Published Online:https://doi.org/10.1152/ajpregu.00114.2004

The development of acidosis during intense exercise has traditionally been explained by the increased production of lactic acid, causing the release of a proton and the formation of the acid salt sodium lactate. On the basis of this explanation, if the rate of lactate production is high enough, the cellular proton buffering capacity can be exceeded, resulting in a decrease in cellular pH. These biochemical events have been termed lactic acidosis. The lactic acidosis of exercise has been a classic explanation of the biochemistry of acidosis for more than 80 years. This belief has led to the interpretation that lactate production causes acidosis and, in turn, that increased lactate production is one of the several causes of muscle fatigue during intense exercise. This review presents clear evidence that there is no biochemical support for lactate production causing acidosis. Lactate production retards, not causes, acidosis. Similarly, there is a wealth of research evidence to show that acidosis is caused by reactions other than lactate production. Every time ATP is broken down to ADP and Pi, a proton is released. When the ATP demand of muscle contraction is met by mitochondrial respiration, there is no proton accumulation in the cell, as protons are used by the mitochondria for oxidative phosphorylation and to maintain the proton gradient in the intermembranous space. It is only when the exercise intensity increases beyond steady state that there is a need for greater reliance on ATP regeneration from glycolysis and the phosphagen system. The ATP that is supplied from these nonmitochondrial sources and is eventually used to fuel muscle contraction increases proton release and causes the acidosis of intense exercise. Lactate production increases under these cellular conditions to prevent pyruvate accumulation and supply the NAD+ needed for phase 2 of glycolysis. Thus increased lactate production coincides with cellular acidosis and remains a good indirect marker for cell metabolic conditions that induce metabolic acidosis. If muscle did not produce lactate, acidosis and muscle fatigue would occur more quickly and exercise performance would be severely impaired.

REFERENCES

  • 1 Bangsbo J, Gollnick PD, Graham TE, Juel C, Kiens B, Mizuno M, and Saltin B. Anaerobic energy production and O2 deficit-debt relationship during exhaustive exercise in humans. J Physiol 422: 539–559, 1990.
    Crossref | PubMed | ISIGoogle Scholar
  • 2 Bangsbo J. Quantification of anaerobic energy production during intense exercise. Med Sci Sports Exerc 30: 47–52, 1998.
    Crossref | PubMed | ISIGoogle Scholar
  • 3 Bernardi P. Mitochondrial transport of cations: channels, exchangers, and permeability transition. Physiol Rev 79: 1127–1155, 1999.
    Link | ISIGoogle Scholar
  • 4 Busa WB and Nuccitelli R. Metabolic regulation via intracellular pH. Am J Physiol Regul Integr Comp Physiol 246: R409–R438, 1984.
    Link | ISIGoogle Scholar
  • 4a Clarence DH. The Handbook of Biochemistry and Biophysics. Cleveland, OH: World, 1966.
    Google Scholar
  • 5 Corey HE. Stewart and beyond: new models of acid-base balance. Kidney Int 64: 777–787, 2003.
    Crossref | PubMed | ISIGoogle Scholar
  • 6 Davis EJ, Bremer J, and Akerman KE. Thermodynamic aspects of translocation of reducing equivalents by mitochondria. J Biol Chem 255: 2277–2283, 1980.
    PubMed | ISIGoogle Scholar
  • 7 Dennis SC, Gevers W, and Opie LH. Protons in ischemia: where do they come from; where do they go to? J Mol Cell Cardiol 23: 1077–1086, 1991.
    Crossref | PubMed | ISIGoogle Scholar
  • 8 Finkel KW and DuBose TD. Metabolic acidosis. In: Acid-Base and Electrolyte Disorders: A Companion to Brenner and Rector's The Kidney, edited by DuBose TD and Hamm LL. Philadelphia, PA: Saunders, 2002, p. 55–66.
    Google Scholar
  • 9 Fitts RH and Holloszy JO. Lactate and contractile force in frog muscle during development of fatigue and recovery. Am J Physiol 231: 430–433, 1976.
