POLL: Do You Get PEM From Physical Exercise? Are You Sensitive To Lactate Probiotics Or Prebiotics?

[JaimeS]

If you glance at those studies, you'll see that creatine, BCAA and Q10 prevent the release of lactate from exercise (they increase what's called the lactate threshold). So for these supplements to work, I expect they will need be in your system before you perform the exercise. They probably need to be taken say 1 or 2 hours before you start your physical exertion, to sure they are properly assimilated in your body by the time you begin the exercise and muscle usage.

Sodium bicarbonate is slightly different, in that it does not stop the release of lactate, but the study suggests it can neutralize the lactate that is already in the blood. So that means sodium bicarbonate would probably work if taken before or after exercise; but I guess that before may be better.

Citrulline I am not quite sure about, but I think it may be another supplement that prevents the release of lactate from exercise.

Ugh, had an awful crash... after taking those probiotics that contained Lactobacillus. I stopped taking them, but it was BAD. So more support for your theory, @Hip ...

Took alkaline water (a commercial brand, w/pH 8) when I had a breathing episode and it stopped it in its tracks - which makes me think (respiratory?) acidosis. For me, a breathing episode can precipitate a crash.

Next day, same thing - much worse. Full crash. Took water with baking soda and collapsed. Arms and hands had been hurting for a few days, and blood vessels seemed enlarged in hands. While mostly asleep, arms and hands seemed to light on fire for a minute or two, but then before I could fully awaken, the feeling died down, and those muscles seemed to relax fully for the first time in what felt like days.

It's such fun being a medical mystery! :thumbdown::thumbdown::thumbdown:

 

[Crux]

This article adds Anaerostipes coli to the mix, and brings up some candidates for lactate utilization.

http://onlinelibrary.wiley.com/doi/10.1111/j.1574-6941.2011.01086.x/pdf

I think this or one of the other articles mentions that these bacteria utilize d-lactate.

It seems that one good way of reducing d-lactate would be to reduce the bacteria that produce it. In addition to certain LAB and Bifidos, there would also be some streptococcus species.

These guys love carbs and sugars. I do too. They've been winning in past years. I'm trying to lower them by reducing carbs and sugars. I don't think I can go ketogenic, blood sugar feels too low. ( I'm not a 'fat burning beast'.)

Reducing carbs has helped tremendously, but, it's a struggle to find the right amount.

 

[Hip]

Ugh, had an awful crash... after taking those probiotics that contained Lactobacillus. I stopped taking them, but it was BAD. So more support for your theory, @Hip ...

Took alkaline water (a commercial brand, w/pH 8) when I had a breathing episode and it stopped it in its tracks - which makes me think (respiratory?) acidosis. For me, a breathing episode can precipitate a crash.

Next day, same thing - much worse. Full crash. Took water with baking soda and collapsed. Arms and hands had been hurting for a few days, and blood vessels seemed enlarged in hands. While mostly asleep, arms and hands seemed to light on fire for a minute or two, but then before I could fully awaken, the feeling died down, and those muscles seemed to relax fully for the first time in what felt like days.

It's such fun being a medical mystery! :thumbdown::thumbdown::thumbdown:

Thanks for the info to support the theory. The theory was not really mine, though; I think it was people on the Resistant Starch thread who were discussing the idea lactate producing probiotics may cause problems for ME/CFS patients. I just set up this poll to try to probe this theory.


Are you saying you think it may have been lactic acidosis you experienced when your "arms and hands seemed to light on fire for a minute or two", and you had a breathing episode? That certainly seems to match lactic acidosis symptoms.

The symptoms of lactic acidosis:

A burning feeling in your muscles, cramps, nausea, weakness, and feeling exhausted. It's your body's way to tell you to stop what you're doing.

Source. here.

Common symptoms of lactic acidosis:

• Abdominal pain
• Anxiety
• Fatigue
• Irregular heart rate (arrhythmia)
• Lethargy
• Nausea with or without vomiting
• Rapid breathing (tachypnea)
• Rapid heart rate (tachycardia)
• Shortness of breath
• Weakness

Serious symptoms that might indicate a life-threatening condition:

• Bluish coloration of the lips or fingernails
• Change in level of consciousness or alertness, such as passing out or unresponsiveness
• Chest pain, chest tightness, chest pressure, palpitations
• High fever (higher than 101 degrees Fahrenheit)
• Not producing any urine, or an infant who does not produce the usual amount of wet diapers
• Rapid heart rate (tachycardia)
• Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, rapid breathing, or not breathing
• Severe abdominal pain

Source: here.

Lactic acidosis can be caused by too much exercise. Though I could not find any info on whether lactic acidosis can be caused by the creation of too much lactate by gut bacteria.

