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Acidosis & Alkalosis

Acidosis and alkalosis are two conditions that are categorized as either "metabolic" or "respiratory" depending on their cause.  Neither are considered diseases, as they are more the result of a wide variety of disorders.  

Metabolic acidosis & alkalosis
Caused by an imbalance in the production of acids or alkalis and the ability of the kidneys to excrete them.  

Respiratory acidosis & alkalosis
Caused primarily by changes in the carbon dioxide we exhale, due to lung or breathing disorders.

Acidosis (the blood has too much acid)

This condition is the result of excessive blood acidity caused by:

  • Too much acid in the blood.
  • A build-up of carbon dioxide from poor lung function.
  • Slow breathing.

If too much acid overwhelms the body's ability to neutralize it, the blood will become acidic.  The brain then causes us to breathe faster and deeper to increase the carbon dioxide we exhale (which is mildly acidic).  The kidneys also excrete more acid in the urine.  But if the body simply produces too much acid, it can become overwhelmed leading to severe acidosis.

Even normal amounts of acid can lead to acidosis if it is the consequence of abnormal metabolism.  Acidosis can also be due to the kidneys not functioning properly and being unable to excrete sufficient quantities of acid in the urine.  Mild acidosis has no clear symptoms, but it can cause nausea, vomiting, and fatigue.  Severe acidosis can progress into shock, coma, and death.

The diagnosis of acidosis generally requires the measurement of blood pH in a sample of arterial blood, usually taken from the radial artery (in the wrist).  To learn about the cause of acidosis, doctors also measure the levels of carbon dioxide and bicarbonate in the blood.  Additional blood tests may be done to help determine the cause.

Respiratory Acidosis 

This is a condition that occurs when the lungs do not expel enough carbon dioxide (such as with pneumonia, emphysema, chronic bronchitis, pulmonary edema, and asthma).  It can also develop when diseases of the brain or nerves impair our breathing, or when breathing is slowed down due to drugs or sedatives.  Symptoms can include headaches and drowsiness, which can develop into stupor and even coma.

Chronic Low-Grade Acidosis

Chronic low-grade acidosis is the result of the body experiencing chronic stress over a period of time, or the result of eating a primarily acidic diet (the standard American diet), which takes its toll over the long term.  The symptoms are not obvious, and the effects compound over time as the tissues of the body degrade and become more acidic.  

As the body degrades, we set the stage for serious health conditions such as cancer and autoimmune conditions.

chronic stress leaf acidic diet

Alkalosis (the blood has too much alkali)

This condition is excessive blood alkalinity caused when the body gains too much alkali, or loses too much acid from the blood.  This is caused by:

  • Stomach acid can be lost during prolonged vomiting, or if someone has taken in too much bicarbonate or alkaline substances.  
  • It can also develop when too much sodium or potassium is lost, affecting the kidney's ability to control the acid/alkaline balance.  
  • Rapid breathing can also cause a low level of carbon dioxide in the blood.  

Similar to mild acidosis, mild alkalosis has no clear symptoms.  It may cause irritability, and can cause muscle twitching/cramps/spasms. 

Doctors usually treat metabolic alkalosis by replacing water and electrolytes (sodium and potassium) while treating the cause.  Occasionally, when metabolic alkalosis is very severe, diluted acid is given intravenously.

Respiratory Alkalosis 

This is a condition that develops when we hyperventilate, causes too much carbon dioxide to be released from the blood.  This is why breathing into a paper bag can helps because carbon dioxide is breathed back in after breathing it out.  Anxiety is a contributing cause of respiratory alkalosis, as is pain, fever, or large doses of aspirin.  The only treatment needed is to slow down the rate of breathing.  If pain is the cause, relieving the pain can also relieve the alkalosis. 



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