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Who Would Like to Participate in a Simple Study to Measure Blood Lactate Levels?

Mij

Messages
2,353
I had my lactate level measured 14yrs ago 2 or 3 days after a 30 minute jog :nervous: and it was at 4.6. I was not completely recovered from PEM at the time of testing, back then my PEM was not as bad as it is now. I could never jog for 30 minutes again.
 

Hip

Senior Member
Messages
17,824
What about this device John, one in the device review you linked (thanks): EKF Lactate Scout +

That model does not appear to be as accurate as the EDGE lactate analyzer, according to the conclusion of this study that myself and @John Mac cited above.

That study tested 6 blood lactate analyzer models, and from what it says in the study conclusion, the EDGE lactate analyzer appears to be the most accurate for both high and low lactate levels.
 

gregh286

Senior Member
Messages
976
Location
Londonderry, Northern Ireland.
I think the patient's severity of ME/CFS (mild, moderate or severe) needs to be noted in the results, but I think this test should be open to all severity levels. The intensity of exercise needed to trigger a bit of PEM would be different for each patient though.

For very severe patients like Mark Vink, it was just the 5 or 6 yard walk to his bathroom. For a moderate patient, some PEM may be triggered from a 10 minute walk.

ME/CFS patients are normally quite good at knowing what level of exercise will begin to trigger PEM. So each participant in our informal study would have to choose their own level of PEM-inducing exercise; they would need to do just enough exercise to trigger some PEM (but obviously you don't want to do too much and trigger a major crash).

I believe this sort of lactate testing normally uses a short bout (ie, one to two minutes) of intense exercise, and then measures the lactate levels in the minutes following this short bout.

So for a moderate patient, instead of a 10 minute walk, in order to "compress" their exercise into a short 2 minute intense bout, they may need to do two minutes of running, and then measure their lactate 5 minutes after this exercise, and then 30 minutes after this exercise.

For a severe patient, perhaps just walking up and down the stairs once or twice will be enough to trigger some PEM.

For a mild patient, it's possible that they would have to do very intense exercise for two minutes (like sprinting at absolute top speed) in order to trigger some PEM.





If we did replicate this (and even if we did not), I think we could then post up the results as an informal study in a PR forum thread, and then email a few ME/CFS researchers that are interested in the PEM and exercise aspects of ME/CFS. This may well help get more research done in this area.

What I am (optimistically) thinking is that if many ME/CFS patients exhibit this exaggerated production of lactate after a short bout of exercise, then ultimately this might become the basis of a useful diagnostic test for ME/CFS.

It would be much simpler and cheaper (and much less strenuous on the patient) than the 2-day CPET test. If it were viable, this lactate test could even be done in a primary care doctor's surgery: the doctor would simply ask a (say moderate) ME/CFS patient to jog on the spot for two minutes in the doctor's office, then measure their lactate level 5 and 30 minutes later. It could be a quick and easy diagnosis.





I don't think that is the case, unless patients are pushing themselves past their limits.

I would say its the ratio of aerobic/anaerobic. A mild cfs.patient might have 50/50 energy production..a severe patient almost all anaerobic.and little.aerobic.
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
I believe this sort of lactate testing normally uses a short bout (ie, one to two minutes) of intense exercise, and then measures the lactate levels in the minutes following this short bout.

So for a moderate patient, instead of a 10 minute walk, in order to "compress" their exercise into a short 2 minute intense bout, they may need to do two minutes of running, and then measure their lactate 5 minutes after this exercise, and then 30 minutes after this exercise.

For a severe patient, perhaps just walking up and down the stairs once or twice will be enough to trigger some PEM.

For a mild patient, it's possible that they would have to do very intense exercise for two minutes (like sprinting at absolute top speed) in order to trigger some PEM.
I only consider myself moderate, but I don't think I could run for 2 minutes! I tend to take things slowly, for example cutting my hedge for half an hour. That is quite likely to give me some PEM. Ditto my weekly shopping trip. I have a huge amount to do, and constantly struggling to get through that, so don't want to do any exercise for the sake of it. If I could just do the tests following my essential activities I am interested.

I was surprised when cutting my hedge recently that my heart rate was only in the 80s, yet I was tired and a bit short of breath, so I wonder whether I was in anaerobic respiration or not. I am on a beta blocker which has slowed my heart rate.
 

Hip

Senior Member
Messages
17,824
I would say its the ratio of aerobic/anaerobic. A mild cfs.patient might have 50/50 energy production..a severe patient almost all anaerobic.and little.aerobic.

Would you have any references for that?
 
