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

Hip

Senior Member
Messages
17,858
Under the Bohr effect, O2 saturation inside the cell and mitochondria require increased CO2, not increased oxygen. A person who hyperventilates passes out for lack of oxygen! It's because of the Bohr effect, and the lower saturation of CO2 in the blood means less O2 gets inside of the cell. You suffocate for oxygen in face of red blood cells that are full of oxygen.

The Bohr effect only applies to oxygen bound to hemoglobin on red blood cells. It does not apply to oxygen which is dissolved in the water component of the blood.

Normally, around 1.4% to 1.9% of the oxygen carried in the blood is dissolved in the water component of the blood; the rest of the oxygen is carried by hemoglobin. So in normal circumstance, hemoglobin carries the vast bulk of your oxygen.

Hyperbaric oxygen therapy (HBOT) uses high ambient pressures of up to 3 atmospheres to dissolve more oxygen into the water component of your blood. HBOT increases the amount of dissolved oxygen by a factor of around 20 times, meaning that with HBOT, up to 30% of the oxygen carried in your blood is oxygen dissolved in the water, and the other 70% is hemoglobin-bound oxygen carried by red blood cells.

In that way, HBOT makes a lot more oxygen available in the tissues.


HBOT does not affect the amount of oxygen attached to hemoglobin, because the hemoglobin is nearly always fully saturated with oxygen, and thus cannot carry any more oxygen than it normally does, even when oxygen supply is plentiful.

HBOT also does not affect the amount of CO2 in your blood, because when you do HBOT, you are breathing normally, not hyperventilating. So the Bohr effect does not really apply to HBOT.

So you would expect that HBOT would deliver much more oxygen to the cells, and thus if a shortage of oxygen at the cellular level were an issue in ME/CFS, then you would expect HBOT to make dramatic improvements to ME/CFS. HBOT does provide some mild benefits for ME/CFS patients (and especially for fibromyalgia patients), see this study, but nothing much more than that.

So the fact that HBOT does not help ME/CFS very much seems to indicate that oxygen shortage is not the issue in ME/CFS.



Also, none of these studies are measuring (or attempting to measure) localized tissue hypoxia as evidenced by high lactate numbers just in peripheral tissues. It's hard to argue about what strategies do or do not treat or change when they are not even observing the hypothesized potential cause of the problem. If you have the same high lactate numbers I was getting in peripheral tissue, our stories have a common thread and we should share notes. If you have no common symptoms with me, maybe we can't learn as much from each other.

I don't myself have much problems with PEM from physical exertion (though I do get PEM from mental exertion), and even when my ME/CFS was more severe, and I was very weak physically, and could barely do 5 press-ups, I still did not get any of the lactic acid burning feeling in my muscles. So unfortunately I cannot really get involved in the interesting lactic acid experiments and testing detailed in this thread.

But if you look at the Myhill et al research on the energy metabolism in ME/CFS, they found blockages and impairments in mitochondrial function in ME/CFS — and remember it's in the mitochondria that oxygen is utilized, so an impairment in mitochondrial function would impair oxygen utilization.

Myhill et al then discovered that ME/CFS patients try to compensate for their blocked mitochondria by generating energy by other means. Some ME/CFS patients, like yourself, appear to increase their anaerobic glycolysis in order to generate energy by alternative means, and in these patients, you get the problem of lactic acid build up and lactic acid burn in the muscles. These patients who use anaerobic glycolysis to make up for the energy shortage are known as the Group A ME/CFS patients.

But not all ME/CFS patients use anaerobic glycolysis to make up for their mitochondrial blockages and energy shortfall: the Group B patients likely use the adenylate kinase reaction to generate energy during exercise. In my understanding, these Group B patients will not experience the lactic acid build up.


I think your experiments in using hot / cold exposures to dilate muscle blood vessels and capillaries are interesting; however, my own interpretation of why this blood vessel dilation helps is simply because it washes away the excess lactic acid from your muscles (which then gets converted back to glucose in the liver).
 
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Messages
171
Location
London
Are you all thinking of going ahead and purchasing this device? I think we need to devise a physical stressor that we can standardize e.g:

i) take lactate pre-exercise
ii) repetitive hand grip, with:
ii) maximal muscle contraction every 2 seconds (timing using a metronome soundtrack) with 1kg or so light resistance.
iii) repeat lactate post-exercise

The key seems to be long duration low-moderate intensity muscular exertion. Deconditioning of the hand muscle is unlikely to be a valid argument. Then we need a control group. I get a perceived acidosis of the hand muscles after writing a few paragraphs.

