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Alkalosis: Too low acidity of the blood

Alkalosis is a condition in which the patient has body fluids that are excessively basic (alkaline). People with healthy kidneys and lungs do not normally have severe alkalosis, but when problems arise in these organs, a patient is more likely to develop alkalosis. There is a neutral pH (acidity) in the blood when it is 7.35-7.45. In alkalosis the pH is 7.5 or higher. This means that there is a loss of acid or a build-up of alkali in the body. Alkalosis exists in various forms and therefore has various causes. Vomiting, dizziness and confusion are some symptoms of the condition. The treatment is individually determined and tailored to the precise cause of alkalosis. Usually, the outlook for patients with alkalosis is excellent if the doctor initiates treatment quickly. If prompt treatment is not provided, various (life-threatening) complications are possible.

  • Causes of too low acidity in the blood
  • Types of alkalosis
  • Symptoms: Vomiting, muscle cramps and confusion
  • Diagnosis and examinations
  • Treatment: Eliminate cause
  • Prognosis is excellent
  • Complications
  • Prevention


Causes of too low acidity in the blood

Alkalosis is the opposite of acidosis, where the acidity of the blood is too high. The kidneys and lungs maintain the correct balance (correct pH) of acids and bases in the body. A reduced level of carbon dioxide (an acid) or increased level of bicarbonate (a base) makes the body too alkaline, causing alkalosis.

Types of alkalosis

Alkalosis comes in various types:

  • compensated acidosis
  • hypochleremic alkalosis
  • hypokalemic alkalosis
  • metabolic alkalosis
  • respiratory alkalosis


Compensated alkalosis

Compensated alkalosis occurs when the body returns the acid-base balance to normal in case of alkalosis, but bicarbonate and carbon dioxide levels remain abnormal.

Hypochloremic alkalosis

Hypochloremic alkalosis results in an extreme deficiency or loss of chloride. This occurs, for example, with prolonged vomiting.

Hypokalemic alkalosis

Hypokalemic alkalosis results from the kidneys’ response to an extreme lack or loss of potassium. Certain water pills (diuretics) cause this type of alkalosis.Alcohol abuse sometimes causes metabolic alkalosis / Source: Jarmoluk, PixabayMetabolic alkalosis Metabolic alkalosis is the most common acid-base disturbance occurring in hospitalized patients, accounting for approximately 50% of all acid-base disturbances. This type of alkalosis is due to too much bicarbonate in the blood (bicarbonate is found in baking soda). It also occurs as a complication of certain kidney diseases such as Bartter syndrome. Metabolic alkalosis also occurs with adrenal gland disease (such as Cushing’s disease), the use of laxatives (drugs for constipation) and alcohol abuse.

Respiratory alkalosis

Respiratory alkalosis is due to low levels of carbon dioxide in the blood. This is the consequence of:

  • a liver disease
  • a lung condition that causes the patient to breathe faster (such as hyperventilation)
  • fever
  • pain
  • poisoning with aspirin
  • are at high altitude
  • oxygen deficiency


Symptoms: Vomiting, muscle cramps and confusion

The following symptoms of alkalosis occur; they are not present in everyone.

  • tremors in the hands
  • vomit
  • dizziness
  • numbness or tingling in the face, hands or feet
  • prolonged muscle cramps as part of tetany
  • nausea
  • irritability
  • muscle cramps
  • twitching
  • confusion, sometimes resulting in stupor or coma. In stupor, the body is immobile in combination with a strong reduction or complete abolition of mental functions.


Diagnosis and examinations

The doctor questions the patient about the symptoms and then performs a physical examination. A blood test is needed to confirm the diagnosis of alkalosis. This examination sometimes reveals hypophosphatemia (decreased phosphate levels in the blood). Sometimes a urine test is necessary to determine the cause of alkalosis

Treatment: Eliminate cause

The doctor must first know the cause of alkalosis and then tailor appropriate treatment accordingly. With hyperventilation it helps to slow down breathing by having a helper say the breathing rate out loud and then follow this breathing rate. In this way, the carbon dioxide level in the body increases, which improves the symptoms of alkalosis. When the oxygen level in the blood is low, the patient receives extra oxygen. Medicines correct the deficiency of chloride or potassium. Furthermore, the doctor thoroughly monitors the patient’s vital functions. In other words, he regularly checks the temperature, heart rate, breathing rate and blood pressure.

Prognosis is excellent

Most patients with alkalosis respond well to treatment.


Untreated or improperly treated alkalosis leads to the following complications

  • breathing problems
  • loss of consciousness
  • coma
  • an electrolyte imbalance (such as low potassium = hypokalemia)
  • a reduced mental state
  • epileptic attacks
  • severe breathing difficulties
  • cardiac arrhythmias (heartbeat is too fast, too slow or irregular)
  • rapidly worsening symptoms of alkalosis

According to the Emedicine website, 45% of patients die with a pH value of 7.55 and 80% of patients die when the pH is greater than 7.65.


A healthy and balanced diet and sufficient fluids maintain the electrolyte balance and prevent dehydration.

read more

  • Acidosis: Too high acidity of the blood
  • Fever and increased body temperature with weakness
  • Confusion: Disorientation in time, place and person

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