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What Is Alkalosis?

Medically Reviewed by Dan Brennan, MD on June 18, 2021

Alkalosis is a condition concerning the pH of your blood and fluids. It occurs when your blood pH levels are imbalanced. When your blood is too acidic, it’s called acidosis. When it’s too alkaline, it’s alkalosis. 

Your blood pH should always be balanced. An increase in alkali (alkaline chemicals) is typically caused by an increase in bicarbonate, a drop in acid levels, or a decrease in carbon dioxide. The cause of the alkalosis determines what type it is. 

What Is pH?

The pH of a fluid is the measurement of how alkaline or acidic it is. A fluid’s pH is affected by the type of ions present, which is dependent on the chemicals in the fluid. 

You likely drink acidic beverages daily. Coffee, soda, and lemon juice all have an acidic pH. Even your saliva has a slightly acidic pH level. 

Most alkaline fluids, however, are actually dangerous to you. Seawater and cleaning chemicals have an alkaline pH and are dangerous to ingest. 

Your blood should be right in the middle. It ideally has a neutral, balanced pH to maintain regular bodily functions. 

Causes of Alkalosis

Increased bicarbonate and decrease in acid. Your kidneys maintain the body’s pH to ensure it doesn’t become too alkaline. Some circumstances can cause your blood pH to shift dramatically and lead to alkalosis. 

A common cause of alkalosis is digestive problems. Excessive vomiting can eliminate too much of the body’s acid, causing an imbalance. Conditions affecting your heart, liver, or kidneys can also alter your alkalinity. 

This is one of two types of alkalosis. This imbalance in bicarbonate is referred to as metabolic alkalosis. 

Lack of carbon dioxide. When you don’t have enough carbon dioxide in your bloodstream, you’ve developed respiratory alkalosis. This is typically the result of hyperventilation and other events that make you breathe quickly and deeply. 

Other causes for respiratory alkalosis include: 

The Symptoms of Alkalosis

Even a slight imbalance of your blood pH can make you sick, irritable, and uncomfortable. Some of the common symptoms for metabolic and respiratory alkalosis are: 

  • General confusion
  • Tremors
  • Feeling faint
  • Muscle spasms
  • Nausea
  • Vomiting
  • Numbness in your face, feet, or hands

Alkalosis can range in severity. It can have no noticeable symptoms or result in nearly constant, painful muscle spasms. If severe tetany (muscle spasms) develops, you’ll need to contact your doctor. 

For most people with healthy kidneys, alkalosis won’t likely be severe. Severe symptoms to keep an eye out for include: 

Testing and Diagnosing Alkalosis

The first step in diagnosing alkalosis is a physical exam. Your doctor will evaluate your symptoms before moving on to any invasive tests. If there are any urgent symptoms, such as hyperventilation, your doctor will treat those first before any complications arise. 

Your doctor will then perform a blood test. This will tell them quickly if you have a pH imbalance and alkalosis. This blood test will check for several factors, including: 

  • Blood gases
  • Acid-base balance
  • Electrolyte levels

If necessary, your doctor may perform a urinalysis or other urine test. This will help them pin down the cause of your alkalosis. 

Treatment for Alkalosis

The aim when treating alkalosis is to treat the cause, not just the imbalance. After the initial symptoms are treated, your doctor will determine the cause and begin a more in depth treatment process. 

Once your initial treatment is over, you’ll start feeling better within a few hours or after a night’s rest. If the cause isn’t treated, you may experience alkalosis again. 

Treating metabolic alkalosis. If you’re experiencing metabolic alkalosis, you’ll need to intake plenty of water and electrolytes to balance your blood pH levels. This can be done through drinks containing sodium and potassium. 

Treating respiratory alkalosis. The first step when treating respiratory alkalosis is to breathe and get enough oxygen. If you’re hyperventilating, being able to slow down your breathing, breathing calmly, and easing anxiety will help restore your oxygen. 

Preventing Alkalosis

Certain conditions like kidney disease may put you at risk for alkalosis. Additionally, you’re at an increased risk for metabolic alkalosis if you’re dehydrated. 

If you’re at risk, your doctor will work with you on a prevention plan. The exact methods for preventing alkalosis will vary. 

Depending on the cause of your alkalosis, your doctor may alter any treatments you’re receiving for other conditions. For example, certain medications like water pills or antacids can put you at risk for alkalosis. 

WebMD Medical Reference

Sources

SOURCES:

Cleveland Clinic: “Metabolic Alkalosis.”
Merck Manual: “Alkalosis.”
Mount Sinai: “Alkalosis.”
USGS: “pH Scale.” 

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