Acidosis and Alkalosis

Lactic Acidosis and Alkalosis Testing and health information

Order a lactic acidosis test to evaluate if the lactate level in your blood is high enough to disrupt your acid-base (pH) balance causing lactic acidosis and inadequate oxygen in your cells and tissues (hypoxia). 

Learn about your health today and order your labs directly from Ulta Lab Tests to detect, monitor, and manage metabolic acidosis and metabolic alkalosis.      

Below the list of tests is a guide that explains and answers your questions on what you need to know about acidosis and alkalosis tests, along with information on acidosis and alkalosis, signs, symptoms, and diagnosis.

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A Complete Blood Count (CBC) Panel is used as a screening test for various disease states including anemia, leukemia, and inflammatory processes.

A CBC blood test includes the following biomarkers: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet count, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs)

NOTE: Only measurable biomarkers will be reported.

Reflex Parameters for Manual Slide Review
  Less than  Greater Than 
WBC  1.5 x 10^3  30.0 x 10^3 
Hemoglobin  7.0 g/dL  19.0 g/dL 
Hematocrit  None  75%
Platelet  100 x 10^3  800 x 10^3 
MCV  70 fL  115 fL 
MCH  22 pg  37 pg 
MCHC  29 g/dL  36.5 g/dL 
RBC  None  8.00 x 10^6 
RDW  None  21.5
Relative Neutrophil %  1% or ABNC <500  None 
Relative Lymphocyte %  1% 70%
Relative Monocyte %  None  25%
Eosinophil  None  35%
Basophil  None  3.50%
Platelet  <75 with no flags,
>100 and <130 with platelet clump flag present,
Instrument Flags Variant lymphs, blasts,
immature neutrophils,  nRBC’s, abnormal platelets,
giant platelets, potential interference
The automated differential averages 6000+ cells. If none of the above parameters are met, the results are released without manual review.
CBC Reflex Pathway

Step 1 - The slide review is performed by qualified Laboratory staff and includes:

  • Confirmation of differential percentages
  • WBC and platelet estimates, when needed
  • Full review of RBC morphology
  • Comments for toxic changes, RBC inclusions, abnormal lymphs, and other
  • significant findings
  • If the differential percentages agree with the automated counts and no abnormal cells are seen, the automated differential is reported with appropriate comments

Step 2 - The slide review is performed by qualified Laboratory staff and includes: If any of the following are seen on the slide review, Laboratory staff will perform a manual differential:

  • Immature, abnormal, or toxic cells
  • nRBC’s
  • Disagreement with automated differential
  • Atypical/abnormal RBC morphology
  • Any RBC inclusions

Step 3 If any of the following are seen on the manual differential, a Pathologist will review the slide:

  • WBC<1,500 with abnormal cells noted
  • Blasts/immature cells, hairy cell lymphs, or megakaryocytes
  • New abnormal lymphocytes or monocytes
  • Variant or atypical lymphs >15%
  • Blood parasites
  • RBC morphology with 3+ spherocytes, RBC inclusions, suspect Hgb-C,
  • crystals, Pappenheimer bodies or bizarre morphology
  • nRBC’s

Comprehensive Metabolic Panel

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Dipstick urinalysis is important in accessing the chemical constituents in the urine and the relationship to various disease states. Microscopic examination helps to detect the presence of cells and other formed elements.

NOTE: Only measurable biomarkers will be reported.

Lactate Dehydrogenase (LD) (LDH)

Elevations in serum lactate dehydrogenase occur from myocardial infarction, liver disease, pernicious and megaloblastic anemia, pulmonary emboli, malignancies, and muscular dystrophy

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Serum glucose levels may be abnormally high (hyperglycemia) or abnormally low (hypoglycemia). Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolic disorders including diabetes mellitus, idiopathic hypoglycemia, and pancreatic islet cell neoplasm.

Lactate Dehydrogenase (LD) is an enzyme that is present in many different organs and tissues. LD Isoenzymes (LDI) are useful in distinguishing the different isoenzymes expressed differentially in tissues and organs, e.g., cardiac muscle, skeletal muscle, and liver.

See individual tests

Potassium measurements are useful in monitoring electrolyte balance in the diagnosis and treatment of disease conditions characterized by low or high blood potassium levels. Potassium is elevated in adrenal cortical insufficiency, acute renal failure and in some cases of diabetic acidosis. Potassium is decreased in diuretic administration and renal tubular acidosis.

Lactic acid is the endproduct of the anaerobic metabolism of glucose. The blood lactic acid concentration is affected by its production in muscle cells and erythrocytes and its rate of metabolism in the liver. During exercise, blood lactate can increase up to ten times of normal levels.

