Hypothesis: inflammatory acid-base disruption underpins Long Covid 2023, van der Togt & Rossman

What I suspect is that lactic acidosis can occur too easily (as a downstream effect of compromised metabolism) and this may be part of the rapid fatiguability we experience. One question I had was whether the degree of fatiguability had any relationship to progression to PEM — i.e. can we tolerate pushing our barely adequate 'rescue' metabolism up to a point but go too far and the result is PEM? If so, could that have any relationship to measurable lactate levels and potentially be predicted and avoided?

I hope this might have been well evaluated by NIH and so we might get a proper answer. Reading Brian's descriptions of what the heroic patients put themselves through I think much valuable data will have been obtained.

 

I've had my RBC lactate values measured during next day delayed PEM and my results were normal. I felt horrible both cognitively and physically during the blood draw.

 

Not sure if this answers your question but I noticed in the manual of the lactate device I bought that it says either venous or capillary blood can be used on the test strips.

 

The device I bought (Glucorx x6) includes claims about accuracy in the leaflet that comes with test strips, including differences in accuracy between venous and capillary tests. See image.

 

I did a two day exercise test at a facility that usually tests athletes. When I asked if there was anything unusual in the tests the lady said that the amount of lactate I was producing was more like a young person than someone 56 years old.

 

That's interesting if your lactate was low after exercise because a couple of days ago I tested with my lactate machine and after walking 2 miles and resting an hour the two tests were almost identical. I was only walking but to me it felt like I had been running - I collapsed on the bed after doing the first test - exhausted and legs burning. But no apparent increase in lactate. I would have expected at least 3 or 4 mmol/L and then a reduction for the second test.