# Acidosis

Category: Conditions

A blood pH below 7.4.

10 passages · 3 authors · 1925–2022 · Most-cited: [Ray Peat](https://bioenergeticoracle.com/md/voices/ray-peat/index.md)

Canonical page: https://bioenergeticoracle.com/concepts/acidosis

## Synthesis

**Acidosis** is not a simple state of excess acid in the body, but a complex metabolic disturbance centered on the failure of oxidative energy production, with the accumulation of lactic acid being a primary consequence rather than the root cause. [Source 1, 3] Ray Peat argued that the popular conception of acidosis as a systemic acidic condition is fundamentally flawed, because a healthy, respiring cell actively maintains a *mildly acidic internal state* (around pH 6.8-6.9) through the production of **carbon dioxide**, while the blood is kept slightly alkaline. [Source 3, 5] When a cell is stressed and cannot produce adequate CO2, it shifts internally to an alkaline state and begins inefficiently producing lactic acid, which acidifies the cell's external environment. [Source 3] This distinction is critical: the internal alkalinity of the stressed cell, not an acidic interior, is the pathological shift, while the measurable acidity in tissues and blood is a sign of this underlying respiratory defect. [Source 3]

The central mechanism driving pathological acidosis is the **Randle Cycle**, a metabolic competition where increased oxidation of **free fatty acids (FFA)** directly inhibits the oxidation of glucose. [Source 1] Georgi Dinkov has synthesized this with Otto Warburg's observations, describing a vicious feedback loop: the lactic acidosis of the Warburg "Effect" blocks glucose oxidation, which in turn increases both fatty acid oxidation and synthesis, further suppressing glucose metabolism and generating more lactic acid. [Source 1] This cycle is a *necessary and sufficient condition* to trigger cancerization of healthy tissue, a process that can be initiated by drugs like metformin that promote acidosis and can be reversed by blocking systemic acidosis with agents like baking soda. [Source 1, 6] Peat similarly emphasized that estrogen, stress, and **unsaturated oils** promote this pathology by increasing free fatty acids and inhibiting thyroid function and glucose metabolism. [Source 8]

From a chemical perspective, Peat rejected the simple Brønsted-Lowry acid-base model for physiological regulation, instead pointing to the **Lewis acid** theory where an acid is an electron acceptor. [Source 4] In this framework, the carbon atom in **carbon dioxide** acts as a powerful, instantaneous electron acceptor, making it the primary physiological acidifying agent without needing to form carbonic acid. [Source 4] This aligns with the historical view that the oxidation of sugar in tissues is a controlling factor in regulating blood alkali, where the administration of glucose alone is often sufficient to correct the symptoms of clinical acidosis by restoring the cell's ability to produce CO2. [Source 2, 7] The condition is therefore not a matter of neutralizing the body's alkali with acids, but of restoring *oxidative glucose metabolism* to break the cycle of lactic acid production and fatty acid dominance. [Source 2, 7]

The clinical definition of acidosis as a mere reduction in the blood's "alkaline reserve" of bicarbonate has been recognized as inadequate for over a century. [Source 9] Yandell Henderson noted that healthy individuals at high altitude could have blood alkali levels indicating marked acidosis yet feel extremely well, proving that a low bicarbonate level alone is not the critical feature of the disease state. [Source 9] The true danger is the metabolic acidosis seen in critical illness, such as COVID-19, where **lactic acid** rises to lethal levels as carbon dioxide falls. [Source 10] Dinkov notes that the primary therapy for this condition should be carbon dioxide, which can oxidize lactic acid back to pyruvate, rather than merely buffering the acid with bicarbonate infusions. [Source 10] Peat advised that preventively, one should avoid foods containing bacterial lactic acid, like yogurt and sauerkraut, and prioritize light and thyroid-supportive nutrition to maintain a high background of CO2 production that prevents the shift to anaerobic glycolysis. [Source 8]

## People also ask

### How does the Randle Cycle drive pathological acidosis?

The entry describes the Randle Cycle as a metabolic competition where increased oxidation of free fatty acids directly inhibits glucose oxidation, creating a vicious loop that suppresses glucose metabolism and generates more lactic acid.

