To get the basics of how this started and my research focus, please read the Self-Treatment background page.
Through a combination of events in early December 2013, I spent more time re-reading my blood test reports. I was surprised to find that my pH level was 5.5. This caused quite a bit of concern – from what I understand, at a blood pH level of 6.8, things like comas start to become reality, and death is possible. At 5.5, I should not even be standing. It took me a bit more than 24 hours to clarify this by re-reading the lab test reports several times. I finally noticed that the section the pH was listed under was the Urinalysis. At a urine pH level of 5.5, it is still a concern, but not critical.
Blood pH should be in the range of 7.35 and 7.45. Urine pH and saliva pH should be in the range of 6.8 to 7.2. Mine, at 5.5, was low and needed some attention. A low pH means that gastric acid is at high levels. In my research, I found several terms that can be confusing. Let me clarify those for you: acidosis, acidemia, and low alkaline levels all mean that you have high gastric acid. If this is chronic, the gastric acids end up in your blood and cause a situation where they suppress glucon and insulin from supplying (and assimilating) nutrients to your cells.
The connection between acidosis, diabetes, and digestive disorders has been known since at least 1915. I have found quite a few scholarly articles and medical reports that discuss acidosis in relation to diabetes and pancreatitis. As a matter of fact, digestive enzymes that are prescribed for us today are all enteric coated so that they are not destroyed by gastric acid. One company has digestive enzymes that are not enteric coated, but they must be taken with proton pump inhibitors (type of acid blockers).
I also found references that make it clear, to me at least, that everyone with pancreatitis and other digestive diseases mostly all have high levels of gastric acid. That is when I also found that I had made a mistake in my research. I had taken at face value what my doctors were telling me about my pancreas: that it had two main functions, 1) produce insulin; and 2) produce digestive enzymes. Scholarly articles and medical reports also say the same thing. While that is correct, I missed the nuance of the word "main" ... the pancreas has other functions. One of those is to produce bicarbonate that regulates gastric acid. It does this in conjunction with the liver. The liver produces a small amount of bicarbonate as well. Well, with my pancreas nearly 100% destroyed, it cannot be producing much bicarbonate (if any). My goal then was to find out how I could measure my own urine or saliva pH and how I could increase my pH or lower the levels of gastric acids.
I reached this conclusion on Thursday December 12 2013. I found that the quickest way to reduce high levels of gastric acids is to neutralize with sodium bicarbonate. Sodium bicarbonate is more commonly called "baking soda". Next, it is important to understand dosage levels ... in my research, I also found information on alkalosis, which is high levels of alkaline and just as dangerous as high levels of gastric acids. My research indicated that 1/2 teaspoon could be taken every two hours to a maximum of seven times daily. (that was a medical doctor recommendation to his patients). We just happened to have enough for one single dose (we were almost out of baking soda). I took that in 8 oz. of water at about 6 pm.
The next day, December 13, I went out and bought a bag of baking soda from the bulk section of the health food store. This is where I found out that baking soda can have additives, particularly aluminum. The label on the health food store baking soda that I bought clearly states "no aluminum or other additives". This is at least a one year supply: total cost was $1.19. I went back home and that day I took six doses, spread apart by two hours. Later that day, I went to the local pharmacy to buy some pH test strips so that I could measure my saliva pH. First time I ever did this, and they convinced me that Keto-Diastix by Bayer were the same thing. They are not. Keto-Diastix measure glucose and ketones. While the presence of ketones always indicates high gastric acid, you can have high levels of gastric acid and test negative for ketones. So the next day (Saturday now, Dec. 14), I made it my mission to find pH test strips. Not that easy, did not find any until nearly 5 pm, and by that time I had taken four doses of sodium bicarbonate.
pH test strips are normally sold at garden centers (for soil testing), pool/spa centers to to measure pool and spa water, and pet food stores to measure water in aquariums. At this time of year, all were out, and some had switched to the newer 5-in-1 test strips that are designed for water testing only. I finally found pH test strips at a health food store. They cost about $8. for 80 strips, I use two strips each day (actually, I cut one strip into four pieces so that one strip lasts two days).
Needless to say, by the time I had found the pH test strips, I had overdosed on sodium bicarbonate. I was measuring at danger levels for alkalosis and quickly took some Pepsi MAX to lower the alkaline. Within one hour, I was in normal ranges and I have been very careful since then to stay in that range.
I also switched to testing urine pH levels. Saliva pH is influenced by everything that goes in - mouthwash, food, drinks, toothpaste, etc. -- it is too difficult to wait two hours with no intake to test - and more convenient to test urine (which ends up being more stable test).
It took four days to get to what I now consider a "normal" dose for me. On any given day, I test between 6.0 and 7.4. When at 6.8 or higher, I take no sodium bicarbonate. When at 6.4 to 6.6, I take 1/4 teaspoon. When at 6.0 to 6.2 (or less), I take 1/2 teaspoon.
