• Welcome to Phoenix Rising!

    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

    To become a member, simply click the Register button at the top right.

high D-lactate on urine test

lizw118

Senior Member
Messages
315
Hello everyone,
I am new here! I have never had an official CFS diagnosis but I have adrenal fatigue, hashimotos thyroiditis, POTs symptoms, etc, all after having a virus years ago, so I suppose it is all pretty closely related. Many of my symptoms involve fatigue and various forms of inflammation.
I just had an ion profile test done (urine). One of the things that came up was high markers for gut dysbiosis with very high D-lactate levels. I have been doing as much research on this online as possible, but it doesn't seem like there is too much info out there. I realize this probably means I have carbohydrate malabsorption, and I should probably do the specific carb diet, at least. What I can't figure out is, can I eat fruit? Every since I was little I have always ingested tons of fruit. I don't feel good without eating it. Is this part of the problem? I can't imagine not being able to eat it.
Does anyone know any other symptoms associated with D-lactate build up? I actually don't have many gut symptoms, ironically.
Thanks
Liz w
 

SDP

Messages
12
Hello Liz.. from one newbie to another (my first post too)

I am only a layman but I discussed these issues with my doc after tests indicated I have gut dysbiosis, and have done a bit of reading online. From what I can gather, D-lactate, dysbiosis and glucose/fructose are intimately connected in that lactate is produced when fructose/glucose come into contact with certain bacteria - eg strep. My advice would be to cut all fruit and sugars from your diet.

Kenny De Meirleir and Michael Maes have written on this (or related) topics.

Others with more knowledge may wish to add to/correct any of what I have just said!
 

JPV

ɹǝqɯǝɯ ɹoıuǝs
Messages
858
Hello everyone,
I am new here! I have never had an official CFS diagnosis but I have adrenal fatigue, hashimotos thyroiditis, POTs symptoms, etc, all after having a virus years ago, so I suppose it is all pretty closely related. Many of my symptoms involve fatigue and various forms of inflammation.
I just had an ion profile test done (urine). One of the things that came up was high markers for gut dysbiosis with very high D-lactate levels. I have been doing as much research on this online as possible, but it doesn't seem like there is too much info out there. I realize this probably means I have carbohydrate malabsorption, and I should probably do the specific carb diet, at least. What I can't figure out is, can I eat fruit? Every since I was little I have always ingested tons of fruit. I don't feel good without eating it. Is this part of the problem? I can't imagine not being able to eat it.
Does anyone know any other symptoms associated with D-lactate build up? I actually don't have many gut symptoms, ironically.
Thanks
Liz w

Here's an excerpt from an interview that Cort did with Dr. Alan Logan regarding H2S and D-Lactate.

I strongly suggest you read the whole article...


Dr. Logan on H2S, Fiber and the Gut


On a personal level your conjecture that fiber induced fermentation in the gut could be associated with increased anxiety and aggression was intriguing since I’ve always felt that ’edginess’ is a key factor in my version of ME/CFS. But how do fiber induced problems in the gut translate into central nervous system problems? A study by Dr. Shungu has suggested increased lactate production in the brain may be occurring in ME/CFS patients; could this have anything to do with lactate production in the gut?

When too much fermentable fiber shows up in the large intestine there is a massive uptick in the production of D-lactate. Since, in CFS, we now know there is already over-production of D-lactate the blanket statements to eat more fiber may not be well suited to CFS. For example, animal studies show that excessive D-lactate production, due to excess fermentable carbohydrates showing up in the distant portion s of the gut, can increase aggressive an anxious behavior. It completely throws them off.

The same phenomenon has been written up numerous times in cases of short bowel syndrome. These are individuals who have had a portion of the small intestine removed, they are more prone to the over-fermentation of fiber-rich carbohydrates in the large intestine and an excess amount of D-lactate is produced. They can experience brain fog, lowered mood state, hypothamic dysfunction and anxiety when transient elevations in D-lactate occur.

Since we know that CFS patients have both bacterial overgrowth and excess D-lactate production (and/or lack of D-lactate clearance) a similar situation may be occurring. Ultimately, excess prebiotics and even excess Lactobacillus strains may worsen the situation in short bowel syndrome, and perhaps CFS as well.

