Difference Between Respiratory And Metabolic Acidosis And Alkalosis

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Simple Method Of Acid Base Balance Interpretation

A FOUR STEP METHOD FOR INTERPRETATION OF ABGS Usefulness This method is simple, easy and can be used for the majority of ABGs. It only addresses acid-base balance and considers just 3 values. pH, PaCO2 HCO3- Step 1. Use pH to determine Acidosis or Alkalosis. ph < 7.35 7.35-7.45 > 7.45 Acidosis Normal or Compensated Alkalosis Step 2. Use PaCO2 to determine respiratory effect. PaCO2 < 35 35 -45 > 45 Tends toward alkalosis Causes high pH Neutralizes low pH Normal or Compensated Tends toward acidosis Causes low pH Neutralizes high pH Step 3. Assume metabolic cause when respiratory is ruled out. You'll be right most of the time if you remember this simple table: High pH Low pH Alkalosis Acidosis High PaCO2 Low PaCO2 High PaCO2 Low PaCO2 Metabolic Respiratory Respiratory Metabolic If PaCO2 is abnormal and pH is normal, it indicates compensation. pH > 7.4 would be a compensated alkalosis. pH < 7.4 would be a compensated acidosis. These steps will make more sense if we apply them to actual ABG values. Click here to interpret some ABG values using these steps. You may want to refer back to these steps (click on "linked" steps or use "BACK" button on your browser) or print out this page for Continue reading >>

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    So sorry to hear of your experience. Sadly, it sounds like you have a bit more information about PCOS than your doctor. Hate to echo all the previous comments to change doctors, however that might be the best option. I'd humbly suggest, and agree with those who also think, it may be time for a **Reproductive Endocrinologist.**
    I backed into my PCOS diagnosis after having children; my OB-GYN put me on Clomid simply because I didn't ovulate regularly. And two cycles in, we conceived twins. It was only after the children were a few years old -- and 150+ pounds later -- that an Ann Landers/Dear Abby column my mother read connected the dots between my various symptoms to lead to PCOS. My OB, when presented with the option, totally agreed. She put me on oral contraceptives (to regulate hormones) and spironolactone (a diuretic to help flush excess testosterone from my system).
    It wasn't long after that we prepared to move to a military installation and my OB, who was trained by the military, suggested that once I was there, I seek out a "reproductive endocrinologist." I'd never heard the term before, but followed her advice. While sitting in that waiting room, I think I was part of a very small percentage of patients not already or actively trying to become pregnant.
    And yes, this doctor -- who in 2001 had already published articles on PCOS -- pretty immediately added metformin to the other meds I was already using. He did explain that it was an "off-label" use for it, however it was the beginning of cutting edge treatment for PCOS at the time. (With the 150+ pound weight gain, it was pretty evident I was also insulin-resistant; cell walls not allowing nutrients to pass through --> starving cells send out messages for hunger/needing nutrients --> repeat cycle)
    In discussing the medication change, I recall asking whether I'd continue to take the metformin IF my husband and I hoped to become pregnant again. His response sort of floored me -- so this is very much a paraphrase: In the past, we had pregnant women stop it. However, Yes, we're beginning to think it's important for the body to maintain the benefits of the metformin throughout the pregnancy. And we're likely to have fewer miscarriages then...
    (The miscarriage part floored me, because I'd had one AFTER the first pregnancy triggered the dormant aspects of PCOS and kicked them to the new level that included the insulin resistance. Suddenly my miscarriage was no longer an "act of God" but a failure of my body to create a conducive environment for a developing child. So, I grieved even more 5 years after the fact than I had at the time of the actual miscarriage itself.)
    About this same time, PCOS was a featured cover story in my husband's JAPA (Journal of Association of Physician Assistants) magazine. I read it, understood about 2/3 of it, and greatly appreciated it was a syndrome finally getting more attention. At that time, the cycle was understood -- yet it was still attempting to determine the actual starting point. (i.e. the chicken and egg scenario).
    A few years later, I dropped the oral contraceptive on my own (probably a mistake) and was so giddy about menstruating on a regular cycle *without* it, that I literally called my husband at work with the news. And yes, that was because of the metformin. I remained regular thereafter and, I hate to admit, felt more like "a real woman" again....
    More recently (and several moves later), I sought out the help of a reproductive endocrinologist again. While I'm past child-bearing (i.e. hysterectomy), I likely will be on metformin for the rest of my life. A fact pretty much confirmed at a very recent diabetes education consultation. I explained that a frustration for me was even if I lost 150+ pounds, was that I'd likely always be on the metformin and spironolactone *because of the PCOS* for the rest of my life. They agreed...
    Don't give up hope. There ARE other pathways out there. You'll ultimately find the one for the two of you. And yes, life's too short to continue working with a medical provider that a) doesn't listen to you and/or b) doesn't explain their decisions. Best Wishes!


