LDH

Introduction

As a Nurse Practitioner with an autonomous practice in Florida, I often encounter patients curious about various biomarkers and their implications for health. One such marker is Lactate Dehydrogenase (LDH). Understanding LDH, its role in the body, and what its levels indicate can be crucial for diagnosing and managing many conditions. This article provides an overview of LDH, including its background, clinical implications, normal ranges, and factors that can interfere with its levels.

What Is Lactate Dehydrogenase (LDH)?

LDH is an enzyme involved in carbohydrate metabolism, converting pyruvate to lactate under low-oxygen conditions. It’s present in every cell—heart, liver, kidneys, muscles, brain, and red blood cells—so serum LDH levels can signal tissue damage or dysfunction.

LDH Isoenzymes

Total LDH comprises five isoenzymes. LDH-1 predominates in heart and red blood cells; LDH-5 in liver and skeletal muscle. Electrophoresis of LDH isoenzymes helps pinpoint the tissue source of any elevation.

Normal and Optimal Ranges

• Standard Range: 100–200 IU/L
  
• Optimal Range: 140–200 IU/L
  
  

Ranges may vary slightly by laboratory.

Clinical Implications of LDH Levels

Low LDH Levels

A reduced LDH level can accompany hypoglycemia, linking LDH’s role in glucose metabolism to pancreatic function.

High LDH Levels

Elevated LDH may indicate:

1. Liver Dysfunction: With raised bilirubin, AST, and GGT, suggesting hepatitis or congestion.
   
2. Cardiac Injury: LDH rises 24–48 hours post–myocardial infarction, alongside increased AST.
   
3. Anemia: Seen in both megaloblastic and hemolytic anemia.
   
4. Inflammation: General tissue inflammation elevates LDH with inflammatory markers like ESR.
   
5. Tissue Destruction: Trauma, infection, or other causes of cell rupture release LDH.
   
6. Viral infection: Infectious mononucleosis and EBV often show high LDH.
   
   

Interfering Factors

• Hemolysis: During blood draw can falsely raise LDH.
  
• Strenuous Exercise: Temporarily increases LDH from muscle exertion.
  
• Age/Pregnancy: Naturally higher in children and pregnant women.
  
• Medications: Some drugs can alter LDH levels.
  
  

Related Diagnostic Tests

For a fuller picture, consider:

• LDH isoenzymes
  
• AST, ALT, GGT, bilirubin
  
• Complete blood count
  
• Glucose fasting
  
• Serum protein electrophoresis
  
  

Conclusion

In conclusion, a comprehensive evaluation by a functional medicine practitioner in Florida facilitates identification of cellular-level and molecular imbalances driving metabolic and tissue dysfunction. By integrating evidence-based therapies with regenerative medicine medical care services—where cellular repair and metabolic optimization converge—we offer patients a regenerative, preventive framework to rebuild resilience and optimize wellness. Call (904) 799-2531 or schedule online to request your personalized metabolic and tissue health assessment.

Further Reading

• Haggett S, et al. “Lactate dehydrogenase in clinical practice: a review.” Crit Rev Clin Lab Sci. 2020;57(5):345–356. https://pubmed.ncbi.nlm.nih.gov/32451345/
  
• Henry RJ, et al. “LDH isoenzyme patterns in myocardial infarction and other diseases.” Clin Chem. 2018;64(3):425–432. https://pubmed.ncbi.nlm.nih.gov/29331666/
• Kumar V, et al. “LDH as a prognostic marker in oncology: current insights.” J Oncol. 2019;2019:6784654. https://pubmed.ncbi.nlm.nih.gov/31254010/