Pyruvic

Decreased urinary pyruvate if:

Diet:

• Low calorie diets or fasting

Gastrointestinal disorders:

• Malabsorption

Problems with glycolysis, gluconeogenesis, or fatty oxidation

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Low levels of pyruvate may occur if there are low levels of precursors (glucose, amino acids), if there are nutritional enzyme inhibitions, or if a low-activity enzyme variant is inherited. Low levels can indicate problems with the glycolysis pathway, fatty acid oxidation, or problems with gluconeogenesis. If the person is on a low-carbohydrate or “keto” diet, the CAC will obtain precursors from amino acids or fats, instead of carbohydrates. During long-term fasting, most pyruvate will be diverted into gluconeogenesis rather than into the Citric Acid Cycle.

Consider supporting pyruvate production from carbohydrates or proteins with biotin, r-lipoic acid, B1, B3, B6, magnesium, potassium, zinc, and glutathione (antioxidants)

• High-lycopene tomato sauce (160 g/day) has increased lactate and pyruvate in human subjects.

If pyruvate is low and lactate is higher, then the person may not be able to interconvert the two compounds. This can occur if the person cannot synthesize enough NAD+ or if there is an inherited low-activity enzyme variant.

• Consider vitamin B3 supplements to improve NAD+ levels.

Phthalate chemical exposures can inhibit the enzyme that interconverts pyruvate and lactate.

High levels of pyruvate may occur if there is nutritional inhibition of the breakdown enzymes if inherited, inherited low-activity enzyme variations are present on the breakdown pathway, if there are high levels of precursors (glucose, amino acids) or if there are high levels of downstream products (lactate, citrate). High pyruvate levels can indicate problems with entry into the CAC; check citrate levels. Medical conditions, such as acidosis or chronic fatigue syndrome, may increase pyruvate levels. High levels of pyruvate may prevent the synthesis of carbohydrates, fatty acids, ketone bodies, alanine, and steroids needed by the body.

If pyruvate is high and lactate is lower, then the patient may not be able to interconvert the two compounds. This can occur if the patient cannot synthesize enough NAD+ or if there is an inherited low-activity enzyme variant.

• Consider vitamin B3 supplements to improve NAD+ levels.

If pyruvate is high and citrate is low, consider supporting pyruvate’s entry into the Citric Acid Cycle with B1, B3, biotin, r-lipoic acid, magnesium, manganese, potassium, zinc, and glutathione.

Pyruvate entry into the CAC may be inhibited by arsenic or other toxic metal exposures. Arsenic exposure can increase alpha-ketoglutarate and pyruvate, while citrate and succinate levels decrease.

• Arsenic is a common contaminant in ground water and well water; it may be added to factory-farmed poultry feed and used as a pesticide on fruits.

• Medical conditions may increase pyruvate levels

  • Secondary lactic acidosis

    • Sleep apnea, blood infections, seizures, respiratory or cardiac insufficiency

    • Dicarboxylic acids (cis-aconitate, isocitrate, succinate, malate, suberate, and adipate) may also be elevated

  • Chronic fatigue

    • Levels of citrate, cis-aconitate, isocitrate, malate may be low

  • Phthalate exposures can inhibit the enzyme that interconverts pyruvate and lactate.