AS A SIDE EFFECT FROM 6 YEARS OF NRTI S, MY LACIIC ACID LEVELS ROSE TO 46. NORMAL IS 12. AFTER 16 WEEKS OF STOPPING MEDS, LEVELS WENT DOWN TO 12(NORMAL). THEY STAYED THERE FOR A MONTH WITHOUT MEDS, THEN SUDDENLY SPIKED TO 26. WILL THEY COME BACK DOWN? AM STILL OFF MEDS WITH NO SIDE EFFECTS BUT SCARED I KNOW HOW SERIOUS THESE ELEVATED LEVELS ARE. MY DOCTOR SAYS HE IS SAILING UNCHARTED WATERS. THANK YOU. S.N.

It is tough to say how signficant those numbers are, especially since you don't mention that you have ever been symptomatic. I would collect the next lactate level very carefully (e.g., no alcohol or exercise for 24 hours prior to its being drawn, no tourniquet use, etc.) and send it to the lab immeditately on ice, but even if it came back somewhat elevated I would not be greatly concerned unless you develop symptoms or are shown to be actually acidotic. If the lactate is documented to be elevated, you may want to consider a nucleoside analogue sparing regimen when you restart ARVs.