Lactic Acidosis: Understanding Causes, Symptoms, Types and Treatment

Introduction

Lactic acidosis is a serious medical condition that occurs when there is too much lactic acid in the bloodstream. It can lead to various symptoms and complications if not treated promptly. Understanding the causes, symptoms, and types of lactic acidosis is crucial for timely diagnosis and effective treatment. In this article, we will provide an in-depth overview of lactic acidosis, including its causes, symptoms, diagnostic tests, and treatment options, to help you better understand and manage this condition.

What is lactic acidosis?

Lactic acidosis is a medical condition that occurs when there is too much lactic acid in the bloodstream. Lactic acid is a normal byproduct of cellular metabolism, but when it builds up faster than the body can process it, it can lead to an imbalance in the body's pH levels. This disruption of the acid-base balance is what characterises lactic acidosis.

Some common questions that people have about lactic acidosis include:

• What causes the body to produce excess lactic acid?
• Is there a cure for lactic acidosis?
• How serious is lactic acidosis?

Why does our body produce lactic acid?

Our cells produce lactic acid when they break down glucose (sugar) for energy in the absence of sufficient oxygen. This process, called anaerobic metabolism, is a normal response to strenuous exercise or other situations where oxygen demand exceeds supply. Normally, the liver and kidneys work to clear excess lactic acid from the blood, keeping levels in check.

What happens during lactic acidosis?

In lactic acidosis, the body's ability to clear lactic acid is overwhelmed, causing it to accumulate in the bloodstream. This can happen due to increased lactic acid production or decreased clearance by the liver and kidneys. The elevated lactic acid levels disrupt the blood's pH balance, leading to potentially life-threatening complications if untreated.

What are the symptoms of lactic acidosis?

Symptoms of lactic acidosis can vary from person to person, but common lactic acidosis symptoms include:

• Rapid, shallow breathing
• Confusion and disorientation
• Abdominal pain, nausea, and vomiting
• Muscle weakness and cramping
• Fatigue and lethargy
• Yellowing of skin or eyes (jaundice)
• Irregular heartbeat

It's important to note that these symptoms can also be indicative of other health issues, so it's crucial to consult with a healthcare professional for an accurate diagnosis.

Types of lactic acidosis

There are two main lactic acidosis types:

Type A lactic acidosis

Type A lactic acidosis is the more common type and is caused by poor oxygen delivery to tissues. This can happen due to:

1. Shock (septic, cardiogenic, or hypovolemic)
2. Severe anemia
3. Heart failure
4. Respiratory failure

Type B lactic acidosis

Type B lactic acidosis occurs when lactic acid buildup is due to reasons other than poor oxygen delivery. Causes can include:

1. Certain medications (like diabetes drug)
2. Liver or kidney disease
3. Diabetes
4. Cancer
5. Inherited metabolic disorders

What are the causes of lactic acidosis?

Several health conditions and factors can contribute to the development of lactic acidosis. Some common lactic acidosis causes include:

Heart Disease

In severe heart failure, the heart may not be able to pump enough blood to meet the body's oxygen needs, leading to lactic acid buildup.

Severe Infection (Sepsis)

Sepsis, a life-threatening complication of infection, can impair tissue perfusion and lead to poor oxygen delivery and lactic acidosis.

HIV

Some HIV medications, particularly nucleoside reverse transcriptase inhibitors (NRTIs), can interfere with cellular energy production and cause lactic acidosis.

Cancer

Certain cancers and cancer treatments can alter cellular metabolism, increasing the risk of lactic acidosis.

Short Bowel Syndrome

This condition, where part of the small intestine is missing, can lead to malabsorption and lactic acidosis.

Acetaminophen Use

Overdose of acetaminophen (Tylenol) can cause liver damage, impacting its ability to clear lactic acid.

Alcohol Use Disorder

Excessive alcohol consumption can damage the liver, increasing the risk of lactic acidosis.

Use of Some Medications

Certain medications, such as metformin (for diabetes), salicylates (like aspirin), and epinephrine, can increase lactic acid production as a side effect.

How is lactic acidosis diagnosed?

If your doctor suspects lactic acidosis, they will likely order the following tests:

1. Lactic acid blood test: This measures the level of lactic acid in your blood. A level higher than 4 mmol/L is considered elevated.
2. Blood gas analysis: This test measures the acidity (pH) and oxygen and carbon dioxide levels in your blood.
3. Comprehensive Metabolic Panel: Assesses electrolyte and acid-base balance.
4. Anion Gap Test: Helps identify the type of metabolic acidosis.
5. Other tests: Depending on your symptoms and medical history, your doctor may order additional tests to check your organ function and rule out other conditions.

What tests are used to diagnose lactic acidosis?

The primary tests used to diagnose lactic acidosis are:

• Lactic acid blood test
• Blood gas analysis
• Comprehensive metabolic panel
• Complete blood count (CBC)

Your healthcare provider may also recommend imaging tests, such as X-rays or CT scans, to look for any underlying conditions that may be causing your lactic acidosis.

How is lactic acidosis treated?

Lactic acidosis treatment involves addressing the underlying cause and supporting the body's ability to clear lactic acid. Treatment may include:

1. Oxygen therapy: Providing extra oxygen can help improve tissue oxygenation and reduce lactic acid production.
2. Intravenous fluids: Fluids can help improve blood flow and support the body's ability to clear lactic acid.
3. Medications: Depending on the cause, medications may be used to treat the underlying condition (e.g., antibiotics for sepsis).
4. Dialysis: In severe cases, dialysis may be needed to directly remove lactic acid from the blood.

What is the outlook for lactic acidosis?

The prognosis for lactic acidosis depends on the underlying cause and the promptness of treatment. Mild cases can often be managed successfully with timely interventions. However, severe lactic acidosis can be life-threatening, with mortality rates ranging from 30-50%. Early diagnosis and appropriate treatment are crucial for improving outcomes.

Some tips for preventing lactic acidosis include:

• Managing chronic conditions like diabetes effectively
• Avoiding excessive alcohol intake
• Discussing medication side effects with your doctor
• Seeking prompt medical care for severe infections

Conclusion

Dealing with lactic acidosis can be challenging, but understanding the condition is a crucial first step in taking control of your health. Remember, the key to managing lactic acidosis is identifying and treating the underlying cause. If you suspect you or a loved one may have lactic acidosis, don't hesitate to reach out to a healthcare professional.

At Metropolis Healthcare, we offer a wide range of diagnostic tests that can help identify lactic acidosis and other health conditions. Our team of experts is committed to providing accurate results and personalized care to support you on your health journey. Take the first step today and book a test with Metropolis Healthcare.