What is CO₂?
CO₂ helps regulate how easily oxygen is released from red blood cells into your tissues. Low levels of CO₂ can leave you feeling breathless, lightheaded, and anxious, while elevated levels can cause shortness of breath, headaches, and fatigue.
As a vital signaling molecule, CO₂ supports your metabolic health, manages blood flow, and balances the body’s acid-base levels.
Why Does CO2 Matter?
CO₂ is important for:
- Balancing pH levels
- Supporting oxygen delivery to your tissues and brain by regulating the environment that allows red blood cells to release oxygen
- Transporting cellular waste to the lungs to be exhaled
- Regulating heart and muscle contraction by stabilizing electrical signals
- Reducing exercise fatigue by buffering acid buildup during intense exercise
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How to Interpret CO₂
(Ranges may vary slightly by lab)
Standard reference ranges represent the middle 95% of healthy individuals but don’t necessarily reflect levels associated with longevity. Optimal ranges are derived from clinical guidelines, peer-reviewed research, and real-world outcomes data, with an emphasis on levels associated with peak functioning and reduced disease risk.
Benefits of Optimizing CO₂
- Better oxygen delivery to tissues
- Reduced stress and anxiety
- Improved athletic performance1
- Improved blood flow and circulation
- Faster healing and repair2
- Reduced inflammation3
- Supports efficient cellular energy production
- Support neurologic stability
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Low CO₂ Levels (Hypocarbia/Hypocapnia)
Symptoms:
- Mouth breathing
- Shallow chest breathing
- Anxiety
- Waking up at night
- Dizziness
- Feeling breathless during light activity
- Cold hands and feet
- Brain fog
Causes:
- Hyperventilation
- Altitude sickness
- Metabolic acidosis (often the result of kidney disease, severe diarrhea, or diabetic ketoacidosis)
- Aspirin toxicity
- Adrenal gland disorder (Addison’s disease)
- Liver disease
- Severe infection
- Chronic pain or fatigue conditions (e.g., fibromyalgia)
Healthspan Impacts:
High CO₂ Levels (Hypercarbia/Hypercapnia)
Symptoms:
- Headaches
- Persistent tiredness
- Disorientation
- Fatigue
- Dizziness or confusion
- Shortness of breath
Causes:
- Sleep apnea
- Chronic obstructive pulmonary disease (COPD)
- Hypothyroidism
- Conditions of the spinal cord, nerves, or muscles (e.g., ALS; multiple sclerosis)
- Vascular disease
- Tetanus or botulism poisoning
- Pulmonary embolism
Healthspan Impacts:
How Hone Treats Out of Range CO₂
Your Hone physician will evaluate your CO₂ levels from a blood test along with electrolytes, kidney markers (BUN and creatinine), and blood pH patterns to determine the root cause of your symptoms. They’ll use this information alongside your symptoms to create a treatment plan
- IV fluids* – to address severe dehydration
- Sodium Bicarbonate* – for clinical cases of chronic acidity
- Bronchodilators* – to open airways
- Steroids* – to reduce airway inflammation
- Oxygen therapy* – to balance blood gases
- Antibiotics (tetracyclines)* – to lower bicarbonate levels
*Your Hone Physician does not prescribe these treatments but will recommend further evaluation and help coordinate care with your primary care provider when medical treatment is indicated.
- Electrolytes
- Sodium bicarbonate
- Beta-alanine (acts as a pH buffer during exercise-induced acidosis)8
- Practice nasal breathing, which helps maintain more optimal CO₂ levels9
- Be mindful of your breath, reducing the volume and rate of your breathing10
- Gentle breath holds to train the brain to be more tolerant of higher CO₂ levels11
- Quit smoking
- Get regular aerobic exercise
- Increase fruit and vegetable intake to maintain acid-base balance12
Ueha, T., et al. (2018). Increase in carbon dioxide accelerates the performance of endurance exercise in rats. J Physiol Sci.
↑Prazeres, J., Lima, A., & Ribeiro, G. (2025). Effects of Carbon Dioxide Therapy on Skin Wound Healing. Biomedicines.
↑Rivers, R. J., & Meininger, C. J. (2023). The Tissue Response to Hypoxia: How Therapeutic Carbon Dioxide Moves the Response toward Homeostasis and Away from Instability. International Journal of Molecular Sciences.
↑Deng, Ru-Ming et al. (2020). The role of carbon dioxide in acute brain injury. Medical Gas Research.
↑Hu, D., et al. (2021). Decreased CO2 Levels as Indicators of Possible Mechanical Ventilation-Induced Hyperventilation in COVID-19 Patients: A Retrospective Analysis. Frontiers in Public Health.
↑Wilson, M.W., et al. (2021). Mortality and Healthcare Use of Patients with Compensated Hypercapnia. Annals of the American Thoracic Society.
↑Drechsler M & Morris J. (2023) Carbon Dioxide Narcosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
↑Baguet A, et al. (2010). Beta-alanine supplementation reduces acidosis but not oxygen uptake response during high-intensity cycling exercise. Eur J Appl Physiol.
↑Recinto, C., et al. (2017). Effects of Nasal or Oral Breathing on Anaerobic Power Output and Metabolic Responses. International Journal of Exercise Science.
↑Bentley, T., et al. (2023). Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature. Brain Sciences.
↑Trembach, N., & Zabolotskikh, I. (2017). The Influence of Age on Interaction between Breath-Holding Test and Single-Breath Carbon Dioxide Test. BioMed Research International.
↑Goraya N., et al. (2012) Dietary acid reduction with fruits and vegetables or bicarbonate attenuates kidney injury in patients with a moderately reduced glomerular filtration rate due to hypertensive nephropathy. Kidney Int.
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Reviewed for Accuracy by Our Medical Review Board
This biomarker information has been reviewed by a member of Hone’s medical review board. As part of the medical review team, physicians fact-check this content against the latest research and their own experience treating their patients.
Ashley Winter, M.D., is a board-certified urogynecologist trained at Weill Cornell and Cleveland Clinic. She specializes in female and male sexual dysfunction, urinary issues, genital pain, and hormone therapy.
James Staheli, D.O., is the Medical Director for Broad Health, Hone Health’s affiliated medical practice and a family medicine doctor in Atlanta, Georgia.
