Another way in which blood pH may be protected is by changes in endogenous acid production (Fig. 25.4). An increase in blood pH caused by the addition of base to the body results in increased production of lactic acid and ketone body acids, which then reduces the alkaline shift in pH. A decrease in blood pH results in decreased production of lactic acid and ketone body acids, which opposes the acidic shift in pH.
This scenario is especially important when the endogenous production of these acids is high, as occurs during strenuous exercise or other conditions of circulatory inadequacy (lactic acidosis) or during ketosis as a result of uncontrolled diabetes, starvation, or alcoholism. These effects of pH on endogenous acid production result from changes in enzyme
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