Metabolic acidosis refers to a serious health condition in which there is and acid-base imbalance in your body, or in other words, there are too high levels of acid in your body fluids. For optimal health, your body needs to keep a balance between acidity and alkalinity. But if your body becomes too acidic (acidosis) or in contrast too alkaline (alkalosis, in which there is too much base in your body fluids) may lead to serious health issues and an overall feeling of ill health. Even more, severe acidosis can be fatal without treatment.

Normally, the kidneys and lungs are able to get rid of excess acid in your body. However, unhealthy diet, some lifestyle habits, certain health conditions and prescription drugs may increase the risk of having too much acid in your body and finally lead to severe acidosis.

Symptoms of acidosis may include headaches, sleeping problems, difficulty swallowing, bumps on the tongue, lack of energy, low body temperature, depression, frequent infections, dry skin, leg cramps, and more.

Eating more alkaline foods or taking certain supplements can help balance acidity in your body, but in some cases medications are needed. Here in this article we discuss the symptoms, causes, risk factors, complications, and natural treatment of metabolic acidosis (1, 3).


How to Know if You Have Too Much Acid in Your Body – What is pH and What Does The pH Scale Measure

When discussing balancing the acidity levels in your body, it’s firstly important to understand pH, as the acidity and alkalinity are measured by the pH scale. Overall, everything below 7.0 is acidic, and everything above 7.0 is alkaline. The pH value ranges from 0–14:

  • 0.0–6.9: Acidic
  • 7.0: Neutral
  • 7.1–14.0: Alkaline (basic)

The perfect pH range for the human body is considered to be between 6.0 and 6.8. However, it’s important to note that pH differs significantly within your body. While certain parts of your body are alkaline, others are acidic. For example:

  • Stomach: Due to hydrochloric acid (that is necessary to break down food), your stomach is highly acidic, as the pH is 2–3.5.
  • Blood: On the contrary, your blood is always slightly alkaline, as the pH values range from 7.36 to 7.44.
  • Urine: Normally, your urine pH values may range from 4.6 to 8.0. However, the normal value ranges may differ a bit between laboratories, so you should discuss with your provider about the meaning of your specific test results (6, 13, 14, 15).

Testing Your PH Levels at Home

One way to measure your pH value (the level of acid in the body) at home is to test your urine. To do this, you can use a simple PH test strip. For best test accuracy, you should perform the test first thing in the morning. However, some suggest to test the second urine of the day, as the first pee will be too acidic (because it dumps the wastes from the night before).

Urine test pH levels

  • Lower than 6.5: Your body is considered acidic
  • Between 6.5 and 7.5: These are optimal pH levels
  • Higher than 7.5: Your body is considered alkaline (13, 15).

Types of Acidosis

The kidneys and lungs maintain the balance (proper pH level) of chemicals called acids and bases in the body. Acidosis occurs when acid builds up or when bicarbonate (a base) is lost, and is classified as metabolic or respiratory acidosis.

  • Metabolic acidosis. Metabolic acidosis usually happens when your body stores or produces too much acid, when the kidneys are not able to remove this excess acid from the body or there is a loss of bicarbonate from your bloodstream.
  • Respiratory acidosis. This type of acidosis occurs when there is too much CO2 (carbon dioxide, which is an acid) in your body, and when your body is unable to remove this excess carbon dioxide through breathing. Respiratory acidosis is sometimes also called hypercapnic acidosis and carbon dioxide acidosis (1).


Metabolic Acidosis Signs and Symptoms

Sometimes, some individuals may not have any symptoms of metabolic acidosis. In those people who do, the common signs may include symptoms such as:

  • An increased heart rate
  • Lack of appetite
  • Need to take deeper, longer breaths than usual
  • Headache
  • Lack of energy
  • Depression
  • Fatigue
  • Weakness
  • Nausea and vomiting
  • Confusion
  • Shallow and rapid breathing
  • Sleeping problems and insomnia
  • Yellowing of the whites of your eyes or your skin (jaundice)
  • Dry skin
  • Brittle nails
  • Hives
  • Frequent sighing
  • Water retention
  • Low blood pressure
  • Foul-smelling stools
  • Difficulty swallowing
  • Sensitivity to vinegar and acidic fruits
  • Bumps on the tongue
  • Low body temperature
  • Frequent infections
  • Teary eyes
  • Sensitive teeth
  • Leg cramps
  • In addition, breath that smells fruity (a sign of diabetic acidosis (ketoacidosis)) (2, 3, 6).


Metabolic Acidosis Causes

Metabolic acidosis usually develops when your body stores or produces too much acid, when the kidneys are not able to remove this excess acid from the body or there is a loss of bicarbonate from your bloodstream (low levels of bicarbonate are those less than 22 millimoles per liter (mmol/l) and indicate that the blood is more acidic). Your kidneys also help maintain bicarbonate levels stable in the body.