If it were lactic acidosis that is causing some ME/CFS patients to have problems with lactate producing probiotics, then possibly a solution might be to take say a ¼ teaspoon of sodium bicarbonate as you did.

 

[Snow Leopard]

PEM & I don't tolerate probiotics, but I don't believe our symptoms are due to excessive lactate.

 

[Hip]

PEM & I don't tolerate probiotics, but I don't believe our symptoms are due to excessive lactate.

Would you have any speculations as to why Lactobacillus / Bifidobacterium probiotics are causing problems for quite a few ME/CFS patients?

 

[Crux]

Most of the cases of d-lactic acidosis are about folks with short bowel syndrome. It's worth reading them though, because the clinical presentation is familiar to some ME/CFS symptoms.

Many cases of d-lactic acidosis were precipitated by a high carbohydrate meal, or the ingestion of fermented foods.

http://www.ncbi.nlm.nih.gov/pubmed/9556700
http://www.hindawi.com/journals/grp/2015/476215/
http://pmj.bmj.com/content/79/928/110.full

 

[Sidereal]

Some cases of D-lactic acidosis in the literature were triggered by ingestion of Lactobacillus and Bifidobacteria probiotics. The symptoms of D-lactic acidosis and ME/CFS are remarkably similar as noted by KDM a few years ago. D-lactate doesn't cause all the symptoms of D-lactic encephalopathy, by the way. It would appear that other toxic products of bacterial fermentation in the gut contribute to symptoms.

Two main hypotheses have been proposed to explain the neurologic manifestations of the syndrome: 1) d-lactate itself is toxic to the brain, and 2) unknown compounds produced along with d-lactate are toxic to the brain. Indeed, compounds such as formate, histamine, ethanol, tyramine, and endotoxin have been found in the rumen of cattle with d-lactic acidosis [22], and excessive urinary excretion of hydroxyphenyllactic and phenylacetic acids [8] has been observed in patients with this condition. The role that each of these compounds may play in causing the neurologic abnormalities is uncertain but it is clear that ethanol is not responsible for the symptoms. Although the patients appear drunk, serum levels of ethanol have been normal. D-lactate can penetrate into the central nervous system by simple diffusion and can thus reach high concentrations in the brain [43]. Although it has been hypothesized that d-lactate may accumulate in the brain because of the low local level of catabolizing enzyme [51], levels of dlactate in the cerebrospinal fluid have been found to be equal to those in the blood [40,61]. Moreover, the correlation between plasma d-lactate levels and severity of symptoms is poor. Thurn et al [66] found that 16 of 33 patients with jejunoileal bypass reported symptoms consistent with d-lactic acid encephalopathy but only 9 of them had high plasma levels of d-lactate, while some individuals with high plasma d-lactate levels did not have symptoms. The fact that some patients present with encephalopathy but without high plasma d-lactate levels strengthens the suggestion that the encephalopathy results from toxins which may be produced simultaneously with d-lactic acid. A further argument against a direct role for d-lactate in the alteration of mental status is that normal subjects who received an infusion of d-lactate did not develop any neurologic symptoms despite the attainment of serum levels up to 6 mmol/L in 1 study [52] and up to 3.5 mmol/L in another study [17].

Source

 

[adreno]

The theory was not really mine, though; I think it was people on the Resistant Starch thread who were discussing the idea lactate producing probiotics may cause problems for ME/CFS patients.

This has been known for years before the resistant starch thread. Several studies have found increased lactate in ME/CFS. There's absolutely nothing new about this theory.

 

[JaimeS]

@Hip - yes, I strongly suspect metabolic acidosis due to excess lactate!

This has been known for years before the resistant starch thread. Several studies have found increased lactate in ME/CFS. There's absolutely nothing new about this theory.

True enough. KDM tests for lactate on the breath as a matter of course... and blood CO2 levels tend to be low in people with chronic fatigue.

-J

 

[snowathlete]

Did you persist with this probiotic, just to see if your feeling worse might have been a temporary die off or re-adjustment reaction? Or did you find the worsening of symptoms too problematic to want to continue?

I always find worsening of symptoms makes me stop taking whatever medication triggered it very quickly, unless I have it on good authority that it is necessity to go through the bad period before you start feeling better.

Well it made my colitis quite a bit worse, so after a few days of it getting worse and that being the only change I stopped taking it. I then waited a couple of months until my colitis was starting to come under control, I was noticably better, but still not well with it, and then tried taking the same probiotic again, and within a matter of hours I was much worse again, so I then decided it was likely to be the cause and stopped taking it. Usually the stuff I try has less obvious effects, but this was quite strong.

 

[Hip]

This has been known for years before the resistant starch thread. Several studies have found increased lactate in ME/CFS. There's absolutely nothing new about this theory.

