Research Blog

April 7, 2023

Alkalizing the Urine for Better Health

Acidic urine may be a sign of acid-base imbalance and metabolic acidosis. The kidneys play a crucial role in maintaining acid-base balance and are responsible for excreting excess acid. The metabolic acid load can build up with an unsupplemented high-protein, low-carbohydrate diet. This pattern decreases urinary magnesium, citrate, and pH and increases urinary calcium, phosphate, and uric acid excretion (Schwalfenberg 2012).

Acidosis may not only contribute to kidney stones but can adversely affect detoxification due to a number of factors (Minich 2007):

  • Alkalizing the urine and the alkalinity of the renal proximal tubules supports the excretion of toxins.
  • Alkalizing foods can positively affect urinary pH within just a few hours.
  • Phytonutrients support detoxification and are found in alkalizing foods, including the cruciferous family of vegetables which contain potassium, sulforaphane, and indole-3-carbinol.
  • The transporters that move toxins out of the cell are sensitive to pH.
  • The alkalizing compound citrate is converted to bicarbonate in the body and supports alkalization as well as energy generation as a Krebs cycle intermediate.

Urine pH can significantly affect the formation of kidney stones. Acidic urine can contribute to the formation of calcium oxalate, cystine, and uric acid kidney stones. In contrast, alkaline urine may contribute to calcium phosphate and struvite (magnesium ammonium phosphate) kidney stones. Urine pH can be increased to 6.5-7 by increasing dietary or supplemental alkalizing factors. If urine pH is too alkaline, it can be lowered to 7 with diet and supplement changes as well (Frassetto 2011).

Increasing dietary or supplemental citrate is one of the easiest ways to alkalize urine, as citrate can be converted directly to bicarbonate. Dietary citrate sources include lemon and lime juice, as well as supplemental potassium citrate (Rahman 2017)

Conditions associated with acidosis and acidic urine:

  • Bone loss (Buehlmeier 2012, 2016)
  • Diabetes, type 2 (Maalouf 2010)
  • Gout (Xue 2021)
  • Insulin resistance and metabolic syndrome (Ferraro 2020)
  • Obesity (Frassetto 2011)
  • Uric acid crystallization at a urine pH of 5.5. or below (Kamphuis 2019)

Compounds associated with acidic urine:

  • Betaine (Frassetto 2011)
  • Cranberry juice (Frassetto 2011)
  • Free fructose in excess or from sucrose (Taylor 2008)
  • High-protein, low-carbohydrate diet (Schwalfenberg 2012)
  • Meat and non-dairy animal products (Ferraro 2020)
  • Sodium chloride in excess (Buehlmeier 2012, 2016)

Compounds that help alkalize urine include:

  • Alkaline diet (Pizzorno 2010)
  • Alkaline mineral water rich in bicarbonate (Wynn 2009)
  • Citrate supplementation, lemon or lime juice (Frassetto 2011)
  • Fruits and vegetables (Ferraro 2020, Frassetto 2011)
  • Potassium bicarbonate (Barbera 2016, Cicerello 2010, Buehlmeier 2012, 2016)
  • Potassium citrate (Minich 2007, He 2010 Cicerello 2010)
  • Sodium bicarbonate (Xue 2021) (sodium as tolerated)

Optimal Takeaways for Alkalizing Urine

  • Increase intake of vegetables, lemon juice, or lime juice, and alkaline water
  • Decrease intake of meat and non-dairy animal protein, excess sodium, excess sugar, and excess free fructose, especially from high-fructose corn syrup
  • Consider supplementing with potassium citrate and potassium bicarbonate for low-sodium choices
  • Strive for a urine pH of 6.5-7

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