    Link | ISIGoogle Scholar
  • 10 Gevers W. Generation of protons by metabolic processes in heart cells. J Mol Cell Cardiol 9: 867–874, 1977.
    Crossref | PubMed | ISIGoogle Scholar
  • 11 Gevers W. Generation of protons by metabolic processes other than glycolysis in muscle cells: a critical view [letter to the editor]. J Mol Cell Cardiol 11: 328, 1979.
    ISIGoogle Scholar
  • 12 Hagberg H. Intracellular pH during ischemia in skeletal muscle: relationship to membrane potential, extracellular pH, tissue lactic acid and ATP. Pflügers Arch 404: 342–347, 1985.
    Crossref | PubMed | ISIGoogle Scholar
  • 13 Harmer AR, McKenna MJ, Sutton JR, Snow RJ, Ruell PA, Booth J, Thompson MW, Mackay NA, Stathis CG, Crameri RM, Carey MF, and Eager DM. Skeletal muscle metabolic and ionic adaptations during intense exercise following sprint training in humans. J Appl Physiol 89: 1793–1803, 2000.
    Link | ISIGoogle Scholar
  • 14 Hill AV, Long CNH, and Lupton H. Muscular exercise, lactic acid, and the supply and utilization of oxygen. Proc R Soc Lond B Biol Sci 16: 84–137, 1924.
    Google Scholar
  • 15 Hill AV. Croonian lecture. Proc R Soc Lond B Biol Sci 100: 87, 1926.
    CrossrefGoogle Scholar
  • 16 Hochachka PW and Mommsen TP. Protons and anaerobiosis. Science 219: 1391–1397, 1933.
    Google Scholar
  • 17 Holten CH, Muller A, and Rehbinder D. Lactic Acid: Property and Chemistry of Lactic Acid and Derivatives. Germany: Verlag Chemie, 1971.
    Google Scholar
  • 18 Howlett RA, Heigenhauser GJF, and Spriet LL. Skeletal muscle metabolism during high-intensity sprint exercise is unaffected by dichloroacetate or acetate infusion. J Appl Physiol 87: 1747–1751, 1999.
    Link | ISIGoogle Scholar
  • 19 Juel C, Klarskov C, Nielsen JJ, Krustrup P, Mohr M, and Bangsbo J. Effect of high intensity intermittent training on lactate and H+ release from human skeletal muscle. Am J Physiol Endocrinol Metab 286: E245–E251, 2004.
    Link | ISIGoogle Scholar
  • 20 Juel C. Lactate/proton co-transport in skeletal muscle: regulation and importance for pH homeostasis. Acta Physiol Scand 156: 369–374, 1996.
    Crossref | PubMedGoogle Scholar
  • 21 Juel C. Lactate-proton cotransport in skeletal muscle. Physiol Rev 77: 321–358, 1977.
    Google Scholar
  • 22 Juel C. Muscle pH regulation: role of training. Acta Physiol Scand 162: 359–366, 1988.
    Google Scholar
  • 23 Kaplan RS. Structure and function of mitochondrial anion transport proteins. J Membr Biol 179: 165–183, 2001.
    Crossref | PubMed | ISIGoogle Scholar
  • 24 Karlsson J. Lactate and phosphagen concentrations in working muscle of man. Acta Physiol Scand Suppl 358: 1–72, 1971.
    PubMedGoogle Scholar
  • 25 Katz A and Sahlin K. Regulation of lactic acid production during exercise. J Appl Physiol 65: 509–518, 1988.
    Link | ISIGoogle Scholar
  • 26 Kowalchuk JM, Heigenhauser GJF, Lindinger MI, Sutton JR, and Jones NL. Factors influencing hydrogen ion concentration in muscle after intense exercise. J Appl Physiol 65: 2080–2089, 1988.
    Link | ISIGoogle Scholar
  • 27 Laski ME and Wesson DE. Lactic acidosis. In: Acid-Base and Electrolyte Disorders: A Companion to Brenner and Rector's The Kidney, edited by DuBose TD and Hamm LL. Philadelphia, PA: Saunders, 2002, p. 835–108
    Google Scholar
  • 28 Lehninger AL. The Principles of Biochemistry (2nd ed). New York: Worth, 1982.
