Lactate dehydrogenase (LD, LDH)

Lactate dehydrogenase (LDH, LD)

Lactate dehydrogenase (LDH, LD) is an enzyme found in all blood cells that readily enters the blood serum when cells die or when cell membrane permeability increases due to toxins or an imbalance of ions in the blood. Measuring serum lactate dehydrogenase (LDH) levels and combining the results with those of other clinically relevant enzyme tests (including GOT, AspAT, CRK) provides an excellent tool to help doctors make decisions in cases involving tissue damage or changes in membrane permeability. The result report is issued in Polish. During a heart attack, serum LDH levels begin to rise within 12 hours, reaching their maximum after 48-72 hours. The elevated enzyme level is proportional to the damage to the heart muscle tissue (in severe cases, it may be as much as three times the normal level). Increased serum LDH activity may also indicate other diseases (e.g. anaemia, cancer or liver disease), so it is important to know exactly which tissue has released lactate dehydrogenase into the bloodstream.

Isoenzymes, which are different forms of lactate dehydrogenase, can indicate the type of cells that have been damaged and may be crucial in deciding on treatment.

The LDH1 and LDH2 isoenzymes were used to diagnose heart attacks because of their characteristic profile in the heart muscle. However, because changes in LD levels take a relatively long time to occur, this measurement was discontinued and the test is no longer used for this purpose.
Currently, LDH-C4, which is present in the seminal fluid of men with oligospermia, has some diagnostic value. Observations have shown that patients who received testosterone therapy and responded positively to it showed an increase in LDH-C4 activity before an increase in sperm count. These findings make it possible to identify a group of people in whom the treatment may proceed favourably and achieve therapeutic success.
High enzyme activity in people with azoospermia may be a reason to consider starting hormone therapy, which may also have a positive outcome. In the diagnosis of hepatitis, an increase in the serum LDH5 fraction is observed. Lactate dehydrogenase levels are also measured in conditions such as leukaemia, cancer, anaemia and others, indicating its considerable diagnostic importance.

The reference range for lactate dehydrogenase (LDH, LD) is 120-230 U/l, although it should be remembered that higher LDH levels are normal in children from 2-3 years of age.

A substantial increase in lactate dehydrogenase (LDH, LD) can be observed for up to 10 days after a heart attack. The following may also contribute to an increase in this enzyme in the blood:

• viral hepatitis
• liver tumours
• melanomas
• muscle damage
• anaemia
• muscle atrophy
• acute pancreatitis
• stroke
• drugs: anaesthetics, aspirin, procainamide, narcotics, alcohol
• haemolytic anaemia
• pernicious (megaloblastic) anaemia
• infectious mononucleosis
• mesenteric infarction, pulmonary embolism (tissue necrosis)
• kidney disease
• liver disease
• muscular dystrophy
• pancreatitis
• testicular cancer, lymphomas and some other cancers.

LDH levels correlate with disease severity.

• In acute pancreatitis, a level above 600 j.m./l is a poor prognostic factor.
• An increase in someone with cancer indicates a recurrence of the disease.
• In Hodgkin lymphoma, a high lactate dehydrogenase level indicates significantly advanced disease.
• In cases of jaundice, when the ratio of LDH to AST (AST is one of the liver enzymes) is above 5, jaundice caused by the breakdown of red blood cells can be suspected with a high degree of probability.

A low LDH level is not a cause for concern. A substantial decrease sometimes occurs in people who take large amounts of vitamin C.

Lactate dehydrogenase and its isoenzymes are useful diagnostic tools for assessing the extent of organ damage. Testing LDH levels is very simple and involves taking a venous blood sample in the morning. The result is available after one day.

* If your results fall outside the reference range, we recommend consulting a doctor.

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