Lactate and panic across infusion and exercise contexts: an interoceptive context-gating hypothesis
Lactate is an oxidative fuel, a gluconeogenic precursor, and a signaling molecule. Sodium lactate challenges can provoke panic in susceptible patients, whereas exercise-associated hyperlactatemia seldom does. However, lactate clamps at rest and during exercise also provide exogenous lactate without reported panic, so endogenous versus exogenous origin cannot explain the observations. We review…
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