You need a certain amount of bicarbonate in the blood to keep your body healthy. The typical Western diet generates 20-30 mEq of acid each day, and people with normal kidney function increase the production of ammonia to eliminate the acid. However, as kidney function decreases, the tubules lose the ability to eject this unwanted excess dietary acid. 

There can be numerous causes why metabolic acidosis happens, and therefore the causes are sometimes grouped by the absence or presence of a normal anion gap. The anion gap test shows you how much acid is in your blood. Acid levels that are higher or lower than normal can signal a certain health condition. Anion gap is considered to be high if anion gap is over 12 mEq/L, and normal when anion gap is less than 11 mEq/L (2, 7).

Health Conditions and Lifestyle Habits That Can Lead to Metabolic Acidosis Include:

  • Lactic acidosis is a condition when lactic acid builds up in your bloodstream. For example, your body makes more lactic acid if you’re not getting enough oxygen for a long time during intense exercise.

  • Diabetic ketoacidosis, also called diabetic acidosis and DKA (e.g., Alcoholic, diabetic, or starvation) is a serious complication of diabetes that happens when your body produces excess levels of blood acids called ketones during uncontrolled diabetes.

  • Severe diarrhea. Hyperchloremic acidosis is a disease where acidosis (pH less than 7.35) happens due to the loss of too much sodium bicarbonate from the body, which can develop due to severe diarrhea.

  • Kidney disease or kidney failure (such as for example distal renal tubular acidosis, uremia or proximal renal tubular acidosis).

  • Drug-induced acidosis or poisoning that may be caused by certain drugs, treatment methods or other substances that can increase acidity in the body. These include substances, medications and treatment methods such as: 

    • Salicylates, ethylene glycol (found in antifreeze), methanol, aspirin
    • Statins, beta-blockers, antiretrovirals, antibacterial drugs (such as trimethoprim)
    • Acetazolamide
    • Spironolactone
    • Topiramate (medication used to treat epilepsy and prevent migraines)
    • Organic acids, ethanol, paraldehyde, formaldehyde
    • Carbon monoxide, cyanide, ibuprofen, metformin
    • Propylene glycol (frequently found in infusions for certain intravenous medications used in the intensive care unit)
    • Isoniazid, iron, phenelzine, tranylcypromine, valproic acid, verapamil
    • Sulfates. These are chemicals often used as cleansing agents. Sulfates are found in household cleaners, detergents, and even shampoo we all use daily.
    • Saline infusion
    • Hyperalimentation
  • Severe dehydration.

  • Transient 5-oxoprolinuria that can happen due to long-term ingestion of high-doses of acetaminophen (frequently seen with sepsis, malnutrition, liver failure, or kidney failure).

  • Massive rhabdomyolysis (a dangerous condition caused by muscle breakdown and muscle death that can result from trauma, overexertion, toxic substances or disease).

  • Certain other health conditions such as for example Sjogren’s syndrome, biliary fistula, Addison disease.

  • Diet induced acidosis. Some foods may also increase acidity in the body leading to diet-induced acidosis. A diet might be acidic due to high levels of foods and drinks such as:

    • Phosphoric acid (contained in soda)
    • Amino acids that contain sulfur (contained in eggs, dairy products and meat)
    • Salt
    • Other acidic foods and drinks such asparagus, coffee, tea, alcohol, legumes, oatmeal, sauerkraut, and vinegar (1, 2, 4, 5, 8).


Metabolic Acidosis Risk Factors and Risk Groups

Risk factors for metabolic acidosis include health conditions and lifestyle habits such as:

  • A western diet high in animal protein and salt and low in fruits and vegetables
  • Kidney problems
  • Diabetes
  • Certain diseases, such as Sjogren’s syndrome (2).

Metabolic Acidosis Complications

Different types of acidosis can lead to many severe diseases and complications. Metabolic acidosis may lead to severe complications such as:

  • Cancer
  • Worsened kidney damage
  • Osteoporosis, that happens when your body makes too little bone or loses too much bone, or both, as bone is living tissue that is constantly being broken down and replaced. As a result, bones become weak and brittle and may break from a fall. Also other types of acidosis may lead to osteoporosis because if the lungs and kidneys are unable to eliminate excess acid, your body starts to take calcium from your bones, and then uses this calcium to neutralize the acid.
  • Improper growth in children, because metabolic acidosis impedes the growth hormone.
  • Muscle wasting or loss due to less protein in your body.
  • High blood sugar.
  • Endocrine system problems (the glands which produce hormones are not working like they should), which may cause insulin resistance and possibly diabetes.
  • Inflammation (for instance swelling, redness, and pain).
  • Amyloid accumulation (when protein builds-up in your body, it can hurt your joints, organs and brain).
  • Increased risk of death (2, 8, 9).


