Sometimes, our bodies behave abnormally and we are not sure of what is going on, we get worried and jittery. Imagine when your breathing peaks up suddenly, becomes confused, fatigued and have a headache and do not know what to do, especially after strenuous activity? It could be a case of acidosis. Let us see what exactly happens. Blood acidity increases when people ingest substances that contain or produce acid or when the lungs do not expel enough carbon dioxide. People with metabolic acidosis often have nausea, vomiting, and fatigue and may breathe faster and deeper than normal. People with respiratory acidosis often have headache and confusion, and breathing may appear shallow, slow, or both. Tests on blood samples typically show pH below the normal range.

If an increase in acid overwhelms the body’s acid-base control systems, the blood will become acidic. As blood pH drops (becomes more acidic), the parts of the brain that regulate breathing are stimulated to produce faster and deeper breathing (respiratory compensation). Breathing faster and deeper increases the amount of carbon dioxide exhaled. The kidneys also try to compensate by excreting more acid in the urine. However, both mechanisms can be overwhelmed if the body continues to produce too much acid, leading to severe acidosis and eventually heart problems and coma. The acidity or alkalinity of any solution, including blood, is indicated on the pH scale.

Blood pH

Acidity and alkalinity are expressed on the pH scale, which ranges from 0 (strongly acidic) to 14 (strongly basic or alkaline). A pH of 7.0, in the middle of this scale, is neutral.

Blood is normally slightly basic, with a normal pH range of 7.35 to 7.45. Usually the body maintains the pH of blood close to 7.40

 Causes of Acidosis

Acidosis is categorized depending on its primary cause as

  1. Metabolic
  2. Respiratory

Metabolic acidosis

Metabolic acidosis develops when the amount of acid in the body is increased through ingestion of a substance that is, or can be broken down (metabolized) to, an acid—such as wood alcohol (methanol), antifreeze (ethylene glycol), or large doses of aspirin (acetylsalicylic acid). Many other drugs and poisons can cause acidosis.

Metabolic acidosis can also occur as a result of abnormal metabolism. The body produces excess acid in the advanced stages of shock (lactic acidosis) and in poorly controlled type 1 diabetes mellitus (diabetic ketoacidosis).

Even the production of normal amounts of acid may lead to acidosis when the kidneys are not functioning normally (kidney failure) and are therefore not able to excrete sufficient amounts of acid in the urine.

Metabolic acidosis also develops when the body loses too much base. For example, bicarbonate can be lost through the digestive tract due to diarrhea or an ileostomy.

Respiratory acidosis

Respiratory acidosis develops when the lungs do not expel carbon dioxide adequately (inadequate ventilation), a problem that can occur in disorders that severely affect the lungs (such as chronic obstructive pulmonary disease, severe pneumonia, heart failure, and asthma).

Respiratory acidosis can also develop when disorders of the brain or of the nerves or muscles of the chest (such as Guillain-Barre syndrome or amyotrophic lateral sclerosis) impair breathing. In addition, people can develop respiratory acidosis when their breathing is slowed due to over sedation as a result of opioids (narcotics), alcohol, or strong drugs that induce sleep (sedatives). As a result of the slowed breathing, the level of oxygen in the blood may be low. Sleep-disordered breathing (for example, sleep apnea) can repeatedly pause breathing long enough to cause temporary respiratory acidosis.

What foods cause acidosis?

Generally, the foods that contribute most to the release of acids into the bloodstream are meats (beef, pork, or poultry), eggs, beans, and oilseeds, and the foods that contribute most to the release of bases are fruits and vegetables.

Symptoms of Acidosis

In mild metabolic acidosis, people may have no symptoms but usually experience

  • Nausea
  • Vomiting
  • Fatigue

Breathing becomes deeper and slightly faster (as the body tries to correct the acidosis by expelling more carbon dioxide). As the acidosis worsens, people begin to feel extremely weak and drowsy and may feel confused and increasingly nauseated. Eventually, in severe cases, heart problems may develop and blood pressure can fall, leading to shock, coma, and death.

In respiratory acidosis, the earliest symptoms are

  • Headache
  • Drowsiness

Drowsiness may progress to stupor and coma as the oxygen in the blood becomes inadequate. Stupor and coma can develop within moments if breathing stops or is severely impaired or over hours if breathing is less dramatically impaired. 

How to know if you have Acidosis

The diagnosis of acidosis generally requires the measurement of blood pH and carbon dioxide in a sample of arterial blood, usually taken from the radial artery in the wrist. Arterial blood is used because venous blood is generally not as reliable when measuring the body’s pH status.

To learn more about the cause of the acidosis, doctors also measure the levels of bicarbonate in the blood. Additional blood tests are then done to help determine the specific cause.

Who is at risk for lactic acidosis?

Risk factors for lactic acidosis include any disease state that has the potential to either increase the production or decrease the removal of lactic acid. Conditions that may increase risk include congestive heart failure, liver disease, shock, alcohol use, hypoxic states, renal failure, sepsis, and advanced age.

Can acidosis kill you?

If left untreated, metabolic acidosis can lead to a system-wide medical emergency called shock, which occurs when blood pressure falls too low to deliver adequate amounts of oxygen to the body’s tissues. In turn, untreated shock can lead to death.

Managing metabolic acidosis

  • Stay hydrated. Drink plenty of water and other fluids.
  • Keep control of your diabetes. If you manage your blood sugar levels well, you can avoid ketoacidosis.
  • Stop drinking alcohol. Chronic drinking can increase the buildup of lactic acid.

Now you know if you have acidosis, and what to do in case you find yourself with too much acid in your blood.

 As always, stay well and healthy.

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