Lactate has become a big deal in both chronic fatigue syndrome (ME/CFS) and fibromyalgia (FM). A by-product of anaerobic energy metabolism, lactate ordinarily gets pumped out of our cells in large amounts during exertion.
The lactate findings suggest that the energy needs of ME/CFS/FM patients are largely being addressed by glycolysis or anaerobic energy production.
Anaerobic energy production plays an important role in energy production, but when aerobic energy production is not available and it becomes the major source of energy it produces metabolites that produce the burning muscles, fatigue and other symptoms we associate with over-exercise. Continue reading
Though this article refers to Chronic Fatigue Syndrome, these symptoms often overlap with other chronic conditions, like Fibromyalgia. Also, people with EDS are often suspected of having mitochondrial issues.
It has been well documented that there is an abnormal increase in cytokines (chemicals released by the immune system) in CFS/ME patients following mild exercise. This causes another type of fatigue on top of the mitochondrial dysfunction fatigue discussed below. Cytokines in general, without the exercise trigger, can cause fatigue. There are probably additional causes of fatigue (such as orthostatic intolerance) as well.
Role of mitochondria in cellular function
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. Continue reading
Statin Adverse Effects: A Review of the Literature and Evidence for a Mitochondrial Mechanism | 2008 | Free Full Text
HMG-CoA reductase inhibitors (statins) are a widely used class of drug, and like all medications have potential for adverse effects (AEs).
Here we review the statin AE literature, first focusing on muscle AEs as the most reported problem both in the literature and by patients.
Evidence regarding the statin muscle AE mechanism, dose effect, drug interactions, and genetic predisposition is examined. Continue reading
Is Lactic Acidosis Behind Many Chronic Fatigue Syndrome / Fibromyalgia Symptoms? By Ken Lassesen | October 12, 2015
As a person who’s been gifted with being in remission from chronic fatigue syndrome (for the third time), I adhere to a model of what I believe causes typical ME/CFS in hope of staying in remission.
The model is stable and consistent with the latest (and older) research studies. It follows William Osler’s principle basing diagnosis and treatment on a strict observation of symptoms (not forgone conclusions and KISS (Keep It Simple Stupid).
“Listen to your patient, he is telling you the diagnosis”
– William Osler
This is from an interview with Dr. Myhil about the central role of mitochondria in fatigue. She believes that CFS/ME is a cluster of symptoms that can have many causes. She’s the author of the book, It’s Mitochondria Not Hypochondria
Q: You have a car analogy in your book. Please explain that.
Let’s start from the beginning. The first and most important thing to grasp about Chronic Fatigue Syndrome is that it is not a diagnosis, it is a clinical picture that may have many causes. Continue reading
Debilitating fatigue is a symptom of many other illnesses, like EDS, and reduced mitochondrial capacity could be the culprit.
a model exploring mitochondrial dynamics – may help explain what’s causing the post-exertional problems
this study extended a well-known metabolic model explaining what happens to the mitochondria in the skeletal muscles during exercise. The authors enhanced it by adding some processes to it (lactate accumulations / purine degradation) known to occur in the mitochondria.
Acetyl-L-Carnitine in the Treatment of Peripheral Neuropathic Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials | PLoS One. 2015 Mar | free full text PubMed
Acetyl-L-carnitine (ALC), a constructive molecule in fatty acid metabolism, is an agent potentially effective for treating peripheral neuropathic pain (PNP). Its effect, however, remains uncertain. We aimed to access the efficacy and safety of ALC for the treatment of patients with PNP.
The current evidence suggests that ALC has a moderate effect in reducing pain measured on VAS in PNP patients with acceptable safety. Larger trials with longer follow-up, however, are warranted to establish the effects. Continue reading
The genesis of severe fatigue and disability in people following acute pathogen invasion involves the activation of Toll-like receptors followed by the upregulation of proinflammatory cytokines and the activation of microglia and astrocytes.
This is also true of many patients presenting with severe, apparently idiopathic, fatigue accompanied by profound levels of physical and cognitive disability often afforded the non-specific diagnosis of chronic fatigue syndrome
Multiple lines of evidence demonstrate a positive association between:
- the degree of peripheral immune activation,
- inflammation and oxidative stress,
- gray matter atrophy,
- glucose hypometabolism and
- cerebral hypoperfusion
in illness, such as multiple sclerosis, Parkinson’s disease and chronic fatigue syndrome. Continue reading
How a Mitochondrial Booster Became an Antidepressant
Acetyl L-carnitine (ALCAR) is best known as an energy supplement and mitochondrial booster the but folks in this fibromyalgia clinical trial were looking for more than increased energy; they were looking for relief from pain and depression as well. They pinned ALCAR not as an energy booster per se, but as a central nervous system protectant – and they had good reason to do so.
Clin Exp Rheumatol. 2015 Mar-Apr;33(1 Suppl 88):82-5. Epub 2015 Mar 18. A randomised controlled trial comparing duloxetine and acetyl L-carnitine in fibromyalgia patients: preliminary data.