Metabolic Acidosis Treatment and Home Remedies For Metabolic Acidosis – How to Alkalize Your Body?

The proper treatment method for metabolic acidosis depends mostly on its cause. 

1. Sodium bicarbonate or sodium citrate pills

Bicarbonate (a form of carbon dioxide) is an alkaline (the opposite of an acid), and may therefore help balance the acid in the blood, as well as help prevent kidney disease from getting worse. Intravenous (IV) treatment with sodium bicarbonate is used to treat conditions that cause acidosis through bicarbonate (base) loss. This can occur due to diarrhea, some kidney conditions, and vomiting. However, do not attempt this type of treatment without the supervision of a doctor.

2. Supplements to alkalize the body

Certain supplements may help balance the acidity and fight inflammation in your body if your metabolic acidosis is caused by an unhealthy diet.

3. Healthy diet

Metabolic acidosis that is caused by unhealthy diet (diet induced metabolic acidosis) can be reversed with more alkaline forming foods. A diet that contains mostly plant-based protein, and plenty of fruit and vegetables (as fruit and vegetables can increase alkaline levels in your body) instead of animal protein can help prevent acid levels from climbing too high in the body. Alkaline forming foods include foods such as:

  1. Honey
  2. Raisins
  3. Corn
  4. Avocados
  5. Spinach
  6. Celery
  7. Cucumber
  8. Broccoli
  9. Pepper
  10. Figs
  11. Fresh fruits
  12. Fresh vegetables
  13. Soy products
  14. Coconut
  15. Molasses
  16. Lemon water. For instance, some suggest drinking lemon water every morning. You can make it by pressing the juice of half of the lemon with one cup of water (2, 3, 9, 12).

4. Treating diabetes

Treatment for metabolic acidosis that is caused by uncontrolled diabetes involves first treating your diabetes and balancing blood sugar levels to help your body stop producing acids and remove acids. Treatment includes for example:

  • Fluids
  • Electrolytes (sodium, chloride, potassium)
  • Diabetes medications
  • Insulin (which works only if diabetes is causing the metabolic acidosis)

5. Hemodialysis

Dialysis is treatment for severe kidney problems or kidney failure that helps to remove wastes and excess acids from the blood.

6. Detoxification

If metabolic acidosis is caused by alcohol or drug poisoning, it is treated with detoxification, or in severe cases sometimes also with hemodialysis.

7. Inotropes and other medications

If your metabolic acidosis is caused by a heart problem, inotropes and other medications may help to improve heart function in conditions like heart failure and low blood pressure. These treatments improve oxygen flow to your body and lower blood acid levels (6).

Metabolic Acidosis Prevention

If you want to lessen your risk of metabolic acidosis you can follow these tips:

  • Hydrate. Try to drink plenty of pure water and other healthy fluids.
  • Eat plenty of raw fruits and vegetables.
  • Do not drink alcohol. Heavy drinking can rocket the buildup of lactic acid which causes metabolic acidosis
  • Control of your diabetes. You can avoid ketoacidosis by managing your blood sugar levels (6).

NB! The information provided here is for informational purposes only, so do not consider it as health care or medical diagnosis and treatment. Do not consider this information as a guarantee of the results you want to achieve. In addition, do not take this information as a replacement for the advice of your physician or other healthcare professional.

Even more, you should not use it to diagnose or treat a health problem. Before changing or discontinuing your existing medication, treatment, or care, or taking any dietary supplements, be sure to consult with your healthcare professional or doctor before starting any diet or program, or if you suspect you may have a medical condition.

Written by Maria-Helena Loik



  1. Acidosis: MedlinePlus Medical Encyclopedia
  2. Acidosis: Types, symptoms, complications, and treatment (
  3. Signs of Poor pH Balance in the Body (
  4. Metabolic acidosis – Wikipedia
  5. High Anion Gap Metabolic Acidosis – StatPearls – NCBI Bookshelf (
  6. Acidosis: Symptoms, Causes, and Treatment for Blood pH Levels (
  7. Metabolic Acidosis | National Kidney Foundation
  8. Examining the relationship between diet-induced acidosis and cancer (
  9. Metabolic acidosis – symptoms, complications & treatment – American Kidney Fund (AKF)
  10. Respiratory Acidosis: Types, Symptoms, and Causes (
  11. Respiratory acidosis (patient information) – wikidoc
  12. Dietary Treatment of Metabolic Acidosis in Chronic Kidney Disease (
  13. Are You Acidic or Alkaline? – Rose Wellness
  14. Acid-Base Homeostasis (
  15. Urine pH test (

Was this post helpful?

Leave a Reply