Are you alkaline or acidic? Test your diet with this quick trick.

Image Credit: your neighborhood librarian / Flickr. This image has been modified.

Test to See If your Diet is Alkaline- or Acid-Forming

In my video Alkaline Diets, Animal Protein, & Calcium Loss I presented evidence challenging the notion that our body is buffering the acid formed from our diet with calcium from our bones. How then is our body neutralizing the acid? Maybe with our muscles! Our blood gets more acidic as we age and our kidney function declines, and this may be a reason we lose muscle mass as we get older. As a pair of researchers note: “The modern Western diet based on animal products generates an acid load that may cause a lifespan state of unnoticed and growing metabolic acidosis.” This chronic low-level diet-dependent metabolic acidosis might contribute to the progressive shrinking of our muscle mass as we age.

Muscle wasting appears to be an adaptive response to acidosis. When our muscles break down, amino acids are released into the bloodstream. Our liver can then take these amino acids and make something called glutamine, which our kidneys can use to get rid of excess acid. And indeed, in a three year study I profile in my video, Testing Your Diet with Pee & Purple Cabbage, those over age 65 eating alkaline diets were better able to preserve their muscle mass, which the researchers think may be because the alkaline-producing fruits and vegetables helped relieve the mild acidosis that occurs with the ingestion of the standard American diet.

So what should we think about the latest review’s question, “Does an alkaline diet benefit health?” If the question is “Does a diet low in meat, eggs, and dairy—all acid-producing—and high in fruits and vegetables with lots of dark green leafies benefit health?” then of course the answer is yes, an alkaline diet benefits health. But if the question is “Does it matter what our ‘peeH’ is (whether our urine is acid or alkaline) regardless of what actually goes into our mouth?” then the answer is… still yes, but the accepted benefits of having alkaline urine appear limited to two areas: lower risk of kidney stones and better uric acid clearance.

We’ve known about kidney stones and alkalinity for a while, but the uric acid data is new. Researchers have found that alkalization of the urine is effective for removing uric acid from the body. If you remember from my video Flesh & Fructose, uric acid is bad stuff (potentially increasing one’s risk of fatal stroke, heart disease, and death), so clearing more from your system is a good thing.

Those eating plant-based diets appear then to have an advantage in this regard. The average vegetarian diet is alkaline producing, and the average meat-eating diet is acid producing. Even though there are some acid-forming meat-substitutes, like some of the Quorn products, they’re not as bad as something like tuna, and they’re typically consumed in smaller quantities than meat consumers consume meat. Since the protein in plants is usually accompanied by much more potassium (which is alkalinizing), there is good reason to try to meet protein needs from plant sources. And when researchers actually measure urine pH, those eating strictly plant-based diets have the greatest advantage, with significantly more alkaline urine than omnivores.

How can we tell what our urine pH is? Well we can be all boring and order some pH paper strips to pee on. Or… we can use what everyone should have right now in their crisper, a purple cabbage. Everyone should have a red or purple cabbage in their fridge since it is not only one of the single best nutrition bangs for our buck, but we can also do science with it!

First, either boil some purple cabbage until the water turns deep purple or (a quicker and safer way since there’s no hot liquids) blend some raw with water in a blender and strain out the solids. Then what you can do with that royal purple liquid is pour it in the toilet bowl after you urinate. (You can imagine how much fun kids have with this!)

If it stays purple, your urine is acidic and you should eat more dark green leafy vegetables. If the toilet bowl turns pink, your urine is really acidic, so you should definitely eat more dark green leafy vegetables. We’re looking for blue. If it turns blue that means your urine is neutral or even basic. If it’s sky blue, you should… continue to eat more dark green leafy vegetables. Now I have a low-flow toilet, so there’s very little water in the bowel to start with. The effect might not be as dramatic if diluted in a larger quantity of water. For a step-by-step tutorial, see my video Testing Your Diet with Pee & Purple Cabbage.

More bathroom chemistry can be found in Pretty in Pee-nk and Asparagus Pee.

How else can we protect our muscles? We can eat healthy enough to avoid statin drugs (see Statin Muscle Toxicity) and the neurotoxins that can cause movement disorders (Muscle Tremors & Diet).

