Polyatomic anion
POPULARITY
4 episodes with Bicarbonate
4 episodes with Bicarbonate
3 episodes with Bicarbonate
2 episodes with Bicarbonate
3 episodes with Bicarbonate
3 episodes with Bicarbonate
2 episodes with Bicarbonate
2 episodes with Bicarbonate
2 episodes with Bicarbonate
In hour 1, our guest is Dr. Mark Sircus, Ac., OMD, DM (P) (acupuncturist, doctor of oriental and pastoral medicine). He is a prolific writer and author of some astounding medical and health-related books. Dr. Sircus's methods are based on medical science and long years of clinical experience, not only his own but experiences of doctors from around the world who have been practicing brilliant medicine. His books are heavily referenced, but the layperson finds little difficulty in understanding his presentation of medical topics. For many years Dr. Sircus has been researching into the human condition and into the causes of disease; he has distilled many of the divergent medical systems into a new form of medicine that he has coined Natural Allopathic Medicine.https://drsircus.comIn hour 2, our guest is Jack Moore. He is a former prosecutor turned pitching coach and podcaster, blending his love for competition, strategy, and storytelling into everything he does. A lifelong sports fanatic, Jack has a deep passion for old-time baseball—the days when the game was about grit, not contracts, and anyone with talent and heart could step onto a sandlot and prove themselves. For him, baseball was once the ultimate neighborhood sport, where communities came together, and the best players rose to the top, regardless of background.But Jack's interests don't stop at the pitcher's mound. He's just as passionate about football, especially his beloved Washington Commanders, and he can talk Constitutional law with the best of them. A true history buff, he has a sharp eye for dissecting major moments in American history—none more fascinating to him than the JFK assassination, a topic he's spent countless hours analyzing from every angle.https://www.mooretoconsider.comOur radio show is live every week from Noon to 2 PM ET. You can listen here:https://rumble.com/c/TheFactHunterhttps://radiosoapbox.com https://x.com/RealFactHunterhttps://x.com/RealFactHunter
This week's episode leans hard into sports science as we share some new thoughts on creatine, sodium bicarbonate, and caffeine for performance. We also talk through the why and how of lactate testing and whether this is a worthwhile thing to spend your time and money on, the “feel and stair test” as an organic and data-free way to assess your training readiness, how our coaching styles have and have not evolved over time, and how we approach coaching men vs. women. We finish up with some fun challenges and gear picks related to self-care and sleep. Check it out!View extended show notes for this episode here. To share feedback or ask questions to be featured on a future episode, please use this form or email: Katie@TheEnduranceDrive.com.
What does Valentine's Day mean to you?And how do you make your special person feel extra loved on this (sometimes tricky and weird) day?Yumi and Simon have some experiences and advice to share - and a REALLY GREAT cake from the legendary Belinda Jefferey that would make the perfect gift cake - or just a treat for yourself.Ingredients300g (about 2 medium sized) tart apples, peeled, cored, chopped200g pitted dates, finely chopped1tsp bicarbonate of soda150g plain flour75g self-raising flour125g soft unsalted220g caster sugar1 egg1½tsp vanilla extract50g pecans and 50g slivered almondsTOPPING:90g unsalted butter½ cup milk170g soft brown sugar110g pecan nuts sliced and almonds if you love nuts like Yumi does1 tsp vanilla extractStepsPreheat oven to 180°C. Butter a 20cm springform cake tin. Line the base with baking paper.Put the apple into a heatproof bowl with the dates. Add the Bicarbonate of soda and pour in 250ml boiling water. Thoroughly stir together then leave the mixture to cool to room temperature.Sift both flours and ½tsp salt into a bowl ensuring they are well mixed or even go fastidious and run it through the food processor.Put the butter and caster sugar into the bowl of a stand mixer fitted with the paddle. Beat. Then add in the egg and vanilla extract.Reduce speed to low and add the flour mixture, alternatively with the apple and date mixture until both are incorporated. Take care not to over work the mixture or it could make for a tough cake. Lastly stir through the nuts.Scrape the cake batter into the tin and bake for 1hr 15mins, aka, a lifetime.About 15mins before the end of the cake cooking time make the toppingHeat the butter and milk in a small saucepan until the butter has melted. Stir in the sugar, pecan nuts (and almonds) and vanilla extract. Adjust the heat so the mixture bubbles steadily and cook stirring regularly for approximately 5 mins or until it slightly thickens. Keep warm until the cake is ready.Remove cake from the oven and make sure you have an audience. Pour over the molten, nutty caramel. Some will run down the sides. Return the cake to the over for 10 to 15mins until the topping is a deep brown.Sit the cake tin on a rack with baking paper underneath to catch the drips. Leave the cake to cool completely in the tin.Serve whenever you want cos it's your cake. Good with cream, icecream, all the good things! Happy Valentine's Day! Hosted on Acast. See acast.com/privacy for more information.
durée : 00:02:25 - Le bicarbonate de soude, un allier au jardin
In this episode of the PFC Podcast, Dennis and Jamie discuss the critical topic of tourniquet conversion versus replacement in trauma care. They explore the guidelines for when and how to convert a tourniquet, the implications of prolonged tourniquet use, and the importance of assessing limb salvageability. The conversation also covers the management of reperfusion injury and the use of calcium and bicarbonate in resuscitation. Jamie emphasizes the need for medics to be prepared and confident in their decision-making to ensure the best outcomes for their patients. Takeaways Tourniquet conversion is crucial for effective hemorrhage control. Understanding the difference between conversion and replacement is essential. Guidelines for conversion depend on the tactical situation. The two-hour mark for tourniquet application is significant for patient outcomes. Resuscitation goals should guide the timing of tourniquet conversion. Be prepared for potential reperfusion injuries after conversion. Assess the viability of the limb before making decisions. Calcium administration can help stabilize the heart during resuscitation. Medics should be confident in their ability to convert tourniquets. Always prioritize patient resuscitation over limb preservation. Chapters 00:00 Understanding Tourniquet Conversion vs. Replacement 03:14 Guidelines for Tourniquet Conversion 08:59 The Two-Hour Rule and Its Implications 12:55 Techniques for Tourniquet Conversion 18:11 Challenges of Prolonged Tourniquet Use 23:48 Assessing Limb Salvageability 29:36 Managing Reperfusion Injury 35:30 Calcium and Bicarbonate in Resuscitation 46:40 Final Advice for Medics on Tourniquet Conversion Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to www.prolongedfieldcare.org Consider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care
This episode features Stevie Lyn Smith a registered dietitian with a speciality in sports dietetics. Stevie speaks with Molly about a host of nutritional concepts that concern masters athletes including concerns about over-fueling, the risks of under-fueling, Red-S, Sodium-Bicarbonate, and the concept of fall weight loss when training load is lower. This Episode is Brought to You By: The Payable Add-on for Google Forms – Try it out for your next Event, Pizza day, jersey order or clinic/camp! AG1- drinkAG1.com/MOLLYH – to receive your bonus of a free 1-year supply of Vitamin D and 5 Free Travel Packs Consummate Athlete Event and Goal Based Training Plans, available in the Training Peaks Store. This ready to go plans are available to start whenever you are and provide a valuable and proven workouts to guide you to your goal or event. Use Code ‘CAPOD' to get 25% of any of the plans . bit.ly/PGPLANS Curious about becoming a Consummate Athlete Podcast Sponsor? Please Connect with us HERE Listen to the Consummate Athlete Podcast Find links to your favorite Podcast App (remember to rate and review!) https://pod.link/1100471297 Watch The Consummate Athlete Podcast on Youtube Show Notes For Consummate Athlete Visit Stevie Lyn Smith Website Consummate Athlete Phone Consultation Connect with Molly & Peter Subscribe to our Newsletter Books By Molly Hurford https://amzn.to/3bOztkN Follow The Consummate Athlete on Instagram and Facebook Follow Molly Hurford on Instagram Follow @PeterGlassford on Instagram Consummate Athlete Links for Coaching and other services Past Consummate Athlete Guests: Stacy Sims,Stephen Seiler, Simon Marshall,Frank Overton, Dean Golich, Joe Friel,Marco Altini, Katerina Nash, Kelly Starrett, Geoff Kabush, Ellen Noble, Phil Gaimon, David Roche, Matt Fitzgerald, Dr. Marc Bubbs, Christopher McDougall,Rebecca Rusch, Kate Courtney, David Epstein ,Kelly Starrett, Juliet Starrett, and many more
Sodium Bicarbonate has been in medical use since the 1700's. Our kidneys product about 1/2 pound per day to help keep the blood stream slightly alkaline. Bicarbonate deficiencies are real and contribute to minor health problems all the way to cancers, lupus, myastenia gravis, MS, scleroderma. Dr. Tulio Simoncini pioneered treating cancer tumors with direct injections of sodium bicarbonate.
OVERVIEW: Sports Dietitian Kristen Arnold MS, RDN, CSSD is back to discuss exactly how sodium bicarbonate can improve cycling performance, how much to consume, when to take it, and what workouts or races it works best for. Coach Adam Pulford and Kristen also discuss new research showing that using sodium bicarbonate during an 8-week training program improves training adaptations.Key topics in this episode:What sodium bicarbonate does in the bodyWhat's the problem with sodium bicarbonate?What athlete types benefit from sodium bicarbonate?Is sodium bicarbonate safe?How much sodium bicarbonate should you take?Multi-day loading with sodium bicarbonateSodium bicarbonate in long-term training planGuestKristen Arnold MS, RDN, CSSD is a registered dietitian (RDN), retired professional cyclist and Women's Development Road Director for USA Cycling. She is a board-certified specialist in sports dietetics (CSSD) and is a Level 1 USA Cycling coach. Her private practice nutrition counseling business focuses on sports nutrition for women athletes.LinksKristin's WebsiteKristin's InstagramReferences:2020 Study on Individualization of Sodium Bicarb Ingestion: Meta Analysis:Extracellular Buffering Supplements to Improve Exercise Capacity and Performance: A Comprehensive Systematic Review and Meta-analysis | Sports MedicineAsker Jeukedrup Summary: Sodium bicarbonate, cheap and effective?Why Top Olympic Athletes Use Baking Soda to Boost Performance The effect of sodium bicarbonate mini-tablets ingested in a carbohydrate hydrogel system on 40 km cycling time trial performance and metabolism in trained male cyclists - PubMed Knowledge is Watt articleHostAdam Pulford has been a CTS Coach for more nearly two decades and holds a B.S. in Exercise Physiology. He's participated in and coached hundreds of athletes for endurance events all around the world.Listen to the episode on Apple Podcasts, Spotify, Stitcher, Google Podcasts, or on your favorite podcast platformGET FREE TRAINING CONTENTJoin our weekly newsletterCONNECT WITH CTSWebsite: trainright.comInstagram: @cts_trainrightTwitter: @trainrightFacebook: @CTSAthlete
In this episode, Dennis discusses the role of sodium bicarbonate in medical protocols, particularly in the context of rhabdomyolysis and hyperkalemia. He emphasizes the importance of fluid management and the potential over-hyping of bicarbonate as a treatment. The conversation explores the risks associated with rhabdomyolysis, the mechanisms of potassium management, and the clinical considerations for bicarbonate use in critical care settings. Takeaways Sodium bicarbonate is often over-hyped in medical treatments. Rhabdomyolysis can lead to serious kidney damage. Immediate fluid administration is crucial in suspected rhabdo cases. Bicarbonate has not shown clinical benefits in trials. Managing potassium levels is essential in rhabdomyolysis treatment. Insulin can help drive potassium back into cells. Urine output is a key indicator in treatment effectiveness. Alkalizing urine may not significantly prevent kidney injury. Correcting pH can be important in severe shock situations. Bicarbonate should be used judiciously in critical care. Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to www.prolongedfieldcare.org Consider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care
In this episode, Natalie explores the beauty and tranquility of the seaside during the autumn and winter months. She discusses the importance of preparing beach huts for the cooler seasons, particularly in preventing damp and mould, which can be exacerbated by the humid coastal climate. Natalie shares practical tips on ensuring good ventilation, such as installing wall vents or using whirligigs, and offers advice on moisture absorbers like bicarbonate of soda and silica gel. She emphasizes the value of protecting belongings with airtight storage solutions and highlights the mental health benefits of spending time at the beach, even in less favourable weather. KEY TAKEAWAYS Autumn and winter offer unique opportunities to enjoy the beach, with fewer crowds and the chance to witness dramatic weather conditions, making it a peaceful time for beach hut enthusiasts. Proper ventilation is crucial for beach huts to prevent damp and mould. Keeping air vents open and ensuring airflow can help maintain a dry environment inside the hut. Various methods can be employed to absorb moisture, such as using bicarbonate of soda, silica gel, or commercial moisture absorbers. These can help mitigate dampness even if ventilation is limited. Using airtight storage containers or vacuum packs can safeguard items inside the beach hut from moisture damage, especially during long periods of closure. Before locking up a beach hut for the winter, it's important to prepare it by ensuring good ventilation, using moisture absorbers, and protecting belongings to avoid costly damage from mould and mildew. BEST MOMENTS "The brilliant thing about a beach hut is that you can still enjoy the beach. Sun, rain, wind or worse." "Mould is a microscopic fungus that spreads by travelling through the air in the form of tiny spores." "Good ventilation is really important. Blocking air vents and ceiling windows might prevent heat escaping, but in a small space like your hut, this can also block essential ventilation." "Bicarbonate of soda has a high water absorption capacity, so is rather good at removing excess moisture from the air." "If you intend to leave the hut for a long period of time, one option is to use a damp proof storage container." HOST BIO My name is Natalie Young. I bought a beach hut to bring joy into my life after escaping an abusive relationship and a difficult divorce. Based in Christchurch, Dorset, my beach hut is affectionally called the Salty Seagull and is located on Friars Cliff beach with sea views to the Needles on the Isle of White. It is my slice of heaven. Owning and hiring a beach hut is more complicated than I realised and I am on a constant mission to discover the best ways to manage and care for your hut. I have researched the pros and cons of renting and the best ways to market and host. The beach, the sights and the sounds of the sea bring me huge joy. I hope this podcast will bring you smiles, laughter and joy too! https://www.facebook.com/profile.php?id=61559730024536&sk=about https://www.linkedin.com/company/103555627/admin/feed/posts/?feedType=following PODCAST DESCRIPTION Welcome to the Bonkers about Beach Huts podcast, the show that's all about beach huts! Whether you are thinking of buying a beach hut and don't know where to begin or if you have had a beach hut in your family for generations this podcast is for you. As I travel across the UK exploring these coastal retreats and sharing personal stories of how the humble beach hut has shaped lives, I will also be creating the UK's first beach hut map. I will give tips on where and how to buy a beach hut. And share everything you need to know about beach hut maintenance plus advice on hiring a beach hut. We will be chatting with special guests from estate agents to lock specialists, beach hut associations to beach hut builders, and artists to interior designers. If you don't know what all the fuss is about, join us every week and you too will become a little bit Bonkers Bbout Beach Huts.
