Lactic Acidosis Treatment in Knoxville, TN
*WARNING: this condition is potentially life-threatening. If you or someone you know is experiencing these symptoms, don't wait. Call 911 or go to the nearest emergency room right away. *
Do you feel weak, nauseated, abdominal pain, or muscle cramps after taking diabetes medication, having surgery, or being diagnosed with diabetes? It could be lactic acidosis, a condition arising when your body produces too much lactic acid and cannot metabolize it quickly enough.
Lactic acidosis can result from a number of different diseases or medications, as well as over-exercising. This causes the acid to increase to harmful levels, causing symptoms like nausea and weakness.
Lactic acidosis is a medical emergency, as not treating it can cause life-threatening complications. To speak with a lactic acidosis specialist today in Knoxville, call (423) 482-8711 or contact Dr. Dalal Akoury online.
What are the symptoms of lactic acidosis?
Depending on the cause, symptoms of lactic acidosis can develop suddenly or over the course of several days. These symptoms include:
- muscle pains or cramping
- abdominal pain
- reduced appetite
Contact emergency medical personnel if you experience the following signs of lactic acidosis:
- bluish lips or fingernails
- high fever (over 101°F)
- lack of urination
- shallow or rapid breathing
- rapid or irregular heart beat
- chest pain
- severe abdominal pain
- loss of consciousness
If left untreated, lactic acidosis complications can include:
- major organ failure
What causes lactic acidosis?
There are three main types of lactic acidosis:
- type A lactic acidosis: when your body has lower-than-normal oxygen levels (tissue hypoxia) from critical illness or exercise
- type B lactic acidosis: caused by renal disease, cancer, chronic liver disease, medications for type 2 diabetes mellitus and HIV, and chronic alcoholism
- d -lactic acidosis: when d-lactic acid - a byproduct of colon surgeries like jejunoileal bypass or intestinal resection - is absorbed
Other common lactic acidosis causes include:
- severe heart failure
- cardiogenic shock: the heart is unable to pump enough blood
- hypovolemic shock: losing more than 20% of your blood or fluid
- severe asthma or repertory failure
- carbon monoxide poisoning
- a massive immune response to bacterial blood infection (sepsis)
- severe anemia
- severe trauma
- kidney conditions
How is lactic acidosis diagnosed?
Making a lactic acidosis diagnosis involves a blood test to detect:
- electrolyte levels: patients taking diabetes medication like metformin, will have electrolyte levels checked 1-2 weeks after beginning doses
- blood lactate levels: diagnosis requires blood pH < 7.35 and lactate > 5 to 6 mmol/L
- measuring the anion gap: this is the difference between the sum of the cations (sodium plus potassium) and the anions (chloride plus bicarbonate); the anion gap will be higher in lactic acidosis.
Specific tests are needed to diagnose d-lactate levels.
How is lactic acidosis treated?
The goal of lactic acidosis treatment is to correct the underlying cause and restore oxygen to the affected tissues. In cases where you or someone you know are not breathing or suffering cardiac arrest, don't wait - call 911 immediately.
While a doctor is trying to find the underlying cause of lactic acidosis, or if the exact cause cannot be immediately found, these treatments are given to support oxygen delivery and circulation:
- face mask delivery of 100% oxygen
- mechanical ventilation for patients with deteriorating SaO2 (how much hemoglobin is saturated with oxygen) to provide them with oxygen
- using intravenous fluids to help support circulation
- treating any obvious underlying cause, such as using intravenous antibiotics for infection
- hemodialysis with bicarbonate
- vitamin therapy
Emergency medical personnel will decide on the best treatment. Other treatments include kidney dialysis to treat the casual kidney conditions and treatment for alcohol abuse , like Alcoholic Anonymous.
