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

Research 1st

Severe ME, POTS & MCAS.
Messages
768
Good points. In addition we need to have a baseline fasting morning lactate, or our 'within range' lactate level during the day may not be as normal as we think ( if we have no idea how much lactate we're running when fasting).
 

Research 1st

Severe ME, POTS & MCAS.
Messages
768
Random day below within normal range results will need to change machine calibration if we're all doing mmol/l?).

Fasting Lactate (12hrs+):= 9 mg/dl
After small meal (4hrs) = 11 mg/dl.

If it's of any interest compared to this normal range Lactate (finger prick test), my LDH -Lactate Dehydrogenase (blood draw) is always elevated, and never within range despite sitting still or in bed.

I don't understand the relationship between Lactate & Lactate Dehydrogenase (LDH), but I'm guessing the former is more to do with metabolic capacity and the latter, cell damage/inflammation.
 

Biarritz13

Senior Member
Messages
699
Location
France
Random day below within normal range results will need to change machine calibration if we're all doing mmol/l?).

Fasting Lactate (12hrs+):= 9 mg/dl
After small meal (4hrs) = 11 mg/dl.

If it's of any interest compared to this normal range Lactate (finger prick test), my LDH -Lactate Dehydrogenase (blood draw) is always elevated, and never within range despite sitting still or in bed.

I don't understand the relationship between Lactate & Lactate Dehydrogenase (LDH), but I'm guessing the former is more to do with metabolic capacity and the latter, cell damage/inflammation.

Your values are very high. Are you a severe ME?
 

Research 1st

Severe ME, POTS & MCAS.
Messages
768
Your values are very high. Are you a severe ME?

Hi, I think my result is low and not high isn't it? ( You may be making the same error as I made, and reading the result in mmoL/L and not mg/dl?). I did fast for something crazy like 17 hours though.

Yes I am severe. However, If I am correct we should all probably have normal (or actually low lactate at rest when fasting overnight) and what is expected to be abnormal in ME CFS is the time it takes to clear the lactate post exercise.

We also have a slight problem how severe affected are going to 'exercise' and would the result be worse on a 'bad day' or not? I mean everyday is bad day, but sometimes we can have better periods of health where out stamina is better. I wonder if these skew the results we report? Same presumably applies for less severely affected.

E.g I can walk to the shops, Vs another day I could only walk to the car and back into the house. Would bad day vs good day vs average day, show any difference in lactate levels? Presumably not, and this experiment is based on response to forcing your body into early metabolic switch over from actual exercise?

Thanks.

P.S As I forget this thread all the time, if I don't join in, please PM me and I'll spot it hopefully.
 

wastwater

Senior Member
Messages
1,271
Location
uk
Just putting a note here for later,doesnt seem a bad idea to measure lactate.Spinal lactate would be interesting,think it's used for inborn errors of metabolism and mitochondrial disease
 
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Biarritz13

Senior Member
Messages
699
Location
France
Hi, I think my result is low and not high isn't it? ( You may be making the same error as I made, and reading the result in mmoL/L and not mg/dl?). I did fast for something crazy like 17 hours though.

Yes I am severe. However, If I am correct we should all probably have normal (or actually low lactate at rest when fasting overnight) and what is expected to be abnormal in ME CFS is the time it takes to clear the lactate post exercise.

Oh sorry, indeed I made this error...

Why did you fast? Are you eating and doing intermittent fasting? Eating during a window of 7 hours and fasting during 17 hours?

Cold shower clears lactate, I think NO does too but according to the paper of last year (the australian study about metabolites), lactate is indeed low at rest.
 

pemone

Senior Member
Messages
448
I recently bought an EDGE Lactate meter, and I would say it is the single best purchase I have ever made for a healthcare device. It is driving my understanding of my disease, and it is informing my doctors about places we should dig further.