    I totally understand the frustrating road of IF and PCOS! You want to get going and the tests take time (and $), which is a pain. But... the Dr. it being realistically thorough. Going through various levels of treatment only to find that your spouse has issues or you have complicating factors would be beyond frustrating - infact everyone here would be telling you to find a new Dr. because they should have tested you, etc. :)
    The tests cost money out of pocket, but you can't get proper treatment without them having a full picture of both of you.
    Did the Dr. say Metformin was not at all in your future?

    Pounds lost: 0.0







    Whilst Metformin should be the primary allopathic drug of choice in treating Metformin, as supported by all the studies to date and it is ridiculous that the US has not approved it for use in PCOS, there are other options.
    There are plenty of natural supplements that have either a similar action to Metformin, or have been proven in clinical trials to be as effective.
    They are generally cheaper than pharmaceutical medicines, with less side effects if taken appropriately.
    As Nyxwolfwalker said and SweetSunshine reiterated more eloquently ... not all women with PCOS have clinically present Insulin Resistance to warrant treatment with Metformin. Insulin levels can be kept in check in some instances through strict dietary and exercise changes. I would reiterate PTPHELAN's point to ensure that you do get a good workup prior to going on Metformin. As SweetSunshine said, you need to know for certain that you have a high fasting insulin level. Not glucose, but insulin. The euglycaemic clamp test is the most effective, but it's invasive, must be done in a hospital and very few practitioners will agree to do it. Ron Rosedale, Chief Medial Officer of Advanced Metabolic Laboratories I think does them, but he is in Denver Colorado.
    You may have more success locally getting a frequently sampled IV glucose tolerance test performed. It generally believed to provide comparable accuracy to a euglycaemic clamp.
    The other factor to take into consideration in whether or not Metformin will be beneficial to you or not, is the amount and type of carbohydrates you consume. From speaking with many women with PCOS (and having had a negative reaction to Metformin myself) I have come up with a hypothesis that Metformin is not helpful and may actually be detrimental to women who closely control their carbohydrate intake, eat a large percentage of fresh, unprocessed, low GI food and exercise regularly - at least once and even multiple times per day.
    Anyway, to end this long ramble, because it's nearly 3 am ... make sure that you have your insulin levels tested on fasting and as part of a glucose tolerance test of some description. Many GTTs only test for glucose. With PCOS it is imperative that they also check insulin levels at each interval.
    Did anyone mention how important appropriate amounts of sleep is in the treatment of PCOS? I truly need my head read ;) Good night.
    Edited by: BELROSA at: 5/31/2009 (12:54)
    I have a website with loads of PCOS info www.mypcos.info Please stop by!
    Leader of Managing PCOS Naturally www.sparkpeople.com/myspark/groups_i

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Anion gap usmle - anion gap metabolic acidosis normal anion gap metabolic acidosis


The kidneys and lungs maintain the balance (proper pH level) of chemicals called acids and bases in the body. Acidosis occurs when acid builds up or when bicarbonate (a base) is lost. Acidosis is classified as either respiratory or metabolic acidosis. Respiratory acidosis develops when there is too much carbon dioxide (an acid) in the body. This type of acidosis is usually caused when the body is unable to remove enough carbon dioxide through breathing. Other names for respiratory acidosis are hypercapnic acidosis and carbon dioxide acidosis. Causes of respiratory acidosis include: Chest deformities, such as kyphosis Chest injuries Chest muscle weakness Chronic lung disease Overuse of sedative drugs Metabolic acidosis develops when too much acid is produced in the body. It can also occur when the kidneys cannot remove enough acid from the body. There are several types of metabolic acidosis: Diabetic acidosis (also called diabetic ketoacidosis and DKA) develops when substances called ketone bodies (which are acidic) build up during uncontrolled diabetes. Hyperchloremic acidosis is caused by the loss of too much sodium bicarbonate from the body, which can happen with severe diarrhea. Continue reading >>

