Metabolic Acidosis

What is Metabolic Acidosis

Metabolic acidosis is a condition in which there is too much acid in the blood. It happens when certain chemicals in the body’s cells are too high or too low.

This condition can happen at any age, and there are many different causes. It may be a symptom of a sudden, short-term (acute) condition, or the result of a long-term (chronic) condition.

Metabolic acidosis can be mild or it can be severe and life-threatening, depending on the cause. It can be reversed if the cause is identified and properly treated. This condition is a medical emergency.

What are the causes?

This condition may be caused by:

  • The body producing too much acid.
  • Losing too much of a chemical that balances acid levels (bicarbonate). This can result from diarrhea or from certain surgeries on the stomach and intestines.
  • Extra buildup of acidic chemicals (ketone bodies) in the blood due to untreated type 1 diabetes.
  • Extra buildup of a chemical (lactic acid) that forms when the body is low on oxygen. This can result from:
    • The heart, lungs, liver, kidneys, or brain not getting enough blood, oxygen, and nutrients (shock).
    • Intense physical activity.
    • Certain diseases.
    • Serious infections.
  • Exposure to a poisonous substance (toxin), such as:
    • Carbon monoxide.
    • Cyanide.
    • Antifreeze (ethylene glycol).
    • Methanol.
  • Certain medicines, such as acetazolamide or large doses of aspirin.
  • Kidney disease or kidney infection.
  • Too much iron in the body.
  • Excessive alcohol use.
  • Conditions that cause you to have a low level of red blood cells (anemia).

What are the signs or symptoms?

Symptoms of this condition vary depending on the cause and severity. Common symptoms include:

  • Rapid breathing.
  • Difficulty breathing.
  • Nausea or vomiting.
  • Headache.
  • Confusion.
  • Weakness.
  • Feeling restless.
  • Feeling drowsy and emotionless (lethargy).

Mild acidosis may not cause any symptoms. Severe acidosis can result in shock, coma, or death.

How is this diagnosed?

This condition may be diagnosed based on:

  • A physical exam.
  • Your medical history.
  • Blood tests. These may include:
    • An arterial blood gas (ABG) test or a venous blood gas (VBG) test. These tests measure the acidity levels (pH balance) of your blood.
    • A serum electrolytes test. This test measures the amounts of minerals in your blood.
  • Urine tests.

How is this treated?

Treatment for metabolic acidosis depends on the underlying condition and the severity of symptoms. The goal of treatment is to balance the amount of acid in the body and to treat the underlying cause.

Mild metabolic acidosis may be treated with:

  • Fluids given through an IV.
  • Medicines.
  • Close monitoring with blood tests.

Severe forms of metabolic acidosis may require:

  • Hospitalization and close monitoring with blood tests.
  • Medicines or procedures.
  • Bicarbonates. These may be given through an IV if your condition is very severe.

Follow these instructions at home:

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
  • Drink enough fluid to keep your urine pale yellow.
  • Do not drink alcohol.
  • Follow instructions from your health care provider about eating or drinking restrictions.
  • If you have diabetes, check your urine for ketones when you are ill and as told by your health care provider.
  • Pay attention to your symptoms for any changes.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you have:

  • Any new symptoms.
  • Side effects from medicines you are taking.
  • Nausea, vomiting, or diarrhea that does not get better with medicine or that gets worse.
  • Body aches or lethargy that gets worse.
  • Dark urine or you urinate less often than you usually do.
  • A decreased appetite.
  • A fever.

Get help right away if you:

  • Have shortness of breath, chest pain, or a fast heartbeat (palpitations).
  • Feel like you are losing consciousness, or you faint.
  • Feel drowsy or confused.
  • Have severe pain in your joints and limbs.
  • Have severe abdominal pain.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

  • Metabolic acidosis is a condition in which there is too much acid in the blood. It happens because of a chemical imbalance in your cells in the body.
  • Metabolic acidosis can be mild or it can be severe and life-threatening, depending on the cause. Metabolic acidosis can be corrected if the cause is identified and properly treated.
  • If you are at risk for this condition, be aware of symptoms of metabolic acidosis.
  • Metabolic acidosis is a medical emergency.
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