk with your doctor before making major dietary and exercise changes, and never stop taking medication without your doctor’s approval. Certain foods have been known to interact with certain medication; consult with your doctor or pharmacist if you have concerns about possible interactions.
Allen, S., Cherney, K., & Boskey PhD, E. (2017, June 16). Acidosis. Retrieved from Healthline: https://www.healthline.com/health/acidosis
Casiday, R., & Frey, R. (2008, September 05). Blood, Sweat, and Buffers: pH Regulation During Exercise. Retrieved from Washington University in Saint Louis: http://www.chemistry.wustl.edu/~edudev/LabTutorials/Buffer/Buffer.html
Del Carmen, C. (2010, May 21). Aerobic or Anaerobic – Which One Maintains Body’s Ph Balance? Retrieved from The Alkaline Diet: https://thealkalinediet.org/blog/aerobic-or-anaerobic-which-one-maintains-bodys-ph-balance
Diet for Kidney Stone Prevention. (n.d.). Retrieved from National Kidney and Urologic Diseases Information Clearinghouse : https://www.uaf.edu/chc/community-resources/educational-resources/NKUDIC_KidneyStoneDiet_FS.pdf
Flannery, D. (2014, April 08). How Alkaline and Acidic Diets Affect Your Health. Retrieved from Healthwise Clinical Nutrition: http://drflannery.com/how-alkaline-and-acidic-diets-affect-your-health/
Gottfried, D. S. (n.d.). Eating Alkaline Foods: How to Test and Improve Your pH Levels. Retrieved from Dr. Sara Gottfried: http://www.saragottfriedmd.com/eating-alkaline-foods-how-to-test-and-improve-your-ph-levels/
Kellum, J. A. (2000, January 24). Determinates of Blood pH in Health and Disease. Retrieved from National Center for Biotechnology Information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC137247/
Kim, D. B. (2017, August 07). The Truth About Alkalizing Your Blood. Retrieved from Dr. Ben Kim: http://drbenkim.com/ph-body-blood-foods-acid-alkaline.htm
Pietrangelo, A. (2016, November 02). Acid-Base Balance. Retrieved from Healthline: https://www.healthline.com/health/acid-base-balance
Samuel, L. (n.d.). Handling pH: How Your Body Regulates Acidity. Retrieved from Interactive Biology: http://www.interactive-biology.com/4081/handling-ph-how-your-body-regulates-acididity/
Sellers, K. (2008, April 24). Can Your Body’s pH Be Too Alkaline? Retrieved from Natural News: https://www.naturalnews.com/023097_alkaline_water_body.html
 Kim, D. B. (2017, August 07)
 Samuel, L.
 Gottfried, D. S
 Diet for Kidney Stone Prevention
 Flannery, D. (2014, April 08)
 Pietrangelo, A. (2016, November 02)
 Sellers, K. (2008, April 24)
 Del Carmen, C. (2010, May 21)
 Allen, S., Cherney, K., & Boskey PhD, E. (2017, June 16)