We filled the pauses in conversation with all of our deepest confessions before recording this great episode! A main topic was how we thought about strength work and heat training in the Leadville 100 build. While David's mileage wasn't wildly high, he made some big changes in the last year that harness the power of heat to spur hematological changes, and strength to spur booty changes. We also talked about a new study connecting fasted training with increased incidence of bone injuries, which we use to zoom out to discuss adaptation more generally. The science has a message: Give the body carbs and give the body time, and it will give you the world. And this one had so many of our favorite topics! Other topics: David's interview on the Rich Roll podcast, how you can get us to give every deep secret if you just leave a pause in conversation, the 15 minutes of fame coming to an end, a new study on contraceptives choices in female athletes (and considerations for decisions), why you should do as we say and not as we do, The Feed's new Leadville 100 fueling pack, fatigue resistance tips stemming from a new study, Kilian Jornet's massive adventure in the Alps, epic power in sailing training, sodium bicarbonate thoughts, hot takes, and a beautiful listener corner message. This episode is buffet of joy, humor, and questionable hot takes. Come for the science, stay for the deep evolutionary thoughts about toenails. We love you all! Follow Huzzah for science insights: https://www.instagram.com/thehuzzahhub/ Click "Claim Reward" for $80 at The Feed here: thefeed.com/swap Check out The Feed's Leadville 100 CR collection: https://thefeed.com/collections/david-roche-collection Buy Janji's amazing gear: https://janji.com/ (code "SWAP") For weekly bonus podcasts, articles, and videos: patreon.com/swap
Send us a textIn this week's episode we talk with researchers Amanda Regnier and Eli Shannon about:Their recently published study on sodium bicarbonate (Maurten's Bicarb System) use in athletesHow the study was conducted, and the findingsWhere the research is going, and what they hope to learn in the future about sodium bicarbonateAmanda Regnier is a PhD student in Exercise Physiology and Nutrition, with a research focus on sodium bicarbonate supplementation in females. She is deeply passionate about endurance physiology and has a specific interest in coaching half marathon, marathon and ultramarathon runners. In her spare time she enjoys road cycling and hiking in the Canadian Rocky Mountains. Through her research and coaching, she aims to empower others to reach their full athletic potential.Eli Shannon is currently a PhD candidate in Exercise Physiology, Nutrition and Metabolism at Edge Hill University in the United Kingdom (UK). Eli's research interests center on enhancing exercise performance, particularly through physiological and nutritional interventions. Prior to arriving at Edge Hill University, Eli spent four years playing full-time soccer against professional academies at the i2i International Soccer Academy whilst completing his Bachelor's in Sport and Exercise Science (BSc, Hons) and his Masters of Science by Research (MSc by Research) at York St. John University in York, UK. Please note that this podcast is created strictly for educational purposes and should never be used for medical diagnosis and treatment.***Connect w/ Amanda & Eli: Amanda IG: @runningwithregnier Eli IG: @elishannon2000Eli X: @elishannon5Eli LinkedIn: www.linkedin.com/in/eli-shannon-710a841a2/Mentioned:The effect of sodium bicarbonate mini-tablets ingested in a carbohydrate hydrogel system on 40km cycling time trial performance and metabolism in trained male cyclists: link.springer.com/article/10.1007/s00421-024-05567-3The effects of a novel sodium bicarbonate ingestion system on repeated 4km cycling time trial performance in well-trained male cyclists: link.springer.com/article/10.1007/s40279-024-02083-4Maurten Bicarb System: Available on MORE NR New customers save 10% off all products on our website with the code NEWPOD10 If you would like to work with our practitioners, click here: https://nutritional-revolution.com/work-with-us/ Save 20% on all supplements at our trusted online source: https://us.fullscript.com/welcome/kchannell Join Nutritional Revolution's The Feed Club to get $20 off right away with an additional $20 Feed credit drop every 90 days.: https://thefeed.com/teams/nutritional-revolution Interested in blood testing? Use code NUTRITIONALREVOLUTION at InsideTracker for 20% off any test: store.insidetracker.com/nutritionalrevolution If you're interested in sponsoring Nutritional Revolution Podcast, shoot us an email at nutritionalrev@gmail.com.
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00:00 - Introduction03:16 - pH buffering04:43 - Bicarbonate, cyanurate and borate06:41 - pH is based on H2O and hydrolysis09:56 - Carbonate alkalinity means dissolved CO2 determines pH11:51 - Bicarbonate converts into carbonate at 8.3 pH13:22 - High TA, more buffering capacity, more acid demand15:19 - Acids and conjugate bases18:16 - pKa values and buffering strength20:52 - What does pKa stand for?23:05 - Closing ------------------------------------Connect with Orenda TechnologiesWebsite: https://www.orendatech.comHelp Center: https://ask.orendatech.comBlog: https://blog.orendatech.comYouTube: https://www.youtube.com/user/OrendaTechnologiesFacebook: https://www.facebook.com/orendatech/Instagram: https://www.instagram.com/orendatechnologies/Swim Across America | Team Orenda: https://www.swimacrossamerica.org/goto/orenda
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Ève Côté nous parle de l'effet Mandela, Louis Morissette parle de couple et de politique, Pierre Hébert nous dévoile ce qu'il a trouvé dans l'ordinateur à côté du studio des Fantastiques BONNE ÉCOUTE !
In this Thursday's episode of the Talking Pools Podcast, Rudy takes over as host, filling in for Wayne, and delves into the intricacies of water testing, focusing specifically on the function of buffers in maintaining pH balance in swimming pools. Rudy begins by explaining the vital role of buffers, such as bicarbonate and borate buffering systems, in preventing fluctuations in pH levels. Drawing an analogy to fortifications, Rudy likens buffers to frontline troops defending against pH shifts, elucidating how these chemical systems convert substances that could alter pH into harmless forms. He emphasizes the importance of maintaining a well-fortified frontline to safeguard the pool's pH stability, highlighting the effectiveness of borate buffers in countering both upward and downward pH drifts. Throughout the episode, Rudy provides detailed insights into the chemistry behind buffers, their practical applications in pool maintenance, and optimal levels for achieving water balance.Furthermore, Rudy explores the resurgence of borate buffering systems in the post-pandemic era, citing their multifaceted benefits ranging from algae control to energy savings in chlorine usage. He discusses the historical roots of borate research in pool maintenance and the recent recognition of its efficacy by industry experts. Rudy concludes by outlining recommended parameters for establishing an ideal borate bicarbonate buffer system in pools and clarifies misconceptions surrounding the concept of buffering. With his thorough explanation and practical advice, Rudy equips listeners with a comprehensive understanding of how buffers contribute to pool water chemistry management, ensuring a safe and enjoyable swimming experience. LaMotte Company LaMotte Company is a leading manufacturer of water quality testing products & pool test kitsDisclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the showThank you so much for listening! You can find us on social media: Facebook Instagram Tik Tok Email us: talkingpools@gmail.com
"Sodium Bicarbonate: Basically Useless Therapy"https://publications.aap.org/pediatrics/article-abstract/122/4/831/71328/Sodium-Bicarbonate-Basically-Useless-Therapy?redirectedFrom=fulltext?autologincheck=redirectedNo content or comments made in any TIPQC Healthy Mom Healthy Baby Podcast is intended to be comprehensive or medical advice. Neither healthcare providers nor patients should rely on TIPQC's Podcasts in determining the best practices for any particular patient. Additionally, standards and practices in medicine change as new information and data become available and the individual medical professional should consult a variety of sources in making clinical decisions for individual patients. TIPQC undertakes no duty to update or revise any particular Podcast. It is the responsibility of the treating physician or health care professional, relying on independent experience and knowledge of the patient, to determine appropriate treatment.
Le bicarbonate de soude sert à tout faire mais c'est un peu perturbant de se dire que deux poudres blanches, qui ont l'air, a priori, identiques peuvent à la fois alléger nos gâteaux et récurer nos toilettes. Alors existe-t-il une différence entre le bicarbonate alimentaire et bicarbonate de soude ménager ? Déjà, dans le bicarbonate de soude, il n'y a pas soude du tout. La soude est corrosive, elle est au max de l'échelle du pH, c'est un élément dit basique. Le bicarbonate qu'on utilise à la maison lui, a une base de sodium, il a un pH autour des 8,4, on dit qu'il est alcalin. Que ce soit pour la cuisine ou pour le ménage, la composition chimique des deux produits est la même, c'est grosso modo, du sel et du calcaire. On le trouve naturellement dans l'eau de mer par exemple et on connait ses bienfaits depuis longtemps. Dans l'Égypte antique, on se sert du natron, un minéral composé de bicarbonate et de carbonate de sodium. Il est extrait de l'évaporation des lacs salés. Notre poudre blanche est désormais fabriquée chimiquement par les industriels et il y a deux différences notables : la finesse du grain : plus grossier dans le ménager, et le taux d'impuretés. Le bicarbonate ménager en contient davantage que l'alimentaire. C'est pour cela qu'il est déconseillé d'utiliser le ménager pour faire la cuisine. À l'inverse, l'alimentaire peut servir à tout, vraiment tout, c'est assez magique. Ce qui nous intéresse, c'est son usage en cuisine et la liste est longue. Avec tout d'abord, son effet gonflant qui permet de remplacer la levure chimique. Cette levure est elle-même composée de bicarbonate de sodium. Lorsque cet élément chimique est en contact avec l'humidité, il dégage du dioxyde de carbone et crée des bulles. Il sert à alléger vos préparations : les gâteaux, les omelettes, il permet d'attendrir les viandes, de laver vos légumes (on la connait cette astuce, on l'a tous fait pendant la pandémie) mais il permet aussi de conserver leurs couleurs. Il rectifie l'acidité des plats vu qu'il est, je vous dit plus tôt dans ce podcast, alcalin. C'est un peu la même chose pour le vinaigre blanc alimentaire et ménager. Celui qu'on utilise pour nettoyer notre intérieur est davantage concentré en acide mais c'est le même produit à savoir du vinaigre d'alcool. Moins de 10% pour l'alimentaire, le vinaigre ménager a un taux en acide acétique qui dépasse les 12 %. C'est une auditrice de Choses à savoir gastronomie qui m'a posée cette question sur l'usage du bicarbonate de soude. Merci à elle :) Ça me donne l'occasion de vous remercier d'écouter ce podcast, n'hésitez pas à le partager sur les réseaux et à vous abonner si ce n'est pas déjà fait ! Learn more about your ad choices. Visit megaphone.fm/adchoices
We brought some big-time gratitude to this supersized Thanksgiving episode! The main topic was a new study looking at how fueling during training impacts next-day performance and protein degradation. We are seeing a new world order in eating and training! We also present some contrasting perspectives from prominent coaches, trying to discern between data and anecdotes, highlighting where there is nuance. The future is here. The future is TASTY. And sometimes the future will be STICKY. With many listeners traveling for Thanksgiving, we figured it would be a good time to do our longest episode ever, full of our favorite discussions. Topics: methods to improve running cadence, training with music, winter gear and staying warm, a profound listener message on their fueling journey, a ballad for the thick hogs, the Western States lottery's exponential growth, an NCAA Cross Country Champs recap, Parker Valby's low volume running plan, the great Between Two Pines podcast, UTMB Whistler follow-up, our thoughts on Sam Altman's ouster from OpenAI, concerns about a SWAP podcast curse, Strava as a dating app, some of the science on sodium bicarbonate supplementation, worries about doping using worm blood (seriously), and hot takes. We hope this episode is like your Thanksgiving celebration: wet and covered in gravy. For a weekly bonus episode (and bi-weekly newsletter, plus merch), make sure you're subscribed to our Patreon. We love you all! HUZZAH! Support the podcast: patreon.com/swap Try Athletic Greens: drinkAG1.com/swap Buy Janji's amazing gear: https://janji.com/ (code "SWAP") Precision Hydration discount link: https://visit.pfandh.com/swap
Welcome back to today's #FridayReview where I'll be breaking down the best of the week! I'll be sharing specifics on these topics: Free EquiLife CBD Oil Weekly Podcast Recap Baking Soda Remedies (product review) Sodium Bicarbonate (book review) Highly Processed Foods & Addiction (research) Diet & Hip Fractures (research) For all the details tune in to today's #CabralConcept 2821 – Enjoy the show and let me know what you thought! - - - For Everything Mentioned In Today's Show: StephenCabral.com/2821 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!
