What happens when your body is acidic?

The notion that your body might be "too acidic" is a common topic, but when a clinical imbalance actually occurs, the condition is known medically as acidosis, a serious disruption of the body's tightly controlled $\text{pH}$ environment. ^[2][5] Maintaining a stable $\text{pH}$ is non-negotiable for life; the body works constantly to keep the blood $\text{pH}$ within a very narrow range, typically between $\text{7.35}$ and $\text{7.45}$. ^[8] When the $\text{pH}$ drops below $\text{7.35}$, the condition is acidosis. ^[5][7] This isn't about the food you ate yesterday; it reflects a significant physiological problem where acids are either produced too quickly, or the body cannot excrete them efficiently enough. ^[1][5]

# $\text{pH}$ Control

Your body manages its acid-base equilibrium using several sophisticated, interconnected defense lines, often called buffering systems. ^[8] The two main organs responsible for day-to-day $\text{pH}$ management are the lungs and the kidneys. ^[1]

The lungs handle the volatile component, carbonic acid, by controlling the level of carbon dioxide ($\text{CO}_2$) in the blood. ^[5] If the blood becomes too acidic, you instinctively start breathing faster and deeper—a process called hyperventilation—to exhale more $\text{CO}_2$, which effectively removes an acid and raises the $\text{pH}$ back toward normal. ^[5] This is rapid-response compensation.

The kidneys manage the non-volatile acids and conserve bicarbonate ($\text{HCO}_3^{-}$), which is the body's primary chemical buffer. ^[1][4] This renal compensation is slower, taking hours or days to fully kick in, but it is much more powerful and sustained for long-term corrections. ^[5] If the kidneys fail to excrete enough acid or reabsorb enough bicarbonate, metabolic acidosis develops. ^[4]

# Types of Acidosis

Acidosis is generally categorized based on which system is failing to keep the balance: respiratory or metabolic. ^[2][5]

# Metabolic Problems

Metabolic acidosis occurs when there is a problem with the non-respiratory component, meaning either too much acid is being added to the body, or too much base (like bicarbonate) is being lost. ^[5] A common measure used by clinicians is the anion gap, which helps determine the cause of the metabolic acidosis. ^[1]

Key ways metabolic acidosis develops include:

• Increased acid production: Conditions like diabetic ketoacidosis ($\text{DKA}$), where the body produces excessive ketones because it cannot use glucose for fuel. ^[1][5] Severe lactic acidosis, caused by insufficient oxygen delivery to tissues (shock, severe infection), also dumps large amounts of lactic acid into the system. ^[5]
• Loss of bicarbonate: Severe diarrhea leads to the loss of bicarbonate-rich fluids from the lower gastrointestinal tract. ^[5]
• Impaired excretion: This is frequently seen in kidney failure. ^[1][4] When the kidneys are damaged, they cannot adequately excrete fixed acids or regenerate the necessary bicarbonate, leading to a buildup. ^[4]

# Respiratory Issues

Respiratory acidosis arises when the lungs cannot remove $\text{CO}_2$ effectively, often due to inadequate breathing (hypoventilation). ^[5] This traps $\text{CO}_2$ in the bloodstream, which then combines with water to form carbonic acid, lowering the $\text{pH}$. ^[5] Causes include severe lung diseases such as chronic obstructive pulmonary disease ($\text{COPD}$), pneumonia, or situations where breathing is suppressed by drugs or injury. ^[2][7]

# Visible Signs

When the body's buffering capacity is overwhelmed, symptoms begin to appear as the $\text{pH}$ drifts significantly below $\text{7.35}$. ^[5] While some sources discuss vague symptoms associated with general "acidity," the medically defined consequences of true acidosis relate directly to organ function. ^[6]

The most immediate and noticeable effect often involves the respiratory system trying to compensate. ^[5] In metabolic acidosis, the body attempts to blow off the excess acid by breathing rapidly and deeply—a pattern known as Kussmaul breathing. ^[5] This is the body's emergency attempt to lower $\text{CO}_2$ levels. ^[5]

As the condition progresses, especially when caused by kidney issues or other severe metabolic disturbances, general symptoms can include:

• Lethargy, weakness, and general fatigue. ^[10][6]
• Headaches. ^[6]
• Confusion or, in severe cases, loss of consciousness. ^[10]
• Nausea and vomiting. ^[6]
• Abdominal pain. ^[6]

If metabolic acidosis is linked to kidney disease, patients might also experience signs of fluid overload, such as swelling. ^[10] The $\text{pH}$ imbalance itself can also negatively affect the heart, leading to irregular heart rhythms or decreased heart muscle contraction, which can result in low blood pressure. ^[10]

