Pyruvate

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • 2-Chloroethylpyruvate, 2-oxopropanoate, 2-oxypropanoic acid, acetylformate, acetylformic acid, alpha-keto acid, alpha-ketocarboxylic acid, alpha-ketopropionate, alpha-ketopropionic acid, calcium pyruvate, calcium pyruvate monohydrate, creatine pyruvate, Diet Pyruvate™, ethyl pyruvate, magnesium pyruvate, methyl pyruvate, o-ethoxybenzylhydrazone of diethanolamine pyruvate, organic acid, potassium pyruvate, proacemic acid, pyr, pyroracemate, pyroracemic acid, Pyruvate™ 1000, pyruvate anion, Pyruvate Burn™, pyruvate ester, pyruvate eyedrops, Pyruvate Fuel™, pyruvic acid, ringer’s ethyl pyruvate, sodium pyruvate.

Background

  • Pyruvate is a three-carbon organic acid (alpha-ketocarboxylic acid) that is formed in the body during glycolysis, a metabolic process that converts glucose to pyruvate.

  • Pyruvate supplementation is commonly used for weight and fat loss. In general, the marketing of pyruvate for these purposes is based on studies using a combination of pyruvate and dihydroxyacetone. While several clinical trials do support the use of pyruvate for this purpose, results are mixed overall. Although pyruvate is commonly used for exercise performance improvement, this use is not supported by scientific evidence.

  • There is inconclusive evidence regarding the use of pyruvate for alcoholic liver disease, chronic obstructive pulmonary disease (COPD), congestive heart failure, high cholesterol, and hyperkeratotic skin conditions. Further research is also needed to assess the effects of pyruvate in combination with cardioplegic solution for protecting heart muscle during surgery.

Scientific Evidence

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Alcoholic liver disease

Research results regarding the use of pyruvate for alcoholic liver disease is inconclusive. Further research is needed.

Chronic obstructive pulmonary disease (COPD)

Research results regarding the use of pyruvate for chronic obstructive pulmonary disease are inconclusive. Additional research is needed in this area.

Congestive heart failure

Research results regarding the use of pyruvate for congestive heart failure are inconclusive. Further research is needed.

Heart muscle protection during heart surgery

Limited evidence suggests that the addition of pyruvate to cardioplegic solution may enhance the protection of heart muscle during heart surgery. Additional research is needed in this area.

High cholesterol

Research results regarding the use of pyruvate for high cholesterol are inconclusive. Further research is needed.

Reducing body fat mass

Research results regarding the use of pyruvate for reducing body fat mass are mixed. Additional research is needed in this area.

Skin conditions (hyperkeratotic skin conditions)

Research results regarding the use of pyruvate for hyperkeratotic skin conditions are inconclusive. Further research is needed.

Exercise performance enhancement

The evidence does not support the use of pyruvate for exercise performance enhancement.

*Key to grades:

Tradition

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Acute respiratory distress syndrome, antiaging, anti-inflammatory, antioxidant, arthritis, blood thinner, burns, cancer, cardiac arrest, cardiopulmonary resuscitation, critical illness, diabetes, energy, exercise recovery, fatigue, immune system function, kidney dysfunction, lactic acidosis (neonatal), low blood sugar, muscle strength, nerve disorders (Leigh syndrome), nerve pain, obesity/weight loss, pancreatitis (inflamed pancreas), radiation injuries, sepsis, shock (endotoxemic), stroke, wound healing.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

  • Pyruvate is supplied as sodium pyruvate or calcium pyruvate in capsules, powder, and tablets. According to some sources, 2-5 grams of oral pyruvate daily may offer the most benefit.

  • For alcoholic liver disease, sodium pyruvate has been infused for 10 days (54-86.4 grams of pyruvate daily, 150-180 milligrams per minute, over 6-8 hours) and for 15 days (50-54 grams daily, 100 milligrams per minute, over six hours).

  • For chronic obstructive pulmonary disease (COPD), sodium pyruvate (0.5 millimolar) has been inhaled three times daily for six weeks.

  • For congestive heart failure, intracoronary pyruvate has been injected or infused (300 millimolars at 90 milliliters per hour for 10 minutes and then 180 milliliters per hour for 10 minutes and then 360 milliliters per hour for 10 minutes, or 370 milliliters per hour for 15 minutes and then 740 milliliters per hour for 15 minutes).

  • For heart muscle protection during heart surgery, a 4:1 pyruvate-fortified blood cardioplegic solution, consisting of pyruvate ringer’s with 10 millimolars of sodium pyruvate has been injected or infused.

  • For high cholesterol, 36-53 grams of pyruvate has been taken by mouth daily in three divided doses for six weeks.

  • For reducing body fat mass, three grams has been taken by mouth twice daily for six weeks, and 22-44 grams has been taken by mouth daily in three divided doses for six weeks.

  • For hyperkeratotic skin conditions, Eucerin® cream with 5% pyruvate has been applied to the affected area three times daily.

Children (under 18 years old)

  • There is no proven safe or effective dose for pyruvate in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid with known allergy or hypersensitivity to pyruvate or its constituents.

Side Effects and Warnings

  • Pyruvate may cause bloating, deeper sleep, diarrhea, gas, and loose stools.

  • Pyruvate may affect blood sugar by decreasing insulin response. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar, especially insulin. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Pyruvate may cause low blood pressure. Caution is advised in patients taking drugs, herbs, or supplements that lower blood pressure.

  • Use cautiously in patients with cardiomyopathy (heart muscle problems), due to a reported death in a case study following a pyruvate-loading test in a child with restrictive cardiomyopathy.

  • Use cautiously in patients taking lipid-lowering agents, as supplemental pyruvate use may decrease total and low-density lipoprotein (LDL) cholesterol significantly in subjects consuming a high-cholesterol and high-fat diet.

