Lactic Acidosis: Definition and Overview -Diabetes Self-Management


A lactic acidosis is a form of metabolic acidosis that begins when a person overproduces or underutilizes lactic acid, and their body is not able to adjust to these changes.
People with lactic acidosis have problems with their liver (and sometimes their kidneys) being able to remove excess acid from their body. If lactic acid builds up in the body more quickly than it can be removed, acidity levels in bodily fluids — such as blood — spike.
This buildup of acid causes an imbalance in the body’s pH level, which should always be slightly alkaline instead of acidic. There are a few different types of acidosis.
Lactic acid buildup occurs when there’s not enough oxygen in the muscles to break down glucose and glycogen. This is called anaerobic metabolism.
There are two types of lactic acid: L-lactate and D-lactate. Most forms of lactic acidosis are caused by too much L-lactate.
There are two types of lactic acidosis, Type A and Type B:
  • Type A lactic acidosis is caused by tissue hypoperfusion resulting from hypovolemiacardiac failuresepsis, or cardiopulmonary arrest.
  • Type B lactic acidosis is caused by impairment of cellular functioning and localized areas of tissue hypoperfusion.
Lactic acidosis has many causes and can often be treated. But if left untreated, it may be life-threatening.
  • symptoms 

  • fruity-smelling breath (a possible indication of a serious complication of diabetes, called ketoacidosis)
  • confusion
  • jaundice (yellowing of the skin or the whites of the eyes)
  • trouble breathing or shallow, rapid breathing
  • exhaustion or extreme fatigue
  • muscle cramps or pain
  • body weakness
  • overall feelings of physical discomfort
  • abdominal pain or discomfort
  • diarrhoea
  • decrease in appetite
  • headache
  • rapid heart rate   
  • causes 
Lactic acidosis has a wide range of underlying causes, including carbon monoxide poisoningcholeramalaria, and asphyxiation.
  1. Heart disease

Conditions such as cardiac arrest and congestive heart failure may reduce the flow of blood and oxygen throughout the body. This can increase lactic acid levels.
2. severe infections( sepsis)
Any type of severe viral or bacterial infection can cause sepsis. People with sepsis may experience a spike in lactic acid, caused by reduced oxygen flow.

HIV

HIV medications, such as nucleoside reverse transcriptase inhibitors, can spike lactic acid levels. They also may cause liver damage. This makes it harder for the body to process lactate.

Cancer

Cancer cells create lactic acid. This buildup of lactic acid may accelerate as a person loses weight and the disease progresses.

Short bowel syndrome (short gut)

While rareTrusted Source, people with short gut may experience a buildup of D-lactic acid, caused by bacterial overgrowth in the small bowel. People who’ve had gastric bypass surgery may also get D-lactic acidosis.

Acetaminophen use

Regular, frequent use of acetaminophen (Tylenol) can cause lactic acidosis, even when taken in the correct dosage. This is because it can cause an accumulation of pyroglutamic acid in the blood.

Chronic alcoholism

Drinking alcohol to excess over an extended period of time can lead to lactic acidosis and alcoholic ketoacidosis. Alcoholic ketoacidosis is a potentially fatal condition if left untreated, but it can be combated with intravenous (IV) hydration and glucose.
Alcohol increases phosphate levels, which negatively impact the kidneys. This makes the body’s pH more acidic. If you’re having trouble reducing your alcohol intake, support groups can help.

Intense exercise or physical activity

A temporary buildup of lactic acid can be caused by vigorous exercise if your body doesn’t have enough available oxygen to break down glucose in the blood. This can cause a burning feeling in the muscle groups you’re using. It can also cause nausea and weakness.
  • Treatment

  • intravenous fluid to promote circulation
  • oxygen, delivered with a face mask or another way
  • positive pressure ventilation to deliver oxygen to the lungs
  • vitamin therapy
  • hemodialysis with bicarbonate 

  • complication

  • irregular heart rhythm
  • unconsciousness or coma
  • shock
  • major organ failure




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