Isocitric Acid

Optimal Result: 22 - 65 mmol/mol creatinine.

A two-carbon group from Acetyl-CoA is transferred to oxaloacetate to form citric acid. Citric acid is then converted to isocitric acid through a cis-aconitic intermediate using the enzyme aconitase. Aconitase is an iron-sulfate protein that controls iron homeostasis.


- Bullock GC, Delehanty LL, Talbot A-L, et al. Iron control of erythroid development by a novel aconitase-associated regulatory pathway. Blood. 2010;116(1):97-108.

- Paul BT, Manz DH, Torti FM, Torti SV. Mitochondria and Iron: current questions. Expert Rev Hematol. 2017;10(1):65-79. 120. Han D, Canali R, Garcia J, Aguilera R, Gallaher TK, Cadenas E. Sites and Mechanisms of Aconitase Inactivation by Peroxynitrite: Modulation by Citrate and Glutathione. Biochemistry. 2005;44(36):11986-11996.

- Pace C, Dagda R, Angermann J. Antioxidants protect against arsenic induced mitochondrial cardio-toxicity. Toxics. 2017;5(4):38.

- Zatta P, Lain E, Cagnolini C. Effects of aluminum on activity of Citric Acid Cycle enzymes and glutamate dehydrogenase in rat brain homogenate. Eur J Biochem. 2000;267(10):3049-3055.

- Carocci A, Rovito N, Sinicropi MS, Genchi G. Mercury toxicity and neurodegenerative effects. In: Rev Environ Contam Toxicol. Springer; 2014:1-18.

- Houston MC. The role of mercury and cadmium heavy metals in vascular disease, hypertension, coronary heart disease, and myocardial infarction. Altern Ther Health Med. 2007;13(2):S128-S133.

What does it mean if your Isocitric Acid result is too low?

Low levels of these analytes may reflect insufficient precursors, or suboptimal glycolysis or fatty acid oxidation.

What does it mean if your Isocitric Acid result is too high?

Iron deficiencies and overload at the systemic or cellular levels can negatively impact the aconitase enzyme and overall mitochondrial health and function. Due diligence with iron assessment is recommended when levels of these organic acids are abnormal. Glutathione may also be an important means of modulating aconitase activity during oxidative stress. Various toxins may influence mitochondrial enzymes and contribute to mitochondrial dysfunction, such as fluoride, aluminum, mercury, arsenic, and tin.

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