What does the Energy Production Markers — Pyruvate, Lactate, and Fatty Acid Oxidation Metabolites test measure?

Why is Energy Production Markers — Pyruvate, Lactate, and Fatty Acid Oxidation Metabolites measured?

In the OAT clinical context, energy production markers characterise the efficiency of the primary ATP-generating metabolic pathways. Elevated pyruvate and lactate with normal lactate:pyruvate ratio suggests increased glycolytic flux from high carbohydrate intake or metabolic stress. Elevated lactate:pyruvate ratio (above 20:1) indicates NADH-NAD+ imbalance consistent with mitochondrial respiratory chain dysfunction and warrants metabolic specialist evaluation. Elevated dicarboxylic acids suggest medium-chain fatty acid oxidation impairment — MCAD deficiency is the most prevalent inborn error of metabolism in populations of Northern European descent and is potentially life-threatening during metabolic stress without early intervention. In functional medicine, mildly elevated dicarboxylates in adults are interpreted as evidence of partial fatty acid oxidation impairment amenable to riboflavin, carnitine, and CoQ10 support.

Reference ranges

Standard reference

# REVIEWER FLAG: Confirm Mosaic Diagnostics reference ranges for pyruvic acid, lactic acid, 3-hydroxybutyric acid (BOHB), adipic acid, suberic acid, sebacic acid (medium-chain fatty acid oxidation markers), and ethylmalonic acid (short-chain fatty acid oxidation marker). These analytes have distinct clinical significance and individual reference intervals.

Functional medicine optimal

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Units

mmol/mol creatinine

Reference ranges vary by laboratory and assay platform. Interpret in context of the issuing laboratory's stated range.