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Metabolic acidosis occurs when the blood becomes too acidic, with a pH level of 7.35 or lower. This can be caused by other health conditions, such as kidney disease or diabetes, or when the kidneys and lungs cannot maintain the body's pH balance. Acidosis can also be caused by an excess of lactic acid in the body, known as lactic acidosis, which can result from intense exercise, liver failure, low blood sugar, alcohol use disorder, or cancer. While lactic acid is often associated with muscle soreness and burning, recent studies have shown that it is flushed out of the muscles too quickly to cause pain or injury. Instead, muscle soreness after exercise is caused by microtears in the muscle fibres. Symptoms of lactic acidosis include nausea, vomiting, exhaustion, rapid breathing, muscle cramps, and body aches.
| Characteristics | Values |
|---|---|
| What is acidosis? | Acidosis occurs when your body fluids contain too much acid. |
| What is the pH level of blood in a person with acidosis? | The pH of blood in a person with acidosis is below 7.35. |
| What is metabolic acidosis? | Metabolic acidosis happens when your blood becomes too acidic. |
| What causes metabolic acidosis? | It occurs when the kidneys can't eliminate enough acid or when they get rid of too much base. |
| What are the types of metabolic acidosis? | Diabetic acidosis, hyperchloremic acidosis, and lactic acidosis. |
| What is lactic acidosis? | Lactic acidosis occurs when there is a buildup of lactic acid in the bloodstream. |
| What causes lactic acidosis? | Lactic acidosis can be caused by excessive exercise, liver failure, low blood sugar, alcohol use disorder, cancer, or intense exercise. |
| What are the symptoms of lactic acidosis? | Muscle ache, burning, rapid breathing, nausea, stomach pain, muscle cramps, body aches, exhaustion, fatigue, weakness, and drowsiness. |
| Can lactic acid cause muscle pain? | Lactic acid does not cause muscle pain or burning. |
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What You'll Learn
Lactic acidosis and muscle pain
Lactic acidosis is a type of metabolic acidosis that occurs when there is a buildup of lactic acid in the bloodstream, causing the blood to become too acidic. This happens when the body produces too much lactic acid or when the liver and kidneys are unable to metabolize it efficiently.
Lactic acid is a natural byproduct of cellular metabolism. During intense exercise, when the body is in need of immediate energy that cannot be supplied by oxygen, our cells convert glucose to lactate to use for energy in a process called anaerobic glycolysis. This leads to a buildup of lactic acid in the muscles, which can cause a burning sensation and fatigue. However, this buildup of lactic acid during exercise is usually temporary and should go away when you stop exercising.
Lactic acidosis is different from the normal buildup of lactic acid during exercise. It occurs when there is a persistent buildup of lactic acid in the body or when the liver and kidneys are consistently unable to process it effectively. This is often associated with an underlying illness, such as liver or kidney disease, heart conditions, or lung disorders that deprive the blood of sufficient oxygen levels. Other causes include chronic alcohol use, cancer, seizures, low blood sugar, and prolonged lack of oxygen.
The symptoms of lactic acidosis include a burning feeling in the muscles, cramps, nausea, weakness, exhaustion, rapid breathing, vomiting, and muscle aches. If you experience these symptoms during exercise, it is important to stop the activity and allow your body to rest. If the symptoms persist after stopping the activity, it is recommended to seek medical help.
In summary, lactic acidosis is a condition that occurs when there is a buildup of lactic acid in the bloodstream, causing the blood to become too acidic. It can be caused by various factors, including excessive exercise, underlying health conditions, or a combination of both. The symptoms of lactic acidosis include muscle pain, cramps, and a burning sensation, among others. It is important to listen to your body and seek medical advice if necessary.
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Causes of lactic acidosis
Lactic acidosis occurs when there is a buildup of lactic acid in the bloodstream. Lactic acid is a natural byproduct of cellular metabolism. When the body is in need of immediate energy that cannot be supplied by oxygen, our cells convert glucose (sugar) to lactate to use for energy in a process called anaerobic glycolysis. This process usually occurs during a short burst of intense exercise when our muscles are oxygen-deprived.
There are two types of lactic acidosis: Type A and Type B. Type A lactic acidosis occurs when the tissues are deprived of oxygen, often due to severe medical illnesses such as pulmonary disorders, circulatory disorders, hemoglobin disorders, septic shock, or carbon monoxide poisoning. It can also occur temporarily from excessive exercise. Type B lactic acidosis occurs without hypoxemia or hypoxia and is caused by underlying diseases that inhibit the body's ability to metabolize lactate, such as liver disease, kidney disease, or vitamin B1 deficiency.
Lactic acidosis can also be caused by chronic alcohol use, heart failure, cancer, seizures, liver failure, low blood sugar, or prolonged lack of oxygen. Prolonged exercise can also lead to lactic acid buildup. Certain medications, such as antiretroviral therapy, beta-adrenergic agonist inhalers, and antibiotics, have also been linked to lactic acidosis.
Symptoms of lactic acidosis include nausea, vomiting, exhaustion, fast deep breathing, muscle cramps, body aches, weakness, and confusion. If left untreated, lactic acidosis can lead to organ failure and death.
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Diagnosing lactic acidosis
Lactic acidosis is a type of metabolic acidosis that occurs when there is a buildup of lactic acid in the blood. This happens when the body produces too much lactic acid or cannot metabolize it efficiently. The liver and kidneys are responsible for clearing excess lactic acid from the body, but if they are impaired or overwhelmed, lactic acid can accumulate. A moderate buildup of lactic acid is called hyperlactatemia, while lactic acidosis refers to a more significant buildup that turns the body's pH balance acidic.
