Acidosis and Alkalosis

Acidosis and alkalosis are acid–base imbalances that occur when your blood pH moves outside its healthy range.

  • Acidosis = blood becomes too acidic (low pH).

  • Alkalosis = blood becomes too basic/alkaline (high pH).

These imbalances can be metabolic (caused by changes in bicarbonate/HCO3?) or respiratory (caused by changes in carbon dioxide/CO2). Triggers include dehydration, kidney disease, diabetes complications (DKA), sepsis/lactic buildup, lung conditions (e.g., COPD), prolonged vomiting, diuretic use, and certain toxins.

Ulta Lab Tests provides access to acid–base–related blood and urine markers (e.g., bicarbonate/CO2 on a chemistry panel, electrolytes for anion gaplactateketonesosmolality, and urine studies) that help your clinician evaluate suspected acid–base disorders, monitor trends, and rule in/out common causes.


Signs & Symptoms (When to consider testing)

Common, non-specific: fatigue, headache, confusion, dizziness, weakness.
Breathing pattern clues:

  • Metabolic acidosis: deep, rapid breathing (Kussmaul-type), shortness of breath.

  • Respiratory acidosis: slow or shallow breathing, drowsiness.

  • Respiratory alkalosis: fast breathing/hyperventilation, lightheadedness, tingling in fingers or around mouth.
    GI/other clues: nausea, vomiting, abdominal pain (DKA/lactic acidosis), dehydration, palpitations/irregular heartbeat, muscle cramps, tremor.
    When to seek urgent care: severe shortness of breath, chest pain, extreme drowsiness/confusion, or signs of shock.

Related searches: acid–base imbalance, blood pH test, metabolic acidosis labs, respiratory alkalosis testing, lactic acidosis test, anion gap, bicarbonate (CO2) test.


Why These Tests Matter

What acid–base labs can do

  • Show whether an acidic or alkaline shift is present or likely (via bicarbonate/CO2anion gaplactateketoneschloridepotassium).

  • Help differentiate metabolic vs. respiratory processes and reveal mixed disorders when paired with clinical context.

  • Narrow causes (e.g., high anion gap acidosis → lactic acidosis, DKA, toxins; normal anion gap acidosis → diarrhea, renal tubular acidosis; alkalosis patterns tied to vomiting/diuretics/hyperventilation).

  • Provide baseline and trend data to monitor improvement or worsening.

What they cannot do

  • Replace a clinical exam or imaging; some cases need arterial or venous blood gas (performed in clinical settings) for direct pH/CO2/HCO3? measurement.

  • Identify the exact cause without your history, medications, vitals, and sometimes additional testing.


What These Tests Measure (at a glance)

  • Basic/Chemistry panel (BMP/CMP):

    • Bicarbonate (reported as CO2): primary metabolic buffer; low in metabolic acidosis, high in metabolic alkalosis.

    • Electrolytes (Na?, K?, Cl?): used to calculate the anion gap and assess chloride/potassium shifts.

    • Creatinine/BUN: kidney function (renal causes).

  • Anion Gap (calculated): helps distinguish high-gap vs. normal-gap metabolic acidosis.

  • Lactate: elevated in lactic acidosis (sepsis, hypoperfusion, hypoxia, certain meds).

  • Ketones (β-hydroxybutyrate): elevated in DKA or starvation ketosis.

  • Serum Osmolality / Osmolal Gap: screens for toxic alcohols and mixed states.

  • Glucose: supports DKA workup.

  • Urinalysis/Urine electrolytes (incl. urine chloride, urine ketones, urine pH): help separate GI loss vs. renal causes (e.g., metabolic alkalosis with low urine chloride suggests vomiting; high suggests diuretics).

  • Blood gas (ABG/VBG): pH, pCO2, HCO3?, base excess (usually performed in clinical settings; availability varies).


How the Testing Process Works

  1. Order online: choose an acid–base screening panel or specific markers (e.g., bicarbonate/CO2, electrolytes for anion gap, lactate, ketones).

  2. Visit a nearby lab: quick blood draw and, when ordered, urine collection.

  3. Get results fast: most post within 24–48 hours in your secure account.

  4. Review with your clinician: combine labs with symptoms and exam; some cases require clinic/hospital blood gas testing.


Interpreting Results (general guidance)

  • Metabolic acidosis: low bicarbonate (CO2), often high anion gap (lactate, ketones, toxins) or normal anion gap(GI bicarbonate loss, renal tubular acidosis). Potassium may be high or normal.

  • Metabolic alkalosis: high bicarbonate; look at chloride and urine chloride (low → vomiting; high → diuretics or mineralocorticoid states). Potassium often low.

  • Respiratory acidosis: elevated CO2 from hypoventilation (clinical blood gas clarifies).

  • Respiratory alkalosis: low CO2 from hyperventilation (anxiety, pain, hypoxemia, pregnancy).

  • Mixed disorders: patterns that don’t fit a single process—your clinician may compare expected vs. observed compensation.

Always interpret results with a qualified healthcare professional.