    Google Scholar
  • 29 Lusk G. The Elements of the Science of Nutrition. Philadelphia: Saunders, 1928.
    Google Scholar
  • 30 Lindinger MI and Heigenhauser GJ. The roles of ion fluxes in skeletal muscle fatigue. Can J Physiol Pharmacol 69: 246–253, 1991.
    Crossref | PubMed | ISIGoogle Scholar
  • 31 MacRae HSH and Dennis SC. Lactic acidosis as a facilitator of oxyhemoglobin dissociation during exercise. J Appl Physiol 78: 758–760, 1995.
    Link | ISIGoogle Scholar
  • 32 Margaria R, Edwards HT, and Dill DB. The possible mechanisms of contracting and paying the oxygen debt and the role of lactic acid in muscular contraction. Am J Physiol 106: 689–715, 1933.
    LinkGoogle Scholar
  • 33 Medbo JO and Tabata I. Anaerobic energy release in working muscle during 30 s to 3 min of exhaustive bicycling. J Appl Physiol 75: 1654–1660, 1993.
    Link | ISIGoogle Scholar
  • 34 Noakes TD. Challenging beliefs: ex Africa semper aliquid novi. Med Sci Sports Exerc 29: 571–590, 1997.
    Crossref | PubMed | ISIGoogle Scholar
  • 35 Raju TN. The Nobel Chronicles. 1922: Archilbald Vivian Hill (1886–1977), Otto Fritz Meyerfhoff (1884–1951). Lancet 352: 1396, 1998.
    PubMedGoogle Scholar
  • 36 Robergs RA. Exercise-induced metabolic acidosis: where do the protons come from? Sportscience 5 [ sportsci.org/jour/0102/rar. htm, 2001].
    Google Scholar
  • 37 Roth DA and Brooks GA. Lactate transport is mediated by a membrane-bound carrier in rat skeletal muscle sarcolemmal vesicles. Arch Biochem Biophys 279: 377–385, 1990.
    Crossref | PubMed | ISIGoogle Scholar
  • 38 Sahlin K. Intracellular pH and energy metabolism in skeletal muscle of man. Acta Physiol Scand Suppl 455: 7–50, 1978.
    Google Scholar
  • 39 Sahlin K. NADH in human skeletal muscle during short-term intense exercise. Pflügers Arch 403: 193–196, 1985.
    Crossref | PubMed | ISIGoogle Scholar
  • 40 Sahlin K, Edstrom L, Sjoholm H, and Hultman E. Effects of lactic acid accumulation and ATP decrease on muscle tension and relaxation. Am J Physiol Cell Physiol 240: C121–C126, 1981.
    Link | ISIGoogle Scholar
  • 41 Sahlin K, Edstrom L, Sjoholm H, and Hultman E. Effects of lactic acid accumulation and ATP decrease on muscle tension and relaxation. Am J Physiol Cell Physiol 240: C121–C126, 1981.
    Link | ISIGoogle Scholar
  • 42 Sahlin K, Harris RC, Nylind B, and Hultman E. Lactate content and pH in muscle samples obtained after dynamic exercise. Pflügers Arch 367: 143–149, 1976.
    Crossref | PubMed | ISIGoogle Scholar
  • 43 Sahlin K and Henriksson J. Muscle buffer capacity and lactate accumulation in skeletal muscle of trained and untrained men. Acta Physiol Scand 122: 331–339, 1984.
    Crossref | PubMedGoogle Scholar
  • 44 Sahlin K, Katz A, and Henriksson J. Redox state and lactate accumulation in human skeletal muscle during dynamic exercise. Biochem J 245: 551–556, 1987.
    Crossref | PubMed | ISIGoogle Scholar
  • 45 Sahlin K, Tonkonogi M, and Soderlund K. Energy supply and muscle fatigue in humans. Acta Physiol Scand 162: 261–266, 1998.
    Crossref | PubMedGoogle Scholar
  • 46 Sahlin K. Metabolic changes limiting muscle performance. In: Biochemistry of Exercise, edited by Saltin B. Champaign, IL: Human Kinetics, 1986, vol. 16, p. 323–344.
