The 12th Invest in ME Conference, Part 1
OverTheHills presents the first article in a series of three about the recent 12th Invest In ME international Conference (IIMEC12) in London.
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Relation between lactic acid and fatigue / PEM

Discussion in 'Post-Exertional Malaise, Fatigue, and Crashes' started by Dechi, Feb 12, 2017.

  1. Dechi

    Dechi Senior Member

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    I have never found any info about this and I am wondering. As we know, the aerobic process doesn't function well with ME, so it's best to use the anaerobic process as much as possible. Heart rate beyond a certain point and more than 2 minutes of exercise are said to bring on the aerobic process. So it's relatively easy to avoid getting there, at least when you don't have POTS or other forms of orthostatic intolerance.

    But what about lactic acid ? Where does it fit between the aerobic and anaerobic energy paths ? Does it happen in the aerobic pathway too ? And what does it mean when we get lactic acid build-up ? I think it's a by-product of the anaerobic pathway, but how is it possible to avoid it ?

    If figure if I had a clear answer for that, I could maybe avoid lactic acid build-up. Somedays I don't feel it much, and some days I feel it a lot, even when chewing my food. I have no idea why this is. Am I causing over-exerting if I keep doing something when there is a build-up ? Does it have an effect on my overall fatigue ?

    Many questions, I know, but I have a feeling that's all related.
     
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  2. lnester7

    lnester7 Seven

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    Mine was awful, I was convinced that I had too much producing latic acid bacteria because I had no other way to explain why I had it sooo bad.

    I got so much better with l-glutamine ( high dose I am using for leaky gut) and after 10 year I have a relieve. Ussually I start and stop something 3 times to make sure is what it is doing the trick. I have not done this ( because I was so miserable I can't fantom to go back there). I will eventually stop and make sure but for now I am way to happy to do my "make sure it is this supplement and not random" test.
     
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  3. Bansaw

    Bansaw Senior Member

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    My doctor was convinced that my PEM muscle aches were caused by Ammonia release, and so she put me on supps that are supposed to mop Ammonia up. However, that never worked for me.
    It was only when I switched to taking Bicarbonate of Soda (half a teaspoon soon after exercise) that I experienced real help with my PEM aches. And that, addresses Lactic Acid, not Ammonia.
     
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  4. Dechi

    Dechi Senior Member

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    In my case I don't have aches, really. It's just this feeling of almost trembling as soon as a muscle is used more than a few seconds.

    @lnester7 how long did it take for l-glutamine to work for you, do you know ?
     
  5. Eastman

    Eastman Senior Member

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  6. AndyPR

    AndyPR Senior Member

    From a recent presentation by Fluge
    16667107_1250994638302816_1163896336_o.png
    Fluge and Mella's theory is that the issues with poor functioning of PDH, the green box in the middle, causes a partial blockage of the glucose that would have been passed into the mitochondria and then converted to ATP (energy) in the TCA cycle. As we exert ourselves, our body sends more glucose to be converted into energy but hits the same partial blockage. In order to deal with this "backed up" glucose it is converted into lactate, and so we get a double whammy - less energy being made anyway, plus a build up of lactate which the body then has to reconvert, using more energy, back into glucose. While that partial blockage exists, excessive lactate generation will be happening all the time but will obviously get worse with exertion.
     
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  7. Valentijn

    Valentijn Senior Member

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    My lactate levels are frequently mildly elevated in the evening, despite being well-rested. Those elevations don't crash me, thought it seems they can trigger a headache.

    I did a 4-minute self-inflicted exercise test at home. Instead of having a normal peak at around 5 minutes after exertion followed by a steady decline in lactate levels, I had multiple peaks during the 90 minutes following the exertion, while I rested on the couch:
    lactate.jpg

    My heart rate has to be around 130 or higher to produce lactate. I aim to keep it under 110 with pacing.
     
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  8. Dechi

    Dechi Senior Member

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  9. Dechi

    Dechi Senior Member

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    @AndyPR thanks for the simplified explanation ! I had seen this chart, but didn't make sense of it so clearly. Now I can see why my lactate levels are up all the time. Does their research give any insight as to how to avoid it with behavior modification ?
     
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  10. Dechi

    Dechi Senior Member

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    @Valentijn Interesting ! In my case, there is absolutely no correlation between heart rate and lactate levels. I feel it just by blowing my hair, writing, masticating something hard, like cereals or almonds or harder physical tasks, such as climbing stairs. On some days I won't feel it as much in the smaller muscles, but it's always in my legs.

    This is what I am trying to understand, in hopes I can improve it. What causes my lactate levels to vary so much from day to day ?
     
