Endocrine diseases

Lactic acidosis

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Lactic acidosis
portrait of Fernando Martínez Sáez
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Fernando Martínez Sáez
Medically reviewed by our Medical staff

Last update: 03-03-2022

How else can it be called?

  • Hyperlactatemia

  • ICD-10: E87.2

What is lactic acidosis?

Lactic acidosis is a condition caused by the buildup of lactic acid in the blood.

Lactic acidosis is the most common type of metabolic acidosis and it is due to the effect of lactate accumulation in the blood causing it to become excessively acidic.

Lactic acid is a product of the breakdown of glucose to generate energy. Lactic acid is mainly produced in muscle cells and RBCs (Red Blood Cells).

Lactic acid level in the blood depends on the metabolism and the level of lactic acid is increased during exercise. Lactic acid is mainly metabolized in the liver (but also in the kidneys) into pyruvate and ultimately converted to glucose.

Lactic acid buildup occurs when there is not enough oxygen for a correct metabolism of the cells.

What is the cause of lactic acidosis?

Lactic acidosis is produced by an excessive production of lactate or by a decrease in the metabolism of lactate.

Thus, lactic acidosis may occur in a variety of conditions, including:

What are the main symptoms of lactic acidosis?

When the level of lactic acid in the blood increases the person starts feeling ill with symptoms such as:

  • Epigastric pain
  • Vomiting
  • Nausea
  • Lethargy
  • Rapid breathing (Kussmaul breathing)

Breathing in patients with lactic acidosis is deep and labored and patient may lose consciousness.

How can it be diagnosed?

The criteria for diagnosis of lactic acidosis are high levels of lactates in the blood exceeding 45 mg/dl (5 mmol/l) and pH of 7.25 or below.

What is the recommended treatment?

The primary therapy for lactic acidosis is to treat the underlying disorder.

In addition, the following treatments may be used:

  • Sodium bicarbonate to correct acidemia and the excess of lactate in the blood.
  • Dicloacetate in case of congenital lactic acidosis.
  • Trishydroxymethyl aminomethane (THAM) may be administered to counter sodium overload
Medically reviewed by our Medical staff on 03-03-2022

Bibliography

  • Encyclopedia of Human Nutrition (2nd Ed) 2005, A Pietrobelli, ISBN 0-12-150110-8, Vol. III Pag. 98.
  • Manual of Clinical & Practical Medicine. G.S. Sainani, V.R. Joshi, Rajesh G. Sainani. 2010. Pag 249. ISBN: 978-81-312-2313-0.

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