POINT-COUNTERPOINTREBUTTAL FROM DR. VAN HALLPublished Online:01 Jun 2007https://doi.org/10.1152/japplphysiol.00039c.2007MoreSectionsPDF (55 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInEmailWeChat In his Point, West tries to convince the reader with a list of 21 references that the lactate paradox phenomenon exists and that there are many more articles published supporting the concept. However, if the literature is so overwhelming, then why refer to 1) articles that do not contain any lactate data (Refs. 1, 3); 2) reviews that use lactate data from original studies that are also in the reference list (Refs. 11, 16, 18, 22, 26); 3) an article from the Operation Everest II study (Ref. 23), if it is claimed not to be a good study of chronic hypoxia; 4) an article that supports the nonexistence of the lactate paradox (Ref. 8, see Counterpoint above for explanation); 5) a study that did not include acute hypoxia but only compared sea level and acclimatization (Ref. 7); 6) an article with odd data on chronic hypoxia, significantly lower pre-exercise muscle glycogen content compared with sea level and acute hypoxia, a very low lactate serum accumulation but rather similar muscle glycogen breakdown compared with acute hypoxia, and an invalid fatty acid glycerol ratio (Ref. 29); 7) articles that have been shown to be incorrect (Refs. 14, 15). Thus only eight references are left, of which most are field studies at very high altitudes. These articles do not contain information on acute hypoxia (see also comment 5) and are prone to confounders related to the uncontrolled nature of these studies, like one of our own (Ref. 20). Moreover, several of these studies were carried out above 5,000–6,000 m, meaning that pathophysiology is studied rather than normal physiology since humans cannot survive without oxygen at these altitudes. Therefore, the relationship of lactate and altitude presented by West, which heavily relies on studies carried out at these very high altitudes, may well be correct observations. However, they do not reflect normal hypoxia lactate metabolism.This article has no references to display. Download PDF Previous Back to Top Next FiguresReferencesRelatedInformationCited ByThe lactate paradox revisited in lowlanders during acclimatization to 4100 m and in high-altitude natives27 February 2009 | The Journal of Physiology, Vol. 587, No. 5 More from this issue > Volume 102Issue 6June 2007Pages 2402-2402 Copyright & PermissionsCopyright © 2007 the American Physiological Societyhttps://doi.org/10.1152/japplphysiol.00039c.2007History Published online 1 June 2007 Published in print 1 June 2007 Metrics