Sodium bicarbonate is essentially a salt. That means it can raise blood pressure. In my case, that is non issue, I already have low blood pressure. Raising it a bit would be good. At maintaining dosages, the blood pressure is not affected that much - but I would suggest anyone with elevated blood pressure to check blood pressure frequently if trying the sodium bicarbonate. (As I write this, I have just tested by blood pressure: 117/79 with pulse at 68 - this is three hours after taking 1/2 teaspoon of baking soda).
While doing the research on pH levels, I also found that calcium is quite rampant throughout the body and is being drawn from the bones. I do not know by which process it gets deposited in my pancreas, but I decided to add magnesium for better assimilation of calcium. I take two 250 mg tablets between two and three times a day.
On December 30, I added Potassium Citrate (99 mg, once a day). In research, I found that potassium is also quite low for those with pancreatitis. As long as not taken in mega doses, there should be no risks in adding potassium (at least it is worth me testing it). Plus, potassium citrate works quite well either as a replacement or in conjunction with sodium bicarbonate. It is recommended for those that have high blood pressure (potassium citrate will lower blood pressure).
In summary for pain reduction, anti-inflammation, and improve digestion:
- Sodium Bicarbonate, as indicated by your pH test strip
- Magnesium Citrate, 250 mg tablets, two at a time, two to three times daily.
- Potassium Citrate, 99 mg tablets, once daily.
I am writing this note as of January 20, 2014, thirty-nine days after starting the sodium bicarbonate part of the strategy (and exactly one year after my last hospital discharge). I am quite pleased with the results, and I expect more changes in the weeks to come. So far, I can report:
- urine pH that average 7.2 daily, and adjusted as needed with sodium bicarbonate
- improved blood sugar levels, lower than expected (I have reduced basal insulin units, and like will also reduce bolus insulin units)
- no pain whatsoever
- no bloating whatsoever
- no aches whatsoever
- no headaches
- improved digestion: stools well formed, color more "normal" and "normal" odor
- better sleep: I now get 6-7 hours at a time (instead of 3-4 for the past 1 year +)
- increased weight (I am up 20 lbs net)
On Day 25 (Jan.6 2013), I had a bit of chocolate and ice cream, just enough for the taste. I had spent more than 6 hours digging out from the Toronto Canada ice/snow storm. At the end of my driveway, the plow had left a good 2.5 foot snow bank. That, combined with at least four inchces of ice, covered with six inches of snow, covered with another two inches of ice made it awful hard to clear out the driveway. I ended up taking a DEX4 tablet at around hour 5, and ended up with BG of 4.1 mmol/L (73.8 mg/dl) when done, and decided that was low enough to try a few "treats". This would normally easily have brought on a flare-up ... however, I felt comfortable that my self-treatment would hold up to this onslaught of sugars. And, it did. Still feel totally normal. No pain, no aches, no bloating, no headaches ... nothing.
I have had one night with nausea and vomiting. After vomiting, everything went back to normal. I believe that was something bad I ate.
As of January 3, I am quite confident with the results and no longer carry spare underwear for emergencies.
I have been asked if there are other methods of regulating digesting acids. Yes there are. Those include potassium citrate (or potassium bicarbonate), over-the-counter antacids, prescription acid blockers (H2 Blockers), and prescription proton pump inhibitors (PPI). In the United States, there are several proton pump inhibitors available over-the-counter (ie. PrilosecOTC). There are no PPIs available over the counter in Canada. Most of you reading this will recognize the last two (H2 Blockers, PPIs), they are typically prescribed along with digestive enzymes (usually without much explanation on what they do, or why). I had originally chosen not to use potassium citrate because I have no way of measuring potassium after taking supplemental doses. Potassium citrate (or Potassium Bicarbonate) can be used instead of sodium bicarbonate if one has high blood pressure (potassium lowers blood pressure). Potassium can be quite dangerous though. If taking Potassium Citrate, do not exceed the maximum 99 mg dose once a day. I have chose not to take acid blockers because I am concerned that acid blockers will have a negative impact on my liver and the long-term use risks are not known. I also decided not to take proton pump inhibitors for the same reason (I have sample packs of Tecta, enough for about one week). At this point, the sodium bicarbonate is working, it is quite inexpensive (about $0.03 per dose) and producing desirable results. There are no known side effects to the dosage levels that I take to regulate to 7.4 blood pH.
Medical Report, 1915 (preview)
Medical Report, 1915 (full, PDF, 4 pages)
Explanations of body pH, not medical/scholarly
Potassium (read section near bottom re: diabetes)
A blog, pharmacist, explanations of how digestion works and pH levels
University of Nebraska, Acidosis and starch,
FDA: Approved Digestive Enzymes
Cleveland Clinic, Acute/Chronic Pancreatitis
Cleveland Clinic, primarily discussing Acute Pancreatitis
Pancreas Foundation, primarily discussing Chronic Pancreatitis
UK (medical/university): Chronic Pancreatitis Seminar
Medical: WebMedCentral, Case Study
University of Minnesota: TP/AIT
University of Minnesota: TP/AIT (more details)
Reading Your Blood Test Results (mmol/L as well as US mg/dl