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We need to keep in mind what information the test is trying to give us Try to picture *logarithmic* BLa responses during your exercise sessions, instead of exponential This might improve how we apply information from our tests to our training!

to predict real world performance LTs can be useful to extrapolate / predict transitions between intensity domains, or race performances This 2018 study found that differences in LTs could explain 30-60% of the variance in TT performance

So why do we care about lactate testing? Two reasons: to monitor change over time The major thing that matters for monitoring is consistency of the test LTs are reliable within around 5-10% (10-15 W) 12/

BLa⁻ production & release is greatest at the start of exercise V̇O₂ (OXPHOS) is still ramping up, and substrate (“anaerobic”) glycolysis must buffer the immediate energetic demand

BLa observed during a lactate test is the product of whole-body balance of: La⁻ production & release from working muscles into blood La⁻ oxidation/disposal by other tissues: muscle, heart, etc

If we continued our incremental lactate test and clamped workload above the lactate threshold, would it continue to increase exponentially? Nope! BLa accumulation *decelerates* over time, even at high intensity Because

We care about what our lactate curve predicts about our *constant workload* performance at every intensity What happens to BLa if we clamped workload during a lactate test and continued exercising at that constant workload? At lower intensities, something like this

We don’t actually care about the deflection point in a lactate curve on its own True exponential curves don't have deflections. it's like finding the corner of a circle There are lots of corners depending on our operational definitions

I found this thread on X interesting We are probably familiar with the BLa curve during an incremental exercise test As intensity increases BLa accumulates at a faster rate, approximating an exponential increase We can estimate a 'threshold' in this curve, but what is this threshold telling us?

That link is a good explanation from what I've read from pwME who don't have a known or obvious baseline. They can monitor their symptoms and pace to avoid worsening. I don't experience many symptoms, but during allergy season and immune/viral or whatever is going on can bring on immediate...

Editor’s summary Intracellular lipids are an important energy source for skeletal muscle during exercise and must be replenished afterward. Chan et al. investigated the role of the myokine BDNF in post-exercise metabolic reprogramming and recovery in skeletal muscle. Mice with a muscle-specific...

@Trish I've read about several similar experiences over the years. I also didn't experience PEM or delayed PEM until several years after onset and this was during the time period when I didn't have cognitive issues or OI either. This is why I feel most of my immediate "fatiguability"...

Some of us don't experience symptoms at all during the activities, in fact I sometimes get an adrenaline boost which is tricky in itself b/c it's pushing me to do more. I could go for a 45 min run and feel fine for the next 12-14 hours. I sleep well and feel ok the next morning and then the...

Same with my Mother.

This was in the news recently. Calgary judge rules woman with autism can seek MAiD Justice Colin Feasby said his decision will be stayed for 30 days so lawyers for the father of the woman can decide whether to file an appeal. “This is a terrible choice that should not be forced on MV, as...

Doctors need to get better at listening to our patients

Prodrome Glia is my #1 recommendation for anyone with #MECFS and #LongCovid with "neuro symptoms" (including brain fog, cognitive issues, migraine, headache, tinnitus etc). It comes in liquid form! If the capsules are sold out (as they often are) just buy the liquid. Its even easier to take for...

Which also includes cognitive impairment for pwME that worsens over time from PEM.

Merged thread Tam’s journey began with one of her family medicine patients in 2015. She couldn’t figure out what was causing their persistent fatigue, which was debilitating enough to keep them out of work. Tam said her patient ultimately had to seek that answer across the country...

Diagnosing dysautonomia is often partly a process of elimination. It also involves determining how and when symptoms occur and finding patterns that connect them. It could be caused by many other issues that haven't been diagnosed that brings on fatigability.