  11. Valentijn

    Valentijn Senior Member

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    Are you actually testing lactate levels? How much my muscles ache doesn't correlate with my levels.
     
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  12. Dechi

    Dechi Senior Member

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    @Valentijn I don't have musce aches unless I train, and it's normal muscle aches then. I have never had my lactate levels measured. I know what lactic acid feels like, because I have been weight training for many years (or course I can't do it like I used to). This feeling is very unique and it is what I feel in my muscles.
     
  13. AndyPR

    AndyPR Senior Member

    As far as my understanding goes no, no additional insight other than avoiding over exertion, which will be individual for all of us. My assumption on that at the moment is, if this model is correct, that part of the variability in severity of symptoms comes down to how badly the PDH functioning is affected. There is a thread elsewhere with talk on affecting PDK and SIRT4 (these are up regulated in the model and they then have the effect of down regulating PDH functioning, if this effect was removed then theoretically we'd have more energy available to us and less lactate produced).
     
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  14. PatJ

    PatJ far and free I gaze

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    It's similar for me and varies somewhat each day. My arms are the worst, but sometimes it happens in my jaw muscles or even tongue when chewing. I have to stop and wait for the feeling to pass before continuing. It's the feeling of an exhausted muscle that just can't continue working. I experience it in my upper body more than lower body.

    If I try to push the muscle to work more, or experience the sensation frequently in a short period of time, then I'll experience PEM.
     
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  15. lnester7

    lnester7 Seven

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    I was taking it for leaky gut so I just notice the difference after a while since I didn't expect to do anything but seal my gut. For sure it was after the first 1 bag (from bulk supplements) when I notice, why I ordered the second one. Sorry cannot be more helpful.
     
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  16. Artstu

    Artstu Senior Member

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    I have more PEM from low level physical and mental activities than from more physical activities.
    Passenger ride in a car or say playing a board game, is lactic acid likely to play any part in that?
     
  17. Hip

    Hip Senior Member

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    The short answer to your question is no, lactic acid is not created by aerobic energy production, only by anaerobic energy production. The long answer, which explains why, is as follows:

    In human beings, when we use sugar for energy, there is a two-stage process that extracts the energy contained in sugar.

    The first stage of the process is called glycolysis, and this occurs outside of the mitochondria; glycolysis is a separate system of energy production in the cell, that can if necessary function independently of the mitochondria in the cell.

    The second stage of energy extraction from sugar occurs within the mitochondria.

    Basically, glycolysis extracts a portion of the energy in the sugar, and then typically passes the job on to the mitochondria, which extracts the remaining energy from the sugar. That's the two stage process, with both glycolysis and the mitochondria working together in a sort of production line to produce energy.

    In this two stage production line process, as glycolysis extracts energy from the sugar, it converts the sugar into pyruvate (and does not need oxygen to do this). The pyruvate created by the glycolysis process still contains further energy, and is passed on to the mitochondria in order to extract this energy; once the pyruvate enters the mitochondria, it is burnt with oxygen (aerobic process), which extracts the energy pyruvate contains. So that's the two stage process.


    But if there are any blockages in the mitochondria (as studies have shown may exist in ME/CFS), then the handover of pyruvate from glycolysis to the mitochondria may not occur. Then instead, the pyruvate needs to be got rid of, and so is converted into lactic acid, and this lactic acid waste product is flushed out of the cell and into the blood (where ultimately the liver deals with it).

    So in ME/CFS, this is probably how excess lactic acid arises: when the blocked mitochondria are unable to accept the pyruvate created by the glycolysis process.

    When the pyruvate is not passed on to the mitochondria, and instead gets converted to lactic acid, this is termed anaerobic glycolysis, because no oxygen is involved. By contrast, when the pyruvate from glycolysis is passed on to the mitochondria, this is termed aerobic glycolysis, because in the mitochondria, oxygen is used to burn the pyruvate and extract the energy pyruvate contains.

    Aerobic glycolysis produces energy more efficiently than anaerobic glycolysis, and aerobic glycolysis does not create the problematic lactic acid waste product that anaerobic glycolysis produces.


    However, even in healthy people and athletes, you will get a degree of anaerobic glycolysis going on. This is because on a short term basis, in the first few minutes of vigorous exercise, anaerobic glycolysis can supply energy faster (it has a high power output) than aerobic glycolysis (which has a lower power output).

    This is the one main advantage of anaerobic glycolysis: it has a high power output, and can supply energy faster than aerobic glycolysis can.

    Though the high power output capabilities of anaerobic glycolysis quickly expire and exhaust themselves after 1 to 3 minutes of vigorous exercise, as a result of the lactic acid build up, and then in healthy people, they fall back on the aerobic glycolysis for energy (which utilizes the mitochondria and oxygen). Aerobic glycolysis can operate and supply energy for hours.

