Formed from pyruvate in anaerobic or oxygen-starved (hypoxic) conditions to allow for ongoing production of ATP.
Lactate is formed from pyruvate in anaerobic or oxygen starved (hypoxic) circumstances to allow for ongoing production of ATP in these anaerobic conditions. There are no known clinical problems associated with low lactic acid. Low levels are usually a result of reduced amounts of its precursor, pyruvic acid.
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Elevated by a number of nonspecifc influences, such as vigorous exercise, bacterial overgrowth of the GI tract, shock, poor perfusion, B-vitamin deficiency, mitochondrial dysfunction or damage, and anemia, among others. Tiglylglycine is a more specific indicator of mitochondrial dysfunction or damage. The possibility of an inborn error of metabolism increases when the lactic acid value exceeds 300 mmol/ mol creatinine. There are many inborn errors of metabolism that are present with elevated lactic acid, including disorders of sugar metabolism, pyruvate dehydrogenase deficiency, and mitochondrial disorders.
Possible causes:
- Hypoxia and/or zinc deficiency
- Metabolic stress (e.g. alcohol, toxic metal exposure, or anaemia)
- Possibly insignificant when pyruvic acid is also high
Additional investigations:
- Iron Studies & Red Cell Zinc
- Comprehensive Urine Elements Profile
- Functional Liver Detoxification Profile
Treatment considerations:
If pyruvate NOT high:
- Correct hypoxia
- Remove metabolic stress
- Correct anaemia
- Zn, CoQ10, B2, B3
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2-Hydroxybutyric, 2-Hydroxybutyric (Males Age 13 and Over), 2-Hydroxybutyric (Males Under Age 13), 2-Hydroxyhippuric, 2-Hydroxyhippuric (Females Under Age 13), 2-Hydroxyhippuric (Males Age 13 and Over), 2-Hydroxyhippuric (Males Under Age 13), 2-Hydroxyisocaproic, 2-Hydroxyisocaproic (Males Age 13 and Over), 2-Hydroxyisocaproic (Males Under Age 13), 2-Hydroxyisovaleric, 2-Hydroxyisovaleric (Males Age 13 and Over), 2-Hydroxyisovaleric (Males Under Age 13), 2-Hydroxyphenylacetic, 2-Hydroxyphenylacetic (Males Age 13 and Over), 2-Hydroxyphenylacetic (Males Under Age 13), 2-Oxo-4-methiolbutyric, 2-Oxo-4-methiolbutyric (Males Age 13 and Over), 2-Oxo-4-methiolbutyric (Males Under Age 13), 2-Oxoglutaric, 2-Oxoglutaric (Males Age 13 and Over), 2-Oxoglutaric (Males Under Age 13), 2-Oxoisocaproic, 2-Oxoisocaproic (Males Age 13 and Over), 2-Oxoisocaproic (Males Under Age 13), 2-Oxoisovaleric, 2-Oxoisovaleric (Males Age 13 and Over), 2-Oxoisovaleric (Males Under Age 13), 3-Hydroxy-3-methylglutaric (HMG), 3-Hydroxy-3-methylglutaric (Males Age 13 and Over), 3-Hydroxy-3-methylglutaric (Males Under Age 13), 3-Hydroxybutyric, 3-Hydroxybutyric (Males Age 13 and Over), 3-Hydroxybutyric (Males Under Age 13), 3-Hydroxyglutaric, 3-Hydroxyglutaric (Males Age 13 and Over), 3-Hydroxyglutaric (Males Under Age 13), 3-Indoleacetic, 3-Indoleacetic (Males Age 13 and Over), 3-Indoleacetic (Males Under Age 13), 3-Methyl-2-oxovaleric, 3-Methyl-2-oxovaleric (Males Age 