### Why did Peat consider carbon dioxide the key physiological acid rather than lactic acid?

Peat used the Lewis acid theory, where an acid is an electron acceptor; the carbon atom in carbon dioxide acts as a powerful, instantaneous electron acceptor, making it the primary acidifying agent that healthy cells produce to maintain a mildly acidic internal state.

### What dietary factors did Peat suggest avoiding to prevent acidosis?

Peat advised avoiding foods containing bacterial lactic acid, such as yogurt and sauerkraut, and instead prioritizing light and thyroid-supportive nutrition to maintain high carbon dioxide production and prevent a shift to anaerobic glycolysis.

## Related concepts

- [Reverse T3](https://bioenergeticoracle.com/md/concepts/reverse-t3/index.md)
- [Alkalosis](https://bioenergeticoracle.com/md/concepts/alkalosis/index.md)
- [Arthritis](https://bioenergeticoracle.com/md/concepts/arthritis/index.md)
- [Beta oxidation](https://bioenergeticoracle.com/md/concepts/beta-oxidation/index.md)
- [Bohr effect](https://bioenergeticoracle.com/md/concepts/bohr-effect/index.md)
- [Carbon Dioxide (CO2)](https://bioenergeticoracle.com/md/concepts/carbon-dioxide-co2/index.md)

## Cited passages

Passage numbers match the `[Source N]` markers in the synthesis above.

### Source 1 — Acidosis (Warburg Effect) drives cancer through increased fat oxidation (Randle Cycle)

Georgi Dinkov · Article · Oct 16, 2019 · https://haidut.me/?p=653

> The evidence continues to pile on that naming the (in)famous observation made by Otto Warburg in regards to cancer an “effect” is one of the most profound falsehoods the medical profession has ever concocted. Almost a century after the Warburg “Effect” term was coined, the evidence rapidly accumulates that the lactic acidosis is not at all a minor and therapeutically insignificant topic in oncology. Recent studies have directly implicated lactic acidosis (and chemicals like metformin that can cause it) as a necessary and sufficient condition for “cancerization” of healthy tissue. Conversely, blocking the systemic acidosis (in the study above baking soda was used) has been shown to have profoundly therapeutic effects, shrink the primary tumors and completely prevent metastases development.
>
> [references]
>
> Despite these recent developments, the medical profession continues to insist that even if the Warburg “Effect” is indeed as much a cause of the cancer as it is its effect, the main driver of both the acidosis and tumor growth is glucose. This simplistic and frankly idiotic hypothesis likely grew out of the equally idiotic proposition that diabetes is a “sugar” disease due to the elevated blood glucose levels in such patients. Yet, regardless of the origins of these idiotisms, the actual evidence accumulated over the last 100 years points to increased free fatty acids (FFA) in the blood being a core aspect of both the diabetes and cancer pathologies. This is most readily visible in patients with diabetes II who are almost always obese, and the elevated FFA in blood of obese patients is a medical fact taught in introductory endocrinology at every medical school. However, it has also been confirmed in wasting patients with diabetes I, cancer, HIV/AIDS, Alzheimer, etc. A closely related concept – the so-called Randle Cycle – is also taught in introductory courses in medical school but unfortunately does not get much attention beyound that and most doctors not only quickly forget about it but it is not used clinically in any medical system around the world.
>
> The study below is a great addition to this pile of evidence because not only it confirms the role of acidosis in cancer once again but also demonstrates that, the Warburg “Effect” and the Randle cycle are actually two ends of a positive feedback cycle.

