Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.
Citrate, cis-Aconitate (and Isocitrate) are involved in both energy production and removal of toxic ammonia.
High levels can indicate ammonia toxicity. Chronic loss of these valuable compounds can contribute to loss of organ reserve and disturbances in neurological function. If they are low they can indicate a need for essential amino acids, especially arginine.
Possible causes:
Low or high pyruvic acid or low acetyCoA (from fatty acid oxidation)
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Elevations may be due to increased intake of citric acid-containing foods or result from intestinal yeast-producing citric acid, or perhaps inhibiting the human citric acid cycle. Increased citric acid may also indicate depletion of glutathione, which is required for the enzyme, aconitase to metabolize both aconitic and citric acids. If pyroglutamic acid values are low, consider supplements containing glutathione, or n-acetyl-cysteine.
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2-Hydroxybutyric, 2-Hydroxybutyric (Males Age 13 and Over), 2-Hydroxyhippuric, 2-Hydroxyhippuric (Females Under Age 13), 2-Hydroxyhippuric (Males Age 13 and Over), 2-Hydroxyisocaproic, 2-Hydroxyisocaproic (Males Age 13 and Over), 2-Hydroxyisovaleric, 2-Hydroxyisovaleric (Males Age 13 and Over), 2-Hydroxyphenylacetic, 2-Hydroxyphenylacetic (Males Age 13 and Over), 2-Oxo-4-methiolbutyric, 2-Oxo-4-methiolbutyric (Males Age 13 and Over), 2-Oxoglutaric, 2-Oxoglutaric (Males Age 13 and Over), 2-Oxoisocaproic, 2-Oxoisocaproic (Males Age 13 and Over), 2-Oxoisovaleric, 2-Oxoisovaleric (Males Age 13 and Over), 3-Hydroxy-3-methylglutaric (HMG), 3-Hydroxy-3-methylglutaric (Males Age 13 and Over), 3-Hydroxybutyric, 3-Hydroxybutyric (Males Age 13 and Over), 3-Hydroxyglutaric, 3-Hydroxyglutaric (Males Age 13 and Over), 3-Indoleacetic, 3-Indoleacetic (Males Age 13 and Over), 3-Methyl-2-oxovaleric, 3-Methyl-2-oxovaleric (Males Age 13 and Over), 3-Methylglutaconic, 3-Methylglutaconic (Males Age 13 and Over), 3-Methylglutaric, 3-Methylglutaric (Females Under Age 13), 3-Methylglutaric (Males Age 13 and Over), 3-Oxoglutaric, 3-Oxoglutaric (Males Age 13 and Over), 3-Oxoglutaric (Males Under Age 13), 4-Cresol, 4-Cresol (Males Age 13 and Over), 4-Hydroxybenzoic, 4-Hydroxybenzoic (Males Age 13 and Over), 4-Hydroxybutyric, 4-Hydroxybutyric (Females Under Age 13), 4-Hydroxybutyric (Males Age 13 and Over), 4-Hydroxyhippuric, 4-Hydroxyhippuric (Males Age 13 and Over), 4-Hydroxyphenylacetic, 4-Hydroxyphenylacetic (Females Under Age 13), 4-Hydroxyphenylacetic (Males Age 13 and Over), 4-Hydroxyphenyllactic, 4-Hydroxyphenyllactic (Males Age 13 and Over), 5-Hydroxyindoleacetic (5-HIAA), 5-Hydroxyindoleacetic (5-HIAA) (Males Age 13 and Over), 5-Hydroxymethyl-2-furoic, 5-Hydroxymethyl-2-furoic (Males Age 13 and Over), 5-Hydroxymethyl-2-furoic (Males Under Age 13), Acetoacetic, Acetoacetic (Males Age 13 and Over), Aconitic, Aconitic (Males Age 13 and Over), Adipic, Adipic (Males Age 13 and Over), Arabinose, Arabinose (Females