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[Biochemistry](https://durgical.com/en/biochemistry/) · Molecule

# 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.

**Also called**
Lactic acid

**Formula**
C₃H₆O₃

**PubChem**
[CID 107689](https://pubchem.ncbi.nlm.nih.gov/compound/107689)

## Structure

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

## Clinical notes

- 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.

## Pathways

- [Glycolysis](https://durgical.com/en/biochemistry/pathways/glycolysis/)

## Related conditions

- [Lactic acidosis](https://durgical.com/en/conditions/lactic-acidosis/)
- [Sepsis and septic shock](https://durgical.com/en/conditions/sepsis-and-septic-shock/)
- [Hypovolaemic shock](https://durgical.com/en/conditions/hypovolaemic-shock/)

## Related

- [Pyruvate](https://durgical.com/en/biochemistry/molecules/pyruvate/)
- [NAD⁺ (nicotinamide adenine dinucleotide)](https://durgical.com/en/biochemistry/molecules/nad/)

## Test yourself

Think of the answer, then tap the question to see it.

## 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.

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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)](https://pubchem.ncbi.nlm.nih.gov/compound/107689) (PubChem, NCBI, 2026) · Public domain; [Lactate Test: MedlinePlus Medical Test](https://medlineplus.gov/lab-tests/lactic-acid-test/) (MedlinePlus, US National Library of Medicine, 2026); [Lactic acidosis: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000391.htm) (MedlinePlus, US National Library of Medicine, 2026).

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