Understanding Lactic Acidosis

Lactic acid is a natural chemical in your body. It fuels your muscles during intense activity like running and jumping. Normally, your body can keep the right balance of this substance. But when the amount of lactic acid exceeds what’s normal, your liver and kidneys can’t get rid of it. This is called lactic acidosis. It’s a serious health problem that can be fatal.

Several things can trigger lactic acidosis:

• Not enough oxygen supply to your tissues

• Infections such as HIV/AIDs or sepsis

• Conditions such as diabetes, kidney and liver problems, heart failure, specific types of cancer, alcohol use disorder, and seizures

• Certain medicines such as metformin and acetaminophen, or illegal drugs like cocaine

• Too much or very intense exercise beyond your usual limits

Symptoms

• Feeling tired

• Rapid breathing

• Nausea and vomiting, poor appetite

• Belly (abdominal) pain

• Muscle pain or cramps

• Confusion

• Low blood pressure

• Clammy skin

• Less urine production

Diagnosis

Lactic acidosis can make you very ill. It’s often diagnosed after you’ve gone to the hospital. A healthcare provider will give you a physical exam and review your health history. This includes listing any drugs and medicines you take and any toxins you may have been exposed to. You may also be asked about recent physical activity. You will have a blood test to check the lactic acid level in your blood.

Risk factors

People who are very ill or have life-threatening complications of infection (such as sepsis) are at risk for lactic acidosis.

Certain medicines can result in lactic acidosis. In many cases, this is caused by taking too much of the medicine. It can also occur as a complication of underlying disorders such as liver or kidney failure. If you have had lactic acidosis or are at risk from underlying conditions, your healthcare provider may need to make changes to your medicines. Medicines that may trigger lactic acidosis include:

• Certain medicines to treat AIDS

• Certain medicines for diabetes such as metformin

• Certain medicines to treat asthma or COPD

• Certain medicines to treat tuberculosis (isoniazid)

• Acetaminophen (pain reliever)

• Certain pain-killing medicines (anesthetics)

• Salicylates such as aspirin and aspirin-containing medicines

• Valproic acid. This is used to treat epilepsy, migraines, and certain mental health disorders.

• Sulfasalazine. This is used to treat certain arthritis conditions.

• Cocaine

Review your medicines and any drugs you take with your healthcare provider.

Treatment

Lactic acidosis is very treatable once identified. Your healthcare provider will want to:

• Find any underlying cause. If lactic acidosis is from an infection or medicine, they will treat the infection or change medicine to help resolve the problem.

• Give you oxygen to help heal the tissues and organs.

• Give you oral or IV (intravenous) fluids to help get rid of excess lactic acid and increase blood pressure.

In some cases, your provider may prescribe medicines that can lower lactic acid levels in your blood.

Preventing lactic acidosis

Follow these measures to prevent lactic acidosis:

• Follow your healthcare provider’s advice. This includes taking any medicines exactly as prescribed.

• Do physical activity. Regular, moderate exercise can help your body better process lactic acid. But don’t overdo it.

• Stay well hydrated. Drink plenty of water to help get rid of excess lactic acid.

• Eat a balanced diet. Choose fruits, vegetables, whole grains, and lean meats for overall good health.