Pyruvic

Elevated by a number of nonspecific factors, including vigorous exercise, bacterial overgrowth of the GI tract, shock, poor perfusion, B-vitamin deficiency, mitochondrial dysfunction or damage, and anemia, among others. High pyruvic acid indicates the possibility of an inborn error of metabolism increases as the value exceeds 100 mmol/mol creatinine.

- Impaired metabolism due to cofactor insufficiencies or toxic metals (As, Pb, Hg, Cd)

- Muscle injury

- Severe adrenal insufficiency (impaired conversion of pyruvate to alanine)

Additional investigations if high:

- Vitamins & Minerals Analysis

- Comprehensive Urine Elements Profile

- Adrenal Hormone Profile

Treatment considerations if high:

- Supplement cofactors (B1, B2, B3, B5, Mg, Lipoic acid)

- Remove toxic metals

- Adrenal support if required

- Deficient substrate for energy production

- Impaired production from glycogen (glycogenolysis), carbohydrates (glycolysis), or proteins (gluconeogenesis)

Additional investigations if low:

- Urinary Amino Acids

- Vitamin & Mineral Analysis

- Adrenal Hormone Profile

Treatment considerations if low:

- Gluconeogenic amino acids (e.g. L-alanine, glycine, L-serine)

- B6, Mg

- Correct glucose/insulin imbalances

- Adrenal support if required

- Consider Ca pyruvate supplementation

Pyruvic Acid feeds into the citric acid cycle & converts into acetyl CoA. Pyruvate is formed from carbohydrate via glucose or glycogen & secondarily from fats (glycerol) & glycogenic amino acids.