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Alkalosis: Symptoms, Types, Causes & Prevention

Alkalosis [1]  is a condition developed from a reduction in the hydrogen ion concentration of the arterial blood plasma. Basically, it arises when the body fluids have an excess of alkali or too many bases. The excess of alkali occurs due to decreased levels of carbon dioxide (acid) or increased blood levels of [2]  bicarbonate (base).

alkalosis

The condition can also arise due to health issues such as [3]  hypokalemia, which is the lack of adequate amount of potassium in your body. The overabundance of bicarbonate in your bloodstream causes an imbalance between bases and acids. The imbalance, even in the slightest form causes various health problems.

Symptoms Of Alkalosis

The signs of the condition vary during the early and later stages. The early symptoms [4] include

  • numbness or tingling in the face, hands, or feet, 
  • nausea or vomiting,
  • prolonged muscle spasms or tetany, 
  • muscle twitching or weakness, and
  • hand tremors.

The serious symptoms of the condition include [5]

  • lightheadedness, 
  • confusion
  • dizziness
  • difficulty breathing, 
  • stupor
  • low blood calcium concentration, and 
  • coma.

Types Of Alkalosis

The condition of excess of bases is classified into four types.

1. Respiratory alkalosis

This condition occurs when there is a lack of adequate amount of [6]  carbon dioxide in the bloodstream. Respiratory alkalosis is caused due to hyperventilation, which is rapid and deep breathing that causes an excessive amount of carbon dioxide to be discharged from your bloodstream.

Causes of respiratory alkalosis 

  • High fever [7] ,
  • lack of oxygen,
  • salicylate poisoning,
  • hyperventilation, which commonly occurs with anxiety,
  • being in high altitudes,
  • liver disease, and
  • lung disease.

2. Metabolic alkalosis

This condition develops when your body gains too much base or due to an excess of [8] bicarbonate in your bloodstream. Metabolic alkalosis also develops when your body loses too much acid.

Causes of metabolic alkalosis

  • Alcohol abuse [9]
  • excess vomiting, which causes the loss of electrolyte, 
  • adrenal disease,
  • overuse of diuretics,
  • accidental ingestion of excessive bicarbonate, which can be found in baking soda, 
  • a large loss of potassium or sodium in a quick span of time [10]
  • antacids, and 
  • laxatives.

3. Hypokalemic alkalosis

This condition develops when your body does not possess the necessary amount of [11] potassium. Potassium is usually gained by consuming potassium-rich foods. Failing to consume the proper amount of potassium-rich foods can cause potassium deficiency. Your body can also lose potassium due to excessive sweating, kidney disease and [12]  diarrhoea. Hypokalemic alkalosis can cause hindrance to the proper functioning of your muscles, heart, kidneys, digestive system and nervous system.

Causes of hypokalemic alkalosis

  • An extreme lack of potassium, and [13]
  • consumption of water pills or diuretics.

4. Hypochloremic alkalosis

This condition arises when there is a critical reduction in the amount of [14]  chloride in your body. Chloride is necessary for the proper functioning of your body, as it maintains the proper amount of bodily fluids and is also an essential digestive fluid.

Causes of hypochloremic alkalosis

  • Prolonged vomiting, and [15]
  • excessive sweating.

Diagnosis Of Alkalosis

The symptoms shown by the condition is similar to that of many other conditions. Therefore, it is necessary to note that self-diagnosis is not the right way to go about alkalosis. Consult a doctor if you are having the above mentioned [16]  symptoms.

In case of severe breathing difficulties, seizures, or loss of consciousness, it is critical that you get immediate medical help.

The doctor will carry out a number of tests to analyse and understand the condition.

1. Urinalysis

By carrying out this test, the doctor will be able to detect the problems by analysing your [17] urine sample. Urinalysis can be carried out through methods such as a microscopic exam, dipstick test, and a visual examination.

2. Urine pH level test

In this test, the doctor will analyse the alkalinity of your urine sample. The pH level of your urine, an indicator of your health, will help the doctor understand what is going on in your body.

3. Basic metabolic panel

A combination of a number of tests that help assess the functioning of your body, this test is carried out by taking your [18]  blood sample. The tests are for checking the levels of albumin, chloride, potassium, bicarbonate, sodium, calcium, glucose, creatinine and blood urea nitrogen.

4. Arterial blood gas analysis

This test will measure the amount of carbon dioxide and [19]  oxygen in your blood. The blood gas test is also used to analyse the pH and acidic level of your blood.

Treatment For Alkalosis

The cause of the condition is the single factor that determines the type of medical care to be received.

  • In case of respiratory alkalosis caused by [20]  hyperventilation, the treatment method advised is to breathing into a paper bag. By doing so, your body can retain more carbon dioxide and thereby improve the condition. If there is a lack of oxygen, the same process is advised. But in severe cases, you will need to get oxygen through an oxygen mask.
  • If the rapid breathing is caused by some sort of pain, you can improve the condition by treating the pain.
  • If the condition arises due to [21]  chemical loss (loss of potassium or chloride), medicines or supplements will be needed to improve the condition.
  • In the case of alkalosis due to electrolyte imbalance, drinking plenty of fluids that contain electrolyte is necessary. If the condition is severe, it is a must that you go to the hospital.

Prevention Of Alkalosis

By maintaining a healthy diet and staying hydrated, you can reduce the risk of developing[22] alkalosis.

