What are three symptoms of metabolic alkalosis?
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Alkalosis is a condition in which the body fluids have excess base (alkali). This is the opposite of excess acid (acidosis). Show The kidneys and lungs maintain the proper balance (proper pH level) of chemicals called acids and bases in the body. Decreased carbon dioxide (an acid) level or increased bicarbonate (a base) level makes the body too alkaline, a condition called alkalosis. There are different types of alkalosis. These are described below. Respiratory alkalosis is caused by a low carbon dioxide level in the blood. This can be due to:
Metabolic alkalosis is caused by too much bicarbonate in the blood. It can also occur due to certain kidney diseases. Hypochloremic alkalosis is caused by an extreme lack or loss of chloride, such as from prolonged vomiting. Hypokalemic alkalosis is caused by the kidneys' response to an extreme lack or loss of potassium. This can occur from taking certain water pills (diuretics). Compensated alkalosis occurs when the body returns the acid-base balance to near normal in cases of alkalosis, but bicarbonate and carbon dioxide levels remain abnormal. Symptoms of alkalosis can include any of the following:
The health care provider will perform a physical exam and ask about your symptoms. Laboratory tests that may be ordered include:
Other tests may be needed to determine the cause of the alkalosis. These may include:
To treat alkalosis, your provider needs to first find the underlying cause. For alkalosis caused by hyperventilation, breathing into a paper bag allows you to keep more carbon dioxide in your body, which improves the alkalosis. If your oxygen level is low, you may receive oxygen. Medicines may be needed to correct chemical loss (such as chloride and potassium). Your provider will monitor your vital signs (temperature, pulse, rate of breathing, and blood pressure). Most cases of alkalosis respond well to treatment. Contact your provider if you become confused, unable to concentrate, or unable to "catch your breath." Go to the emergency room or call the local emergency number (such as 911) if there is:
Prevention depends on the cause of the alkalosis. People with healthy kidneys and lungs do not usually have serious alkalosis. Oh MS, Briefel G, Pincus MR. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 15. Sanghavi S, Albert TJ, Swenson ER. Acid-base balance. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 12. Seifter JL. Acid-base disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 110. Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Alkalosis is excessive blood alkalinity caused by an overabundance of bicarbonate in the blood or a loss of acid from the blood (metabolic alkalosis), or by a low level of carbon dioxide in the blood that results from rapid or deep breathing (respiratory alkalosis). People may have irritability, muscle twitching, muscle cramps, or even muscle spasms. Blood is tested to diagnose alkalosis. Metabolic alkalosis is treated by replacing water and mineral salts such as sodium and potassium (electrolytes) and correcting the cause. Respiratory alkalosis is treated by correcting the cause. Acidity and alkalinity of any solution, including blood, is indicated on the pH scale, which ranges from 0 (strongly acidic) to 14 (strongly basic or alkaline). A pH of 7.0, in the middle of this scale, is neutral. Blood is normally slightly basic, with a normal pH range of 7.35 to 7.45. Usually the body maintains the pH of blood close to 7.40.
Metabolic alkalosis develops when the body
For example, stomach acid is lost during periods of prolonged vomiting or when stomach acids are suctioned with a stomach tube (as is sometimes done in hospitals). In rare cases, metabolic alkalosis develops in a person who has ingested too much base from substances such as baking soda (bicarbonate of soda). In addition, metabolic alkalosis can develop when excessive loss of fluids and electrolytes (such as sodium or potassium) affects the kidneys' ability to maintain the blood's acid-base balance. For instance, loss of potassium sufficient to cause metabolic alkalosis may result from an overactive adrenal gland Hyperaldosteronism In hyperaldosteronism, overproduction of the hormone aldosterone leads to fluid retention and increased blood pressure, weakness, and, rarely, periods of paralysis. Hyperaldosteronism can be... read more or the use of diuretics (for example, thiazides, furosemide, or ethacrynic acid). Respiratory alkalosis develops when
Alkalosis may cause
Tingling (paresthesia) is a common complaint in hyperventilation due to anxiety. Sometimes alkalosis causes no symptoms at all. If the alkalosis is severe, painful muscle spasms (tetany) can develop.
A doctor evaluates a person's acid-base balance by measuring the pH, and levels of carbon dioxide (an acid) and bicarbonate (a base) in the blood. To learn more about the cause of the alkalosis, doctors also measure levels of electrolytes in samples of blood and urine.
Almost always, treatment of alkalosis is directed at reversing the cause. Doctors rarely simply give acid, such as hydrochloric acid, to reverse the alkalosis. Metabolic alkalosis is usually treated by replacing water and electrolytes (sodium and potassium) while treating the cause. Rarely, when metabolic alkalosis is very severe, dilute acid is given intravenously. In respiratory alkalosis, the first step is to ensure that the person has enough oxygen. The doctor then looks for a serious cause, such as an infection. If pain is causing the person to breathe rapidly, relieving the pain usually suffices. When respiratory alkalosis is caused by anxiety or a panic attack, a conscious effort to relax and slow breathing may make the condition disappear. Calming reassurance and emotional support can help, and breathing into a paper (not a plastic) bag may help raise the carbon dioxide level in the blood as the person breathes carbon dioxide back in after breathing it out.
CLICK HERE FOR THE PROFESSIONAL VERSION Copyright © 2022 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. All rights reserved.  What are the symptoms of metabolic alkalosis?Symptoms of alkalosis can include any of the following:. Confusion (can progress to stupor or coma). Hand tremor.. Lightheadedness.. Muscle twitching.. Nausea, vomiting.. Numbness or tingling in the face, hands, or feet.. Prolonged muscle spasms (tetany). What is the most common cause of metabolic alkalosis?The most common causes of metabolic alkalosis are the use of diuretics and the external loss of gastric secretions.
What happens when you have metabolic alkalosis?In metabolic alkalosis there is excess of bicarbonate in the body fluids. It can occur in a variety of conditions. It may be due to digestive issues, like repeated vomiting, that disrupt the blood's acid-base balance. It can also be due to complications of conditions affecting the heart, liver and kidneys.
Which 4 of the following conditions could result in metabolic alkalosis?Metabolic alkalosis is primary increase in bicarbonate (HCO3−) with or without compensatory increase in carbon dioxide partial pressure (Pco2); pH may be high or nearly normal. Common causes include prolonged vomiting, hypovolemia, diuretic use, and hypokalemia.
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