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25658 Pyruvic Acid, Blood (PYR)

Pyruvic Acid, Blood (PYR)
Test Code: PYRSO
Synonyms/Keywords
ETC, Mitochondrial Electron Transport Chain Defects, Mitochondrial Respiratory Chain Disorders, PC, PDH (Pyruvate Dehydrogenase) Deficiency, PDHC (Pyruvate Dehydrogenase Complex), Pyruvate Carboxylase Deficiency, Pyruvate Decarboxylase Deficiency, Pyruvate Dehydrogenase (PDH) Deficiency, Pyruvate Dehydrogenase Complex (PDHC), blood pyruvate
Useful For

Screening for possible disorders of mitochondrial metabolism, when used in conjunction with blood lactate collected at the same time, to determine the lactate-to-pyruvate ratio.

The lactate:pyruvate (L:P) ratio is considered a helpful (not diagnostic) tool in the evaluation of patients with possible disorders of mitochondrial metabolism, especially in patients with neurologic dysfunction and either elevated or normal L:P ratios. Pyruvic acid levels alone have little clinical utility.

Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Fast at least 4 hours ​Whole Blood ​Special Collection tube containing 2.5mL of 6% perchloric acid provided by Marshfield Labs ​1 mL ​1 mL ​1 mL
Collection Processing Instructions

1) Special collection tube must be pre-chilled prior to draw.

2) Draw enough blood directly into syringe to add exactly 1 mL of blood to the special collection tube (pre-chilled).

3) Once drawn, immediately transfer 1 mL to the pre-chilled tube and shake vigorously to mix.

Specimen Stability Information
Specimen Type Temperature Time​Special Container
​Whole Blood ​Refrigerate ​15 days​PYRUVATE
Rejection Criteria
Gross Hemolysis
​Gross Lipemia
​Use of any anticoagulant other than in the special collection tube
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Clinic Laboratories ​Tuesday, Thursday; Varies ​6 days ​Spectrophotometry (SP)
Reference Lab
Reference Range Information
Performing Location Reference Range
​Mayo Clinic Laboratories

0.08-0.16 mmol/L      

NIH Unit 0.7-1.4 mg/dL

Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​84210
Synonyms/Keywords
ETC, Mitochondrial Electron Transport Chain Defects, Mitochondrial Respiratory Chain Disorders, PC, PDH (Pyruvate Dehydrogenase) Deficiency, PDHC (Pyruvate Dehydrogenase Complex), Pyruvate Carboxylase Deficiency, Pyruvate Decarboxylase Deficiency, Pyruvate Dehydrogenase (PDH) Deficiency, Pyruvate Dehydrogenase Complex (PDHC), blood pyruvate
Ordering Applications
Ordering Application Description
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Fast at least 4 hours ​Whole Blood ​Special Collection tube containing 2.5mL of 6% perchloric acid provided by Marshfield Labs ​1 mL ​1 mL ​1 mL
Collection Processing

1) Special collection tube must be pre-chilled prior to draw.

2) Draw enough blood directly into syringe to add exactly 1 mL of blood to the special collection tube (pre-chilled).

3) Once drawn, immediately transfer 1 mL to the pre-chilled tube and shake vigorously to mix.

Specimen Stability Information
Specimen Type Temperature Time​Special Container
​Whole Blood ​Refrigerate ​15 days​PYRUVATE
Rejection Criteria
Gross Hemolysis
​Gross Lipemia
​Use of any anticoagulant other than in the special collection tube
Useful For

Screening for possible disorders of mitochondrial metabolism, when used in conjunction with blood lactate collected at the same time, to determine the lactate-to-pyruvate ratio.

The lactate:pyruvate (L:P) ratio is considered a helpful (not diagnostic) tool in the evaluation of patients with possible disorders of mitochondrial metabolism, especially in patients with neurologic dysfunction and either elevated or normal L:P ratios. Pyruvic acid levels alone have little clinical utility.

Reference Range Information
Performing Location Reference Range
​Mayo Clinic Laboratories

0.08-0.16 mmol/L      

NIH Unit 0.7-1.4 mg/dL

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Clinic Laboratories ​Tuesday, Thursday; Varies ​6 days ​Spectrophotometry (SP)
Reference Lab
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​84210
For most current information refer to the Marshfield Laboratory online reference manual.