Rhiza Labs FluTracker Forum

I should also note, there was a study done on elderly that required mechanical ventilation (not due to a virus)
in that study it was indicated that keeping them in slight ACIDOSIS helped with O2 transfer.

Any physicians now following those recommendations which were
#1 for elderly
#2 for patients without a viral load

Could very well be killing their patients.

This virus WANTS you acidic. Think about it.
Its why it does what it does.
It needs to be able to replicate efficiently.
Its why you have those high mortality groups, its what they all have in common. It seems to be the tie that binds them.

I can go into the enzymatic details of why it has a preference for low Ph (acidic)
but ive tried to reserve that for a possible publication.

The Happy Scientist

Never said you couldn't (if you're responding to me, that is -- you didn't say). In fact, I definitely said you could when I wrote the following:
"BTW, I take care of quite a few patients each year who successfully changed their body's normal pH (which by the way is NORMALLY kept slightly alkaline at 7.35 to 7.45).... "

These were the exact types of patients I was referring to with the comment above.
Happy wrote:

A "more acidic environment" doesn't necessarily mean an "acidic" environment. A pH of 7.3, for instance, is "more acidic" than a pH of 7.4, but both are still alkaline environments, chemically speaking. Do you have any data on the pH range over which the influenza virus' enzymes are able to function or a graph of viral replication versus pH in vivo? I'm interested to see it if you've got the data. Just how steep is the change in viral load vs. pH? And what is the "optimal" pH for a flu virus?

Where it comes to pH in flu patients...it's one thing to advocate normalizing the pH of the blood and trying to prevent a significant acidosis and quite a different thing to suggest taking measures to make the body go beyond a normal pH range to become abnormally alkalotic. Most patients are slightly alkaline (from a chemical standpoint) even when their pH is considerably below the normal 7.35-7.45 range. The only patients I've seen reach a neutral (pH = 7.0) or truly acidic pH (below 7.0) we were CODING. To what degree and in what way would you suggest the pH be adjusted?

The study you're talking about probably refers to something called "permissive hypercapnia." I'll get to that in a sec. First, you need to consider more than the effect of pH in flu patients, Happy. Think about the other things going on for the patient. You mentioned one above when you said they can't breathe well. Remember these patients are often in ARDS, with incredibly stiff, non-compliant lungs that cannot effectively transfer oxygen to the blood. In addition to worrying about their pH and viral load, we have to worry about their oxygenation status. They are profoundly hypoxemic (very low blood oxygen levels). Because their lungs are already so damaged, they are prone to barotrauma (lung damage caused by positive pressure ventilation) and mechanotrauma (alveolar damage caused by repeatedly forcing collapsed alveoli open with each forced breath) if they are subjected to ventilator settings that might fully correct an acidosis. The last thing we want to do is damage their already severely-damaged lungs more trying to push their pH into alkalosis. I should note that many patients are put on high-frequency ventilators because of the incredible difficulty of adequately ventilating them without causing further injury to their lungs. Some are so bad that they cannot be effectively ventilated at all and must be placed on lung bypass (v-v ECMO), where a machine does all the gas exchange instead of the lungs.

Permissive hypercapnia refers to allowing the carbon dioxide in the blood to build up to higher levels than normal homeostatic levels, done by not adjusting the ventilator to settings required to blow off all the carbon dioxide being produced, because these settings would be directly harmful to the lungs if used. Carbon dioxide acts as an acid in the body, so the pH gradually shifts from a slightly higher alkaline pH (7.35-7.45) to a slightly lower alkaline state (7.25-ish). Notice here that the pH is STILL alkaline from a chemistry standpoint, but this less alkaline state is considered an "acidosis" because it is RELATIVELY more acidic than normal for the body.

It might well be true that an acidic environment is favorable to influenza viral replication. However, the slightly less alkaline environment than normal provided by permissive hypercapnia is favorable to providing adequate ventilation in ARDS -- to getting every bit of oxygen to the tissues we can in a profoundly hypoxemic patient who desperately needs that oxygen or they're going to die sooner rather than later or suffer severe hypoxia-induced organ damage -- and the less traumatic vent settings also help in preventing direct lung damage in a patient whose lungs are already on the brink. Toast the lungs, and viral load becomes a secondary issue. The lung damage itself will kill them. Furthermore, some research shows allowing permissive hypercapnia actually decreases free radical and toxin-induced tissue damage in the lungs and decreases damage to other organs (brain, liver, etc) due to disease-induced hypoxia. So, there are multiple reasons why this strategy might be implemented with H1N1 patients, especially those with ARDS. If permissive hypercapnia is used, the goal is to not let the patient's pH drop below 7.25. We are talking a slight decrease in pH from normal blood pH levels.

My questions back to you would be how much does a 0.1 drop in blood pH impact viral replication and viral load, and are the viral studies looking at intracellular or extracellular pH? I've never seen data presented on this. If you don't want to post any data on the board because of your forthcoming potential publication, would you consider PM'ing me if I offer my promise that I will not share or publish the info? You've got me intensely interested in this matter of pH in influenza patients.

I am not a very good writer.
I am not asking you to push them into alkalosis, but keep them "slightly alkaline"
and as you must know, human blood ideally when normal is THAT. "Slightly Alkaline".

As stated, too far either way and you will have issues. However, this virus, will over time create a more acidic environment for itself.

