Organic Acids, Comprehensive, Quantitative

Fumaric

Optimal result: 0 – 1 mmol/mol creatinine

Quest Diagnostics

By Healthmatters Editorial Team

Peer-reviewed sources

Excess urea cycle function can generate high levels of fumarate, because fumaric acid is one of the urea cycle products.

Higher levels of these compounds in urine indicate inefficiencies in energy production.

Possible causes:

- Impaired metabolism due to low B3

- May be secondary to high pyruvate or lactate

- Yeast overgrowth

Additional investigations:

- Vitamin and Mineral Analysis

- Comprehensive Urine Elements Analysis

- Adrenal Hormone Profile

- Complete Digestive Stool Analysis

Treatment considerations:

- Consider B3 supplementation, unless secondary to high pyruvate or lactate

- Rule out/address yeast overgrowth

If α-ketoglutarate is elevated along with succinate, malate, and fumarate, you may need additional CoQ10, a nutrient that enables the body to use oxygen to generate large amounts of energy.

Low levels of Fumarate can indicate a general amino acid insufficiency.

Fumarate (together with Succinate and Malate) is used in the body’s metabolic pathway that generates cellular energy – the Citric Acid Cycle.

Fumarate (together with Succinate and Malate) is used in the body’s metabolic pathway that generates cellular energy – the Citric Acid Cycle. This cycle critically supports organ maintenance and neurological function. Fumarate is also a product of the urea cycle. Much like vitamin D, fumaric acid is formed by the body, in the skin, during exposure to sunlight.

Organize and understand all your lab results

Start organizing — $15/mo →

For Health Professionals Healthmatters Pro Multiple clients’ results in one dashboard. See Pro plans →

Fumaric

Every lab result you’ve ever had, charted and explained.

Healthmatters is a tracker for your lab results. Upload a report from any lab, any country — every marker charted and explained.

Start with my report →

Clinical Sources & References

All our content is backed by peer-reviewed studies, academic research, and trusted medical sources. We’re committed to accuracy and transparency — see our editorial policy for details.

Article Review Log

Written by Healthmatters Editorial Team

Organize and understand all your lab results

Start organizing — $15/mo →

For Health Professionals Healthmatters Pro Multiple clients’ results in one dashboard. See Pro plans →

Healthmatters Lifetime Plan

Pay $250. Track your health forever

One payment. No renewals. Yours for life.

10,000+ biomarkers explained · trends over time

See other plans →

Secure checkout via Stripe · GDPR & HIPAA

We accept results from any lab

LabCorp Quest Diagnostics Genova Diagnostics DUTCH Test Doctor's Data Vibrant America ZRT Laboratory Cyrex Labs + any other lab

What members are saying

★★★★★ 10,000+ happy members

★★★★★

"Watching my numbers move over the years — instead of forgetting last time's results — completely changed how I manage my health."

Daniel

Member since 2022

★★★★★

"Living across several countries made keeping my lab results organized a real challenge. Healthmatters brought my results from the USA, Spain, and Germany together — 20 years of history, with long-term trends instead of scattered reports."

Ben

Member since 2021 · tracks across countries

★★★★★

"Standard lab ranges are too wide for how I practice — 'normal' isn't optimal. I set my own bands, so a client sees yellow before a marker goes officially out of range. That's the conversation I want to be having."

Dr. Alexandra

Functional medicine · 6 yrs on Pro