# Lactic acidemia

Category: Conditions

The presence of lactic acid in the blood.

10 passages · 1 author · 2013–2020 · Most-cited: [Ray Peat](https://bioenergeticoracle.com/md/voices/ray-peat/index.md)

Canonical page: https://bioenergeticoracle.com/concepts/lactic-acidemia

## Synthesis

**Lactic acidemia** is not merely a marker of oxygen debt but a *causal agent* in the suppression of mitochondrial respiration, a phenomenon Peat described as a **systemic Crabtree effect** where glycolysis actively shuts down oxidative metabolism. [Source 7] This state represents a fundamental bioenergetic crisis in which cells abandon the efficient oxidation of glucose to carbon dioxide in favor of the primitive, inefficient production of lactate, consuming sugar at a high rate without yielding adequate energy. [Source 4, 7] Peat argued that the presence of lactic acid creates a condition of **pseudo-hypoxia** or *reductive stress*, which mimics sepsis and drives the mortality-associated features of many degenerative conditions, even when normal oxygen levels are present. [Source 2]

The primary trigger for elevated lactic acid is the shift toward *free fatty acid oxidation*, which occurs under any form of stress. [Source 3] When stress liberates fatty acids from tissues into the bloodstream, these circulating fats block the ability to oxidize glucose, reducing carbon dioxide production. [Source 3] Since carbon dioxide normally suppresses glycolysis, its absence allows the cell to shift toward lactic acid production. [Source 3, 9] This creates a vicious cycle: the resulting lactate further suppresses respiration, which in turn mobilizes more free fatty acids as an alternative fuel, reinforcing the **Randle effect** and deepening the metabolic dysfunction. [Source 7] Peat noted that even a modest 50% elevation in circulating lactic acid is sufficient to initiate the inflammatory process, as lactate triggers the release of mediators of inflammation and fibrosis. [Source 3, 5]

Clinically, Peat viewed lactic acidemia as a central feature of diabetes, shock, and chronic stress states. He observed that diabetics characteristically cannot oxidize sugar fully to carbon dioxide, instead producing lactic acid, and that **lactic acidosis** was historically a common terminal event in the disease. [Source 8, 9] In surgical and trauma patients, the degree of lactic acidemia is recognized as a severity indicator, yet Peat pointed to evidence that resuscitation with lactated Ringer's solution worsens outcomes compared to no early treatment or alternative fluids, underscoring lactate's harmful rather than neutral role. [Source 1] He also noted that well-trained athletes paradoxically carry elevated blood lactate for days after exercise, challenging the notion that post-exercise soreness and lactic acid are benign signals of adaptation. [Source 5]

The antidote to lactic acidemia lies in restoring efficient oxidative metabolism. Peat emphasized that a truly fit or well-adapted organism produces abundant carbon dioxide and resists lactic acid formation, as seen in high-altitude natives who exhibit the **lactate paradox**—the ability to work intensely without accumulating lactate due to higher tissue carbon dioxide levels. [Source 2, 9] Dietary strategy centers on deriving energy predominantly from carbohydrates to suppress fat oxidation, as stress-induced fat burning is the background condition for lactic acid formation. [Source 3, 10] Peat warned that ketogenic diets, by shifting the brain's energy supply toward fats, cause astrocytes to produce significant lactic acid, reframing a metabolic menace as a virtue. [Source 10] Even environmental exposures to nanoparticles from silica, titanium dioxide, and other particulates can increase lactic acid production, promoting the inflammatory cascade of edema, collagen synthesis, and fibrosis. [Source 6]

## People also ask

### How does lactic acid suppress mitochondrial respiration?

Peat described a systemic Crabtree effect in which glycolysis actively shuts down oxidative metabolism, creating a pseudo-hypoxic state that mimics sepsis even when normal oxygen levels are present.

### Why does stress-induced fat oxidation lead to elevated lactate?

Stress liberates free fatty acids that block glucose oxidation and reduce carbon dioxide production; since carbon dioxide normally suppresses glycolysis, its absence allows the cell to shift toward lactic acid production.

### What dietary approach did Peat recommend to reverse lactic acidemia?

Peat emphasized deriving energy predominantly from carbohydrates to suppress fat oxidation, and warned that ketogenic diets cause astrocytes to produce significant lactic acid by shifting the brain's energy supply toward fats.