See this device: http://www.vivomed.com/en/Therapy-i...tm_medium=shopping&utm_campaign=UnitedKingdom

We just need less resistance than what that provides. Let me know if you're game to proceed with any of this in the UK?
 

TreePerson

Senior Member
Messages
292
Location
U.K.
seems more difficult.
but easy to try for you.
jeanatte is on facebook, ask her what see thinks

http://www.dailymail.co.uk/health/a...rinking-two-litres-protein-milkshake-DAY.html

Hi again @gregh286
I thought I would give the protein shakes a try as described. I also noted from another thread that you use them to good effect. They seem to give me night sweats. I have googled and seen other people mention the same thing but nobody really seems to know why. Yesterday I supplemented with 30g whey protein and was awake at 2 AM absolutely drenched. Today I have classic flu/detox type symptoms. (Headache glands up etc). I don't know if this is good or bad. I just wondered if you have experienced this or come across this?
 

gregh286

Senior Member
Messages
976
Location
Londonderry, Northern Ireland.
Hi again @gregh286
I thought I would give the protein shakes a try as described. I also noted from another thread that you use them to good effect. They seem to give me night sweats. I have googled and seen other people mention the same thing but nobody really seems to know why. Yesterday I supplemented with 30g whey protein and was awake at 2 AM absolutely drenched. Today I have classic flu/detox type symptoms. (Headache glands up etc). I don't know if this is good or bad. I just wondered if you have experienced this or come across this?

hi,
thats not a good indication.
something is triggering an immune response from the shakes.
Maybe casein or something in it not agreeing with you,
you may be better switching to hemp proteins.
i get mad night sweats from chinese food - bizarrely.....
its an immune alarm response....trigger.
 

TreePerson

Senior Member
Messages
292
Location
U.K.
hi,
thats not a good indication.
something is triggering an immune response from the shakes.
Maybe casein or something in it not agreeing with you,
you may be better switching to hemp proteins.
i get mad night sweats from chinese food - bizarrely.....
its an immune alarm response....trigger.

Thanks I will try that. I have some rice protein. I will give that a go and then buy some hemp. I was unsure if it was an immune response - I am not generally speaking intolerant to dairy. I also wondered if the sudden provision of very available amino acids had caused some kind of detox reaction or changed my hormones or neurotransmitters or whatever! I slept deeply apart from that which normally I don't.
But trying a different protein would be a good test. Thanks for your help.
 

Valentijn

Senior Member
Messages
15,786
My lactate meter arrived today, so I did a little testing.
11:00am, well-rested: 1.8 (not quite enough blood), 1.7
12:15pm, after chopping veggies (seated) and rinsing dishes: 1.1
2:45pm, after shower (seated), going up & down stairs, starting laundry: 1.5
3:15pm, after more chopping: 2.4
4:15pm: 1.6

There might be a 30 minute peak for me there, with the reading 2.4 30 minutes after the shower. But it's not a high peak. I didn't pace the shower, which would typically trigger heart rate above 110 for the duration, followed by a crash the next day.

I think the suggestion to use heart rate for consistency is a good one, since it approximates the point at which our metabolism shifts from aerobic to anaerobic, and where lactate is being produced.

My plan would be to do something keeping me in the range of 65-85% of maximal heart rate, perhaps for 5 minutes. I'm housebound, and don't think I could handle 10 minutes.

Calculated maximal heart rate is 220 - age, which is 182 for me. 65% of that is 118 and 85% is 155. So I'd want to keep my heart rate between around 120 and 150. (For pacing I aim to keep it under 110, and stop and rest when over 100.)

I'd probably do it in the morning before breakfast, to avoid any variation caused by meals. So I'd test resting, then spend 5 minutes doing stair steps at the bottom of the staircase, adjusting speed to stay in the desired heart rate range. Then I'd test immediately after, and every 5-10 minutes after that for up to an hour.
 

Valentijn

Senior Member
Messages
15,786
A VO2max CPET a couple years ago showed that I hit the anaerobic stage at 130 bpm. So I'll use that as a minimum instead of the calculated 120, and aim for 130-150 heart rate.
 