Under Age 13), Arabinose (Males Age 13 and Over), Arabinose (Males Under Age 13), Ascorbic, Ascorbic (Males Age 13 and Over), Ascorbic (Males Under Age 13), Carboxycitric, Carboxycitric (Males Age 13 and Over), Citramalic, Citramalic (Males Age 13 and Over), Citric, Citric (Males Age 13 and Over), DHPPA (Beneficial Bacteria), DHPPA (Beneficial Bacteria) (Males Age 13 and Over), Dihydroxyphenylacetic (DOPAC), Dihydroxyphenylacetic (DOPAC) (Females Under Age 13), Dihydroxyphenylacetic (DOPAC) (Males Age 13 and Over), Dihydroxyphenylacetic (DOPAC) (Males Under Age 13), Ethylmalonic, Ethylmalonic (Males Age 13 and Over), Fumaric, Fumaric (Males Age 13 and Over), Furan-2,5-dicarboxylic, Furan-2,5-dicarboxylic (Males Age 13 and Over), Furancarbonylglycine, Furancarbonylglycine (Females Under Age 13), Furancarbonylglycine (Males Age 13 and Over), Furancarbonylglycine (Males Under Age 13), Glutaric, Glutaric (Females Under Age 13), Glutaric (Males Age 13 and Over), Glyceric, Glyceric (Males Age 13 and Over), Glycolic, Glycolic (Males Age 13 and Over), Hippuric, Hippuric (Females Under Age 13), Hippuric (Males Age 13 and Over), Homogentisic, Homogentisic (Males Age 13 and Over), Homovanillic (HVA), Homovanillic (HVA) (Males Age 13 and Over), HPHPA, HPHPA (Males Age 13 and Over), HVA / VMA Ratio, HVA / VMA Ratio (Males Age 13 and Over), HVA/ DOPAC Ratio, HVA/ DOPAC Ratio (Males Age 13 and Over), Kynurenic, Kynurenic (Males Age 13 and Over), Lactic, Lactic (Males Age 13 and Over), Lactic (Males Under Age 13), Malic, Malic (Males Age 13 and Over), Malic (Males Under Age 13), Malonic, Malonic (Males Age 13 and Over), Mandelic, Mandelic (Males Age 13 and Over), Methylcitric, Methylcitric (Males Age 13 and Over), Methylmalonic, Methylmalonic (Males Age 13 and Over), Methylsuccinic, Methylsuccinic (Males Age 13 and Over), N-Acetylaspartic, N-Acetylaspartic (Males Age 13 and Over), N-Acetylcysteine (NAC), N-Acetylcysteine (NAC) (Males Age 13 and Over), Orotic, Orotic (Females Under Age 13), Orotic (Males Age 13 and Over), Oxalic, Oxalic (Females Under Age 13), Oxalic (Males Age 13 and Over), Pantothenic (B5), Pantothenic (B5) (Males Age 13 and Over), Phenyllactic, Phenyllactic (Males Age 13 and Over), Phenylpyruvic, Phenylpyruvic (Males Age 13 and Over), Phosphoric, Phosphoric (Males Age 13 and Over), Pyridoxic (B6), Pyridoxic (B6) (Males Age 13 and Over), Pyroglutamic, Pyroglutamic (Males Age 13 and Over), Pyruvic, Pyruvic (Females Under Age 13), Pyruvic (Males Age 13 and Over), Quinolinic, Quinolinic (Males Age 13 and Over), Quinolinic / 5-HIAA Ratio, Sebacic, Sebacic (Males Age 13 and Over), Suberic, Suberic (Males Age 13 and Over), Succinic, Succinic (Females Under Age 13), Succinic (Males Age 13 and Over), Tartaric, Tartaric (Males Age 13 and Over), Thymine, Thymine (Males Age 13 and Over), Tricarballylic, Tricarballylic (Females Under Age 13), Tricarballylic (Males Age 13 and Over), Tricarballylic (Males Under Age 13), Uracil, Uracil (Males Age 13 and Over), Vanillylmandelic (VMA), Vanillylmandelic (VMA) (Males Age 13 and Over)