What is Citrate or Cis-Aconitic Acid?

Citric acid (aka Citrate), cis-Aconitic acid, and Isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.

citric acid krebs cycle.jpg

krebs cycle at a glance citric acid cycle high low treatment cis-aconitic acid

Illustration Of Krebs Cycle - Tricarboxylic Acid (citric) Cycle

Citrate, cis-Aconitate (and Isocitrate) are involved in both energy production and removal of toxic ammonia.

High levels can indicate ammonia toxicity. Chronic loss of these valuable compounds can contribute to loss of organ reserve and disturbances in neurological function. If they are low they can indicate a need for essential amino acids, especially arginine.

High levels:

Impaired metabolism due to toxic metals (Fl, Hg, As, Sb) OR low cofactors (Fe, GSH— depleted in oxidative stress); OR high amounts of dietary citric acid; OR metabolic acidosis (if mildly increased cis-aconitic acid but markedly increased citric acid). High Citrate and Cis-aconitate can indicate arginine insufficiency for ammonia clearance through the Urea Cycle Consider supplementing with arginine Rule out toxic metals; glutathione, N-acetylcysteine, Mg, or L-glutamine; consider antioxidants; rule out pancreatic insufficiency (can lead to metabolic acidosis from deficient bicarbonate).

Possible causes:

  • Impaired metabolism due to toxic metals (Fl, Hg, As)
  • Low glutathione
  • High amounts of dietary citric acid
  • Metabolic acidosis (if mildly increased cis-aconitic acid but markedly increased citric acid)

Additional investigations:

  • Comprehensive Urine Elements Profile
  • Functional Liver Detoxification Profile
  • Complete Digestive Stool Analysis

Treatment considerations:

  • Rule out toxic metals
  • Glutathione

Low levels:

Possible causes:

  • Low or high pyruvic acid or low acetyCoA (from fatty acid oxidation)


The information on is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.

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