## Related concepts

- [Lactic acid](https://bioenergeticoracle.com/md/concepts/lactic-acid/index.md)
- [Acidosis](https://bioenergeticoracle.com/md/concepts/acidosis/index.md)
- [Bohr effect](https://bioenergeticoracle.com/md/concepts/bohr-effect/index.md)
- [Cholesterol](https://bioenergeticoracle.com/md/concepts/cholesterol/index.md)
- [Cori Cycle](https://bioenergeticoracle.com/md/concepts/cori-cycle/index.md)
- [Crabtree effect](https://bioenergeticoracle.com/md/concepts/crabtree-effect/index.md)

## Cited passages

Passage numbers match the `[Source N]` markers in the synthesis above.

### Source 1 — Mitochondria and mortality

Ray Peat · Article · 2016 · https://raypeat.com/articles/articles/mitochondria-mortality.shtml

> This fatty acid exposure "decreases glucose tolerance," and undoubtedly explains women's higher incidence of diabetes. While most fatty acids inhibit the oxidation of glucose without immediately inhibiting glycolysis, palmitic acid is unusual, in its inhibition of glycolysis and lactate production without inhibiting oxidation. I assume that this largely has to do with its important function in cardiolipin and cytochrome oxidase.
>
> Exercise, like aging, obesity, and diabetes, increases the levels of circulating free fatty acids and lactate. But ordinary activity of an integral sort, activates the systems in an organized way, increasing carbon dioxide and circulation and efficiency. Different types of exercise have been identified as destructive or reparative to the mitochondria; "concentric" muscular work is said to be restorative to the mitochondria. As I understand it, this means contraction with a load, and relaxation without a load. The heart's contraction follows this principle, and this could explain the observation that heart mitochondria don't change in the course of ordinary aging.
>
> When a person has an accident, or surgery, and goes into shock, the degree of lactic acidemia is recognized as an indicator of the severity of the problem. Lactated Ringer's solution has been commonly used to treat these people, to restore their blood pressure. But when prompt treatment with lactated Ringer's solution has been compared with no early treatment at all, the patients who are not "resuscitated" do better than those who got the early treatment. And when Ringer's lactate has been compared with various other solutions, synthetic starch solutions, synthetic hemoglobin polymer solution, or simply a concentrated solution of sodium chloride, those who received the lactate solution did least well. For example, of 8 animals treated with another solution, 8 survived, while among 8 treated with Ringer's lactate, 6 died.
>
> Mitochondrial metabolism is now being seen as the basic problem in aging and several degenerative diseases. The tendency has been to see random genetic deterioration as the driving force behind mitochondrial aging. Genetic repair in mitochondria was assumed not to occur. However, recently two kinds of genetic repair have been demonstrated. One in which the DNA strand is repaired, and another, in which sound mitochondria are "recruited" to replace the defective, mutated, "old" mitochondria.
>
> In ordinary nuclear chromosomal genes, DNA repair is well known.

### Source 2 — One Radio Network: Nothing is as it seems with COVID (July 20, 2020)

Ray Peat · Interview · Jul 20, 2020

> **Patrick Timpone:** So the lactic acid can be a real issue with all kinds of things, including the heart muscles, right?
>
> **Ray Peat:** Yeah, and some of the doctors have... One of the earliest New York City doctors reported that... They weren't low in oxygen especially, but they were low in carbon dioxide. And that lets the lactate rise and the lactic acid, even in the presence of normal amounts of oxygen, the presence of lactic acid creates what they call pseudo-hypoxia or reductive stress. which is similar to sepsis and all of the mortality-associated features of COVID. It's all basically a stress syndrome, which is intensified by the treatment, and the COVID has a very small role in triggering that in people who actually have a very intense respiratory infection.
>
> **Patrick Timpone:** So in general, when we are exercising, we get stronger in lung capacity and such and do not have to breathe as often while we're moving, whatever, treadmill or even walking. We're retaining more carbon dioxide, right? And then that puts more oxygen where we need it, in the cells, right?
>
> **Ray Peat:** Yeah, that's when you're called fit.

### Source 3 — One Radio Network: Top Contrarian on Health

Ray Peat · Interview · Dec 17, 2019

> ## Lactic Acid and Stress
>
> **Ray Peat:** If the white blood cells are slightly poisoned by a bad diet and your thyroid hormone doesn't provide the energy, then there tends to be quite a bit of lactic acid in circulation. Maybe only 50% above average, but that's enough to start the inflammation process. By increasing energy production, you lower the lactic acid and reduce the basis of the inflammation. With the lactic acid removed, oxidative metabolism can energize the cleanup process.
>
> **Patrick Timpone:** What are the causes of high lactic acid?
>
> **Ray Peat:** The basic general cause is anything that shifts you over to having free fatty acids circulating in your blood. Any kind of stress that runs into a limitation of energy capacity will break down the fatty acids in your tissues and put them into your bloodstream. This can keep the organism running for weeks eating its own tissues, but when fatty acids are circulating, they block the ability to oxidize glucose. When you aren't oxidizing glucose, you aren't producing as much carbon dioxide. That lack of carbonic acid inside the cell allows the cell to shift over to the production of lactic acid. The healthy cell oxidizes glucose, which produces a lot more carbon dioxide than oxidizing fat does. That higher carbon dioxide suppresses glycolysis and lactic acid production.

