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Alcohol Associated Lactic Acidosis

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Severe Metabolic Acidosis In The Alcoholic: Differential Diagnosis And Management

1 A chronic alcoholic with severe metabolic acidosis presents a difficult diagnostic problem. The most common cause is alcoholic ketoacidosis, a syndrome with a typical history but often misleading laboratory findings. This paper will focus on this important and probably underdiagnosed syndrome. 2 The disorder occurs in alcoholics who have had a heavy drinking-bout culminating in severe vomiting, with resulting dehydration, starvation, and then a β- hydroxybutyrate dominated ketoacidosis. 3 Awareness of this syndrome, thorough history-taking, physical examination and routine laboratory analyses will usually lead to a correct diagnosis. 4 The treatment is simply replacement of fluid, glucose, electrolytes and thiamine. Insulin or alkali should be avoided. 5 The most important differential diagnoses are diabetic ketoacidosis, lactic acidosis and salicylate, methanol or ethylene glycol poisoning, conditions which require quite different treatment. 6 The diagnostic management of unclear cases should always include toxicological tests, urine microscopy for calcium oxalate crystals and calculation of the serum anion and osmolal gaps. 7 It is suggested here, however, that the value of th Continue reading >>

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Popular Questions

  1. saku11

    caffeine slows ketosis for anybody else?

    after my first weekend carbup, 2 days of gorging, i took me until this morning to get back into ketosis, the first time i got in it took me 2 days, is this because of all the caffeine ive beeen drinking? anybody else have this observation

  2. c10d

    Originally Posted by saku11
    after my first weekend carbup, 2 days of gorging, i took me until this morning to get back into ketosis, the first time i got in it took me 2 days, is this because of all the caffeine ive beeen drinking? anybody else have this observation

    YES, thats why I've been asking about caffiene a lot, because most people says it has no effect.
    I think it actually may temporarily kick me out of ketosis when I drink it. It definitly has 'some' type of effect on insulin, and I know some people say heavy coffee drinking can lead to insulin resistance.
    Hopefully someone can clear all this up
    EDIT- I didn't mean "YES" saying that IS WHY you're having trouble getting back into ketosis, I was saying "YES" like in excitement seeing that I'm not the only one that has been thinking this

  3. magnumfreak

    Has no effect on me, and I live off of caffeine (shiftwork). It could be that you ate so many carbs over the weekend that it took this long to get back. When I did a dirty carb up it took me until wed. to get back to ketosis. Clean it only takes me 1-2 days.

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