In the modern world, science does not stand still. Diseases are carefully studied, and scientists are looking for ways to deal with them. Doctors are often prescribed to take tests that are not at all clear to ordinary people, but this result can confirm or refute the doctor’s fears. So the analysis on LDH, and especially elevated lactate dehydrogenase, says a lot. What is it, and what are the consequences, we will talk further.
What is LDH?
Lactate dehydrogenase is one of the enzymes that shows the presence of damaged cells. It is found in both blood and tissues in different quantities. During respiration, a lactic acid salt is formed in the cells. Lactate dehydrogenase promotes its transition to pyruvic acid, which is involved in the high-energy oxidation process. It contributes to the rapid release of energy from glucose, which is necessary for muscle contraction, the flow of biochemical processes. The bottom line is products that are easily removed from the body - carbon dioxide and water. If oxygen is not supplied enough, the enzyme accumulates, pathologies arise that accelerate the decay of cells. They will lead to the fact that lactate dehydrogenase is increased. This indicator is very sensitive to the destruction of cellular structures.
Lactate dehydrogenase, if arranged in decreasing order, is found in such organs and tissues:
- In the kidneys.
- Heart muscle.
- Skeletal muscle.
- The pancreas.
- The spleen.
- The chemical laboratory of our body is the liver.
- Lungs.
- In blood serum.
Types of LDH
The enzyme lactate dehydrogenase has several forms that differ from each other by isoenzymes, and they are in different tissues. Depending on the higher concentration of the isoenzyme in a particular organ, there are types of this enzyme:
- LDH-1 - mainly in the heart and blood cells.
- 2 - in white blood cells.
- 3 - in the lung tissue.
- LDH - 4 - most in the kidneys, placenta, pancreas.
- 5 - found in the liver and striated muscle tissue.
Thanks to this, it can be concluded, due to which isoenzyme, LDH level is increased, and disease can be determined.
When this analysis is prescribed
There are several conditions in which it is necessary to control the level of LDH:
- With diseases of the hepatobiliary system.
- After myocardial infarction.
- When detecting various tumors.
- If necessary, determine the type of anemia.
- In diseases with increased hemolysis.
- With sharp pains in the chest area.
- If there are liver or kidney lesions.
- For examination of tissues and muscles after injury by trauma or disease.
The influence of factors on the result of the analysis
If the doctor suspects that you have elevated lactate dehydrogenase, only an analysis can refute or confirm this.
A blood test for LDH is given in the morning on an empty stomach. Blood is drawn from a vein. Before going to the treatment room , special nutrition is not required. It is only necessary to know that there are factors that can distort the result. What can affect the accuracy of the analysis result:
- Taking vitamin C can lower LDH levels in the blood.
- The use of electropulse therapy on the eve of the analysis.
- Skin problems.
- Blood alcohol content.
- Thrombocytosis.
- The use of hemodialysis.
- Some medications, such as Aspirin, Mitramycin, anesthetics, fluorides can increase the level of the enzyme.
- Excessive exercise.
These factors can affect the result, but this does not mean that there are pathological processes in the body.
Before you find out the content of the enzyme in your blood, you need to consult a doctor what drugs should be discontinued before going to the laboratory.
It is very important to properly transport and store the collected blood, since non-compliance with the rules can lead to hemolysis of the blood, and as a result, increased lactate dehydrogenase.
LDH rates for children and adults
Lactate dehydrogenase levels change with age. The older a person becomes, the lower they are. So, the concentration of LDH:
- Newborns - up to 28.9 mkkat / l.
- From 1 year to 3 years - up to 14.2 mkkat / l.
- In boys from 7 years to 12 years - up to 12.7 mkkat / l.
- Girls from 7 years to 12 years old - up to 9.67 mkkat / l.
- Men - up to 11.4 mkkat / l.
- Women - up to 7.27 mkkat / l.
LDH can be higher and lower than normal.
Elevated Lactate Dehydrogenase - Causes
Increased rates are observed in pregnant women and with excessive physical exertion.
If, as a result of the analysis, lactate dehydrogenase is increased. The reasons for this are the development of the following conditions:
- Myocardial infarction.
- Viral diseases of the liver.
- Cirrhosis of the liver.
- Oncology.
- Acute pancreatitis.
- Pathological diseases of the kidneys.
- Anemia.
- Leukemia
- Conditions in which extensive cell breakdown occurs: shock, severe hypoxia, large area burns.
- Extensive injuries.
- Diseases of the muscular system.
However, not only this analysis confirms the presence of pathology in the body. Further examination is required. By studying the activity of isoenzymes, a specialist will be able to determine the localization of the disease.
The value of indicators of LDH isoenzymes
If we consider in more detail the increase in lactate dehydrogenase of a certain type, we can determine the foci of a possibly developing pathology.
An increase in LDH-1 or the ratio of LDH-1 / LDH-2 is possible under the following conditions:
- Acute heart attack.
- Hemolytic megaloblastic anemia.
- Acute renal necrosis.
- In the presence of tumors of the male and female genitalia.
An increase in LDH-5 is characteristic of:
- Liver disease.
- Cancer
- Injury to skeletal muscle.
An increase in LDH-2 and LDH-3 is usually observed with:
- Acute leukemia.
- Chronic granulocytosis.
An increase in LDH-3, possibly partially LDH-4 and LDH-5, most often happens if there are:
- Kidney disease.
- Pulmonary embolism.
- Heart failure, developing with the involvement of lung tissue.
An increase in LDH-4 LDH-5 is detected if it is diagnosed:
- Circulatory disturbance due to poor heart function.
- Damage to the liver.
- Muscle injuries.
LDH in children
If we talk about children, then the age of the child should be taken into account. In children, LDH is higher. Also, before going to the doctor, it is necessary to trace what drugs the child is taking and observe his physical activity. If lactate dehydrogenase is elevated in a child, the causes may be caused by one of the pathologies described above. It should be borne in mind that if the baby is allergic, it can also affect the result, especially with severe childhood eczema or bronchial asthma. Injuries and bruises can distort the analysis, as well as the presence of anemia in the child.
If the first result is above the norm, it is necessary to retake the analysis to make sure its accuracy. If nevertheless lactate dehydrogenase is elevated in a child, then a full examination is necessary. This indicator alone does not give the right to make a final diagnosis and prescribe treatment.
Disease Treatment and LDH Change
If lactate dehydrogenase is increased, treatment of the disease can gradually bring this indicator back to normal.
- In acute renal exacerbations, LDH is increased, while in the chronic course of the disease it remains normal. It rises after hemodialysis.
- With liver cirrhosis and chronic hepatitis, LDH values are normal, at the time of exacerbation of the disease, the values increase.
- For anemia, LDH is used for differential diagnosis.
- With a heart attack, LDH rises, and after 10-14 days it returns to normal. Control of this enzyme allows the doctor to analyze the course of treatment.
If at the beginning of the disease lactate dehydrogenase is increased, then with the successful treatment of anemia, leukemia, and tumor diseases, LDH activity decreases.
Here is a not-so-simple analysis that most of us are not even aware of. But he, it turns out, can tell a lot about the attending physician.