Bicarbonate Levels: Striking a Delicate Balance

The Biomarker Handbook is a curated series that seeks to provide readers with insights on each biomarker we cover in our blood test packages and its relation to our body.


When your body utilises oxygen to produce energy, carbon dioxide (CO2) is produced and expelled through your lungs. The CO2 produced is carried in the blood as bicarbonate, a negatively charged electrolyte that plays a vital role in maintaining the acid-base balance (pH) of our cells and blood.

Why is it Important to Track Bicarbonate Levels?

Your body is at optimal health when the acidity around the cells is within a tight range; any imbalance can harm your health, causing either acidosis or alkalosis.

Normally, our blood’s acidity is around a pH of 7.35 to 7.45, which is considered a neutral range. Decreases in the blood pH can result in acidosis while increases in it can result in a state of alkalosis. A bicarbonate test can give a good indication of an acid-base imbalance.

Bicarbonate is also important in checking for any electrolyte imbalances. Just like the blood pH, our body also regulates the other electrolytes within tight ranges. Sodium, potassium, chloride and bicarbonate ions make up the major electrolytes. Imbalances in the bicarbonate blood level will indicate a state of electrolyte imbalance in the body.

When is the Test Ordered?

The bicarbonate blood test is part of the routine health-screening panel, but may also be ordered specifically by your doctor if you experience any symptoms of an acid-base or an electrolyte imbalance. These symptoms could include:

  • Unexplained persistent vomiting
  • Diarrhoea
  • Breathlessness
  • Fatigue
  • For monitoring liver, kidney and heart disease

What Causes an Imbalance in Bicarbonate Levels?

The lungs and the kidneys are the primary organs in the excretion of bicarbonate (thus removing carbon dioxide). Any damage to these organs can cause changes in the circulating levels of the bicarbonate ion. Other conditions such as a potassium deficiency, certain drugs, prolonged exercise, poisoning and anxiety may also affect bicarbonate levels in the blood.

High Bicarbonate: An elevated bicarbonate level may arise due to lung diseases (asthma, emphysema), prolonged vomiting and/or diarrhoea, or Cushing’s disease.

Low Bicarbonate: Low levels of bicarbonate have many causes – more common ones include diabetic ketoacidosis, chronic diarrhoea, hyperventilation, shock, kidney disease and aspirin overdose.

Other Relevant Tests

Sometimes your doctor may order other relevant blood tests to get a better outlook of the acid-base balance in your body. The blood gas analysis test, in which the blood is drawn from an artery instead of a vein, is a test that measures the levels of blood gases in your body. It is a more specific test compared to the bicarbonate test, but requires more skill and expertise to perform. Since this test requires special skill-set and handling of the blood, it is usually carried out in the hospital setting.

Managing Imbalance with Lifestyle Changes

Your diet can play a role in determining the pH and electrolyte balance in your blood. All food items have a specific pH and including or removing them from your diet can affect your blood pH as well.

If your doctor tells you that you have acidosis or decreased blood pH, stick to alkali-rich foods. These include soy, tofu, fruits, vegetables, milk, yogurt, whole grains, beans, lentils, nuts, olive oil and spices excluding salt and mustard.

It is also important to steer clear of acid-rich food if you suffer from acidosis as well. Acid-rich foods include processed grains, fish, sugar, fizzy drinks and high-protein foods and meat.

On the other hand, people with a high blood pH can benefit from a diet that is opposite to the one mentioned above, that is, by excluding alkali-rich foods and including healthy acid-rich foods in your diet.

Bicarbonate Ion: is it Really Important?

When the blood pH and electrolyte balance is normal, the body is able to perform to its best capacity. That’s what makes the bicarbonate ion so important– it helps to keep the pH and electrolyte balance appropriate.

If you have been experiencing symptoms of an imbalance, it’s a good idea to check in with your physician immediately and get a bicarbonate test done!


If you want to find out more about bicarbonate and why its important for the body, take a look at our lifestyle article here!

Interested in other biomarkers? Check out the rest of The Biomarker Handbook.

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