Podcast summary of articles from the August 2023 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include EMS and COVID, COVID intubations, pediatric EMS handoffs, pediatric headaches, post operative complications, and the ED use of bicarbonate. Guest speaker is Dr. James O'Hora.
Share the podcast with your friends, and rate it 5-stars! iTunes: https://trainerroad.cc/apple2 Spotify: https://trainerroad.cc/spotify2 Google Podcasts: https://trainerroad.cc/google TOPICS COVERED (0:00) Welcome! (0:40) Sarah's athletic and educational background (1:20) Why are pro cyclists using nicotine in their training?! (12:36) How we tested sodium bicarbonate products in-house (26:58) The impact of temporary caloric restriction on our metabolism (33:37) Why the amount of carbs in your recovery drink might matter more than the 4:1 ratio (40:15) Data driven ways to use aerobic exercise to recover from a concussion STUDIES REFERENCED IN THIS EPISODE https://pubmed.ncbi.nlm.nih.gov/28574230/ https://pubmed.ncbi.nlm.nih.gov/29405793/ https://pubmed.ncbi.nlm.nih.gov/35405933/ https://pubmed.ncbi.nlm.nih.gov/27120294/ Watch our latest Cycling Science Explained video now! https://youtu.be/k3IIJqNxNMo Subscribe to the Science of Getting Faster Podcast below! Spotify: https://trainerroad.cc/spotifysogf iTunes: https://trainerroad.cc/itunessogf TRY TRAINERROAD RISK FREE FOR 30 DAYS! TrainerRoad is the #1 cycling training app. No other cycling app is more effective. Over 13,000 positive reviews, a 4.9 star App Store rating. Adaptive Training from TrainerRoad uses machine learning and science-based coaching principles to continually assess your performance and intelligently adjust your training plan. It trains you as an individual and makes you a faster cyclist. Learn more about TrainerRoad: https://trainerroad.cc/3LBb5Ur Learn more about Adaptive Training: https://trainerroad.cc/35Tqtea ABOUT THE ASK A CYCLING COACH PODCAST Ask a Cycling Coach podcast is a cycling and triathlon training podcast. Each week USAC/USAT Level I certified coach Chad Timmerman, pro athletes, and other special guests answer your cycling and triathlon questions. Have a question for the podcast? Ask here: https://trainerroad.cc/3HTFXNi MORE PODCASTS FROM TRAINERROAD Listen to the Successful Athletes Podcast: https://trainerroad.cc/3JmKrN5 Listen to the Science of Getting Faster Podcast: https://trainerroad.cc/3LpuIhP STAY IN TOUCH Training Blog: https://trainerroad.cc/3gCdNdN TrainerRoad Forum: https://trainerroad.cc/3uHvLnE Instagram: https://www.instagram.com/trainerroad/ Strava Club: https://www.strava.com/clubs/trainerroad Facebook: https://www.facebook.com/TrainerRd Twitter: https://twitter.com/TrainerRoad TrainerRoad Podcast Network Submit your Question to the Ask a Cycling Coach Podcast Subscribe to the Ask a Cycling Coach Podcast Subscribe to the Successful Athletes Podcast Submit your story to the Successful Athletes Podcast Subscribe to the Science of Getting Faster Podcast Submit a topic to the Science of Getting Faster Podcast
Bicarbonate did not slow the loss of GFR in this well done Swiss, single-blind study of transplant patients.The Filtrate:Joel TopfNayan AroraSwapnil HiremathPirya YenebereWith Special Guest:Nav Tangri nephrologist and epidemiology at the University of ManitobaEditor:Nayan AroraShow Notes:Arsenal FCThe London study that kicked it all off!de Brito-Ashurst, I., Varagunam, M., Raftery, M. J., & Yaqoob, M. M. (2009). Bicarbonate supplementation slows progression of CKD and improves nutritional status. Journal of the American Society of Nephrology: JASN, 20(9), 2075–2084.The multi center (but unblinded) UBI Study with mortality benefit!Di Iorio, B. R., Bellasi, A., Raphael, K. L., Santoro, D., Aucella, F., Garofano, L., Ceccarelli, M., Di Lullo, L., Capolongo, G., Di Iorio, M., Guastaferro, P., Capasso, G., & UBI Study Group. (2019). Treatment of metabolic acidosis with sodium bicarbonate delays progression of chronic kidney disease: the UBI Study. Journal of Nephrology, 32(6), 989–1001.The BiCARB Study: Double blinded and negativeBiCARB study group. (2020). Clinical and cost-effectiveness of oral sodium bicarbonate therapy for older patients with chronic kidney disease and low-grade acidosis (BiCARB): a pragmatic randomised, double-blind, placebo-controlled trial. BMC Medicine, 18(1), 91.The initial Veverimer StudyWesson, D. E., Mathur, V., Tangri, N., Stasiv, Y., Parsell, D., Li, E., Klaerner, G., & Bushinsky, D. A. (2019). Long-term safety and efficacy of veverimer in patients with metabolic acidosis in chronic kidney disease: a multicentre, randomised, blinded, placebo-controlled, 40-week extension. In The Lancet (Vol. 394, Issue 10196, pp. 396–406). doi.org/10.1016/s0140-6736(19)31388-1The Valor CKD trial is still unpublished. But here is the press release. VALOR-CKD design manuscriptThe study of the night: Sodium bicarbonate for kidney transplant recipients with metabolic acidosis in Switzerland: a multicentre, randomized, single-blind, placebo-controlled, phase 3 trialNephJC | PubMed | LancetAlkali with normal bicarb? Sure, take a look at: Goraya, N., Simoni, J., Jo, C., & Wesson, D. E. (2012). Dietary acid reduction with fruits and vegetables or bicarbonate attenuates kidney injury in patients with a moderately reduced glomerular filtration rate due to hypertensive nephropathy. Kidney International, 81(1), 86–93.Metforminator!The BASE Trial: Raphael, K. L., Isakova, T., Ix, J. H., Raj, D. S., Wolf, M., Fried, L. F., Gassman, J. J., Kendrick, C., Larive, B., Flessner, M. F., Mendley, S. R., Hostetter, T. H., Block, G. A., Li, P., Middleton, J. P., Sprague, S. M., Wesson, D. E., & Cheung, A. K. (2020). A Randomized Trial Comparing the Safety, Adherence, and Pharmacodynamics Profiles of Two Doses of Sodium Bicarbonate in CKD: the BASE Pilot Trial. Journal of the American Society of Nephrology: JASN, 31(1), 161–174.Tubular SecretionsSwap The Three-Body Problem (novel) | NetflixNayan Women's World CupTangri English Premier Soccer and InflationPriya Silo on Apple TVJoel Live Podcast recording at ASN Kidney
The Filtrate:Joel TopfNayan AroraSwapnil HiremathPirya YenebereWith Special Guest:Nav Tangri nephrologist and epidemiology at the University of ManitobaEditor:Nayan AroraShow Notes:Arsenal FCThe London study that kicked it all off!de Brito-Ashurst, I., Varagunam, M., Raftery, M. J., & Yaqoob, M. M. (2009). Bicarbonate supplementation slows progression of CKD and improves nutritional status. Journal of the American Society of Nephrology: JASN, 20(9), 2075–2084.The multi center (but unblinded) UBI Study with mortality benefit!Di Iorio, B. R., Bellasi, A., Raphael, K. L., Santoro, D., Aucella, F., Garofano, L., Ceccarelli, M., Di Lullo, L., Capolongo, G., Di Iorio, M., Guastaferro, P., Capasso, G., & UBI Study Group. (2019). Treatment of metabolic acidosis with sodium bicarbonate delays progression of chronic kidney disease: the UBI Study. Journal of Nephrology, 32(6), 989–1001.The BiCARB Study: Double blinded and negativeBiCARB study group. (2020). Clinical and cost-effectiveness of oral sodium bicarbonate therapy for older patients with chronic kidney disease and low-grade acidosis (BiCARB): a pragmatic randomised, double-blind, placebo-controlled trial. BMC Medicine, 18(1), 91.The initial Veverimer StudyWesson, D. E., Mathur, V., Tangri, N., Stasiv, Y., Parsell, D., Li, E., Klaerner, G., & Bushinsky, D. A. (2019). Long-term safety and efficacy of veverimer in patients with metabolic acidosis in chronic kidney disease: a multicentre, randomised, blinded, placebo-controlled, 40-week extension. In The Lancet (Vol. 394, Issue 10196, pp. 396–406). https://doi.org/10.1016/s0140-6736(19)31388-1The Valor CKD trial is still unpublished. But here is the press release. VALOR-CKD design manuscript The study of the night: Sodium bicarbonate for kidney transplant recipients with metabolic acidosis in Switzerland: a multicentre, randomized, single-blind, placebo-controlled, phase 3 trialNephJC | PubMed | Lancet Alkali with normal bicarb? Sure, take a look at: Goraya, N., Simoni, J., Jo, C., & Wesson, D. E. (2012). Dietary acid reduction with fruits and vegetables or bicarbonate attenuates kidney injury in patients with a moderately reduced glomerular filtration rate due to hypertensive nephropathy. Kidney International, 81(1), 86–93.Metforminator!The BASE Trial: Raphael, K. L., Isakova, T., Ix, J. H., Raj, D. S., Wolf, M., Fried, L. F., Gassman, J. J., Kendrick, C., Larive, B., Flessner, M. F., Mendley, S. R., Hostetter, T. H., Block, G. A., Li, P., Middleton, J. P., Sprague, S. M., Wesson, D. E., & Cheung, A. K. (2020). A Randomized Trial Comparing the Safety, Adherence, and Pharmacodynamics Profiles of Two Doses of Sodium Bicarbonate in CKD: the BASE Pilot Trial. Journal of the American Society of Nephrology: JASN, 31(1), 161–174.Tubular SecretionsSwap The Three-Body Problem (novel) | Netflix Nayan Women's World CupTangri English Premier Soccer and InflationPriya Silo on Apple TVJoel Live Podcast recording at ASN Kidney
Finishing our Essentials of Electrolytes series, we're going to focus on Magnesium, Calcium, Vitamin K-2, Phosphorus, and Bicarbonate. Make sure you go back if you haven't listened to Part 1 if you haven't already and at the end of this episode, I have a special offer you can take advantage of if you'd like! Topics include: - What We'll Cover in Part 2 - Please Share, Rate, and Review - What We Covered In Part 1 - Function of Magnesium - Deficiency Risks of Low Magnesium - Calcium: More Than Bone Health - Vitamin K-2 - Phosphorus and Bicarbonate - Other Similar Episodes in the Feed - LMNT - Please Share, Rate, and Review ---------- LNMT: Free Sample Pack with Any Purchase: drinklmnt.com/sammiller ---------- No-Cost Coaching Resources and Gifts for Our Listeners The Check-In Checklist: https://www.academy.sammillerscience.com/checklist [Free] Metabolism School 101: The Video Series http://www.metabolismschool.com/metabolism-101 ---------- Grab a Copy of My New Book - Metabolism Made Simple ---------- My Live Program for Coaches: The Functional Nutrition and Metabolism Specialization www.metabolismschool.com ---------- Stay Connected Blogs and Coaching Resources: www.Sammillerscience.com Instagram: @sammillerscience Facebook: The Nutrition Coaching Collaborative Community https://www.facebook.com/groups/nutritioncoachingcollaborative TikTok: @sammillerscience - https://vm.tiktok.com/ZTdPVQtMH/ ---------- “This Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast and the show notes or the reliance on the information provided is to be done at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment and is for educational purposes only. Always consult your physician before beginning any exercise program and users should not disregard, or delay in obtaining, medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions. By accessing this Podcast, the listener acknowledges that the entire contents and design of this Podcast, are the property of Oracle Athletic Science LLC, or used by Oracle Athletic Science LLC with permission, and are protected under U.S. and international copyright and trademark laws. Except as otherwise provided herein, users of this Podcast may save and use information contained in the Podcast only for personal or other non-commercial, educational purposes. No other use, including, without limitation, reproduction, retransmission or editing, of this Podcast may be made without the prior written permission of Oracle Athletic Science LLC, which may be requested by contacting the Oracle Athletic Science LLC by email at team@sammillerscience.com. By accessing this Podcast, the listener acknowledges that Oracle Athletic Science LLC makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information featured in this Podcast."
