When there is an acute attack of pain, doctors often prescribe sodium bicarbonate tablets to be taken orally, so some “old gout” patients think that sodium bicarbonate tablets can cure gout and are uric acid-lowering drugs. In addition, people often hear that gout patients should drink more soda.
So, can sodium bicarbonate tablets treat gout or not? Can they lower uric acid? What is the connection between soda and sodium bicarbonate? Is soda water when sodium bicarbonate tablets are dissolved in water?
Not all sodas contain sodium bicarbonate
Soda sold in the market is divided into natural soda and synthetic soda.
Natural soda contains a variety of ingredients, including sodium bicarbonate. Sodium bicarbonate is what we commonly call “baking soda”. It is important to note that not all sodas sold outside contain sodium bicarbonate, but some may contain only carbonic acid (water and carbon dioxide) and other added ingredients.
Many patients are concerned about this issue: Is dissolving sodium bicarbonate tablets in water the same as selling soda? Actually, it is not. We often refer to soda as a beverage, and some of them have added sweeteners or flavors. Clinicians prescribe that people take sodium bicarbonate tablets directly by mouth and drink enough water at the same time.
Drinking soda has its advantages and disadvantages
Soda is definitely more suitable for gout patients than other beverages.
However, not everyone likes the taste of soda; furthermore, soda cannot replace the therapeutic effect of sodium bicarbonate tablets, so it is not necessary to choose soda specifically.
Soda containing sodium bicarbonate is a double-edged sword because although it is weakly alkaline and helps increase urine pH, it contains a lot of sodium salts, which may increase the burden on the kidneys and raise blood pressure.
Since many gout patients often have other chronic underlying diseases, such as hypertension and coronary heart disease, people with complications who choose to drink soda must pay attention to the right amount, usually about 500-800 ml per day, depending on the individual, and also reduce the daily salt intake.
The role of sodium bicarbonate is to alkalize urine
As you know, one of the dangers of high uric acid in the body is the formation of uric acid stones, and the two main factors that promote the formation of uric acid stones are.
High urate concentration and acidic urine (urine that is clearly acidic). The effect of acidic urine is more important (unfortunately, most gout patients have acidic urine). The solubility of urinary uric acid is about 1.2 mmol/L at a urinary pH of 7.0, and drops to 0.09 mmol/L at a urinary pH of 5.0.
This shows that the more acidic the urine, the less uric acid is excreted in the urine.
At urine pH = 6.75, more than 90% of the total uric acid in the urine is in the form of soluble urates and is excreted, thus minimizing the risk of uric acid precipitation and stone formation.
As you can see here, both sodium bicarbonate and soda containing sodium bicarbonate actually do what they are intended to do – alkalize urine, which in turn helps uric acid to be excreted from the urine.
As you can see, the purpose of sodium bicarbonate is to increase the dissolution of uric acid salts in the urine, it is not a real sense of lowering uric acid drugs, and can not really reduce blood uric acid! It can not play the role of “acid-base balance, neutralize uric acid”!
Urine is not the more alkaline the better
Since alkaline urine can help excretion of uric acid, is the more alkaline the better?
The answer is no. Because higher urine pH (i.e., more alkaline) may increase the risk of calcium-related stones, long-term use of sodium bicarbonate does increase the risk of urinary stones.
In addition, because it contains sodium ions, long-term use can increase the sodium load in the body causing hypertension and edema. Therefore, patients are advised to make sure to follow up regularly and take it under the guidance of their physicians.
How should I take sodium bicarbonate tablets?
The dosage of sodium bicarbonate is 1 to 4 tablets 3 times a day (depending on the specifications, the total amount is usually around 3 grams per day, but you should consult your doctor for the specific dosage.) It is best to take it before meals to facilitate absorption. It is also important to drink more water while taking the tablets.
How long should I take sodium bicarbonate tablets?
In other words, it is best to monitor the pH of the urine in order to assess the degree of alkalinization of the urine.
As for how long you need to take sodium bicarbonate, it is recommended that you strictly “follow your doctor’s instructions” and do not buy and take it on your own because you have been “sick for a long time”.