Succinic acid

Optimal Result: 0 - 9.4 mmol/mol.

Succinyl CoA becomes succinic acid using succinyl CoA synthetase. This reaction produces NADH which directly provides electrons for the electron transport chain or respiratory chain. Succinic acid requires the enzyme succinate dehydrogenase to become fumarate. This enzyme is ironbased and requires vitamin B2 to support flavin adenine dinucleotide (FAD) as a redox coenzyme. Succinate dehydrogenase plays a critical role in mitochondrial metabolism. Impairment of this enzyme’s activity has been linked to a variety of diseases such as cancer and neurodegenerative diseases.

References:

- Tretter L, Adam-Vizi V. Alpha-ketoglutarate dehydrogenase: a target and generator of oxidative stress. Philos Trans R Soc Lond B Biol Sci. 2005;360(1464):2335-2345.

- Rutter J, Winge DR, Schiffman JD. Succinate dehydrogenase - Assembly, regulation and role in human disease. Mitochondrion. 2010;10(4):393-401.

- Van Vranken JG, Na U, Winge DR, Rutter J. Protein-mediated assembly of succinate dehydrogenase and its cofactors. Crit Rev Biochem Molec Biol. 2015;50(2):168-180.

- Connors J, Dawe N, Van Limbergen J. The Role of Succinate in the Regulation of Intestinal Inflammation. Nutrients. 2018;11(1):25.

- Wentzel JF, Lewies A, Bronkhorst AJ, Van Dyk E, Du Plessis LH, Pretorius PJ. Exposure to high levels of fumarate and succinate leads to apoptotic cytotoxicity and altered global DNA methylation profiles in vitro. Biochimie. 2017;135:28-34.

- Harris RA, Joshi M, Jeoung NH, Obayashi M. Overview of the Molecular and Biochemical Basis of Branched-Chain Amino Acid Catabolism. J Nutr. 2005;135(6):1527S-1530S.

What does it mean if your Succinic acid result is too low?

Low levels of succinic acid can be seen with poor dietary intake or absorption of branched-chain amino acids. Branched-chain amino acids are catabolized to acetyl-CoA or succinyl-CoA to feed the Citric Acid Cycle. Additionally, vitamin B12 deficiency can induce a defect in the conversion of methylmalonyl-CoA to succinyl-CoA at the distal end of the valine and isoleucine pathways which can then decrease succinyl-CoA.

The succinate precursor succinyl-CoA can be synthesized in the liver from dietary fats via the omega-oxidation pathway, or from dietary proteins. Inhibition of the omega-oxidation pathway may result in low succinate levels.

→ Consider supporting succinate synthesis from alpha-ketoglutarate with vitamins B1, B2, calcium, and lipoic acid.

→ The succinate precursor succinyl-CoA may also be derived from branch-chain amino acids or fatty acids. Support this pathway in patients on “keto”, high protein, or low carbohydrate diets. Consider supporting alternate pathways with vitamins B1, B2, B3, B6, B12, biotin, r-lipoic acid, iron (if deficient), magnesium, and molybdenum. If the liver omega-oxidation pathway is inhibited (B3 or zinc deficiency) then levels of adipate, suberate, ethylmalonate, and methylsuccinate may be low.

What does it mean if your Succinic acid result is too high?

Elevated levels of succinate may occur when there are nutritional enzyme inhibitions of the breakdown pathways, inherited low-activity enzymes are present, if there are high levels of precursors (succinyl-CoA, alpha-ketoglutarate), or if there are higher levels of its downstream products (fumarate).

High levels of succinate may also occur if there is complex II electron transport chain (ETC) inhibition. A loss of gastrointestinal barrier function (leaky gut) can increase circulating levels of bacterial proteins (lipopolysaccharides), which may also inhibit these enzymes.

Chronically increased succinate levels may increase oxidative stress and dysregulate the immune system. Dicarboxylic acids (cis-aconitate, isocitrate, succinate, malate, suberate, and adipate) may be excreted in high amounts due to increased mobilization of fatty acids, beta-oxidation defects (increased adipate and suberate), increased gut permeability or fasting.

