Bicarbonate Vs. PaCO2 Blood Tests

[charlie]

The main problem with getting this test as suikerbuik mentioned is that very few people are specially trained to draw blood from an artery and special equipment must be available to analyze the results with in 10 minutes of obtaining a sample.

And they hurt. I got them regularly as a kid and it was the thing I dreaded the most. The artery is deep so its not easy to get to. It's just not a very nice experience at all.

 

[Suikerbuik]

Thanks Wilfrid :)!

 

[Blossom]

The main problem with getting this test as suikerbuik mentioned is that very few people are specially trained to draw blood from an artery and special equipment must be available to analyze the results with in 10 minutes of obtaining a sample.

And they hurt. I got them regularly as a kid and it was the thing I dreaded the most. The artery is deep so its not easy to get to. It's just not a very nice experience at all.

They probably hit your radial nerve .

 

[haidut]

OK, one last question. I am still confused about one thing. If bicarbonate represents 94% of CO2 reserves in healthy humans, and if high bicarbonate implies high CO2 then why is high bocarbonate indicative of alkalosis? Wouldn't the high CO2 level, which bicarbonate is a surrogate for, imply acidosis instead? In other words, hypercapnia, implied by high bicarbonate levels, would be a condition called respiratory acidosis. However, if you blood tests show high bicarbonate levels your doctor will assume the exact opposite - i.e. that you are developing alkalosis. The links I posted in my first post also state that high bicarbonate levels indicate alkalosis.
How is this possible??? One of these options is wrong, or I am missing something in this whole mess.

 

[InChristAlone]

Your questions on alkalosis are exactly what I wondered a couple years ago when I joined the Peat community and everyone was saying a high bicarbonate was good. I would like clarity as well! When I felt my worst, after a panic attack in the ER it was 29! I think Peat did say there are errors in measuring this on a blood test though.

 

[haidut]

Your questions on alkalosis are exactly what I wondered a couple years ago when I joined the Peat community and everyone was saying a high bicarbonate was good. I would like clarity as well! When I felt my worst, after a panic attack in the ER it was 29! I think Peat did say there are errors in measuring this on a blood test though.

Yeah, I think it may come down to blood bicarbonate being only slightly reliable and only under conditions of very good health and probably only around the middle range. At the two ends of the "normal" range blood bicarbonate levels probably do not tell a good picture of CO2 levels.
So, anybody want to rise up to this "challenge" and explain?

 

[Suikerbuik]

Good point, I think it's in the flow of substances either in the reaction equation itself as in total flow regulated by the kidneys mainly.

 

[Blossom]

OK, one last question. I am still confused about one thing. If bicarbonate represents 94% of CO2 reserves in healthy humans, and if high bicarbonate implies high CO2 then why is high bocarbonate indicative of alkalosis? Wouldn't the high CO2 level, which bicarbonate is a surrogate for, imply acidosis instead? In other words, hypercapnia, implied by high bicarbonate levels, would be a condition called respiratory acidosis. However, if you blood tests show high bicarbonate levels your doctor will assume the exact opposite - i.e. that you are developing alkalosis. The links I posted in my first post also state that high bicarbonate levels indicate alkalosis.
How is this possible??? One of these options is wrong, or I am missing something in this whole mess.

In medicine if a person has high PaCO2 and high HCO3 it's considered either a 'compensated respiratory acidosis' or a 'compensated metabolic alkalosis' depending on the other values of the ABG and the clinical picture.
http://www.thoracic.org/professionals/c ... n/abgs.php
This link goes into detail on the medical interpretations of arterial blood gasses.
I'll admit to not yet spending much time comparing and contrasting Peat's views with the medical establishment on this topic simply because I've been working on my own health issues! I'm not sure if the first link will help clarify anything but this one might. http://www.manuelsweb.com/abg.htm

 

[Blossom]

Good point, I think it's in the flow of substances either in the reaction equation itself as in total flow regulated by the kidneys mainly.

YES

 

[haidut]

OK, one last question. I am still confused about one thing. If bicarbonate represents 94% of CO2 reserves in healthy humans, and if high bicarbonate implies high CO2 then why is high bocarbonate indicative of alkalosis? Wouldn't the high CO2 level, which bicarbonate is a surrogate for, imply acidosis instead? In other words, hypercapnia, implied by high bicarbonate levels, would be a condition called respiratory acidosis. However, if you blood tests show high bicarbonate levels your doctor will assume the exact opposite - i.e. that you are developing alkalosis. The links I posted in my first post also state that high bicarbonate levels indicate alkalosis.
How is this possible??? One of these options is wrong, or I am missing something in this whole mess.

In medicine if a person has high PaCO2 and high HCO3 it's considered either a 'compensated respiratory acidosis' or a 'compensated metabolic alkalosis' depending on the other values of the ABG and the clinical picture.
http://www.thoracic.org/professionals/c ... n/abgs.php
This link goes into detail on the medical interpretations of arterial blood gasses.
I'll admit to not yet spending much time comparing and contrasting Peat's views with the medical establishment on this topic simply because I've been working on my own health issues! I'm not sure if the first link will help clarify anything but this one might. http://www.manuelsweb.com/abg.htm

Thanks for the links and the explanation!
OK, then it looks like the regular bicarbonate test being done as part of the routine metabolic panels is not to be trusted unless combined with other test that a person most likely cannot get outside of the ER.
So, then maybe we should be getting tested for lactic acid as a surrogate for carbon dioxide levels. Those two are almost perfectly negatively correlated.

 

[Blossom]

That sounds like it would be much easier to me.

