There are two types of Lactic Acid.

• L-lactic acid (L-lactate, (S)-lactic acid, or (+)-lactic acid):
  • This is the form produced in human metabolism, especially during anaerobic glycolysis (when oxygen is limited, such as during intense exercise or tissue hypoperfusion).
  • L-lactate is the predominant form found in human blood and tissues.
• D-lactic acid (D-lactate, (R)-lactic acid, or (−)-lactic acid):
  • This form is produced mainly by certain bacteria during carbohydrate fermentation, including some gut bacteria.
  • Humans produce very little D-lactate, but it can accumulate in specific conditions, such as short bowel syndrome, where bacterial overgrowth leads to increased D-lactate production and absorption. Typically this form often manifest itself as Brain Fog.

Excessive Lactic Acid is called Acidosis

 Clinical Types of Lactic Acidosis

Background Article: Lactic Acidosis [2014]

Lactic acidosis refers to the accumulation of lactic acid in the body, leading to a decrease in blood pH. It is classified based on the underlying cause:

• Type A Lactic Acidosis:
  • Caused by tissue hypoperfusion and hypoxia (lack of oxygen), leading to increased anaerobic metabolism and L-lactate production.
  • Common in shock (septic, cardiogenic, hypovolemic), severe hypoxemia, or cardiac arrest.
  • This is the most serious and common form.
• Type B Lactic Acidosis:
  • Occurs without obvious tissue hypoxia or hypoperfusion.
  • Subdivided into:
    • Type B1: Associated with underlying diseases (e.g., liver failure, cancer, diabetes).
    • Type B2: Caused by drugs or toxins (e.g., metformin, antiretrovirals).
    • Type B3: Due to inborn errors of metabolism or microbiome dysbiosis.
  • Can also result from intense exercise, seizures, or certain metabolic conditions.
• D-Lactic Acidosis:
  • A rare form caused by excess D-lactate, typically in patients with short bowel syndrome or after certain intestinal surgeries.
  • Human enzymes cannot efficiently metabolize D-lactate, so it can accumulate and cause neurological symptoms (encephalopathy)

In Home Treatment Options for Normal Acidosis

The common approaches include:

• Vitamin B1 or Thiamine : A deficiency of this vitamin can cause lactic acid issues
  • An Overview of Type B Lactic Acidosis Due to Thiamine (B1) Deficiency. [2023]
• Sodium bicarbonate: may help correct pH imbalance that can contribute
  • Sodium bicarbonate for the treatment of lactic acidosis [2020]
• Water / hydration: Goal is to urinate out the excessive lactic acid
• Stop any medication associated, to do this do google search or use perplexity.ai naming your medication or supplement and asking if lactic acidosis can be cause by it. Example below

Treatment Options for d-Lactic Acidosis

“Symptoms typically present after the ingestion of high-carbohydrate feedings. Neurologic symptoms include altered mental status, slurred speech, and ataxia, with patients often appearing drunk. Onset of neurologic symptoms is accompanied by metabolic acidosis and elevation of plasma D-lactate concentration. “

D-lactic acidosis [2005]

From D-lactic acidosis: an underrecognized complication of short bowel syndrome [2015]

• “Treatment includes correcting the acidosis and decreasing substrate for D-lactate such as carbohydrates in meals. In addition, antibiotics can be used to clear colonic flora.”
• “Oral antibiotics that are poorly absorbed are most effectively used locally in the gut—these include clindamycin, vancomycin, neomycin, and kanamycin” 
• “There have been reports as described above regarding probiotics being implicated as a causative agent in a few cases of D-la”

Bottom line for d-Lactic Acidosis

• Reduce or eliminate carbohydrates
• Antibiotics
• Avoid probiotics
• Get a detailed microbiome report (ideally shotgun) to identify candidate bacteria and then alter diet appropriately.

The following bacteria are cited in studies of d-lactic acidosis

• Methylomonas sp. DH-1   ⬆️    
• Pseudomonas syringae   ⬆️    
• Salmonella   ⬆️    
• Escherichia coli   ⬆️    
• Salmonella enterica subsp. enterica serovar Enteritidis   ⬆️    
• Neisseria meningitidis   ⬆️    
• Listeria monocytogenes   ⬆️    
• Sporolactobacillus   ⬆️ ⬆️    
• Staphylococcus aureus   ⬆️    
• Streptococcus pneumoniae   ⬆️ ⬆️    
• Lactococcus lactis   ⬆️    
• Lactococcus piscium   ⬆️    
• Leuconostoc   ⬆️ ⬆️    
• Weissella   ⬆️ ⬆️    
• Leuconostoc citreum   ⬆️    
• Leuconostoc mesenteroides   ⬆️ ⬆️ ⬆️    
• Leuconostoc gelidum   ⬆️    
• Lactobacillus acidophilus   ⬆️ ⬆️    
• Lactobacillus delbrueckii   ⬆️ ⬆️ ⬆️ ⬆️    
• Lactobacillus gasseri   ⬆️ ⬆️    
• Lactobacillus johnsonii   ⬆️ ⬆️    
• Lactobacillus crispatus   ⬆️    
• Lactobacillus delbrueckii subsp. bulgaricus   ⬆️    
• Limosilactobacillus reuteri   ⬆️    
• Limosilactobacillus fermentum   ⬆️    
• Limosilactobacillus mucosae   ⬆️    
• Lacticaseibacillus rhamnosus   ⬆️    
• Lacticaseibacillus casei   ⬆️    
• Lacticaseibacillus rhamnosus GG   ⬆️    
• Lactiplantibacillus plantarum   ⬆️ ⬆️ ⬆️ ⬆️ ⬆️ ⬆️    
• Ligilactobacillus salivarius   ⬆️ ⬆️    
• Lentilactobacillus buchneri   ⬆️    
• Weissella soli   ⬆️    

A theoretical diet to alter bacteria reported in studies is shown below

Probiotic/Bacteria Solution

In response to this post, this was a comment.

See what encourage it here. MAKE SURE TO EXCLUDE everything that could contain d-lactic producing probiotics (i.e. ANY probiotics, i.e. Yogurt). Items that modifies Veillonella are there.

Studies supporting this:

• Meta’omic analysis of elite athletes identifies a performance-enhancing microbe that functions via lactate metabolism [2020]
• Impact of probiotic Veillonella atypica FB0054 supplementation on anaerobic capacity and lactate [2023]

The product is V•Nella contains the proprietary FitBiomics strain Veillonella atypica.