AND, in those that already were a bit acidic in the first place, it would stand to reason, could very well carry a bigger viral load as the virus was in a more "happy environment" for a longer period of time.
Think about it, what OTHER connection do you see between these most hard hit mortality groups? Ashthma, diabetics, smokers, late term pregnancy, folks that have metabolic issues that make is so they cant stay in the ideal state of "slightly alkaline".

You were correct, when you used the term "normalize".

Tell me, what measures do they take to monitor this PH when you do have patients with ARDS etc and who are on mechanical ventilation? How often are they testing, and how successful are they are "normalizing" the PH?

What I would really like to know, is what the PH is in the actual lung cells in both high risk patients as well as normal healthy adults PRIOR to infection.
Then do a direct comparison post infection.

Now that would be good information but nearly impossible to get. If I had animal models I would be able to demonstrate more. Right now its all based on theory and a pretty solid understanding basic enzymology (in which PH dictates "on off" for many processes) And many enzymes work in very narrow range of course.

Basically and simply put, the viral infection of the lungs will tend to put people in "acidosis".
And as a result I would not be surprised to see many "symptoms" of the virus be equal to those you would see from symptoms of "acidosis".

And I would bet money that many of these mortalities had very little done in which establishing "normal" slightly alkaline PH was successful.

From some of the papers I have read it could very well be doctors are trying to keep them in a slight state of acidosis to help o2 transfer like in that published study with uninfected elderly. And I think that would be exactly what would make this virus happy. So far as I have seen ECMO seems the best option for these folks going onto mechanical ventilation. Help them get the CO2 OUT. But at the same time, it would make sense to try to normalize their PH. Tell me what IV fluids are they usually using on these people in ICU?

But of course until someone opens their minds, and tries it on some ferrets etc its all speculation of course.
I only have 32 co-authored scientific publications at this time but they are certainly not in influenza. This is a crash course for me, so I really appreciate your input on everything:)
I am basically a biochemist and enzymologist, however I do work with pathogens. I have no way to do In-vivo here.

I know it sounds simple.
Almost TOO simple. But think about the hard hit mortality groups.

I would bet nearly all of them, were an ideal candidate for some form of even slight acidosis due to their condition before the virus infected them. They were a very Happy Home for the virus to do its thing. As opposed to a healthy person in a normal slightly alkaline state in which the virus could infect, but would not do as well......


The Happy Speculative Scientist

OH and as far as studies, I several you may be very interested in. INcluding some details on enzymes.
I doubt it will ever get published because it has nothing to do with a medication which can be sold. I was going to submit it to hypothesis, I have over 65 papers right now tying the hypothesis together.
Some do have detailed enzymology.

I will probably be until the weekend before I can send you some stuff though.

I would love to converse with you further on it:)
Just glad someone will think outside "the box" with me

Also remember, do not think in black and white.
In the eyes of the virus and the enzymes it requires for replication:
There is an "optimal Ph" in which everything works very very well:
There is an "acceptable Ph" in which things work, at a slower pace
There is a range where nothing will work, but in that range humans also not survive.
Think in ranges instead of absolutes.

Lynn wrote:


Per request, a pH thread moved back into the active topics for posting of commentary on pH balance and influenza. Here you go, Lynn!

Those ads expounding the benefits of "deacidifying" drive me crazy.

One company claims the alkaline products they offer "lowers the body's pH." I wonder if they dont understand the fundamental principles or they do it deliberately knowing the target consumer's understanding of those same principles.

I'm not trying to rehash anything here but this pH thread was started as some of the following information (which I've edited in view of the pH topic) somehow ended up on the Vitamin d thread. The info might be more relevant here. I've spliced a few of my main points.



BUT at what cost to human health?

The body does operate at very specific pH levels, just over 7 and slightly alkaline, and does have lot's of systems to help maintain this but to say that the abuse of these systems do not impact overall health is naive at best, downright dangerous at worst.

The compartmentalized mind sees one fact not impacting another, so just because blood plasma ph might seem unaffected by dietary choices, it does not mean we've not paid for that choice somewhere else in the body. For example, drinking soda (which has a ridiculously acidic PH of around 2.5 and rarely over 3.5), the body can and does work amazingly hard to buffer this onslaught. But in doing so, it prefers to leech calcium (highly alkaline) out of our bones to do it. The years and years of poor dietary choices DOES indeed eventually lead to the breakdown of these buffer systems. They can only work so hard for so long. Couple this with inadequate D levels to metabolize calcium and one can easily make the link to Osteoporosis. Overly acidic diets CAN and DOES in some people eventually weaken their bones. Overly anything is bad for that matter. Lost count of how many times I talk about balance and harmony with regards to the body. You can easily google lists of foods that are acid / alkaline to help keep your systems working under normal conditions. Is it not amazing that most fruits, vegetables etc (the food intended for our bodies to consume) are around pH neutral, compatible with those systems NOT working overtime and NOT having to delve into other areas to achieve homeostasis? (balance)

I've read quite a lot of research regarding all viruses, pathogens etc preferring acidic environments. I've read that they also prefer oxygen depleted environments at the cellular level. Fixing pH and oxygen exchange / amounts at the cellular level, to me at least, seems common sense and plausible enough to create an environment unfavorable to infection / disease or at least chronically so. The info is not too hard to find if one digs a little.

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