USA: Mount Sinai PACS clinic and Dr David Putrino

I hope the Putrino slide is taken out of context and it’s a hypothesis, not stating a “fact”. Though to be honest Putrino is not known for properly hedging claims, he’s more known for making BioBS type claims…
 
I'm not sure where the lactic acid is supposed to be. I don't think there is good evidence for increased levels of lactic acid in the blood of people with ME/CFS, or for abnormal responses to exercise in terms of lactic acid?

I know there was that n=1 paper by Vink, but I think members' experimentation with lactic acid monitors, including my own, didn't find that issues with lactic acid were a common problem.
 
Hutan said:
I'm not sure where the lactic acid is supposed to be. I don't think there is good evidence for increased levels of lactic acid in the blood of people with ME/CFS, or for abnormal responses to exercise in terms of lactic acid?

I know there was that n=1 paper by Vink, but I think members' experimentation with lactic acid monitors, including my own, didn't find that issues with lactic acid were a common problem.
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For what it's worth, in the PEM conference the other day, I believe three different groups (Putrino, Puta and another one) showed either preliminary or clinical data from their clinics - all of them seeing increased plasma lactate during rest and activity compared to healthy adults. It was explained with dysfunctional TCA / increased anaerobic glycolysis iirc (pyruvate -> lactate -> exported lactate). I don't remember them trying to explain that this increased lactate is anything else but an outcome of the former - I don't think they made lactate more than a potential diagnostic marker. Not a main driver of disease state I think. Not 100% certain I remember correctly.
 
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My lactate was 1 decimal point below the top end of normal when first seen in the emergency dept. Really, that was quite abnormal for a supposedly fit and healthy 50yo (at the time). I was doing nothing and the normal range encompasses the full adult age and fitness range.

@Kiwipom I wonder if you might have a comment on your experience with looking at lactate.
 
Adding this n=2 data from a reddit post today here, noting elevated lactate readings after a long delay. Someone who classifies themselves as very severe and another responding.

Lactate levels 24 hours after an appointment at which I was told I'm just deconditioned and need to exercise. FML
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The reading in the submitted image is 7.2 mmol/L

For context, the 'exertion' involved in this was being taken into hospital on a stretcher in an ambulance, lying down for the entirety of the appointment, and then being taken home and not being able to get out of bed since.

Interestingly, my lactate levels were only somewhat elevated (2.4 mmol/l) immediately after the appointment. This huge increase seems to have come later, i.e. some time after the actual activity itself.
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A reply from someone who classifies themselves as suspected/undiagnosed —

I once did a test where i had to sit down and stand back up for 3 minutes at the pneumologists, with the point being to text my blood oxygenation. My oxygenation was perfectly fine but my lactate went from 1,2 mmol/l to 8,0 mmol/l in these 3 min- No one gave a single fuck about this, while it felt like a very clear "this could be something" moment for me. Since i dont have any other clue as to whats going on with me and why im in so much pain during and after any exhaustion.
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My lactate was below 1mmol/l only twice, and both times after a shower, 1000 mg ibuprofen and much rest.
It was always way above 1mmol/l the other days. I didnt ever exercise or do anything straining and yet it was always above 2 mmol/l in the morning and on average 3-4mmol/l in the evening. And after exhaustion i noticed 4-5mmol/l HOURS afterwards (example exhaustion at 10am, measuring at 3pm).
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