# Compensatory Speed Comparison

The body’s response mechanism offers a fascinating look into physiological prioritization. When metabolic acidosis strikes (e.g., from kidney failure), the respiratory system reacts immediately—within minutes—by increasing the rate and depth of breathing to expel $\text{CO}_2$. This speed is essential for immediate survival, essentially acting like a temporary chemical sponge. However, this rapid breathing can be exhausting for the patient and often causes distress. Meanwhile, the kidneys, the true long-term fixers, are much slower. They start retaining bicarbonate and excreting hydrogen ions, a process that takes hours to days to achieve meaningful correction. If the underlying cause (like kidney failure or uncontrolled diabetes) persists, the slow renal response means the patient remains vulnerable until that primary issue is resolved. ^[5]

# Critical Impacts

If the state of acidosis is allowed to persist or becomes severe, the consequences spread throughout multiple organ systems, moving past mere discomfort into life-threatening territory. ^[10]

# Neurological Function

The central nervous system is highly sensitive to $\text{pH}$ changes. A lowered $\text{pH}$ directly impairs brain function. Patients become increasingly drowsy, progressing from mild confusion to stupor, and eventually coma if the $\text{pH}$ drops too low. ^[10] This effect is compounded in respiratory acidosis, where high $\text{CO}_2$ itself acts as a central nervous system depressant. ^[5]

# Cardiovascular System

The heart muscle’s ability to contract properly is hindered by low $\text{pH}$. ^[10] This leads to decreased cardiac output, meaning the heart cannot pump enough blood to meet the body's demands. Furthermore, high potassium levels (hyperkalemia) frequently accompany severe metabolic acidosis, which significantly increases the risk of dangerous, unstable heart rhythms. ^[10]

# Bone Health and Mineral Shifts

In chronic metabolic acidosis, such as that seen in long-term kidney disease, the body attempts to buffer the excess acid by releasing alkaline substances stored elsewhere. One primary buffer source is the skeleton. The body draws on bone mineral—which is alkaline—to neutralize the circulating acid, potentially leading to bone demineralization over time if the acidic state is poorly managed. ^[4]

# Diagnosing the Imbalance

Determining the exact nature and severity of acidosis requires specific laboratory tests. A doctor will typically order an arterial blood gas ($\text{ABG}$) test. ^[5] This blood sample, usually drawn from an artery, provides precise real-time measurements of the blood's $\text{pH}$, the partial pressure of $\text{CO}_2$ ($\text{PCO}_2$), and bicarbonate ($\text{HCO}_3^{-}$ ) levels. ^[5][7] These values immediately tell the clinician whether the problem is primarily respiratory ($\text{PCO}_2$ is high) or metabolic ($\text{HCO}_3^{-}$ is low), and whether the body is attempting to compensate. ^[7] Further blood tests are then run to look for the underlying causes, such as checking glucose and ketone levels for $\text{DKA}$ or assessing kidney function markers. ^[1]

# Correction Strategy

Treating acidosis is not just about raising the $\text{pH}$ number; it is about fixing the underlying condition that caused the acid buildup in the first place. ^[4][9]

If the acidosis is respiratory, the primary goal is to improve ventilation. This might involve treatments to open airways (bronchodilators), clear infections, or, in severe cases, mechanical ventilation to assist breathing until the patient can manage on their own. ^[9]

For metabolic acidosis, the approach varies widely based on the cause:

1. Diabetic Ketoacidosis: Requires prompt administration of intravenous fluids and insulin to stop ketone production. ^[1]
2. Lactic Acidosis: Demands restoring adequate tissue oxygenation through IV fluids and supporting blood pressure. ^[5]
3. Kidney-related Acidosis: Long-term management often involves prescribing oral alkali supplements, typically sodium bicarbonate, to replace the base the damaged kidneys cannot retain, alongside managing the progression of the kidney disease itself. ^[4][10]

In very acute, life-threatening situations where the $\text{pH}$ is dangerously low (often below $\text{7.1}$), physicians may administer intravenous sodium bicarbonate directly to temporarily raise the blood $\text{pH}$ while working on the definitive treatment. ^[9] However, giving bicarbonate itself must be done cautiously, as it can sometimes worsen the $\text{CO}_2$ load or shift potassium levels unpredictably. ^[5]

While many wellness discussions focus heavily on modifying diet—such as emphasizing fruits and vegetables to promote an "alkaline" environment—it is critical for the general reader to understand that these dietary adjustments, while perhaps beneficial for overall health, have a negligible impact on the serious, life-threatening $\text{pH}$ levels defining clinical acidosis. The body’s renal and pulmonary systems are designed to buffer massive dietary fluctuations. True acidosis arises when these high-capacity systems fail due to disease, trauma, or poisoning, not simply from eating too much protein or dairy. ^[1][5] Recognizing the difference between mild dietary shifts and genuine organ system failure is the key to knowing when immediate medical intervention is required.