If you experience lactic acidosis while exercising, stop what you're doing, drink some water, and rest. Treatments for d-lactic acidosis include IV fluids, restriction of carbohydrates, and oral antibiotics for short bowel syndrome and bicarbonate for severe acidosis. Metformin-induced lactic acidosis can be treated with IV hydration therapy if diagnosed quickly enough.1
A diet that supports blood oxygenation includes:
- iron-rich foods like beef, lamb, dark chocolate, leafy greens, black beans, raisins, tofu, turkey, tuna, eggs, shrimp, and brown rice
- vitamin C-rich foods like pineapple, kale, strawberries, red and green peppers, peas, and cauliflower
- folate-rich foods like chickpeas, beets, liver, avocado, broccoli, and cereals
Supplements for lactic acid balance include:
- coenzyme Q10: this nutrient improves respiratory control and liver function; mild side effects including stomach upset, loss of appetite, nausea, vomiting, diarrhea, and low blood pressure
- iron: this mineral helps women maintain high-enough levels of hemoglobin during exercise; may cause stomach pain, constipation or diarrhea, nausea, and vomiting, iron poisoning can cause stomach and intestinal distress, liver failure , dangerously low blood pressure, and death
- magnesium: this mineral may help reduce lactate production during exercise; may cause nausea, vomiting, and diarrhea, and high doses may cause irregular heartbeat, low blood pressure, confusion, slowed breathing, coma, and death
- sodium phosphate: this salt may improve exercise duration in athletes; may include abdominal cramps, gas, diarrhea, dehydration, or nausea; serious side effects include chest pain, slow/irregular/fast heartbeat, and seizures
- dimethylglycine (DMG): this amino acid helps decrease lactic acid buildup by enhancing oxygen delivery to cells
- creatine: this amino acid increases your energy and lessens lactic acid buildup; can cause water weight, and high doses can harm your kidneys, liver, or heart
- multivitamin and mineral complex: this provides nutrients necessary for healthy muscles; side effects include upset stomach, headache
- safflower: this plant helps eliminate lactic acid buildup and post-exercise soreness
These nutritional and herbal treatments may have contraindications with a variety of unrelated conditions:
- breast feeding
- premature birth
- allergies to ragweed
- bipolar disorder
- kidney disease or failure
- high and low blood pressure
- heart block
- hemorrhagic diseases
- stomach or intestinal ulcers
- clotting disorders
- restless leg syndrome
- stomach infections
- immune diseases
- inflammatory bowel disease
There may also be contraindications with the following pharmaceuticals:
- anticoagulants like aspirin, diclofenac (Voltaren, Cataflam), naproxen (Anaprox, Naprosyn), heparin, and warfarin (Coumadin)
- nephrotoxics like cyclosporine (Neoral, Sandimmune)
- aminoglycosides like amikacin (Amikin), and gentamicin (Garamycin, Gentak)
- nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and indomethacin (Indocin)
- quinolone antibiotics like ciprofloxacin (Cipro), norfloxacin (Chibroxin, Noroxin), and sparfloxacin (Zagam)
- tetracycline antibiotics like demeclocycline (Declomycin) and minocycline (Minocin)
- bisphosphonates like alendronate (Fosamax), risedronate (Actonel), and tiludronate (Skelid)
- calcium channel blockers like nifedipine (Adalat, Procardia) and verapamil (Calan, Isoptin, Verelan)
- muscle relaxants like carisoprodol (Soma) and orphenadrine (Banflex, Disipal)
- water pills (Potassium-sparing diuretics) like amiloride (Midamor) and spironolactone (Aldactone)
- levothyroxine drugs like Armour Thyroid, Euthyrox, and Levoxyl
- methyldopa (Aldomet)
- mycophenolate mofetil (CellCept)
- penicillamine (Cuprimine, Depen)
- alkylating agents for chemotherapy
- antihypertensive drugs like captopril (Capoten), enalapril (Vasotec), and amlodipine (Norvasc)
- angiotensin-converting-enzyme (ACE) inhibitors like lisinopril
- tretinoin (Vesanoid)
- isotretinoin (Accutane, Amnesteen, Clavaris, Sotret)
- trimethoprim and sulfamethoxazole (Cotrim, Bactrim, Septra)
Children and the elderly may have adverse reactions to these treatments. Ask your healthcare provider which treatment is best for.
How can I prevent lactic acidosis?
Ways to prevent lactic acidosis include:
- working with your healthcare provider to take your medications correctly, and informing your provider of any side-effects you may experience
- drinking lots of water and resting (as needed) when exercising
- when beginning a new exercising regimen, starting slowly and increasing the intensity or duration of your workout each week
- practicing slow, steady breathing during exercise
- avoiding strenuous activity when feeling ill
- not abusing alcohol
Reserve your appointment now
A build-up of lactic acid can cause serious effects and can even be fatal. If you're at risk of lactic acidosis or think you've experienced it, get medical attention to prevent future health complications.
1. Chowdhury, Waliul et al. "Metformin-Induced Lactic Acidosis: A Case Study." Ed. Alexander Muacevic and John R Adler. Cureus 10.2 (2018): e2152. PMC. Web. 14 June 2018.
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