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  1. MathWiz

    I wasn’t sure which section I should post this in, my strategy is what I call the 4–2–1 plan, I fast 2 day non consecutive days a week, eat a low carb but not calorie restricted diet 4 days a week to keep the fat burning benefits of ketosis going and then I give myself 1 day a week to indulge and eat whatever I want, usually a Saturday pasta dinner and wonderful dessert. I also walk 4 to 6 miles a day during the week and 10 to 12 miles on Saturday.
    Low Carb plans such as Atkins can be very effective for some people including me, many people who start a low carb diet experience get what’s called the “ketosis flu” or the “induction flu” in the first few days while the body is adapting to burning ketones instead of glucose.
    The basic symptoms are:
    – Headaches
    – Nausea
    – Upset stomach
    – Lack of mental clarity (brain fog)
    – Sleepiness
    – Fatigue
    It’s called the “ketosis flu” for a reason: you feel sick. I’ve gone through it and it wasn’t a pleasant experience. Fortunately it only lasted 2 days but then suddenly I woke up feeling much better, less hungry and my energy level was really high and consistent throughout the day!
    The first time I thought to myself: “What the heck am I doing? I feel like I’m going to die!” but I persevered and when it was over I didn’t regret a thing because what I had gained mentally and physically was 100% worth it.
    For those of you that are going through the ketosis flu, don’t give up! I know you feel like it’s never going to get better but stick with it and you´ll be so happy you did! I’m telling you, waking up refreshed for the first time in years, not getting the afternoon “blah” feeling and stuffing my face with carbs to try to boost my energy is the best side effect of the low carb diet I’ve experienced. Okay, losing weight while eating good food, feeling full and satisfied is great too.
    First you have to understand why your body is reacting this way. Your body’s been burning glucose for energy so it’s basically full of enzymes that are waiting to deal with the carbs you eat, but now the body needs to make new enzymes that burn fat for fuel instead of carbs, and the transition period causes the flu-like symptoms.
    There are some things you can do to lessen the symptoms of the ketosis flu and to make it go away sooner (to force the body to transition sooner) Ok, let’s get to the good part – what to do:
    First of all – you’re probably dehydrated. Drink PLENTY of water while you’re on a low carb diet, and then drink some more.
    Watch your electrolytes. When the body is getting rid of excess insulin from your former carb-crazy diet you´ll lose lots of fluids that have been retained in your body. This causes the rapid weight loss most people see in their first few days of ketosis, it’s mostly water, sorry. When you lose all the retained water you also lose electrolytes like sodium, magnesium and potassium. When you’re lacking them you´ll feel like crap so when you’re feeling really ill on the ketosis flu try things like chicken/beef broth and look for foods rich in these minerals. Take a multi-vitamin and a multi-mineral.
    Ok, here is where people throw the red flag – Eat more fat – Yup, I said MORE fat. Have some butter, just not on a roll, eat some bacon and eggs for breakfast, just skip the potatoes and toast. This will force your body to hurry up the transition. You´ll think this is crazy and think you´ll never get lose weight eating this way, but you will.
    Don’t eat too much protein – The body can transform protein into glucose so if you eat too much of it in the first days it will slow down the transition. Go for fatty meat and cheese if you can, add fat to protein shakes etc.
    Drink water, replenish electrolytes (sodium, magnesium, potassium) with food and supplements, drink broth, eat fat and not too much protein.
    I hope this helps, and have a great day

  2. rockyromero

    ” Take a multi-vitamin and a multi-mineral.”
    I have been forgetting to take a multi-vitamin on fast days. Thanks for the reminder.
    “Eat more fat – Yup, I said MORE fat. ”
    I will have avocado more often.

