Pyruvic Acid

Nutritional Considerations: Primary consideration including one or more insufficiencies amongst these nutrient factors: B1, B2, B3, B5, Lipoic Acid. Other additional nutrient considerations include CoQ10, Magnesium and Manganese.

Possible Interfering Factors: High Carb diet without adequate co-factors to fuel metabolic needs.

Clinical Considerations: This finding suggests insufficient cofactors to fuel the next metabolic step to fuel the creation of Acetyl-CoA, a critical step in energy production. In the presence of hypoglycemia, consider possible fructose 1,6-DP Deficiency and Carboxykinase deficiency. Though this organic acid test does not measure for inborn errors of metabolism, this may be a consideration. In the absence of hypoglycemia, then one may consider pyruvate dehydrogenase deficiency and pyruvate carboxylase deficiency that also warrants further investigation, if not clinically modifiable.

Nutritional Considerations: Increase complex carbohydrates to decrease glycemic load to ensure proper balance with proteins and fat intake. Support glucose metabolism with B complex, chromium and vanadium. Ensure there is sufficient intake of vitamin B3 (niacin).

Possible Interfering Factors: Very low carbohydrate diet in susceptible individuals.

Clinical Considerations: Though this finding is not common, a low pyruvate can result in numerous other low metabolite scores. Low energy would be a common symptom of this finding in many patients.

Further examination of daily dietary intake is important in these individuals to make sure a well-balanced diet with sufficient high fiber complex carbohydrates are being consumed. Need to rule out excess lactate that if high warrant further investigation.

Other possible causes can include, high intensity exercise, low oxygen conditions such as asthma or other pulmonary disease, sleep apnea, cardiac insufficiency, ketoacidosis, poorly controlled diabetes and prolonged fasting or severe dieting.

Pyruvic Acid feeds into the citric acid cycle & converts into acetyl CoA. Pyruvate is formed from carbohydrate via glucose or glycogen & secondarily from fats (glycerol) & glycogenic amino acids.