What I think people are failing to appreciate is that the lactate meter is a direct window into how much anaerobic glycolysis your body is doing at a given point in time. The key to understanding when post-exertional malaise may strike is understanding when you have crossed a workload threshold and started to exert anaerobically. Different people will have different causes for CFS, but ultimately we all get to a combination of factors where a low level of exertion makes us produce significant components of our energy production anaerobically. I guarantee you that in a condition like CFS you probably cannot detect this threshold without the aid of a meter.

In my case, I got the shock of my life when I tested my peripheral limbs and had really elevated lactate levels, even at rest. In my fingers, I was getting numbers as high as 9 mmol/L at rest. In my toes, I was getting far larger numbers, as high as 17 mmol/L. I realized after significant testing that these were not reflective of systemic lactate. I was, in fact, measuring localized tissue hypoxia, and the amount of hypoxia was different in different parts of my body.

I have been able to totally clear these high lactate levels just by going to a gym and engaging in hot/cold therapy to dilate my vascular system. So, for example, I will alternate between a cold pool, steam room, sauna, jacuzzi, etc. After 50 minutes of that, my vascular system relaxes, and if I re-test lactate it normalizes below 2 mmol/L. It's too early in my experimentation cycle, but at this point, I am 80% certain that my version of CFS is being driven by narrowing of capillaries in my vascular system, or alternately by the presence of some immune or inflammatory reactions in the peripheral tissues.

The bottom line is that I believe my peripheral tissues are not receiving oxygen and the reasons for that likely deal with issues that exist outside the cell. Aerobic metabolism is impaired simply because oxygen cannot get into the mitochondria. The high lactate levels are only an artifact of a cell struggling to create energy by the more primitive anaerobic glycolytic system. The fact that I am able to totally reverse the lactate levels by a therapy that dilates small capillaries is highly suggestive to me that I will be able to take actions that reverse many of the symptoms.

I need a few months to follow through on this research, and I will try to come back and update on conclusions. But I would say that *if* you are a person with a careful mind and an ability to formulate valid experiments, run do not walk and buy a lactate meter and begin testing widely, in many different peripheral tissues, at many times of day, under many types of workload. Within three weeks of initiating testing, you will have a fairly precise understanding of when your body is going into anaerobic glycolysis and the steps you can take to stop that and reverse it before PEM sets in. Having said that, most people don't form valid experiments. If you don't know how to create experiments with single independent variables, and with well-defined dependent variables, you will have a harder time making progress with the meter.
 

gregh286

Senior Member
Messages
976
Location
Londonderry, Northern Ireland.
I recently bought an EDGE Lactate meter, and I would say it is the single best purchase I have ever made for a healthcare device. It is driving my understanding of my disease, and it is informing my doctors about places we should dig further.

What I think people are failing to appreciate is that the lactate meter is a direct window into how much anaerobic glycolysis your body is doing at a given point in time. The key to understanding when post-exertional malaise may strike is understanding when you have crossed a workload threshold and started to exert anaerobically. Different people will have different causes for CFS, but ultimately we all get to a combination of factors where a low level of exertion makes us produce significant components of our energy production anaerobically. I guarantee you that in a condition like CFS you probably cannot detect this threshold without the aid of a meter.

In my case, I got the shock of my life when I tested my peripheral limbs and had really elevated lactate levels, even at rest. In my fingers, I was getting numbers as high as 9 mmol/L at rest. In my toes, I was getting far larger numbers, as high as 17 mmol/L. I realized after significant testing that these were not reflective of systemic lactate. I was, in fact, measuring localized tissue hypoxia, and the amount of hypoxia was different in different parts of my body.

I have been able to totally clear these high lactate levels just by going to a gym and engaging in hot/cold therapy to dilate my vascular system. So, for example, I will alternate between a cold pool, steam room, sauna, jacuzzi, etc. After 50 minutes of that, my vascular system relaxes, and if I re-test lactate it normalizes below 2 mmol/L. It's too early in my experimentation cycle, but at this point, I am 80% certain that my version of CFS is being driven by narrowing of capillaries in my vascular system, or alternately by the presence of some immune or inflammatory reactions in the peripheral tissues.

