What Medications Can Cause Metabolic Acidosis?

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What is BASAL METABOLIC RATE? What does BASAL METABOLIC RATE mean? BASAL METABOLIC RATE meaning - BASAL METABOLIC RATE definition - BASAL METABOLIC RATE explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. Basal metabolic rate (BMR) is the minimal rate of energy expenditure per unit time by endothermic animals at rest. It is reported in energy units per unit time ranging from watt (joule/second) to ml O2/min or joule per hour per kg body mass J/(hkg)). Proper measurement requires a strict set of criteria be met. These criteria include being in a physically and psychologically undisturbed state, in a thermally neutral environment, while in the post-absorptive state (i.e., not actively digesting food). In bradymetabolic animals, such as fish and reptiles, the equivalent term standard metabolic rate (SMR) is used. It follows the same criteria as BMR, but requires the documentation of the temperature at which the metabolic rate was measured. This makes BMR a variant of standard metabolic rate measurement that excludes the temperature data, a practice that has led to problems in defining "standard" rates of metabolism for many mammals. Metabolism comprises the processes that the body needs to function. Basal metabolic rate is the amount of energy expressed in calories that a person needs to keep the body functioning at rest. Some of those processes are breathing, blood circulation, controlling body temperature, cell growth, brain and nerve function, and contraction of muscles. Basal metabolic rate (BMR) affects the rate that a person burns calories and ultimately whether that individual maintains, gains, or loses weight. The basal metabolic rate accounts for about 60 to 75% of the daily calorie expenditure by individuals. It is influenced by several factors. BMR typically declines by 12% per decade after age 20, mostly due to loss of fat-free mass, although the variability between individuals is high. The body's generation of heat is known as thermogenesis and it can be measured to determine the amount of energy expended. BMR generally decreases with age and with the decrease in lean body mass (as may happen with aging). Increasing muscle mass has the effect of increasing BMR. Aerobic (resistance) fitness level, a product of cardiovascular exercise, while previously thought to have effect on BMR, has been shown in the 1990s not to correlate with BMR when adjusted for fat-free body mass. But anaerobic exercise does increase resting energy consumption (see "aerobic vs. anaerobic exercise"). Illness, previously consumed food and beverages, environmental temperature, and stress levels can affect one's overall energy expenditure as well as one's BMR. BMR is measured under very restrictive circumstances when a person is awake. An accurate BMR measurement requires that the person's sympathetic nervous system not be stimulated, a condition which requires complete rest. A more common measurement, which uses less strict criteria, is resting metabolic rate (RMR).

Drug-induced Metabolic Acidosis

Go to: Introduction Metabolic acidosis is defined as an excessive accumulation of non-volatile acid manifested as a primary reduction in serum bicarbonate concentration in the body associated with low plasma pH. Certain conditions may exist with other acid-base disorders such as metabolic alkalosis and respiratory acidosis/alkalosis 1. Humans possess homeostatic mechanisms that maintain acid-base balance ( Figure 1). One utilizes both bicarbonate and non-bicarbonate buffers in both the intracellular and the extracellular milieu in the immediate defense against volatile (mainly CO 2) and non-volatile (organic and inorganic) acids before excretion by the lungs and kidneys, respectively. Renal excretion of non-volatile acid is the definitive solution after temporary buffering. This is an intricate and highly efficient homeostatic system. Derangements in over-production, under-excretion, or both can potentially lead to accumulation of excess acid resulting in metabolic acidosis ( Figure 1). Drug-induced metabolic acidosis is often mild, but in rare cases it can be severe or even fatal. Not only should physicians be keenly aware of this potential iatrogenic complication but they should Continue reading >>

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  1. Hans Luijendijk

    Ketosis is a normal metabolic process in your body. If you don't have sufficient glucose in your body, it will turn to burning fat. A process we call ketosis.
    It does not cause kidney damage in healthy people with normal balanced food intake.

