Metabolic Acidosis is a condition that occurs when the chemical balance of acids and bases in your blood is out of balance. Think of it like a kitchen scale. If you put too much weight on one side, it will tip over, right? That's how it is. This condition occurs when our body has too much acid and not enough base to control it. Sometimes this can be a mild condition, but in some cases it can be life-threatening.
Why does this happen? (Causes of Metabolic Acidosis)
There are various reasons why this acid-base imbalance in our blood can occur. Let's look at the main causes.
| Reason | Simple explanation |
|---|---|
| Ketoacidosis ( ketoacidosis ) | When a person with diabetes does not get enough insulin and becomes dehydrated, the body starts burning fat for energy. This results in the production of chemicals called ketones. When these ketones accumulate in the blood, the blood becomes acidic. This condition can also occur in people who drink too much alcohol, do not eat properly, or are fasting. |
| Lactic Acidosis | When our body's cells don't get enough oxygen, they produce a substance called lactic acid. This can also build up in the blood. This can happen during strenuous exercise, when blood pressure suddenly drops, in cases of heart failure, cardiac arrest, and overwhelming infections. |
| Kidney problems (Renal Tubular Acidosis) | Healthy kidneys filter out excess acids from the blood and excrete them in the urine. However, when the kidneys are damaged due to kidney disease, certain immune system disorders, and genetic disorders, they are unable to properly remove these acids. The acids then remain in the blood. |
| Hyperchloremic Acidosis | Severe diarrhea, misuse of laxatives , and some kidney diseases can cause our body to have low levels of bicarbonate. Bicarbonate is a base that neutralizes acids. When it is low, the blood becomes acidic. |
Important: There is another type called Respiratory Acidosis. In this, the blood also becomes acidic , but the cause is a problem in the lungs that causes excess carbon dioxide to accumulate in the body. This is different from Metabolic Acidosis.
What are the symptoms of this? (Symptoms)
Although symptoms may vary from person to person, these are common symptoms that a person with Metabolic Acidosis may experience.
- Rapid breathing : This is because the body is trying to expel excess acid (as carbon dioxide) from the body.
- Heart palpitations
- Headache
- Feeling confused (Confusion)
- Feeling of weakness
- Feeling tired all the time
- Appetite
- Nausea and vomiting
A fruity smell on the breath is a well-known symptom, especially in diabetic ketoacidosis (DKA).
If you have these symptoms, see your doctor immediately. If they feel severe, do not delay going to a hospital's Emergency Department (ETU) .
How do I find this exactly? (Testing)
The doctor will run several tests to determine exactly whether you have this condition. Only then can the correct treatment be given.
- Anion Gap Test: This is a test that measures the chemical balance of the blood. Simply put, it compares the positive and negative charged particles (such as sodium, chloride, bicarbonate) in the blood. In some types of metabolic acidosis, the "gap" between these values is more visible.
- Arterial Blood Gases (ABG) test: This measures the pH, or acidity, and oxygen and carbon dioxide levels of your blood.
- Urine tests: These can detect ketones, kidney problems, or poisoning from things like aspirin, alcohol, or antifreeze. People with diabetes can test their urine for ketones at home using test strips available at the pharmacy.
How to treat?
Metabolic Acidosis is treated by treating the underlying cause. Think of it like a roof leaking water. It's better to fix the hole in the roof than to put a bucket down and catch the water. That's how it is.
If this condition is not controlled, it can affect your bones, muscles, and kidneys. In severe cases, shock and even death can occur. A condition like DKA can also lead to a coma.
Therefore, it is very important to seek treatment as soon as possible . Some of the commonly prescribed treatments are:
- Detoxification: If this condition is caused by drug or alcohol poisoning, treatment is given to remove the poison from the body. If you suspect any poisoning, immediately call the National Poisons Information Center at the Colombo National Hospital for advice.
- Insulin: Insulin is given for DKA caused by diabetes.
- Intravenous fluids (IV fluids): Fluids such as saline are given through a vein in your arm.
- Sodium bicarbonate: In some cases, this medication is given through a vein to increase the alkalinity of the blood.
You will probably have to be hospitalized.
How to protect yourself from this situation? (Prevention)
Although metabolic acidosis cannot always be prevented, there are things you can do to reduce your risk.
- Drink plenty of water and non-alcoholic fluids. If your urine is clear or light yellow, it means you are getting enough water.
- Limit alcohol. Alcohol can increase acid buildup in the body and cause dehydration.
- If you have diabetes, control it well. Follow your doctor's instructions exactly.
- When taking medication, follow the instructions given by your doctor or on the package exactly.
Take-Home Message
- Metabolic acidosis is a disruption in the acid-base balance in your blood. Don't take this lightly.
- If you have symptoms like rapid breathing, confusion, and extreme fatigue, it could be a sign of a serious problem inside the body.
- This is treated by treating the underlying cause (such as diabetes, kidney disease, poisoning).
- If you have any doubts or symptoms, never guess. See your doctor immediately for proper advice and treatment.
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