What Causes Acidosis?

Acidosis is a buildup of acid in the body. Your body maintains levels of acidity for overall health. Acid levels that are too high can lead to serious health issues. This article discusses the cause of acidosis. It also talks about treatment, complications, and the prevention of the condition.

Acidosis is the buildup of acid or a loss of bicarbonate in your body. There are many possible causes of high levels of acid.

Metabolic acidosis occurs when your body generates excess acid, causing it to buildup in your blood. This is due to your kidneys being unable to remove an adequate amount of acid from your body. It is also often due to excess production of acid by the tissues. Certain conditions cause this to happen, including:

• increased acid production
• increased acid ingestion
• decreased acid excretion
• gastrointestinal or renal bicarbonate loss

Learn more about metabolic acidosis.

Respiratory acidosis usually occurs when there is an accumulation of carbon dioxide (CO₂) in your body. This is often due to a decrease in your respiratory rate or volume. Common causes of this include:

• chronic obstructive pulmonary disease (COPD)
• use of opioids
• myasthenia gravis
• muscular dystrophy
• Guillain-Barré syndrome
• obesity hypoventilation syndrome or Pickwickian syndrome
• pneumonia

Learn more about respiratory acidosis.

Renal tubular acidosis (RTA) results when your kidneys do not remove acids from the blood into the urine.

Causes of RTA include:

• genetics
• sickle cell anemia
• Ehlers-Danlos syndrome
• Sjögren’s disease
• lupus
• certain medications
• Addison’s disease
• Fanconi syndrome
• lead poisoning
• diabetic kidney disease
• HIV or AIDS
• congenital adrenal insufficiency

Learn more about renal tubular acidosis.

Lactic acidosis occurs due to an overproduction of lactate, decreased metabolism of lactate, or both. Lactate is a byproduct of glucose and amino acid metabolism.

Causes of lactic acidosis include:

• impaired oxygen delivery to tissues
• hypovolemic, cardiogenic, or septic shock
• certain systemic and congenital conditions
• ingesting certain medications or toxins

Medications or toxins that can cause lactic acidosis include:

• alcohol
• acetaminophen
• metformin
• cocaine
• highly active antiretroviral therapy (HAART)
• beta-adrenergic agonists
• cyanogen
• halothane
• propofol
• certain tuberculosis medications
• aspirin or other types of salicylates
• certain medications to treat ulcerative colitis

Learn more about lactic acidosis.

Ketoacidosis occurs when there is a high serum and urine concentration of ketone bodies. Ketones are chemicals that help your body break down fat to use for energy. The most common types of ketoacidosis are diabetic ketoacidosis (DKA), alcoholic ketoacidosis (AKA), and starvation acidosis.

Causes of ketoacidosis include:

• uncontrolled diabetes
• chronic misuse of alcohol
• prolonged fasting hypoglycemia

Symptoms of acidosis depend on the type of acidosis you are experiencing and the underlying cause. If you experience any symptoms of acidosis, contact your doctor.

Not everyone with metabolic acidosis experiences symptoms. Those who do have symptoms may experience the following:

• feeling the need to take long, deep breaths
• having a fast heartbeat
• having headaches or confusion
• feeling weak
• feeling extremely tired
• feeling sick or vomiting
• having a loss of appetite

The symptoms of respiratory acidosis vary depending on the severity and progression of the condition. Symptoms may include:

• difficult or labored breathing
• anxiety
• sleep disturbances
• wheezing
• cyanosis or bluish discoloration of the skin due to inadequate oxygen
• altered mental state
• seizures

The major signs of RTA are changes in potassium and bicarbonate levels in your blood. Other symptoms vary based on the type of RTA and may include:

• extreme weakness
• irregular heartbeat
• paralysis
• abdominal pain
• fatigue
• loss of appetite
• unexpected changes in weight

If left untreated, RTA is serious and can be fatal.

The onset of symptoms of lactic acidosis can either come on rapidly or progressively over a few days. Symptoms include:

• signs of shock, including:
  • difficulty breathing or shallow breathing
  • cold, clammy, or pale skin
  • rapid heartbeat or irregular heartbeat
  • dizziness or light-headedness
• signs of toxin ingestion, including:
  • being sick or having stomach pain
  • fever or chills
  • headache or dizziness
  • difficulty breathing
• confusion or slurred speech

Symptoms of ketoacidosis vary based on the underlying cause. These symptoms include:

• frequent urination
• excessive thirst
• weakness
• dehydration
• lethargy
• stomach pains
• vomiting

Treatment for acidosis depends on the underlying cause and the type of acidosis you are experiencing.

Treatment for metabolic acidosis typically includes bicarbonate and increasing your intake of fruits and vegetables.

Treatment for respiratory acidosis includes pharmacological therapy to increase ventilation. Your doctor may also use bronchodilators to help treat obstructive airway conditions. If the respiratory acidosis results from an overdose of opioids, they may use naloxone as a treatment. Severe cases may require endotracheal intubation or mechanical ventilation.

People with RTA typically receive alkaline therapy as a bicarbonate or sodium citrate drink to lower acid levels in the blood. Medications to lower potassium levels may also be required.

Treatment for lactic acidosis includes treating the underlying cause and may include IV fluids.

Treatment for ketoacidosis also includes treating the underlying cause. For DKA, this involves treating hypoglycemia due to low blood sugar levels. For AKA, this can include IV saline or glucose.

Acidosis is a serious medical condition that is often life threatening when severe or untreated.

Complications of metabolic acidosis include:

• osteoporosis
• progression of kidney disease
• loss of muscle
• endocrine disorders

Complications for RTA include:

• progressive kidney or bone disease
• kidney stones
• rickets
• irregular heartbeat
• cardiac arrest

Because many RTA causes are inherited, you usually cannot prevent it.

Dietary changes may help to keep your acid levels at typical levels and decrease your risk of metabolic acidosis. Changes include eating more plant-based proteins and increasing your intake of fruits and vegetables.

To prevent either lactic acidosis or ketoacidosis, seeking treatment for the conditions that may cause these can help prevent them.

Acidosis is a buildup of acid in your body. Your body typically maintains certain levels of acid to maintain your overall health. However, levels too high can lead to serious health conditions.

Various conditions and medications can cause acidosis. Treatment often depends on the underlying cause of the acidosis. Common treatments include bicarbonate, pharmacological therapy, and changes in diet.

If left untreated, acidosis can lead to serious complications and even become fatal. If you experience any symptoms of acidosis, such as difficulty breathing, changes in appetite, and fatigue, contact your doctor right away.