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

Metabolic Acidosis

Metabolic acidosis is primary reduction in bicarbonate (HCO3−), typically with compensatory reduction in carbon dioxide partial pressure (Pco2); pH may be markedly low or slightly subnormal. Metabolic acidoses are categorized as high or normal anion gap based on the presence or absence of unmeasured anions in serum. Causes include accumulation of ketones and lactic acid, renal failure, and drug or toxin ingestion (high anion gap) and GI or renal HCO3− loss (normal anion gap). Symptoms and signs in severe cases include nausea and vomiting, lethargy, and hyperpnea. Diagnosis is clinical and with ABG and serum electrolyte measurement. The cause is treated; IV sodium bicarbonate may be indicated when pH is very low. Acidemia (arterial pH < 7.35) results when acid load overwhelms respiratory compensation. Causes are classified by their effect on the anion gap (see The Anion Gap and see Table: Causes of Metabolic Acidosis). High anion gap acidosis Ketoacidosis is a common complication of type 1 diabetes mellitus (see diabetic ketoacidosis), but it also occurs with chronic alcoholism (see alcoholic ketoacidosis), undernutrition, and, to a lesser degree, fasting. In these conditions, t Continue reading >>

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  1. Timothy Covel

    “Is it safe”… knowing nothing about your general health status, any specific conditions, age, weight, sleep, stress levels, there is no way someone can say yes or no to this question with absolute certainty.
    I can give you a probabilistic answer, which is that most people seem to have no serious side effects or problems on a ketogenic diet, so you probably would not either.
    Or an anecdotal answer, which is that I’ve been doing keto for several years, so 12 weeks seems like a trivial commitment and should be no problem in my experience.

    Unfortunately “Is it safe” sounds like a question for a doctor, for which the answer carries a certain weight of liability, and I am not one.

  2. Elsdon Carel Ward

    A ketogenic diet burns body fat in the absence of carbohydrate. But the process is turned off by eating carbs. I would say that it is perfectly safe to restrict your carbs to the recommended minimum per day - but not to go without any. If you are eating mainly protein - limit your fat intake and eat lean proteins. There is still a question mark over a high fat diet and its relationship to cardio-vascular health - so avoid oils and fats other than what is in nuts and avocados.

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Drug-induced Acid-base Disorders

Abstract The incidence of acid-base disorders (ABDs) is high, especially in hospitalized patients. ABDs are often indicators for severe systemic disorders. In everyday clinical practice, analysis of ABDs must be performed in a standardized manner. Highly sensitive diagnostic tools to distinguish the various ABDs include the anion gap and the serum osmolar gap. Drug-induced ABDs can be classified into five different categories in terms of their pathophysiology: (1) metabolic acidosis caused by acid overload, which may occur through accumulation of acids by endogenous (e.g., lactic acidosis by biguanides, propofol-related syndrome) or exogenous (e.g., glycol-dependant drugs, such as diazepam or salicylates) mechanisms or by decreased renal acid excretion (e.g., distal renal tubular acidosis by amphotericin B, nonsteroidal anti-inflammatory drugs, vitamin D); (2) base loss: proximal renal tubular acidosis by drugs (e.g., ifosfamide, aminoglycosides, carbonic anhydrase inhibitors, antiretrovirals, oxaliplatin or cisplatin) in the context of Fanconi syndrome; (3) alkalosis resulting from acid and/or chloride loss by renal (e.g., diuretics, penicillins, aminoglycosides) or extrarenal (e. Continue reading >>