In this week's episode, we talk to Emeritus Professor Rod Snow, who has studied the effects of sodium bicarbonate on athletic performance, about:How sodium bicarbonate works in the bodyHow it affects athlete performanceWhen you might effectively use sodium bicarbonate to boost performanceEmeritus Professor Rod Snow is an expert in creatine metabolism in skeletal muscle and female reproduction. He has published 123 peer-reviewed journal papers and reviews with a career total citation of over 7100. He remains highly cited after 30 years, showing his work has had a major impact in the field. Professor Snow is academic member of the Institute for Physical Activity and Nutrition (Deakin University). He has had previous NHMRC and ARC project grant funding and has supervised 12 PhD students (+1 current), 3 M.Sc students, and 13 B. Appl. Sc (Hons) students. Professor Snow is a member of the School of Exercise and Nutrition Sciences at Deakin University and provides mentorship for academic staff involved in the Exercise and Sport Science teaching and research programs.Please note that this podcast is created strictly for educational purposes and should never be used for medical diagnosis and treatment.See you in the next episode!***Through 9/5/23, receive 30% off all Nutritional Revolution online programs, webinars and meal plans! Use code LABORDAY23 at checkout.Sports Nutrition Education Program (SNEP), A 4-week course to help you break through training blocks and achieve your goals.Supplement Mini Course: Learn about supplement protocols that will benefit performance in this informative webinar. ***Mentioned:Stay up to date on Professor Snow's Research on Google ScholarSodium Bicarbonate Researchhttps://journals.lww.com/acsm-msse/abstract/9900/sodium_bicarbonate_ingestion_in_a_fasted_state.332.aspxhttps://pubmed.ncbi.nlm.nih.gov/36109008/https://jissn.biomedcentral.com/articles/10.1186/s12970-021-00458-w#:~:text=Supplementation%20with%20sodium%20bicarbonate%20(doses,running%2C%20swimming%2C%20and%20rowing.https://pubmed.ncbi.nlm.nih.gov/34503527/Creatine supplementation and hypoxia: MORE NR New customers save 10% off all products on our website with the code NEWNR10 If you would like to work with our practitioners, click here: https://nutritional-revolution.com/work-with-us/ Save 20% on all supplements at our trusted online source: https://us.fullscript.com/welcome/kchannell Join Nutritional Revolution's The Feed Club to get $20 off right away with an additional $20 Feed credit drop every 90 days.: https://thefeed.com/teams/nutritional-revolution If you're interested in sponsoring Nutritional Revolution Podcast, shoot us an email at nutritionalrev@gmail.com.
Some of the world's top professional cyclists are taking sodium bicarbonate to improve their performance in high-intensity efforts. To find out why, Jack Evans, BikeRadar's digital writer and one of the team's strongest athletes, recently took part in the first independent trial of the Maurten Bicarb System used by Team Jumbo-Visma. In this episode, Jack explains how sodium bicarbonate can potentially improve cycling performance and reveals what happened when he took 20 bicarb capsules. Joined by senior technical editor Ashley Quinlan and senior technical writer Simon von Bromley, Jack discusses what else he discovered about the legal, performance-enhancing supplement while researching an in-depth feature. Learn more about your ad choices. Visit podcastchoices.com/adchoices
In the episode, EIC Josie Briggs discusses a randomized control trial addressing the impact of sodium bicarbonate on the vascular dysfunction in CKD and an observational case control study of the impact of antibiotic use on kidney stone formation.
Marcus and Corey's What You Know 'Bout That trivia game for July 20th, 2023
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode835. In this episode, I'll discuss the results of a pilot trial of sodium bicarbonate for metabolic acidosis in the ICU. The post 835: Results of a Pilot Trial of Sodium Bicarbonate for Metabolic Acidosis in the ICU appeared first on Pharmacy Joe.
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode835. In this episode, I ll discuss the results of a pilot trial of sodium bicarbonate for metabolic acidosis in the ICU. The post 835: Results of a Pilot Trial of Sodium Bicarbonate for Metabolic Acidosis in the ICU appeared first on Pharmacy Joe.
Josh Rowe, a Performance Nutritionist for Maurten, joins the show to talk about all things ultra running nutrition. Timestamps:(1:02) - Exploring Unknowns in Ultra Endurance Nutrition(8:32) - Bicarbonate and Liquid Calorie Strategies(14:54) - Endurance Race Fueling and Hydration(24:31) - Exploring Carbohydrate and Gut Training(38:10) - Hydrogel Technology and Endurance Performance(44:35) - The Importance of Taste in Fueling(50:33) -Exploring Performance Nutrition in Endurance RacingSponsors:Rabbit - use code Singletrack20 at checkout on their website (https://www.runinrabbit.com/discount/SINGLETRACK20) to get 20% off your next orderFeetures - use code Singletrack20 at checkout on their website (https://feetures.com/) to get 20% off your next order). Hoka - check out the new Tecton X2 and Zinal 2 (https://www.hoka.com/en/us/)Maurten - head over to their website (https://www.maurten.com/) and shop for gels, bars, and drink mixes.Additional Links:Follow Finn on Instagram, Strava, Twitter, Youtube, and PatreonFollow Brett on Instagram, Strava, Youtube, and The FeedSupport the show
Topics covered in this episode:What is sodium bicarbonate (baking soda) and what does it have to do with athletic performance?How has bicarb been used to improve performance historically?How athletes can improve performance with bicarb supplementation. Limitations and value proposition of bicarb supplementationDrawbacks and risks associated with bicarb supplementationWhat kind of workouts and competitions are well suited for bicarb supplementation and which are not?ASK A QUESTION FOR A FUTURE PODCASTGuest: Jason KoopJason Koop is the Head Coach of CTS Ultrarunning, author of "Training Essentials for Ultrarunning, 2nd Ed", creator of the "Research Essentials for Ultrarunning" monthly newsletter, and host of "The Koopcast" podcast. He is one of the most sought-after coaches in ultrarunning, and for many years he was the CTS Coaching Director in charge of coaching education and ongoing mentoring of CTS Coaches across all sports. Find Jason on Instagram, Twitter, or his website: https://jasonkoop.com HostAdam Pulford has been a CTS Coach for more than 13 years and holds a B.S. in Exercise Physiology. He's participated in and coached hundreds of athletes for endurance events all around the world.Links2020 Study on Individualization of Sodium Bicarb Ingestion: https://rgu-repository.worktribe.com/output/855283/is-individualization-of-sodium-bicarbonate-ingestion-based-on-time-to-peak-necessaryMeta Analysis: https://link.springer.com/article/10.1007/s40279-021-01575-xAsker Jeukedrup Summary: https://www.mysportscience.com/post/sodium-bicarbonate-cheap-and-effectiveRedBull Study with PR Lotion: https://training.tower26.com/training-tips/red-bull-study-pr-lotion-amp-power-outputListen to the episode on Apple Podcasts, Spotify, Stitcher, Google Podcasts, or on your favorite podcast platformGET FREE TRAINING CONTENTJoin our weekly newsletterCONNECT WITH CTSWebsite: trainright.comInstagram: @cts_trainrightTwitter: @trainrightFacebook: @CTSAthlete
Welcome back to Iron Sights! Today we're switching it up - our producer fielded your questions from Instagram and YouTube so that we could answer them all live on the show. CeCe English & Stephen Brenna joined me to answer:Timestamps00:00 Intro01:27 What are your thoughts on Sodium Bicarbonate / Baking Soda during workouts?12:09 Should you focus on working out or diet first?21:55 Should you worry about working out or not when on summer vacation?28:32 What are 3 lifts I can do on my Jiu-Jitsu off days to develop insane strength that I can bring back on the mats?36:22 Is protein powder a waste of money?42:31 What are the best sports for kids?55:30 How many exercises should I do per body part to gain muscle?01:02:47 How should I eat to lose belly fat?01:08:22 Are there supplements, vitamins or minerals that are good for Mental Health? I suffer from depression, have intense mood swings and think nutrition could play a role.If you'd like to ask a question and have it answered on the show let us know:Instagram: @reddotfitnessEmail: info@reddotfitness.netRed Dot Fitness Training Programs:https://www.rdftrainonline.comOnline Membership (Full Access To All Programs & Virtual Coaching):https://www.reddotfitness.net/online-membershipVirtual Coaching:https://www.reddotfitness.net/virtual-coachingSelf-Guided Programs:https://www.reddotfitness.net/Self-Guided-Programs1Connect With Us:Website - https://ironsightspodcast.com/Instagram - https://www.instagram.com/ironsightspodcast/Facebook - https://www.facebook.com/ironsightspodcast/More Iron Sights Interviews:Triple Feed: https://www.youtube.com/watch?v=VMTc7AE0KaQ&t=384sKayley Gunner: https://www.youtube.com/watch?v=nfGqHxCv7Vc&t=522sMike Salemi: https://www.youtube.com/watch?v=Jq-Nj6M0EBI&t=335sAdam Schafer: https://www.youtube.com/watch?v=BiyrdWdO1y8&t=8sSal Di Stefano: https://www.youtube.com/watch?v=JBdKdSjQ0BM&t=4425sJason Khalipa: https://www.youtube.com/watch?v=YTiq-sID-EMByron Rodgers: https://www.youtube.com/watch?v=XrtEyuVNNpwDonnie Oliver: https://www.youtube.com/watch?v=cKY1_TLKHlIChris Cheng: https://www.youtube.com/watch?v=Wr0zSGSTzKM&t=2sTraver Boehm: https://www.youtube.com/watch?v=r_NLdIg3zBc&t=1394s
Dr Glenn McConell chats with Emeritus Professor David “Doc” Costill who is an absolute legend of exercise physiology and human performance. He was Founder and Director of the Human Performance Laboratory at Ball State University in Muncie, Indiana, USA. He made the lab one of the top labs in the world and has a remarkable track record. He supervised the who's who of exercise physiology research including 7 people (8 including me) who have been on the Inside exercise podcast.0:00. Introduction, Dave's the reason I started this podcast3:54. Frank Pyke5:37. Many people on the podcast were supervised by Dave6:00. Dave a fantastic supervisor6:20. How Dave started his career. Ohio State.10:23. 1966. Cortland College. Coaching running coach etc. Bob Fitts16:18. Dave's incredible swimming ability18:15. Early running/ running groups/running research24:12. PhD: essentially supervised himself27:43. Worked crazy long hours/ Ball State University36:48. Temperature regulation and running research37:53. Heart disease and exercise research38:35. Sports nutrition research39:58. Caffeine and exercise research43:30. He exemplifies the golden age of exercise physiology44:10. Dissemination of information in the lay press/Jim Fixx47:30. Endowed Chair/applying for grants. 48:20. D. Bruce Dill and the Harvard Fatigue Lab51:55. David Costill showed Bengt Saltin soleus biopsies57:35. Phil Gollnick58:50. Dave's sense of humor/treats people as equals1:00:50. Awesome morning routine with Dave / Bill Fink1:05:00. His untimed exactly 10 min naps1:06:40. Dehydration, temp regulation and ex perf1:07:16. Muscle glycogen and exercise (running vs cycling)1:08:50. Eccentric exercise1:11:50. Dave Pearson1:12:48. His swimming research/tapering and his swimming career1:33:17. He found his swimming times really dropped off after 801:37:00. His health1:39:15. Bicarbonate supplementation and exercise performance1:42:48. Bob Fitts and Dave looking at single muscle fibers1:46:00. Space research1:48:03. Bear hibernation research1:52:58. Enjoyed being in the lab, “like being in a candy store”1:56:29. Exercise physiology textbooks vs online learning1:57:40. Dave's treadmill VO2 max at 87 years old1:59:02. Dave's swimming and running textbooks2:01:15. Dave's hobbies: pilot, restoring cars, building planes!2:09:55. Funny Awards Dave gave out2:12:00. Outro (9 seconds) Inside Exercise brings to you the who's who of research in exercise metabolism, exercise physiology and exercise's effects on health. With scientific rigor, these researchers discuss popular exercise topics while providing practical strategies for all.The interviewer, Emeritus Professor Glenn McConell, has an international research profile following 30 years of Exercise Metabolism research experience while at The University of Melbourne, Ball State University, Monash University, the University of Copenhagen and Victoria University.He has published over 120 peer reviewed journal articles and recently edited an Exercise Metabolism eBook written by world experts on 17 different topics (https://link.springer.com/book/10.1007/978-3-030-94305-9).Connect with Inside Exercise and Glenn McConell at:Twitter: @Inside_exercise and @GlennMcConell1Instagram: insideexerciseFacebook: Glenn McConellLinkedIn: Glenn McConell https://www.linkedin.com/in/glenn-mcconell-83475460ResearchGate: Glenn McConellEmail: glenn.mcconell@gmail.comSubscribe to Inside exercise:Spotify: shorturl.at/tyGHLApple Podcasts: shorturl.at/oFQRUYouTube: https://www.youtube.com/@insideexerciseAnchor: https://anchor.fm/insideexerciseGoogle Podcasts: shorturl.at/bfhHIAnchor: https://anchor.fm/insideexercisePodcast Addict: https://podcastaddict.com/podcast/4025218Not medical advice