The bottom line is that I believe my peripheral tissues are not receiving oxygen and the reasons for that likely deal with issues that exist outside the cell. Aerobic metabolism is impaired simply because oxygen cannot get into the mitochondria. The high lactate levels are only an artifact of a cell struggling to create energy by the more primitive anaerobic glycolytic system. The fact that I am able to totally reverse the lactate levels by a therapy that dilates small capillaries is highly suggestive to me that I will be able to take actions that reverse many of the symptoms.

I need a few months to follow through on this research, and I will try to come back and update on conclusions. But I would say that *if* you are a person with a careful mind and an ability to formulate valid experiments, run do not walk and buy a lactate meter and begin testing widely, in many different peripheral tissues, at many times of day, under many types of workload. Within three weeks of initiating testing, you will have a fairly precise understanding of when your body is going into anaerobic glycolysis and the steps you can take to stop that and reverse it before PEM sets in. Having said that, most people don't form valid experiments. If you don't know how to create experiments with single independent variables, and with well-defined dependent variables, you will have a harder time making progress with the meter.

What a post ....sent you a PM
 

Seven7

Seven
Messages
3,444
Location
USA
The fact that I am able to totally reverse the lactate levels by a therapy that dilates small capillaries is highly suggestive to me that I will be able to take actions that reverse many of the symptoms.
They have me on vassocontrictors and the difference is enormous. So I think my CFS is in the same neighborhood. I think the lactate meter is genius, apparently not many brands are accurate and I didnt find the brand you recommend locally. Do you have to prick your finger like in glucose too?
 

gregh286

Senior Member
Messages
976
Location
Londonderry, Northern Ireland.
They have me on vassocontrictors and the difference is enormous. So I think my CFS is in the same neighborhood. I think the lactate meter is genius, apparently not many brands are accurate and I didnt find the brand you recommend locally. Do you have to prick your finger like in glucose too?
??
Vasoconstrictors..? or you mean vasodilators? ARBS, ACE inhibitors etc...
 

Seven7

Seven
Messages
3,444
Location
USA
??
Vasoconstrictors..? or you mean vasodilators? ARBS, ACE inhibitors etc...
I take vasoconstriction midodrine 20mg 3 times a day. ALso have me on florinef 0.1mg + propanalol 20mg 3 times a day. Perfect combo so far.
 

Seven7

Seven
Messages
3,444
Location
USA
Funny thing about CFS, some have POTS and need constrictors, other need dilators, cos hypertensive.
A complete meltdown in the Angiotensin system eh,,
Is what I have observe too, some do well on dilators while others well on constrictors, I saw a video very good about doing what they do for me (for the ones tending on low BP) and they do some motion sickness drug for the ones that have high BP. The good thing is easy for CFSsers to try the natural counterparts and see which made them feel better.

But about the latic acid measurement I would love to do. Do you have another brand recommendation?
 

Hip

Senior Member
Messages
17,824
the lactate meter is a direct window into how much anaerobic glycolysis your body is doing at a given point in time. The key to understanding when post-exertional malaise may strike is understanding when you have crossed a workload threshold and started to exert anaerobically.

You might find of interest Myhill, Booth and McLaren-Howard's theory of how PEM arises in ME/CFS, and how it involves lactic acid. See this post (under the section entitled "Sarah Myhill et al's Theory of PEM"):

Mitochondrial and Energy Metabolism Dysfunction in ME/CFS — Myhill, Booth and McLaren-Howard Papers



It is also worth pointing out that in the research of Myhill et al, they found ME/CFS patients divide into two main groups, Group A and Group B.
  • Group A patients try to compensate for the mitochondrial ATP shortage by increasing glycolysis to make ATP.
  • Group B patients try to compensate for the shortfall in mitochondrial ATP most likely by using the adenylate kinase reaction to make ATP.
See this post for more info.



