Can baking soda cause facial numbness?

Can Baking Soda Cause Facial Numbness?

Yes, baking soda (sodium bicarbonate) can cause facial numbness as a symptom of metabolic alkalosis, which may occur with excessive ingestion. 1, 2

Mechanism of Action

• Baking soda contains sodium bicarbonate, which when consumed in excessive amounts can lead to significant metabolic alkalosis 1
• Metabolic alkalosis can cause electrolyte imbalances, particularly affecting calcium and potassium levels, which can manifest as neuromuscular symptoms including facial numbness 2
• The change in pH from excessive sodium bicarbonate can alter nerve function, potentially leading to paresthesia (numbness and tingling) in facial areas 3

Clinical Presentation

• Facial numbness may be part of a constellation of neurological symptoms resulting from metabolic alkalosis 2
• Other associated symptoms that may accompany facial numbness include:
  • Tingling sensations in extremities 1
  • Muscle weakness or twitching 2
  • Confusion or altered mental status 4
  • In severe cases, seizures or tetany 3

Risk Factors

• Chronic use of baking soda as an antacid (most common reason for misuse at 60.4% of cases) 1
• Using excessive amounts to "beat" drug tests (11.5% of reported cases) 1
• Self-treatment of urinary tract infections (4.7% of cases) 1
• Higher risk in:
  • Elderly individuals 1
  • Pregnant women 1
  • Young children 4
  • Patients with underlying kidney disease 1

Diagnostic Considerations

• When facial numbness occurs after baking soda ingestion, clinicians should consider:
  • Obtaining electrolyte panels to assess for metabolic alkalosis 5
  • Checking arterial blood gases to evaluate pH status 5
  • Monitoring serum potassium levels, as hypokalemia often accompanies metabolic alkalosis 2
  • Evaluating for other neurological symptoms that may indicate progression to more serious complications 3

Management

• Discontinue baking soda ingestion immediately 5
• For severe metabolic alkalosis:
  • Administer IV fluids to restore intravascular volume 5
  • Correct electrolyte imbalances, particularly potassium (target >3.5 mEq/L) 5
  • Monitor cardiac rhythm during treatment, as electrolyte disturbances can cause arrhythmias 5
• For mild cases with isolated facial numbness:
  • Monitor for progression of symptoms 1
  • Ensure adequate hydration 2

Prevention

• Healthcare providers should counsel patients about the potential dangers of misusing baking soda as a home remedy 1
• Patients should be educated that baking soda is not appropriate for regular use as an antacid 2
• Those with recurrent indigestion should be directed to safer, FDA-approved antacid medications 1

Important Considerations

• Facial numbness may be the first sign of developing metabolic alkalosis and should not be ignored 3
• Self-treatment with baking soda can mask or delay proper medical care for underlying conditions 1
• In severe cases, baking soda misuse has been associated with hemorrhagic encephalopathy 3 and cardiopulmonary arrest 2