Human liver homogenate was incubated to study the α-oxidation pathway of phytanic acid. Gas chromatography analysis identified pristanal as the product of the decarboxylation of 2-hydroxyphytanoyl-CoA. Pristanal was converted to pristanic acid in a NAD+-dependent reaction in human liver, demonstrating that pristanal is an intermediate in the production of pristanic acid from phytanoyl-CoA. Deficiencies in α-oxidation enzymes can lead to the accumulation of phytanic acid and cause Refsum's disease.