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Physical changes at high altitude after full acclimatization has been achieved include reduced production of lactate post-exercise,[1] increased tissue carbon dioxide, increased red blood cell mass, increased hematocrit, decreased plasma volume, a higher concentration of capillaries in skeletal muscles, increased myoglobin, increased mitochondria, increased aerobic enzyme concentration, increase in 2,3-Bisphosphoglyceric acid, hypoxic pulmonary vasoconstriction, and right ventricular hypertrophy.

The decreased lactate production at altitude is called the "lactate paradox."

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  1. Hochachka, P.W.; Beatty, C.L.; Burelle, Y.; Trump, M.E.; McKenzie, D.C.; Matheson, G.O. (June 1, 2002). "The Lactate Paradox in Human High-Altitude Physiological Performance". Physiology. 17 (3): 122–126. ISSN 1548-9213. PMID 12021383. Retrieved November 9, 2016.