  • Incorporate foods that are rich in potassium and nutrients, basically fruits and vegetables. Consume carrots, milk, spinach, banana, beans, bran etc.
  • Keep yourself hydrated. Avoid dehydration by drinking 8 to 10 glasses of water per day, using electrolyte-replacement drinks for high-intensity exercises, avoiding drinks that have high sugar content (sodas and juices) and limiting caffeine.

Complications

If left untreated for a longer period of time, alkalosis can develop certain [23]  complications such as

  • coma,
  • electrolyte imbalance, and
  • arrhythmias. 
View Article References
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  2. [2] Rogers, R., Burgess, N., Ross, C., & Myint, K. S. (2018, April). Hyperkalaemia in Conn. In Society for Endocrinology Endocrine Update 2018 (Vol. 55). BioScientifica.
  3. [3] Kanbar, R., Basting, T. M., Burke, P. G., Viar, K. E., Stornetta, D. S., Stornetta, R. L., & Guyenet, P. G. (2015). Hypoxia silences retrotrapezoid nucleus respiratory chemoreceptors via alkalosis.
  4. [4] Wolfe, S. M., & Victor, M. (1969). The relationship of hypomagnesemia and alkalosis to alcohol withdrawal symptoms. Annals of the New York Academy of Sciences, 162(1), 973-984.
  5. [5] OKEL, B. B., & HURST, J. W. (1961). Prolonged hyperventilation in man: Associated electrolyte changes and subjective symptoms. Archives of internal medicine, 108(5), 757-762.
  6. [6] VANAMEE, P., POPPELL, J. W., GLICKSMAN, A. S., RANDALL, H. T., & ROBERTS, K. E. (1956). Respiratory alkalosis in hepatic coma. AMA archives of internal medicine, 97(6), 762-767.
  7. [7] Schuchmann, S., Schmitz, D., Rivera, C., Vanhatalo, S., Salmen, B., Mackie, K., ... & Kaila, K. (2006). Experimental febrile seizures are precipitated by a hyperthermia-induced respiratory alkalosis. Nature medicine, 12(7), 817.
  8. [8] Katzman, D. P., Mirant-Borde, M. C., Kline, M., & Oppenheimer, B. W. (2016). Non-Conventional Use Of Acetazolamide With Simultaneous Chloride Repletion In Severe Metabolic Alkalosis. In A57. CRITICAL CARE CASE REPORTS: NON-PULMONARY CRITICAL CARE (pp. A1972-A1972). American Thoracic Society.
  9. [9] Oppersma, E., Doorduin, J., van der Hoeven, J. G., Veltink, P. H., van Hees, H. W. H., & Heunks, L. M. A. (2018). The effect of metabolic alkalosis on the ventilatory response in healthy subjects. Respiratory physiology & neurobiology, 249, 47-53.
  10. [10] Galla, J. H. (2000). Metabolic alkalosis. Journal of the American Society of Nephrology, 11(2), 369-375.
  11. [11] Attarian, S., Libutti, S. K., & Chuy, J. (2016). ACTH-Producing Pancreatic Neuroendocrine Tumor Presenting with Severe Hypokalemic Alkalosis: A Case Report. Journal of gastrointestinal cancer, 47(2), 217-220.
  12. [12] Bartter, F. C., Pronove, P., Gill Jr, J. R., & MacCardle, R. C. (1962). Hyperplasia of the juxtaglomerular complex with hyperaldosteronism and hypokalemic alkalosis: a new syndrome. The American journal of medicine, 33(6), 811-828.
  13. [13] Gennari, F. J. (1998). Hypokalemia. New England Journal of Medicine, 339(7), 451-458.
  14. [14] Linshaw, M. A., Harrison, H. L., Gruskin, A. B., Prebis, J., Harris, J., Stein, R., ... & Elzouki, A. (1980). Hypochloremic alkalosis in infants associated with soy protein formula. The Journal of pediatrics, 96(4), 635-640.
  15. [15] Fencl, V., & Rossing, T. H. (1989). Acid-base disorders in critical care medicine. Annual review of medicine, 40(1), 17-27.
  16. [16] Bernreiter, M. (1967). Prominent auricular T waves (Ta) as an important guide to the diagnosis of alkalosis. Angiology, 18(3), 191-196.
  17. [17] Free, H. M. (2018). Urinalysis in Clinical Laboratory Practice: 0. Crc Press.
  18. [18] Awqatty, B., Samaddar, S., Cash, K. J., Clark, H. A., & Dubach, J. M. (2014). Fluorescent sensors for the basic metabolic panel enable measurement with a smart phone device over the physiological range. Analyst, 139(20), 5230-5238.
  19. [19] Stein, P. D., Goldhaber, S. Z., Henry, J. W., & Miller, A. C. (1996). Arterial blood gas analysis in the assessment of suspected acute pulmonary embolism. Chest, 109(1), 78-81.
  20. [20] Kiang, T. C., Anthony, Y., Adrian, C. K. W., Sophie, L. T., & Siyue, K. M. (2015). Anxiety, depression and hyperventilation symptoms in treatment-resistant severe asthma. Clinical and translational allergy, 5(2), P7.
  21. [21] Warren, S. E., Swerdlin, A. R. H., & Steinberg, S. M. (1979). Treatment of alkalosis with ammonium chloride: a case report. Clinical Pharmacology & Therapeutics, 25(5part1), 624-627.
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