What is Orotate (Orotic Acid)?

Orotate is a sensitive marker of your liver’s capacity to convert toxic ammonia to non-toxic urea that you can excrete. That capacity can be increased by additional arginine. Ammonia toxicity can also be reduced by supplementation with α-ketoglutarate, magnesium, aspartic acid, and glutamic acid. Ammonia impairs brain function, causing difficulty with thinking, fatigue, headaches, and increased food sensitivities.

Associated nutrients: Arginine, Magnesium

High levels:

Elevations are most commonly associated with ammonia toxicity.

Possible causes:

  • liver damage (e.g. from alcohol)
  • urea cycle dysfunction
  • ammonia excess
  • barbiturates
  • impaired metabolism due to cofactor insufficiencies (vitamins B3, B6, folate, Mg, glutamine, glycine, serine)
  • use of allopurinol or chemotherapy

Additional investigations:

  • Functional Liver Detoxification Profile
  • Vitamins & Minerals Analysis
  • Urinary Amino Acids

Possible treatments:

  • Supplement vitamins B3, B6, folic acid, Mg, glutamine, glycine, serine
  • Consider alpha-ketoglutarate and arginine for ammonia excess
  • Support liver

Low levels:

  • Low orotic acid in the presence of high ammonia indicates magnesium deficiency.
  • Low orotic acid together with low urea levels suggests your cells are not burning protein for fuel at a very high rate. This is consistent with elevated branched-chain amino acids (leucine, isoleucine and valine). It also means that you do not have gut bacteria that are producing a lot of ammonia. Check the bacterial dysbiosis markers to see if they’re consistent.



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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