If the lactate level in the blood rises and the acid-base balance falls at the same time, what is known as lactic acidosis develops . Oxygen deficiency, muscle work or shock states, pulmonary embolisms and operations can trigger hyperacidity.
What is lactic acidosis?
In the context of lactic acidosis, the lactic acid concentration in the blood increases. The pH value then falls below the physiological range, which means that the acidic values also shift. Such a change can have serious consequences. Depending on the cause, even the health and life of those affected can be endangered. See AbbreviationFinder for abbreviations related to Lactic Acidosis.
Causes
People affected by lactic acidosis have too much lactate (lactic acid) in their blood; as a result, hyperacidity occurs. The causes are manifold. On the one hand, lactic acidosis can be triggered by medication (e.g. as part of diabetes mellitus treatment); on the other hand, renal dysfunction or liver failure can trigger lactic acidosis. Sepsis (blood poisoning) can also cause lactic acidosis.
Other causes are pulmonary embolism, shock or operations, which can also cause the body to become acidic. Lactic acidosis can also occur in extreme athletes if the body has to develop excessive muscle strength. However, that cause is not serious; a rest period is sufficient for the values to “calm down” again.
Symptoms, Ailments & Signs
Typical signs are vomiting, nausea, tachycardia, abdominal pain and rapid breathing, fatigue, anxiety, lethargy and weakness.
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Lactic acidosis can cause a variety of symptoms and signs. Typical signs are vomiting, nausea, tachycardia, abdominal pain and rapid breathing, fatigue, anxiety, lethargy and weakness. In many cases, an irregular heart rate also occurs.
A classic symptom is Kussmaul breathing. That breathing ensures compensation in the context of hyperacidity. “Kussmaul breathing” is characterized by very deep and regular breathing, during which the body is busy exhaling excess acid. Sometimes shortness of breath, restlessness and fever can also occur. As the disease progresses, confusion, disturbances of consciousness or even unconsciousness (coma) are possible.
However, lactic acidosis can have such severe effects on the body and its organs that the acidosis can even lead to death. Especially if not treated, there is a risk that the patient will risk his life and sometimes – due to lactic acidosis – die.
Diagnosis & course of disease
The doctor can only diagnose lactic acidosis with a laboratory test. Lactic acidosis occurs when the pH is below 7.36 and at the same time the concentration of lactate exceeds 5 mmol/L. If there is only a low pH value, with the concentration of lactate being in the normal range, doctors speak of metabolic acidosis. No other diagnosis is possible.
The course of lactic acidosis varies. Above all, the reason why lactic acidosis developed plays an important role. When lactic acidosis occurs in extreme athletes, symptoms subside when the athlete takes rest. However, if organ disorders are responsible for lactic acidosis, especially if the liver and kidneys are affected, there is an acute danger to the patient’s life. The patient may fall into a coma; sometimes death of the patient can occur as a result of that cause.
Complications
Those affected by lactic acidosis suffer from various serious symptoms. In the worst case, these symptoms can even lead to the death of the patient and should therefore be treated in any case. Patients suffer from heart palpitations and nausea. There is also general weakness and fatigue in the patient.
The resilience of those affected is also significantly reduced by lactic acidosis. It can also lead to a heart attack or sudden cardiac death. Loss of consciousness or other disorders of consciousness can also occur and significantly reduce the patient’s quality of life. There is also inner restlessness and severe shortness of breath. If lactic acidosis is not treated, the patient usually dies.
Lactic acidosis is usually treated with medication. These can alleviate and reduce the symptoms so that those affected can return to a normal everyday life. Special complications usually do not arise. Successful treatment of lactic acidosis does not affect the patient’s life expectancy.
When should you go to the doctor?
If you experience any unusual symptoms after taking medication or after an operation, you should see a doctor. A doctor should be consulted in the event of nausea, vomiting, discomfort and abnormalities as well as irregularities in the heart rhythm. Severe tiredness, diffuse anxiety or apathy are signs that need to be investigated. If it comes to sweating, inner weakness and loss of appetite, a doctor should be consulted. A doctor is needed if you have a fever, lethargic behavior or feel sick.
Dizziness, unsteady gait, mood swings and an increase in existing discrepancies must be examined by a doctor. A breathing disorder, the feeling of lack of oxygen despite sufficient fresh air supply and states of confusion are warning signs of the organism. In the case of “Kussmaul breathing”, the affected person shows a very characteristic sign of lactic acidosis. A doctor’s visit is necessary so that a diagnosis can be made after various tests and examinations.
If the symptoms mentioned appear after vigorous muscle activity, a doctor should be consulted to clarify the cause. If the victim loses consciousness, call an ambulance as soon as possible. Since untreated lactic acidosis can lead to premature death, timely examination of the affected person is advisable. Delays can also result in irreparable organ damage.