Isn't that D-lactate, rather than L-lactate, that you are thinking about? I don't think L-lactate has been found higher in ME/CFS. L-lactate is the one normally found in the body, and is produced by the muscles during exercise.

I am also not suggesting here that L-lactate is increased in ME/CFS, but rather that ME/CFS patients may have increased sensitivity to L-lactate. My hypothesis was that the normal levels of L-lactate produced by exercise or released from the gut may ramp up existing brain inflammation and thereby worsen ME/CFS symptoms, because L-lactate has been shown to increase the release of pro-inflammatory cytokines from microglia.



D-lactate producing bacteria were found in this De Meirleir study to be higher in ME/CFS patients.The study found higher levels of D-lactic acid producing Enterococcus and Streptococcus species in ME/CFS patients.

I also understand that some Lactobacillus species, such as Lactobacillus plantarum, Lactobacillus sakei and Lactobacillus curvatus, can produce D-lactate as well as L-lactate. These specific Lactobacillus species contain the enzyme lactate racemase which inter-converts L- and D-lactate; these Lactobacillus bacteria first make L-lactate, and then this enzyme converts some of it into D-lactate.

Lactobacillus acidophilus I read can also make D-lactate.


I presume though that if you were taking Lactobacillus probiotics other than these above species, you would not be producing any extra D-lactate in you gut, and if anything, you might be reducing your gut D-lactate production with these probiotics, by crowding out any D-lactic acid producing Enterococcus and Streptococcus species in your gut.

 

[adreno]

Isn't that D-lactate, rather than L-lactate, that you are thinking about? I don't think L-lactate has been found higher in ME/CFS. L-lactate is the one normally found in the body, and is produced by the muscles during exercise.

Not only D-lactate. Here's an example :

http://www.ncbi.nlm.nih.gov/pubmed/22281935

 

[justy]

There isn't an option for me to reply - I DO get PEM, but do not know how I am with the probiotics and prebioitcs you have mentioned as I haven't tried them. (I don't think)

 

[Hip]

There isn't an option for me to reply - I DO get PEM, but do not know how I am with the probiotics and prebioitcs you have mentioned as I haven't tried them. (I don't think)

The poll is only targeted at people who have tried lactate-producing probiotics or prebiotics.

I think nearly all regular probiotics will contain lactate-producing bacteria, so if you have taken a regular probiotic that you bought from a health shop, that likely means you have tried lactate-producing probiotics.

 

[Mij]

@Hip does this include fermented foods? kefir, sauerkraut, kimchi etc?

 

[Hip]

Not only D-lactate. Here's an example :

http://www.ncbi.nlm.nih.gov/pubmed/22281935

Interesting.
Hmm, so they the found higher lactate levels in the cerebrospinal build of ME/CFS patients. I wonder where that comes from.

I have reading recently how neurons can use lactate as a source of energy (it was previous thought that neurons could only use glucose). Astrocytes are involved in supplying lactate to neurons under certain conditions, like hypoxia or hypoglycemia. See this paper for example: Astrocyte glycogen and brain energy metabolism

 

[Hip]

@Hip does this include fermented foods? kefir, sauerkraut, kimchi etc?

Yes it does include these foods, as they are all fermented with lactic acid bacteria.

Though only unpasteurized and uncooked sauerkraut contains live Lactobacillus bacteria.

So if you started taking one of these foods daily, or quite regularly, and found you were sensitive to it, that I think would count as being sensitive to lactate-producing probiotics. Equally, if you were consuming these foods several times a week, but were not sensitive, then that I think would mean you have no problems with lactate-producing probiotics.

 

[Mij]

in this case I'm not sensitive. I eat it every day.

 

[justy]

The poll is only targeted at people who have tried lactate-producing probiotics or prebiotics.

I think nearly all regular probiotics will contain lactate-producing bacteria, so if you have taken a regular probiotic that you bought from a health shop, that likely means you have tried lactate-producing probiotics.

Ok - im not up on probiotics. I have taken them with no problems and also lots of kefir too.

 

[enduin]

Since taking Rifaximin in January 2013 I started reacting with violent nausea and diarrhea to most probiotics and probiotics (including GI revive). The only kind of probiotic I could tolerate was sauerkraut. Things got progressively better and now I tolerate most probiotics but stil can't tolerate yoghurt and kefir. I haven't tried other supplements containing lactobacilli lately.
I voted yes to not tolerating lactic acid probiotics even though it's not really clear cut.

Also I do get PEM after physical exercise, some times making me nauseous by how exhausted I feel, but it's not consistent. I have this issue when I'm flaring up but don't have it when I'm feeling less bad.
Again not clear cut but I voted yes.