ReferencesWe considered the complexity of the machinery to excrete ammonium in the context of research on dietary protein and how high protein intake may increase glomerular pressure and contribute to progressive renal disease (many refer to this as the “Brenner hypothesis”). Dietary protein intake and the progressive nature of kidney disease: the role of hemodynamically mediated glomerular injury in the pathogenesis of progressive glomerular sclerosis in aging, renal ablation, and intrinsic renal diseaseA trial that studied low protein and progression of CKD The Effects of Dietary Protein Restriction and Blood-Pressure Control on the Progression of Chronic Renal Disease(and famously provided data for the MDRD eGFR equation A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study GroupWe wondered about dietary recommendations in CKD. of note, this is best done in the DKD guidelines from KDIGO Executive summary of the 2020 KDIGO Diabetes Management in CKD Guideline: evidence-based advances in monitoring and treatment.Joel mentioned this study on red meat and risk of ESKD. Red Meat Intake and Risk of ESRDWe referenced the notion of a plant-based diet. This is an excellent review by Deborah Clegg and Kathleen Hill Gallant. Plant-Based Diets in CKD : Clinical Journal of the American Society of NephrologyHere's the review that Josh mentioned on how the kidney appears to sense pH Molecular mechanisms of acid-base sensing by the kidneyRemarkably, Dr. Dale Dubin put a prize in his ECG book Free Car Prize Hidden in Textbook Read the fine print: Student wins T-birdA review of the role of the kidney in DKA: Diabetic ketoacidosis: Role of the kidney in the acid-base homeostasis re-evaluatedJosh mentioned the effects of infusing large amounts of bicarbonate The effect of prolonged administration of large doses of sodium bicarbonate in man and this study on the respiratory response to a bicarbonate infusion: The Acute Effects In Man Of A Rapid Intravenous Infusion Of Hypertonic Sodium Bicarbonate Solution. Ii. Changes In Respiration And Output Of Carbon DioxideThis is the study of acute respiratory alkalosis in dogs: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC293311/?page=1And this is the study of medical students who went to the High Alpine Research Station on the Jungfraujoch in the Swiss Alps https://www.nejm.org/doi/full/10.1056/nejm199105163242003Self explanatory! A group favorite! It Is Chloride Depletion Alkalosis, Not Contraction AlkalosisEffects of chloride and extracellular fluid volume on bicarbonate reabsorption along the nephron in metabolic alkalosis in the rat. Reassessment of the classical hypothesis of the pathogenesis of metabolic alkalosisA review of pendrin's role in volume homeostasis: The role of pendrin in blood pressure regulation | American Journal of Physiology-Renal PhysiologyInfusion of bicarbonate may lead to a decrease in respiratory stimulation but the shift of bicarbonate to the CSF may lag. Check out this review Neural Control of Breathing and CO2 Homeostasis and this classic paper Spinal-Fluid pH and Neurologic Symptoms in Systemic Acidosis.OutlineOutline: Chapter 11- Regulation of Acid-Base Balance- Introduction - Bicarb plus a proton in equilibrium with CO2 and water - Can be rearranged to HH - Importance of regulating pCO2 and HCO3 outside of this equation - Metabolism of carbs and fats results in the production of 15,000 mmol of CO2 per day - Metabolism of protein and other “substances” generates non-carbonic acids and bases - Mostly from sulfur containing methionine and cysteine - And cationic arginine and lysine - Hydrolysis of dietary phosphate that exists and H2PO4– - Source of base/alkali - Metabolism of an ionic amino acids - Glutamate and asparatate - Organic anions going through gluconeogenesis - Glutamate, Citrate and lactate - Net effect on a normal western diet 50-100 mEq of H+ per day - Homeostatic response to these acid-base loads has three stages: - Chemical buffering - Changes in ventilation - Changes in H+ excretion - Example of H2SO4 from oxidation of sulfur containing AA - Drop in bicarb will stimulate renal acid secretion - Nice table of normal cid-base values, arterial and venous- Great 6 bullet points of acid-base on page 328 - Kidneys must excrete 50-100 of non-carbonic acid daily - This occurs by H secretion, but mechanisms change by area of nephron - Not excreted as free H+ due to minimal urine pH being equivalent to 0.05 mmol/L - No H+ can be excreted until virtually all of th filtered bicarb is reabsorbed - Secreted H+ must bind buffers (phosphate, NH3, cr) - PH is main stimulus for H secretion, though K, aldo and volume can affect this.- Renal Hydrogen excretion - Critical to understand that loss of bicarb is like addition of hydrogen to the body - So all bicarb must be reabsorbed before dietary H load can be secreted - GFR of 125 and bicarb of 24 results in 4300 mEq of bicarb to be reabsorbed daily - Reabsorption of bicarb and secretion of H involve H secretion from tubular cells into the lumen. - Thee initial points need to be emphasized - Secreted H+ ion are generated from dissociation of H2O - Also creates OH ion - Which combine with CO2 to form HCO3 with the help of zinc containing intracellular carbonic anhydrase. - This is how the secretion of H+ which creates an OH ultimately produces HCO3 - Different mechanisms for proximal and distal acidification - NET ACID EXCRETION - Free H+ is negligible - So net H+ is TA + NH4 – HCO3 loss - Unusually equal to net H+ load, 50-100 mEq/day - Can bump up to 300 mEq/day if acid production is increased - Net acid excretion can go negative following a bicarb or citrate load - Proximal Acidification - Na-H antiporter (or exchanger) in luminal membrane - Basolateral membrane has a 3 HCO3 Na cotransporter - This is electrogenic with 3 anions going out and only one cation - The Na-H antiporter also works in the thick ascending limb of LOH - How about this, there is also a H-ATPase just like found in the intercalated cells in the proximal tubule and is responsible for about a third of H secretion - And similarly there is also. HCO3 Cl exchanger (pendrin-like) in the proximal tubule - Footnote says the Na- 3HCO3 cotransporter (which moves sodium against chemical gradient NS uses negative charge inside cell to power it) is important for sensing acid-base changes in the cell. - Distal acidification - Occurs in intercalated cells of of cortical and medullary collecting tubule - Three main characteristics - H secretion via active secretory pumps in the luminal membrane - Both H-ATPase and H-K ATPase - H- K ATPase is an exchange pump, k reabsorption - H-K exchange may be more important in hypokalemia rather than in acid-base balance - Whole paragraph on how a Na-H exchanger couldn't work because the gradient that H has to be pumped up is too big. - H-ATPase work like vasopressin with premise H-ATPase sitting on endocarditis vesicles a=which are then inserted into the membrane. Alkalosis causes them to be recycled out of the membrane. - H secretory cells do not transport Na since they have few luminal Na channels, but are assisted by the lumen negative tubule from eNaC. - Minimizes back diffusion of H+ and promotes bicarb resorption - Bicarbonate leaves the cell through HCO3-Cl exchanger which uses the low intracellular Cl concentration to power this process. - Same molecule is found on RBC where it is called band 3 protein - Figure 11-5 is interesting - Bicarbonate resorption - 90% in the first 1-22 mm of the proximal tubule (how long is the proximal tubule?) - Lots of Na-H exchangers and I handed permeability to HCO3 (permeability where?) - Last 10% happens distally mostly TAL LOH via Na-H exchange - And the last little bit int he outer medullary collecting duct. - Carbonic anhydrase and disequilibrium pH - CA plays central role in HCO3 reabsorption - After H is secreted in the proximal tubule it combines with HCO# to form carbonic acid. CA then dehydrates it to CO2 and H2O. (Step 2) - Constantly moving carbonic acid to CO2 and H2O keeps hydrogen combining with HCO3 since the product is rapidly consumed. - This can be demonstrated by the minimal fall in luminal pH - That is important so there is not a luminal gradient for H to overcome in the Na-H exchanger (this is why we need a H-ATPase later) - CA inhibitors that are limited tot he extracellular compartment can impair HCO3 reabsorption by 80%. - CA is found in S1, S2 but not S3 segment. See consequence in figure 11-6. - The disequilibrium comes from areas where there is no CA, the HH formula falls down because one of the assumptions of that formula is that H2CO3 (carbonic acid) is a transient actor, but without CA it is not and can accumulate, so the pKa is not 6.1. - Bicarbonate secretion - Type B intercalated cells - H-ATPase polarity reversed - HCO3 Cl exchanger faces the apical rather than basolateral membrane- Titratable acidity - Weak acids are filtered at the glom and act as buffers in the urine. - HPO4 has PKA of 6.8 making it ideal - Creatinine (pKa 4.97) and uric acid (pKa 5.75) also contribute - Under normal cinditions TA buffers 10-40 mEa of H per day - Does an example of HPO4(2-):H2PO4 (1-) which exists 4:1 at pH of 7.4 (glomerular filtrate) - So for 50 mEq of Phos 40 is HPO4 and 10 is H2PO4 - When pH drops to 6.8 then the ratio is 1:1 so for 50 - So the 50 mEq is 25 and 25, so this buffered an additional 15 mEq of H while the free H+ concentration increased from 40 to 160 nanomol/L so over 99.99% of secreted H was buffered - When pH drops to 4.8 ratio is 1:100 so almost all 50 mEq of phos is H2PO4 and 39.5 mEq of H are buffered. - Acid loading decreases phosphate reabsorption so more is there to act as TA. - Decreases activity of Na-phosphate cotransporter - DKA provides a novel weak acid/buffer beta-hydroxybutyrate (pKa 4.8) which buffers significant amount of acid (50 mEq/d).- Ammonium Excretion - Ability to excrete H+ as ammonium ions adds an important amount of flexibility to renal acid-base regulation - NH3 and NH4 production and excretion can be varied according to physiologic need. - Starts with NH3 production in tubular cells - NH3, since it is neutral then diffuses into the tubule where it is acidified by the low pH to NH4+ - NH4+ is ionized and cannot cross back into the tubule cells(it is trapped in the tubular fluid) - This is important for it acting as an important buffer eve though the pKa is 9.0 - At pH of 6.0 the ratio of NH3 to NH4 is 1:1000 - As the neutral NH3 is converted to NH4 more NH3 from theintracellular compartment flows into the tubular fluid replacing the lost NH3. Rinse wash repeat. - This is an over simplification and that there are threemajor steps - NH4 is produced in early proximal tubular cells - Luminal NH4 is partially reabsorbed in the TAL and theNH3 is then recycled within the renal medulla - The medullary interstitial NH3 reaches highconcentrations that allow NH3 to diffuse into the tubular lumen in the medullary collecting tubule where it is trapped as NH4 by secreted H+ - NH4 production from Glutamine which converts to NH4 and glutamate - Glutamate is converted to alpha-ketoglutarate - Alpha ketoglutarate is converted to 2 HCO3 ions - HCO3 sent to systemic circulation by Na-3 HCO3 transporter - NH4 then secreted via Na-H exchanger into the lumen - NH4 is then reabsorbed by NaK2Cl transporter in TAL - NH4 substitutes for K - Once reabsorbed the higher intracellular pH causes NH4 to convert to NH3 and the H that is removed is secreted through Na-H exchanger to scavenge the last of the filtered bicarb. - NH3 diffuses out of the tubular cells into the interstitium - NH4 reabsorption in the TAL is suppressed by hyperkalemia and stimulated by chronic metabolic acidosis - NH4 recycling promotes acid clearance - The collecting tubule has a very low NH3 concentration - This promotes diffusion of NH3 into the collecting duct - NH3 that goes there is rapidly converted to NH4 allowing more NH3 to diffuse in. - Response to changes in pH - Increased ammonium excretion with two processes - Increased proximal NH4 production - This is delayed 24 hours to 2-3 days depending on which enzyme you look at - Decreased urine pH increases diffusion of ammonia into the MCD - Occurs with in hours of an acid load - Peak ammonium excretion takes 5-6 days! (Fig 11-10) - Glutamine is picked up from tubular fluid but with acidosis get Na dependent peritublar capillary glutamine scavenging too - Glutamine metabolism is pH dependent with increase with academia and decrease with alkalemia - NH4 excretion can go from 30-40 mEq/day to > 300 with severe metabolic acidosis (38 NaBicarb tabs) - Says each NH4 produces equimolar generation of HCO3 but I thought it was two bicarb for every alpha ketoglutarate?- The importance of urine pH - Though the total amount of hydrogren cleared by urine pH is insignificant, an acidic urine pH is essential for driving the reactions of TA and NH4 forward.