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Your blood needs the right balance of acidic and basic (alkaline) compounds to function properly. This is called the acid-base balance. Your kidneys and lungs work to maintain the acid-base balance. Even slight variations from the normal range can have significant effects on your vital organs.
Acid and alkaline levels are measured on a pH scale. An increase in acidity causes pH levels to fall. An increase in alkaline causes pH levels to rise.
Respiratory acidosis and alkalosis are due to a problem with the lungs. Metabolic acidosis and alkalosis are due to a problem with the kidneys.
Each of these conditions is caused by an underlying disease or disorder. Treatment depends on the cause.
When you breathe, your lungs remove excess carbon dioxide from your body. When they cannot do so, your blood and other fluids become too acidic.
Symptoms may include fatigue, shortness of breath, and confusion.
There are several different causes of respiratory acidosis including:
There are no noticeable symptoms of chronic respiratory acidosis. This is due to the fact that your blood slowly becomes acidic and your kidneys adjust to compensate, returning your blood to a normal pH balance.
Acute respiratory acidosis comes on suddenly, leaving the kidneys no time to adjust. Those with chronic respiratory acidosis may experience acute respiratory acidosis due to another illness that causes the condition to worsen.
A complete physical examination is necessary. Diagnostic testing may include:
A doctor should be seen immediately to treat acute respiratory acidosis, as this can be a life threatening condition. Treatment is targeted to the cause.
Bronchodilator medications may be given to correct some forms of airway obstruction. If your blood oxygen level is too low, you may require oxygen. Noninvasive positive pressure ventilation or a breathing machine may be necessary.
To treat chronic respiratory acidosis, the underlying cause needs to be determined in order for proper treatment to take place. The cause could be from an organ deformity, an infection, or some type of inflammation. Each cause may require a different treatment ranging from antibiotics to a breathing machine.
In either case, if you smoke, you will be advised to stop.
Respiratory acidosis is serious and requires immediate medical attention. Potential complications of untreated respiratory acidosis include respiratory failure, organ failure, and shock.
You can take steps to help prevent some of the conditions that lead to respiratory acidosis. Maintain a healthy weight. Take sedatives only under strict doctor supervision and never combine them with alcohol. Do not smoke.
Metabolic acidosis occurs either when your body produces too much acid, or when your kidneys are unable to remove it properly.
Symptoms can include rapid breathing, fatigue, and confusion.
There are three main types of metabolic acidosis. Diabetic acidosis, or diabetic ketoacidosis, is a buildup of ketone bodies. This is usually due to uncontrolled type 1 diabetes. Hyperchloremic acidosis is when your body loses too much sodium bicarbonate, often after severe diarrhea.
Lactic acidosis is when too much lactic acid builds up. This can be due to:
Diagnostic testing may include serum electrolytes, urine pH, and arterial blood gases. Once acidosis is confirmed, other tests may be necessary to pinpoint the cause.
The underlying condition behind the acidosis must be treated. In some cases, sodium bicarbonate is prescribed to return the blood to a normal pH.
Severe cases can lead to shock and can be life threatening.
Alkalosis is when alkaline levels are too high due to decreased carbon dioxide or increased bicarbonate. There are five kinds of alkalosis.
Symptoms of alkalosis may include:
Respiratory alkalosis is when your blood has low levels of carbon dioxide. This can be caused by a number of factors, including:
When you have alkalosis your carbon dioxide levels are low. This causes your body to release more bicarbonate to return your blood pH level back to normal. This is called compensated alkalosis. Your blood pH levels will test normal, however your kidneys are releasing more bicarbonate, compensating for the lower levels of carbon dioxide.
When your blood has too much bicarbonate, it is called metabolic alkalosis. This can happen from prolonged vomiting. Prolonged vomiting can also make you lose too much chloride. This is called hypochloremic alkalosis. Some diuretic medicines can cause you to lose too much potassium. This is called hypokalemic alkalosis.
Along with a physical exam, diagnostic testing for alkalosis may include a metabolic panel, blood gas analysis, urinalysis, and urine pH.
Some medications (such as chloride and potassium) can help correct chemical losses. Further treatment will depend on the cause. Your physician will need to monitor your vital signs and create a proper plan to correct your pH imbalance.
In severe cases, alkalosis can lead to heart arrhythmias or coma.
Alkalosis and acidosis can become very serious if they go untreated. Make an appointment with your doctor if you think you have developed symptoms of either condition.
Written by: Ann Pietrangelo
Medically reviewed on: Nov 02, 2016: Debra Sullivan, PhD, MSN, CNE, COI
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