Choosing Panels vs. Individual Tests

  • Broad screening (unclear cause): chemistry panel (CO2/bicarbonate, electrolytes), anion gaplactateglucose, ± ketones, ± osmolality, urinalysis/urine electrolytes.

  • If diabetes or fasting is suspected: add β-hydroxybutyrate (ketones) and glucose.

  • If sepsis/hypoxia is suspected: prioritize lactate and comprehensive chemistry.

  • If vomiting/diuretics suspected: add urine chloride and urine pH.

  • For precise pH/CO2/HCO3?: blood gas testing in a clinical setting (ordered by your clinician).


FAQs

What’s the difference between metabolic and respiratory causes?
Metabolic problems change bicarbonate (HCO3?)respiratory problems change carbon dioxide (CO2). Clinicians look at both to identify the primary process and any compensation.

What is the anion gap and why is it important?
It’s a calculation from electrolytes that helps classify metabolic acidosis as high-gap (lactate, ketones, toxins) or normal-gap (GI losses, renal tubular acidosis).

Is the CO2 on my chemistry panel the same as blood gas CO2?
On a chemistry panel, “CO2” reflects bicarbonate (HCO3?)—the main metabolic buffer. Blood gas reports pCO2 (partial pressure of CO2) and pH/HCO3? directly.

Do I need to fast for these tests?
Fasting isn’t always required, but your clinician may ask for fasting in glucose/ketone evaluations. Follow the prep listed for each test.

Can labs alone diagnose the cause?
No. They guide diagnosis when combined with symptoms, exam, and sometimes imaging or blood gas testing.

How fast will I get results?
Most acid–base-related tests are available within 24–48 hours after your draw.

When should I go to the ER?
Severe shortness of breath, chest pain, confusion, or signs of shock warrant emergency care.


Internal Links & Cross-References

  • Blood Disorders Hub

  • Electrolyte Imbalances

  • Diabetic Testing (Glucose/Ketones)

  •  Lactic Acidosis/Sepsis-Related Tests

  • Kidney Function Tests

  • Key Lab Tests: Bicarbonate (CO2) • Electrolytes (Na?/K?/Cl?) • Anion Gap • Lactate • β-Hydroxybutyrate (Ketones) • Serum Osmolality • Urinalysis • Urine Chloride


Available Tests & Panels

Tip: Start with a core acid–base screen (chemistry panel with CO2/bicarbonate + electrolytes for anion gap) and layer onlactate, ketones, osmolality, and urine studies based on symptoms and clinician guidance.

 

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Name Matches

The Complete Blood Count with Differential and Platelets Test is a comprehensive blood test that checks red blood cells, white blood cells, hemoglobin, hematocrit, and platelets. The differential analyzes types of white blood cells to detect infections, anemia, clotting abnormalities, immune conditions, and certain cancers. This essential test is often ordered for routine health exams, diagnosis, and monitoring treatment progress.

Blood
Blood Draw
Also Known As: CBC Test, CBC with Differential and Platelets Test, CBC w/Diff and Platelets Test, Full Blood Count Test, Complete Blood Count Test

The Comprehensive Metabolic Panel (CMP) Test measures 21 markers to assess metabolic health, liver and kidney function, and electrolyte balance. It includes glucose, calcium, sodium, potassium, chloride, CO2, albumin, globulin, A/G ratio, total protein, bilirubin, ALP, AST, ALT, BUN, creatinine, BUN/creatinine ratio, and eGFR. The CMP helps detect diabetes, liver or kidney disease, and supports routine screening and chronic condition monitoring.

Blood
Blood Draw
Also Known As: CMP Test, Chemistry Panel Test, Chem Test, Chem 21 Test, Chem 14 Test 

The Urinalysis Complete Test evaluates urine for physical, chemical, and microscopic properties to assess kidney health, urinary tract infections, diabetes, and metabolic disorders. It measures appearance, concentration, pH, protein, glucose, ketones, blood, bilirubin, nitrites, leukocyte esterase, and microscopic cells or crystals. Doctors use this test in routine exams, to diagnose urinary symptoms, and to monitor chronic kidney or metabolic disease.

Urine
Urine Collection
Also Known As: Urine Analysis Test, UA Test, Complete Urinalysis Test

The Lactate Dehydrogenase (LDH) Test measures LDH enzyme levels in blood to assess tissue damage and overall health. Elevated LDH may indicate conditions such as liver disease, heart attack, anemia, infections, or certain cancers, while low levels are uncommon. Doctors use this test to help diagnose disease, monitor treatment effectiveness, and track cell damage. It provides valuable insight into metabolic activity and organ function.

Blood
Blood Draw
Also Known As: LD Test, LDH Test, Lactic Acid Dehydrogenase Test

The Phosphate (as Phosphorus) Test measures phosphorus levels in blood to evaluate bone strength, energy metabolism, and kidney health. Abnormal levels may indicate kidney disease, vitamin D imbalance, parathyroid disorders, or malnutrition. Doctors order this test to investigate fatigue, muscle weakness, or bone problems and to monitor conditions like chronic kidney disease. It provides key insight into metabolic, endocrine, and bone health.

