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No unusual activity with lactic acid seen in patients with fibromyalgia, migraine
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Patients with fibromyalgia, migraine or both did not exhibit any differences in the metabolism of lactic acid before, during or after aerobic or anaerobic exercise compared to healthy volunteers, according to a recently published study.
Researchers studied 20 patients with fibromyalgia only, 20 patients with episodic migraine only, 20 patients with chronic migraine, 13 patients with fibromyalgia and episodic migraine and 20 patients with fibromyalgia and chronic migraine in comparison with 20 healthy volunteers. All participants were women and participants in all groups were similar in age, weight, height and BMI. All were considered sedentary.
Medications included: selective inhibitors of serotonin uptake (n = 23); tricyclic antidepressants (n = 23); muscle relaxants (n = 19); levothyroxine (n = 15); benzodiazepines (n = 14) anticonvulsants (n = 10) angiotensin enzyme converting inhibitors (n = 10) diuretics (n = 10) anti-inflammatory drugs (n = 9) proton pump inhibitors (n = 6) antipsychotics (n = 6) selective receptor of serotonin inhibitors, norepinephrine and dopamine (n = 5) antihistamines (n = 4) metformin, insulin and orlistat (n = 10) statins (n = 3) antimalarials (n = 2) anticoagulants (n = 1) and alendronate (n = 1).
All participants engaged in exercise stress tests on a flat treadmill with progressive intensity for a mean duration of 30 minutes. The walking speed at initiation was 2 mph and was increased by 1mph every minute until the speed of 9 mph was reached. Patients with episodic migraine participated following at least 5 days without an occurrence of headache and patients with chronic migraine underwent the test at times of low headache intensity.
Capillary blood samples were obtained with a transdermal punch from the left index finger and analyzed for the presence and volume of lactic acid. Samples were obtained at rest before exercise, after 10 minutes of aerobic exercise, after 3 minutes of anaerobic exercise and after 6 minutes of rest following the test. Lactic acid measurements were obtained from all 113 participants four times for a total of 452 analyses.
A significant increase in lactic acid volume was seen during the anaerobic exercise stage compared to baseline in all participants. Lactic acid levels were increased during the aerobic phase but the levels did not reach significance and no differences were seen between groups. Lactic acid remained elevated in the patients with fibromyalgia and healthy volunteers in the postexercise rest phase. Patients with chronic migraine and chronic migraine with fibromyalgia had elevated levels of lactic acid compared to other groups during the aerobic phase, however, the significance is lost following Bonferroni correction.
Patients with episodic migraine, chronic migraine, fibromyalgia plus episodic migraine and chronic migraine plus fibromyalgia had slightly elevated lactic acid levels compared to baseline but significance was not reached.
No significant differences were seen between groups during the anaerobic and rest phases of the test. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.
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