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Research 1st

Severe ME, POTS & MCAS.
Messages
768
I think the gregh286 is probably referring to V02 max? I say that as I think (don't know) the VO2 max studies have not been on housebound or bedbound, but despite this, some results were really bad? E.g. 50% worse than expected.
Thus the implication is, if someone is much more sick, they will probably have almost total energy depletion at rest (hence some patients can barely speak, never mind speak).

That's if they have the same disease of course.

It would be cool for us to try and get some housebound people in 'our' idea,(lactate) with a little exercise challenge and have two groups or more? Severe, Moderate, Mild and compare the differences between us.
 

Hip

Senior Member
Messages
17,824
I think the gregh286 is probably referring to V02 max?

I managed to find a reference to the aerobic / anaerobic energy production that @gregh286 was talking about:

In Christopher Snell's paper on 2-day CPET testing of ME/CFS patients, it says:
The VT is also an important measure for understanding the activity limitations in CFS. Under normal circumstances, most activities of daily living require energy levels below the VT. However, if the VT occurs at very low levels of oxygen consumption, very low workloads, or both, even normal activities of daily living may exceed the VT. Therefore, it is possible that in CFS the increased stress of requiring anaerobic energy even for normal activities of daily living precipitates the symptom exacerbation seen in PEM.
Note: VT = ventilatory threshold. The ventilatory threshold is used to measure the arrival of the anaerobic threshold — the point during intense exercise when you oxygen-based energy system begins to run out of steam, and you start switch from aerobic to anaerobic energy production (the latter involves the production of lactate).


However, I am not clear from this above excerpt whether the study authors are saying that ME/CFS patients do rely on anaerobic energy for normal activities of daily living, or whether the authors are speculating ME/CFS patients might be relying on anaerobic energy for normal daily activities.
 
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Hip

Senior Member
Messages
17,824
I have changed the title of this thread to something more appropriate for attracting the attention of people who might want to participate in this simple study.
 

Seven7

Seven
Messages
3,444
Location
USA
Where can I buy the EDGE lactate or something similar in USA??? I WANT TO JOINNNNN so bad, because I have noticed the same in my case (not by blood test) but by experience on feeling. I have been using baking soda to lower it.
I think this (latic acid) is the key to solve my major issues.
 

Apple

Senior Member
Messages
217
Location
UK
I would definitely be interested but it would have to be controlled somehow. We all have different and highly variable exercise limits, even within the same categories of mild/mod/severe.

@Hip - Where are you located? UK? US?
 

Hip

Senior Member
Messages
17,824
I would definitely be interested but it would have to be controlled somehow. We all have different and highly variable exercise limits, even within the same categories of mild/mod/severe.

@Hip - Where are you located? UK? US?

What sort of control did you have in mind?

I am thinking that this test could include all levels of ME/CFS severity. ME/CFS patients usually have a good idea of how much exercise it takes to induce PEM, so for each patient in this lactate test, they would want to choose for themselves an exercise level which induces a degree of PEM — but obviously not a major crash.

I am also thinking that we could get a few healthy controls involved (eg, family members who do not have ME/CFS), just for comparison purposes. The healthy control could perform the same exercise as the ME/CFS patient does, so that we can have a direct comparison.

Myself, although I have a moderate level of ME/CFS, I don't actually get PEM from physical exercise, only from mental exertion. I can run a mile without too much difficulty. It's possible this might be reflected in my own lactate response.

I am in the UK.
 
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Apple

Senior Member
Messages
217
Location
UK
I don't know. I was hoping someone else would come up with that one. heh. I mean, hitting your own personal limit would perhaps give up a more accurate representation of what is actually happening with the lactate levels as opposed to say everyone jogging on the spot for 3 mins but the end results would likely be all over the place. It would be fascinating to see, but as a study - would it really mean anything without that common thingymajig.

I mean someone walking a mile will inevitably have a different level than someone walking 30 metres, regardless of illness level - it's too variable.
I'm mostly housebound and couldn't run a mile if my life depended on it.

I'm fascinated but my brain is melting. God, I wish I could study.
 
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daisybell

Senior Member
Messages
1,613
Location
New Zealand
Maybe the actual amount of exercise doesn't matter, as long as we collect enough data.
If we are all using the same scale of our severity, and we agree a scale for how we measure activity (e.g. Steps taken, or number of minutes of particular activity), symptoms post-activity, and time post, then the variation will be interesting and perhaps give some very useful data...
We just need to measure everything each time!

The study will give information both within and between subjects, and perhaps allow us to sub-group?