This article will explain what lactic acidosis is. It will also describe the symptoms, causes, and treatment options of the condition.
Lactic acidosis is a type of acidosis that occurs when the blood becomes too acidic due to the presence of excess lactic acid in the body.
Blood pH is tightly controlled because even slight changes in your pH can have severe effects on many organs. Typically, your blood is slightly basic, or alkaline. Acidosis occurs when the blood becomes more acidic than usual.
Lactic acid forms when structures in the cells called mitochondria respond to high energy demands in cases of relatively low oxygen levels. Lactic acid commonly increases with exercises designed to increase speed, strength, and muscle mass, such as sprinting and lifting weights, but the liver often clears it during rest periods.
Conditions that decrease blood oxygen levels, interfere with the mitochondria, or decrease the clearance of lactic acid can allow lactic acid to increase to harmful levels, causing various medical conditions.
To correct lactic acidosis, doctors need to address the underlying problem. Additional treatment of lactic acidosis may include IV fluids, supplemental oxygen or mechanical ventilation, and vitamins.
There are two types of lactic acidosis, which are types A and B:
- Type A lactic acidosis: A low amount of blood flow in the tissue causes type A, also known as hypoperfusion. Heart failure, sepsis, or cardiac arrest can cause this.
- Type B lactic acidosis: Underlying diseases or certain medications can cause type B lactic acidosis.
Common symptoms of lactic acidosis
If you experience lactic acidosis, symptoms can include:
- abdominal pain
- anxiety
- fatigue
- irregular heart rate, also called arrhythmia
- lethargy
- nausea with or without vomiting
- rapid breathing, also called tachypnea
- rapid heart rate, also called tachycardia
- shortness of breath
- weakness
Serious symptoms that might indicate a life threatening condition
In some cases, lactic acidosis can be life threatening. Get immediate medical care if you, or someone you are with, have any of these life threatening symptoms, including:
- discoloration of the lips or fingernails
- change in the level of consciousness or alertness, such as passing out or unresponsiveness
- chest tightness, pressure, palpitations
- fever higher than 101ºF (38ºC)
- lack of urine production or an infant who does not produce the usual amount of wet diapers
- rapid heart rate
- respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, rapid breathing, or not breathing
- severe abdominal pain
Lactic acidosis can be a serious condition, leading to life threatening complications such as shock. Get immediate medical care for serious symptoms, such as:
- profuse sweating
- discoloration of the lips and nails
- chest pain
- cold and clammy skin
- rapid breathing
- rapid heart rate
- absence of or decrease in urine output
- sweating
- unusual anxiety
- confusion
- unconsciousness
Get prompt medical care if you have treatment for lactic acidosis, but mild symptoms recur or are persistent.
Lactic acid forms when the mitochondria, small structures inside of cells that act somewhat like batteries, need oxygen-free methods to produce energy.
This occurs when energy demands are high and the oxygen supply is not fast enough as would be necessary to meet them. Exercises that involve quick bursts of activity, such as sprinting and powerlifting, commonly result in mitochondrial lactic acid production.
Generally, the lactic acid leaves the blood during rest periods and does not create significant problems.
If lactic acid occurs more quickly than removal, it can build up and cause lactic acidosis. Conditions and medications that interfere with the mitochondria, decrease the amount of oxygen in the blood, or decrease the clearance of lactic acid can cause lactic acid to increase to harmful levels.
Certain conditions can increase lactate levels and lower oxygen,
- heart disease
- sepsis
- HIV
- cancer
A number of factors increase the risk of developing lactic acidosis. Not all people with risk factors will get lactic acidosis.
Risk factors for lactic acidosis
- cancer
- certain inherited metabolic disorders
- chronic alcoholism
- diabetes
- heart or lung disease
- highly stressful exercise without proper rest
- kidney disease, which includes any type of kidney problem, such as kidney stones or kidney failure
- liver disease, which includes any type of liver problem, such as hepatitis, cirrhosis, and liver failure
- medications, including metformin, which is a medication used to treat type 2 diabetes
- transcriptase inhibitors such as nucleotide reverse transcriptase inhibitors, medications used to treat HIV and AIDS, although rare unless other risk factors are present
- seizures
- severe anemia
The main
Although substances can decrease the acidity of your blood, the use of these can lead to a paradoxical increase in lactic acid production.
Common treatments for lactic acidosis
As doctors assess and manage the underlying cause, additional treatments can support circulation and tissue oxygen delivery. These include:
- IV fluids to help support circulation
- mechanical ventilation to help enhance oxygen delivery to the lungs
- oxygen therapy to boost oxygen availability
Doctors may consider other treatments such as vitamin therapy and dialysis.
Complications of untreated lactic acidosis can be severe, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your healthcare professional design specifically for you.
Complications of lactic acidosis include:
- arrhythmia, which is an irregular heart rhythm
- decrease in athletic performance
- shock
- spread of infection
- unconsciousness and coma
Medical professionals can diagnose lactic acidosis by checking the level of lactate in the blood with a blood sample. When someone has lactic acidosis, these levels of lactate will be unusually high.
By managing potential causes, you can prevent lactic acidosis. Be sure to take medications for conditions such as diabetes, heart failure, or liver disease.
Avoiding strenuous exercise without proper rest after will also prevent lactic acidosis, alongside keeping hydrated.
Lactic acidosis occurs when lactic acid builds up in the bloodstream. When oxygen levels become low in cells, the body produces lactic acid.
Common causes of lactic acidosis include medical conditions such as cancer, occurring when blood pressure is low and oxygen has a difficult time reaching tissues in the body. Temporary lactic acidosis can also result from intense exercise.