Alkalosis

Alkalosis is a state of excessive alkalinity in the blood, which Ray Peat distinguished sharply from the healthy, mildly acidic state required inside cells. 2 While the blood is maintained at a slightly alkaline pH of 7.4, a healthy functioning cell is kept in a mildly acidic state, usually around a pH of 6.8 or 6.9. 2 This gradient is actively preserved by the cell excreting sodium into the bloodstream, with the kidneys eliminating the excess to prevent the blood from becoming too alkaline. 1 The crucial distinction is that systemic alkalinity is not a sign of health; rather, the cell's internal acidity, maintained by adequate carbon dioxide (CO2), is essential for proper function. 2

The most common and dangerous form of this condition is respiratory alkalosis, which Peat identified as a consequence of relative hyperventilation. 3 This occurs when CO2 is lost too rapidly through the breath, often triggered by stress, anxiety, or hypothyroidism. 2 In hypothyroidism, metabolic inefficiency leads to low CO2 production and a compensatory increase in adrenaline and lactic acid, which further stimulates hyperventilation, creating a vicious cycle that depletes CO2 and raises blood pH. 6 This pattern is not merely a blood gas disturbance; Peat described it as a systemic metabolic pattern characteristic of many kinds of stress, including cancer, involving generalized vasoconstriction and increased intracellular alkalinity. 4 Even brief hyperventilation can trigger a cascade where platelets release serotonin, a major promoter of collagen synthesis and fibrosis. 2

Peat explained that the body's regulatory systems prioritize the retention of CO2 to maintain cellular acidity, which is why interventions like breathing into a paper bag or the Buteyko method work. 2 He noted that taking a dose of baking soda (sodium bicarbonate) momentarily makes the blood more alkaline, but enzymes can convert the bicarbonate into acidic, oil-soluble CO2 that is retained inside cells; the excess sodium is then excreted by the kidneys, leaving a net gain of cellular CO2. 1 Therefore, the effect of such a substance cannot be understood simply as leaving an alkaline balance. 2 Estrogen powerfully exacerbates the shift toward alkalosis by lowering thyroid function, increasing endotoxin absorption, and promoting hyperventilation, which helps explain its association with increased asthma risk and the tissue edema seen in hypothyroidism. 2

The consequences of alkalosis extend to tissue structure and mineral balance. Stress-induced alkalosis favors increased collagen synthesis, while a lower pH inhibits it, linking the condition directly to fibrotic processes. 2 In the context of bone health, Peat distinguished between respiratory alkalosis, where decreased CO2 impairs calcium retention, and metabolic alkalosis, where increased bicarbonate actually stimulates bone formation and suppresses its dissolution. 5 He cautioned that treatments like calcitonin, vitamin D metabolites, and estrogen HRT can cause respiratory alkalosis, thereby contributing to calcium loss and osteoporosis. 5 The body handles alkaline minerals with considerable flexibility; Peat cited the work of William Frederick Kolk, who found that alkaline minerals like sodium, potassium, and magnesium can substitute for each other to a great extent, allowing the body to sort out an excess. 8

On a practical level, Peat advised that urine pH is a useful indicator, recommending it be kept slightly on the acidic side, around 6.7, as a sign that the blood is being maintained at its proper pH of 7.4. 2 A diet higher in protein naturally makes the urine more acidic due to the sulfate and phosphate content, which is compatible with health. 1 At a fundamental level, Peat framed the issue in terms of electron disposition, noting that excitation creates a field of alkalinity, and that the disposition of electrons in cells integrates metabolism, pH, and sensitivity. 10 The goal is not to make the organism more alkaline, but to support the oxidative metabolism that produces sufficient CO2 to maintain the vital, acidic internal environment of the cell. 2