Mar 26, 2015

Symptoms, Causes and Treatment of Metabolic Acidosis

Metabolic acidosis refers to the condition where the acid-base balance of the body is disrupted due to an increased production of acid or the reduced excretion and decreased production of bicarbonates. The condition can ultimately lead to acidemia or acidity of blood, where arterial pH falls below 7.35. If this condition is left untreated, it can affect the central nervous system and lead to coma and even death.


Metabolic acidosis is caused by an increase in the level of acids due to increased acid production or ingestion of acids or substances that can be converted into acids. It can also be caused by:
  • Loss of bicarbonates as in the case of diarrhea and renal tubular acidosis.
  • Ingestion of substances like large amounts of antifreeze, aspirin, etc. can also increase the level of acid within our body.
  • Accumulation of lactic acid is another contributory factor. It usually takes place due to insufficient availability of oxygen in carbohydrate metabolism, as in the cases of heart failure and shock.
  • Malaria can also be responsible for this condition by destroying the red blood cells and thereby reducing the level of oxygen in the body. This in turn results in the accumulation of lactic acid due to anaerobic breakdown of glucose or carbohydrates. This type of acidosis is known as lactic acidosis.
  • Metabolic abnormalities can lead to acidosis. Use of fat instead of carbohydrates, for deriving energy, as in the case of diabetes mellitus, can lead to an excessive production of acids. Breakdown of fats produces ketones and raises the level of acids in the body. This condition is termed as diabetic ketoacidosis.
  • Sometimes, such a pH imbalance can occur even without the excessive production of acids. For instance, in case of people suffering from kidney failure, kidneys may fail to excrete acids through urine.
  • Conditions like alcoholism and malnutrition are also associated with this condition.

Though metabolic acidosis is usually characterized by rapid breathing, the symptoms may not be specific, and could vary depending on the underlying cause. However, some of the common symptoms are:
  • Chest pain, headaches, palpitations, muscle and bone pain, muscle weakness, abdominal pain, etc.
  • Lactic acidosis is sometimes characterized by low blood pressure and anemia.
  • In diabetic ketoacidosis, patients may suffer from elevated blood sugar level and dehydration. As this condition can affect the central nervous system, individuals may experience anxiety and progressive drowsiness. Nausea, vomiting, loss of appetite, and weight loss are some other symptoms.
  • In extreme conditions, it can cause severe complications like stupor, coma, and seizures.

Physicians generally carry out blood tests like arterial blood gas analysis and a complete count of blood cells to diagnose the condition. The treatment depends on the underlying causes. However, if the blood pH falls below 7.1, the condition can require the administration of bicarbonates intravenously to neutralize the acids. In severe cases, dialysis may be required. Mechanical ventilation is also employed to ease breathing problems.

Monitoring and controlling the factors responsible for causing this condition is the best way to prevent the condition from worsening. As for example, controlling the underlying causes like diabetes can help control the disease in diabetic patients. Metabolic acidosis is often a symptom of some serious diseases like renal and heart failure and diabetes. So the proper monitoring of the symptoms of this condition would be of great help in preventing any complications.


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