cis-Aconitic Acid

Possible causes:

- Impaired metabolism due to toxic metals (Fl, Hg, As) 
- OR low cofactors (Fe, GSH—depleted in oxidative stress)
- OR high amounts of dietary citric acid
- OR metabolic acidosis (if mildly increased cisaconitic acid but markedly increased citric acid).
- Low glutathione
- High amounts of dietary citric acid
- Metabolic acidosis (if mildly increased cis-aconitic acid but markedly increased citric acid)
- High levels can indicate ammonia toxicity or arginine insufficieny.
- An elevated level of this organic acid may be an indication of poor supplies or metabolism of amino acids. A clinical sign is fatigue.
- If elevated with orotate, isocitrate and citrate, suspect hyperammonia.
- High Citrate and Cis-aconitate can indicate arginine insufficiency for ammonia clearance through the Urea Cycle.

Additional investigations:

- Comprehensive Urine Elements Profile

- Functional Liver Detoxification Profile

- Complete Digestive Stool Analysis

Treatment considerations:

- Rule out toxic metals

- Glutathione-

- Consider supplementing with arginine and possibly cysteine.

Some foods high in argininer are:

- Pumpkin seeds

- Sesame seeds

- Dried walnuts

- Almonds

- Pine nuts

- Soy beans

- Chickpeas

- Seaweed

(Do not take L-arginine if you have had a recent heart attack.)

Additional investigations:

- Comprehensive Urine Elements Profile
- Functional Liver Detoxification Profile
- Complete Digestive Stool Analysis
- Rule out toxic metals and check for iron deficiency

Possible causes:

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

Cis-Aconitic Acid is involved in both energy production and removal of toxic ammonia.