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Lactate: The Fallacy of Oversimplification
Jiri Müller1, Jaroslav Radej1, Jan Horak1
1Department of Internal Medicine, Faculty of Medicine in Pilsen, Charles University, Teaching Hospital Pilsen, Alej Svobody 80, 32300 Pilsen, Czech Republic.
Biomedicines
|December 23, 2023
Summary
Lactate, often wrongly seen as a waste product, is vital for cell function even in aerobic conditions. Understanding lactate
Area of Science:
- Biochemistry
- Cellular Metabolism
Background:
- Lactic acid discovered by Carl Wilhelm Scheele, with links to hypoxia in shock established over a century ago.
- Commonly misperceived as a mere byproduct of anaerobic metabolism and a distress marker.
- Deep-seated myths and misunderstandings persist regarding lactate's role.
Purpose of the Study:
- To debunk common misconceptions surrounding lactate.
- To clarify lactate's true role in cellular metabolism and physiological conditions.
- To highlight the complexities in interpreting hyperlactatemia.
Main Methods:
- Review of existing scientific literature and established biochemical pathways.
- Analysis of the physiological roles of lactate beyond anaerobic metabolism.
- Debunking prevalent myths through scientific evidence.
Main Results:
- Lactate is continuously produced and utilized by cells, even under aerobic conditions.
- Hyperlactatemia is not always indicative of life-threatening conditions, nor are all critically ill patients hyperlactatemic.
- Lactate does not independently cause acidosis, is not toxic, and possesses beneficial properties.
Conclusions:
- Lactate is a crucial molecule with diverse physiological functions, not just a waste product.
- The interpretation of hyperlactatemia requires a nuanced understanding beyond simple anaerobic metabolism.
- Challenging ingrained beliefs about lactate is essential for accurate clinical assessment.
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