test interpretations Flashcards by casey barbles

high adipate, suberate and ethylmalonate

carnitine deficiency, anything that interferes with normal fatty acid oxidation may reveal high levels

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associated with coenzyme Q10, biotin and lipoic acid deficiencies.

also: overwhelimng infection, hypoxia, high intake of acetaminophen, increased consumption of alcohol, cocaine, high iron levels, drug side effects, diabetes

if high consider supplementing with CoQ10, vitamin b1,2,3,5, lipoic acid and biotin

high lactate

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elevated with B1, B5 and lipoic acid are insufficient

Pyruvate

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combination of high lactate and pyruvate

lipoic acid deficiency

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lactate elevations alone

Coq10 deficiency

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H a-ketoglutarate, a-ketoisovalerate, a-ketomethulvalerate

impaired metabolism due to cofactor insufficiencys or toxic metals, low B1,3,5,lipoic acid

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L- a-ketoglutarate, a-ketoisovalerate, a-ketomethulvalerate

Low b6 to low branched chain amino acids.

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metabolic marker of blood sugar utilization and insulin function, by product of ketosis

b-hydroxybutyrate

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H b-hydroxybutyrate

low chromium, vanadium or lipoic acid

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Carnitine is needed to

move fatty acids into the mitochrondria where they are converted to energy using b2 (carnitine shuttle)

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has been documented to improve Alzheimers, age related cognitive decline and cognitive function

carnitine

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principal product of glucose metabolism in skeletal muscle and a major player in anaerobic energy production and gluconeogenesis

lactate

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If high, impaired metabolism due to toxic metals (FL, HG, AS, SB) or low cofactors (Fe, GSH, depleted in oxidative stress)

high dietary citric acid

metallic acidosis

Citrate, cis-aconitate

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Can indicate arginine insufficiency for ammonia clearance throught he urea cycle if high

citrate and cis-aconitate

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Food sensitivity/leaky gut syndrome, elevated IGG

Low intestinal secretory IgA

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Suspect ingestion of contaminated food, especially undercooked ground beef, raw milk, upasteurized apple juice, water and lattuce

EHEC (entero-hemorrhagic escherichia coli)

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common source of contamination is swimming pools, outbreaks are associated with raw milk and meal - likely cause to travelers diarrhea

crytosporidium

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fecal-oral transmission and water contaimination are common sources

dientamoeba fragilis

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non-pathogenic amoeba

endolimax nana or entamoeba hartmanni

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transmitted via skin contact with contaminated soil or oral ingrestion of larvae

strongyloides

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taenia sp - via raw meat

tapeworm

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transmitted from ingested feces, contimnated soil or underwashed vegetables

whipworm

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come from dietary carbohydrates that have escaped digestion or absorption in the small bowel or from prebiotics that have undergone fermentation in the colon

SCFA or N-butyrate

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fuel for colonycytes & protective against colon cancer

N-butyrate

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Extremely elevated levels indicate underlying GI abnormalities and need to be evaluated in conjunction with other stool profile markers

elevated total SCFA or N-butyrate

caused by bacterial overgrowth, rapid transit time, malabsorption, pancreatic insufficiency resulting in carbohydrate maldigestion and increased bacterial fementation

elevated total SCFA or N-butyrate

caused by gluten enteropathy or sensitivity in colon

elevated anti-gliadin antibody

caused by bacterial overgrowth, carb maldigestion, lipid malabsorption, rapid transit time

decreassed PH

caused by decreased bacterial production of SCFA, insufficient flora, dietary fiber or water

elevated PH

caused by bleedingin upper GI tract due to peptic ulcer, inflammatory bowel disease, parasite, colon cancer or hemorrhoids

positive occult blood

suspect inadequate physical and immune barrier functions, antibiotics, nsalds, antacids, inadequate digestive and absorptive function

abnormal bacteria, fungi and/or parasites

Causes peptic ulcer disease and associated with gastric cancer

H. pylori

suspect recent antibiotic use, especially the cephalosporins, amoxicillin

C Diff

Elevated lactoferrin, WBCs or Mucus

mucosal inflammation, bacterial or yeast overgrowth, parasite infection, inflammatory bowel disease such as chrohn's

decreased fecal sIgA

chronic stress, immunocompromise, dysbiosis, immunosupressing medication

elevated fecal sigA

food sensitivities, immune response to eliminate pathogenic organisms in GI tract

depressed elastase

suppresed pancreative function, gallstones, chronic pancreatitis, diabetes, hypochlorhydria, cystic fibrosis

