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
When should I see a healthcare provider for alkalosis? Uncontrolled breathing often needs immediate medical care in a hospital. The treatment for respiratory alkalosis depends on the underlying cause and it needs to be determined by a medical professional.
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? ›
There are four main types of alkalosis.
- Respiratory alkalosis. Respiratory alkalosis occurs when there isn't enough carbon dioxide in your bloodstream. ...
- Metabolic alkalosis. Metabolic alkalosis develops when your body loses too much acid or gains too much base. ...
- Hypochloremic alkalosis. ...
- Hypokalemic alkalosis.
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.
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 are the symptoms of too much alkaline in the body? ›
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)
Respiratory alkalosis occurs when you are breathing too fast or too deeply causing your lungs to get rid of too much carbon dioxide. This causes the carbon dioxide levels in the blood to decrease and the blood then becomes alkaline.
What happens if metabolic alkalosis goes untreated? ›
Metabolic alkalosis, on the other hand, can cause irritability, muscle cramps and twitches. If left untreated, you can experience long-term muscle spasms.
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.
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.
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 lab shows alkalosis? ›
In any event, the only definitive way to diagnose metabolic alkalosis is with a simultaneous blood gases analysis that shows elevation of both pH and PaCO2 and increased calculated bicarbonate.
What happens if pH is too high in the body? ›
When your body becomes too acidic (as in acidosis) or too alkaline (as in alkalosis), it can lead to symptoms that make it difficult to manage everyday activities. The exact symptoms will depend on the type of pH imbalance but can include sleepiness, fatigue, headache, loss of appetite, confusion, and vomiting.
How to fix respiratory alkalosis? ›
Treatment for respiratory alkalosis
- Breathe into a paper bag. Fill the paper bag with carbon dioxide by exhaling into it. ...
- Get reassurance. The symptoms of respiratory alkalosis can be frightening. ...
- Restrict oxygen intake into the lungs. To do this, try breathing while pursing the lips or breathing through one nostril.
The most rapid defense against changes in blood pH is buffering of hydrogen ions. Buffer systems in the body, such as proteins, HCO3-, and ammonia, have a very large capacity to absorb or release hydrogen ions as needed to resist a change in pH.
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.
What does alkalosis feel like? ›
Even a slight imbalance of your blood pH can make you sick, irritable, and uncomfortable. Some of the common symptoms for metabolic and respiratory alkalosis are: General confusion. Tremors.
