Alkalosis is a condition in which the body fluids have excess base (alkali). This is the opposite of excess acid (acidosis).
The kidneys and lungs maintain the proper balance (proper pH level) of chemicals called acids and bases in the body. Decreased carbon dioxide (an acid) level or increased bicarbonate (a base) level makes the body too alkaline, a condition called alkalosis. There are different types of alkalosis. These are described below.
Respiratory alkalosis is caused by a low carbon dioxide level in the blood. This can be due to:
Metabolic alkalosis is caused by too much bicarbonate in the blood. It can also occur due to certain kidney diseases.
Hypochloremic alkalosis is caused by an extreme lack or loss of chloride, such as from prolonged vomiting.
Hypokalemic alkalosis is caused by the kidneys' response to an extreme lack or loss of potassium. This can occur from taking certain water pills (diuretics).
Compensated alkalosis occurs when the body returns the acid-base balance to near normal in cases of alkalosis, but bicarbonate and carbon dioxide levels remain abnormal.
Symptoms of alkalosis can include any of the following:
- Confusion (can progress to stupor or coma)
- Hand tremor
- Lightheadedness
- Muscle twitching
- Nausea, vomiting
- Numbness or tingling in the face, hands, or feet
- Prolonged muscle spasms (tetany)
Your health care provider will perform a physical exam and ask about your symptoms.
Laboratory tests that may be ordered include:
Other blood tests may be needed to determine the cause of the alkalosis.
Other tests may be needed to determine the cause of the alkalosis. These may include:
To treat alkalosis, your provider needs to first find the underlying cause.
For alkalosis caused by hyperventilation, breathing into a paper bag allows you to keep more carbon dioxide in your body, which improves the alkalosis. If your oxygen level is low, you may receive oxygen.
Medicines may be needed to correct chemical loss (such as chloride and potassium). Your provider will monitor your vital signs (temperature, pulse, rate of breathing, and blood pressure).
Most cases of alkalosis respond well to treatment.
Untreated or not treated properly, complications may include any of the following:
When to Contact a Medical Professional
Contact your provider if you become confused, unable to concentrate, or unable to "catch your breath."
Go to the emergency room or call 911 or the local emergency number if there is:
Prevention depends on the cause of the alkalosis. People with healthy kidneys and lungs do not usually have serious alkalosis.
Oh MS, Briefel G, Pincus MR. Evaluation of renal function, water, electrolytes, and acid-base balance. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 15.
Sanghavi S, Albert TJ, Swenson ER. Acid-base balance. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 12.
Seifter JL. Acid-base disorders. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 104.
Updated by: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Related MedlinePlus Health Topics
FAQs
According to the American Association for Clinical Chemistry, normal blood pH levels are between 7.35 and 7.45. A blood pH above 7.45 may indicate alkalosis. Your doctor may also want to measure the carbon dioxide and oxygen levels in your blood to rule out respiratory issues.
Why is alkalosis bad for the body? ›
Metabolic alkalosis can have central nervous system manifestations ranging from confusion to coma, peripheral neuropathic symptoms of tremor, tingling and numbness, muscle weakness and twitching, and arrhythmias, particularly when associated with hypokalemia and hypocalcemia.
What are 2 common types of alkalosis? ›
Metabolic alkalosis is caused by too much bicarbonate in the blood. It can also occur due to certain kidney diseases. Hypochloremic alkalosis is caused by an extreme lack or loss of chloride, such as from prolonged vomiting.
How do you get rid of alkalosis? ›
Treatment of Alkalosis
Metabolic alkalosis is usually treated by replacing water and electrolytes (sodium and potassium) while treating the cause. Rarely, when metabolic alkalosis is very severe, dilute acid is given intravenously. In respiratory alkalosis, the first step is to ensure that the person has enough oxygen.
What happens to your blood if you are experiencing alkalosis? ›
Alkalosis occurs when your blood and body fluids contain an excess of bases or alkali. Your blood's acid-base (alkali) balance is critical to your well-being. When the balance is off, even by a small amount, it can make you sick.
How to get rid of too much acid in the body? ›
The over-the-counter (OTC) medications sodium citrate or sodium bicarbonate can help balance the acids in your body. Talk to your healthcare provider before taking any OTC medications to help treat your metabolic acidosis. Your healthcare provider may also prescribe inotropes.
Which organs help you regulate the pH of your blood? ›
The kidneys are able to affect blood pH by excreting excess acids or bases. The kidneys have some ability to alter the amount of acid or base that is excreted, but because the kidneys make these adjustments more slowly than the lungs do, this compensation generally takes several days.
Which patient is most prone to metabolic alkalosis? ›
The patient most prone to metabolic alkalosis is the one with excessive loss of chloride (Cl) (Option B). Metabolic alkalosis is a condition that occurs when there is an excess of bicarbonate or a loss of acids in the body. This leads to an increase in the pH level of the blood, making it more alkaline.
What is the drug of choice for alkalosis? ›
Ammonium chloride is administered to correct severe metabolic alkalosis related to chloride deficiency. NH4Cl is converted to ammonia and HCl by the liver. By releasing HCl, NH4Cl may help correct metabolic alkalosis. This agent is available as 500-mg tablets and a 26.75% parenteral formulation for intravenous use.
What clinical conditions leads to alkalosis? ›
Metabolic alkalosis most commonly results from severe cases of vomiting that cause you to lose the acidic fluids in your stomach. This can usually be reversed by treatment with a saline solution. It can also be the result of a potassium deficiency or a chloride deficiency.
The most common causes are volume depletion (particularly when involving loss of gastric acid and chloride (Cl) due to recurrent vomiting or nasogastric suction) and diuretic use. Metabolic alkalosis involving loss or excess secretion of Cl is termed chloride-responsive.
What foods help alkalosis? ›
The type of diet can deeply affect the body by providing acid or base precursors. Generally speaking, foods such as meat, eggs, cheese, and grains increase the production of acid in the organism, whereas fruit and vegetables are alkalizing.
What diuretic is used for alkalosis? ›
If diuresis is needed, a carbonic anhydrase inhibitor (eg, acetazolamide) or a potassium-sparing diuretic (eg, spironolactone, amiloride, triamterene) can be used to correct the alkalosis.
What is the easiest way to correct respiratory alkalosis? ›
Respiratory alkalosis occurs when low carbon dioxide levels disrupt your blood's acid-base balance. It often occurs in people who experience rapid, uncontrollable breathing (hyperventilation). Treatment includes supplemental oxygen and therapies to reduce the risk of hyperventilation.
What is the mortality rate for alkalosis? ›
Mortality rates have been reported as 45% in patients with an arterial blood pH of 7.55 and 80% when the pH was greater than 7.65.
Is metabolic alkalosis life threatening? ›
Metabolic alkalosis is relatively common. It is often mild, and treating the underlying condition usually cures it. However, metabolic alkalosis can cause life threatening problems in some cases. This happens when it causes low calcium levels, which can lead to seizures or coma.
What pH is severe alkalosis? ›
Most severe metabolic alkalosis is of the chloride-responsive form (as in both our patients), the common causes being loss of gastric acid and the administration of loop or thiazide diuretics. [2] Extreme alkalemia (blood pH greater than 7.65) carries a high risk of complications [Table 3].
Is respiratory alkalosis an emergency? ›
Respiratory alkalosis itself is rarely life threatening. Therefore, emergent treatment is usually not indicated unless the pH level is greater than 7.5. Because respiratory alkalosis usually occurs in response to some stimulus, treatment is usually unsuccessful unless the stimulus is controlled.
