Your body’s pH balance, also referred to as its acid-base balance, is the level of acids and bases in your blood at which your body functions best.

The human body is built to naturally maintain a healthy balance of acidity and alkalinity. The lungs and kidneys play a key role in this process. A normal blood pH level is 7.40 on a scale of 0 to 14, where 0 is the most acidic and 14 is the most basic. This value can vary slightly in either direction.

If the lungs or kidneys are malfunctioning, your blood’s pH level can become imbalanced. Disruption in your acid-base balance can lead to medical conditions known as acidosis and alkalosis. Both conditions require treatment from a medical professional, not simply dietary changes.

The lungs control your body’s pH balance by releasing carbon dioxide.

Carbon dioxide is a slightly acidic compound. It’s also a waste product produced by cells in the body as they use oxygen. The cells release it into your blood, and it’s taken to your lungs.

When you exhale, you’re expelling that carbon dioxide, a process that also helps regulate your body’s pH balance by reducing acidity.

The amount of carbon dioxide you exhale is a function of how deeply you inhale or exhale. Your brain constantly monitors this in order to maintain the proper pH balance in your body.

The kidneys help the lungs maintain acid-base balance by excreting acids or bases into the blood. The kidneys’ effect on acidity works much more slowly than that of the lungs.

A blood pH imbalance can lead to two conditions: acidosis and alkalosis.

Acidosis refers to having blood that’s too acidic, or a blood pH of less than 7.35. Alkalosis refers to having blood that’s too basic, or a blood pH of higher than 7.45.

There are different types of acidosis and alkalosis based on the underlying cause.

When acidosis or alkalosis is caused by a lung disorder or issue with exhalation, it’s referred to as “respiratory.” When acidosis or alkalosis is caused by a problem with the functioning of the kidneys, it’s referred to as “metabolic.”

Respiratory acidosis

Respiratory acidosis is caused by your lungs not being able to remove enough carbon dioxide when you exhale. This can occur when your lungs are affected by a disease or other disorder.

Some conditions that could lead to respiratory acidosis include:

Respiratory acidosis can also be caused by taking narcotics or sleep medications. Brain and nervous system disorders that cause breathing problems may also lead to respiratory acidosis.

The primary symptoms of respiratory acidosis are:

  • extreme sleepiness
  • fatigue
  • confusion
  • headache

If left untreated, respiratory acidosis can become severe and lead to coma or death.

Metabolic acidosis

Metabolic acidosis is a buildup of acid in the body that originates in the kidneys. It occurs when your body can’t get rid of excess acid or loses too much base. Specific causes include:

  • having too little sodium bicarbonate in your blood, a potential complication of severe vomiting or diarrhea
  • a buildup of ketones due to a lack of insulin, a condition known as ketoacidosis that people with diabetes face
  • a buildup of lactic acid, a possible complication of alcohol misuse, cancer, and seizures
  • failure of the kidneys to release acid into the bloodstream, known as renal tubular acidosis

Metabolic acidosis could also be caused by ingesting certain substances, such as:

  • methanol
  • antifreeze
  • aspirin (in large doses)

Symptoms of metabolic acidosis can include nausea, vomiting, and extreme tiredness.

As with respiratory acidosis, metabolic acidosis can result in coma or death if left untreated.

Respiratory alkalosis

Respiratory alkalosis is when there’s too little carbon dioxide in your blood. Causes of respiratory alkalosis include hyperventilation due to anxiety, aspirin overdose, high fever, and possibly even pain.

Symptoms of respiratory alkalosis are muscle cramping and twitching. You may also notice tingling in your fingers, toes, and lips, as well as irritability.

Metabolic alkalosis

Metabolic alkalosis occurs when bicarbonate levels in your blood get too high or your body loses too much acid. It can be brought on by a long period of vomiting, overuse of diuretics, or an overactive adrenal gland.

Other conditions that can lead to metabolic alkalosis are kidney damage caused by a severe loss of fluids or ingestion of a large amount of baking soda.

Symptoms of metabolic alkalosis are the same as those discussed above for respiratory alkalosis.

If you think you have a pH imbalance, it’s important to seek medical attention immediately. In addition to taking your medical history, a doctor will use a variety of blood and urine tests to determine the underlying cause of your pH imbalance.

Possible tests include:

However, depending on your symptoms and the other information your doctor collects, additional tests may be performed. If you have diabetes, your glucose and ketone levels may be tested. If you ingested ethylene glycol or methylene, you may undergo an osmolality test.

Treatments for pH imbalances will vary greatly based on whether you’re experiencing acidosis or alkalosis, and what the underlying cause is. The ultimate goal is to return your acid-base level to a healthy balance.

Acidosis treatment might include:

Alkalosis treatment might include:

  • slowed breathing if the underlying cause is hyperventilation
  • oxygen therapy
  • medications to restore levels of nutrients, such as chloride or potassium
  • fluids or electrolyte drinks to restore electrolyte balance

Your pH balance is important for your health, and you can trust that your body is equipped to maintain that balance on its own. However, if your doctor finds your balance to be off through blood and urine testing, they will do additional tests to determine the exact cause.

Once the cause is discovered, you’ll be given a treatment plan to correct it and get your body’s pH balance back in line.