A review of urinary alkalisers

There are a number of urinary alkalisers on the market that are used to alleviate the uncomfortable symptoms of a urinary tract infection while other treatments have time to work.

Urinary alkalisers are typically made of either potassium citrate, sodium citrate or sodium bicarbonate (bicarb soda). The point of a urinary alkaliser is to reduce the symptoms of a urinary tract infection by creating more alkaline urine.

Hot tip on urinary alkalisers

You can use regular bicarb soda as a urinary alkaliser at home. No need to buy anything, except the shop-bought urinary alkalisers taste better.

It’s important for you to know that using a urinary alkaliser will not cure your urinary tract infection; there is no evidence that this is true or not true, across multiple studies. This means that you can use urinary alkalisers as a tool only, when used with other treatments, if it helps and if it doesn’t interfere with other treatments​1​.

Some treatments work better in an alkaline or acidic environment. Standard treatment for UTIs is antibiotics (but there are other options – see the UTI page for more information), with some research showing that there is a benefit in some cases to urinary alkaliser use with antibiotics.

This is due to the urinary alkaliser reducing the minimum amount of antibiotic required to kill the pathogenic microbe that is causing the UTI​2​. This is also in the face of research that shows a urinary pH within favourable levels can have an antibacterial effect by itself​3​.

A 2016 Cochrane review concluded that ‘Until relevant evidence is generated from randomised trials, the safety and efficacy of urinary alkalisers for the symptomatic treatment of uncomplicated UTI remains unknown​4​‘.

References

  1. 1.
    Kavanagh ON. Alkalising agents in urinary tract infections: theoretical contraindications, interactions and synergy. Therapeutic Advances in Drug Safety. Published online January 2022:204209862210807. doi:10.1177/20420986221080794
  2. 2.
    Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. Published online April 8, 2015:269-284. doi:10.1038/nrmicro3432
  3. 3.
    Ordaz G, Dagà U, Budia A, Pérez-Lanzac A, Fernández JM, Jordán C. Urinary pH and antibiotics, choose carefully. A systematic review. Actas Urológicas Españolas (English Edition). Published online September 2023:408-415. doi:10.1016/j.acuroe.2023.02.002
  4. 4.
    O’Kane DB, Dave SK, Gore N, et al. Urinary alkalisation for symptomatic uncomplicated urinary tract infection in women. Cochrane Database of Systematic Reviews. Published online April 19, 2016. doi:10.1002/14651858.cd010745.pub2


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Jessica Lloyd - Vulvovaginal Specialist Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)
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