I was very interested in Dr Shungu’s work as well. It certainly suggests that if excess lactate is making it to the brain (and we already know that systemic lactate can cause anxiety in adults with no history of anxiety) it can have multiple implications. Obviously, we have just begun to scratch the surface of this research, however in moving forward we should be very selective of the stains we use for CFS clinical trials.
 

lizw118

Senior Member
Messages
315
Thanks so much for all of the replies!
I am glad I read the part about the fiber, as I thought that was what made fructose more easily palatable to the gut. It looks like I am going to have to cut out all fruits, as the other newbie poster said! This makes me really sad, because fruits have always been my favorite food. I crave them all the time and when I feel physically bad I feel like I need a piece of fruit to feel better, perhaps a hypoglycemic impulse. Ugh. Do I crave them because the bacteria needs them to survive?
I bought some probiotics with no D-lactate, and took a scoop yesterday. Today I am feeling really tired and I am wondering if the probiotics might not be a good idea, even if they are d-lactate free.
Does anyone know how long symptoms clear once on a sugar free diet?
One last question. I often have cloudy urine on days I feel terrible. Sometimes my urine smells sweet, too. I have ruled out UTIs, etc. The cloudiness comes and goes. Could this be related to D-lactate?
I am currently going down on cortef for adrenal fatigue and that is making me tired, also.
Thanks so much for all the info and I am enjoying the forum
Liz W
 

lizw118

Senior Member
Messages
315
Oh, one other thing. I read somewhere that sometimes it is okay to eat fruit that has a high glucose to fructose ratio. Is that true? Or is glucose just as bad, pretty much, as fat as D-lactate producing bacteria...
Thanks
Liz
 

gracenote

All shall be well . . .
Messages
1,537
Location
Santa Rosa, CA
lizw,

I really don't have any specific answers to your questions, but I do want to encourage you to make changes slowly. I am always tempted to plunge into things because I'm feeling so poorly, but sometimes that just confuses the picture more.

I've had similar things with my urine in the past, but I never found out why. Let us know if you make any connections.
 

lizw118

Senior Member
Messages
315
Thanks for reminding me to take it slow. I do tend to jump into several treatments at once, and it can be counterproductive.
The only connection I can find regarding cloudy urine, is that sometimes phosphates in the urine can cause cloudiness. I have also seen cloudy urine in connection with keto-acidosis. I have seen phosphates mentioned in articles with D-lactic acidosis, but I am not sure how they are connected. I need to read some more. I will let you know what I find out.
Thanks for the warm welcome and information
Liz
 

JPV

ɹǝqɯǝɯ ɹoıuǝs
Messages
858
I bought some probiotics with no D-lactate, and took a scoop yesterday. Today I am feeling really tired and I am wondering if the probiotics might not be a good idea, even if they are d-lactate free.
Does anyone know how long symptoms clear once on a sugar free diet?

People are quick to mention "die off" and "herx" symptoms but I find that these terms to be completely overused and misused within the community, to the point where I find such comments virtually meaningless. Especially since they usually seem to come from people that are just making wild guesses.

Sometimes it's hard to say whether feeling bad after changing supplements/diet is due to ingesting the wrong foods/supplements or whether it is due to your body adjusting.

Personally, I try to read up as much as possible on any dietary changes I intend to make in order to anticipate such reactions. If there is a negative reaction I just go with it for a few days, if it doesn't seem too dramatic. I do think the body often times needs a period of adjustment for one reason or another.

I doubt that probiotics would be detrimental to your wellbeing. Taking ones that don't produce D-Lactate are a good choice according to Dr. Logan. I've tried Align for awhile and just recently switched to Culturelle. Both seem to be helpful for me so far.

As to how long dietary changes will take to give noticeable results, the consensus seems to be that it could take 2-3 months.

You might also want to read up on digestive enzymes/bitters and Betaine HCL. I'm of the opinion that digestion needs to be worked on first before any other nutritional supplements can even begin to work. If you are not absorbing nutrients properly I think supplements have a hard time doing their job. Also, problems such as "leaky gut" are reported to lead to undigested food entering the blood which supposedly causes extra stress on the immune system which is left with less resources to fight off real pathogens when they appear.

Do a search for posts by Catseye on this forum. She has a lot of good advice for such matters and seems to have made much improvement with her condition. Her and Freddd, with his Active B12 Protocol, have been the biggest inspiration to me the last few weeks. I've been following both their suggestions and feel like I've seen a bit of improvement over the last few of days.
 

lizw118

Senior Member
Messages
315
Hi!
Thanks for the reply

I doubt that probiotics would be detrimental to your wellbeing. Taking ones that don't produce D-Lactate are a good choice according to Dr. Logan. I've tried Align for awhile and just recently switched to Culturelle. Both seem to be helpful for me so far.

I am thinking I will wait til after I do the stool test, then try again. I don't want to mess up the results, just in case, but you could be right that it takes time to adjust.

