Compensatory mechanisms for this include release of hydrogen ion from tissue buffers and excretion of bicarbonate in the kidneys, both of which lower blood pH.

[4][5][6][7][8][9] During exercise, due to the inability to utilize muscle glycogen as a substrate for ATP synthesis, plasma lactate does not significantly rise (and may fall below) compared to resting levels; consequently, McArdle disease individuals do not experience lactic acidosis.

[8][6] Metabolic alkalosis can be caused by repeated vomiting,[2] resulting in a loss of hydrochloric acid in the stomach contents.

Compensatory mechanism for metabolic alkalosis involve slowed breathing by the lungs to increase serum carbon dioxide,[2] a condition leaning toward respiratory acidosis.

As respiratory acidosis often accompanies the compensation for metabolic alkalosis, and vice versa, a delicate balance is created between these two conditions.