### Source 2 — Physiological Regulation of the Acid-Base Balance of the Blood and Some Related Functions

Yandell Henderson · Article · 1925

> The work of Shaffer (53) dealing with the ketogenic-antiketogenic balance indicates a line along which much valuable information is accumulating. Allen justly remarks, however, of some of the too rigid conceptions based on Shaffer’s work that it is necessary to consider not merely the two known chemical factors, glucose versus fatty acids, but also a third variable, the living organism which does not necessarily or invariably deal with the same food mixtures in the same way under all normal and pathological conditions.
>
> In all of these investigations we have evidence that the symptoms of acidosis are due either to the pharmacological action of the products of disturbed oxidation, or to a deep-seated metabolic disturbance, rather than to the mere neutralization of the body’s alkali by acids. In large part the substances occurring are not acids but ketones and related substances. On this point a very significant observation is mentioned by Talbot and his associates (49) as made by Parsons. He found that 20 per cent acetone injected into the rabbit in doses of from 1.5 to 4 cc. depending on the weight of the animal was sufficient to cause shock and often death. If 5 cc. of 20 per cent glucose were given intravenously it was generally sufficient to bring the rabbit out of shock almost immediately and to cause all signs of acetone intoxication to disappear. Somewhat similar observations on post-operative shock in patients are reported by Fisher and Snell (54).
>
> Evidently the utilization of glucose in the tissues is a factor on a par with respiration and with the activity of the kidneys. These three functions interact in the physiological regulation of the acid-base balance of the blood.
>
> ## References
>
> 1. HENDERSON, L. J. Acidosis and the physicochemical equilibrium of the organism. The Oxford Medicine, 1919, Vol. I, Part IV, p. 471.
> 2. VAN SLYKE, D. D. The carbon dioxide carriers of the blood. Physiol. Reviews, 1921, i, 141.
> 3. STRAUB, H. Störungen der physikalisch-chemischen Atmungsregulation. Ergebn. Inn. Med. u. Kinderheilk., 1924, xxv, 1.
> 4.

### Source 3 — Ask the Herb Doctor Acidity X Alkalinity

Ray Peat · Interview · Mar 16, 2012

> ## The Physiology of Carbon Dioxide and Acidity
>
> **Sarah Murray:** Because of the carbonic acid leaving.
>
> **Ray Peat:** Yes. In this healthy metabolism, the mineral gets pulled out of the neutral cell. With the acid being constantly formed, the cell shows its basic protein acidity. So, the respiring cell is normally slightly on the acidic side. A good, healthy cell with plenty of oxygen will be around pH 6.8. If you stress a cell so it isn't getting enough carbon dioxide—or stress it via radiation, lack of oxygen, etc.—the cell becomes activated and shifts to the alkaline because it can't make carbon dioxide to acidify itself. It begins producing lactic acid very inefficiently. With lactic acid, the sugar, instead of being oxidized all the way to carbon dioxide, stops at pyruvic acid. The cell reduces the pyruvic acid to lactic acid by taking some of the energy substance produced in metabolism and wasting it to get rid of the electrons. In that process, the lactic acid takes protons out of the cell and raises the pH of the cell. The conversion of pyruvic acid to lactic acid increases the pH of the cell—just the opposite of what the production of carbon dioxide was doing. So, the stressed cell becomes alkaline.

### Source 4 — Ray Peat and Bud Weiss - The Biology of Carbon Dioxide - 2010

Ray Peat · Interview · Sep 18, 2022 · https://www.youtube.com/watch?v=0tgKX-DkEm4

> **Ray Peat:** That was all the way from about 1910 up to the present. I think probably A.C. Guyton's... textbook of medical physiology, I think, probably is still teaching that. But essentially, it was shown to be wrong, the whole system of the whole context around the focus on bicarbonate as the regulator of pH and so on. Brunsted-Lowry acid is the one based on the definition of an acid as a proton donor and a base as a proton acceptor. But there is a whole class of acids and bases which contain no protons. So the theory can't be right. And G.N. Lewis at the same time that Brinstead-Lowry got their idea accepted, partly because they fit it into a simple reductionist view of chemistry. The Lewis acid looks at electrons. And an electron acceptor is a Lewis acid. An electron donor is a Lewis base. looking at Szent-Györgyi and W.F. Coke from the context of how acids and bases really work, you see that carbon dioxide is, well, if you visualize the Coke reagent, its most powerful reagent, instead of being a quinone with the double-bonded oxygens joined by onto a carbon grain. His reagent that he made by spraying alcohol or methane onto a hot platinum electrode and collecting it in water, which produced a purple dye at a very tiny concentration, showing free electrons in the system. His reagent was just a carbon chain with all of the carbons be having a double bonded oxygen. And so if you look at carbon dioxide as the shortest co-creation, it not only fits into W.F. Coke's view of how respiration works, but it explains that the Lewis acid is the carbon atom with its electrons so pulled away under the oxygens that the carbon atom is a strong electron acceptor. And so it's instantaneously acidic. It doesn't have to form a carbonic acid to be acidic.