13 and Over), 3-Methyl-2-oxovaleric (Males Under Age 13), 3-Methylglutaconic, 3-Methylglutaconic (Males Age 13 and Over), 3-Methylglutaconic (Males Under Age 13), 3-Methylglutaric, 3-Methylglutaric (Females Under Age 13), 3-Methylglutaric (Males Age 13 and Over), 3-Methylglutaric (Males Under Age 13), 3-Oxoglutaric, 3-Oxoglutaric (Males Age 13 and Over), 3-Oxoglutaric (Males Under Age 13), 4-Cresol, 4-Cresol (Males Age 13 and Over), 4-Cresol (Males Under Age 13), 4-Hydroxybenzoic, 4-Hydroxybenzoic (Males Age 13 and Over), 4-Hydroxybenzoic (Males Under Age 13), 4-Hydroxybutyric, 4-Hydroxybutyric (Females Under Age 13), 4-Hydroxybutyric (Males Age 13 and Over), 4-Hydroxybutyric (Males Under Age 13), 4-Hydroxyhippuric, 4-Hydroxyhippuric (Males Age 13 and Over), 4-Hydroxyhippuric (Males Under Age 13), 4-Hydroxyphenylacetic, 4-Hydroxyphenylacetic (Females Under Age 13), 4-Hydroxyphenylacetic (Males Age 13 and Over), 4-Hydroxyphenylacetic (Males Under Age 13), 4-Hydroxyphenyllactic, 4-Hydroxyphenyllactic (Males Age 13 and Over), 4-Hydroxyphenyllactic (Males Under Age 13), 5-Hydroxyindoleacetic (5-HIAA), 5-Hydroxyindoleacetic (5-HIAA) (Males Age 13 and Over), 5-Hydroxyindoleacetic (5-HIAA) (Males Under Age 13), 5-Hydroxymethyl-2-furoic, 5-Hydroxymethyl-2-furoic (Males Age 13 and Over), 5-Hydroxymethyl-2-furoic (Males Under Age 13), Acetoacetic, Acetoacetic (Males Age 13 and Over), Acetoacetic (Males Under Age 13), Aconitic, Aconitic (Males Age 13 and Over), Aconitic (Males Under Age 13), Adipic, Adipic (Males Age 13 and Over), Adipic (Males Under Age 13), Arabinose, Arabinose (Females Under Age 13), Arabinose (Males Age 13 and Over), Arabinose (Males Under Age 13), Ascorbic, Ascorbic (Males Age 13 and Over), Ascorbic (Males Under Age 13), Carboxycitric, Carboxycitric (Males Age 13 and Over), Carboxycitric (Males Under Age 13), Citramalic, Citramalic (Males Age 13 and Over), Citramalic (Males Under Age 13), Citric, Citric (Males Age 13 and Over), Citric (Males Under Age 13), DHPPA (Beneficial Bacteria), DHPPA (Beneficial Bacteria) (Males Age 13 and Over), DHPPA (Beneficial Bacteria) (Males Under Age 13), Dihydroxyphenylacetic (DOPAC), Dihydroxyphenylacetic (DOPAC) (Females Under Age 13), Dihydroxyphenylacetic (DOPAC) (Males Age 13 and Over), Dihydroxyphenylacetic (DOPAC) (Males Under Age 13), Ethylmalonic, Ethylmalonic (Males Age 13 and Over), Ethylmalonic (Males Under Age 13), Fumaric, Fumaric (Males Age 13 and Over), Fumaric (Males Under Age 13), Furan-2,5-dicarboxylic, Furan-2,5-dicarboxylic (Males Age 13 and Over), Furan-2,5-dicarboxylic (Males Under Age 13), Furancarbonylglycine, Furancarbonylglycine (Females Under Age 13), Furancarbonylglycine (Males Age 13 and Over), Furancarbonylglycine (Males Under Age 13), Glutaric, Glutaric (Females Under Age 13), Glutaric (Males Age 13 and Over), Glutaric (Males Under Age 13), Glyceric, Glyceric (Males Age 13 and Over), Glyceric (Males Under Age 13), Glycolic, Glycolic (Males Age 13 and Over), Glycolic (Males Under Age 13), Hippuric, Hippuric (Females