So I have a working hypothesis which is that one of my primary problems is with acidosis. I've had numerous blood tests over the last year, each taken when I was *not* experiencing severe fatigue. These each show an anion gap of 7-9 (normal). However, tests taken a year and a half apart, each in the middle of an episode of severe fatigue showed anion gap of 17 (Na: 144, CL 107, CO2 20) and 15 (Na: 141, CL: 103, C02: 23.4). In addition, on a metametrix lab, I tested high for pyruvate, l-lactate, and d-lactate. Also, I notice that my symptoms progress as the day goes on and that they worsen after meals (especially the neuro symptoms). Unfortunately, since the l-lactate and d-lactate are not standard tests and were done through an alternative practitioner, the MDs generally ignore those results. I've shown my PCP numerous research studies on CFS & acidosis, as well as on the neurotoxic effects of lactate. He replied that the sample sizes are small, and I wonder if it's just that he wasn't trained in this in school. (One of my ID doctors, when I brought it up to her, did not know the difference between l-lactate and d-lactate, and said she had never been taught it.) Anyway, I'd love to get a "legit" in the eyes of the medical establishment lab to confirm the high l-lactate / d-lactate finding. I think one reason why my doctors are so reluctant to think: maybe it's acidosis? is because they expect to see it in ICU patients or people with shortened bowel syndrome. Any tips on how I can convince my doctor to take this hypothesis seriously? Any idea on further testing I might request? For folks who have dealt with this before, how did you treat it?