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.
Low levels of Fumarate can indicate a general amino acid insufficiency.
Nutritional Considerations:
Low levels of fumarate have been correlated with lower levels of: Tyrosine and/or Phenylalanine, B6, B2, Arginine, Essential Amino Acids and CoQ10.
Clinical Observation:
Use of malic acid supplements (such as magnesium malate) often can help short term as the underlying cause of the low result is clinically determined.
Possible Interfering Factors:
Diet low in protein or insufficient in essential amino acid balance. Use of acid blockers that decrease assimilation/breakdown of ingested protein.
Clinical Considerations:
Some individuals with low level of fumarate may have an increased exacerbation of psoriasis. Low levels may correlate with increased fatigue and sense of low energy to perform daily functions. May wish to look at confirmatory tests for possible low iron status, such as ferritin, TIBC, Total Iron, Transferrin. Can be symptomatic of poor conversion of phenylalanine to tyrosine or altered urea cycle metabolism.
Important Clinical Note:
Since Phenylalanine and Tyrosine feed into the CAC pathway via fumarate, supplementation with these two amino acids may be particularly indicated for individuals with lower mood, since the catecholamine pathway (dopamine, epinephrine, norepinephrine) is also fueled by these amino acids.
Understand and improve your laboratory results with our health dashboard.
Upload your lab reports and get your interpretation today.
Our technology helps to understand, combine, track, organize, and act on your medical lab test results.
- Check levels and intake of amino acids that flow into the Krebs cycle: tyrosine and phenylalanine.
- Evaluate B-complex status.
- In chronic kidney disease in those with type 2 diabetes, urinary fumaric acid and malic acid predicted progression of disease.
-----------------------------
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.
Interpret Your Lab Results
Upload your lab report, and we'll interpret and provide you with recommendations today.
Get StartedMonthly plan
Annual plan
Own it for life
Our exclusive data entry service is a convenient way to get your results into your private dashboard. Simply attach an image or a file of your lab test results, and one of our qualified data entry team members will add the results for you. We support all sorts of files, whether PDFs, JPGs, or Excel. This service is excellent whether you have a lot of reports to upload or are too busy to do the data entry yourself.
We strive to make the data entry process easy for you. Whether by offering dozens of templates to choose from that pre-populate the most popular laboratory panels or by giving you instant feedback on the entered values. Our data entry forms are an easy, fast, and convenient way to enter the reports yourself. There is no limit on how many lab reports you can upload.
$15 /month
billed every month
Most popular
Data entry included
$79 /year
$6.60/month billed annually
Data entry included
$250 /once
own it for life
Are You a Health Professional?
Get started with our professional plan
Welcome to Healthmatters Pro.
Save time on interpreting lab results with the largest database of biomarkers online. In-depth research on any test at your fingertips, all stored and tracked in one place. Learn more
Pro Monthly Plus
for health professionals
$75 per month
At HealthMatters, we're committed to maintaining the security and confidentiality of your personal information. We've put industry-leading security standards in place to help protect against the loss, misuse, or alteration of the information under our control. We use procedural, physical, and electronic security methods designed to prevent unauthorized people from getting access to this information. Our internal code of conduct adds additional privacy protection. All data is backed up multiple times a day and encrypted using SSL certificates. See our Privacy Policy for more details.
1-Methylhistidine, 1-Methylhistidine (Plasma), 2-,3-, and 4-Methylhippuric acid, 2-Methylhippuric Acid, 2-Methylsuccinic Acid, 3,4-Dihydroxyhydrocinnamic Acid, 3,5-Dihydroxybenzoic Acid, 3-Methylhistidine (Plasma), 3-Phenylpropionylglycine, 4-Hydroxybenzoic Acid, 4-Hydroxyphenylacetic Acid, 4-Hydroxyphenylpyruvic Acid, 5-Hydroxyindoleacetic Acid, 8-Hydroxy-2'-deoxyguanosine, a-Hydroxybutyric Acid, a-Keto-b-methylvaleric Acid, a-Ketobutyric Acid, a-Ketoglutaric Acid, a-Ketoisocaproic Acid, a-Ketoisovaleric Acid, a-Aminoadipic Acid (Plasma), Adipic Acid, Alanine, Alanine (Plasma), Aldosterone, Anserine (Plasma), Anthranilic Acid, Arabinitol, Arginine (Plasma), Arginosuccinic Acid, Arginosuccinic Acid (Plasma), Asparagine (Plasma), Aspartic Acid (Plasma), b-Hydroxybutyric Acid, b-Hydroxyisovaleric Acid, b-Alanine (Plasma), Benzoic Acid, Benzoylform, Branched Chain Alpha-Keto Organic Acids, Carnosine, Carnosine (Plasma), cis-Aconitic Acid, Citric Acid, Citrulline (Plasma), Cortisol, Cortisone, Creatinine, Cystathionine (Plasma), Cystine (Plasma), D-Lactic Acid, Equol, Ethanolamine (Plasma), Ethylmalonic Acid, Formiminoglutamic Acid, Fructose, Fumaric Acid, g-Aminobutyric Acid (Plasma), Glucaric Acid, Glucose, Glutamic Acid (Plasma), Glutamine (Plasma), Glutamine / Glutamate Ratio (Plasma), Glutaric Acid, Glycine (Plasma), Glycylproline (Plasma), Hexanoylglycine, Hippuric Acid, Histidine (Plasma), Homocitrulline (Plasma), Homocystine (Plasma), Homogentisic Acid, Homovanillic Acid, Hydroxykynurenine, Hydroxyproline, Hydroxyproline (Plasma), Indoleacetic Acid, Isocitric Acid, Isoleucine/allo-Isoleucine (Plasma), KT Ratio, KT Ratio (Plasma), Kynurenic Acid, Kynurenine, Kynurenine (Plasma), Lactic Acid, Leucine (Plasma), Lysine (Plasma), Malic Acid, Mandelic Acid, Methionine (Plasma), Methylmalonic Acid, Microalbumin, Ornithine, Ornithine (Plasma), Orotic Acid, Oxalic Acid, pH, Phenylacetic Acid, Phenylalanine (Plasma), Phosphate, Phosphoethanolamine (Plasma), Picolinic Acid, Pimelic Acid, Proline (Plasma), Pyridoxic Acid, Pyroglutamic Acid, Pyruvic Acid, Quercetin, Quinolinic Acid, Sarcosine (Plasma), Sebacic Acid, Serine (Plasma), Suberic Acid, Suberylglycine, Succinic Acid, Sulfocysteine (Plasma), Tartaric Acid, Taurine (Plasma), Threonine (Plasma), Total Branched Chain Amino Acids (Plasma), Tryptophan, Tryptophan (Plasma), Tyrosine, Tyrosine (Plasma), Valine (Plasma), Vannilylmandelic Acid, Xanthurenic Acid