LDH levels

Posted By
12/4/2010 8:52am
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Replies: 3

Hi!  I was diagnosed stage 2c in June 2008, since then have completed one year interferon and had my second baby.  I really have no complaints.  Just went to the oncologist for my 2.5 year check up, had a clean chest x-ray and he told me my labs were great and that I would see him in April or May, "When the snow melts"  I live in Wisconsin!!

So - my question is my LDH levels have been changing.  They were in the 150's all through out treatment, then this past June it was 379 and this past week it was 514.  The normal range goes to 618, somewhere around there.  Do I need to be worried?  Do I trust that he is not concerned and would like to wait until spring to do a scan due to my age - 31.  I would like to continue to move on with my life and watch my two little girls grow and have a happy life along with them - but this has caused me some concern.

Any ideas?  Is there a way I can lower the lab value?  Is it really indicitive of anything other than a "non-specific tumor marker"??

Thanks!

Michele

Lori C - (12/4/2010 - 9:10am)

Hi,

I am not familiar with LDH in a stage 2 diagnosis.    So please don't take my comments as the last word or get alarmed; my ONLY experience with LDH is with stage IV that had liver involvement.

In that case (with my Will), his LDH rose when his liver involvement became a problem.  I was told that elevated LDH levels were a "poor prognostic indicator".    However, this was because the melanoma had spread to the liver. 

Have you had a CT scan of the abdomen?  I would maybe consider that to rule out any further involvement; if the liver is not involved then I would feel peace about it  not being related to the LDH.

MichaelFL - (12/4/2010 - 6:58pm)

Hi Michele,

Are you taking any medications at this time? Certain ones will raise it. These may include anesthetics, aspirin, clofibrate (a lipid lowering agent used for controlling high cholesterol and triacylglyceride levels), fluorides, mithramycin (antibiotic for plasma calcium), narcotics, and procainamide (for cardiac arrhythmias).

I have discussed this with other people off this forum and I have found that mostly the LDH is checked for stage III and IV, so I am wondering what the rationale is behind having yours checked.

Nearly every type of cancer, as well as many other diseases, can cause LDH levels to be elevated. Therefore, as already stated this marker is a poor prognostic indicator and cannot be used to diagnose a particular type of cancer.

Greater-than-normal LDH levels may suggest:

Heart attack

Hemolytic anemia

Hypotension (low blood pressure)

Hypothyroidism (thyroid doesn't produce enough hormones)

Infectious mononucleosis

Intestinal ischemia (blood deficiency) and infarction (tissue death)

Liver problems or disease such as hepatitis

Muscle injury

Muscular dystrophy

Pancreatitis

Lung tissue death

Stroke

Ischemic cardiomyopathy

I’m not a doctor either, but maybe I can explain it better than some of the websites. 

Lactate dehydrogenase (LDH) is a enzyme that catalyzes the conversion of lactate to pyruvate. Many different types of cells in the body contain this enzyme. Some of the organs relatively rich in LDH are the heart, kidney, liver, and muscle. As cells die, their LDH is released and finds its way into the blood. Normal LDH levels vary with age. Because the LDH enzyme is so widely distributed throughout the body, cellular damage causes an elevation of the total serum LDH. There are five fractions that determine the diagnostic usefulness of this enzyme in the determination to comprise the LDH. These fractions are called isoenzymes and sometimes are better indicators of disease than is the total LDH.

That being said, do you by any chance have the separate numbers for the five fractions? (LDH 1-5) The separate numbers may be better able to help assit you.

LDH-1 (4H) - in the heart

LDH-2 (3H1M) - in the reticuloendothelial system

LDH-3 (2H2M) - in the lungs

LDH-4 (1H3M) - in the kidneys

LDH-5 (4M) - in the liver and striated muscle

Nearly every type of cancer, as well as many other diseases, can cause LDH levels to be elevated. LDH levels can be used to monitor treatment of some cancers, including testicular cancer, Ewing's sarcoma, non-Hodgkin's lymphoma, and some types of leukemia. Elevated LDH levels can also be caused by a number of non-cancerous conditions, including heart failure, hypothyroidism, anemia, and lung or liver problems.

Hope this helps some,

Michael

This information is for general patient educational & information purposes only. It should not be used for diagnosing/treating a health problem or disease. If you have or suspect you may have a health problem, you should consult your healthcare provider.

nicoli - (12/4/2010 - 8:43pm)

My LDH levels went into the 700's when I started drinking 4 oz of red wine each day and went down when I stopped. I now continue to drink 4 oz of Pinot Noir each day due to it's proported anti-cancer qualities and my oncologists doesn't pay much attention to the LDH level unless it goes higher than that. 

Be strong and take heart, all you who HOPE in the Lord. Ps. 31:24