Lactic acidosis occurs when the body’s metabolic processes malfunction. When working properly, these processes make energy from oxygen. Cells need this energy to perform correctly. When these processes are not working, the body does not know how to convert the energy it produces and receives properly. Instead, it ends up making more lactate than it can handle, leading to a dangerous build-up of lactic acid within the cells. That build-up, in turn, negatively affects pH levels. Increased lactic acid and decreased pH levels wreak havoc and can have serious health consequences.
Lactic acidosis may occur in anyone; it is not gender-, ethnic- or age-specific. The presence of a chronic or acute medical condition such as renal failure or diabetes increases one's risk of developing lactic acidosis. People with serious infections such as sepsis are also more at risk, as are those taking certain medications. Excessive exercise or alcohol or drug use may increase the likelihood of developing lactic acidosis, as well.
There are two types of lactic acidosis: type A and type B. A lack of oxygen in the body's cells causes type A, which is most often linked to acute medical diseases, particularly those affecting the liver or cardiovascular system. Critical illnesses such as sepsis or shock can also lead to type A. Finally, lactic acidosis brought on by over-exercising is classified as type A.
Type B lactic acidosis is not associated with a lack of oxygen and is subdivided into three categories. B1 is associated with systemic diseases such as diabetes or renal failure. B2 is related to drug or alcohol use, or other toxins. B3 stems from genetic disorders that render the body incapable of properly turning food into energy.
Symptoms of lactic acidosis depend upon the underlying cause but include nausea, vomiting, labored, deep or rapid breathing, and general weakness. Most cases involve decreased blood flow within the tissue or hypoperfusion. The affected individual may also have low blood pressure or severe hypotension. An altered mental state is also characteristic of lactic acidosis, as is low urine output, which signals depleted body fluids.
To detect the presence of lactic acidosis, the doctor will order lab tests. A test of lactate will show elevated levels in the presence of lactic acidosis. Arterial blood gas samples provide a biochemical blood analysis. In addition, tests will determine the underlying cause of the condition, including whether other ailments are present.
The first step in treating lactic acidosis is determining the underlying cause. When the condition develops due to another illness, the doctor can begin treatment for that illness. If medication is the cause, he can adjust dosage and type. If the patient has a mitochondrial disease, dietary changes or other treatments will be developed.
The next step of treatment is reducing the amount of lactic acid in the body. Historically, medical professionals accomplished this via hemofiltration or purification of the blood. However, this is a difficult process with little evidence to support its effectiveness in this case. Researchers are exploring better treatment options. Another vital step is improving the pH levels in the body. Typically, a doctor will use sodium bicarbonate solutions to achieve this.
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Those without underlying medical conditions that raise their risk can take steps to prevent lactic acidosis. Drinking enough water daily will help maintain optimal cell health. Eating a balanced diet full of fruit, vegetables, whole grains, and lean protein is a good preventative measure, as is moderate regular exercise. For people with diabetes, adhering to a strict medication regiment is also a great preventative measure.
The prognosis for people with lactic acidosis depends on several factors. The age of the individual when the condition develops is significant, as is the presence of other chronic or acute illnesses. Once the condition is diagnosed and treatment is underway, factors such as organ failure and general response to treatment make a significant difference in prognosis. The severity of lactic acid and pH levels, and how long it takes for those levels to normalize, ultimately determines how life-threatening the condition will become.
Interestingly, humans aren’t the only beings who suffer from lactic acidosis. Ruminants, including cattle, sheep, and other animals with similar digestive systems, may contract the illness by eating large amounts of grain. In addition, crocodiles may also suffer from lactic acidosis upon expending large amounts of energy. These skewed lactic acid and pH levels often prove fatal in the animal kingdom.
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