Written by April Khan | Published on July 18, 2012
Medically Reviewed by George Krucik, MD on July 18, 2012


Alkalosis is a condition in which the body fluids have excess base (alkali). This is the opposite of excess acid (acidosis). The fluids in your body contain two substances: acids and bases; alkali is the base. The balance between acids and bases is called pH balance, and having too much or too little base or acid can cause a pH imbalance. Decreased carbon dioxide (an acid) or increased bicarbonate (a base) levels in the blood may result in alkalosis.

What Causes Alkalosis to Occur?

Common causes of alkalosis are:

  • a high level of bicarbonate (a base) in your blood
  • excessive loss of acid from your blood
  • low carbon dioxide level (often caused by hyperventilation)

The Five Types of Alkalosis

Respiratory Alkalosis

Respiratory alkalosis occurs when there isn’t enough carbon dioxide in your bloodstream, and is normally caused by hyperventilation. It can also result from a high fever, lack of oxygen, or salicylate poisoning. People at high altitudes may develop respiratory alkalosis due to oxygen loss. Medical conditions such as liver disease or lung disease may also cause respiratory alkalosis.

Compensated Alkalosis

Compensated alkalosis occurs when your normal pH balance is restored, but carbon dioxide and bicarbonate levels remain abnormal.

Metabolic Alkalosis

Metabolic alkalosis develops when your body loses too much acid or gains too much base.

Hypochloremic Alkalosis

This form of alkalosis occurs when there is a significant decline of chloride in your body, often due to prolonged vomiting or sweating. Chloride is an important chemical needed to maintain balance in bodily fluids, and is an essential part of your body’s digestive fluids.

Hypokalemic Alkalosis

Hypokalemic alkalosis occurs when your body lacks the normal amount of potassium. Potassium is a mineral, often derived from food, which is essential to the proper functioning of the heart, kidneys, muscles, and nervous and digestive systems.

Symptoms of Alkalosis

When alkalosis sets in you may experience:

  • nausea
  • numbness
  • prolonged muscle spasms
  • muscle twitching
  • hand tremor

If it isn’t treated right away, severe symptoms can develop. These symptoms could lead to shock or coma. Severe symptoms include:

  • dizziness
  • difficulty breathing
  • confusion
  • stupor
  • coma

Diagnosing Alkalosis

Because the symptoms of alkalosis mimic symptoms of other conditions, it should not be self-diagnosed. To determine if you have alkalosis, and to rule out conditions that cause similar symptoms, your doctor will check your pH balance, carbon dioxide level, and oxygen level. Common tests used to check these levels are: urinalysis, urine pH, basic metabolic panel, and arterial blood gas analysis.

Receiving Treatment

In order to diagnose and treat alkalosis, your doctor must determine the cause. If you have respiratory alkalosis, your carbon dioxide level needs to return to normal. Slow, deep breathing can often improve symptoms and regulate your oxygen level. If tests reveal that you have a low oxygen level, you will need to receive oxygen through a mask.

If your alkalosis derives from a chemical loss (such as chloride or potassium), you’ll be prescribed medications or supplements to replace these chemicals.

Some cases of alkalosis result from an electrolyte imbalance, which may be corrected by drinking plenty of fluids or electrolyte-enhanced drinks. Advanced cases of electrolyte imbalance must be treated in a hospital.

Recovery from alkalosis is usually not a problem once treatment is administered.

How Do I Prevent Alkalosis?

Reduce your risk for developing alkalosis by maintaining good health, eating a healthy diet, and staying hydrated. Choose foods that are high in nutrients such as fresh fruits and vegetables, focusing on potassium-rich foods such as carrots, bananas, milk, beans, spinach, and bran.

Prevent dehydration by drinking eight to 10 glasses of water each day. If you are an athlete or if you work out, drink water or electrolyte-replacement drinks at regular intervals to keep your electrolytes balanced. Avoid drinking soda or juices with high sugar content, as they can promote dehydration. Remember: If you feel thirsty, you’re already dehydrated.

Alkalosis caused by existing kidney conditions may not be preventable.

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