Lactate !

Lactate is made when cells work without enough oxygen; the liver turns it back into glucose. Measuring it helps spot shock.

Updated 2026-10-31

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Key facts

Lactate dehydrogenase makes it from pyruvate and NADH, regenerating NAD⁺.
Normal blood lactate: under 2 mmol/L; 4 mmol/L or more is an alarm sign in sepsis.
Cori cycle: lactate from muscle and red cells goes to the liver, which turns it back into glucose.

The body makes mostly L-lactate; D-lactate comes from gut bacteria (D-lactic acidosis in short bowel syndrome).

Type A lactic acidosis (oxygen lack: shock, sepsis) and type B (no hypoxia: metformin, liver failure, thiamine deficiency).
LDH isoenzymes (LDH-1 heart, LDH-5 liver and muscle) rise in hemolysis and tissue damage.

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What is the point of making lactate without oxygen?

It regenerates the NAD⁺ that GAPDH needs, so glycolysis keeps making ATP.

Which organ clears most lactate?

The liver, which turns it into glucose (Cori cycle); the kidney and the heart also use it.

Which antidiabetic drug is linked to type B lactic acidosis?

Metformin, mainly with kidney or liver failure.

Molecules are shown in their neutral form, as the databases deposit them; in the cell the acids and phosphates are ionised.

Educational information, not medical advice. For any symptom, see a health professional.

Sources: L-Lactic acid (CID 107689) (PubChem, NCBI, 2026) · Public domain; Lactate Test: MedlinePlus Medical Test (MedlinePlus, US National Library of Medicine, 2026); Lactic acidosis: MedlinePlus Medical Encyclopedia (MedlinePlus, US National Library of Medicine, 2026).

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