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  1. jreinhar

    Hi All, First I would like to mention that I've been on a low carb diet for over 3 months now (strictly keto for at least 2 months) and overall I like it so far… Especially the slight increase in energy, less gas and constipation(!), more balanced energy throughout the day, and possibly a reduction in plaque buildup on my teeth (they are mostly white after a cleaning over 4 months ago!). I also read posts on Reddit Keto almost every day and I must say this is a great resource for people to go to for figuring out their ailments and learning more about their bodies.
    I’ve been doing intermittent fasting, of 16 hours fast and 8 hours feast by skipping breakfast, for the last week. I’m 5’11” and usually hover between 145-150 lbs., but the last couple days I’ve been at 145 lbs., so hopefully I’m burning fat with IF… Also, in case anyone asks, I did read the FAQ and am having at least the recommended electrolyte intake, if that matters at all.
    This week I got a blood test done after being on a food fast for 14.5 hours – blood was sent to a testing lab: Test: measurement (Reference range) Glucose: 89 mg/dL (70-99) Beta Hydroxybutyrate: 1.78 mmol/L (0-0.3) BUN: 11 mg/dL (8-21) Creatinine: 0.79 mg/dL (0.7-1.3) Sodium: 137 mmol/L (136-145) Potassium: 4.6 mmol/L (3.5-5.1) Chloride: 97 mmol/L (98-107) Carbon Dioxide: 24 mmol/L (23-29) Anion Gap: 16 mmol/L (6-16) Calcium: 9.8 mg/dL (8.4-10.4) Protein Total – Blood: 7.5 gm/dL (6.3-8.3) Albumin Level: 4.8 gm/dL (3.5-5.0) Bilirubin Total: 0.6 mg/dL (0.2-1.0) AST: 31 units/L (9-45) Alkaline Phosphatase: 104 units/L (40-129) ALT: 48 units/L (8-63) Cholesterol: 382 mg/dL (<199) Triglyceride: 78 mg/dL (<149) HDL: 87 mg/dL (>40) Non-HDL: 295 mg/dL (<159) **LDL Chol, Calc: 279 mg/dL (<129)** **Chol/HDL: 4.4 (<6)** GFP other male: 112 (>60) C-Reactive Protein (CRP): 0.1 mg/dL (<0.5) Glycosylated Hgb: 4.6 % A1c (<5.9) Estimated Average Glucose: 85 mg/dL Thyroid Stimulating Hormone: 3.03 mIU/L (0.27-3.5)
    I’m also including a test from when I was having a high carb low fat diet - also during a 12+ hour fast. 2014-January; blood drawn from the arm and sent to a lab for testing (same lab as keto test): Glucose: 92 mg/dL Total Cholesterol: 181 mg/dL Triglycerides: 51 mg/dL HDL 83 mg/dL LDL 88 mg/dL
    When my doctor emailed me the keto diet blood test results he just said that my LDL was very high and that I should reduce my fat intake. I’ve seen that people look at the absolute values of HDL and LDL alone or calculate ratios like Cholesterol/HDL to use as indicators of heart disease risk. My LDL (and therefore Total Cholesterol) is very high but my Cholesterol/HDL or Triglyceride/HDL seems good. I’ve also seen that a total cholesterol of over 300 mg/dL is not good.
    I don’t count my total daily carb intake, but instead avoid foods that have lots of carbs as I’m choosing what to eat. My daily intake of carbs is probably ~15-30g/day; protein is around 60-80 g/day; fat is taken until I’m satisfied. I try to avoid processed foods in general and eat lots of veggies (raw and cooked). I also eat on average 2-3 eggs per day with yolk. The types of fats I have primarily are coconut oil, butter, and olive oil (not necessarily in the order based on consumption), but if I cook chicken or other meats I’ll eat the skin and drippings.
    TL/DR: What do you guys think about my new blood test results? Is there any way to lower my LDL? Should I get additional testing done? I’m not entirely convinced that I’m in bad shape just based on my LDL. I heard that on Keto your fasting glucose should be below 80 mg/dL - would this be a problem for me? Thanks!

  2. CPCPub

    If I was you, I'd closely count my food for a while, whislt still making the same food decisions. People are generally really bad at estimating their food intake.

  3. rogerrabbit62

    No problem. In the few month transition period and while losing weight that is a often seen issue. nothing to worry about.

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