Benzoate: Hepatic Phase II glycine conjugation
Hippurate: Intestinal bacterial overgrowth
Microbes resident in the large intestine of the human body help to break down complex aromatic compounds in dietary plant matter, freeing up benzoic acid, which enters the bloodstream. The liver can add the amino acid glycine to benzoic acid to form hippuric acid, which re-enters the blood and is absorbed by the kidneys. As a result, the kidneys excrete hundreds of milligrams of hippuric acid into the urine every day.
Dietary polyphenols include fruits, vegetables, whole grains, coffee, tea, and nuts. Abnormalities of urinary benzoate and hippurate may reveal detoxification or dysbiosis (=microbial imbalance) issues.
| Benzoate | Hippurate | Other bacterial markers | Interpretation |
|
Low
|
Low
|
No elevations | Low intake of benzoate and precursors, plus normal or low dietary polyphenol conversion by intestinal mircrobes |
| Multiple elevations | Low intake of benzoate and precursors with intestinal microbial overgrowth of species that do not metabolize dietary polyhenols (very rare) | ||
|
High
|
Low
|
No elevations | Glycine conjugation deficit (possibly genetic polymorphic phenotype if hippurate is very low); dietary benzoate or precursor intake. |
| Multiple elevations | Glycine conjugation deficit; presume benzoate is at least partially from intestinal microbial action on dietary polyphenols. | ||
|
Low
|
High
|
No elevations | Normal hippurate production via active glycine conjugation; No indication of microbial overgrowth. |
| Multiple elevations | Normal hippurate production via active glycine conjugation; Presume hippurate is at least partially derived from intestinal microbial action on dietary polyphenols. | ||
|
High
|
High
|
No elevations | Very high dietary benzoate or precursor intake with partial conversion to hippurate. |
| Multiple elevations | Very high benzoate load, some, or all, of which is contributed by intestinal microbial action on dietary polyphenols. |
Possible treatment options:
Take appropriate steps to ensure favorable gut microflora population to normalize gut permeability. Treatment for can include diet changes, pre- and probiotics, mucosal support, and possibly further testing such as a stool test or immune reactions from food.
References:
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