### Source 4 — One Radio Network: Top Contrarian on Health

Ray Peat · Interview · Dec 17, 2019

> ## Hypoglycemia and Heart Issues
>
> **Patrick Timpone:** A listener asks about the link between hypoglycemia, lactic acid, and heart conditions like AFib.
>
> **Ray Peat:** When the mitochondria are damaged, usually by fat, you tend to produce lactic acid instead of carbon dioxide. That is many times less efficient than oxidizing sugar. You are producing lactic acid and consuming sugar at a high rate but not getting the energetic benefit. To get maximum energy, you use sugar at an extremely high rate and have trouble keeping blood sugar steady.

### Source 5 — Ask the Herb Doctor: Altitude (July 2013)

Ray Peat · Interview · 2013

> **Sarah Johannesen Murray and Andrew Murray:** And, lactic acid is the thing we feel when we exercise and our muscles cramp?
>
> **Ray Peat:** Yeah, and it triggers release of a whole series of mediators of inflammation and also of fibrosis.
>
> **Sarah Johannesen Murray and Andrew Murray:** OK.
>
> **Ray Peat:** And so they’re now finding that when they are doing abdominal surgery if they blow in a fairly concentrated solution of CO2 solutions or gas, they’ll suppress the formation of fibrosis and adhesions.
>
> **Sarah Johannesen Murray and Andrew Murray:** Cause it decreases inflammation?
>
> **Ray Peat:** Yeah.
>
> **Sarah Johannesen Murray and Andrew Murray:** So, the common myth that when your muscles hurt it means they are growing bigger and that’s better, I mean the common belief, it’s a myth?
>
> **Ray Peat:** Yeah, well anything that injures your muscle, the lactic acid is probably long gone, but the damage persists and the damage involves the loss of CO2 and that causes the uptake of water swelling and so on and the swelling and the injury does cause the muscle to get bigger, but not healthier.

### Source 6 — Particles in Context

Ray Peat · Newsletter · 2019

> Small particles of silica or other inorganic or organic material (such as plastics), can, like radiation, oxygen deprivation, sepsis, or estrogen, increase the production of lactic acid, and this lactate promotes various features of inflammation, including edema, collagen synthesis, and the growth and movement of cells.
>
> Working in a photocopy shop, being exposed to the toner particles in the air, evidence of genetic damage appears in the urine, and exposing cells to the fumes from a laser printer causes DNA breaks (Tang, et al., 2012; Khatri, et al., 2013). All of the known “epigenetic” mechanisms (DNA methylation, histone changes, and non-coding RNA changes), besides the DNA breaks, are known to be caused by nanoparticles (Sierra, et al., 2016). These changes can be caused by extremely small amounts of invisible airborne particles, but the quantities that people are now exposed to are very large, and are increasing year by year. Small amounts of nanoparticles can pass into the skin, especially when it’s moist from sweat, from fabrics that have been impregnated with them to serve as sun blockers and deodorants, and to make them wrinkle resistant, stain resistant, and antiseptic (Bianco, et al., 2015; Crosera, et al., 2016; Filon, et al., 2011; Miquel-JeanJean, et al., 2012; Tang, et al., 2010).
>
> Many perfumes, shampoos, cosmetics, and sunscreens contain them, up to 10% by weight, and are deliberately applied to the skin. Drugs and nutritional supplements frequently contain microparticulate titanium dioxide (a Group 2 carcinogen, according to IARC) and silica, to make attractive tablets. Those things are sometimes even included in encapsulated vitamins and powdered thyroid, to speed filling and reduce static electric charges. Toothpastes frequently contain titanium dioxide for whiteness and opacity, and fumed silica to give it a thicker consistency. For many people, “foods” are probably their main source of exposure to industrial particulate matter. The FDA allows up to 1% of the weight of food to be titanium dioxide, and up to 2% fumed silica.