- Regulation of renal hydrogen excretion - Net acid excretion vary inverse with extracellular pH - Academia triggers proximal and distal acidification - Proximally this: - Increased Na-H exchange - Increased luminal H-ATPase activity - Increased Na:3HCO3 cotransporter on the basolateral membrane - Increased NH4 production from glutamine - In the collecting tubules - Increased H-ATPase - Reduction of tubular pH promotes diffusion of NH3 which gets converted to NH4…ION TRAPPING - Extracellular pH affects net acid excretion through its affect on intracellular pH - This happens directly with respiratory disorders due to movement of CO2 through the lipid bilayer - In metabolic disorders a low extracellular bicarb with cause bicarb to diffuse out of the cell passively, this lowers intracellular pH - If you manipulate both low pCO2 and low Bicarb to keep pH stable there will be no change in the intracellular pH and there is no change in renal handling of acid. It is intracellular pH dependent - Metabolic acidosis - Ramps up net acid secretion - Starts within 24 hours and peaks after 5-6 days - Increase net secretion comes from NH4 - Phosphate is generally limited by diet - in DKA titratable acid can be ramped up - Metabolic alkalosis - Alkaline extracellular pH - Increased bicarb excretion - Decrease reabsorption - HCO3 secretion (pendrin) in cortical collecting tubule - Occurs in cortical intercalated cells able to insert H-ATPase in basolateral cells (rather than luminal membrane) - Normal subjects are able to secrete 1000 mmol/day of bicarb - Maintenance of metabolic alkalosis requires a defect which forces the renal resorption of bicarb - This can be chloride/volume deficiency - Hypokalemia - Hyperaldosteronism - Respiratory acidosis and alkalosis - PCO2 via its effect on intracellular pH is an important determinant of renal acid handling - Ratios he uses: - 3.5 per 10 for respiratory acidosis - 5 per 10 for respiratory alkalosis - Interesting paragraph contrasting the response to chronic metabolic acidosis vs chronic respiratory acidosis - Less urinary ammonium in respiratory acidosis - Major differences in proximal tubule cell pH - In metabolic acidosis there is decreased bicarb load so less to be reabsorbed proximally - In respiratory acidosis the increased serum bicarb increases the amount of bicarb that must be reabsorbed proximally - The increased activity of Na-H antiporter returns tubular cell pH to normal and prevents it from creating increased urinary ammonium - Mentions that weirdly more mRNA for H-Na antiporter in metabolic acidosis than in respiratory acidosis - Net hydrogen excretion varies with effective circulating volume - Starts with bicarb infusions - Normally Tm at 26 - But if you volume deplete the patient with diuretics first this increases to 35+ - Four factors explain this increased Tm for bicarb with volume deficiency - Reduced GFR - Activation of RAAS - Ang2 stim H-Na antiporter proximally - Ang2 also stimulates Na-3HCO3 cotransporter on basolateral membrane - Aldosterone stimulates H-ATPase in distal nephron - ALdo stimulates Cl HCO3 exchanger on basolateral membrane - Aldo stimulates eNaC producing tubular lumen negative charge to allow H secretion to occur and prevents back diffusion - Hypochloremia - Increases H secretion by both Na-dependent and Na-independent methods - If Na is 140 and Cl is 115, only 115 of Na can be reabsorbed as NaCl, the remainder must be reabsorbed with HCO3 or associated with secretion of K or H to maintained electro neutrality - This is enhanced with hypochloridemia - Concurrent hypokalemia - Changes in K lead to trans cellular shifts that affect inctracellular pH - Hypokalemia causes K out, H in and in the tubular cell the cell acts if there is systemic acidosis and increases H secretion (and bicarbonate resorption) - PTH - Decreases proximal HCO3 resorption - Primary HyperCard as cause of type 2 RTA - Does acidosis stim PTH or does PTH stim net acid excretion
Marcela e Lucas discutem como quando repor bicarbonato, como repor e os efeitos adversos da reposição. Referências. Samir Jaber, et al. Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial. The Lancet - Published:June 14, 2018DOI:https://doi.org/10.1016/S0140-6736(18)31080-8 Michael Emmett, et al. Approach to the adult with metabolic acidosis. UpToDate 2023 Josh Farkas - PulmCrit: pH-guided fluid resuscitation & BICAR-ICU - 2018 Michael Wiederkehr, et al. Bicarbonate therapy in lactic acidosis. UpToDate 2023
Ketamine makes it back into our podcast discussion. Our patient, Chris, reflects on his resuscitation while our hosts, Dr. Hill and Scott talk through the resuscitation process.
A recent study published in Kidney Medicine found that increased serum bicarbonate levels in kidney transplant recipients can lower the risk of transplant loss and death. Get valuable information for kidney transplant recipients and their healthcare providers.Reference:Mathur V, et al. Kidney Med. 2022;doi:10.1016/j.xkme.2022.100573.VISIT OUR STOREStore: https://www.selfelements.comFOLLOW USwww.selfprinciple.orgwww. youtube.com/selfprinciplewww.youtube.com/plantbasedkidneyhealthwww.instagram.com/seanhashmimd
The ALL ME® Podcast Sodium Bicarbonate: A Potential Performance Enhancing Supplement? – Pat Dixon, MA, MBA, CSCS, PES, CES Are you one of those individuals who uses baking soda to whiten your teeth, keep your refrigerator from smelling, or to clean your house? Did you realize the main ingredient, sodium bicarbonate, can also be used to help athletes enhance performance, specifically those who are training for speed and power? In this podcast, we speak with Pat Dixon, Director of Applied Sports Science for Momentous to learn more about research on sodium bicarbonate. We specifically discuss how it acts like a buffer, the impact of lactic acid on training intensity, the research behind sodium bicarbonate, which athletes benefit the most, dosage guidelines, and potential side effects if using too much. Pat Dixon, MA, MBA, CSCS, PES, CES Dixon began his career in exercise science at the University of Connecticut while pursuing a Master's Degree under William J. Kraemer and also working in athletics as a strength and conditioning coach. Previous publications, online and in print, have focused on athlete development with a focus on improving power production and performance. He spent 18 years working with college athletes at UConn, Cal-Berkeley, St John's University and Loyola Marymount University with a focus on improving performance and decreasing incidence of injury. While working with athletes, Dixon's efforts helped shape multiple NCAA tournament appearances and Sweet Sixteen Finishes in Women's Basketball, Soccer and Volleyball as well as a National Championship in Softball. Follow Us: Twitter: @theTHF Instagram: @theTHF Facebook: Taylor Hooton Foundation #ALLMEPEDFREE Contact Us: Email: Phone: 214-449-1990 ALL ME Assembly Programs:
ReferencesWe considered the effect of a high protein diet and potential metabolic acidosis on kidney function. This review is of interest by Donald Wesson, a champion for addressing this issue and limiting animal protein: Mechanisms of Metabolic Acidosis-Induced Kidney Injury in Chronic Kidney DiseaseHostetter explored the effect of a high protein diet in the remnant kidney model with 1 ¾ nephrectomy. Rats with reduced dietary acid load (by bicarbonate supplementation) had less tubular damage. Chronic effects of dietary protein in the rat with intact and reduced renal massWesson explored treatment of metabolic acidosis in humans with stage 3 CKD in this study. Treatment of metabolic acidosis in patients with stage 3 chronic kidney disease with fruits and vegetables or oral bicarbonate reduces urine angiotensinogen and preserves glomerular filtration rateIn addition to the effect of metabolic acidosis from a diet high in animal protein, this diet also leads to hyperfiltration. This was demonstrated in normal subjects; ingesting a protein diet had a significantly higher creatinine clearance than a comparable group of normal subjects ingesting a vegetarian diet. Renal functional reserve in humans: Effect of protein intake on glomerular filtration rate.This finding has been implicated in Brenner's theory regarding hyperfiltration: The hyperfiltration theory: a paradigm shift in nephrologyOne of multiple publications from Dr. Nimrat Goraya whom Joel mentioned in the voice over: Dietary Protein as Kidney Protection: Quality or Quantity?We wondered about the time course in buffering a high protein meal (and its subsequent acid load on ventilation) and Amy found this report:Effect of Protein Intake on Ventilatory Drive | Anesthesiology | American Society of Anesthesiologists Roger mentioned that the need for acetate to balance the acid from amino acids in parenteral nutrition was identified in pediatrics perhaps because infants may have reduced ability to generate acid. Randomised controlled trial of acetate in preterm neonates receiving parenteral nutrition - PMCHe also recommended an excellent review on the complications of parenteral nutrition by Knochel https://www.kidney-international.org/action/showPdf?pii=S0085-2538%2815%2933384-6 which explained that when the infused amino acids disproportionately include cationic amino acids, metabolism led to H+ production. This is typically mitigated by preparing a solution that is balanced by acetate. Amy mentioned this study that explored the effect of protein intake on ventilation: Effect of Protein Intake on Ventilatory Drive | Anesthesiology | American Society of AnesthesiologistsAnna and Amy reminisced about a Skeleton Key Group Case from the renal fellow network Skeleton Key Group: Electrolyte Case #7JC wondered about isolated defects in the proximal tubule and an example is found here: Mutations in SLC4A4 cause permanent isolated proximal renal tubular acidosis with ocular abnormalitiesAnna's Voiceover re: Gastric neobladder → metabolic alkalosis and yes, dysuria. The physiology of gastrocystoplasty: once a stomach, always a stomach but not as common as you might think Gastrocystoplasty: long-term complications in 22 patientsSjögren's syndrome has been associated with acquired distal RTA and in some cases, an absence of the H+ ATPase, presumably from autoantibodies to this transporter. Here's a case report: Absence of H(+)-ATPase in cortical collecting tubules of a patient with Sjogren's syndrome and distal renal tubular acidosisCan't get enough disequilibrium pH? Check this out- Spontaneous luminal disequilibrium pH in S3 proximal tubules. Role in ammonia and bicarbonate transport.Acetazolamide secretion was studied in this report Concentration-dependent tubular secretion of acetazolamide and its inhibition by salicylic acid in the isolated perfused rat kidney. | Drug Metabolism & DispositionIn this excellent review, David Goldfarb tackles the challenging case of a A Woman with Recurrent Calcium Phosphate Kidney Stones (spoiler alert, many of these patients have incomplete distal RTA and this problem is hard to treat). Molecular mechanisms of renal ammonia transport excellent review from David Winer and Lee Hamm. OutlineOutline: Chapter 11- Regulation of Acid-Base Balance- Introduction - Bicarb plus a proton in equilibrium with CO2 and water - Can be rearranged to HH - Importance of regulating pCO2 and HCO3 outside of this equation - Metabolism of carbs and fats results in the production of 15,000 mmol of CO2 per day - Metabolism of protein and other “substances” generates non-carbonic acids and bases - Mostly from sulfur containing methionine and cysteine - And cationic arginine and lysine - Hydrolysis of dietary phosphate that exists and H2PO4– - Source of base/alkali - Metabolism of an ionic amino acids - Glutamate and asparatate - Organic anions going through gluconeogenesis - Glutamate, Citrate and lactate - Net effect on a normal western diet 50-100 mEq of H+ per day - Homeostatic response to these acid-base loads has three stages: - Chemical buffering - Changes in ventilation - Changes in H+ excretion - Example of H2SO4 from oxidation of sulfur containing AA - Drop in bicarb will stimulate renal acid secretion - Nice table of normal cid-base values, arterial and venous- Great 6 bullet points of acid-base on page 328 - Kidneys must excrete 50-100 of non-carbonic acid daily - This occurs by H secretion, but mechanisms change by area of nephron - Not excreted as free H+ due to minimal urine pH being equivalent to 0.05 mmol/L - No H+ can be excreted until virtually all of th filtered bicarb is reabsorbed - Secreted H+ must bind buffers (phosphate, NH3, cr) - PH is main stimulus for H secretion, though K, aldo and volume can affect this.