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Alkalosis ˌal-kə-ˈlō-səs

by James L. Lewis, III, MD


  • People may have irritability, muscle twitching, or muscle cramps, or even muscle spasms.

  • Blood is tested to diagnose alkalosis.

  • Metabolic alkalosis is treated by replacing water and electrolytes or correcting the underlying cause.

  • Respiratory alkalosis is treated by slowing breathing.


Respiratory alkalosis develops when rapid, deep breathing (hyperventilation) causes too much carbon dioxide to be expelled from the bloodstream. The most common cause of hyperventilation, and thus respiratory alkalosis, is anxiety. Other causes of hyperventilation and consequent respiratory alkalosis include pain, low levels of oxygen in the blood, fever, and aspirin overdose (which can also cause metabolic acidosis—see see Acidosis).

Symptoms and Diagnosis

Alkalosis may cause irritability, muscle twitching, muscle cramps, or no symptoms at all. If the alkalosis is severe, prolonged contraction and spasms of muscles (tetany) can develop.

A sample of blood usually taken from an artery shows that the blood is alkaline.


Doctors usually treat metabolic alkalosis by replacing water and electrolytes (sodium and potassium) while treating the cause. Occasionally, when metabolic alkalosis is very severe, dilute acid is given intravenously.

With respiratory alkalosis, usually the only treatment needed is slowing down the rate of breathing. When respiratory alkalosis is caused by anxiety, a conscious effort to slow breathing may make the condition disappear. If pain is causing the person to breathe rapidly, relieving the pain usually suffices. When respiratory alkalosis is due to anxiety alone, breathing into a paper (not a plastic) bag may help raise the carbon dioxide level in the blood as the person breathes carbon dioxide back in after breathing it out.

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