Under Age 13), Hippuric (Males Age 13 and Over), Hippuric (Males Under Age 13), Homogentisic, Homogentisic (Males Age 13 and Over), Homogentisic (Males Under Age 13), Homovanillic (HVA), Homovanillic (HVA) (Males Age 13 and Over), Homovanillic (HVA) (Males Under Age 13), HPHPA, HPHPA (Males Age 13 and Over), HPHPA (Males Under Age 13), HVA / VMA Ratio, HVA / VMA Ratio (Males Age 13 and Over), HVA / VMA Ratio (Males Under Age 13), HVA/ DOPAC Ratio, HVA/ DOPAC Ratio (Males Age 13 and Over), HVA/ DOPAC Ratio (Males Under Age 13), Kynurenic, Kynurenic (Males Age 13 and Over), Kynurenic (Males Under Age 13), Lactic, Lactic (Males Age 13 and Over), Lactic (Males Under Age 13), Malic, Malic (Males Age 13 and Over), Malic (Males Under Age 13), Malonic, Malonic (Males Age 13 and Over), Malonic (Males Under Age 13), Mandelic, Mandelic (Males Age 13 and Over), Mandelic (Males Under Age 13), Methylcitric, Methylcitric (Males Age 13 and Over), Methylcitric (Males Under Age 13), Methylmalonic, Methylmalonic (Males Age 13 and Over), Methylmalonic (Males Under Age 13), Methylsuccinic, Methylsuccinic (Males Age 13 and Over), Methylsuccinic (Males Under Age 13), N-Acetylaspartic, N-Acetylaspartic (Males Age 13 and Over), N-Acetylaspartic (Males Under Age 13), N-Acetylcysteine (NAC), N-Acetylcysteine (NAC) (Males Age 13 and Over), N-Acetylcysteine (NAC) (Males Under Age 13), Orotic, Orotic (Females Under Age 13), Orotic (Males Age 13 and Over), Orotic (Males Under Age 13), Oxalic, Oxalic (Females Under Age 13), Oxalic (Males Age 13 and Over), Oxalic (Males Under Age 13), Pantothenic (B5), Pantothenic (B5) (Males Age 13 and Over), Pantothenic (B5) (Males Under Age 13), Phenyllactic, Phenyllactic (Males Age 13 and Over), Phenyllactic (Males Under Age 13), Phenylpyruvic, Phenylpyruvic (Males Age 13 and Over), Phenylpyruvic (Males Under Age 13), Phosphoric, Phosphoric (Males Age 13 and Over), Phosphoric (Males Under Age 13), Pyridoxic (B6), Pyridoxic (B6) (Males Age 13 and Over), Pyridoxic (B6) (Males Under Age 13), Pyroglutamic, Pyroglutamic (Males Age 13 and Over), Pyroglutamic (Males Under Age 13), Pyruvic, Pyruvic (Females Under Age 13), Pyruvic (Males Age 13 and Over), Pyruvic (Males Under Age 13), Quinolinic, Quinolinic (Males Age 13 and Over), Quinolinic (Males Under Age 13), Quinolinic / 5-HIAA Ratio, Sebacic, Sebacic (Males Age 13 and Over), Sebacic (Males Under Age 13), Suberic, Suberic (Males Age 13 and Over), Suberic (Males Under Age 13), Succinic, Succinic (Females Under Age 13), Succinic (Males Age 13 and Over), Succinic (Males Under Age 13), Tartaric, Tartaric (Males Age 13 and Over), Tartaric (Males Under Age 13), Thymine, Thymine (Males Age 13 and Over), Thymine (Males Under Age 13), Tricarballylic, Tricarballylic (Females Under Age 13), Tricarballylic (Males Age 13 and Over), Tricarballylic (Males Under Age 13), Uracil, Uracil (Males Age 13 and Over), Uracil (Males Under Age 13), Vanillylmandelic (VMA), Vanillylmandelic (VMA) (Males Age 13 and Over), Vanillylmandelic (VMA) (Males Under Age 13)