Cherries may also help lower uric acid levels: Gout Treatment with a Cherry on Top.

Superfood Bargains is the video in which purple cabbage takes the gold, though it was unseated in Biggest Nutrition Bang for Your Buck.

Why do I always go on and on about dark green leafy vegetables? Check out my 58 videos on greens and find out! : )

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my videos for free by clicking here and watch my full 2012 – 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.


Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.

39 responses to “Test to See If your Diet is Alkaline- or Acid-Forming

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  1. My friend, a 65 yr. old women with diabetes, has been eating a mostly a plant based diet for about a year now. She recently had a first-time toe swelling that her doctor diagnosed as gout. She is on Metformin which she rarely takes and rarely takes her BP, thyroid, and Lithium medicines also. Do you have any suggestions to help her avoid gout flare-ups in the future? (I suspect she may have eaten a couple of vegetarian meals with milk in the sauce before the flare-up).

      1. Thanks Daniel,  I gave her cherries to eat.  I was hoping there were other things we could do to her diet to prevent any further flare-ups.

      2. 45! I’ve only been eating 5-10. Suppose I’m cost conscious. But I get them quite cheap frozen. £1.50 for 500g of mixed berries. Cheapest I’ve found. (in the UK)

    1. My father has horrendous diabetes. He had a horrible case of gout. I went over his house armed with a bottle of cranberry pills. When I was facing a chronic kidney infection and was no longer responding to antibiotics, I began to take extremely high doses of cranberry pills (5-6 pills, 3x a day until the symptoms were gone–about 2 weeks and then 2-3 a day for about another 2 weeks and then 1 a day for about a month.) This was the ONLY action that worked and I haven’t had a problem since. So I told my father what worked for me and he copied the approach. The results? An almost immediate reduction in gout and he’s since kept it at bay. Perhaps something like this can work for your friend?

    2. I have found that patients following the correct diet will often be able to get off their medications for type two diabetes and high blood pressure. It appears that weight loss and a low fat diet seems to be the best approach for type two diabetes. You can be a “Fat Vegan” however. John McDougall has written newsletter articles on these conditions that you might find of interest. These articles are all available for free on his website. They are: Gout June 2006, Fat Vegan December 2008, Simple Care for Diabetes December 2009, and How I treat Patients with Elevated BP November 2009. I also am a proponent of minimizing psychiatric medications especially after reading Robert Whitaker’s Anatomy of an Epidemic and Peter Breggin’s book on Psychiatric Drug Withdrawal. It is important to work with your physician(s) in adjusting your medications. I would caution against not taking the thyroid medication. We sometimes find that patients have to adjust thyroid medication when they go on a plant based diet. Good luck.

  2. A hilarious typo here: “Now I have a low-flow toilet, so there’s very little water in the bowel to start with. ”

    Thanks, as always, for your insights. So are you saying that the folks claiming that alkaline diets fight cancer are confusing association with cause?

  3. With broccoli sprouts being so packed full of antioxidants – are they an acceptable choice as a green leafy or is that a totally separate animal for different benefits?

  4. This may explain partly why acid producing stress shortens lifespan. Also I will continue to drink very acidic pomegranate juice because of my long and close family history of alzheimer’s.

    1. Although pomegranate juice is acidic by itself, it is not acid, but alkaline, producing in the body. It should in fact help to raise your pH and thereby to preserve bone and muscle.

      1. What about starch? is starch acid? So beans,lentils, wheat, white rice, and corn? Would a plant based diet with no starch be better than one with starch based foods?

  5. I’m perplexed by studies that find vegans have higher uric acid levels such as this one whereas “vegetarians” have the lowest uric acid level of vegans, omnivores and vegetarians. A couple years Esselstyn plant based and I still have high uric acid and urine pH=6 and periodic gout attacks (nipped in the bud with colchicine).

    1. Interesting study. I hope Dr. Greger will address this sometime. The researchers speculate that the vegans had higher uric acid levels because of the lack of dairy and lower calcium intake in general, compared to the other groups.

