Metabolic Acidosis: Causes, Symptoms, & Treatment

Balance is the key to everything. Likewise, our blood needs a proper balance of acidic and basic compounds to work properly. If too much acid builds up in the blood, it is called metabolic acidosis. Untreated metabolic acidosis can cause mild to serious health problems. Read further to know about metabolic acidosis causes, symptoms, complications and treatment.

Metabolic acidosis occurs when the body is making too much acid or the kidneys are unable to remove enough acid from the blood. There are many types of metabolic acidosis, and they are usually a side effect of chronic health conditions. 

What Are Metabolic Acidosis Causes?

Diabetic ketoacidosis: It is a serious complication of diabetes in which the body produces high amounts of blood acids called ketones. This condition occurs when the body doesn't have enough insulin. Without the hormone insulin, our body cannot use sugar properly for energy. So, our body breaks down fat as fuel, which leads to the build-up of acids.

Lactic acidosis: Overproduction or decreased metabolism of lactic acid leads to build up of lactic acid in the blood. It is a common cause of metabolic acidosis in hospitalized patients. Our body cells produce more lactic acid when there is not sufficient oxygen in the muscles to break down glucose and glycogen. 

Heart disorders, severe infections, cancer, and intense exercise can cause lactic acidosis. Liver failure, an overdose of medicines such as metformin or anti-retroviral, seizures, and shock can also cause lactic acidosis.

Hyperchloremic acidosis: It is a condition in which the bicarbonate, the base which neutralizes acids in the blood, becomes low. So, the acids build up excessively in the body. Severe diarrhea, chronic laxative use, kidney diseases and pancreatic problems can cause low bicarbonate levels.

Poor kidney function: kidneys keep the right balance of acids in the body by removing excess acids through urine. In people with kidney disorders, metabolic acidosis is common as their kidneys are not filtering the blood well enough. The acid levels in the blood become very high and disturb many bodily functions. It approximately affects 15% to 19% of chronic kidney disease patients.

Severe dehydration: Severe dehydration following diarrhea, vomiting, etc., can result in bicarbonate loss and excessive lactic acid production.

Chronic alcoholism: Alcohol consumption for extended periods can lead to alcoholic ketoacidosis and lactic acidosis. Alcohol also increases phosphate levels that can negatively influence the kidneys, and this makes the body’s pH more acidic. 

Toxic ingestions: Poisoning by aspirin, methanol, or ethylene glycol (found in antifreeze) can cause metabolic acidosis.

Other causes: Conditions such as asthma, obesity, pneumonia and injury to the chest can cause another type of acidosis known as respiratory acidosis. It develops when the body cannot get rid of enough carbon dioxide. The carbon dioxide builds up in the body and can raise blood acid levels.

What Are The Signs And Symptoms Of Metabolic Acidosis?

Most symptoms are caused by the underlying condition, which causes metabolic acidosis. Symptoms can differ from one person to another, and they may experience:

• Feeling tired
• Feeling weak
• Headache
• Long and deep breaths
• Loss of appetite
• Vomiting
• Fast heartbeat
• Confusion
• Nausea
• Breath which smells fruity (a sign of diabetic ketoacidosis)

Most often, metabolic acidosis causes rapid breathing. Severe acidosis can lead to shock or death.

How Is Metabolic Acidosis Treated?

1. Treating the underlying health condition which causes metabolic acidosis is the first step. For example, if you have diabetes, your health care provider will give you insulin to help the body stop making acids and remove excess acids. Metabolic acidosis caused by drugs or alcohol is treated with detoxification methods.

2. Sodium bicarbonate: Bicarbonate can neutralize acid in the body. Sodium bicarbonate can add more bicarbonate and helps keep the right balance of acids. It is usually used in metabolic acidosis caused by bicarbonate loss. 

This medication can increase sodium in the body. People with end-stage chronic kidney disease, high blood pressure, heart failure, heart diseases, or swelling need to limit sodium in their diet. 

Sodium bicarbonate can make health problems worse in these people. Sometimes, this medication can cause side effects such as belching, flatulence, stomach pain, nausea and vomiting.

3. Hemodialysis: Dialysis is used in people with kidney failure. It helps remove excess fluids, acids, and wastes in the blood. In hemodialysis, the blood is filtered in the machine connected outside to your body. The purified blood will enter the body via connected tubes. Hemodialysis is sometimes used for methanol, ethylene glycol, and salicylate poisoning. 

4. Diet: Foods such as cheese, egg, and meat can cause the body to produce acid, whereas vegetables and fruits produce alkali. A high intake of vegetables and fruits may help decrease the acid load in the body. Limit animal-based proteins. Ask your physician to recommend a dietitian who can formulate a specific nutritional plan for you.

Complications Of Metabolic Acidosis: 

Untreated metabolic acidosis can lead to health complications such as:

• Muscle loss- Metabolic acidosis can lower albumin (protein) levels in the body and cause muscle loss. Albumin helps build and keep muscles healthy.
• Bone loss, which can increase the chance of fractures in important bones like the backbone or hip bone
• Worsening of kidney diseases
• Slowed growth in children
• Endocrine disorders
• Inflammation (redness, pain, and swelling) 
• Buildup of amyloid, a protein in your body that can hurt your organs, and joints

The Bottom Note:

You can reduce the risk of metabolic acidosis by drinking plenty of water, avoiding alcohol consumption and including a more plant-based diet. You may also avoid metabolic acidosis by keeping control of your chronic health conditions such as diabetes.