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[Biochemistry](https://durgical.com/en/biochemistry/) · Molecule

# δ-Aminolevulinic acid (ALA)

ALA is the first committed molecule of heme synthesis; it rises in acute porphyrias and lead poisoning.

Updated 2026-11-01

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## Key facts

- It is made in the mitochondrion from glycine and succinyl-CoA (ALA synthase, with vitamin B6) and moves out to the cytosol.
- High urine ALA with normal porphobilinogen: lead, ALA dehydratase deficiency or tyrosinemia type I.
- High ALA and porphobilinogen together: acute intermittent porphyria, hereditary coproporphyria or variegate porphyria in an attack.
- It resembles GABA and is toxic to neurons: one proposed explanation for the neuropathy of acute porphyrias.

**Also called**
5-ALA, 5-aminolevulinic acid

**Formula**
C₅H₉NO₃

**PubChem**
[CID 137](https://pubchem.ncbi.nlm.nih.gov/compound/137)

## Structure

- A five-carbon keto acid with an amino group at the end (C5); two molecules condense into the porphobilinogen ring.

## Clinical notes

- Given as a drug, tumour cells turn it into fluorescent protoporphyrin IX: photodynamic diagnosis and guided glioma surgery.
- Its liver production rises when something induces ALAS1; givosiran lowers it in acute hepatic porphyria.
- Chronic exposure to liver ALA is associated with chronic kidney disease and hepatocellular carcinoma in acute porphyria.

## Pathways

- [Heme synthesis](https://durgical.com/en/biochemistry/pathways/heme-synthesis/)

## Related conditions

- [Acute intermittent porphyria](https://durgical.com/en/conditions/acute-intermittent-porphyria/)
- [Lead poisoning](https://durgical.com/en/conditions/lead-poisoning/)
- [Hepatocellular carcinoma](https://durgical.com/en/conditions/hepatocellular-carcinoma/)

## Related

- [ALA synthase](https://durgical.com/en/biochemistry/enzymes/ala-synthase/)
- [ALA dehydratase](https://durgical.com/en/biochemistry/enzymes/ala-dehydratase/)
- [Porphobilinogen](https://durgical.com/en/biochemistry/molecules/porphobilinogen/)
- [Protoporphyrin IX](https://durgical.com/en/biochemistry/molecules/protoporphyrin-ix/)

## Test yourself

Think of the answer, then tap the question to see it.

## Which two molecules is ALA made from?

Glycine and succinyl-CoA, by ALA synthase in the mitochondrion.

## Which pattern of urine ALA and porphobilinogen suggests lead poisoning?

High ALA with normal porphobilinogen, because lead blocks ALA dehydratase.

## Why is 5-ALA used in brain tumour surgery?

Glioma cells convert it into protoporphyrin IX, which fluoresces red and helps show the tumour margins.

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Molecules are shown in their neutral form, as the databases deposit them; in the cell the acids and phosphates are ionised.

Educational information, not medical advice. For any symptom, see a health professional.

Sources: [5-Aminolevulinic Acid (CID 137)](https://pubchem.ncbi.nlm.nih.gov/compound/137) (PubChem, NCBI, 2026) · Public domain; [Porphyrins urine test: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/003614.htm) (MedlinePlus, US National Library of Medicine, 2026); [Reactome | Heme biosynthesis](https://reactome.org/PathwayBrowser/#/R-HSA-189451) (Reactome, 2026); Textbook of Biochemistry for Medical Students, 6th ed. (Jaypee Brothers Medical Publishers (Vasudevan DM, Sreekumari S, Vaidyanathan K), 2011).

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