Burning Muscles Could be Caused by Lactate

Lactate – Is it Everywhere in Fibromyalgia and Chronic Fatigue Syndrome (ME/CFS)? – Health Rising

Lactate (L-lactate) is an organic compound produced during anaerobic energy metabolism.  

It’s constantly being formed – even when we are at rest – but is formed in higher quantities when ATP levels are low and anaerobic energy metabolism is high. Several forms of lactate are also produced by anaerobic bacteria in the gut.

Lactate is not bad – it actually reduces muscle fatigue – but the presence of high levels of lactate (lactic acid) signal that the anaerobic energy production process – which produces toxic metabolites that cause pain and fatigue – is in full bore.  

Lactic acidosis is a state of low pH accompanied by high lactate levels.

It most commonly occurs in its temporary form after excessive exercise but is found in a more permanent form in people with illnesses which produce low oxygen levels (hypoxia/hypoperfusion) including

  • heart or lung disease,
  • sepsis,
  • severe physical trauma,
  • shock,
  • Vit B deficiency,
  • or interestingly enough, decreased blood volume.  

Symptoms include

  • a burning feeling in the muscles,
  • muscle weakness,
  • rapid breathing,
  • nausea and vomiting.

The question is blog asks is whether the processes that produce lactate/lactic acid levels could be causing pain, fatigue, cognitive and other symptoms in fibromyalgia and/or chronic fatigue syndrome.

The Gut

D-lactic acidosis is a different form of lactic acidosis caused by the production of D-lactate by bacteria in the gut.

the D-lactate hypothesis posits that D-lactate  contributes to leaky gut problems.

 Streptococcus spp. tend to produce lactic acid, including the D-lactic form which has been associated with increased gut permeability.

The Brain

several studies do suggest lactate may be causing problems in chronic fatigue syndrome (ME/CFS) and fibromyalgia (FM).  

Sheedy’s 2009 study found that two species (E. faecalis and S. sanguinis) found in ME/CFS patients guts were high D-lactic acid producers.

Shungu believes the increased lactate levels he has twice found in the brains of ME/CFS patients may result from reduced oxygen levels. He believes increased oxidative stress may release substances called isoprostanes which restrict the blood vessels in the brain. Those constricted blood vessels result in low oxygen levels (hypoxia), anaerobic energy production and the release of lactate.

In a small study Baraniuk subsequently tied increased brain lactate levels in Gulf War Syndrome to reduced cognition.  A subset of GWS patients with increased brain lactate levels prior to exercise demonstrated significantly reduced cognition after exercise

The Muscles

Significantly higher elevations of lactate have been found in the trapezius muscle of fibromyalgia patients and in women with chronic widespread pain – a condition similar to FM.

While many lactate studies in FM have not been done some studies suggest that the conditions for increased lactate production such as low muscle oxygen levels (hypoxia) may be present.

Reduced oxygen intake during exercise was recently associated with increased pain in FM.

Hypoxic conditions in the skin above tender points are present. Reduced capillary density, altered microcirculation and decreased muscle blood flows could help explain that finding.

EEG studies suggest the muscles in FM have trouble relaxing causing them to stay in a more contracted state – a state that can be associated with hypoxia and causes increased pain sensitivity.

I really wanted to believe I was only dealing with EDS, but the description of muscle symptoms above are exactly what I feel, For years, I’ve noticed that while bicycling at high rpm, with alternate leg muscle groups pushing and pulling (slightly), the opposing muscle groups would no longer relax and my whole leg would eventually be tight and burning.

Another study suggested that deficient activation of the muscle units could be causing fatigue and leading to pain.

Mitochondrial problems are another possible cause of the increased lactate found in the muscles. Enlarged mitochondria, structural muscle abnormalities and reduced numbers of mitochondria all suggested “increased muscle stress” was present.  Biopsies of the trapezius muscle in FM have shown signs of mitochondrial disturbances.

Newton has shown that people with ME/CFS produce up to 20 times more acid and have more difficulty removing acids from their muscles during exercise.

That’s my symptom exactly: not only does lactic acid build up very quickly, it lingers as long as I’m active. My muscles seem unable to remove the acid as quickly as it’s generated and it builds up to excruciating levels.

I remember during long mountain bike rides, dismounting and throwing my bike down, crying with pain and frustration when the pain became intolerable on the last hills to get home. Many times I had to plod home pushing the bike, but grateful that I could still walk uphill.

In a rather remarkable study Newton linked muscle pH issues in ME/CFS with hyperventilation and reduced oxygenation of the brain.

Nijs’s finding that recovery of muscle function after exercise was associated with improved cognition suggested that muscle problems and brain functioning may be linked.

The Lactate Question

The lactate question ends up not being a question about lactate per se, but about whether widespread problems with anaerobic energy production are found in the brains, muscles and/or guts of FM and ME/CFS patients.  

Multiple studies in both diseases suggest that that they may. High lactate or similar problems have been found in multiple areas ME/CFS and in the muscles of FM patients.  

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