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Alpha-ketoglutarate, malate, and citrate: Citric acid cycle intermediates
Alpha-ketoglutarate, malate, and citrate are organic acids that serve as intermediates in the citric acid (Krebs) cycle. This metabolic cycle releases stored energy through the oxidation of carbohydrates, fats, and proteins, and is fundamental to life. These intermediates can be synthesized in the body, and are not required in the diet. The role of citric acid cycle intermediates in the treatment of mitochondrial dysfunction has not been studied. In Dr. Boles’ experience, many people with mitochondrial dysfunction have abnormal levels of Krebs cycle intermediates, including alpha-ketoglutarate, malate, and/or citrate.
Alpha-ketoglutarate and citrate in ActivNeeds
Alpha-ketoglutarate, malate, and citrate are organic acids that serve as intermediates in the citric acid cycle.
The citric acid cycle, also known as the tricarboxylic acid (TCA) cycle or the Krebs cycle, is a series of chemical reactions used to release stored energy through the oxidation of carbohydrates, fats, and proteins into carbon dioxide and chemical energy in the form of NADH and ATP. This cycle is fundamental to all aerobic (oxygen – requiring) life, including humans.
Alpha – ketoglutarate, malate, and citrate can be synthesized in the body by the citric acid cycle, and are not required in the diet.
Deficiency is unknown.
Alpha-ketoglutarate is sometimes used to boost athletic performance and to help heal wounds. In addition, alpha-ketoglutarate can reduce levels of ammonia (and excess nitrogen) formed in the brain, muscles and kidneys. Malate/malic acid, malic acidis sometimes recommended for fibromyalgia and fatigue. Citrate is frequently provided as part of mineral supplements. Citrate is sometimes used to prevent kidney stones and to alkalize the blood or urine in various conditions
Side effects are rare at usual doses used in supplementation
Urine organic acid testing can quantify these citric acid intermediates, but this is not likely to be of clinical utility other than in screening for metabolic/mitochondrial disorder
How and Why are These Nutrients Used in ActivNeeds?
The inclusion of citric acid cycle intermediates in ActivNeeds is based on the hypothesis that improved function of this cycle can benefit some people in which mitochondrial dysfunction is a factor in their condition (e.g., lack of focus, tiredness). Citric acid cycle intermediates added in ActivNeeds include alpha-ketoglutarate, malic acid, magnesium citrate, and potassium citrate. Side effects are unexpected at the doses used in ActivNeeds.
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