Hemorrhagic Encephalopathy From Acute Baking Soda Ingestion

Adrienne Hughes, MD; Alisha Brown, MD; Matthew Valento, MD


Western J Emerg Med. 2016;17(5):619-622. 

In This Article

Abstract and Introduction


Baking soda is a readily available household product composed of sodium bicarbonate. It can be used as a home remedy to treat dyspepsia. If used in excessive amounts, baking soda has the potential to cause a variety of serious metabolic abnormalities. We believe this is the first reported case of hemorrhagic encephalopathy induced by baking soda ingestion. Healthcare providers should be aware of the dangers of baking soda misuse and the associated adverse effects.


Baking soda is marketed to consumers for numerous household and personal purposes. Its active ingredient is sodium bicarbonate. Despite the widespread use of proton pump inhibitors and H2 blockers, baking soda continues to be used as an antacid for relief of indigestion. The recommended dosage for using baking soda as an antacid is ½ teaspoon in 4–8oz of water every two hours. Each teaspoon of baking soda contains 41.8mEq of sodium.[1] Sodium bicarbonate is generally safe when used appropriately. However, if misused, it has the potential for significant toxicity. Metabolic alkalosis, hypernatremia, hypokalemia, hypochloremia, and hypoxia have been reported.[2] Severe hypernatremia can cause neuronal cell shrinkage, retraction of cerebral tissue, and potentially intracranial hemorrhage. We present a case of severe metabolic alkalosis and hypernatremic hemorrhagic encephalopathy after an acute intentional baking soda ingestion.