Collection Instructions

Allow sample to clot for 30 minutes, spin at 3,000 RPM for 10 minutes and transfer serum to plastic, amber vial. If amber vial is not available, wrap tube in aluminum foil to protect from light. Freeze within 30 minutes and send frozen.

Measurements are used in the diagnosis and treatment of numerous potentially serious disorders associated with changes in body acid-base balance.

Anion Gap Panel (Electrolyte Balance) includes the following test.

  • Anion gap 4
  • Sodium
  • Potassium
  • Chloride
  • Carbon dioxide

Serum chloride is the major extracellular anion and counter-balances the major cation, sodium, maintaining electrical neutrality of the body fluids. Two thirds of the total anion concentration in extracellular fluids is chloride and it is significantly involved in maintaining proper hydration and osmotic pressure. Movement of chloride ions across the red blood cell membrane is essential for the transport of biocarbonate ions in response to changing concentrations of carbon dioxide. Chloride measurements are used in the diagnosis and treatment of electrolyte and metabolic disorders such as cystic fibrosis and diabetic acidosis.

Clinical Significance

Urine chloride excretion approximates the dietary intake. The chloride content of most foods parallel that of sodium. An increase in urine chloride may result from water deficient dehydration, diabetic acidosis, Addison's disease, and salt-losing renal disease. Decreased urine levels are seen in congestive heart failure, severe diaphoresis and in hypochloremic metabolic alkalosis due to prolonged vomiting.

This test is intended for the diagnosis and monitoring of inherited disorders affecting multiple metabolic pathways. 

Organic acidurias are inherited disorders resulting from a deficient enzyme or transport protein. Although most are autosomal recessive disorders, several are X-linked. The more than 60 described organic acidurias affect many metabolic pathways including amino acid metabolism, lipid metabolism, purine and pyrimidine metabolism, the urea cycle, the Krebs cycle and fatty acid oxidation. These disorders are characterized by a wide variety of symptoms such as lethargy, coma, hypotonia, seizures, ataxia, vomiting, failure to thrive, developmental delay, liver disease, neutropenia, thrombocytopenia, osteomalacia and osteoporosis. Severity of presentation is highly variable as is age of onset, and patients may not present with the most characteristic features. Laboratory results commonly indicate metabolic acidosis, increased anion gap, hyperammonemia, hypoglycemia, lactic acidemia, ketosis, or abnormal lipid patterns. Treatment may be based on dietary restrictions and/or supplementation with cofactors (e.g., riboflavin or cobalamin) or conjugating agents (e.g., carnitine or sodium benzoate); however, there is no effective therapy for some of the disorders. 

Elevation of one or more organic acids is diagnostic for an organic aciduria; however, elevations should be interpreted in context with clinical findings and/or additional test results. See additional information for a table of selected organic acidurias and associated organic acid elevations. Since many organic acidurias are episodic, the diagnostic efficacy is maximized when the patient is expressing symptoms at the time of specimen collection. 

The test will be capable of diagnosing over 30 inherited metabolic defects, and will also allow physicians to determine dietary compliance or the effectiveness of dietary/cofactor therapy for their patients. It can also be used, alone or in conjunction with other tests, to confirm the findings of a positive expanded newborn screen.

Do you have an excess of acid or alkali, causing the pH of your blood to be out of balance?

When it comes to staying healthy, having your blood tested is an excellent way to ensure everything is going smoothly. Your blood is an important indicator of your overall health. Doctors can examine your red and white blood cell count, nutrient, vitamin, mineral levels, and your blood's overall pH to gauge your body's health.

Your blood is made up of a delicate balance of acids and bases, and retaining the right pH is important to staying healthy. Having an excess amount of either acids or bases can cause many different kinds of health problems, and the earlier you notice signs that something is off, the faster you can treat it and get better. To help with this, scientists have developed a series of acidosis and alkalosis tests, which analyze your blood levels to detect whether things are off or not. 

Your blood is made up of a delicate balance of acids and bases, and retaining the right pH is important to staying healthy. Having an excess amount of either acids or bases can cause many different kinds of health problems, and the earlier you notice signs that something is off, the faster you can treat it and get better. To help with this, scientists have developed a series of acidosis and alkalosis tests, which analyze your blood levels to detect whether things are off or not. Once your blood is drawn by a phlebotomist, it's sent to a lab for analysis. These days, it's easier than ever to get tested -- but what exactly are you preventing with these tests?

What is Acidosis?

As its name would suggest, acidosis refers to an excessive amount of acid in your body. There are several types of acidosis and many different causes. People with diabetes, HIV, cancer, and those who have a poor diet and sedentary lifestyle may be at a higher risk of acidosis. Diagnosis for acidosis usually involves several blood tests, which examine the level of ketones, gases, potassium, and sodium in the blood while also examining organ functionality. Urine tests are also sometimes conducted to analyze ketone levels and pH.

