What are the causes of elevated Lactate Dehydrogenase (LDH)?

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Last updated: May 28, 2025View editorial policy

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From the Guidelines

Increased LDH levels in the blood result from cellular damage or death, and can be caused by various conditions such as heart attack, liver disease, muscle injury, hemolysis, certain cancers, or tissue hypoxia, as stated in the study by 1.

Causes of Elevated LDH

The causes of elevated LDH levels are numerous and can be attributed to various factors, including:

  • Cellular damage or death
  • Heart attack
  • Liver disease
  • Muscle injury
  • Hemolysis (breakdown of red blood cells)
  • Certain cancers
  • Tissue hypoxia

Prognostic Value of LDH

Elevated LDH levels have been associated with a worse prognosis in certain conditions, such as osteosarcoma, as reported in the study by 1. The study found that elevated serum LDH levels were associated with a higher risk of metastatic disease and poor survival rates.

Interpretation of LDH Levels

While elevated LDH is a sensitive indicator of tissue damage, it is not specific to any particular organ or disease, making it necessary to interpret elevated levels alongside other clinical findings and specific tests, as noted in the study by 1. The degree of elevation can sometimes provide clues about the extent of tissue damage, with very high levels often seen in conditions involving widespread cellular destruction like tumor lysis syndrome or severe hemolysis.

Clinical Significance

In clinical practice, elevated LDH levels can be a useful marker for monitoring disease progression and response to treatment, as stated in the study by 1. However, it is essential to consider the clinical context and other diagnostic findings to accurately interpret the results.

From the Research

Causes of Increased LDH

  • Increased LDH levels are typically associated with a poor prognosis in many cancer types 2
  • High serum LDH levels can be a biomarker for acute liver failure and acute liver injury 3
  • Macroenzymes, such as macro-LDH, can cause elevated serum LDH levels in healthy individuals 4
  • Strenuous and enduring physical activity can transiently induce increased total LDH levels, still within its normal range 5
  • Overexpression of LDH in different cancers plays a principal role in anaerobic cellular metabolism 6

Conditions Associated with Increased LDH

  • Cancer 2, 6
  • Acute liver failure and acute liver injury 3
  • Macro-LDH 4
  • Coronary artery disease, where increased normal-range total serum LDH is associated with reduced short-term risk of CAD outcome in a low-risk, physically active population 5
  • Thyroid disorders, tuberculosis, and other common and rare diseases 6

References

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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