Bicarbonate i.v. for PEM

[JollyRoger]

I noticed that all my PEM problems are in relation with lactate- nausea, vomiting, muscle weakness and extrem pain.

A usual lactat acidosis is usually treated with bicarbonate I.v.
Could this treatment prevent my PEM?

 

[Mary]

I noticed that all my PEM problems are in relation with lactate- nausea, vomiting, muscle weakness and extrem pain.

A usual lactat acidosis is usually treated with bicarbonate I.v.
Could this treatment prevent my PEM?

I don't know if IV bicarbonate could prevent PEM though it might help. Many people here supplement orally with baking soda to try to avoid or lessen PEM or to help with recovery. I've been doing it myself lately and it has been helpful with muscle aches.

Also, thiamine deficiency has been linked to lactic acidosis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388689/
https://med.virginia.edu/ginutrition/wp-content/uploads/sites/199/2014/06/Parrish-March-17.pdf

 

[Mary]

@JollyRoger - also, check out this thread which talks about what people use for PEM: http://forums.phoenixrising.me/inde...exertional-malaise-crashes.48438/#post-796639

 

[JollyRoger]

AAhhh.....thiamin is important for the pdh enzyme.... known from the latest research.

I read somewhere that lactic acidosis can happen through mitochondrial dysfunction by shock (low blood volume)

Frequent urination and low blood volume are well known in the cfs world.
I wonder if it could maybe the reason for it......

I copy and paste it.


Aspects which contribute to the formation of acidosis
In shock;
1. Increase acid production (Type A lactic acidosis)
- Insufficient O2 delivered to tissues Flux = Q x O2 content
- ↑anaerobic metabolism through glycolysis with the formation of lactic acid
from pyruvate. This is an energy-inefficient process (yields 2ATP for each
mol of glucose) resulting in the formation of large amounts of lactic acid.
- Hepatic hypoperfusion means that lactic acid is unable to enter the Cori
cycle to convert the lactic acid back to glucose.
Effect on the body:
- Respiratory:
o ↓pH detected by peripheral & central chemoreceptors. Activate
respiratory centre of the medulla and ↑MV through hyperventilation
rapidly ↓PaCO2. ↓pH by 1 → ↑MV by 3L/min
 May lead to eventual exhaustion
 Hyperventilation ↑metabolic demand of mm of respiration
further compounding acidosis
- Cardiovascular:
 Compounding ‘shocked’ state
o ↓pH is negatively inotropic
o Vascular resistance:
 acidosis → direct ↓SVR (metabolic autoregulation), ↑PVR
 Hypovolaemia → ↑SVR 2° ADH (V1 receptor), ATII (AT1R)
activation
o Impaired SNS response, as ↓response to catecholamines <7.2
o Depressed myocardial function and ↑arrythmogenicity through
↑K+ (through cellular H+
/K+ exchange) and ↑Ca2+ (through
dissociation from albumin)
- Right-shift of O2Hb-dissociation curve, ↑O2 delivery to tissues
- CNS effects:
o Impaired consciousness

 

[Mary]

@JollyRoger - I'm afraid I can't comment on this, too complex for me right now! However, you might find these threads interesting and hopefully find people who may be able to better answer your questions:

http://forums.phoenixrising.me/index.php?threads/relation-between-lactic-acid-and-fatigue-pem.49241/
http://forums.phoenixrising.me/index.php?threads/research-on-lactic-acid.48556/#post-798696
http://forums.phoenixrising.me/inde...-study-to-measure-blood-lactate-levels.40152/
If you want to ask a particular member a question, tag them in your post by putting the "@" sign before their name (e.g., @Mary, or as I did with your name above)