### Source 5 — One Radio Network — Peat Ray (July 2021)

Ray Peat · Interview · Jul 19, 2021

> **Patrick Timpone:** Wow, interesting. Amazing. We're talking with Dr. Ray Peat, who's here on the third Monday of the month. And Dr. Peat, we thank you so much for taking the time to visit with us every month. We really appreciate it.
>
> **Ray Peat:** Oh, you're welcome.
>
> **Patrick Timpone:** We really do. Here's a question from David in Australia. And he says, you know, there's a lot of people out there that's kind of demonizing being metabolically acidic, meaning the more acidic, then the more cancer, poor functioning of kidneys. What does Dr. Ray Peat think about this idea of being more alkaline for health?

### Source 6 — #04: Endotoxin, Otto Warburg, Cancer, Ketosis, and PUFA with Georgi Dinkov

Georgi Dinkov · Interview · Jun 14, 2019 · https://open.spotify.com/episode/1JcrW0U6ajwgFaDVe04f0m

> **Georgi Dinkov:** Yeah, so that's another thing which I think you and I have been discussing since 2015. Actually, before I jump on, I just wanted to mention a study which we may have discussed last time. I don't remember. It was about metformin and the cancerization. So we just talked about how the Warburg effect is really not just an effect, but it's also a cause of the cancer. Mm-hmm. And that study that came out maybe two weeks ago showed that acidosis, in other words, the very fact of wasting glucose into lactic acid is a sufficient and necessary condition to trigger cancer. You don't need anything else. I mean, of course, just like Warburg said, it could be multiple other reasons like radiation or toxins, but ultimately the metabolic signal that apparently triggers the cancerization, if it's going on chronically, is simply acidosis, simply the generation of lactic acid. And the reason I wanted to mention is that they found out that they can actually trigger cancer by administering one of the most popular drugs. that is being given to everybody these days, metformin. It's the drug for diabetes. The anti-aging drug you mean, right, Jorge? Yes, the anti-aging, the promising anti-aging drug that is billions of dollars of taxpayers' money are being poured into these anti-aging institutes. I think they're out in California and Boston to basically study how metformin is going to prevent every disease out there and make us live to 200 years. But guess what? That study said, nope, we actually use metformin to cause cancer. And actually, when we gave it to animals with cancer, it killed them much quicker. And the mechanism was this acidosis. So speaking of the acidosis, jumping on to the increased fatty acid oxidation. So just as we mentioned, there's the Randall cycle, right? And they mentioned the Randall cycle in that study on increased fatty acid oxidation. So most people think that... Okay, so if I'm overweight, this means I have too much fat on me.

### Source 7 — Physiological Regulation of the Acid-Base Balance of the Blood and Some Related Functions

Yandell Henderson · Article · 1925

> The condition would thus be analogous to the hemoglobin-alkali which is the chief factor in the buffering of the blood. It would exceed the scope of this review to discuss this topic extensively but some recent investigations which seem to be in accord with the formulation presented in the previous paragraph may be mentioned.
>
> Benedict and Talbot (48) have shown that in children the reserve of sugar is much more rapidly exhausted than in adults; and Talbot, Shaw and Moriarty (49) find that hypoglycemia due to fasting produces a definite acidosis which quickly clears up on administration of even a small amount of sugar. They conclude that clinically when a ketosis is found it must be assumed that there is some interference either with the availability of the sugar or with the ability of the body to oxidize sugar. If the body is able to oxidize sugar, as is the condition in fasting children, then the ketosis must be due either to a sugar deficit or a lowered availability of the sugar deposits of the body. Clinically, the administration of glucose to a child with acidosis is usually all that is necessary to correct the symptoms of this condition if the supply of water also is ample.
>
> The clinical experience and experimental work of Banting and his associates (50) appear to demonstrate that insulin promotes the combustion of glucose. Bock, Field and Adair (34) find that even in diabetic coma the administration of insulin and sugar may be largely effective in overcoming the clinical symptoms and restoring a normal blood alkali. It appears from the observations of John (51) among others that insulin does not act in the blood; presumably its action is in the tissues.
>
> Allen (52) reports observations on puppies closely similar to those above noted in children. Acidosis is induced by sugar depletion and relieved by sugar administration. He shows both by experimental evidence and from clinical facts that low blood alkali is merely a concomitant and not the essential factor in acidosis as a clinical entity; and he urges a broader view than merely that the condition consists in a neutralization of the body’s store of alkali by acids.
>
> The work of Shaffer (53) dealing with the ketogenic-antiketogenic balance indicates a line along which much valuable information is accumulating.