Blood
Blood Draw
Also Known As: Phosphate Test, Phosphorus Test, PO4 Test

Most Popular

The Glucose Test measures blood sugar levels to evaluate energy metabolism and screen for diabetes or prediabetes. Abnormal glucose may indicate hyperglycemia, hypoglycemia, or metabolic disorders. Doctors use this test during routine exams, to investigate symptoms like fatigue, excessive thirst, or frequent urination, and to monitor treatment for diabetes. It provides essential insight into how the body regulates blood sugar and overall metabolic health.

Blood
Blood Draw
Also Known As: Fasting Glucose Test, Fasting Blood Sugar Test

The Lactate Dehydrogenase (LDH) Isoenzyme Panel measures total LDH and separates it into isoenzymes (LDH-1 to LDH-5) to identify tissue damage. LDH-1 is linked to heart, LDH-2 to blood, LDH-3 to lungs, LDH-4 to kidneys, and LDH-5 to liver and muscle. Elevated levels may indicate heart attack, liver disease, anemia, or cancer. Doctors order this test to pinpoint tissue injury, monitor disease progression, and guide treatment strategies.


The Electrolyte Panel Test measures sodium, potassium, chloride, and carbon dioxide in blood to evaluate fluid balance, kidney function, and acid-base status. Abnormal results may indicate dehydration, kidney disease, adrenal disorders, or respiratory issues. Doctors use this test to investigate symptoms such as weakness, confusion, or irregular heartbeat. Results provide essential insight into electrolyte balance, hydration, and overall metabolic and organ health.

Blood
Blood Draw
Also Known As: Lytes Panel, Anion Gap Panel, Electrolyte Test, Lytes Test, Anion Gap Test

The Potassium Test measures potassium levels in blood to evaluate electrolyte balance, kidney function, and overall metabolic health. Abnormal results may indicate dehydration, kidney disease, adrenal disorders, or complications from certain medications. Doctors order this test for patients with weakness, irregular heartbeat, or high blood pressure. Results help diagnose hyperkalemia or hypokalemia and guide treatment to restore proper heart and muscle function.

Blood
Blood Draw
Also Known As: K Test

The Lactic Acid Plasma Test measures lactic acid levels in the blood to help evaluate oxygen delivery, metabolic function, and tissue health. Elevated levels may signal hypoxia, sepsis, shock, heart failure, or severe infection, while mild increases can occur with intense exercise. Doctors use this test to assess critically ill patients, guide urgent treatment, and monitor metabolic or circulatory disorders for timely medical intervention.

Blood
Blood Draw
Also Known As: Lactate Test, L-Lactate Test, Lactate Plasma Test, Lactate Blood Test

Most Popular

The Vitamin B7 Test measures biotin levels in the blood to assess nutritional status and detect deficiency. Biotin is essential for energy metabolism, enzyme activity, and maintaining healthy hair, skin, and nails. Low levels may result from poor diet, genetic conditions, alcoholism, or long-term antibiotic use, leading to fatigue, hair loss, or skin rashes. Doctors use this test to diagnose deficiency, monitor supplementation, and support overall metabolic health.

Also Known As: Biotin Test

The Carbon Dioxide Test measures CO2 levels in the blood to help assess acid-base balance and metabolic function. Abnormal results may reflect respiratory issues, kidney disorders, or metabolic imbalances such as acidosis or alkalosis. This test is often included in electrolyte panels to provide insights into overall health, fluid balance, and how the body maintains proper pH regulation through the respiratory and renal systems.

Blood
Blood Draw
Also Known As: CO2 Test

The Chloride Test measures chloride, an essential electrolyte that helps regulate fluid balance, acid-base status, and nerve and muscle function. Abnormal chloride levels may indicate dehydration, kidney disease, metabolic acidosis or alkalosis, or adrenal disorders. By assessing electrolyte balance, this test provides insight into hydration, metabolic function, and overall health of the renal and endocrine systems.

Blood
Blood Draw
Also Known As: Chloride Serum Test

The Chloride Random Urine Test measures chloride levels in a spot urine sample to help evaluate electrolyte and acid-base balance. Abnormal results may indicate dehydration, metabolic alkalosis, renal tubular disorders, or imbalances linked to adrenal gland conditions. This test provides clinical insight into kidney function, metabolic regulation, and systemic fluid balance by detecting changes in urinary chloride excretion.

Urine
Urine Collection
Also Known As: Random Urine Chloride Test

The Comprehensive Organic Acids Quantitative Urine Test analyzes a broad spectrum of metabolites—organic acids—in urine to assess metabolic pathway function. By quantifying markers of detoxification, mitochondrial energy, and microbial metabolism, this test can help detect inborn errors, mitochondrial dysfunction, or dysbiosis.

Urine
Urine Collection
Also Known As: Organic Acids, Comprehensive, Quantitative, Urine Test

Stool
Stool Collection

 A Urinalysis Screen test is a common diagnostic tool used in healthcare to assess and monitor various disorders by analyzing a patient's urine. This test encompasses a range of examinations including physical, chemical, and microscopic aspects of urine. It's a non-invasive, quick, and often revealing test that can provide significant insights into a person's health.
Urine
Urine Collection

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!