High Bicarbonate level in blood

[knic27]

Hi,

I'm a healthy, fit 39 year old male who dives recreationally - perhaps 20-30 dives a year. I recently had a blood test by an endocrinologist which revealed that I have high CO2 levels in my blood. From my little bit of research, it looks like this shouldn't be a problem for me. I should just make sure I don't over exert myself or skip breathe. Of course, I'll ask my doctor when I see him, but I'd like to see if anyone with expertise in the area on here has any insight.

Thanks

 

[Bubbletrubble]

I'm interpreting a "high" level as one that is above the normal range.
Has your physician investigated/determined the cause of the elevated bicarb level? That gets at the more pressing issue - your overall general health before you hit the water.
Only after this issue is explored can the physician determine what treatment is required, whether you are fit to dive, and/or if you need to take certain precautions to minimize risks.

 

[knic27]

Not yet. I just got the test results last week and this week am in the Bahamas on a scuba vacation. I've got an appointment to follow up on the results next week. I've done 6 dives so far (on this vacation) and everything's been fine. It just occurred to me today, that there might even be an issue with scuba and high CO2 levels.

 

[Bubbletrubble]

Hmm. It's unusual for a healthy 39 year old to have to see an endocrinologist. You were probably referred to him/her by your primary care physician for some reason. That health issue needs to be addressed before any useful conversation about risk while scuba diving can take place. Elevated bicarb levels may be caused by Cushing's syndrome, Conn's syndrome, and metabolic alkalosis, among other things.

The safest thing to do would be to not dive until you figure out what's going on medically.
If you aren't willing to abstain from diving, the next best thing would be to dive very conservatively with respect to nitrogen-loading, ascent rates, physical exertion, etc.

It really isn't as simple as: "Don't overexert yourself, don't skip breathe, and you should be OK."

 

[DocVikingo]

Hi knic27,

At this point, "high" isn't defined with any precision and it's important whether we're talking a value just a few decimal points over the particular testing labs normal range (this can vary slightly among labs) or one that that is significantly elevated.

A representative normal bicarbonate/total CO2 test range is 23-29 mEq/L.

That you were seen by an endocrinologist raises questions regarding what signs/symptoms led to that evaluation. There are hormone disorders that can be associated with elevated blood bicarbonate levels, but at this point we have no idea of your endocrinological status.

I fully concur with Bubbletrouble that return to SCUBA "'... really isn't as simple as: "Don't overexert yourself, don't skip breathe, and you should be OK.'"

Regards,

DocVikingo

 

[Duke Dive Medicine]

Hi Knic27,
There is definitely a problem with diving with an elevated CO2 level. Diving itself can raise the CO2 level in the blood due to the higher gas density. If you're already retaining CO2, you are at increased risk of CO2 toxicity. Of course, avoiding exertion and skip breathing will lower the overall risk, but you're still at a higher risk than the average diver. I doubt you're going to stop your diving vacation just based on advice from people on an internet site, but you need to exercise extreme caution. Make your dive buddy aware of your condition, and ensure that you are both familiar with the symptoms of CO2 toxicity. These can include severe headache, nausea, vomiting and unconsciousness or altered level of consciousness. If you start feeling symptoms, abort the dive immediately.

There's a difference between bicarbonate level and CO2 level. In chronic CO2 elevation as is seen in conditions like chronic obstructive pulmonary disease (COPD), bicarbonate level will increase to buffer the excess acid that's produced as a result of the increased arterial PCO2. Conversely, the body may retain CO2 to counter excess bicarbonate production in conditions like Bubbletrubble mentioned. So, if the only thing you know is that your CO2 and bicarbonate levels are elevated, you're in sort of a chicken/egg situation. I'd definitely echo Bubblerubble and DocVikingo's advice to investigate this further before you think about diving any more.

Best regards,
DDM