 

[tara]

Great topic, Haidut. Thanks for all the contributing explanations, Suikerbuik, Blossom, Wilfrid. :)

I recall Peat taking about ingesting bicarb of soda in water as a way to increase CO2 levels quickly, with sometimes helpful results. Remember the story about the woman who gave here mother, who mother had been impaired by stroke, a glass of bicarb of soda in water, after which she immediately regained some of her capabilities?

Any opinions on how good Buteyko Control Pause is for assessing CO2 levels? What it's got going for it is that it is completely non-invasive, does not require any fancy equipment other than a second timer, and does not require long training to learn to measure it.
My impression is that it is probably not completely accurate in itself, because someone with a very low metabolism may have a higher CP than someone with a faster metabolism at the same CO2 levels. However, it seems like it might be a really useful indicator, along with other ones.

I'd also love to see more good standard science analysis of Reams (RBTI) methods, and interpretations for us lay people. Could be that it has been done and I just didn't come across it. Reams said UpH reflects intercellular tissue pH. I'm not sure that he said it was the same - maybe he was meaning there was a simple linear relationship between them or something. Peat and Reams roughly agree about optimal UpH (slightly acidic).
So since reading about RBTI, I've been thinking UpH measurements would also provide fairly simple, completely non-invasisve, relatively low tech (pH strips or pH meter) diy indicators of intercellur pH that could be used to help protect ourselves from unhealthy extremes of either too acid or too alkaline states.
What do those of you with more scientific training think of this?

Because both of these measurements can be done quickly and easily at home, it is much more likely that most of us can monitor them on a daily or weekly basis to assess the effects of our experiments.

 

[Blossom]

I don't know anything about RBTI but it seems like an interesting angle.

 

[tara]

I don't know anything about RBTI but it seems like an interesting angle.

RBTI also measures several other important variables, all non-invasive.
Reams said these tests gave enough info without blood tests etc. But I suspect he had a much fuller picture of the biochemistry than he was able to pass on completely, and he talked about it in some very non-standard ways.

 

[Blossom]

Did Reams write any books? I remember Matt Stone mentioning him a while back but that's the only time I ran across information about him.

 

[tara]

Did Reams write any books? I remember Matt Stone mentioning him a while back but that's the only time I ran across information about him.

Matt Stone learned to do the testing, was in contact with one of the experienced practitioners, and wrote a short and simplified description of some of the key RBTI ideas (and some of the RBTI practitioners thought it was inaccurate).
There's a thread here: www.raypeatforum.com/forum/viewtopic.php?f=11&t=4433
and I think burtlancast added in a link to one of Reams' books. Not exactly concise, but really interesting.

 

[Blossom]

Thanks tara!

 

[tara]

Just thinking about this again while reading Haidut's recent post on thiamine as carbonic anhydrase inhibitor
(viewtopic.php?f=75&t=6833).
If I'm understanding the discussion, it seems as though it could be particularly important to be well stocked with alkaline minerals before and during supplementation with thiamine or other carbonic anhydrase inhibitors, so as to avoid risking acidosis?
I'm pretty sure that supplementing calcium while not drinking much milk (and maybe magnesium) has been important for me in improving chronic hidden hyperventilation (still not great, but better than it was). I think hyperventilation (which lowers CO2 levels) may be protective against acidosis, and that may be part of why some of us get into such habits.

 

[Blossom]

Good point tara. I have noticed when taking diamox that my breathing rate and depth temporarily increases enough that I notice the difference so my lungs must be compensating. I have also always tried to be extra mindful of getting plenty of electrolytes when using diamox. Certainly by eating significant amounts of fruit and dairy I was taking care of my alkaline minerals too.

 

[haidut]

Just thinking about this again while reading Haidut's recent post on thiamine as carbonic anhydrase inhibitor
(viewtopic.php?f=75&t=6833).
If I'm understanding the discussion, it seems as though it could be particularly important to be well stocked with alkaline minerals before and during supplementation with thiamine or other carbonic anhydrase inhibitors, so as to avoid risking acidosis?
I'm pretty sure that supplementing calcium while not drinking much milk (and maybe magnesium) has been important for me in improving chronic hidden hyperventilation (still not great, but better than it was). I think hyperventilation (which lowers CO2 levels) may be protective against acidosis, and that may be part of why some of us get into such habits.

Somebody on the forum posted a link to a website explaining why why should always supplement potassium when taking large doses of thiamine.
http://charles_w.tripod.com/kandthiamin.html

Something to do with keeping kidneys happy, but now knowing that thiamine is a CA inhibitor as well I think that underscores the importance of alkaline minerals. In the studies I posted about using a combination of acetazolamide and thiamine, the scientists were worried that acetazolamide would deplete the electrolytes (i.e. the alkaline minerals) so they gave the patients 8oz of orange juice daily. Pretty Peaty of them and also cool that just a glass of orange juice could offset the depleting effects acetazolamide. At the time the studies were done it was not known that thiamine is also a CA inhibitor, but it looks like a single glass of orange juice was able to offset the electrolyte depletion of both acetazolamide and thiamine together.
As we know, orange juice is pretty rich in potassium and magnesium so drinking it to taste while taking CA inhibitors would satisfy both the concerns of the guy form the link above and the general concerns of electrolyte depletion. Finally, magnesium is a cofactor for ATP synthesis so taking it with thiamine may have additive effect on the metabolism boosting effects of the vitamin. I think that would be a very Peaty way to raise CO2 without drugs - drink plenty of orange juice for the sugar and magnesium, and take 300mg-500mg thiamine with every glass to boost CO2 and keep it high.