Types of Acidosis and Their Causes

Lactic Acidosis 

Lactic acid is produced primarily in the muscles and red blood cells of the body. A buildup of lactic acid can be caused by drinking too much alcohol, excessive exercise, liver failure, and more. The main symptoms are breathing issues, jaundice, and confusion. However, other symptoms may occur. Depending on the cause, treatment for lactic acidosis varies. We'll get more into this specific type of acidosis later.

Metabolic Acidosis 

Metabolic acidosis refers to when the body produces too much acid. This is often caused by kidney problems, though other causes exist, such as uncontrolled diabetes, extreme dehydration, and poisoning by methanol, ethylene glycol, or aspirin. Symptoms can include hyperventilating, confusion, and tiredness or fatigue. Again, treatment for metabolic acidosis depends on what's causing it.

Respiratory Acidosis 

When too much carbon dioxide is in the body, it's referred to as respiratory acidosis. While it might sound odd, carbon dioxide is acidic, and while your body usually removes it through breathing, sometimes it can build up. This condition can occur due to injuries, deformities, chest weakness, sedatives abuse, and chronic lung disease. Symptoms are also mainly made up of breathing problems, confusion, and fatigue. Treatment usually tackles the root cause and varies accordingly.

What is Alkalosis?

Alkalosis is when your body contains too many bases. There are four main types of this, each with varying causes and symptoms. We'll examine each type and its various causes briefly.

Types of Alkalosis and Their Causes

Metabolic Alkalosis 

When the body produces too many bases or loses an excess of acids, it's known as metabolic alkalosis. This may be due to excessive sweating or vomiting, which can cause a loss of electrolytes, ingesting a large amount of bases, taking laxatives, alcohol abuse, and more.

Hypochloremic Alkalosis

Typically caused by over-sweating or a long period of vomiting, this type of alkalosis causes the body to lose too much chloride, which is a key chemical in your body's digestive processes.

Hypokalemic Alkalosis

When your body loses too much potassium, it triggers this type of alkalosis. Not eating enough potassium can cause, but the leading causes are usually kidney issues, diarrhea, and sweating too much. Potassium is a vital chemical that plays a role in your body's muscles, heart, digestion, and nervous system.

Respiratory Alkalosis

Finally, respiratory alkalosis is caused by a lack of carbon dioxide in the body. This may be triggered by a high fever, a lack of oxygen, a prolonged period in high altitudes, and hyperventilation, though there are other causes.

Signs and Symptoms of Acidosis or Alkalosis

If you've been experiencing any of the following symptoms with no obvious explanation, then you might be suffering from one of the previously mentioned conditions: 

  • tiredness
  • fatigue
  • lack of energy
  • confusion 
  • dizziness
  • jaundice
  • nausea
  • numbness
  • hand tremors
  • spasming muscles or muscle twitches
  • trouble breathing
  • stupor

If you've been experiencing any or some of these symptoms at the same time, then it's recommended you get a blood test to ascertain the cause, as these can signify a variety of medical conditions -- not just acidosis or alkalosis!

Acidosis and Alkalosis Testing 

As we mentioned previously, there are many ways to test for both of these conditions. However, blood tests are the most commonly utilized tests, as blood contains all of the acids and bases that your body requires to function properly, as well as essential gases and ketones.

Lactic Acidosis Testing 

Suppose you suspect you might have lactic acidosis. In that case, it's important to get tested as soon as possible, especially if you've been diagnoses with diabetes, HIV, cancer, heart disease, cholera, malaria, or sepsis. If you suffer from any of these conditions, it's important to be wary of consuming too much of certain substances, particularly alcohol and acetaminophen. It's also imperative to avoid over-exercise, as exercise naturally causes your muscles to release lactic acid.

Testing for lactic acidosis is common for athletes and those at a higher risk for the condition and typically involves examining your lactate levels through blood tests. Usually, your doctor will instruct you not to clench your fist or tense up during the test, which can artificially spike lactate levels, skewing the test results.

Order Your Acidosis and Alkalosis Tests with Ulta Lab Tests

What are you waiting for? If you're showing signs of unbalance acids and bases, you need to act fast. If left untreated to keep the right pH to stay healthy.

Ulta Lab Tests offers highly accurate and reliable tests so you can make informed decisions about your health. Here are a few great things to love about Ulta Lab Tests:

- You'll get secure and confidential results
- You don't need health insurance
- You don't need a physician's referral
- You'll get affordable pricing
- We offer a 100% satisfaction guarantee

Order your Acidosis and Alkalosis lab tests and your results will be provided to you securely and confidentially online in 24 to 48 hours for most tests.

Take control with Ulta Lab Tests today!