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Lactate level?
Jul 25, 2000

I have read in some of your response to ask our doctors about lactate level? My question is why? what will it tell us?

Thank a lot

M.

Response from Dr. Hellerstein

Good question. Blood lactate level is not something that doctors usually worry about or check.

The reason in HIV-infection is that a class of antiviral agents (nucleoside reverse-transriptase inhibitors, or NRTI's) are associated with a syndrome that includes lactic acidosis. The syndrome also includes abdominal pain, nausea, fatigue, loss of body fat, and other symptoms, in many people on NRTI's.

If the lactate is high, it means 2 things. First, that the NRTI may be causing symptoms (if they are present). And, second, that the lactate itself can lead to problems. Values greater than 2 or 3 mmole/L are high (fasting values are simplest to interpret); greater than 5 is reason to worry about complications resulting; and greater than 10 or 15 can cause very serious medical problems, including death.

So measuring lactate is worthwhile, in the proper patient.

Marc Hellerstein, M.D., Ph.D.


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