→ Consider supporting the conversion of succinate into fumarate with vitamins B2, B3, copper, iron, zinc, CoQ10, resveratrol, and antioxidants. Melatonin may help upregulate enzyme activity.

→ Adult-onset complex II ETC inherited defects are rare and may present with cardiac problems or muscle weakness, incoordination, and possibly seizures.

  • Complex II (succinate dehydrogenase)

    • Elevated lactate

    • Some will also have elevated succinate, fumarate

  • Consider supporting ETC function with additional vitamins B2, B3, B5, B12, E, selenium, taurine and melatonin.

→ Obesity or diabetes can decrease alpha-ketoglutarate but increase succinate.

10 000+ happy customers
100% satisfaction
★ ★ ★ ★ ★ customer support

Understand blood, stool, and urine medical results from all your laboratories.

Upload Your Personal Results

Upload Personal Results

For professional account plans go here

for professional account plans go here

Monthly plan

Annual plan

Own it for life

  • Subscription
  • Data entry service included

    Data entry service

    Our exclusive data entry service is a convenient way to get your results into your private dashboard. Simply attach an image or a file of your lab test results, and one of our qualified data entry team members will add the results for you. We support all sorts of files, whether PDFs, JPGs, or Excel. This service is excellent whether you have a lot of reports to upload or are too busy to do the data entry yourself.

  • Instant interpretation
  • Use free data entry form

    Free data entry form

    We strive to make the data entry process easy for you. Whether by offering dozens of templates to choose from that pre-populate the most popular laboratory panels or by giving you instant feedback on the entered values. Our data entry forms are an easy, fast, and convenient way to enter the reports yourself. There is no limit on how many lab reports you can upload.

  • 4000+ biomarkers explained
  • Nutrition recommendations
  • Cancel anytime

Complete

$15 /month

billed every month

  • monthly
  • $15 per report
  • ✓ Instant interpretations
  • ✓ 4000+ biomarkers explained
  • ✓ Nutrition recommendations
  • ✓ Free data entry form
  • ✓ Unlimited data
  • ✓ $15 data entry service
  • ✓ Cancel anytime

Most popular

Data entry included

Advanced

$79 /year

$6.60/month billed annually

  • yearly
  • 5 reports free
  • ✓ Instant interpretations
  • ✓ 4000+ biomarkers explained
  • ✓ Nutrition recommendations
  • ✓ We enter 5 reports for you
  • ✓ Yearly subscription
  • ✓ Cancel anytime

Data entry included

Unlimited

$250 /once

own it for life

  • pay once
  • 10 reports free
  • ✓ Instant interpretations
  • ✓ 4000+ biomarkers explained
  • ✓ Nutrition recommendations
  • ✓ We enter 10 reports for you
  • ✓ No subscription
  • ✓ Dedicated support
  • ✓ Unlimited access

Are You a Health Professional?

Get started with our professional plan

Welcome to Healthmatters Pro.

Save time on interpreting lab results with the largest database of biomarkers online. In-depth research on any test at your fingertips, all stored and tracked in one place. Learn more

Pro Monthly Plus

for health professionals

  • ✓ Track multiple clients results
  • ✓ No setup fees
  • ✓ No hidden costs
  • ✓ Instant interpretations
  • ✓ 4000+ biomarkers explained
  • ✓ Includes data entry service
  • ✓ Personal training and support
  • ✓ Cancel anytime

$75 per month

Use promo code to save 10% off any plan.


We implement proven measures to keep your data safe.

At HealthMatters, we're committed to maintaining the security and confidentiality of your personal information. We've put industry-leading security standards in place to help protect against the loss, misuse, or alteration of the information under our control. We use procedural, physical, and electronic security methods designed to prevent unauthorized people from getting access to this information. Our internal code of conduct adds additional privacy protection. All data is backed up multiple times a day and encrypted using SSL certificates. See our Privacy Policy for more details.