  • Use cautiously in patients taking cardiovascular agents, as pyruvate in solution may increase contraction force, half-time to relaxation, and action potential duration in human heart muscle in patients undergoing open-heart surgery.

  • Use cautiously in patients with gastrointestinal disorders, due to the risk of gastrointestinal side effects when more than 22 grams of pyruvate is taken by mouth.

  • Avoid in pregnant or breastfeeding women or in children, due to a lack of sufficient safety data.

  • Avoid in patients with a known allergy or hypersensitivity to pyruvate or its constituents.

Pregnancy and Breastfeeding

  • Avoid in pregnant or breastfeeding women or in children, due to a lack of sufficient safety data.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

  • Pyruvate may affect blood sugar by decreasing insulin response. Caution is advised when using medications that may also lower blood sugar. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Pyruvate may cause low blood pressure. Caution is advised in patients taking drugs, herbs or supplements that lower blood pressure.

  • Pyruvate may also interact with acetylsalicylic acid, anti-inflammatory agents, cholesterol-lowering agents, cyclosporin, dichloroacetate, drugs for the heart, drugs for the skin, drugs that protect the liver, inosine-phosphate-pyruvate solution, neuroprotective agents, respiratory agents, sleep-inducing drugs, valproate, and weight loss agents.

Interactions with Herbs and Dietary Supplements

  • Pyruvate may affect blood sugar by decreasing insulin response. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

  • Pyruvate may cause low blood pressure. Caution is advised in patients taking drugs, herbs or supplements that lower blood pressure.

  • Pyruvate may also interact with amino acids, anti-inflammatory herbs and supplements, cholesterol-lowering herbs and supplements, dihydroxyacetone, herbs and supplements for the skin, herbs and supplements that protect the heart, herbs and supplements that protect the liver, evening primrose oil, neuroprotective herbs and supplements, respiratory herbs and supplements, sleep-inducing herbs and supplements, sunflower oil, urea, weight loss herbs and supplements, and wheat germ oil.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Andersson A, Fenhammar J, Frithiof R, et al. Haemodynamic and metabolic effects of resuscitation with Ringer’s ethyl pyruvate in the acute phase of porcine endotoxaemic shock. Acta Anaesthesiol Scand 2006;50(10):1198-1206. View Abstract
  2. Boschmann M, Engeli S, Dobberstein K, et al. Dipeptidyl-peptidase-IV inhibition augments postprandial lipid mobilization and oxidation in type 2 diabetic patients. J Clin Endocrinol Metab 2009;94(3):846-852. View Abstract
  3. Faldini A, Marchetti N. [Clinical trial of a new synthetic product: o-ethoxybenzylhydrazone of diethanolamine pyruvate associated with vitamins B 1, B 6 and B 12 and dichloroethanoate of diisopropylammonium in the treatment of rheumatic and neuritic pain syndromes]. Minerva Ortop 1970;21(1):51-56. View Abstract
  4. Fink MP. Ethyl pyruvate: a novel treatment for sepsis. Novartis Found Symp 2007;280:147-156. View Abstract
  5. Fink MP. Ethyl pyruvate: a novel treatment for sepsis and shock. Minerva Anestesiol 2004;70(5):365-371. View Abstract
  6. Hermann HP, Arp J, Pieske B, et al. Improved systolic and diastolic myocardial function with intracoronary pyruvate in patients with congestive heart failure. Eur J Heart Fail 2004;6(2):213-218. View Abstract
  7. Knott EM, Ryou MG, Sun J. Pyruvate-fortified cardioplegia suppresses oxidative stress and enhances phosphorylation potential of arrested myocardium. Am J Physiol Heart Circ Physiol 2005;289(3):H1123-H1130. View Abstract
  8. Knott EM, Sun J, Lei Y, et al. Pyruvate mitigates oxidative stress during reperfusion of cardioplegia-arrested myocardium. Ann Thorac Surg 2006;81(3):928-934. View Abstract
  9. Mallet RT, Sun J, Knott EM,et al. Metabolic cardioprotection by pyruvate: recent progress. Exp Biol Med (Maywood ) 2005;230(7):435-443. View Abstract
  10. Olivencia-Yurvati AH, Blair JL, Baig M,et al. Pyruvate-enhanced cardioprotection during surgery with cardiopulmonary bypass. J Cardiothorac Vasc Anesth 2003;17(6):715-720. View Abstract
  11. Sharma AB, Barlow MA, Yang SH, et al. Pyruvate enhances neurological recovery following cardiopulmonary arrest and resuscitation. Resuscitation 2008;76(1):108-119. View Abstract
  12. Sharma AB, Knott EM, Bi J, et al. Pyruvate improves cardiac electromechanical and metabolic recovery from cardiopulmonary arrest and resuscitation. Resuscitation 2005;66(1):71-81. View Abstract
  13. Stanko RT, Reynolds HR, Hoyson R,et al. Pyruvate supplementation of a low-cholesterol, low-fat diet: effects on plasma lipid concentrations and body composition in hyperlipidemic patients. Am J Clin Nutr 1994;59(2):423-427. View Abstract
  14. Stanko RT, Reynolds HR, Lonchar KD, et al. Plasma lipid concentrations in hyperlipidemic patients consuming a high-fat diet supplemented with pyruvate for 6 wk. Am J Clin Nutr 1992;56(5):950-954. View Abstract
  15. Votto JJ, Bowen JB, Barton RW, et al. Inhaled sodium pyruvate improved FEV1 and decreased expired breath levels of nitric oxide in patients with chronic obstructive pulmonary disease. J Aerosol Med Pulm Drug Deliv 2008;21(4):329-334. View Abstract

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.