Lactic Acid point and counterpoint, which research is correct?

Lactic Acid, aka Lactate, is found at elevated levels in PwME.

You usually don’t detect this [lactate] in the brain at all – and when you do it usually means the chemical reactions in the brain are happening so fast that the blood supply cannot keep up with the demand for oxygen. When this happens, cells switch to an alternative, less efficient, way of producing energy. This alternative pathway produces lactate as a by-product.

This is similar to when athletes run too fast and burn through the oxygen supply in their muscles. They have to convert to a different means of supplying muscles with energy, which leads to a build-up of lactic acid and causes muscle fatigue and pain. The only reason for lactate to be building up in the brain is if there’s neuroinflammation or ifthere’s a problem with the blood vessels, causing a shortage in supply of oxygen, which has been suggested before in ME/CFS (Biswal et al., 2011; Yoshiuchi et al., 2006).

Typically labeled a “waste” product produced by muscles because lactate rises to high levels in the blood during extreme exercise, athletic trainers and competitive athletes think of lactate as the cause of muscle fatigue, reduced performance and pain.

Starting in the 1970s, however, Brooks, his students, postdoctoral fellows and staff were the first to show that lactate wasn’t waste. It was a fuel produced by muscle cells all the time and often the preferred source of energy in the body: The brain and heart both run more efficiently and more strongly when fueled by lactate than by glucose, another fuel that circulates through the blood.

“It’s a historic mistake,” Brooks said. “It was thought that lactate is made in muscles when there is not enough oxygen. It has been thought to be a fatigue agent, a metabolic waste product, a metabolic poison. But the classic mistake was to note that when a cell was under stress, there was a lot of lactate, then blame it on lactate. The proper interpretation is that lactate production is a strain response, it’s there to compensate for metabolic stress. It is the way cells push back on deficits in metabolism.”


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