1. Is there anything I can do to decrease my lactate level?
Generally, no. However, if your elevated lactate level is due to an underlying condition that can be addressed, such as uncontrolled diabetes or a substance that can be avoided, such as ethanol, then you may be able to lower it. If you have been diagnosed with a condition, such as a metabolic disorder, following your prescribed treatment regimen should control your lactate level. If the increase is due to a temporary condition, such as shock or infection, then it will usually return to normal after the condition has been resolved.
2. Why would a health practitioner choose to measure lactate in a blood sample from an artery rather than blood from a vein?
Lactate measurements from arterial blood are thought to be more accurate and, because a tourniquet is not used, they are not generally affected by the collection process. A health practitioner may order an arterial lactate for these reasons or because a group of other tests called arterial blood gases (ABGs) are also being collected and the same sample can be used. When other arterial blood tests are not being ordered, a health practitioner may order a venous lactate because it provides an adequate evaluation of a person's lactate level and because the collection process is not as uncomfortable.
3. Are there other ways to measure lactate than by sending a blood sample to the lab for testing?
Yes. Lactate may be measured using a small hand-held device much like a glucose meter at the point of care (POC, at a patient's bedside) instead of in a laboratory. This type of monitoring is useful, for example, in emergency departments and intensive care units where rapid results are vital to the care of critically ill people. However, since the methods of measurement are different, the results from lactate POC tests may not be comparable with those from tests performed in a laboratory.
4. What is the lactate/pyruvate ratio and how is it used?
A lactate/pyruvate ratio is a calculated result that may be used to differentiate between causes of lactic acidosis.
Pyruvate is a substance produced by and used by cells in the production of energy. The mitochondria within cells metabolize glucose in a series of steps to produce ATP, the body's energy source. One of the steps involves pyruvate and the following step requires oxygen. When the oxygen level is low, pyruvate accumulates and is converted to lactate, resulting in an accumulation of lactate and lactic acidosis. An alternative cause is when there is impaired mitochondrial function and the pathway is interrupted, resulting in increased pyruvate and hence more lactate. The lactate/pyruvate ratio will be high in these cases.
However, there are certain congenital disorders (inborn errors of metabolism) in which pyruvate is not converted to lactate. One example is pyruvate dehydrogenase deficiency. In these cases, pyruvate will accumulate, the blood level will be high, and the lactate to pyruvate ratio will be low.
This article was last reviewed on November 24, 2014. | This article was last modified on February 24, 2015.
The review date indicates when the article was last reviewed from beginning to end to ensure that it reflects the most current science. A review may not require any modifications to the article, so the two dates may not always agree.
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