    Because of its high power output, anaerobic glycolysis is also called fast glycolysis; and because of its lower power output, anaerobic glycolysis is termed called slow glycolysis.


    Some athletes will specifically train certain parts of their energy metabolism, depending on their sport. For example, if the sport you compete in is a short duration exercise lasting only 1 or 2 minutes (eg, 400 m or 800 m sprints), then you'd really want to train your anaerobic glycolysis system (fast glycolysis), as this is where you will be getting most of your energy from.

    To target and athletically train your anaerobic glycolysis energy system, you generally perform very short bouts of exercise, lasting no longer than say 60 to 90 seconds, and then take a rest for 5 to 10 minutes. That way, you engage the anaerobic glycolysis system, but not the aerobic glycolysis system, because the latter only really comes into play after the first 1 to 3 minutes of exercise is complete.



    Anaerobic glycolysis and aerobic glycolysis are 2 out of the 4 energy systems that you use during exercise.

    A good overview on these 4 different energy systems, and how to train each one, is given in this article.

    It has occurred to me that ME/CFS patients might benefit from exercise training that specifically targets the anaerobic glycolysis energy system (which as explained above, involves short bouts of exercise no longer than 60 to 90 seconds, followed by 5 or 10 minutes rest). In ME/CFS, as @Dechi mentions, the anaerobic glycolysis system is probably working fine; it is the aerobic glycolysis system that is likely blocked.

    So it is possible that exercise which only targets and engages the fully functioning anaerobic glycolysis system may not cause ill effects; and by training this particular anaerobic glycolysis system, you might in principle be able to raise your PEM threshold.

    On the other hand, such targeted exercise may be just as bad for ME/CFS patients as regular exercise, so I think one would need to be very cautious about trying any anaerobic glycolysis training. We don't know enough about ME/CFS to be certain about what causes PEM.



    Lactic acid, though, is not the only factor thought to contribute to PEM. If you read about the Myhill, Booth and McLaren-Howard Theory of PEM, lactic acid is just part of the PEM picture. But according to their theory, the main factor causing PEM is the temporary physical loss of ATP molecules that they propose occurs when ME/CFS patients exercise.



    You may also be interested in some of the "PEM Buster" supplements detailed in this thread. Many of these likely work by reducing exercise-induced lactic acid.
     
    Last edited: Feb 13, 2017
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  18. Dechi

    Dechi Senior Member

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    @Hip Thank you for this detailed explanation. I will have to read it a few times, my brain isn't up tp fully comprehending.

    I did understand that only the anaerobic pathway produces lactic acid. This makes me wonder, though, what do you call this extreme fatigue in the muscle when you use it for more than a few seconds / minutes ?

    For example, when I did my stress echo last december, I had to pedal lying down and make my heart rate go up to 145, which I did, but after less than 9 minutes, my legs were hurting so bad we had to stop even though it should have lasted 20 minutes. I always thought it was lactic acid build-up too, just like it happens when I am drying my hair and my arm is having the burning sensation of lactic acid. After this event, I crashed for about 12 days. Any idea about that ?

    Oh, and I wanted to say that I have managed to find a safe way to weight train using only the anaerobic pathway. It took me a while to make it work, but it does. I can't say I feel good after training, like a healthy person would, on the contrary, I have to be very careful, but it does make me feel better about myself overall.
     
    Last edited: Feb 13, 2017
  19. Strawberry

    Strawberry Senior Member

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    Good grief! Half a teaspoon? Is that why it never works for me? I use 1/4 teaspoon at the most. Guess I need to start measuring more. FAR more.

    Great info here from everyone. My personal thanks to everyone that has posted!
     
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  20. Hip

    Hip Senior Member

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    It took me a while to understand it myself, but with all these recent papers finding energy metabolism dysfunctions in ME/CFS, I thought I'd better get to grips with the basics of energy metabolism.


    Yes, that's right.



    I don't really know. I remember that extreme fatigue and weakness from a few years ago, when at that time my ME/CFS was approaching severe, and I could barely do one press-up. I would not have thought the muscle fatigue and weakness was due to lactic acid, as this takes a while to build up, and the muscle weakness I experienced was immediate, from the very first press-up.



    Hard to say. Perhaps muscle inflammation was involved, causing some pain. Maybe some lactic acid build up also. But if you read about lactic acid and post-exercise muscle soreness online, the original idea was that lactic acid caused this muscle soreness, but others say this is a myth, and that lactic acid does not cause the soreness, and that the cause remains a mystery.
     
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