Pyruvic acid

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 is an intermediate compound in the metabolism of carbohydrates, proteins, and fats. Pyruvic acid is found to be associated with Fumarase deficiency, which is an inborn error of metabolism. It is also a metabolite of Corynebacterium. Elevated levels of pyruvic acid are associated with 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 when the value exceeds 100 mmol/mol creatinine.