Optimal Result: 0 - 5.8 mmol/mol creatinine.

Citramalic acid and tartaric acid are yeast metabolites that are also influenced by dietary intake of fruits, wine, and sugars.

Common Dietary Sources:

Apples, cranberries, sugar beets


- Sugimoto N, Forsline P, Beaudry R. Volatile profiles of members of the USDA Geneva Malus Core Collection: utility in evaluation of a hypothesized biosynthetic pathway for esters derived from 2-methylbutanoate and 2-methylbutan-1-ol. J Agric Food Chem. 2015;63(7):2106-2116.

- Hulme AC. The isolation of l-citramalic acid from the peel of the apple fruit. Biochim Biophys acta. 1954;14(1):36-43.

- Liu H, Garrett TJ, Su Z, Khoo C, Gu L. UHPLC-Q-Orbitrap-HRMSbased global metabolomics reveal metabolome modifications in plasma of young women after cranberry juice consumption. J Nutri Biochem. 2017;45:67-76.

- Khorassani R, Hettwer U, Ratzinger A, Steingrobe B, Karlovsky P, Claassen N. Citramalic acid and salicylic acid in sugar beet root exudates solubilize soil phosphorus. BMC Plant Biol. 2011;11:121.

- Marconi O, Floridi S, Montanari L. Organic acids profile in tomato juice by HPLC with UV detection. J Food Qual. 2007;30(2):253-266.

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

Though often used by clinicians to gain insight into yeast overgrowth, it should be noted that fruit intake can influence levels. High levels may simply reflect a high dietary fruit intake. A high intake of sugars feeds gastrointestinal yeast, which can promote yeast overgrowth. When these markers are elevated, and dietary influences have been ruled out, a stool test may be warranted to evaluate the presence of yeast in the GI tract.

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