Organic Acid Test: part 4, Glycolytic Cycle and Krebs Cycle Metabolites

Please note: The content of this post is my own unless the technical terms are too hard to explain, then the content is copy and paste. I am not a medical professional and thus the post is my point of view. But the content is science-based and credible. Just because it is a new science, does not necessarily make it quackery.

Test Results, Part 2

In our South African test, the Glycolytic Cycle and Krebs Cycle results are combined, whereas in the Great Plains test it is separate.

Glycolysis is the metabolic pathway by which we convert glucose into lactate and pyruvate to form energy. If levels of lactic and pyruvic acids are elevated, a person has mitochondrial dysfunction.

High values for these markers may indicate that environmental toxins, particularly mold, are affecting your mitochondria. High lactic acid is commonly elevated with mold issues.

Glycolytic Cycle

Urine organic acids: Glycolysis and Krebs Cycle intermediates

2-Oxoglutaric acid/2-Ketoglutaric acid 1.72 L 36 – 103 mmol/mol
Aconitic acid 24.67   17.3 – 63.3 mmol/mol
Citric acid 31.44   < 656 mmol/mol
D/L-2-Hydroxyglutaric acid 2.47   < 35 mmol/mol
DL-Lactic acid 3.4 L 20 – 346 mmol/mol
Fumaric acid BDL   2 – 42 mmol/mol
Isocitric acid 12.97   < 99 mmol/mol
Malic acid 0.13   < 73 mmol/mol
Pyruvic acid 0.05   < 19 mmol/mol
Succinic acid 10.09 L 16 – 156 mmol/mol

In the Glycolytic we look at the following markers

  1. Lactic acidLactic acid is produced as part of the cycle when your body takes food, or sugars, and process it for energy. You know that burn you feel in your muscles after some exercises, that is lactic acidosis. In Afrikaans, we speak of “miltsteek”, that sharp pain you somethings get in your side after exercising especially when you are unfit. Elevations of lactic acid and/or pyruvic acid can also be caused by many nonspecific factors, such as vigorous exercise, bacterial overgrowth, shock, anaemia, mitochondrial dysfunction, or other causes.
  2. Pyruvic acid – Pyruvic acid can be made from glucose (sugar) through glycolysis, converted back to carbohydrates (such as glucose) via gluconeogenesis, or to fatty acids through a reaction with acetyl-CoA.
  3. 2-Hydroxybutyric acid – 2-Hydroxybutyric acid is a ketone body produced as a by-product of fatty acids oxidation for energy. This acid will be elevated if there is a yeast overgrowth.

Elevated levels of these three acids might indicate there are inborn errors of metabolism, including disorders of sugar metabolism and pyruvate dehydrogenase deficiency. The possibility of an inborn error of metabolism increases as the lactic acid value exceeds 300 mmol/mol creatinine and when pyruvic acid exceeds 100 mmol/mol creatinine.

Krebs Cycle

For more details on the Krebs Cycle, you can read more about it as part of the MTHFR series, click here.

Like previously mentioned the Glycolytic Cycle and the Krebs cycle is actually part of the same process. The Krebs cycle uses sugars to create lactic acid and pyruvic acid to produce energy for the cells.

In the Krebs Cycle they look at these markers:

  1. SuccinicLow levels could indicate a need for the branch chain amino acids leucine and isoleucine. An elevated result may also indicate a relative deficiency of riboflavin and/or coenzyme Q10.  Suggest supplementation with a minimum of 20 mg riboflavin and/or 50 mg per day of coenzyme Q10.  Also produced by bacterial degradation of unabsorbed glutamine supplement. Foods that contains Succinic acid include broccoli, rhubarb, sugar beets, fresh meat extracts, various cheeses, and sauerkraut.  
  2. Fumaric (Increased urinary fumaric acid may be due to impaired Krebs cycle function, a defect in the enzyme fumarase or in mitochondrial function.)
  3. Malic (Slightly elevated values usually indicate a higher need for nutrients such as niacin and coenzyme Q10.When malic acid is simultaneously elevated with citric, fumaric and 2-ketoglutaric acids, a mitochondrial energy pathway dysfunction is strongly suggested.)
  4. Citric (Elevations may be due to increased intake of citric acid containing foods or result from intestinal yeast producing citric acid or perhaps inhibiting the human citric acid cycle.  Increased citric acid may also indicate depletion of glutathione, which is required for the enzyme aconitase to metabolize both aconitic and citric acids.  If pyroglutamic acid values are low, consider supplements containing glutathione, n-acetyl cysteine, or lipoic acid.)
  5. 2-Ketoglutaric acids/ 2-Oxoglutaric acid – Increased values in urine may be due to dietary vitamin deficiencies or the intake of 2-ketoglutaric acid as a supplement.  The conversion of 2-oxoglutaric acid to succinyl-CoA requires coenzyme A (derived from pantothenic acid), lipoic acid, flavin adenine dinucleotide (FAD) derived from riboflavin (B2), and thiamine (B3).
  6. Aconitic Acid (Aconitase, the enzyme that metabolizes citric and aconitic acids, is dependent upon glutathione. Elevated in mitochondrial disorders (e.g. Complex I and Pierson Syndrome).  Elevated aconitic acid may indicate an additional requirement for reduced glutathione.)

Elevations in Krebs Cycle metabolites are commonly due to environmental toxins such as heavy metals or mold, yeast/fungal or bacterial overgrowth, high oxalate levels, or high oxidative stress. A less common indication of high levels would be a genetic issue.

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