Note that glycolysis can operate in two modes:
  • Anaerobic glycolysis — this is where glycolysis works independently of the mitochondria in order to supply energy in the form of ATP. When glycolysis works independently, it is much less efficient, and also produces lactic acid as part of its operation.
  • Aerobic glycolysis — this is where glycolysis works in conjunction with the mitochondria to supply energy in the form of ATP. When glycolysis works in conjunction with the mitochondria, it is much more efficient, and does not produce lactic acid.
According to the research and theories of Myhill, Booth and McLaren-Howard, ME/CFS patients may be forced into generating energy by the inefficient anaerobic glycolysis route because their mitochondria may be dysfunctional.

(The theory is that dysfunctional mitochondria are not able to supply sufficient energy during exercise when there is high energy demand. As a result, in ME/CFS the body has to use alternative routes of ATP energy production during exercise, and one of these alternative routes is glycolysis, which takes place in the cytosol of the cell, rather than in the mitochondria. Dysfunctional mitochondria may also prevent aerobic glycolysis from taking place, since aerobic glycolysis involves the mitochondria; instead, ME/CFS patients may be forced into anaerobic glycolysis, as this works without the involvement of the mitochondria.)
 
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Hip

Senior Member
Messages
17,824
Also of interest is the fact that both Fluge and Mella and Ron Davis at the Open Medicine Foundation think there may be something wrong with the pyruvate metabolism in the mitochondria of ME/CFS patients. See this article.

Pyruvate is output by the process of glycolysis, and if this pyruvate can be transported into the mitochondria and therein burnt with oxygen, this results in aerobic glycolysis (aerobic glycolysis works in conjunction with the mitochondria in this way — pyruvate is the glycolysis–mitochondria bridge).

But if the pyruvate output by glycolysis cannot get into the mitochondria for whatever reason, then instead the pyruvate is converted to lactic acid, and this results in anaerobic glycolysis.


So if there were a problem with pyruvate metabolism in ME/CFS, this could explain why ME/CFS patients are forced into anaerobic glycolysis, because aerobic glycolysis is not available unless the pyruvate metabolism in mitochondria is working properly, and unless the mitochondria in general are working properly.
 
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gregh286

Senior Member
Messages
976
Location
Londonderry, Northern Ireland.
Also of interest is the fact that both Fluge and Mella and Ron Davis at the Open Medicine Foundation think there may be something wrong with the pyruvate metabolism in the mitochondria of ME/CFS patients. See this article.

Pyruvate is output by the process of glycolysis, and if this pyruvate can be transported into the mitochondria and therein burnt with oxygen, this results in aerobic glycolysis (where glycolysis works in conjunction with the mitochondria).

But if the pyruvate output by glycolysis cannot get into the mitochondria for whatever reason, then instead the pyruvate is converted to lactic acid, and this results in anaerobic glycolysis.


So if there were a problem with pyruvate metabolism in ME/CFS, this could explain why ME/CFS patients are forced into anaerobic glycolysis, because aerobic glycolysis is not available unless the pyruvate metabolism in mitochondria is working properly.

yea they are bloody close i reckon...the 3 groups now seem to be fairly aligned....aussies included.

fluge and mella used to have dysfunctional NO as a possible cause but seem to be leaning to pyruvate now.
would make.more sense why we cant get our HR above 120/130.
Elderly people with lowered NO dont seem too badly effected with decreased heart rates?
Old guys that need viagra can still run marathons ffs!!
 

pemone

Senior Member
Messages
448
They have me on vassocontrictors and the difference is enormous. So I think my CFS is in the same neighborhood. I think the lactate meter is genius, apparently not many brands are accurate and I didnt find the brand you recommend locally. Do you have to prick your finger like in glucose too?

The meter I use is from a Polish company:
https://lactatedge.pl/

They don't sell to the US. But you can probably find someone in the UK willing to ship to the US (cough).

It is exactly like the glucose meter....

Which drugs do they have you on?
 

pemone

Senior Member
Messages
448
I take vasoconstriction midodrine 20mg 3 times a day. ALso have me on florinef 0.1mg + propanalol 20mg 3 times a day. Perfect combo so far.

That won't dilate your capillaries. That drug would make it even harder to deliver O2 to deep tissues....

I guess you have low blood pressure issues. That can't be resolved by increasing your fluid volumes?