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Nutritional Testing

Nutritional Testing


 
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Metabolomix+ : A Non-Invasive Personalized Nutritional Assessment

The Metabolomix+ is a unique combination of nutritional tests that provides an analysis of key nutritional biomarkers. A first morning void (FMV) urine collection, with optional add-on bloodspot finger stick and buccal swab, the Metabolomix+ nutritional test is a non-invasive, patient-friendly way to assess the functional need for antioxidants, B-vitamins, minerals, digestive support, fatty acids, and amino acids. Insights gained from the Metabolomix+ nutritional test allows clinicians to target nutritional therapies to meet the precise needs of their patients.

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Metabolomix+ is one of the most comprehensive functional and nutritional assessments available. It is designed to help practitioners identify root causes of dysfunction and provide a systems-based approach to help patients overcome chronic conditions and live a healthier life.

The Metabolomix+ report offers:

  • Nutrient recommendations for key vitamins, minerals, amino acids, fatty acids, and digestive support
  • Functional pillars with a built-in scoring system to guide therapy around needs for methylation support, toxic exposures, mitochondrial dysfunction, fatty acid imbalances, and oxidative stress
  • Interpretation-At-A-Glance pages for patient education
  • Dynamic biochemical pathway charts for clearer understanding

What is a functional nutritional assessment?

Marked accumulation of organic acids in urine can signal a metabolic inhibition or block. The metabolic block may be due to a nutrient deficiency, an inherited enzyme deficit, toxic build-up, or drug effect.

Enzymes that are responsible for metabolizing organic acids are vitamin and mineral dependent. With this, elevations in organic acids can reflect a functional need for these nutrients on a cellular and biochemical level, even despite normal serum levels.1-5 Recommendations for nutrient supplementation based on elevated organic acid results are generated using a literature-based proprietary algorithm.

Traditionally, urinary organic acid assessment has been used in neonatal/pediatric medicine to identify genetic inborn errors of metabolism, with severity depending on the degree and type of error.* In many cases of genetic inborn errors, the enzymatic defect may be compensated for by high doses of specific vitamin and mineral cofactors and/or dietary interventions. Intervention with higher-dose nutrient cofactors may also be effective in cases of decreased enzyme activity due to causes other than frank inborn errors.

* Genova's organic acid testing is not intended for the diagnosis of neonatal inborn errors of metabolism.

Which patients might benefit from functional nutritional testing?

Common clinical indications for testing include:

  • Mood Disorders6,7
  • Mitochondrial Dysfunction8
  • Fatigue9
  • Chronic Stress10
  • Inflammation11

Several diseases are associated with abnormal organic acid, amino acid, and fatty acid levels such as depression, anxiety, cardiovascular disease, neurocognitive decline, diabetes, cancer, anorexia, and many others.12-15

About the Metabolomix+ Profile

The Metabolomix+ Profile report allows for easy interpretation and clinically actionable results. It includes a Suggested Supplement Schedule that provides personalized recommendations based on test results. The Interpretation-At-A-Glance section of the report provides facts related to nutrient function, causes and complications of their deficiencies, and dietary sources.

The Metabolomix+ Profile report categorizes results into several metabolic areas:

COMPONENTS

  • Malabsorption and Dysbiosis Markers are metabolites produced by the gastrointestinal microbiome
  • Cellular Energy & Mitochondrial Markers are biomarkers of carbohydrate and fatty acid metabolism, and the citric acid (Kreb's) cycle
  • Vitamin Markers are specific analytes used to assess functional levels of vitamin cofactors
  • Neurotransmitter Metabolites are downstream byproducts of epinephrine, norepinephrine, serotonin and dopamine
  • Toxin & Detoxification Markers relate to certain toxic metabolites and the body's detoxification capacity
  • NEW Oxalate Markers relate to kidney stone formation, oxidative stress and metabolic dysfunction
  • Essential Amino Acids must be derived from dietary sources
  • Nonessential Amino Acids are synthesized by the body
  • Intermediary Metabolites are byproducts of amino acid metabolism
  • Dietary Peptide Related Markers can indicate incomplete protein breakdown

