Elevations of ventricular lactate levels occur in both chronic fatigue syndrome and fibromyalgia, 2017, Natelson et al

All this ME stuff makes my brain cell hurt we need a samosa corner where discussion of food takes place I love lamb karahi and mumtaz make The best supermarket curries

 

Seems to me that this particular research would be most revealing if it were done a couple of days after a big exercise challenge.

 

Would this brain lactate elevation be subjectively felt as a "feverish" feeling or some other kind of cerebral malaise?

I believe you have said elsewhere that inflammation needs not be invoked to account for fever-like sensations. What about lactate? Is it a naïve view to say: if lactate build-up can be such a pain in muscles, imagine what a pain it is in the brain?

 

When a diabetes med gave me symptoms of lactic acidosis, the headache was unlike anything I'd experienced before. It was a burning pain which really felt like my brain was soaked in acid. I couldn't think coherently during the worst of it. Those symptoms peaked about 12 hours after stopping the med. For days or weeks after (I can't remember that time very well), thinking was very painful. Over a couple months, I slowly recovered from that and was pretty much back to my normal ME-brain.

I can get a headache during a PEM crash, or without a crash the day after doing too much physical exertion. A few hours after the exertion I generally have elevated lactate levels in my blood (I have a home tester), so the headache might be a delayed response to the elevated lactate, as it accumulates and/or gets taken up into the spinal fluid and brain. In that case it's more of a dull ache in the back of my skull, near the top of my spine. More of a bruised/swollen feeling, though it also makes thinking a bit painful.

 

I have no direct information about lactic acid in my brain, as @Valentijn relays, but wonder if certain physical sensations I have in my brain might be a result of a build up. I too get a swollen feeling when my brain has been overworked. A swollen, overpressurized sensation that tells me I am well over my limit and need to back off with the thinking, especially thinking/mental processing at a higher speed than my brain is comfortable at. My normal, balanced brain speeds with ME are lower/slower than those of healthy people, so I can push myself to try to match their speed for the purposes of communication, social interaction. It is too much of that kind of effort that results in a“swollen brain” feeling.

Another feeling which may be relevant. Early on, over twenty years ago when this began, I described my brain as feeling as if glue had been poured into it. That description, glue, also reflects the physical feeling of slowness, impediment, restricted movement, as well as the effort it took to try to overcome this. I would also compare this feeling to the work it takes to try to climb uphill in the snow, instead of walking easily along as I (my brain) had before.

 

It's like a glucose meter for diabetes, but takes a lot more blood It's pretty easy, though strips are expensive - about 2 euros each I think.

It has been helpful in confirming that lactate is a problem for me, and doesn't behave like it should, which indicates that I should probably avoid activities or meds which can generate more lactate. And if I suspect a med is causing problems, I can easily test it now. I couldn't do that while I was having my reaction to metformin, and it was unsettling not to know exactly what was happening, or why it was happening.

Lactate levels should peak at 5-10 minutes after exertion with a steady decline after that, but mine stayed high for about an hour, and continued creating extra peaks. Testing has also been helpful in drawing a connection between triggers and certain symptoms.

 

Thank you. And I gather there is nothing that can be taken to neutralise the lactate?

 

Bicarbonate IVs are used in hospitals. There's some speculation that drinking bicarbonate can also help, but there's a lack of evidence for that and it doesn't make a lot of sense. I think the main approach is to avoid getting elevated lactate levels in the first place.

 

If I find that drinking a small amount of water containing sodium bicarbonate doesn't make me burp within about 4 or 5 minutes, I assume that I am short of sod bic, so drink more until I am burping within 2 or 3 minutes.

Hope I've got this right - I'm going through a sod bic correction at the moment!

 

I know that head feeling all too well including the problems thinking! It's no fun. There are lots of things going on in my brain and lactate build-up is likely to be one of them. I recall you once considered you might have MELAS and I too thought I may have had it.

Your lactate meter sound interesting. Do you have a link to it or to something similar to give me an idea of what it's like?

Some of my symptoms might be attributed to lactate but doesn't your lactate meter measure blood lactate whereas the headache and thinking problems would come from brain lactate?

 

Basically the same symptoms, but apparently not the genetic cause. So perhaps an acquired form of a mitochondrial disease.

https://www.lactatelevel.co.uk/contents/en-uk/d27_blood_analyzer.html

Excess lactate in the blood can get taken up in the CSF (cerebrospinal fluid) and accumulate.

 

Is this associated with leaky gut (leaky brain barrier?)?

 

The impression I'm getting from browsing a variety of research into elevated lactate in the CSF is that it's due to a trigger (the disease, an infection) rather than itself being an abnormality. So elevated CSF lactate seems to be an expected consequence of more general lactate issues. But some lactate issues might be the result of failure to clear it out effectively (rather than just producing too much of it), including in the brain.