Optimal Result: 10 - 78 mmol/mol creatinine.

Alanine is a nonessential amino acid. It is the second most abundant amino acid in circulation, after glutamine. It is found in many foods including eggs, meat, lentils, and fish. Alanine is involved in sugar metabolism for energy and is important in immune system function, specifically T lymphocyte activation. Interestingly, alanine is an agonist that binds to the glycine site of N-methyl-d-aspartate (NMDA) receptors in the brain and improves the positive and cognitive symptoms of patients with schizophrenia.

Alanine plays an important role in BCAA metabolism. BCAA are released from skeletal muscle during prolonged exercise. Their carbon backbones are used as fuel, while their nitrogen portion is used to form alanine. Alanine then gets converted to pyruvate and subsequently glucose in the liver using the glucose-alanine cycle (Cahill Cycle). This cycle is critical for regenerating glucose in prolonged fasting and is upregulated when glucagon, epinephrine, and cortisol are elevated.

It ultimately helps clear ammonia and provides glucose to energy-deprived muscle tissue.

The Cahill Cycle uses the enzyme alanine aminotransferase (ALT). ALT catalyzes the transfer of the amino group from alanine to an alpha keto acid (typically alpha-ketoglutarate), forming pyruvate and glutamate as byproducts. ALT is commonly measured on standard laboratory chemistry profiles to assess liver health.


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What does it mean if your ALANINE result is too low?

May point to hypoglycemic conditions because of its role in gluconeogenesis. Supplement with alanine and the branched chain amino acids leucine, isoleucine and valine.

Low protein intake, low BCAA levels, gastrointestinal malabsorption and maldigestion, or increased demands in gluconeogenesis, may result in lower alanine levels.

There is some literature to suggest that vitamin B6 and vitamin B3 normalized plasma alanine levels.

Because of its role in the CNS, lower plasma alanine levels have been seen in schizophrenic patients and an increase in plasma alanine correlated with symptom improvement.

What does it mean if your ALANINE result is too high?

Possible inadequate cellular energy substrates. Check for hypoglycemia or for exercise prior to blood draw. Chronic use of alanine for energy can lead to muscle wasting. Supplement the branched-chain amino acids.

High protein intake of alanine-rich foods can elevate levels. Because of the relationship between alanine and the clearance of ammonia and nitrogen, it may be elevated in urea cycle disorders to serve as a reservoir for waste nitrogen.

Biotin, thiamine, other nutrients are cofactors within the pathways of alanine metabolism. Functional need for these nutrients may elevate alanine levels.

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