    Google Scholar
  • 47 Shampo MA and Kyle RA. Otto Meyerhoff—Nobel Prize for studies of muscle metabolism. Mayo Clin Proc 74: 67, 1999.
    Crossref | PubMed | ISIGoogle Scholar
  • 48 Smith GL, Donoso P, Bauer CJ, and Eisner DA. Relationship between intracellular pH and metabolite concentrations during metabolic inhibition in isolated ferret heart. J Physiol 472: 11–22, 1993.
    Crossref | PubMed | ISIGoogle Scholar
  • 49 Spriet LL, Sodeland K, Bergstrom M, and Hultman E. Aerobic energy release in skeletal muscle during electrical stimulation in men. J Appl Physiol 62: 611–615, 1987.
    Link | ISIGoogle Scholar
  • 50 Spriet LL, Sodeland K, Bergstrom M, and Hultman E. Skeletal muscle glycogenolysis, glycolysis, and pH during electrical stimulation in men. J Appl Physiol 62: 616–621, 1987.
    Link | ISIGoogle Scholar
  • 51 Spriet LL. Anaerobic metabolism in human skeletal muscle during short-term, intense activity. Can J Physiol Pharmacol 70: 157–165, 1992.
    Crossref | PubMed | ISIGoogle Scholar
  • 52 Stringer W, Wasserman K, Casaburi R, Porzasz J, Maehara K, and French W. Lactic acidosis as a facilitator of oxyhemoglobin dissociation during exercise. J Appl Physiol 76: 1462–1467, 1994.
    Link | ISIGoogle Scholar
  • 53 Stringer W, Casaburi R, and Wasserman K. Acid-base regulation during exercise and recovery in humans. J Appl Physiol 72: 954–961, 1992.
    Link | ISIGoogle Scholar
  • 54 Stryer L. Biochemistry (4th ed). San Francisco: Freeman, 1995.
    Google Scholar
  • 55 Tafaletti JG. Blood lactate: biochemistry, laboratory methods and clinical interpretation. CRC Crit Rev Clin Lab Sci 28: 253–268, 1991.
    CrossrefGoogle Scholar
  • 56 Trump BD, Mergner WJ, Kahng MW, and Saladino AJ. Studies on the subcellular pathophysiology of ischemia. Circulation 53: I17–I26, 1976.
    PubMed | ISIGoogle Scholar
  • 57 Vaghy PL. Role of mitochondrial oxidative phosphorylation in the maintenance of intracellular pH. J Mol Cell Cardiol 11: 933–940, 1979.
    Crossref | PubMed | ISIGoogle Scholar
  • 58 Webster’s Ninth New Collegiate Dictionary. Springfield: Merriam-Webster, 1984.
    Google Scholar
  • 59 Westerblad H, Allen DG, and Lannergren J. Muscle fatigue: lactic acid or inorganic phosphate the major cause? News Physiol Sci 17: 17–21, 2002.
    AbstractGoogle Scholar
  • 60 Wilkie DR. Generation of protons by metabolic processes other than glycolysis in muscle cells: a critical view. J Mol Cell Cardiol 11: 325–330, 1979.
    Crossref | PubMed | ISIGoogle Scholar
  • 61 Williamson JR, Schaffer SW, Ford C, and Safer B. Contribution of tissue acidosis to ischemic injury in the perfused rat heart. Circulation 53: I3–I16, 1976.
    Crossref | PubMed | ISIGoogle Scholar
  • 62 Wilson MC, Jackson VN, Heddle C, Price NT, Pilegaard H, Juel C, Bonen A, Montgomery I, Hutter OF, and Halestrap AP. Lactic acid efflux from white skeletal muscle is catalyzed by the monocarboxylate transporter isoform MCT3. J Biol Chem 273: 15920–15926, 1998.
    Crossref | PubMed | ISIGoogle Scholar
  • 63 Zilva JF. The origin of the acidosis in hyperlactataemia. Ann Clin Biochem 15: 40–43, 1978.
    Crossref | PubMed | ISIGoogle Scholar