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NutrEval Results: Drop in Pyruvic Acid to Citric Acid

Hi All - Recently got my Nutreval results. I've since added copper, ubiquinol, and Nicotinamide Riboside as supplements and have to say the Nicotinamide seems to have helped greatly with fatigue and brain fog. The ubiquinol helps a lesser extent with brain fog.

I still would like to feel a little bit more "energized" and have recently ordered oxaloacetate. Although, I have to say my energy levels are significantly improved after the above-added supplements. However, still looking for that remaining 5-10%.

The area I've honed in on the test results is the mitochondrial energy markers, which are all on the low end. There's a significant drop from Pyruvic Acid to Citric Acid (and the following markers all stay low) and I'm convinced my fatigue issues lie here and/or with the Krebs cycle. I think the Nicotinamide supplementation helps to confirm this (essentially a NAD booster).

My integrative doctor didn't key in on this area, however, I did due to my own research on this topic (as Im sure many of us here have done).

I originally thought the issue could have been a lack of cofactors or other compounds which help to turn pyruvic acid into citric acid. These are primarily CoA, Pantothenic Acid, and Lysine per my research. I've since ruled out Pantothenic Acid and Lysine per trial and error. It seems CoA doesn't really exist so I may be stuck there. However, Oxaloacetate is the last item remaining in the Krebs cycle before being recycled back into Citric Acid so I'm hoping that will be last piece (fingers crossed).

Anyway, my question is two-fold:
1) Am I correct to Focus on this Citric Acid drop, and if so, what else may I consider to boost this (and other energy markers in the Krebs Cycle).
2) Is there any other glaring issues with my NutrEval results (primarily focusing on energy/fatigue).

Other related info: My Thyroid labs were all fairly normal, in range. I've had an ACTH stim test with a starting level of 14 and 60-min result of 19 (hence a blunted response). I've been on low dose HC for a few months which initially helped mildly with energy and passing out feeling. I'm currently working my way off HC. Haven't tested Thyroid antibodies or RT3. I've also been on a vegan diet for a few years and anecdotally red meat does seem to have a positive effect on general fatigue/feeling well (although it's very difficult to tell with certainty). I'll also mention my fatigue and other symptoms did start well before a vegan diet.

Many Thanks.


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