Treatment & Therapy
Lactic acidosis is usually treated in the hospital (inpatient), with the patient being taken to the intensive care unit. This is because permanent surveillance must be possible until the cycle is stable. In order to reduce the acid concentration in the body, doctors also administer bicarbonate as an antidote.
Even if the symptoms of lactic acidosis are primarily treated at the beginning, care must be taken to determine which cause is responsible and then treat the triggering factor. The basic/alkaline bicarbonate is administered, which is intended to neutralize the acidification in the body. It is important that lactic acid production is also slowed down or stopped completely. This is the only way for the body to be able to break down the lactate.
Therefore, care should be taken to use the bicarbonate carefully. Sometimes that remedy can also aggravate hyperacidity. If there are signs that the drug is not having the desired effect, the therapy must be stopped immediately. As an alternative treatment method – either right at the beginning or after the therapy with bicarbonate has not brought about the desired effect – different liquids can be injected.
These should subsequently improve the oxygen supply of the person concerned, so that the production of lactate can be counteracted. With oxygen therapy, it is possible for the patient to be provided with enough oxygen again or for the body of the person concerned to regenerate.
If the lactic acidosis develops due to a diabetic disorder, the patient is injected with insulin. In this way, the blood sugar level can be lowered again. Vitamin therapies or even dialysis treatments also cleanse the acidified blood.
However, if the liver is irreversibly damaged, so that lactic acidosis is subsequently triggered, only a liver transplant can provide relief. In the case of liver damage, primarily only the symptoms are treated; the cause can only be treated when an organ is ready for transplantation.
Outlook & Forecast
The course of the disease and the prognosis of lactic acidosis depend on the causal disorder. If left untreated and without consulting a doctor, an unfavorable course can lead to a heart attack or sudden cardiac death. If the symptoms occur as a side effect of the administration of medication, a change in the original treatment plan can already trigger freedom from symptoms. The prescribed medicines should be checked for their ingredients. Subsequently, alternative preparations are to be determined and used.
Immediately after discontinuing the triggering medication, there is an improvement in the symptoms and, over time, recovery. In the case of an existing organ disorder, it is necessary to check how far this has progressed and how severe the damage to the organ is. In most cases, the organ damage is irreversible and, in the case of a severe course of the disease, can lead to a failure of organ activity. This poses a potential threat to human life.
For many patients, only an organ transplant can ultimately alleviate the symptoms. The procedure is complex and associated with numerous complications. If lactic acidosis occurs in connection with diabetes, the treatment plan must be reviewed. The blood sugar level has to be monitored and optimizations have to take place. Acidification of the blood can be normalized in dialysis treatment.
Prevention
In almost all cases, it is possible to prevent lactic acidosis. It is important that medication is only taken if the liver and kidneys are fully functional. Taking medication even though the organs are damaged can inevitably lead to lactic acidosis.
Aftercare
In most cases, aftercare measures are relatively difficult in the case of lactic acidosis, so that a doctor should be consulted as quickly as possible in the case of this disease. It cannot heal on its own, and the symptoms of lactic acidosis usually continue to worsen if the disease is not treated properly.
Therefore, the affected person should consult a doctor at the first signs and symptoms. In most cases, those affected are dependent on taking various medications. It is always important to ensure that the dosage is correct and that the medication is taken regularly. The doctor’s instructions should always be followed. If anything is unclear or if you have any questions, you should first consult a doctor.
Since most of those affected by lactic acidosis are also dependent on dialysis, help and support from family and friends is often necessary. In many cases, this can also prevent depression or other mental disorders. A healthy lifestyle with a healthy diet also has a positive effect on the course of the disease, and a nutrition plan can also be drawn up by a doctor.
You can do that yourself
After the lactic acidosis has been treated in intensive care, the patient must take it easy. Recovery can be aided by monitoring the effectiveness of the prescribed bicarbonate and notifying the doctor of any unusual symptoms. The active ingredient often does not bring the desired result and must then be discontinued or adjusted differently. Anyone who feels side effects and interactions should first note them in a complaints diary and promptly contact the doctor responsible to discuss further steps.
Finally, the cause of the lactic acidosis must be determined. The condition is often based on a diabetic disorder, which can be avoided through preparation and changes in lifestyle. In addition, there are alternative measures such as vitamin therapy, which the patients can sometimes carry out at home.
If lactic acidosis necessitates a liver transplant, steps must be taken to find a donor organ quickly. The patient should contact a specialist clinic and at the same time look for a suitable donor among friends or via online portals. Rest and bed rest apply again after a transplant. In parallel, the doctor in charge must monitor the state of health.