Pyruvate 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
Nutrient associations:
Vitamins B1, B3, B5, Lipoic acid
Metabolic pathway:
Anaerobic energy production
High levels:
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.
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- 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
Low levels:
- 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