  3. AussieJess

    Thanks for that info, very interesting

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Acidosis Symptoms | Symptoms of Acidosis Contact Info: Rich Adams Direct Phone: 262-353-5665 Website: www.2berich.enagicweb.net Email: [email protected] To share this video, click here: http://youtu.be/A37e9tPv1kA Are you concerned about Symptoms of Acidosis? Do you want to know what the Acidosis Symptoms are? There are seven prevalent Acidosis Symptoms. You may display or experience some or all of these Acidosis Symptoms. Before we can understand Acidosis Symptoms, we must first know what acidosis is and second, we must know what causes acidosis! So what is acidosis? Acidosis is an increased acidity in the blood and other body tissue (i.e. an increased hydrogen ion concentration). If not further qualified, it usually refers to acidity of the blood plasma or metabolic acidosis. Acidosis is said to occur when arterial pH (potential hydrogen) falls below 7.35 (except in the fetus). Normal pH range is 7.35 to 7.45 for humans. The term acidemia describes the state of low blood pH, while acidosis is used to describe the processes leading to these states, i.e. the seven acidosis symptoms or stages. The kidneys and lungs maintain the balance (proper pH level) of chemicals called acids and bases in the body. Acidosis occurs when acid builds up or when bicarbonate (a base) is lost. What causes acidosis? The causes for acidosis can be many. Acidosis can be caused by physiological problems like asthma, deformed chest cavity, obesity, problems with the nervous system, kidney failure, and other such physical conditions. Typically however, acidosis is most commonly caused by drinking alcohol, drinking wine, beer or soda, having a high-fat, low-carbohydrate diet, dehydration, or not drinking enough of the right water, prescription drugs and OTC drugs like aspirin, Aleave, etc. All of these are highly acidic and create and acidic environment in your body in which disease, illness, and cancer can thrive! Acidosis Symptoms. Acidosis Symptoms typically manifest themselves in 7 stages and are listed below: Acidosis Symptoms 1. Tired or lethargic Acidosis Symptoms 2. Irritation of the skin, allergies, acne, psoriasis, rashes, etc. Acidosis Symptoms 3. The formation of mucus in your throat. Acidosis Symptoms 4. Inflammation, arthritis, rheumatism, bursitis, gout, etc. Acidosis Symptoms 5. Solidification - Acid waste buildup in your arteries which results in high cholesterol. Acidosis Symptoms 6. Ulceration Acidosis Symptoms 7. Degenerative diseases, cancer, diabetes, osteoporosis, kidney stones. So what can you do about acidosis and the Symptoms of Acidosis? First of all, you can change your diet to include more alkaline food. You can eliminate soda from your diet as soda is extremely acidic! It takes 32 cups of alkaline water to neutralize the acid in 1 cup of soda!!! You can also try to eliminate many OTC medications as they create an acidic environment in your body. Once you start the conversion from acidic to alkaline in your body, your body will be better able to fight illness and disease on its own! 00:02 Acidosis Symptoms Introduction 00:11 Acidosis Symptoms Stage One 00:39 Acidosis Symptoms Stage Two 01:06 Acidosis Symptoms Stage Three 01:20 Acidosis Symptoms Stage Four 01:36 Acidosis Symptoms Stage Five 01:53 Acidosis Symptoms Stage Six 02:12 Acidosis Symptoms Stage Seven Reference: The pH Miracle by Dr. Robert Young M.D.


For acidosis referring to acidity of the urine, see renal tubular acidosis. "Acidemia" redirects here. It is not to be confused with Academia. Acidosis is a process causing increased acidity in the blood and other body tissues (i.e., an increased hydrogen ion concentration). If not further qualified, it usually refers to acidity of the blood plasma. The term acidemia describes the state of low blood pH, while acidosis is used to describe the processes leading to these states. Nevertheless, the terms are sometimes used interchangeably. The distinction may be relevant where a patient has factors causing both acidosis and alkalosis, wherein the relative severity of both determines whether the result is a high, low, or normal pH. Acidosis is said to occur when arterial pH falls below 7.35 (except in the fetus – see below), while its counterpart (alkalosis) occurs at a pH over 7.45. Arterial blood gas analysis and other tests are required to separate the main causes. The rate of cellular metabolic activity affects and, at the same time, is affected by the pH of the body fluids. In mammals, the normal pH of arterial blood lies between 7.35 and 7.50 depending on the species (e.g., healt Continue reading >>

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  1. nboylie

    I have searched rexall and shoppers drug mart and I can't seem to find them?

  2. quality_time

    I get mine at shoppers. I ask for them from the pharmacist as they keep them behind the counter. I've also gotten them from the pharmacy at the grocery store - same deal behind the counter. If they don't have them behind the counter it's on order. Typically with the diabetic stuff.

  3. rolodex9

    yep, Shoppers has them behind the pharmacists counter. In regards to how expensive they are, I combat that by cutting mine in half. They're still readable and instead of 50 you get 100 strips

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