- Blood Lactate Levels: Doctors will measure blood lactate levels to determine if they are above the normal threshold. Lactic acidosis is typically defined by a serum lactate concentration above 4 mmol/L, which is considered elevated. This elevated lactate level indicates that the body is either producing too much lactate or unable to clear it effectively.
- Blood pH Levels: Blood samples are also used to measure pH levels. Lactic acidosis is associated with acidic blood, which is indicated by a blood pH below 7.35. This drop in pH occurs due to the accumulation of lactic acid, which lowers the blood's pH.
- Anion Gap Measurement: Healthcare providers may also calculate the anion gap, which is the difference between positively and negatively charged electrolytes in the blood. Electrolytes such as magnesium, sodium, and calcium help maintain the balance between acids and bases in the body. An abnormal anion gap can suggest that something is wrong with acid-base balance in the body.
- Arterial Blood Gas Analysis: An arterial blood gas test is performed to assess the levels of oxygen and carbon dioxide in the blood. This test also provides information about blood pH. It helps determine if there are any issues with respiratory function contributing to the lactic acidosis.
- Basic Metabolic Panel: This test checks kidney function and measures calcium, protein, blood sugar, and electrolyte levels. It helps identify any underlying issues with kidney function that could be contributing to the lactic acidosis.
- Corrected Anion Gap Calculations: In certain cases, such as when hypoalbuminemia is present, corrected anion gap calculations are applied to improve the accuracy of the diagnosis. This calculation takes into account the presence of other factors that may influence the anion gap.
- Identification of Underlying Conditions: Lactic acidosis can be caused by underlying health conditions such as sepsis, shock, liver failure, or other illnesses. Doctors may investigate and diagnose these underlying conditions through further tests and examinations.
By combining these diagnostic tests and analyzing the results, healthcare providers can identify and confirm cases of lactic acidosis. This diagnosis guides subsequent treatment approaches to manage the condition and address any underlying causes.
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Treatment for lactic acidosis
Lactic acidosis is a condition that occurs when there is a buildup of lactic acid in the bloodstream, causing the body's pH level to become too acidic. This can be caused by various factors, including chronic alcohol use, heart failure, cancer, seizures, liver failure, low blood sugar, or prolonged lack of oxygen. It can also be brought on by intense exercise, although this is usually temporary.
The treatment for lactic acidosis aims to address the underlying cause and optimize tissue oxygen delivery. This can include the following:
- Administration of appropriate antibiotics
- Surgical drainage and debridement of a septic focus
- Chemotherapy for malignant disorders
- Discontinuation of causative drugs
- Dietary modification for certain types of congenital lactate acidosis
- Fluid replacement and vasoactive drugs to treat cardiovascular collapse secondary to hypovolemia or sepsis
- Intravenous thiamine treatment, particularly in the absence of an obvious alternate etiology
- Sodium bicarbonate (NaHCO3) for severe metabolic acidosis, although this is controversial
- Tromethamine, a buffering agent that does not generate carbon dioxide
It is important to note that lactic acidosis can be a serious condition, and if symptoms such as persistent nausea, vomiting, exhaustion, muscle cramps, or body aches are experienced, medical advice should be sought.
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Metabolic acidosis and muscle pain
Metabolic acidosis is a condition in which acids build up in the body. It occurs when the kidneys cannot eliminate enough acid or when they get rid of too much base. It is characterised by a rapid heartbeat, fatigue, confusion, and a general sense of feeling unwell. The pH of the blood in a person with metabolic acidosis should be around 7.35 or lower.
Chronic metabolic acidosis can result from impaired kidney function and/or bicarbonate wasting. It has detrimental effects on the muscles and bones. Acid buffering leads to bone density loss, resulting in an increased risk of bone fractures, renal osteodystrophy, and bone disease. Increased protein catabolism leads to muscle wasting.
Higher acidity increases the concentration of H+ ions, which compete with Ca2+ ions involved in muscle contraction. A low pH also hinders the resynthesis of phosphocreatine, a source of energy in skeletal muscle. In addition, metabolic acidosis has complex effects on the myosin cross-bridge cycle. Experiments using isolated actin and myosin filaments showed that acidic conditions slowed the rates of myosin attachment.
Lactic acidosis is a type of metabolic acidosis that occurs when there is a buildup of lactic acid in the bloodstream. This can be caused by excessive exercise, a lung or heart condition, or a toxin or medicine that gets in the way of breaking down lactate. Symptoms of lactic acidosis include muscle ache, burning, rapid breathing, nausea, stomach pain, exhaustion, muscle cramps, and body aches.
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Frequently asked questions
Acidosis occurs when your body produces too much acid, or your kidneys don’t remove enough acid from your blood. The pH of your blood should be around 7.4. Acidosis is characterized by a pH of 7.35 or lower.
Symptoms of acidosis include nausea, vomiting, exhaustion, rapid breathing, muscle cramps, body aches, weakness, confusion, and a general sense of feeling unwell. In severe cases, acidosis can lead to organ failure and death.
While lactic acid, which is produced during intense exercise, was once believed to cause muscle pain, recent studies have shown that it is flushed out of the muscles too quickly to cause damage or pain. Instead, muscle pain after exercise is typically caused by microtears in the muscle fibers. However, in rare cases, severe muscle pain may be a sign of an injury such as a pulled muscle.
