Biomarkers

What is Pyruvate/Pyruvic Acid?

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.

  • 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

 

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