Optimal Result: 0.03 - 1.8 mmol/mol creatinine.

What is 2-Hydroxybutyric acid?

2-Hydroxybutyric acid (aka α-Hydroxybutyrate) is a by-product of glutathione production. Levels of 2-Hydroxybutyric acid in the urine may reflect levels of glutathione production.

What is Glutathione?

Glutathione is an important antioxidant that can prevent damage to cellular components caused by reactive oxygen species such as free radicals, peroxides, lipid peroxides, and heavy metals.

Glutathione is constantly being used up in the removal of toxic molecules and prevention of oxidative damage.

2-Hydroxybutyric acid is a by-product from the process in which the body forms more glutathione. When that process is running at high rates, α-hydroxybutyrate excretion is increased.

What does it mean if your 2-Hydroxybutyric result is too high?

All of the conditions associated with increased 2-Hydroxybutyric acid (aka α-Hydroxybutyrate) excretion may be related to increased rates of hepatic glutathione synthesis from methionine. Elevated 2-Hydroxybutyric acid thus shows increased flow through the hepatic glutathione synthesis pathway as required during times of increased oxidative stress or for detoxification functions.

- Smoking, poor diet, and lack of exercise significantly inhibit the activity of AHBD (=Alpha-Hydroxybutyrate dehydrogenase catalyzes oxidation of AHB to acetate), suggesting that urinary elevation of Alpha-Hydroxybutyrate may be related to these factors via increased glutathione demand.

- High 2-Hydroxybutyric acid is also found during phases of increased lymphocyte destruction in infectious diseases such as measles.

- Elevated 2-Hydroxybutyric acid is found in birth asphyxia and in inherited metabolic diseases such as “cerebral” lactic acidosis, glutaric aciduria type II, dihydrolipoyl dehydrogenase deficiency, and propionic acidemia.

- 2-Hydroxybutyric acid is also an early marker for both insulin resistance and impaired glucose regulation that appears to arise due to increased lipid oxidation and oxidative stress.

- Elevated levels of 2-Hydroxybutyric acid in the plasma is a good marker for early-stage type II diabetes.

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