DEAR DR. ROACH: I have a friend who’s 28 with “really low” urine pH (I don’t know how low). Apparently, it is due to constant dehydration and drinking coffee all day long, to the point that the doctor recommended that he drink lots of water with lemon (perhaps just to prevent dehydration and nothing else.)
That sounds counterintuitive to me. I recall you mentioning before that the body maintains a fairly constant pH. Does that also apply to urine? Could you please comment on urine pH, its spontaneous changes, causes and potential issues that acidic urine may cause in otherwise healthy males? — K.S.
ANSWER: The body maintains a very constant pH of the blood at a slightly alkaline 7.4 (7 is neutral; below 7 is acidic, above 7 is alkaline). Even a few tenths of a point higher or lower and the body is in severe trouble, as enzymes stop working properly.
The primary method the body uses to regulate blood pH is by increasing or decreasing carbonic acid loss through breathing out more or less carbon dioxide, but the kidneys play their part by adjusting urine pH. Most North Americans consume a diet high in meat, which requires the kidney to excrete acid, but the urine pH cannot get much below 4.5 due to limitations of the kidney.
It is counterintuitive that consuming lemon juice, which is a quite strong acid (with a pH between 2 and 3), will cause the urine to become less acidic. This is because citric acid (which makes lemons “tart,” i.e., acidic) is metabolized to bicarbonate, which is alkaline and excreted in the urine. Nephrologists use this effect therapeutically in people with calcium oxalate stones.
If your friend has normal kidneys, a change in diet away from meat and with more plants will make the urine pH less acidic.
That said, there are a host of unusual causes of urine pH changes. The ones making the urine pH acidic are quite uncommon, and they include Cushing’s syndrome (excess cortisone) and excess licorice ingestion. Yes, really. Licorice contains glycyrrhizic acid, which acts like a hormone on the kidney to affect urine pH. Coffee has no consistent effect on urine pH, but dehydration can make urine more acidic. Because of the body’s immense capacity to maintain blood pH, however, it is unlikely your friend will develop medical issues due to low urine pH.
DEAR DR. ROACH: Do chromium or biotin have a role in treating Type 2 diabetes? — N.F.E.
ANSWER: There was a great deal of enthusiasm for chromium picolinate a few years ago, and there is still evidence that the combination of chromium and biotin may decrease insulin resistance in people with Type 2 diabetes. Recent studies have suggested that these may improve glucose control, although the improvement was small, about 5% in a two-hour glucose tolerance test.
By themselves, they are not likely to dramatically improve control in people with Type 2 diabetes, particularly if they are not well controlled. However, it may be enough to tip the balance in some people. I am not yet ready to recommend it generally, despite a good safety profile.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
ARIES (March 21-April 19)
Friends include you in projects that combine pleasure with serious work. You have the opportunity to become more active in a worthwhile organization. Leisure pursuits will be stimulating mentally as well as physically. Tonight: Dance like there’s no one watching.
TAURUS (April 20-May 20)
Family members are growing and changing. Your residence might require remodeling, minor repairs or redecorating to make it more comfortable for everyone. Be patient with less than perfect family situations; problems will smooth over. Tonight: Add more fun to the moment.
GEMINI (May 21-June 20)
Your natural acting ability and charisma will be expressed in your conversations and emails today. Don’t adhere too closely to old habits and ideas. New information brings a different viewpoint to the fore. Business travel will be productive. Tonight: Catch up with long lost friends.
CANCER (June 21-July 22)
Your birth sign is shared with more bankers and millionaires than any other. There has been financial upheaval lately, however. Be flexible, and don’t invest in risky ventures today. Take advice with the proverbial grain of salt. Practice being patient. Tonight: Defer to a child.
LEO (July 23-Aug. 22)
Your natural effervescence shines. You are gratified as avenues for fulfillment of desires open. There is an overall brightness of outlook today. Your creativity is at a peak. Express the artist within. Tonight: Celebrate yourself as only you know how.
VIRGO (Aug. 23-Sept. 22)
It is best to work behind the scenes today and avoid any conflicts or confrontations, especially with women. Keep your deepest feelings secret. Unconscious attitudes can be difficult. You might be dealing with a matter from the past. Tonight: Read between the lines.
LIBRA (Sept. 23-Oct. 22)
Control your impulses today. Set aside romantic notions for the time being. Persevere and fulfill your obligations. You are building foundations for your creativity. Emphasize quality. Examine your overall goals. These goals should be an expression of who you are. Tonight: Rest easy.
SCORPIO (Oct. 23-Nov. 21)
Focus on creating the right impression. Combine professional expertise with the human touch, and your project is off to a wonderful beginning. Be aware of patterns at work, and keep a sense of humor about office gossip. Tonight: Show what you’re made of.
SAGITTARIUS (Nov. 22-Dec. 21)
You’re inspired to begin a new study. Through the day you feel motivated. The competitive spirit others recognize in you will be in full flower. You make every effort to be a winner and have an excellent chance of doing so. Tonight: Up late.
CAPRICORN (Dec. 22-Jan 19)
Fate takes a hand in the direction of your money situation. Friends offer financial opportunities. The path to realizing a long cherished financial goal opens today. Investments, settlements or possibly an inheritance is involved. Tonight: Get a good night’s sleep.
AQUARIUS (Jan. 20-Feb. 18)
Partners and associates are going through a catharsis. Don’t take it personally if a familiar group breaks up. Let others grow and change. Cultivate new social and business contacts. You will charm and attract others. Tonight: Dinner with your most loved ones.
PISCES (Feb. 19-March 20)
The impact of longtime health and eating habits become apparent today. It is an excellent time to draw down the lunar energy for healing. Reach fitness goals with patience and attention to detail. Tonight: A fateful meeting opens new doors.
For entertainment purposes only.