### Source 8 — Mitochondria and mortality

Ray Peat · Article · 2016 · https://raypeat.com/articles/articles/mitochondria-mortality.shtml

> Glycolysis produces both pyruvate and lactate, and excessive pyruvate produces almost the same inhibitory effect as lactate; since the Crabtree effect involves nitric oxide and fatty acids as well as calcium, I think it is reasonable to look for the simplest sort of explanation, instead of trying to experimentally trace all the possible interactions of these substances; a simple physical competition between the products of glycolysis and carbon dioxide, for the binding sites, such as lysine, that would amount to a phase change in the mitochondrion. Glucose, and apparently glycolysis, are required for the production of nitric oxide, as for the accumulation of calcium, at least in some types of cell, and these coordinated changes, which lower energy production, could be produced by a reduction in carbon dioxide, in a physical change even more basic than the energy level represented by ATP. The use of Krebs cycle substances in the synthesis of amino acids, and other products, would decrease the formation of CO2, creating a situation in which the system would have two possible states, one, the glycolytic stress state, and the other, the carbon dioxide producing energy-efficient state.
>
> Besides the frequently discussed interactions of excessively accumulated iron with the unsaturated fatty acids, producing lipid peroxides and other toxins, the accumulated calcium very probably forms some insoluble soaps with the free fatty acids which are released even from intracellular fats during stress. The growth of new mitochondria probably occasionally leaves behind such useless materials, combining soaps, iron, and porphyrins remaining from damaged respiratory enzymes.
>
> When the background of carbon dioxide is high, circulation and oxygenation tend to prevent the anaerobic glycolysis that produces toxic lactic acid, so that a given level of activity will be harmful or helpful, depending on the level of carbon dioxide being produced at rest.
>
> Preventively, avoiding foods containing lactic acid, such as yogurt and sauerkraut, would be helpful, since bacterial lactic acid is much more toxic than the type that we form under stress. Avoiding the stress-promoting antithyroid unsaturated oils is extremely important. Their role in diabetes, cancer, and other age-related and degenerative diseases (and I think this includes the estrogen-promoted autoimmune diseases) is well established.

### Source 9 — Adventures in Respiration: Modes of Asphyxiation and Methods of Resuscitation

Yandell Henderson · Book · 1938

> The acidity or alkalinity of a solution is therefore conceived as determined by theconcentration of H ions: a quantity expressed by the symbol pH, the negative logarithm of their concentration.
>
> This conception was introduced into physiology by L. J. Henderson, who showed that in the acid base balance of the blood the acid is chiefly carbonic acid (H,CO3), which is carbon dioxide in solution, while the alkaline factor is chiefly bicarbonates: NaHCO3 in the blood plasma, KHCO; in the corpuscles, or BHCO; for both. Van Slyke recognized that to measure the bicarbonates, which he called the “alkaline reserve,” it was necessary merely to determine the amount of carbon dioxide that could be obtained from the blood. For their measurement he invented the modification of the mercury pump that is now in universal use. Under this conception the alkaline reserve serves to neutralize any acid that may enter the blood, and thus normally protects the body from acidosis. If the “alkaline reserve” is lowered—that is, if the blood holds, or can hold, less than the normal amount of carbon dioxide—that condition is “acidosis.” | Few developments in medical science have excited wider interest or met with more complete acceptance than the conception of “acidosis” thus defined. Accordingly it was made the subject of a general discussion before the Association of American Physicians in 1916. Eminent clinicians first presented papers dealing with the various conditions which they called “acidosis”: papers from which I have quoted freely in the preceding section of this chapter. Then two biochemists—L. J. Henderson and D. D. Van Slyke—presented their new conception of acidosis, essentially as it is summarized in this section. Everyone was delighted that Chemistry had come to the aid of Medicine and had solved this fundamental problem.
>
> I was the last speaker on the program and ventured to point out that perhaps a number of different conditions were being confused under the same name. “Acidosis” in the biochemical sense could not be in itself the critical feature of the various conditions in disease that the clinicians called by that name. I had been a member of a party with Haldane, not a great while before, that had spent five weeks on top of Pike’s Peak. In all our bloods the alkali had there been reduced to levels that would indicate marked degrees of acidosis.

