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Pathology/Elevated lactic acid, anion gap, hematocrit.



My lab work has continually shown mildly elevated lactic acid (under 4 always) and mildly elevated anion gap (18). I am a diabetic and very overweight with a fatty liver and hemangioma as well.  Recently my hematocrit was elevated to slightly. My doctor does not seem too concerned.  Does this mean I have acidosis or what else would cause mild elevations?  I have no symptoms of acidosis but very tired all the time and sometimes short of breath.  Should I be worried?  Thanks.

Hello Shannon:

If the levels are consistently around 4 this may be the upper limit of normal for you. If there are no accompanying symptoms, there is no cause for concern. All the values are an average of the levels for a set of normal population. There will always be some people who fall out of this range and still have no symptoms.

However, if the levels continue to increase, then further evaluation is required.
Dehydration, anemia, infection, liver disease or damage are some of the common cause for elevation of lactic acid.
The elevation in lactic acid can cause increase in anion gap.

Please follow up closely with your physician if you have any symptoms.


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Neha Dahiya MD


Help patients understand the medical terminology of their lab results and / or tissue biopsy reports.


I am a pathologist and director of clinical laboratory services. I have been a practicing pathologist for last 9 years in a 350 bed multi specialty hospital laboratory in India.

Indian association of pathologists and microbiologists.
International Academy of Cytology
International association of Pathologists - Indian division
Indian association of Cytology

MD (pathology) MBA

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