Lactate dehydrogenase

LDH is an enzyme found in almost every cell in your body. Its main job is to help turn sugar into energy, especially when oxygen is low, like during exercise or illness. When cells are damaged or stressed, LDH leaks into the blood, so higher levels can mean your body is fighting an infection, inflammation, or another health problem. LDH is measured with a simple blood test and is used by doctors to help understand what’s happening inside your body

LDH is important because it can help doctors spot serious health issues early. High LDH can be a sign of cell damage from infections (like COVID-19), inflammation, cancer, heart problems, or even severe skin diseases. In cancer, high LDH often means the disease is more active or harder to treat. In COVID-19 and other infections, high LDH can mean the illness is more severe and may need closer monitoring. LDH is also used to track recovery—falling levels can show that treatment is working. However, LDH is not specific to one disease, so doctors always look at other tests and symptoms to get the full picture.

LDH can go up or down for many reasons:

• Diet: There’s no direct link between food and LDH, but poor nutrition can make cells more vulnerable to damage.

• Lifestyle: Intense exercise, injuries, or heavy alcohol use can raise LDH.

• Related biomarkers: LDH often rises with other markers of inflammation, like C-reactive protein (CRP) or lactate.

• Micronutrients: Deficiencies in vitamins (like B1/thiamine) can affect cell metabolism and LDH.

• Environmental: Infections, toxins, medications, and chronic diseases (like heart, liver, or kidney problems) can all raise LDH.

• The Lactate and the Lactate Dehydrogenase in Inflammatory Diseases and Major Risk Factors in COVID-19 Patients.

  Gupta GS. Inflammation. 2022;45(6):2091-2123. doi:10.1007/s10753-022-01680-7.

• Lactate Dehydrogenase in Dermatology Practice.

  Livesey A, Garty F, Shipman AR, Shipman KE. Clinical and Experimental Dermatology. 2020;45(5):539-543. doi:10.1111/ced.14134.

• Lactate Metabolism in Health and Disease.

  Kane DA, Goodwin ML, Gladden LB. Advances in Experimental Medicine and Biology. 2025;1478:573-613. doi:10.1007/978-3-031-88361-3_24.

• Lactate Dehydrogenase: An Old Enzyme Reborn as a COVID-19 Marker (And Not Only).

  Panteghini M. Clinical Chemistry and Laboratory Medicine. 2020;58(12):1979-1981. doi:10.1515/cclm-2020-1062.

• Serum Lactate Dehydrogenase Activities as Systems Biomarkers for 48 Types of Human Diseases.

  Wu Y, Lu C, Pan N, et al. Scientific Reports. 2021;11(1):12997. doi:10.1038/s41598-021-92430-6.

• The Multiple Roles of LDH in Cancer.

  Claps G, Faouzi S, Quidville V, et al. Nature Reviews. Clinical Oncology. 2022;19(12):749-762. doi:10.1038/s41571-022-00686-2.

• Proteomic and Metabolomic Investigation of Serum Lactate Dehydrogenase Elevation in COVID-19 Patients.

  Yan H, Liang X, Du J, et al. Proteomics. 2021;21(15):e2100002. doi:10.1002/pmic.202100002.

• Prognostic Value of Pretreatment Serum Lactate Dehydrogenase Level in Patients With Solid Tumors: A Systematic Review and Meta-Analysis.

  Zhang J, Yao YH, Li BG, et al. Scientific Reports. 2015;5:9800. doi:10.1038/srep09800.

• Etiology and Therapeutic Approach to Elevated Lactate Levels.

  Andersen LW, Mackenhauer J, Roberts JC, et al. Mayo Clinic Proceedings. 2013;88(10):1127-40. doi:10.1016/j.mayocp.2013.06.012.

• Demystifying Lactate in the Emergency Department.

  Wardi G, Brice J, Correia M, et al. Annals of Emergency Medicine. 2020;75(2):287-298. doi:10.1016/j.annemergmed.2019.06.027.

• Lactic Acidosis: An Update.

  Seheult J, Fitzpatrick G, Boran G. Clinical Chemistry and Laboratory Medicine. 2017;55(3):322-333. doi:10.1515/cclm-2016-0438.

• L-Lactic Acidosis: Pathophysiology, Classification, and Causes; Emphasis on Biochemical And metabolic Basis.

  Kamel KS, Oh MS, Halperin ML. Kidney International. 2020;97(1):75-88. doi:10.1016/j.kint.2019.08.023.