menopause and acidosis

I don't know about you, but until now, I had never heard about an association between menopause and acidosis, and I've already entered the golden years of postmenopause! However, although it appears I passed through perimenopause and menopause without encountering this symptom, some women do not.

What is acidosis?

Acidosis, or more specifically metabolic acidosis, is a process that causes an elevated level of acidity in the bloodstream and other tissues. For those who like a more scientific explanation, it involves an elevated hydrogen ion concentration, which occurs when the body overproduces acid.

It is worth being clear about what that means, because the word gets used very loosely online. Metabolic acidosis is a specific finding on a blood test, not a mood or a general feeling of being run down. It is diagnosed in a hospital or a lab, usually on a blood gas or a metabolic panel, and the people who have it are acutely unwell rather than vaguely off (MedlinePlus, U.S. National Library of Medicine).

When acidosis develops, it also can make the body more susceptible to disease because the pH balance has been disrupted. The presence of acidosis makes the body less able to fight off disease because of this pH imbalance. Acidosis also can inhibit bone formation. This can be especially critical for women in perimenopause and beyond because of the threat of osteoporosis.

Read about how you can beat and prevent osteoporosis naturally

In true metabolic acidosis, where the lungs and kidneys cannot clear the acid load, the body begins to draw calcium from the bones to buffer it. That is a real process, and it is what makes untreated acidosis a bone problem. It is not what happens to you after a slice of cheese.

Why does diet come up in this conversation?

The link researchers actually study is not blood acidity. It is dietary acid load, meaning how much acid your kidneys have to clear after what you eat, and what that may mean for bone over years. A 2014 study found that postmenopausal women who consumed a diet high in acid (e.g., high in meat and dairy) had lower bone density in their leg and spine than those who had a more balanced diet.

Can diet change your body's acidity?

A correction we owe you. This page used to tell you that alkaline water is an easy and effective way to neutralize the acid in your body, and it recommended buying it or an ionizer. We have taken that out. Your blood pH is held in a very narrow band, roughly 7.35 to 7.45, by your lungs and kidneys, and it stays in that band regardless of what you eat or drink (MedlinePlus, U.S. National Library of Medicine). Food and drink can change the pH of your urine. They do not change the pH of your blood. If you have been buying alkaline water or an ionizer for this reason, you can stop spending the money. We also took out a suggestion to cleanse regularly with supplements to eliminate toxins, because your liver and kidneys already do that job and no supplement has been shown to do it better.

The vague "acidic" feeling a lot of pages describe, low energy, aches, feeling generally inflamed, is not metabolic acidosis. It may well be worth investigating. It is just a different thing.

What research on dietary acid load does support is more modest. In one study of postmenopausal women, researchers found that taking potassium bicarbonate for 18 days improved the balance between calcium and phosphorus, increased the rate of bone formation, and reduced bone loss. That is a measurable effect on how the kidneys handle minerals. It is not a change in blood pH, and it is not a reason to overhaul your diet around an acid and alkaline chart.

Read about acidic and alkaline foods

The eating pattern this research keeps pointing at is not complicated, and it is worth doing for your bones and the rest of you. Just do not expect it to move your blood pH.

• Eat more plants: fruits and vegetables, including citrus, garlic, and leafy greens, plus nuts, beans and legumes, and whole foods generally. This is good for bone and general health.
• Go easier on the ultra-processed end: sugars, soft drinks, and heavily processed foods. This is also good for bone and general health, and it is a reasonable thing to do without any pH story attached to it.
• Get enough magnesium, calcium, and vitamin D, which are the nutrients with the clearest evidence behind them for bone in midlife. Food first, and talk to your doctor about whether a supplement makes sense for you.

when to see a health provider

Metabolic acidosis is not something you book an appointment for. It is a hospital diagnosis, made on a blood test, and its causes include uncontrolled diabetes, kidney problems, and severe dehydration (MedlinePlus, U.S. National Library of Medicine).

Get emergency care now, not an appointment, for any of these:

• Deep, rapid breathing that you cannot slow down
• Confusion or unusual drowsiness
• Severe nausea and vomiting
• Extreme fatigue with breath that smells sweet or fruity

That last combination is a warning sign of diabetic ketoacidosis. The Centers for Disease Control and Prevention lists fruity-smelling breath alongside fast deep breathing, nausea and vomiting, and being very tired. Call 911 or go to an emergency room. Do not wait for an appointment and do not try to manage it at home.

If what you have is ongoing tiredness, aches, or digestive discomfort with none of the above, that is still worth raising with your doctor at a normal appointment. It is just not acidosis, and treating it as acidosis will send you down the wrong road.

bottom line

Acidosis associated with the years around menopause is not real common. Real metabolic acidosis is a medical emergency with a specific set of causes, and it is diagnosed on a blood test rather than felt. The everyday version of the word, the sense of being generally acidic or inflamed, is something else, and no food or water will change your blood pH. What is worth your attention in these years is bone health, and the ordinary levers there are diet, weight-bearing exercise, and a conversation with your doctor.