Dechi

Senior Member
Messages
1,454
@Valentijn If I do areobics, I never go over 2 minutes. My heart rate goes up to about 70%-80% capacity. More than than I risk crashing. I did a test where they had to bring my heart rate to 150 and keep me going for 20 minutes, but after a little less than 9 minutes, my lactate levels were very high (not measured, my feeling), my legs were killing me and I had to stop. After that Imhad a crash that lasted 12 days. And I am moderately ill.

So be careful. Start slow and increase. Better safe than sorry.
 

Hutan

Senior Member
Messages
1,099
Location
New Zealand
I got my lactate monitor last week. It's an Edge Monitor (mentioned earlier in this thread). I got it from a supplier, Ryan Sports Marketing, in Australia who has been great - highly recommended. He has knowledge of ME.
His email is: john@theedgemonitor.com.au

Costs, in Australian dollars, were
$300 for the monitor (includes a vial of 5 strips, a tool for making the drops of blood (lancet device) and 5 disposable lancets)
$65 for a vial of 25 strips
$30 for shipping to New Zealand

So, I'll report results in mmol/L with blood from a finger prick.

Morning before eating - at rest 2.2
I then did two minutes of aerobic exercise - squats and star jumps. I found it very hard work.
Two minutes after exercise 8.1
10 minutes after exercise 9.7
15 minutes after exercise 14.9
20 minutes after exercise 10.8
30 minutes after exercise 10.8
35 minutes after exercise LOW (less than 0.7)
40 minutes after exercise 1.0
55 minutes after exercise 0.8

(Toe after 55 minutes of exercise LOW (less than 0.7))

After hanging out the washing that afternoon - body and particularly arms very heavy 1.1

Following morning at rest LOW (less than 0.7)

I haven't spent time finding out if these lactate levels are normal yet. But, given how quickly the lactate clears, I expect that my lactate levels and ability to clear it from my system after exercise are disappointingly normal. I expected that the heaviness and aches I feel after even minor exertion would be lactic acid but the testing I've done doesn't support that idea. I feel a bit sad about this, there must be something going on surely, but for me it doesn't seem to be peripheral lactate.

I might try doing two lots of exercise in one day or on subsequent days to see if that shows up anything. But the impact of the exercise isn't fun so I haven't rushed.

I'm happy to lend my monitor to others in New Zealand. You will need a vial of testing strips and some lancets. If there are a couple of people interested, I could arrange to buy those from Australia and pass the cost on with the shipping cost shared.
 

Sidney

Senior Member
Messages
146
Location
East Sussex, U.K.
My lactate meter arrived today, so I did a little testing.
11:00am, well-rested: 1.8 (not quite enough blood), 1.7
12:15pm, after chopping veggies (seated) and rinsing dishes: 1.1
2:45pm, after shower (seated), going up & down stairs, starting laundry: 1.5
3:15pm, after more chopping: 2.4
4:15pm: 1.6

There might be a 30 minute peak for me there, with the reading 2.4 30 minutes after the shower. But it's not a high peak. I didn't pace the shower, which would typically trigger heart rate above 110 for the duration, followed by a crash the next day.

I think the suggestion to use heart rate for consistency is a good one, since it approximates the point at which our metabolism shifts from aerobic to anaerobic, and where lactate is being produced.

My plan would be to do something keeping me in the range of 65-85% of maximal heart rate, perhaps for 5 minutes. I'm housebound, and don't think I could handle 10 minutes.

Calculated maximal heart rate is 220 - age, which is 182 for me. 65% of that is 118 and 85% is 155. So I'd want to keep my heart rate between around 120 and 150. (For pacing I aim to keep it under 110, and stop and rest when over 100.)

I'd probably do it in the morning before breakfast, to avoid any variation caused by meals. So I'd test resting, then spend 5 minutes doing stair steps at the bottom of the staircase, adjusting speed to stay in the desired heart rate range. Then I'd test immediately after, and every 5-10 minutes after that for up to an hour.

There seems to be a difference of opinion as to what percentage of max HR to use for ME calculation. Some say 50%, some 60%, some 80%. Do you just intuit it, depending on how severe your ME is?
 

Valentijn

Senior Member
Messages
15,786
There seems to be a difference of opinion as to what percentage of max HR to use for ME calculation. Some say 50%, some 60%, some 80%. Do you just intuit it, depending on how severe your ME is?
Guideline for pacing is to stay under 60%. I go a little lower because my heart rate will continue to rise a bit after I stop a activity. That gives me a safe margin to stay under the anaerobic threshold. For the purpose of measuring blood lactate, I want to make sure I'm going beyond that threshold.
 