- Renal Hydrogen excretion - Critical to understand that loss of bicarb is like addition of hydrogen to the body - So all bicarb must be reabsorbed before dietary H load can be secreted - GFR of 125 and bicarb of 24 results in 4300 mEq of bicarb to be reabsorbed daily - Reabsorption of bicarb and secretion of H involve H secretion from tubular cells into the lumen. - Thee initial points need to be emphasized - Secreted H+ ion are generated from dissociation of H2O - Also creates OH ion - Which combine with CO2 to form HCO3 with the help of zinc containing intracellular carbonic anhydrase. - This is how the secretion of H+ which creates an OH ultimately produces HCO3 - Different mechanisms for proximal and distal acidification - NET ACID EXCRETION - Free H+ is negligible - So net H+ is TA + NH4 – HCO3 loss - Unusually equal to net H+ load, 50-100 mEq/day - Can bump up to 300 mEq/day if acid production is increased - Net acid excretion can go negative following a bicarb or citrate load - Proximal Acidification - Na-H antiporter (or exchanger) in luminal membrane - Basolateral membrane has a 3 HCO3 Na cotransporter - This is electrogenic with 3 anions going out and only one cation - The Na-H antiporter also works in the thick ascending limb of LOH - How about this, there is also a H-ATPase just like found in the intercalated cells in the proximal tubule and is responsible for about a third of H secretion - And similarly there is also. HCO3 Cl exchanger (pendrin-like) in the proximal tubule - Footnote says the Na- 3HCO3 cotransporter (which moves sodium against chemical gradient NS uses negative charge inside cell to power it) is important for sensing acid-base changes in the cell. - Distal acidification - Occurs in intercalated cells of of cortical and medullary collecting tubule - Three main characteristics - H secretion via active secretory pumps in the luminal membrane - Both H-ATPase and H-K ATPase - H- K ATPase is an exchange pump, k reabsorption - H-K exchange may be more important in hypokalemia rather than in acid-base balance - Whole paragraph on how a Na-H exchanger couldn't work because the gradient that H has to be pumped up is too big. - H-ATPase work like vasopressin with premise H-ATPase sitting on endocarditis vesicles a=which are then inserted into the membrane. Alkalosis causes them to be recycled out of the membrane. - H secretory cells do not transport Na since they have few luminal Na channels, but are assisted by the lumen negative tubule from eNaC. - Minimizes back diffusion of H+ and promotes bicarb resorption - Bicarbonate leaves the cell through HCO3-Cl exchanger which uses the low intracellular Cl concentration to power this process. - Same molecule is found on RBC where it is called band 3 protein - Figure 11-5 is interesting - Bicarbonate resorption - 90% in the first 1-22 mm of the proximal tubule (how long is the proximal tubule?) - Lots of Na-H exchangers and I handed permeability to HCO3 (permeability where?) - Last 10% happens distally mostly TAL LOH via Na-H exchange - And the last little bit int he outer medullary collecting duct. - Carbonic anhydrase and disequilibrium pH - CA plays central role in HCO3 reabsorption - After H is secreted in the proximal tubule it combines with HCO# to form carbonic acid. CA then dehydrates it to CO2 and H2O. (Step 2) - Constantly moving carbonic acid to CO2 and H2O keeps hydrogen combining with HCO3 since the product is rapidly consumed. - This can be demonstrated by the minimal fall in luminal pH - That is important so there is not a luminal gradient for H to overcome in the Na-H exchanger (this is why we need a H-ATPase later) - CA inhibitors that are limited tot he extracellular compartment can impair HCO3 reabsorption by 80%. - CA is found in S1, S2 but not S3 segment. See consequence in figure 11-6. - The disequilibrium comes from areas where there is no CA, the HH formula falls down because one of the assumptions of that formula is that H2CO3 (carbonic acid) is a transient actor, but without CA it is not and can accumulate, so the pKa is not 6.1. - Bicarbonate secretion - Type B intercalated cells - H-ATPase polarity reversed - HCO3 Cl exchanger faces the apical rather than basolateral membrane- Titratable acidity - Weak acids are filtered at the glom and act as buffers in the urine. - HPO4 has PKA of 6.8 making it ideal - Creatinine (pKa 4.97) and uric acid (pKa 5.75) also contribute - Under normal cinditions TA buffers 10-40 mEa of H per day - Does an example of HPO4(2-):H2PO4 (1-) which exists 4:1 at pH of 7.4 (glomerular filtrate) - So for 50 mEq of Phos 40 is HPO4 and 10 is H2PO4 - When pH drops to 6.8 then the ratio is 1:1 so for 50 - So the 50 mEq is 25 and 25, so this buffered an additional 15 mEq of H while the free H+ concentration increased from 40 to 160 nanomol/L so over 99.99% of secreted H was buffered - When pH drops to 4.8 ratio is 1:100 so almost all 50 mEq of phos is H2PO4 and 39.5 mEq of H are buffered. - Acid loading decreases phosphate reabsorption so more is there to act as TA. - Decreases activity of Na-phosphate cotransporter - DKA provides a novel weak acid/buffer beta-hydroxybutyrate (pKa 4.8) which buffers significant amount of acid (50 mEq/d).- Ammonium Excretion - Ability to excrete H+ as ammonium ions adds an important amount of flexibility to renal acid-base regulation - NH3 and NH4 production and excretion can be varied according to physiologic need. - Starts with NH3 production in tubular cells - NH3, since it is neutral then diffuses into the tubule where it is acidified by the low pH to NH4+ - NH4+ is ionized and cannot cross back into the tubule cells(it is trapped in the tubular fluid) - This is important for it acting as an important buffer eve though the pKa is 9.0 - At pH of 6.0 the ratio of NH3 to NH4 is 1:1000 - As the neutral NH3 is converted to NH4 more NH3 from theintracellular compartment flows into the tubular fluid replacing the lost NH3. Rinse wash repeat. - This is an over simplification and that there are threemajor steps - NH4 is produced in early proximal tubular cells - Luminal NH4 is partially reabsorbed in the TAL and theNH3 is then recycled within the renal medulla - The medullary interstitial NH3 reaches highconcentrations that allow NH3 to diffuse into the tubular lumen in the medullary collecting tubule where it is trapped as NH4 by secreted H+ - NH4 production from Glutamine which converts to NH4 and glutamate - Glutamate is converted to alpha-ketoglutarate - Alpha ketoglutarate is converted to 2 HCO3 ions - HCO3 sent to systemic circulation by Na-3 HCO3 transporter - NH4 then secreted via Na-H exchanger into the lumen - NH4 is then reabsorbed by NaK2Cl transporter in TAL - NH4 substitutes for K - Once reabsorbed the higher intracellular pH causes NH4 to convert to NH3 and the H that is removed is secreted through Na-H exchanger to scavenge the last of the filtered bicarb. - NH3 diffuses out of the tubular cells into the interstitium - NH4 reabsorption in the TAL is suppressed by hyperkalemia and stimulated by chronic metabolic acidosis - NH4 recycling promotes acid clearance - The collecting tubule has a very low NH3 concentration - This promotes diffusion of NH3 into the collecting duct - NH3 that goes there is rapidly converted to NH4 allowing more NH3 to diffuse in. - Response to changes in pH - Increased ammonium excretion with two processes - Increased proximal NH4 production - This is delayed 24 hours to 2-3 days depending on which enzyme you look at - Decreased urine pH increases diffusion of ammonia into the MCD - Occurs with in hours of an acid load - Peak ammonium excretion takes 5-6 days! (Fig 11-10) - Glutamine is picked up from tubular fluid but with acidosis get Na dependent peritublar capillary glutamine scavenging too - Glutamine metabolism is pH dependent with increase with academia and decrease with alkalemia - NH4 excretion can go from 30-40 mEq/day to > 300 with severe metabolic acidosis (38 NaBicarb tabs) - Says each NH4 produces equimolar generation of HCO3 but I thought it was two bicarb for every alpha ketoglutarate?- The importance of urine pH - Though the total amount of hydrogren cleared by urine pH is insignificant, an acidic urine pH is essential for driving the reactions of TA and NH4 forward.- Regulation of renal hydrogen excretion - Net acid excretion vary inverse with extracellular pH - Academia triggers proximal and distal acidification - Proximally this: - Increased Na-H exchange - Increased luminal H-ATPase activity - Increased Na:3HCO3 cotransporter on the basolateral membrane - Increased NH4 production from glutamine - In the collecting tubules - Increased H-ATPase - Reduction of tubular pH promotes diffusion of NH3 which gets converted to NH4…ION TRAPPING - Extracellular pH affects net acid excretion through its affect on intracellular pH - This happens directly with respiratory disorders due to movement of CO2 through the lipid bilayer - In metabolic disorders a low extracellular bicarb with cause bicarb to diffuse out of the cell passively, this lowers intracellular pH - If you manipulate both low pCO2 and low Bicarb to keep pH stable there will be no change in the intracellular pH and there is no change in renal handling of acid. It is intracellular pH dependent - Metabolic acidosis - Ramps up net acid secretion - Starts within 24 hours and peaks after 5-6 days - Increase net secretion comes from NH4 - Phosphate is generally limited by diet - in DKA titratable acid can be ramped up - Metabolic alkalosis - Alkaline extracellular pH - Increased bicarb excretion - Decrease reabsorption - HCO3 secretion (pendrin) in cortical collecting tubule - Occurs in cortical intercalated cells able to insert H-ATPase in basolateral cells (rather than luminal membrane) - Normal subjects are able to secrete 1000 mmol/day of bicarb - Maintenance of metabolic alkalosis requires a defect which forces the renal resorption of bicarb - This can be chloride/volume deficiency - Hypokalemia - Hyperaldosteronism - Respiratory acidosis and alkalosis - PCO2 via its effect on intracellular pH is an important determinant of renal acid handling - Ratios he uses: - 3.5 per 10 for respiratory acidosis - 5 per 10 for respiratory alkalosis - Interesting paragraph contrasting the response to chronic metabolic acidosis vs chronic respiratory acidosis - Less urinary ammonium in respiratory acidosis - Major differences in proximal tubule cell pH - In metabolic acidosis there is decreased bicarb load so less to be reabsorbed proximally - In respiratory acidosis the increased serum bicarb increases the amount of bicarb that must be reabsorbed proximally - The increased activity of Na-H antiporter returns tubular cell pH to normal and prevents it from creating increased urinary ammonium - Mentions that weirdly more mRNA for H-Na antiporter in metabolic acidosis than in respiratory acidosis - Net hydrogen excretion varies with effective circulating volume - Starts with bicarb infusions - Normally Tm at 26 - But if you volume deplete the patient with diuretics first this increases to 35+ - Four factors explain this increased Tm for bicarb with volume deficiency - Reduced GFR - Activation of RAAS - Ang2 stim H-Na antiporter proximally - Ang2 also stimulates Na-3HCO3 cotransporter on basolateral membrane - Aldosterone stimulates H-ATPase in distal nephron - ALdo stimulates Cl HCO3 exchanger on basolateral membrane - Aldo stimulates eNaC producing tubular lumen negative charge to allow H secretion to occur and prevents back diffusion - Hypochloremia - Increases H secretion by both Na-dependent and Na-independent methods - If Na is 140 and Cl is 115, only 115 of Na can be reabsorbed as NaCl, the remainder must be reabsorbed with HCO3 or associated with secretion of K or H to maintained electro neutrality - This is enhanced with hypochloridemia - Concurrent hypokalemia - Changes in K lead to trans cellular shifts that affect inctracellular pH - Hypokalemia causes K out, H in and in the tubular cell the cell acts if there is systemic acidosis and increases H secretion (and bicarbonate resorption) - PTH - Decreases proximal HCO3 resorption - Primary HyperCard as cause of type 2 RTA - Does acidosis stim PTH or does PTH stim net acid excretion
Confused about your PKD and kidney labs? Listen now to learn my 4-step framework to master your labs, once and for all! Plus, I'll share a powerful, and 100% FREE, tool to help you start today. RESOURCES: FREE Download >>> Track & Trend Your Labs More info >>> Master Your Labs for PKD LABS TO START WITH: GFR - Glomerular Filtration Rate BUN - Blood Urea Nitrogen Creatinine Carbon Dioxide (CO2) or Bicarbonate >>> ENROLL IN MASTER YOUR LABS FOR PKD
So that's the life lesson... But why? Find out why a pot of bicarbonate of soda is a must-have in any household. It all starts with an email from somebody with a stinking hangover! Make sure you're subscribed! Don't forget! How To Survive Family Holidays by Jack Whitehall (with Hilary & Michael Whitehall!) is now available in paperback, at all good book shops! You can email your questions, thoughts or problems to TheWitteringWhitehalls@gmail.com
