Lactic Acidosis: Symptoms, Causes and Treatment

Lactate is a by-product formed when glucose is broken down aerobically by the cell's mitochondria - the power house of the cell. When the body or a region of the body is deprived of oxygen, it leads to tissue hypoxia. This results in anaerobic breakdown of the glucose in the cells. The end product of this reaction is lactic acid. Lactic acidosis is a rare condition. People who suffer from lactic acidosis, develop serious complications. It may also lead to death.

The body generates most of its energy aerobically, that is, by using oxygen. Under normal circumstances, the cells break down glucose by a process called glycolysis, to generate pyruvate, which is further broken down by an aerobic pathway for more energy. However, under certain conditions, like trying to outrun a hungry lion or pumping iron to increase triceps and biceps, our body requires more energy. The requirement of energy becomes inversely proportional to the body's capacity to deliver the required amount of oxygen. Thus, pyruvate is converted to lactate, which allows glucose production and energy is produced. Within one or two minutes the lactic acid level increases in the blood.

Symptoms
The symptoms for lactic acidosis are nausea, vomiting, abdominal pain, lethargy, abnormal breathing, low blood pressure and irregular heart rhythm.

Causes
Lactic acidosis may be the result of several underlying medical conditions. They include:

• Genetic disorders like mitochondrial encephalomyopathy, glycogen storage disease, Fructose 1,6-diphosphatase deficiency, pyruvate dehydrogenase deficiency.
• Kidney Conditions
• Diabetic nephropathy
• Heart diseases
• Lung diseases like decrease in oxygen intake
• Drugs like phenformin, metformin, also causes Lactic acidosis.

Other causes include hypoxia, hemorrhage, liver disease, shock, sepsis, Non-Hodgkin's and Burkitt lymphoma.

In some children, lactic acidosis occurs due to a rare congenital disease where the cells do not convert pyruvate into carbon dioxide and water. When such children are engaged in any physical activity, their body breaks down more glucose and pyruvate gets accumulated. The cells do not oxidize the accumulated pyruvate resulting in an increase in lactic acid level. This in turn leads to lactic acidosis. Diabetics and people with stomach ulcers often complain of Lactic acidosis.

Treatment
There are a number of treatments for lactic acidosis.

• Sodium bicarbonate, an alkaline to neutralize the acid, can be administered intravenously. This therapeutic treatment should be used sparingly as it can lead to serious complications.
• Sodium nitroprusside, by the method of alleviating regional hypoperfusion, has been suggested for the treatment of some forms of lactic acidosis.
• Peritoneal dialysis and hemodialysis can be used sometimes for cleansing the blood of lactic acid.
• Insulin therapy is very useful in phenformin associated lactic acidosis.
• Dichloroacetate can also be a useful adjunct in treating lactic acidosis.

The latest treatments for Lactic acidios are:

• Early Intubation
• Thimine
• Naloxone
• I.V. Fluids

Suggestions

• It is extremely important to keep a watch on your diet. One should reduce the intake of beef, pork, junk food and animal proteins.
• Excessive intake of Vitamin C also increases the chances of acidosis.
• Beans, cereals, crackers, eggs, flour products, grains, oily food and sugar should be used sparingly.
• Prunes, cranberries, and plums form acid and remain in the body which increases lactic acid levels in the blood. Therefore, limit the intake of these fruits in your diet.
• Vitamin A, Vitamin B, Potassium help in keeping the levels of lactic acid in check.
• Citrus fruits do not increase the acidic level of the blood, instead they convert to carbon dioxide and water and have an alkaline effect on the body.

Lactic acidosis is a dangerous condition. Consult your doctor if you suspect that you have lactic acidosis. If a specific treatment has been advised, do not stop taking your medication. It's always better to be alert when it concerns your health. As the old saying goes, Health is Wealth!