As to how long dietary changes will take to give noticeable results, the consensus seems to be that it could take 2-3 months.

Ugh. I am really having a hard time getting through one day without fruit. I must be really addicted.

You might also want to read up on digestive enzymes/bitters and Betaine HCL. I'm of the opinion that digestion needs to be worked on first before any other nutritional supplements can even begin to work. If you are not absorbing nutrients properly I think supplements have a hard time doing their job. Also, problems such as "leaky gut" are reported to lead to undigested food entering the blood which supposedly causes extra stress on the immune system which is left with less resources to fight off real pathogens when they appear.

This actually raises another question for me. Should I take Betaine HCL or not? I mean, I don't want more acid in there if everything is already fermenting, right? I have some and I have been taking it, as well as pancreatin, but I am not sure if it is the right thing to do

Do a search for posts by Catseye on this forum. She has a lot of good advice for such matters and seems to have made much improvement with her condition. Her and Freddd, with his Active B12 Protocol, have been the biggest inspiration to me the last few weeks. I've been following both their suggestions and feel like I've seen a bit of improvement over the last few of days.[/QUOTE]

I'l do a search. Much appreciated!
Nice forum!
Cheers
Liz
:Retro smile:
 

JPV

ɹǝqɯǝɯ ɹoıuǝs
Messages
858
Ugh. I am really having a hard time getting through one day without fruit. I must be really addicted.

Yeah, I noticed that a few days into cutting out sugar and doing probiotics with digestive aids, I had severe sugar cravings. The only problem is I really don't normally have a sweet tooth. I assumed that I was killing something off that needed sugar.

This actually raises another question for me. Should I take Betaine HCL or not? I mean, I don't want more acid in there if everything is already fermenting, right? I have some and I have been taking it, as well as pancreatin, but I am not sure if it is the right thing to do

I'm still trying to learn more about this subject myself so I'm afraid I won't be much help here. I'm still experimenting with what works for me. I feel that I can do better in this department. That's why I recommended doing some research on your own. Others here, like Catseye, seem more knowledgeable about the such matters. There seems to be numerous ways to aid digestion with acids and enzymes, each playing a different role in the process. It seem like an intricate system say the least. Doing tests is probably a good idea. I think I will pursue that avenue myself soon, instead of shooting in the dark.
 

lizw118

Senior Member
Messages
315
Yeah, I noticed that a few days into cutting out sugar and doing probiotics with digestive aids, I had severe sugar cravings. The only problem is I really don't normally have a sweet tooth. I assumed that I was killing something off that needed sugar.



I'm still trying to learn more about this subject myself so I'm afraid I won't be much help here. I'm still experimenting with what works for me. I feel that I can do better in this department. That's why I recommended doing some research on your own. Others here, like Catseye, seem more knowledgeable about the such matters. There seems to be numerous ways to aid digestion with acids and enzymes, each playing a different role in the process. It seem like an intricate system say the least. Doing tests is probably a good idea. I think I will pursue that avenue myself soon, instead of shooting in the dark.

I did check out Catseye's threads-very informative, indeed. She does recommend HCL, going to the point where it burns then cutting back. I am not sure if she has the d-lactic acid problem, though.
I have been using it and have not noticed ill-effects, so maybe it is okay. I will let you know if I find out anything...
Cheers
liz
 

susan

Senior Member
Messages
269
Location
Gold Coast Australia
I have high levels of D Lactate. My Dr who had me do the Metametrix tests says to just eat everything except Gluten and no HCL. Instead he put me on Enzymes....ones that contain DPP1V.....this apparently heals the bowel and you can eat gluten and casein if you dont have a really high sensitivity to gluten. It digests these substances. Of course I am on probiotics and he told me the methylation program will help solve the D Lactate problem once the gut dysbiosis is finally arrrested. Only people with short bowels who have had cancer should worry about finding a probiotic without D.lactate he said.
 

JPV

ɹǝqɯǝɯ ɹoıuǝs
Messages
858
Only people with short bowels who have had cancer should worry about finding a probiotic without D.lactate he said.

If I were you I'd change doctors. Sounds like he doesn't know what he's talking about. Most of them don't...

Excerpt from: The Cheney Clinic - Gut Dysbiosis Modulates Significant CFS Symptoms

A recent publication from both Kenny DeMeirleir and Australian investigators has important implications regarding the management of gut dysbiosis. The bottom line is that they showed increased bacterial overgrowth in the GI tract in CFS that produces bacterial derived D-Lactate that is likely responsible for significant cognitive problems, especially memory. There is also a high likelihood of increased H2S associated with this D-Lactate which will cause even more weakness and fatigue and put you in bed as well as disrupt sleep.