### Source 10 — Episode 7: Georgi Dinkov (Haidut) on Carbon Dioxide (CO2) and Testosterone

Georgi Dinkov · Interview · Jun 12, 2020 · https://www.youtube.com/watch?v=ztzIGcwMu3M

> **Veselin Velichkov:** Hello to our viewers. Today we are again with Georgi. So, now better known as Georgi, not so much as Haidut. Maybe people prefer to mention you by name, which is maybe good. Haidut in the forest, here Georgi. Haidut in the forest, yes. So it does not have to be... yes. So, today we are making the next episode of our podcast Feel, Think, Act, or Sense and Think, Act. That also sounds good. For the female consciousness, yes. Yes. Maybe mostly. Now we have to look at the statistics, to look at the rest. Whether YouTube knows, whether it can. I think it has it. The topic I have chosen today, well actually I did not choose it. Last time there was a poll we had done. This is simply the topic that was in second place, and it was very clearly in second place, which is about carbon dioxide. Modernly it is called carbon dioxide; the old Bulgarian term is carbonic dioxide. I honestly do not know why the pronunciation of this thing changed. It sounds like a foreign word, because in English it is dioxide and, you know, in order to adapt to Western thinking we tried to copy the words too. Yes, maybe that is something too. This topic, actually, clearly interests many people, but is very little known. I admit that obviously we have talked with you about it, but I have not dug in very much to read about it. And it would maybe be interesting now for you to say, briefly as we usually do, a lecture. They even say these are not podcasts but lectures by Georgi Dinkov. So I think I have sort of... I have asked the question. What from here onward, you tell us.
>
> **Georgi Dinkov:** Yes, so carbon dioxide, modern medicine looks at it with something like absolute contempt, in the same way it looks at water. That is, for it, these are two waste products of metabolism, and generally carbon dioxide, its role, medicine is interested only if its levels either fall too low or rise too high. When they fall too low, since carbon dioxide is inversely related to lactic acid, if your carbon dioxide is very low, usually lactic acid in the blood, so-called lactate, will be very high, and metabolic acidosis occurs, which is dangerous, because most people in critical condition die from metabolic acidosis; it is the final cause of death. That is, people with COVID-19, to mention this disease, most of them who enter the hospital are already in some phase, some degree of metabolic acidosis. And it has a very high mortality, about 30-40% of people with metabolic acidosis die, because medicine simply does not know how to treat them. They try, they give them infusions with sodium bicarbonate and various other buffer compounds like that, which can to some extent neutralize lactate, but the main therapy in such a situation should be therapy with carbon dioxide, because it is the agent in the body that is directly opposite to lactic acid. And in many cases it can oxidize lactic acid back to pyruvate. That is, pyruvate, which is a product of the metabolism of glucose, has two paths it can take. After glucose turns into pyruvate, the pyruvate either enters the Krebs cycle, so-called, also known as the citric acid cycle, or if it cannot enter this cycle, pyruvate begins to accumulate. But because of pyruvate accumulation, when pyruvate accumulates, the organism begins to fall into a so-called reduced balance of metabolism, which is not useful for the organism, that is, cells can die if the organism becomes too reduced a state.

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