Orotate
Optimal Result:
0 - 1.04 ug/mg creatinine.
Orotate is a sensitive marker of your liver’s capacity to convert toxic ammonia to non-toxic urea that you can excrete. That capacity can be increased by additional arginine. Ammonia toxicity can also be reduced by supplementation with α-ketoglutarate, magnesium, aspartic acid, and glutamic acid. Ammonia impairs brain function, causing difficulty with thinking, fatigue, headaches, and increased food sensitivities.
Associated nutrients: Arginine, Magnesium
Lab Results Explained and Tracked
What does it mean if your Orotate result is too high?
High levels of orotate may occur if there are inherited low-activity enzyme variations on its breakdown pathway or if there are higher levels of its precursor amino acids. Orotate is metabolized into uridine, a DNA building block. High levels of orotate can inhibit fatty oxidation.
High levels of orotate may also result in lower rates of DNA synthesis or repair. Long-term impairment of DNA repair may increase cancer risks. Blockage of the uridine pathway may, over time, contribute to glutamate neurotoxicity. Higher levels of orotate with lower levels of fumarate may indicate problems with the urea cycle and ammonia processing. Very high levels may inhibit fatty acid oxidation. If indicated by the signs and symptoms of ammonia excess, consider decreasing the protein load.
- Adult symptoms of ammonia excess include headaches, confusion, drowsiness, disorientation, poor motor coordination, mood swings, and hand tremors; in children vomiting, irritability and seizures may also occur. There is no nutritional cofactor for orotate breakdown enzymes.
- If there are concerns regarding DNA synthesis or repair, consider citicholine (CDP-choline 250-1,000 mg 2x daily) which is metabolized into uridine and choline.
- If fatty acid oxidation is impaired, levels of adipate and suberate (and perhaps ethylmalonate and methylsuccinate) will be increased.
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What does it mean if your Orotate result is too low?
Low levels of orotate may occur if there are low levels of precursors (amino acids), if there are nutritional enzyme inhibitions, or if a low-activity enzyme variant is inherited. Levels may be lower if the patient has an arginine deficiency or a liver disorder. Low levels of orotate and malate may further impair liver function and increase oxidative stress. Low levels of orotate may impair folate and vitamin B12 metabolism. A low-protein diet or digestive disorders that impair the absorption of proteins and amino acids may result in lower levels of orotate. Long-term (greater than overnight) fasting may decrease orotate levels by up to 50%.
- Support orotate synthesis with vitamins B2, magnesium, and zinc.
- High levels of methylmalonate, quinolinate and pyroglutamate, with low levels of cis-aconitate and isocitrate may also indicate oxidative stress. Consider antioxidant supports. Antioxidant supports may include CoQ10, alpha-lipoic acid, vitamins C and E, curcumin, resveratrol, etc. Fresh fruits and vegetables are rich in antioxidant compounds.
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