Sidney

Senior Member
Messages
146
Location
East Sussex, U.K.
Guideline for pacing is to stay under 60%. I go a little lower because my heart rate will continue to rise a bit after I stop a activity. That gives me a safe margin to stay under the anaerobic threshold. For the purpose of measuring blood lactate, I want to make sure I'm going beyond that threshold.
Thank you!!!
 

Valentijn

Senior Member
Messages
15,786
Test was done fasting, with water only - no meds or supplements. I did stair steps on the bottom stair of a staircase, where I could hold onto the rail for balance.

Resting heart rate before test was 82, temp was 36.7, blood sugar was 11.1, and lactate was 1.2. It took 60 seconds to get to a heart rate of 130, which is my threshold for anaerobic activity. Heart rate then stayed at 140-145 for most of the remaining 3 minutes. I spent a total of 4 minutes doing stair steps.

I then took all additional measurements at 5 minute intervals while sitting on the couch with my feet up, still drinking water but not taking meds or supplements or eating. I mostly caught my breath at 35 minutes, got cold and started using a blanket at 70 minutes, got up to use the bathroom and get more water at 75 minutes, and fully caught my breath at 85 minutes.

Temperature stayed between 36.4 and 36.7. Glucose levels stayed between 10.3 and 11.1, with little variation and entirely within the margin of error for glucose meters.

heart rate.jpg


lactate.jpg

120 minutes after exertion, lactate was 2.3, and 2.0 at 150 minutes after exertion.
 

Valentijn

Senior Member
Messages
15,786
Reading some of the lactate research. The general message seems to be that recovery of lactate levels takes 30-60 minutes, and that doesn't vary much based on sedentary or active status of the trial participants.

But the published falling lactate levels always trend entirely downward. The research shows none of these late peaks that I'm seeing with my data or that Vink reported. There should be a single peak, at approximately 5 minutes after stopping the exercise, and always within 10 minutes of stopping the exercise. Then a steady slide toward normal lactate levels.

An example from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769631/ :
lactate curve.jpg


Our levels aren't particularly high, though Vink's certainly was for the amount of exertion (walking 10-12 yards and having a pee).
 

pattismith

Senior Member
Messages
3,941
I would be very interested to do the exercice test!
I believe most of us has a Lactates problem. Lactates can be absorbed from the microbiota, or secreted by our cells activity.
of course the more the cell is activated, the more it will produce Lactates.
The three cell types that need quick increase level of energy are:
-muscles cells
-gut cells
-brains cells

Research has already shown that Brain lactates levels are higher in CFS and FM patients than controls.
Testing blood lactates may be highly related to muscle cells activity, but may not correlates as well with brain cells or gut cells.

However, as I am very very tired after eating since I am a teenager (which is 35 years ago now), I started to test my blood L-lactates levels before and after eating a few weeks ago, and what I found was amazing:

The more I am tired, the more my lactates are high (but never over 4 mmol/l)
The more what I eat is difficult to digest, the more my lactates are high

In the book by Zschocke et Kolker (Inherited Metabolic Disease: a clinical approach p514),
the postprandial Lactate test is proposed to detect inherited problems.
https://books.google.fr/books?id=nc...ted metabolic disease Zschocke Kolker&f=false


You have to eat for 50kg: 200 gr of white cooked rice and 200 gr of meat, and then test your lactates 90 min after eating.

I did it and my lactates went from 1.8 mmol/l to 2.8 mmol/l
This is not normal. Normal test is supposed to be an increase of less than 20% and stay below 2.1 mmol/l


I am convinced that the lactates tests (exercice and postprandial) should be part of the diagnosis of the CFS/FM/ME.


The brain lactates are more difficult to test and I need to look deeper into the problem of the correlation of brain and blood lactates, but the blood lactates tests could be an easy and cheap way of diagnosis. Very promising!

(and also a good way to test the efficacity of treatments)
 
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MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
You have to eat for 50kg: 200 gr of white cooked rice and 200 gr of meat, and then test your lactates 90 min after eating.

I did it and my lactates went from 1.8 mmol/l to 2.8 mmol/l
This is not normal. Normal test is supposed to be an increase of less than 20% and stay below 2.1 mmol/l

I am convinced that the lactates tests (exercice and postprandial) should be part of the diagnosis of the CFS/FM/ME.
There would have to be a vegetarian/vegan alternative to the meat test.