The phenomenon known as the lactate paradox has been a topic of heated debate since it gained worldwide attention following Operation Everest in the early 1980s. What began as the simple finding that blood lactate (blood [La]) for a given sub-maximal workload or VO2 following acclimatization to high altitude is reduced compared with sea-level values, morphed into a complex set of parameters that have been redefined several times in the nearly 30 years that the lactate paradox has been researched. Though several strong hypotheses have been proposed to, to date, no one hypothesis has been able fully to explain the lactate paradox. The goal of the current article was to bring together the most prominent studies done on the lactate paradox and illuminate the details brought forth by each. In doing so we hope to stimulate new hypotheses and research studies that will further our understanding of the lactate paradox.
