Metabolic Acidosis: Causes, Symptoms, and Treatment

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  • 0:01 The Terrible Effects of Acid
  • 0:32 What Is Metabolic Acidosis?
  • 4:08 How the Body Tries to…
  • 6:08 Test Results
  • 8:19 Treatment of Metabolic…
  • 9:13 Lesson Summary
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Lesson Transcript
Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

This lesson discusses a condition called metabolic acidosis, what causes it, how buffer and the respiratory systems are involved, what tests results reveal, and how it's treated.

The Terrible Effects of Acid

Acid corrosion is a well-known fact. Acid rain can peel the paint off of a car. Acidifying ocean water bleaches and destroys coral reefs. Acid can burn a giant hole through metal. It can also burn holes, called cavities, into your teeth.

I think I've made my point. Acid, regardless of where it's at, is going to hurt. And when your body is full of acid, then it's going to destroy your fragile, soft, internal organs even more quickly than it can destroy your bony teeth and chunks of thick metal.

What Is Metabolic Acidosis?

The condition that fills your body with proportionately too much acid is known as metabolic acidosis. Metabolic acidosis refers to a physiological state characterized by an increase in the amount of acid produced or ingested by the body, the decreased renal excretion of acid, or bicarbonate loss from the body.

Metabolism is a word that refers to a set of biochemical processes within your body that produce energy and sustain life. If these processes go haywire, due to disease, then they can cause an excess production of hydrogen (H+) ions. These ions are acidic, and therefore the level of acidity in your body increases, leading to acidemia, an abnormally low pH of the blood, <7.35. The pH of the blood mimics the overall physiological state in the body.

In short, a metabolic process is like a power plant producing energy. If a nuclear power plant goes haywire for any reason, then we know what the consequences will be: uncontrolled and excessive nuclear energetic reactions leading to the leakage of large amounts of radioactive material out into the environment. In our body, this radioactive material is acid (or hydrogen ions).

Acidemia can also occur if the kidneys are sick and they do not excrete enough hydrogen ions out of the body (that's their job, by the way). Then, hydrogen ions accumulate in excess within you, leading to the same problem.

Finally, note how I mentioned before that there may be proportionately too much acid. Unlike the first two scenarios that result in too much acid period, sometimes the levels of hydrogen ions stay roughly the same, but the acid's buffer, the thing that neutralizes acid, may be too low. A buffer is like a bodyguard. The bodyguard knocks out or neutralizes your enemy that's trying to hurt you.

The hydrogen ion's buffer is known as bicarbonate. If bicarbonate levels in the body drop and the levels of acid stay the same, then, proportionately speaking, the levels of hydrogen ions increase, resulting in acidosis. So, if your bodyguards run away from you, leaving you to face your enemies alone, then you are outnumbered. That's what happens when bicarbonate is lost in the body: the hydrogen ions outnumber the bicarbonate ones, leading to acidosis.

This scenario namely occurs during kidney disease or diarrhea when lots of bicarbonate is lost from the gastrointestinal tract. This is the exact opposite of what happens when a person vomits. Vomiting causes metabolic alkalosis because a lot of stomach acid is lost when someone vomits, and this leads to the reduction of acidity within the body.

Anyways, other than diarrhea and kidney disease, metabolic acidosis can occur due to ketoacidosis as a result of diabetes or from lactic acidosis due to shock, to name a few possibilities.

Metabolic acidosis shouldn't be confused with respiratory acidosis, where the improper exhalation of carbon dioxide leads to increased levels of acidity in the body. In metabolic acidosis, we assume the lungs are just fine to start off.

How the Body Tries to Compensate

As levels of acid rise in the body, many times due to kidney malfunction, your body tries to protect itself from this corrosive acid through two main ways: buffers and lungs.

Bicarbonate is just one important buffer that latches onto hydrogen ions and neutralizes their acidity.

This combination of bicarbonate and hydrogen is subsequently converted into carbon dioxide. Carbon dioxide is then exhaled by your lungs in order to rid itself of excess acid. How does your body try to get rid of excess carbon dioxide as a result of excess hydrogen ions in the body? It hyperventilates, meaning you breathe faster and faster to exhale more and more 'acidic' CO2 out of the body. This compensation is known as compensatory respiratory alkalosis.

This process is a bit different from respiratory acidosis, where the healthy kidneys are the ones that compensate for the acidosis due to the malfunctioning lungs. The kidneys do so by excreting acid and conserving bicarbonate, which then, in turn, serves to buffer the remaining excess hydrogen just like in metabolic acidosis.

But the difference is that, although compensation begins soon after the onset of respiratory acidosis, it takes several days for the kidneys to rev up to full compensatory function. Conversely, in metabolic acidosis, both the buffers and the lungs begin to compensate hours or even minutes after the problem begins.

An easy way to remember this concept is to think about the fact that you breathe constantly but you only have to go #1 only so often. That's because, in a simple way, it takes longer for your kidneys to do their job than it does for your lungs, and therefore the kidneys take longer to compensate for something going wrong in the body.

Test Results

So, with that pathophysiology out of the way, it's important we see how this affects test results.

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