PH Imbalance: Acidosis, Alkalosis, Diagnosis, And Treatment

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Understanding the Symptoms, Causes, Treatments of pH Imbalance in the Body

Medically reviewed by Meredith Goodwin, MD, FAAFP — Written by S. Srakocic — Updated on April 23, 2025

What it is
Acidosis types
Alkalosis types
Symptoms
Causes
Risk factors
Diagnosis
Treatment
Outlook
Takeaway

When your body is healthy, it maintains pH balance on its own. However, certain health conditions can cause pH imbalances, which make it difficult for your body to function properly.

Sometimes, factors as simple as intense exercise or dehydration can lead to temporary pH imbalances. In other cases, pH imbalances can be caused by chronic conditions such as kidney failure.

No matter the cause, pH imbalances can lead to symptoms such as confusion, headaches, and vomiting. Often, treatment focuses on addressing the underlying cause.

What is pH imbalance?

The pH scale describes whether something is acidic, neutral, or alkaline. Your body needs a specific acid-to-alkaline balance, or pH balance.

The pH balance of substances such as your bodily fluids and organs can affect your digestion, hormones, metabolism, and overall body function.

When your body is healthy, it maintains pH balance on its own. Most of this balancing takes place in your kidneys, which filter acids and bases. Any acids or bases your body doesn’t need are then left in your urine.

But certain factors and health conditions can cause pH imbalances, which can make it difficult for your body to function as it should.

What are the types of acidosis?

Acidosis occurs when your body cannot remove acid from your airways, your blood, or other body fluids. There are a few types of acidosis:

Lactic acidosis: Lactic acidosis is a type of metabolic acidosis. It happens when too much lactic acid builds up in your blood.
Diabetic acidosis: This type of metabolic acidosis happens when too many ketone acids build up in your blood.
Renal tubular acidosis: This type of metabolic acidosis occurs when your kidneys let too much acid back into your blood.
Hyperchloremic acidosis: This type of metabolic acidosis happens when the level of sodium bicarbonate, an alkaline, in your blood becomes too low.
Respiratory acidosis: Respiratory acidosis occurs when your lungs don’t expel enough carbon dioxide.

What are the types of alkalosis?

Alkalosis occurs when your body is too alkaline. There are a few types of alkalosis, including:

Metabolic alkalosis: This happens when there is too much of a chemical called bicarbonate in your blood.
Respiratory alkalosis: This happens when there is not enough carbon dioxide in your body.

What are the symptoms of pH imbalance?

The symptoms of a pH imbalance depend on the type of imbalance you’re experiencing. Symptoms differ between metabolic and respiratory pH imbalances and between acidosis and alkalosis. Common symptoms of major types are listed below.

Metabolic acidosis symptoms:

fatigue
nausea
vomiting

Respiratory acidosis symptoms:

fatigue
sleepiness
confusion

Metabolic alkalosis symptoms:

confusion
fatigue
headache
nausea
vomiting
loss of appetite
rapid heartbeat
heart palpitations

Respiratory alkalosis symptoms:

headache
shortness of breath
fatigue
muscle spasms
confusion
sleepiness

What causes pH imbalance?

The cause of a pH imbalance depends on the type of pH imbalance. For instance, diabetic ketoacidosis (DKA) is caused by a buildup of glucose and ketone bodies, and DKA is dangerous. Ketone bodies by themselves are not dangerous and do not cause pH imbalances.

Hyperchloremic acidosis occurs when your body doesn’t have enough sodium bicarbonate.

Causes of other common pH imbalances are listed below.

Causes of lactic acidosis:

certain medications
low blood sugar
excessive exercise
heavy alcohol use
lack of oxygen
dehydration
liver failure
kidney failure
cancer
seizure
aspirin poisoning

Causes of respiratory acidosis:

obesity
high altitude
lack of oxygen
lung disease
pneumonia
chronic airway diseases such as chronic obstructive pulmonary disease (COPD)
chest injuries or abnormalities
overuse of sedatives
sleep apnea

Causes of respiratory alkalosis:

fever
lung disease
lack of oxygen
high altitude
liver diseases
salicylate poisoning

What are the risk factors for pH imbalance?

Anyone can get a pH imbalance from simple factors such as exercise or high elevation. However, the following risk factors increase your chances of developing a pH imbalance:

type 1 diabetes
kidney conditions
liver conditions
respiratory and lung conditions
obesity
epilepsy
heavy alcohol use

How are they diagnosed?

It’s a good idea to make a medical appointment if you suspect you have a pH imbalance. A doctor can diagnose the imbalance and can begin treatment. Tests to confirm a diagnosis might include:

Arterial blood gas: This blood test determines the levels of oxygen and carbon dioxide in your blood.
Metabolic panel: A metabolic panel can check the levels of electrolytes, proteins, fats, and other substances in your blood. It’s a good way to test kidney function.
Glucose test: If you have diabetes, you’ll likely have a glucose test.
Urinalysis: A urinalysis can check the proportion of acids being eliminated in your urine.
Urine pH: This test will measure the acidity and alkalinity of your urine.

How is pH imbalance treated?

Treatments will depend on the type of pH imbalance you have and its cause.

For instance, insulin is the primary treatment for diabetic ketoacidosis, but acidosis that is caused by kidney dysfunction, such as lactic acidosis or renal tubular acidosis, might be a sign that you need to begin dialysis treatments.

Often, treating the pH imbalance involves treating the underlying condition.

Examples of this include:

using medications to treat COPD or other chronic respiratory conditions
using continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) to improve breathing
being placed on a ventilator if you cannot breathe on your own
treating a fever with appropriate medications
drinking electrolyte solutions to address dehydration
changing medications or starting new medications

What’s the outlook for individuals with pH imbalance?

Your exact outlook will depend on the type of pH imbalance you have and its cause. For many people, treatment can restore pH balance.

However, some pH issues are chronic or caused by chronic conditions. In these cases, you might need to take a new medication or take other steps to manage your pH in the long term.

Takeaway

Your pH balance is an important part of keeping your body functioning well. When your body becomes too acidic (as in acidosis) or too alkaline (as in alkalosis), it can lead to symptoms that make it difficult to manage everyday activities.

The exact symptoms will depend on the type of pH imbalance but can include sleepiness, fatigue, headache, loss of appetite, confusion, and vomiting. Treatment for a pH imbalance depends on the type and the cause.

Treatment plans typically focus on addressing the underlying cause. Often, once the underlying cause is treated or better managed, the pH imbalance will resolve.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Brinkman JE, et al. (2023). Physiology, metabolic alkalosis.https://www.ncbi.nlm.nih.gov/books/NBK482291/
Hopkins E, et al. (2022). Physiology: Acid base balance.https://www.ncbi.nlm.nih.gov/books/NBK507807/
Jung B, et al. (2019). Diagnosis and management of metabolic acidosis: Guidelines from a French expert panel.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695455/
Overview of acid-base and electrolyte disorders. (2025).https://bestpractice.bmj.com/topics/en-us/1072
Patel S, et al. (2023). Respiratory acidosis.https://www.ncbi.nlm.nih.gov/books/NBK482430/
Tinawi M. (2021). Pathophysiology, evaluation, and management of metabolic alkalosis.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7896805/
Sharma S, et al. (2023). Hyperchloremic acidosis.https://www.ncbi.nlm.nih.gov/books/NBK482340/

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Medically reviewed by Meredith Goodwin, MD, FAAFP — Written by S. Srakocic — Updated on April 23, 2025

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