Excerpt from: Bringing the Heat - Dr. Logan on H2S, Fiber and the Gut

When too much fermentable fiber shows up in the large intestine there is a massive uptick in the production of D-lactate. Since, in CFS, we now know there is already over-production of D-lactate the blanket statements to eat more fiber may not be well suited to CFS. For example, animal studies show that excessive D-lactate production, due to excess fermentable carbohydrates showing up in the distant portion s of the gut, can increase aggressive an anxious behavior. It completely throws them off.

The same phenomenon has been written up numerous times in cases of short bowel syndrome. These are individuals who have had a portion of the small intestine removed, they are more prone to the over-fermentation of fiber-rich carbohydrates in the large intestine and an excess amount of D-lactate is produced. They can experience brain fog, lowered mood state, hypothamic dysfunction and anxiety when transient elevations in D-lactate occur.

Since we know that CFS patients have both bacterial overgrowth and excess D-lactate production (and/or lack of D-lactate clearance) a similar situation may be occurring. Ultimately, excess prebiotics and even excess Lactobacillus strains may worsen the situation in short bowel syndrome, and perhaps CFS as well.

I was very interested in Dr Shungu’s work as well. It certainly suggests that if excess lactate is making it to the brain (and we already know that systemic lactate can cause anxiety in adults with no history of anxiety) it can have multiple implications. Obviously, we have just begun to scratch the surface of this research, however in moving forward we should be very selective of the stains we use for CFS clinical trials.

Excerpt from: Bringing the Heat - Dr. Logan on H2S, Fiber and the Gut
Yes, but not all Lactobacillus strains produce the undesirable D-Lactate (for example, the well-researched Lactobacillus GG does not produce D-Lactate, but most strains of Lactobacillus have not been investigated for D-Lactate production. Its time to map that out properly).

It’s generally true that L.acidophilus does turn sugars into lactic acid, but not all Lactobacillus strains produce the D-Lactate; the L-Lactate can be cleared with a fair amount of ease by most.
 

IntuneJune

Senior Member
Messages
562
Location
NorthEastern USA
JPV and others:

Culturelle has the GG variety, so we are safe with that??

I just double checked on line since I throw my box out to see if it did contain the GG variety and there are coupons available for Culturelle. I knew that.....but forgot.

Over the years I have tried different brands but have been using Culturrelle as I felt it was more effective.

June
 

JPV

ɹǝqɯǝɯ ɹoıuǝs
Messages
858
JPV and others:

Culturelle has the GG variety, so we are safe with that??

I just double checked on line since I throw my box out to see if it did contain the GG variety and there are coupons available for Culturelle. I knew that.....but forgot.

Over the years I have tried different brands but have been using Culturrelle as I felt it was more effective.

June

I have use both Culturelle and Align, mostly based on recommendations from an interview that Cort did with Dr. Logan. He mentioned that the GG variety was a good choice...

http://blog.aboutmecfs.org/?p=633
 

Glynis Steele

Senior Member
Messages
404
Location
Newcastle upon Tyne UK
Hi Liz,

If you have high d-lactic acid it is important that you should be seen be a GI, as they are the specialist's in this regard. Please feel free to write back for further info, or read my thread on d-lactic on the research page.

BW

Glynis
 

August59

Daughters High School Graduation
Messages
1,617
Location
Upstate SC, USA
Thanks so much for all of the replies!
I am glad I read the part about the fiber, as I thought that was what made fructose more easily palatable to the gut. It looks like I am going to have to cut out all fruits, as the other newbie poster said! This makes me really sad, because fruits have always been my favorite food. I crave them all the time and when I feel physically bad I feel like I need a piece of fruit to feel better, perhaps a hypoglycemic impulse. Ugh. Do I crave them because the bacteria needs them to survive?
I bought some probiotics with no D-lactate, and took a scoop yesterday. Today I am feeling really tired and I am wondering if the probiotics might not be a good idea, even if they are d-lactate free.
Does anyone know how long symptoms clear once on a sugar free diet?
One last question. I often have cloudy urine on days I feel terrible. Sometimes my urine smells sweet, too. I have ruled out UTIs, etc. The cloudiness comes and goes. Could this be related to D-lactate?
I am currently going down on cortef for adrenal fatigue and that is making me tired, also.
Thanks so much for all the info and I am enjoying the forum
Liz W

I'm with you on this! I crave fruit terribly and if I don't get the fruit then it's on to the junk food. If I eat a typical meal I get nauseated and am able to finish it, but it is not an enjoyable meal at all.