    2. I had a problem with high levels of uric acid and severe gout but discovered high doses of niacin can cause it. discovered my multivitamin was loaded with niacin. I haven’t had my checked in a year, back then it was 9.0

    3. You could probably remedy this by supplementing your diet with potassium bicarbonate. A good one available online is called “Potassium Basics.” You can Google it; there are a couple of sites that carry it.

      I would recommend two capsules (containing 2.7 grams of potassium bicarbonate) with each meal 3 times a day for a total of 8.1 grams. The mineral compound potassium bicarbonate contains 39% (or 3.16 grams) of elemental potassium. The RDA for elemental potassium is 4.7 grams.

      This should raise your urine pH up to 7 or higher, especially if you continue with your plant-based diet.

  6. You can get the same results taking a potassium bicarbonate supplement as you can eating lots of fruits and vegetables, which are high in potassium citrate, since potassium citrate converts to potassium bicarbonate in the body. Potassium bicarbonate has also been shown to preserve muscle mass (along with preserving bone mineral density, e.g.,… ):

    Dawson-Hughes B, Castaneda-Sceppa C, Harris SS, Palermo NJ, Cloutier G, Ceglia L, Dallal GE. Impact of supplementation with bicarbonate on lower-extremity muscle performance in older men and women. Osteoporos Int 2009 Sep 1. [Epub ahead of print]


    1. What is potassium bicarbonate? Where do you get it, and is it safe? Most potassium supplements limit the amount of potassium in them, or should I say all … down to 99mg … when the recommended daily intake is over 6 grams … 60 times more.

      What is it with potassium? Is potassium bicarbonate a good safe source of it.

      I like coconut water, which has about 1/2 gram in it per serving … except that when you look on the labels of different coconut water that amount of potassium is all over the place … leading me to think this is just a made up number?

      Here is what Wikipedia has to say:

      According to the US Food and Drug Administration (FDA), potassium bicarbonate is “generally recognized as safe”.[2] There is no evidence of human carcinogenicity, no adverse effects of overexposure, and an undetermined LD50. Physically, potassium bicarbonate occurs as a crystal or a soft white granular powder. Potassium bicarbonate is very rarely found in its natural form, the mineral calledkalicinite.

      Potassium bicarbonate is an effective fungicide against powdery mildew and apple scab, allowed for use in organic farming.

      Maybe that is where it gets into coconuts from use as an anti-fungal agent, which would explain why some brands have more potassium than others?

    1. dogulas: To my knowledge, Dr. Greger has not formally updated his official optimal nutrition recommendations since 2011. In fact, I just got the latest Volume 20 DVD (excellent!) and it still had the recommendations insert for version 1.3 that I believe match the web page you linked to above.

      At one point Dr. Greger hinted that he was going to update his recommendations. I do not know what is up with that project (change of mind on needing changes? other priorities?). So, I think the most we can do is continue to pay attention to the blog posts and adapt information from the videos as relevant. At some point, a new set of recommendations may appear.

      1. Thanks very much! Do you happen to know if any of the recommendations have in fact changed much? Or dramatically? I don’t want my family to be supplementing something that might be causing harm. There aren’t that many listed on that page. Maybe you wouldn’t mind quickly glancing over the recommended doses?

        1. douglas: To my knowledge, nothing has officially changed concerning those specific recommendations. However, from videos on this site, I know we can refine the information. For example, there is at least one NutritionFacts video where Dr. Greger recommend eating 2 Tbl ground flaxseed every day. And if you have specific problems or goals, there can be specific recommendations. For example, suppose you had diabetes? Then I would recommend looking up the videos about diabetes to learn what foods might be especially important for managing that disease.

          That’s all I know.

  7. As a person train in laboratory techniques, this Urine pH test really struck my funny bone. We both did the test today only using jelly jars , not the toilet bowl. My result was very acidic and my husband’s was acidic. I like dark green leafy’s but they do tend to be on our plates more seldom. That is changing!

    Kathy in Missouri

  8. Is “alkaline” diet an abbreviated way of saying plant based, since sulfur is mostly (or is it always) in animal based products?

    What is it about veggies that make them alkaline … simply the lack or sulfur?