References for Chapter 10We did not mention many references in our discussion today but our listeners may enjoy some of the references below. Effects of pH on Potassium: New Explanations for Old Observations - PMC although the focus of this article is on potassium, this elegant review by Aronson and Giebisch reviews intracellular shifts as it relates to pH and K+.Josh swooned for Figure 10-1 is this right? Which figure was it? which shows the relationship between [H+] and pH. You can find this figure in the original reference from Halperin ML and others, Figure 1 here. Factors That Control the Effect of pH on Glycolysis in Leukocytes Here's Leticia Rolon's favorite Henderson-Hasselbalch calculator website: Henderson-Hasselbalch Calculator | Buffer Solutions [hint! for this site, use the bicarbonate (or “total CO2”) for A- and PCO2 for the HA] There's also a cooking tab for converting units! Fundamentals of Arterial Blood Gas Interpretation - PMC this review published posthumously from the late but beloved Jerry Yee and his group at Henry Ford Hospital, explores the details and underpinnings of our understandings of arterial blood gas interpretation (and this also addresses how our colleagues in clinical chemistry measure total CO2 - which JC referenced- but JC said “machine” and our colleagues prefer the word “instrument.”)Amy went deep on bicarbonate in respiratory acidosis. Here are her refs:Sodium bicarbonate therapy for acute respiratory acidosisSodium Bicarbonate in Respiratory AcidosisBicarbonate therapy in severe metabolic acidosisEffect of Intravenous Sodium Bicarbonate on Ventilation, Gas Exchange, and Acid-Base Balance in Patients with Chronic Pulmonary InsufficiencyBicarbonate Therapy in Severe Metabolic Acidosis | American Society of Nephrology this review article from Sabatini and Kurtzman addresses the issues regarding bicarbonate therapy including theoretical intracellular acidosis. Bicarbonate in DKA? Don't do it: Bicarbonate in diabetic ketoacidosis - a systematic review Here's a review from Bushinsky and Krieger on the effect acidosis on bone https://www.sciencedirect.com/science/article/abs/pii/S0085253822002174Here is the primary resource that Anna used in here investigation of meat replacements Nutritional Composition of Novel Plant-Based Meat Alternatives and Traditional Animal-Based MeatsWe enjoyed this paper that Dr. Rose references from the Journal of Clinical Investigation 1955 in which investigators infused HCl into nephrectomized dogs and observed changes in extracellular ions. https://www.jci.org/articles/view/103073/pdWe wondered about the amino acids/protein in some available meat alternatives they are explored in this article in the journal Amino Acids: Protein content and amino acid composition of commercially available plant-based protein isolates - PMC and you may enjoy this exploration of the nutritional value of these foods: Full article: Examination of the nutritional composition of alternative beef burgers available in the United StatesOutlineChapter 10: Acid-Base Physiology - H concentration regulated tightly - Normal H+ is 40 nm/L - This one millionth the concentration of Na and K - It needs to be this dilute because H+ fucks shit up - Especially proteins - Cool foot note H+ actually exists as H3O+ - Under normal conditions the H+ concentration varies little from normal due to three steps - Chemical buffering by extracellular and intracellular bufffers - Control of partial pressure of CO2 by alterations of alveolar ventilation - Control of plasma bicarbonate by changes in renal H+ excretion - Acid and bases - Use definition by Bronsted - Acid can donate protons - Base can accept protons - There are two classes of acids** - Carbonic acid H2CO3 - Each day 15000 mmol of CO2 are generated - CO2 not acid but combines with water to form carbonic acid H2CO3 - CO2 cleared by the lungs - Noncarbonic acid - Formed from metabolism of protein. Sulfur containing AA generate H2SO4. Only 50-100 mEq of acid produced from these sources. - Cleared by the kidneys - Law of Mass Action - Velocity of reaction proportional to the product of the concentrations of the reactants - Goes through mass action formula for water - Concludes that water has H of 155 nanoM/L, more than the 40 in plasma - Says you can do the same mass experiment for every acid in the body - Can do it also for bases but he is not going to. - Acids and Bases can be strong or weak - Strong acids completely dissociate - Weak acids not so much - H2PO4 is only 80% dissociated - Weak acids are the principle buffers in the body - Then he goes through how H is measured in the blood and it becomes clear why pH is a logical way to measure. - Then there is a lot of math - HH equation - Derives it - Then uses it to look at phos. Very interesting application - Buffers - Goes tot he phosphate well again. Amazing math describing how powerful buffers can be - Big picture the closer the pKa is to the starting pH the better buffer, i.e. it can absorb lots of OH or H without appreciably changing pH - HCO3 CO2 system - H2CO3 to H + HCO3 has a PKA of 2.72 but then lots of Math and the bicarb buffer system has a pKa of 6.1 - But the real power of the bicarb buffer is that it is not a sealed system. The ability to ventilate and keep CO2 constant increases the buffering efficiency by 11 fold and the ability to lower the CO2 below normal increases 18 fold. - Isohydric principle - There is only one hydrogen ion concentration and since that is a critical part of the buffer equation, all buffer eq are linked and you can understand all of them by understanding one of them. So we just can look at bicarb and understand the totality of acid base. - Bicarb is the most important buffer because - High concentration in plasma - Ability for CO2 to ventilate - Other buffers include - Bone - Bone is more than just inorganic reaction - Live bone releases more calcium in response to an acid load than dead bone - More effect with metabolic acidosis than respiratory acidosis - Hgb - Phosphate - Protein
Welcome to December 30, 2022 on the National Day Calendar. Today we celebrate the power of ordinary ingredients. With only 24 hours left till the new year, it's time for a quick science lesson. Trust us, you'll wanna remember this. If you plan to tie one on for New Year's Eve remember that not all hangover cures are made equal. Some swear by the hair of the dog, or an over the counter remedy like Alka Seltzer, but a magical ingredient is waiting to be discovered right in your own kitchen. If you guessed baking soda you are correct. It turns out that products like Alka Seltzer contain only a few active ingredients and bicarbonate of soda is one of them. Add in some aspirin and you are totally prepared for a wicked hangover. On National Bicarbonate of Soda Day discover this mighty wonder and please celebrate responsibly. “Bringing home the bacon” is a saying that goes back to 12th century England, when married men would swear an oath that they had not argued with their spouse for a whole year and a day. Upon taking this oath they were rewarded with a side of bacon. The phrase then referred to men who were seen as exemplary citizens and husbands. This might be a good day to make a similar resolution for the coming new year, although it's much easier to simply buy bacon these days. It's true that few people can resist the smell of bacon frying up in a pan, so it's bound to lead to a harmonious home. On Bacon Day we celebrate a food that is delicious no matter who brings it home. I'm Anna Devere and I'm Marlo Anderson. Thanks for joining us as we Celebrate Every Day. Learn more about your ad choices. Visit megaphone.fm/adchoices
For Video Edition, Please Click and Subscribe Here: https://youtu.be/_KCQch_2u8c We celebrate the king of meat and the delicious recipes made from it on National Bacon Day on December 30. Falling Needles Family Fest is a special day that is celebrated on December 30 every year. This day reminds us to clean up Christmas trees and recycle them instead of letting them rot away. We will be bringing some great minds together to celebrate the end of another week and YEAR! Reach out to us if you have questions to ask...OR if there is something on your mind from the past week! You may even win a giveaway!
Science of Getting Faster Podcast - Presented by TrainerRoad
The buffering capacity of Sodium Bicarbonate and Sodium Citrate has been well-studied for their potential to decrease the acidity of our blood during exercise, and ultimately attenuate fatigue. In a larger effort to reevaluate the hyperhydration strategies in the lead-up to the Tokyo Olympics, Dr. Siegler and colleagues aimed to uncover if buffering agents such as Sodium Bicarbonate and Sodium Citrate have the potential to enhance performance in ways that had not been previously studied. In this episode of the Science of Getting Faster Podcast, Dr. Siegler, a leader on the subject of buffering agents, joins us to discuss buffering agents and his study The Hyperhydration Potential of Sodium Bicarbonate and Sodium Citrate. TOPICS COVERED IN THIS EPISODE: (0:45) What is a buffer? (3:05) How does our blood become more acidic during exercise? (4:03) Can we train our buffering capacity? (6:22) How do our bodies naturally buffer our blood? (9:47) Can our nutrition impact the acidity of our blood and thus our buffering capacity? (11:35) Currently, why do athletes supplement with buffering agents? (14:30) At what intensity of exercise do buffering agents have the greatest impact? (15:31)The side effects of buffering agents and how you can mitigate those side effects (16:50) Why you might experience side effects and what those side effects are? (18:50) Buffering agents for endurance events (19:32) How long do buffering agents stay in your blood? (21:10) How your supplementation regimen and method of delivery can impact GI symptoms (25:21) Differences between Sodium Citrate and Sodium Bicarbonate (26:25) Why this study is novel (31:40) What is hyperhydration and why is it beneficial to endurance performance? (34:08) Study protocol (40:51) Supplementation and fluid regiment for both hyperhydration and buffering protocols • Continue the discussion on the TrainerRoad Forum: https://trainerroad.cc/3LvmBRn • Submit a study, researcher or topic to be covered on the Science of Getting Faster Podcast: https://www.TrainerRoad.com/SOGF ABOUT TRAINERROAD — CYCLING'S MOST EFFECTIVE TRAINING SYSTEM TrainerRoad makes cyclists faster. Athletes get structured indoor workouts, science-backed training plans, and easy-to-use performance analysis tools to reach their goals • Introducing Adaptive Training: https://bit.ly/3qb8KDn • Build Your Custom Plan: https://bit.ly/3rbc0jM • Train Together with Group Workouts: https://bit.ly/3r8PRlQ • Get Started: https://bit.ly/302vUkW SCIENCE OF GETTING FASTER PODCAST The Science of Getting Faster Podcast cuts through the noise and talks directly to the scientists doing the latest research into how to become a faster cyclist, stronger athlete, and healthier person. Join Sarah Laverty of TrainerRoad as she interviews a new researcher every month about their latest studies, what questions they were hoping to answer, what they observed and what they are still hoping to learn. • Subscribe to the Science of Getting Faster Podcast on iTunes: https://www.TrainerRoad.com/SOGF FOLLOW TRAINERROAD • Facebook: https://www.facebook.com/TrainerRd • Instagram: https://www.instagram.com/trainerroad/ • Twitter: https://twitter.com/TrainerRoad • Strava Club: https://www.strava.com/clubs/trainerroad
Contributor: Peter Bakes, MD Educational Pearls: Patients in renal failure may have elevated serum potassium levels which can result in EKG changes. EKG changes in the setting of hyperkalemia generally depend on the serum level. Mild elevation may cause peaked T waves. At higher serum levels there will be loss of P waves plus wide complex tachycardia. There can be progression to fatal arrhythmias. Treatment of acute hyperkalemia involves multiple mechanisms. Calcium gluconate stabilizes the cardiac membrane (of note, its duration of action is 1 hour). Insulin with Glucose and Bicarbonate both act to shift extracellular potassium into cells. Enhanced elimination of potassium is accomplished via Kayexalate or Lokelma. Definitive treatment for hyperkalemia is hemodialysis. The differential for wide complex non-tachycardic rhythm on EKG includes: left ventricular hypertrophy, left bundle branch block, pacemaker, electrolyte abnormalities including hyperkalemia. References Palmer BF, Clegg DJ. Diagnosis and treatment of hyperkalemia. Cleve Clin J Med. 2017;84(12):934-942. doi:10.3949/ccjm.84a.17056 Watanabe R. Hyperkalemia in chronic kidney disease. Rev Assoc Med Bras (1992). 2020;66Suppl 1(Suppl 1):s31-s36. Published 2020 Jan 13. doi:10.1590/1806-9282.66.S1.31 Summarized by Kirsten Hughes, MS4 | Edited by John Spartz, MD & Erik Verzemnieks, MD The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account. Donate to EMM today!
Welcome back to this week's #FridayReview! Today we'll be covering: Herb of the Week: Bee Pollen The Untold Story of Milk (book review) Sodium Bicarbonate (book review) Early Dementia & Heart Rate (research) Nutritional Supplements & Autoimmune Disease (research) For all the details and much more check out today's #CabralConcept 2303 – Enjoy the show and let me know if you have any questions! - - - For Everything Mentioned In Today's Show: StephenCabral.com/2303 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!
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