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Operational Medicine 2001
Lactic Acid Dehydrogenase (LDH, LD)
LDH Isoenzymes

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LDH is an enzyme found within the cells of:
  • Heart
  • Liver
  • Skeletal Muscle
  • Kidney
  • Brain 
  • Lung

Whenever these structures are injured, either through trauma or disease, LDH can be released into the blood.

Elevations found in:

  • Any traumatic injury to any of these structures. 
  • Any disease affecting one of these structures.
  • Acute myocardial infarction (2-10X normal)
  • Pulmonary Infarction (2-4X normal)
  • Liver disease 
  • Infectious mononucleosis
  • Cancer
  • Hemorrhagic shock
  • Hemolysis
  • Hypothyroidism
  • Once elevated, the LDH remains elevated for up to 2 weeks days, if the injury is acute. 
  • If there is on-going injury, the LDH will remain elevated indefinitely.

LDH Isoenzymes

These five isoenzymes (LD1, LD2, LD3, LD4, and LD5) are found in somewhat different concentrations in different tissues. Some patterns of elevations have been observed:

  • LD1 and LD2 are elevated in acute MI, hemolysis and renal infarction.
  • Sometimes only LD1 is elevated in acute MI
  • When LD1 > LD2, this is strong suggestive evidence of an acute MI
  • LD3 elevates with pneumonia and pulmonary infarction
  • LD5 elevates in some cancers and liver disease
  • A frequent elevation of LDH in patients with malignancy is in LD2, LD3 and LD4.

Normal Values of LDH*

Men 95-200 U/L

Women

 200-450 U/L
Pregnancy 200-450 U/L

 

Normal Values of LDH Isoenzymes*

  % of Total

LD1

 14-26
LD2 29-39
LD3 20-26
LD4 8-16
LD5 6-16

*These are general values taken from a variety of sources. The actual normal values may vary from lab to lab and from one type of testing protocol to another.

Approved for public release; Distribution is unlimited.

The listing of any non-Federal product in this CD is not an endorsement of the product itself, but simply an acknowledgement of the source. 

Operational Medicine 2001

Health Care in Military Settings

Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300

Operational Medicine
 Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
  January 1, 2001

 United States Special Operations Command
7701 Tampa Point Blvd.
MacDill AFB, Florida
33621-5323

*This web version is provided by The Brookside Associates Medical Education Division.  It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense.

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