+ COMPONENTS

  • Omega 3 Fatty Acids are essential for brain function and cardiovascular health and are anti-inflammatory
  • Omega 6 Fatty Acids are involved in the balance of inflammation
  • Omega 9 Fatty Acids are important for brain growth, nerve cell myelin, and reducing inflammation
  • Saturated Fatty Acids are involved in liproprotein metabolism and adipose tissue inflammation
  • Monounsaturated Fats include omega 7 fats and unhealthy trans fats
  • Delta-6 Desaturase Activity assesses efficiency of this enzyme to metabolize omega 6's and omega 3's
  • Cardiovascular Risk includes specific ratios and the Omega 3 Index
  • APO E (C112R + R158C)
  • MTHFR Combined (A1298C + C677T)
  • TNF-α
  • COMT (V158M)

Genova's Methodology

Urinary organic and amino acids are measured via GCMS, LC/MS/MS and alkaline picrate. Fatty acids are measured via GCMS. Urinary oxidative stress markers are measured using colorimetric, thiobarbituric acid reactive substances (TBARS) and LC/MS/MS. Nutrient and toxic elements are measured using ICP-MS and Kinetic (Jaffe). Reference ranges are age and gender specific and are based on a questionnaire-qualified healthy cohort. Testing is not performed in patients under 2 years old.

References

  1. Kałużna-Czaplińska J. Noninvasive urinary organic acids test to assess biochemical and nutritional individuality in autistic children. Clin Biochem. 2011;44(8-9):686-691.
  2. Broquist HP, Luhby AL. Detection and isolation of formiminoglutamic acid from urine in folic acid deficiency in humans. Proc Soc Exp Biol Med. 1959;100(2):349-354.
  3. Sun A-l, Ni Y-h, Li X-b, et al. Urinary methylmalonic acid as an indicator of early vitamin B12 deficiency and its role in polyneuropathy in type 2 diabetes. J Diab Res. 2014;2014.
  4. Kwok T, Cheng G, Lai W, Poon P, Woo J, Pang C. Use of fasting urinary methylmalonic acid to screen for metabolic vitamin B12 deficiency in older persons. Nutrition. 2004;20(9):764-768.
  5. Brown R, Thornton MJ, Price J. The effect of vitamin supplementation on the urinary excretion of tryptophan metabolites by pregnant women. J Clin Invest. 1961;40(4):617-623.
  6. Lykouras L, Markianos M, Hatzimanolis J, Malliaras D, Stefanis C. Association of biogenic amine metabolites with symptomatology in delusional (psychotic) and nondelusional depressed patients. Prog Neuro-Psychopharmacol Biol Psych. 1995;19(5):877-887.
  7. Frankenhaeuser M, Lundberg U, Von Wright MR, Von Wright J, Sedvall G. Urinary monoamine metabolites as indices of mental stress in healthy males and females. Pharmacol Biochem Behav. 1986;24(6):1521-1525.
  8. Mitochondrial Medicine Society's Committee on D, Haas RH, Parikh S, et al. The in-depth evaluation of suspected mitochondrial disease. Mol Genet Metab. 2008;94(1):16-37.
  9. Dimmock DP, Lawlor MW. Presentation and Diagnostic Evaluation of Mitochondrial Disease. Pediatr Clin North Am. 2017;64(1):161-171.
  10. Wu H, Jiang K, Gu G, Wu Y, Yu S. [The relationship of occupational stress and the level of some hormone metabolites in urine]. Chin J Indust Hyg Occup Dis. 2014;32(2):83-86.
  11. Jeon SW, Kim Y-K. Inflammation-induced depression: Its pathophysiology and therapeutic implications. J Neuroimmunol. 2017;313:92-98.
  12. Rao TSS, Asha MR, Ramesh BN, Rao KSJ. Understanding nutrition, depression and mental illnesses. Indian J Psychiatry. 2008;50(2):77-82.
  13. O'Connell BS. Select vitamins and minerals in the management of diabetes. Diabetes Spectr. 2001;14(3):133-148.
  14. Harris WS. Omega-3 fatty acids and cardiovascular disease: a case for omega-3 index as a new risk factor. Pharmacol Res. 2007;55(3):217-223.
  15. Spencer SJ, Korosi A, Layé S, Shukitt-Hale B, Barrientos RM. Food for thought: how nutrition impacts cognition and emotion. Sci Food. 2017;1(1):1-8.
Test Type: Urine Test
  • Organic Acids (urine)
  • Amino Acids (urine)
  • Oxidative Stress Markers (urine) include the oxidative damage markers lipid peroxides and 8-OHdG
  • Essential and Metabolic Fatty Acids - Bloodspot (if selected as add-on profile)
  • Nutrient and Toxic Elements - urine (if selected as add-on profile) assesses 20 toxic and 15 mineral elements
  • Genomics (if one or more of the following SNPs are selected as add-ons)