A health condition in which acids begin to build up in the body is called metabolic acidosis. It often occurs due to untreated diabetes, the loss of bicarbonate in the body, and certain kidney diseases. Those who develop it may experience fast heartbeats, confusion, and extreme tiredness (fatigue). Doctors often treat it with Sodium bicarbonate, IV (intravenous) fluids, and insulin.
In other words, metabolic acidosis occurs when you have too many acids in the blood that wipe out bicarbonate (high anion gap metabolic acidosis), or you lose too much bicarbonate due to a kidney disease or kidney failure (normal anion gap metabolic acidosis). Generally, bicarbonate is a base (a form of carbon dioxide, which is a waste product after the body converts food into energy).
In addition, an anion gap is the difference between the negative and positive electric charges in the electrolytes of the blood. Moreover, all metabolic processes in the body are regulated by ions (electrolytes), including bringing nutrients into the cells, taking waste products out of the cells, and others. Other types of electrolytes include Sodium, Calcium, Potassium, Chloride, and Phosphate.
What Happens to The Body If I Have Metabolic Acidosis?
In normal circumstances, the body must have a specific pH balance to work properly. Moreover, the pH scale is the level of acids and bases in the blood. This scale ranges from 0 (which is very acidic) to 14 (very basic or alkaline). A normal pH range in the blood is considered from 7.35 to 7.45.
Usually, the kidneys and lungs help maintain a normal pH level in the blood. For instance, the kidneys remove excess acids and bases from the blood through the urine, but the lungs are responsible for regulating the amount of carbon dioxide in the blood. Thus, people often develop metabolic acidosis when the body produces too much acid or the kidneys or lungs do not work properly.
Symptoms
Commonly, people with metabolic acidosis experience the following symptoms. Examples include:
- Tachycardia (fast heart rate)
- Fatigue (extreme tiredness)
- Confusion
- Dizziness
- Appetite changes
- Headaches
- Fast breathing
- Weakness
If any of the previous symptoms occur without an obvious reason, immediately contact your healthcare professional. Otherwise, it may lead to serious and even life-threatening complications.
Causes and Risk Factors
While the most common causes of metabolic acidosis are untreated diarrhea and kidney failure, it may also occur due to the following causes. For example:
- Diabetes-related acidosis – In such cases, metabolic acidosis occurs when ketone bodies build up in the body from an untreated diabetes. In normal circumstances, the body produces ketone bodies while it turns fats into energy. Commonly, the body uses ketone bodies for energy when you have reduced glucose levels in the blood.
- Hyperchloremic acidosis – Sometimes, people may also develop metabolic acidosis when the body loses too much Sodium bicarbonate. Often it occurs in people with severe diarrhea or who administer too many laxatives.
- Lactic acidosis – This form of the condition occurs when you have increased lactic acid in the body. It is an organic acid produced by the muscle cells and red blood cells for energy. This process occurs when a person has reduced oxygen levels in the blood. Possible causes include hypoglycemia (low blood sugar), alcohol use disorder, cancer, intense exercise, liver failure, and others.
- Renal tubular acidosis – If your kidneys do not work properly, it often leads to renal tubular acidosis.
Furthermore, physicians have identified some factors that may elevate your risk of developing metabolic acidosis. Check some of them below:
- Kidney disease (including chronic kidney disease)
- Toxic ingestions (such as ethylene glycol, methanol, or excessive Aspirin)
- Lifestyle factors, including eating too many saturated fats, obesity (excessive body weight), smoking, and others.
- Severe dehydration
- Malnutrition
- Liver failure
- Hyperkalemia (increased Potassium levels in the blood)
- Albuminuria (excessive protein in the urine)
- Anemia (low red blood cell count)
What Are The Long-term Effects of Metabolic Acidosis?
People with this condition may experience serious complications, especially if they leave it untreated. Check some examples below:
- Chronic kidney disease (CKD)
- Osteoporosis (brittle bones) and an increased risk of fractures
- Hypotension (low blood pressure)
- Heart failure
- Arrhythmia (irregular heart rhythm)
- Delayed growth in children
- Muscle wasting
- Chronic (long-term) inflammation
- Coma and even death (in more severe cases)
Consult with your healthcare professional about measures to reduce the risk or even prevent the previous complications.
How to Prevent Metabolic Acidosis?
Physicians often recommend the following tips to reduce the risk of developing this disease. For example:
- Manage chronic health conditions (including diabetes, high cholesterol, hypertension, and others)
- Drinking plenty of fluids
- Limit or avoid alcoholic beverages
- Quit smoking – If you face problems with smoking cessation, discuss it with your healthcare professional.
- Physical exercise – You should aim for 30 minutes of physical exercise per day, at least 5 days a week, to get or maintain a healthy weight.
Diagnosis
Like many other health conditions, the diagnosis of metabolic acidosis starts with a physical examination to check for abnormalities linked to the disease. Doctors may also ask some questions about the symptoms and medical history to get more information about your disease. They may also perform some tests to confirm or exclude metabolic acidosis. Check some examples below:
Blood Tests
Doctors often perform blood tests to get important information about chemicals in the blood. They often include:
- Anion gap – During this test, doctors will use a small needle to get a sample of blood from a vein in the arm for testing. Thus, they will compare the difference between the negative and positive electrolytes in the blood. If there is a large gap between these electrolytes, it may indicate metabolic acidosis.
- Arterial blood gas (ABG) – This test is used to measure the oxygen and carbon dioxide levels in the blood. ABG may also measure the blood’s pH balance. For instance, if test results show a blood pH below 7.35, it means you have too much acid or too little base in the blood.
Urine Tests
This test is also known as a urinalysis, and it is used to check the pH level in the urine.
Treatment
Doctors often recommend the following options for people who develop metabolic acidosis. These include:
- IV Sodium bicarbonate to balance the acids in the blood
- Sodium citrate for people with kidney disease or kidney failure
- Insulin to treat diabetes-related acidosis
- IV fluids
- Procedures to remove toxic substances from the blood. For example, Aspirin, methanol, or ethylene glycol.
Medicines
Sometimes, doctors may recommend some over-the-counter (OTC) medicines, such as Sodium citrate or Sodium bicarbonate, that will help balance the acids in the body. You may also get a prescription for Inotropes, which are used to improve the strength of the heart muscle, which helps get more oxygen in the blood. In any case, do not take any OTC medicines without your doctor’s approval because it may lead to unpleasant outcomes.
Dietary Changes
Doctors may recommend some dietary changes because there are some foods that can make your body produce more acids. Check below some foods that can cause the body to produce acids:
- Eggs
- Cheese
- Alcohol
- Grains
- Meats (such as poultry and fish)
However, there are some foods that may improve the production of alkali. For example:
- Nuts
- Legumes
- Vegetables
- Alkaline water
- Fruits and others
Frequently Asked Questions
When should I see my healthcare provider?
It is recommended to see a doctor if you experience symptoms that resemble metabolic acidosis.
Is metabolic acidosis contagious?
No, because this condition does not spread from one person to another.
What can I expect if I have metabolic acidosis?
In general, the prognosis for this condition varies among people because it depends on several factors. For example, the severity and cause of metabolic acidosis, age, gender, overall health, and your response to treatment. While in mild cases, people experience temporary symptoms that often do not need treatment, in more severe cases, metabolic acidosis may lead to coma and even death, especially if it is left untreated. If you have additional questions, ask your healthcare provider.
