Acidosis refers to high levels of acid in the body. The body needs to maintain a balance of acidity for optimal health. If the body becomes too acidic or too alkaline, this can cause serious health problems.

High levels of acid in the body cause the body to compensate and try to remove the acid. The lungs and kidneys are usually able to get rid of excess acid in the body. If acidosis puts too much pressure on these organs, it can cause serious complications.

Certain health conditions, prescription drugs, and dietary factors can cause acidosis. Some cases of acidosis are reversible, but without treatment, severe acidosis can be fatal.

In this article, we discuss the possible causes and types of acidosis.

Causes

There are many possible causes of high levels of acid in the body, including those below.

Metabolic acidosis

Metabolic acidosis happens when too much acid builds up in the body due to a disruption to the metabolism. Several different health conditions can cause this to happen, including:

• diabetes
• Sjogren's syndrome
• severe diarrhea
• biliary fistula
• insulin resistance

It is not always clear whether these conditions cause metabolic acidosis, or whether acidosis causes these conditions. These conditions may create a cycle of increasing metabolic acidosis, which then worsens the condition.

Some people may not experience any symptoms of metabolic acidosis. In those who do, the possible symptoms include:

• an increased heartbeat
• needing to take longer, deeper breaths than usual
• headaches
• fatigue and weakness
• nausea and vomiting
• a loss of appetite
• confusion

If people notice any of the above symptoms, they should see their doctor straight away.

Renal tubular acidosis

Kidney disease or kidney failure can cause metabolic acidosis. In these cases, doctors often refer to the condition as renal tubular acidosis. The roles of the kidneys include the removal of excess acid, which passes out of the body through urine. If there is a problem with the kidneys, these organs are unable to remove acid effectively from the body.

The kidneys also help keep bicarbonate levels stable in the body. People need a certain amount of this molecule in the blood to keep the body healthy.

One sign of metabolic acidosis is low levels of bicarbonate in the bloodstream, which indicate that the blood is more acidic. According to the National Kidney Foundation, low levels of bicarbonate are those less than 22 millimoles per liter (mmol/l).

Respiratory acidosis

Respiratory acidosis happens when the body is unable to remove enough carbon dioxide, which then builds up in the body, increasing acid levels in the blood.

Causes of respiratory acidosis include:

• stroke
• drugs that affect the central nervous system, such as opioids
• disorders that affect the muscles involved in breathing, such as muscular dystrophy or Guillain-Barre syndrome
• chronic obstructive pulmonary disease (COPD)

The symptoms of respiratory acidosis can vary depending on the underlying cause but may include:

• wheezing
• difficulty breathing
• anxiety
• disturbed sleep
• a blue tinge to the skin due to a low level of oxygen in the blood

Diet-induced acidosis

Some foods and drinks can increase acidity in the body. It is not the pH of the food or drink that determines whether this occurs but how the food affects the balance between acid and alkaline levels once inside the body.

According to a 2015 review of acidosis, the average diet of people in the United States produces acid in the body. In many cases, a diet is acidic due to high levels of:

• amino acids that contain sulfur, which are present in meat, eggs, and dairy products
• salt, which may make it harder for the kidneys to get rid of excess acid
• phosphoric acid, which soda contains

Drug-induced acidosis

Some prescription medications can increase acidity in the body. Examples of these include:

• beta-blockers
• antibacterial drugs, such as trimethoprim (Primsol)
• antiretrovirals
• statins

Risk factors

People more at risk of developing respiratory acidosis include those:

• undergoing surgery
• with asthma
• with end stage COPD
• who smoke, as it can cause respiratory problems
• who use opioids

Risk factors for metabolic and diet-induced acidosis include:

• a diet high in salt and animal protein and low in fruits and vegetables
• diabetes
• kidney problems
• certain diseases, such as Sjogren's syndrome

Complications

Metabolic acidosis can lead to serious complications, including:

• osteoporosis, which is a loss of bone that can increase the risk of fractures
• improper growth in children, as metabolic acidosis restricts the growth hormone
• increased kidney damage, which can worsen chronic kidney disease
• muscle loss or wasting
• high blood sugar
• problems with the endocrine system (the glands that create hormones), which can lead to insulin resistance and potentially diabetes
• increased risk of death

Complications of other types of acidosis also include osteoporosis. Osteoporosis can develop because if the kidneys and lungs are unable to get rid of excess acid, the body starts to take calcium from the bones. The body then uses this calcium to neutralize the acid.

A 2012 study looked at the link between diet-induced acidosis and cancer. Research has identified a possible association between higher levels of acidity in the body and cancer. A long-term diet of acid-forming foods, such as salt and animal protein, can increase acidity in the body.

Although there is not yet enough evidence to determine whether diet-induced acidosis alone could increase the risk of cancer, it may play a part alongside other risk factors, such as obesity. Researchers need further evidence to support these findings.

Treatment

The treatment for acidosis depends on its type and cause.

Metabolic or renal tubular acidosis

Bicarbonate is an alkaline, which is the opposite of an acid. Bicarbonate can help balance the acid in the blood. A small amount of research has found that sodium bicarbonate or sodium citrate pills may help prevent kidney disease from worsening. However, people should only attempt this type of treatment under the supervision of a doctor.

Respiratory acidosis

To treat respiratory acidosis, people must treat the underlying cause. Treatment will vary depending on the cause, but it is likely to focus on making breathing easier. Bronchodilators are drugs that help widen the airways and relax the muscles that play a role in breathing.

Diet-induced acidosis

According to the National Kidney Foundation, a diet that is higher in plant-based protein than animal protein can help prevent acid levels from increasing in the body.

Eating plenty of fruit and vegetables each day also helps. Research has shown that an increase in fruit and vegetables can increase alkali levels in the body.

Summary

Acidosis is a high level of acid in the body, which causes an imbalance in the body's pH. If the kidneys and lungs are unable to get rid of excess acid, it can cause serious health problems.

If a disease or health condition is causing acidosis, treating the condition can help lower acidity in the body. If a person is taking acid-forming prescription medicine, they can talk to their doctor about the potential issues that it may cause.

Diets high in salt, soda, and animal protein can cause acidosis. People can moderate their intake of these foods and increase their daily intake of fruits and vegetables.

If people experience any symptoms of acidosis, they should see their doctor for tests and a treatment plan. For severe symptoms, such as difficulty breathing, they should seek immediate medical help.