An unusual cause of metabolic alkalosis: Hiding in plain sight

Carmen Elena Cervantes, Steven Menez, Bernard G. Jaar, Mohamad Hanouneh

Research output: Contribution to journalArticlepeer-review


Background: Sodium bicarbonate, in the form of baking soda, is widely used as a home remedy, and as an additive for personal and household cleaning products. Its toxicity has previously been reported following oral ingestion in the setting of dyspepsia. However, its use as a non-ingested agent, like a toothpaste additive, has not been reported as a potential cause of toxicity. Case presentation: We are reporting a case of an 80-year-old woman who presented with chronic metabolic alkalosis and hypokalemia secondary to exogenous alkali exposure from baking soda as a toothpaste additive, which might have represented an underreported ingestion of the substance. Conclusions: Considering that one teaspoon of baking soda provides approximately 59 m-equivalents (mEq) of bicarbonate, specific questioning on its general use should be pursued in similar cases of chloride resistant metabolic alkalosis.

Original languageEnglish (US)
Article number296
JournalBMC nephrology
Issue number1
StatePublished - Jul 23 2020


  • Baking soda
  • Hypokalemia
  • Metabolic alkalosis
  • Sodium bicarbonate
  • Toxicity

ASJC Scopus subject areas

  • Nephrology


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