Drinking Baking Soda: What It Means for Immunity and Acid–Base Balance

Baking soda, also known as sodium bicarbonate (NaHCO₃), is a weak base used as an antacid and leavening agent. In aqueous solution, bicarbonate buffers acid by accepting protons, forming carbonic acid that dissociates to water and carbon dioxide. Beyond simple pH buffering, research suggests that drinking baking soda can transiently modulate immune signalling and macrophage phenotypes, potentially shifting the balance from pro-inflammatory to anti-inflammatory activity. In parallel, clinically supervised bicarbonate therapy is sometimes used to correct metabolic acidosis in chronic kidney disease (CKD), and over-the-counter antacids containing baking soda are available for occasional indigestion.

What happens in your body when you drink baking soda?

When sodium bicarbonate reaches the stomach, it neutralises gastric acid in proportion to the dose. Paradoxically, this buffering can signal the stomach to produce acid in anticipation of the next meal.

Animal and human experiments conducted by researchers at Augusta University propose an additional pathway: mesothelial cells – specialised cells lining body cavities and covering organs – appear to “sense” the buffered environment and send cholinergic (acetylcholine-mediated) messages to the spleen. The spleen, a blood-filtering lymphoid organ, is rich in macrophages and other leukocytes that orchestrate inflammatory responses. According to the researchers, this cross-talk biases the splenic environment toward anti-inflammatory signalling, dampening unnecessary immune activation.

The team also observed that physically disturbing or removing the spleen disrupted the effect, and that cutting the vagus nerve did not abolish the mesothelial signalling – pointing to a local, mesothelium-to-spleen pathway rather than a direct vagal nerve input.

Credit: iStock.

Immune modulation: Macrophage polarisation and regulatory T cells

Macrophages can assume pro-inflammatory M1 or anti-inflammatory M2 phenotypes depending on local cues. In rodent models and in healthy volunteers drinking baking soda, the researchers reported a shift from M1-dominant toward M2-dominant macrophage populations in spleen, kidney and peripheral blood, accompanied by an increase in regulatory T cells (Tregs). The anti-inflammatory profile persisted for hours in humans and days in rats. Mechanistically, acetylcholine – a neurotransmitter also used by non-neuronal cells – was implicated in this shift. While the precise molecular steps were not fully delineated, the observations align with the concept of a cholinergic anti-inflammatory reflex, a well-studied pathway in which cholinergic signals modulate cytokine production.

“You are not really turning anything off or on, you are just pushing it toward one side by giving an anti-inflammatory stimulus,” said Dr. Paul O’Connor, professor at Augusta University and the study’s corresponding author. “It’s potentially a really safe way to treat inflammatory disease.”

The macrophage/Treg shifts were observed under controlled experimental conditions and provide a biological rationale for studying bicarbonate as an adjunctive anti-inflammatory strategy. They do not establish clinical efficacy for autoimmune disorders.

Beyond the vagus nerve

Mesothelial cells possess microvilli that sample the peritoneal environment. The researchers suggest these cells form contacts with the spleen and release acetylcholine locally, biasing splenic immune tone. Notably, interrupting the vagus nerve did not negate the effect, whereas mechanical manipulation of the spleen – which disrupts mesothelial contacts – did. This supports a model in which local mesothelial signalling can shape systemic immune output via the spleen, complementing – rather than replacing – the canonical vagal pathway.

Independent clinical work supports the broader cholinergic anti-inflammatory concept: Studies have demonstrated that augmenting cholinergic signalling can modulate inflammation in people with autoimmune disease.

Applications of drinking baking soda in health and fitness

Baking soda can be used for indigestion and other purposes; however, drinking baking soda can be dangerous and is not suitable for long-term use or for certain individuals. The potential health applications of baking soda are listed below and summarized in Table 1.

Autoimmune and inflammatory disorders

The macrophage-shift and Treg data suggest that immune tone can be directed by drinking baking soda. Translational relevance includes conditions characterised by pathological inflammation, such as rheumatoid arthritis or inflammatory bowel disease. However, rigorous trials are needed to determine whether dosing, timing and patient selection can produce clinically meaningful benefits without adverse effects.

Chronic kidney disease and acid–base balance

In CKD, reduced acid excretion can cause metabolic acidosis, which contributes to bone demineralisation, muscle catabolism and faster kidney function decline. Oral bicarbonate is sometimes recommended when serum bicarbonate falls below target thresholds to correct acidosis and protect organs, with attention given to the accompanying sodium load and blood pressure.

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Over-the-counter antacid use

As an antacid, sodium bicarbonate offers a temporary solution to relieve occasional heartburn and indigestion by neutralising the excess gastric acid that causes symptoms.

Exercise physiology

Sodium bicarbonate has been proposed as a performance-enhancing aid to augment extracellular buffering during high-intensity exercise. Studies have shown the following benefits; however, drinking baking soda for fitness or health purposes should not be undertaken without the supervision of a doctor:

• Duration of exercise might be influential for inducing a performance-enhancing effect; the extent to which remains unclear.
• One 2020 meta-analysis found that sodium bicarbonate supplementation improves muscle endurance but not muscle strength.
• A randomized, double-blind study found evidence to suggest that sodium bicarbonate improved performance among trained runners, though the sample consisted only of males.

Table 1. A summary of potential health benefits from drinking baking soda.

Drinking baking soda exerts predictable acid–base effects and, according to experimental data, can transiently tilt splenic immune tone toward anti-inflammatory signalling via mesothelial cell–mediated cholinergic pathways. Clinically, sodium bicarbonate is a tool – not a cure-all – with clear roles in antacid relief and supervised CKD management, and an intriguing but as yet unproven potential in inflammatory disorders.

This article is a rework of a press release issued by Augusta University. Material has been edited for length and the content has been updated to provide additional context and details of related developments since the original press release was published on our website. This article includes text that has been generated with the assistance of AI. Technology Networks' AI policy can be found here.