### Source 7 — Mitochondria and mortality

Ray Peat · Article · 2016 · https://raypeat.com/articles/articles/mitochondria-mortality.shtml

> The Crabtree effect is usually thought of as just something that happens in tumors, and some tissues that are very active glycolytically, and some bacteria, when they are given large amounts of glucose. But when we consider lactate, which is produced by normal tissues when they are deprived of oxygen or are disturbed by a stress reaction, the Crabtree effect becomes a very general thing. The "respiratory defect" that we can see on the organismic level during hyperventilation, is very similar to the "systemic Crabtree effect" that happens during stress, in which respiration is shut down while glycolysis is activated. Since oxidative metabolism is many times more efficient for producing energy than glycolysis is, it is maladactive to shut it down during stress.
>
> Since the presence of lactate is so commonly considered to be a normal and adaptive response to stress, the shut-down of respiration in the presence of lactate is generally considered to be caused by something else, with lactate being seen as an effect rather than a cause. Nitric oxide and calcium excess have been identified as the main endogenous antirespiratory factors in stress, though free unsaturated fatty acids are clearly involved, too. However, glycolysis, and the products of glycolysis, lactate and pyruvate, have been found to have a causal role in the suppression of respiration; it is both a cause and a consequence of the respiratory shutdown, though nitric oxide, calcium, and fatty acids are closely involved.
>
> Since lactic acid is produced by the breakdown of glucose, a high level of lactate in the blood means that a large amount of sugar is being consumed; in response, the body mobilizes free fatty acids as an additional source of energy. An increase of free fatty acids suppresses the oxidation of glucose. (This is called the Randle effect, glucose-fatty acid cycle, substrate-competition cycle, etc.) Women, with higher estrogen and growth hormone, usually have more free fatty acids than men, and during exercise oxidize a higher proportion of fatty acids than men do. This fatty acid exposure "decreases glucose tolerance," and undoubtedly explains women's higher incidence of diabetes. While most fatty acids inhibit the oxidation of glucose without immediately inhibiting glycolysis, palmitic acid is unusual, in its inhibition of glycolysis and lactate production without inhibiting oxidation.

### Source 8 — Herb Doctors: Field Biology

Ray Peat · Interview · Sep 19, 2014 · http://l-i-g-h-t.com/files/herb-doctors-field -biology.mp4

> **Ray Peat:** But lactic acid is one of the basic disrupting signals if it continues too long. And it turns out that one of the basic features of diabetes is that they can’t oxidize sugar all the way to carbon dioxide. Instead they produce lactic acid. And if that continues too long, lactic acidosis is very often what diabetics used to die from. But any of these stresses will interfere with the ability to oxidize glucose in the brain or blood vessels in the organ that’s under too much stress and not getting repair materials, will shift over to producing lactic acid and the lactic acid then is a stress signal and an immune signal for the rest of the organism.

### Source 9 — Herb Doctors: Field Biology

Ray Peat · Interview · Sep 19, 2014 · http://l-i-g-h-t.com/files/herb-doctors-field -biology.mp4

> **Andrew Murray:** That kind of reminds me – and I know we’ve discussed this previously on shows of – various parts through various shows. But lactic acid, now this is something that I think most people can identify with – well, there’s two forms of it, perhaps that most people will probably quite commonly associate it with. One we think would be in yogurt, lactic acid formed during the fermentation process, but I think probably more commonly still during exercise when people exercise their muscles, when either running or aerobically exercising, the lactic acid builds up in the muscles. It is often felt as a cramp. And this is the same lactic acid that you are saying is completely a destabilizer of the cell and quite disruptive to the field.
>
> **Ray Peat:** Yeah. A very well developed athlete will not produce lactic acid too easily. A sedentary person, who is forced to exercise, will be flooded with lactic acid because they haven’t developed the system for delivering oxygen and a fuel to the tissues. So a really good athlete is resistant to producing lactic acid. And carbon dioxide produced by healthy metabolism directly participates in suppressing lactic acid and in maintaining and promoting oxidative energy production. And a place where you can see this is people who live at high altitude where the balance between oxygen and carbon dioxide leaves the bodies having a higher residual carbon dioxide level. They can work very intensely without producing lactic acid. That’s called the lactate paradox sometimes because ordinarily oxygen efficiency is what turns on lactic acid, but once you get adapted and are able to produce a lot of carbon dioxide or hold it in your tissues, then that in itself prevents this toxic formation of lactic acid.

### Source 10 — One Radio Network: Top Contrarian on Health

Ray Peat · Interview · Dec 17, 2019

> ## Lactic Acid and Stress
>
> **Patrick Timpone:** In simple dietary terms, what do we do unknowingly to increase this lactic acid?
>
> **Ray Peat:** Ideally, you would get all of your energy from carbohydrates—sugars or starches—and not have to rely on burning fat. Stress turns on fat burning, and that turns on background lactic acid formation.

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