If there is little glutathione available to be recycled, pyroglutamate will be low. Low values may indicate glutathione deficiency due to oxidative stress or chemical exposure. Supplementation with reduced glutathione, N-acetyl L-cysteine, lipoic acid, and vitamin C (buffered) can raise glutathione levels. Selenium is essential to the antioxidant activity of glutathione; usually, adequate selenium can be obtained from a quality multivitamin.

Additional investigations:

• Functional Liver Detoxification Profile
• Total Antioxidant Status

Treatment considerations:

• Identify & correct toxicity

If the body cannot convert pyroglutamate forward, it will show up elevated in the urine. Pyroglutamate elevation indicates the body is using up glutathione to keep from losing amino acids. Supplementation with various amino acids, especially methionine and glycine, can help rebuild total body glutathione.

Possible causes:

• Impaired recycling to glutathione due to cofactor insufficiencies (Mg, cysteine, glycine, glutamine)
• Consistent with impaired GSH
• Elevated values may be due to supplementation with glutathione or N-acetyl cysteine.
• Elevated pyroglutamic acid may also result from a genetic disorder, metabolic effects of certain antibiotics, or intake of certain infant formulas.

Additional investigations:

• Vitamins & Minerals Analysis
• Urinary Amino Acids

Treatment considerations:

• Supplement Mg, glycine, glutamine, N-acetylcysteine (NAC)