A digestive enzyme excreted by the pancreas exclusively and has a direct correlation with pancreatic function

Elastase 1

elevated vegetable fibers, triglycerides

mal digestion, hypochlorhydria, pancreatic insuffiency, bile salt insuffiency, indaquate chewing

elevated LCFA, total fat or cholesterol

indicates mal absorption, high dietary fat intake, medications designed to bind and eliminate fat,

Elevated SCFA

bacterial overgrowth in small intestine

magnesium, NADP (b3), FAD (b2), low homocysteine, oxidative stress, NAC

markers that may indicate glutathione depletion

radioimmunoassay for undercarboxylated osteocalcin and the measurement of y-carboxylglutamate measure what vitamin

low citrate and cis-aconitate

low or high pyruvic acid or low acetyl coa (from fatty acid oxidation)

high isocitrate

arginine insuffiency, impared metabolism due to low cofactors (b3, MG, MN) inhibited by aluminum

low isocitrate

Impaired metabolism due to toxic metals (Fl, Hg, As, Sb) OR low cofactors (Fe, GSH— depleted in oxidative stress); OR high amounts of dietary citric acid; OR metabolic acidosis (if mildly increased cisaconitic acid but markedly increased citric acid).

are used in the body’s metabolic pathway that generates cellular energy – the Citric Acid Cycle. Higher levels of these compounds in urine indicate inefficiencies in energy production. If ketoglutarate is elevated along with succinate, malate, and fumarate, you may need additional CoQ10.

succinate, fuumarate and malate

e are metabolites of the amino acids leucine & isoleucine and phenylalanine & tyrosine respectively.

succinate and fumarate

low succinate, fumarate and malate

Consider over-utilization of the Citric Acid Cycle. Fatigue and weakness are common symptoms. Consider supplementing with L-Leucine, L-Isoleucine and Vitamin B12 with low succinate, tyrosine & phenylalanine with low fumarate and balanced amino acid blend with low malate.

is a metabolic precursor of cholesterol used by your cells to make CoQ10, a nutrient that enables the body to use oxygen to generate large amounts of energy.

hydroxymethylglutarate (HMG)

HIgh levels of HMG

COq10 deficiency & use of chholesterol-lowering statin drugs

e can reveal a block in your body’s synthesis of coenzyme Q10. Other functional markers such as Lactate, Succinate, Fumarate, and Malate, indicate whether your body is able to produce energy efficiently by utilizing coenzyme Q10.

HMG

is a functional marker of B6 (Pyridoxine) and is a metabolite of the amino acid tryptophan.

Xanthurenate

High levels can indicate an insufficiency of B6, a vitamin critical for all protein metabolism.

xanthurenate

is a sensitive indicator of biotin deficiency and is a metabolite of the amino acid isoleucine.

B-hydroxyisovalerate

is a functional marker of vitamin B12 and a metabolite of the amino acid valine. High levels indicate insufficient vitamin B12. Increased alcohol consumption, dysbiosis, aging and HIV infection will all have a detrimental impact on B12 absorption.

Methylmalonate

is a functional marker of insufficiency of folic acid and is a compound made from the amino acid histidine. High levels indicate insufficient folic acid. Increased alcohol consumption, excessive consumption of processed foods, oral contraception, smoking and pregnancy will all have a detrimental impact on folic acid absorption.