    I have been reading a lot of plant and gardening books lately, and it’s kind of interesting that most point out that most plants benefit from an acidic soil … which seems bit ironic.

  9. What about starch? All starch is acid is it not? Obviously not as acid as animal products but, are there any studies on plant based Alkaline starchles diets vs Semi alkaline starch promoting plant based diets. Now that study would be interesting.

  10. Does anyone have any idea if glutamine supplementation (temporary) can help with IBS/IBS and suspected leaky gut?

    Can’t find much plantbased information on it as it tends to be for gym goers and the like… who tend to eat more meat.

    1. Mike: I can’t answer your specific question, but I thought you might be interested in knowing that Michael Klaper has an excellent talk on leaky gut. The talk includes a set of steps a person can take to get rid of the problem. I believe you have to pay for the DVD, but form someone who has leaky gut, it would be WELL worth it. I have heard the talk myself and think it is very good.

      1. Thanks Thea, I have seen it – I am currently looking into SIBO as a possible cause of my constant bloating. It’s a shame Dr Greger has no videos on it. My fear is that it is deeply associated with the Paleo community… my trust of doctors who advocate paleo as a treatment for anything raises my eye brows – but they do seem to be onto something.

        If you’re interested check out Mark Pimentel, Allison Sibecker or ‘SIBO’ in google. Seems to be a common destination for idiopathic IBS.

        Most starchy food triggers me – I can’t touch beans, lentils… I am getting dry skin, swollen veins.. really having a horrible time, whilst my gastro tells me its all in my head. I am over eating at times due to stress, but nothing as excessive as I have done in the past (part of my problem)

        Desperate to find plant based digestion experts here in the UK – one thing I’ve looked at is ‘Symprove’ – looks quite promising.

        He does recommend Glutamine interestingly. Maybe I will try it.

        1. Mike: Yikes. That’s a real pickle. (Hey, can you have pickles ;-) ) I know it is no joking matter, but your situation seems like one of those ones where you either laugh or cry.

          I’m sorry I don’t have any more information for you. I’m hoping you find some help and/or relief soon. Good luck.

          1. Yeh. I’ve done both believe me. I have good days, OK days, but most days I’m very very tired. I just about manage to keep a decent mood, go out for a walk, prepare my meals, listen to some podcasts. I’m very lucky if I get even 30 minutes of cognitive focus to get something done.

            It really is horrible. But I’ve just about saved enough to get some private care. I’ve researched some potential action plans and I’m just waiting for a few things to fall into place before I pursue them. My trump card – my plan B – is an FMT….first thing I’m going to try is a liquid diet for one week at least, just not sure which foods to include (was thinking smoothies blended with greens) and simple soups with cabbage and simple veggies…then doing some herbal anti biotics followed by VSL 3 or Symprove…if all that fails and the FMT fails well, then I’ll really cry.

            Leukema at 13 was a walk in the park compared to this!

  11. My urine used to have pH 5.5 or 6.0. Now, after 3 months with an exclusive plant-based diet, its pH is 5.0! Ok, I can eat more green leafs, but if I stopped eating animal stuff, how can it be?

  12. Andrea,

    Your right… in that you may need to up the level of green leafy products and also might find, paradoxically, that using some lemon/lime in water or on a salad will also be of assistance to raising the pH..

    The reason that your finding an acidic change is that your body is finding an equilibrium between the new fluids/food products. Have you also changed your intake of fluids ?

    Dr. Alan Kadish moderator for Dr. Greger

  13. Any opinions on drinking baking soda and blackstrap molasses / Dr. Simoncini and all that?

    I have a very indolent follicular lymphoma. I’d like to get rid of it. Next I will be asking about medical cannabis. And supervised water-fasting.


  14. Normal pH values for urine are 4.6 to pH 8.0. Here is an article you may want to review on urine pH values, although your value at 9 is just over what’s normal and may not denote any of the problems listed for higher values. Remember as the article points out “The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.” and “A diet high in fruits, vegetables, or non-cheese dairy products can increase your urine pH.”
    Unless you are having symptoms or there was a reason why you had your urine pH tested, you needn’t worry your urine is too alkaline.

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