Lactic acidosis

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Lactic acidosis

Definition

Lactic acidosis refers to lactic acid build up in the bloodstream. Lactic acid is produced when oxygen levels become low in cells within the areas of the body where metabolism takes place or in response to sympathetic overactivity related to epinephrine-type substances or exercise.

Causes

The most common cause of lactic acidosis is severe medical illness in which blood pressure is low and too little oxygen is reaching the body's tissues. Intense exercise or convulsions can cause temporary lactic acidosis. Certain diseases can also cause the condition, including:

Acquired immunodeficiency syndrome (AIDS)
Alcoholism
Cancer
Cirrhosis
Cyanide poisoning
Kidney failure
Respiratory failure
Sepsis (severe infection)

Some medicines can rarely cause lactic acidosis:

Beta adrenergic agonist inhalers used to treat asthma or chronic obstructive pulmonary disease or COPD (albuterol and salmeterol)
Epinephrine
Linezolid
Metformin, used to treat diabetes (most often when overdosed)
Nucleoside reverse transcriptase inhibitors used to treat HIV infection
Propofol

Symptoms

Symptoms may include:

Nausea
Vomiting
Weakness
Muscle cramping
Shortness of breath

Exams and Tests

Tests may include a blood test to check lactate and electrolyte levels.

Treatment

The main treatment for lactic acidosis is to correct the medical problem that causes the condition.

References

McCoin NS, Self WH. Acid-base disorders. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 113.

Palmer BF. Metabolic acidosis. In: Johnson RJ, Floege J, Tonelli M, eds. Comprehensive Clinical Nephrology. 7th ed. Philadelphia, PA: Elsevier; 2024:chap 13.

Seifter JL. Acid-base disorders. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 104.

Review Date: 10/27/2024
Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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