small microscope

Lactate - whats the deal?

Lactate is a naturally occurring by-product of normal body metabolism. However, in patients with mitochondrial disease, blocks in the energy producing pathway, the electron transport (respiratory) chain, can lead to the shunting of electrons away from energy production towards additional lactate creation. Under normal circumstances, lactate, an acid, is buffered adequately by the body’s bicarbonate but if abnormal amounts of lactate are produced the body’s buffering system may become overwhelmed creating metabolic acidosis. Several facts regarding lactate and mitochondrial disease are important to understand:

  1. not all patients with mitochondrial disease develop elevated lactate levels so its absence does NOT exclude this diagnosis;
  2. only lactate elevations that overwhelm the body’s buffering system are dangerous whereas mild elevations are merely reflective of mito but are not typically concerning from a stability perspective;
  3. people can develop elevated lactate levels over time even if previous levels have been normal due to disease progression.


Fran Kendall, M.D.

This post is not meant to be a recommendation or a substitute for professional advice and services rendered by qualified doctors, allied medical personnel, and other professional services. The responsibility for any use of this information, or for proper medical treatment, rests with you.