Sodium bicarbonate is an important drug for the treatment of gout, and many patients are taking sodium bicarbonate, but do you really know this drug?
Can sodium bicarbonate lower uric acid?
In the textbook of Internal Medicine, 8th edition, sodium bicarbonate is classified as a uric acid-lowering drug, and many students and patients believe that “uric acid is acidic and sodium bicarbonate is alkaline, so the acid-base neutralization reaction leads to the reduction of uric acid”.
This seemingly reasonable explanation is actually incorrect. Many doctors do not consider sodium bicarbonate to be a uric acid-lowering drug either.
Is this news a blow to patients who only use sodium bicarbonate to lower uric acid? Wake up! Taking sodium bicarbonate tablets or drinking soda for a long time will not bring your uric acid up to the standard. Therefore, please choose a real uric acid-lowering drug.
Why do you need to take sodium bicarbonate for gout?
Uric acid exists in urine in both free and bound forms, and the amount of both states of uric acid depends on the pH (pH) of the urine.
Normal human urine is weakly acidic, with a pH of about 6. When the pH of urine is at 6.75, more than 90% of uric acid is in the free state; when the pH drops to 4.75, more than 90% of uric acid is present in the urine in the bound state. This bound form of urate can be deposited in the kidney parenchyma, blocking the urinary tract, or forming stones that can damage kidney function.
The gout treatment guidelines recommend that gout patients maintain a urinary pH of 6.2 to 6.9, with values not exceeding 7.0, otherwise calcium salt stones are likely to occur.
It turns out that the purpose of taking sodium bicarbonate is not to lower uric acid, but to alkalize the urine and maintain the urinary pH within the normal range, thus avoiding the deposition or crystallization of uric acid.
Can I take it for more than 7 days in a row?
I am often asked by gout patients, “Why do you let me continue to take sodium bicarbonate when it is clearly stated in the instruction manual that it should not be taken for more than 7 consecutive days?
The indications of sodium bicarbonate in the instruction manual are: for relieving stomach pain, heartburn (heartburn) and acid reflux caused by excessive stomach acid. Moreover, the precautions clearly state that this product should not be used continuously for more than 7 days, and please consult your physician or pharmacist if the symptoms are not relieved or disappear.
In other words, if you still have symptoms of excessive stomach acid after 7 days of continuous use, you should consult your doctor, and it does not say that you absolutely cannot exceed 7 days. More importantly, gout patients use sodium bicarbonate to alkalize urine and improve the solubility of urate.
Therefore, gout patients can generally continue to take sodium bicarbonate for multiple days without the need to limit it to 7 days, which needs to be adjusted according to uric acid alkalinity and uric acid levels.
Do I need to take sodium bicarbonate for a long time?
How long a gout patient needs to take sodium bicarbonate needs to be decided according to their urine pH. Try to maintain the urine pH at 6.2-6.9 to maximize urate solubility and prevent urate deposition in the joints and kidneys.
However, it is worth noting that patients with cardiac insufficiency, renal insufficiency and hypertension, as excessive sodium load may aggravate the condition, need to be used with caution, taken according to the specialist’s recommendation, and not for long-term use on their own.
What other medications can I take to alkalize urine?
Sodium bicarbonate is not the only drug that can alkalinize urine. Potassium sodium bicarbonate is very good in alkalinizing urine and has a low sodium salt content, which makes it suitable for patients with cardiac insufficiency and hypertension who need to limit sodium intake.
However, due to the presence of potassium salts, sodium potassium hydrogen citrate is not suitable for patients with renal insufficiency. In addition, sodium potassium bicarbonate is tens of times more expensive than sodium bicarbonate, and its long-term use can cause some financial stress to patients.
Health Tip.
Has your opinion of sodium bicarbonate changed?
Do you still think of sodium bicarbonate as a uric acid-lowering drug?
Do you understand why your doctor asked you to review your urine routine?
Gout patients, please note that while improving your lifestyle habits, make sure you go to the rheumatology department for regular treatment and take your medication as prescribed by your doctor!