FIGLU/ formiminoglutamate

p-Hydroxyphenyllactate i

is a metabolite of the amino acid Tyrosine.

is a metabolite of the amino acid Tyrosine. It is a sensitive marker for the depletion of methyl- p-hydroxyphenyllactate which is an important cell growth inhibiting agent. Due to its pro-oxidative character high levels are associated with carcinogenesis.

p-Hydroxyphenyllactate

is marker for oxidative damage to DNA. Causes of increased levels of may be due to stress, smoking, chronic inflammation, diabetes, air pollution, high polyunsaturated fat intake, irradiation, thermal injury, heavy metal and pesticide toxic exposure.

8-Hydroxy-2-deoxyguanosine

High levels of p-Hydroxyphenyllactate, 8-Hydroxy-2’-deoxyguanosine, Glucarate, and Quinolinate are associated with

increased oxidative stress

metabolite of phenylalanine - Excessive phenylalanine (dietary or PKU) or tyrosine; OR reduced oxygenation (e.g., iron deficiency anemia, pulmonary disorder); OR low tetrahydrobiopterin (BH4), which may result in low neurotransmitters and/or nitric oxide

2-hydroxyphenlactic acid

metabolite of tyrosine -- if high If HIGH Impaired metabolism to homogentisic acid due to cofactor insufficiencies (copper, vitamin C, O2); OR possible low iron (if homogentisic acid is markedly elevated); Supplement vitamin C or Cu, improve oxygenation (e.g., correct anemia, pulmonary problems, cardiac insufficiency, etc.)

4-hydroxphenlpyruvic acid

IF HIGH | Impaired metabolism due to cofactor insufficiency (iron, vitamin C, O2); OR alkaptonuria (rare)

Homogentisic acid

(Made from tryptophan and lysine via alpha-aminoadipic acid, also a byproduct of yeast; precursor of glutaric acid) If HIGH May be secondary to high glutaric acid (check glutaric level); OR impaired metabolism due to cofactor insufficiencies OR toxic metals (As, Hg, Sb, Cd); OR may be secondary to yeast or fungal infection (derives from alphaaminoadipic acid)—see yeast markers.

a-ketoadipic acid (AKAA)

Metabolite of lysine and tryptophan. If HIGH Possible low FAD (riboflavin) (cofactor for alternative metabolism of one of glutaric acid’s precursors); OR inborn error of metabolism; may be associated with CETP genetic polymorphism.

glutaric acid

(Metabolite of aspartic acid. If HIGH Possible liver damage (e.g., from alcohol), urea cycle dysfunction, ammonia excess OR; barbiturates; OR impaired metabolism due to cofactor insufficiencies (vitamins B3, B6, folate, Mg, glutamine, glycine, serine); OR use of allopurinol or chemotherapy

Orotic acid

Intermediate in the recycling of glutathione) If HIGH Impaired recycling to glutathione due to cofactor insufficiencies (Mg, cysteine, glycine, glutamic acid); consistent with deficient GSH Supplement Mg, N-acetylcysteine (NAC), possible glycine, L-glutamine, &/or GSH

Pyroglutamic acid

``` If LOW Low glutathione (insufficient precursors, toxicity, or oxidant stress) ```

pyroglutamic acid

(Formed from “omega” oxidation of fats when beta oxidation is impaired) If HIGH Impaired mitochondrial beta oxidation of fats; may be secondary to insufficient carnitine, B2, or acetyl CoA, or to insulin excess; OR may be secondary to ketosis. Consider supplementing with L-carnitine or acetyl-L-carnitine, riboflavin, acetyl CoA precursors

adipic acid

from acetyl CoA, precursor of cholesterol and CoQ10) If HIGH Citric acid cycle impairment (anaerobic glycolysis); OR carbohydrate unavailability (e.g., high-protein diet, fasting, diabetes); OR inhibited utilization of HMG (e.g., from high cholesterol diet, yeast overgrowth, glucocorticoid excess, statins)

B-OH-b-methyglutaric acid

If HIGH Ketosis from carbohydrate unavailability (e.g., fasting, diabetes, strenuous exercise, ketogenic diet)

B-oh-butyric

test interpretations Flashcards

(72 cards)