0490 ION with Amino Acids 40 Profile

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1 Metametrix 1234 Main St. Anywhere, GA Accession Number: Order Number: G Number: Patient: Age: 51 Date Collected: Report Date: Telephone: Fax: Reprinted: Comment: Sex: 4/3/13 Date Received: 4/4/13 Female Date of Birth: 02/05/1962 4/5/ /24/ ION with Amino Acids 40 Profile

2 Date Received:04/04/2013 Date Reported: 04/05/2013 Amino Acids 40 Profile - Plasma Essential Amino Acids Limiting Amino Acids µmol/l Methodology: High Performance Liquid Chromatography 95% Lysine Methionine Tryptophan H Branched Chain Amino Acids 4 Isoleucine 5 Leucine 6 Valine Other Essential Amino Acids 7 Phenylalanine 8 Histidine 9 Threonine Conditionally Essential Amino Acids 10 Arginine Taurine Glycine Serine Functional Categories Vitamin B6 Status Markers 14 α-aminoadipic acid 15 α-amino-n-butyric acid (α-anb) 16 γ-aminobutyric acid (GABA) 17 Cystathionine < <0.6 <0.2 H <= 1.5 <= 39 <= 1.5 <= 0.3 Page 1

3 Date Received:04/04/2013 Date Reported: 04/05/2013 Amino Acids 40 Profile - Plasma Vascular Function µmol/l Methodology: High Performance Liquid Chromatography 95% 18 Arginine Taurine α-aminoadipic acid <0.5 Neurotransmitters and Precursors <= Phenylalanine Tyrosine Tryptophan Glutamic Acid 205 H Taurine 73 Sulfur Amino Acids (Glutathione - related) Methionine Cystathionine < Homocystine < Cystine Taurine <= <= Urea Cycle and Ammonia Detoxification Arginine Citrulline Ornithine Glutamine Asparagine Aspartic Acid Page 2

4 Date Received:04/04/2013 Date Reported: 04/05/2013 Amino Acids 40 Profile - Plasma Glycine, Serine and Related Amino Acids µmol/l Alanine Glycine Sarcosine Serine Phosphoserine < Ethanolamine Phosphoethanolamine 3.6 Collagen - Related Amino Acids 44 Proline Hydroxyproline Lysine 295 H 47 Hydroxylysine β-amino Acids and Derivatives 48 β-alanine 49 Histidine < Carnosine Methylhistidine Anserine 30 DNA (Thymine) Degradation 53 β- Aminoisobutyric Acid Muscle-Specific Amino Acids < Methodology: High Performance Liquid Chromatography % <= <= 0.8 <= 11.6 <= <= <= <= <= 6.3 <= 9.8 <= 43 <= Methylhistidine <= 52 Ratios 55 Phenylalanine/Tyrosine Glutamic Acid/Glutamine 0.42 H 57 Hydroxyproline/Proline α-anb/leucine 0.30 H Tryptophan/LNAA* L *Large neutral amino acids (Leu+Ile+Val+Phe+Tyr) <= <= <= Page 3

5 Homocysteine Assay - Plasma nmol/ml Date Received: 4/4/2013 Date Reported: 4/5/2013 Methodology: Competitive Immunoassay 95% Homocysteine 10.3 H Page 4

6 Date Received: 4/4/2013 Date Reported: 4/5/2013 Nutrient & Toxic Elements Profile - Blood Methodology: Inductively Coupled Plasma /Mass Spectroscopy 95% Nutrient Elements Erythrocytes (packed cells) 3,055 1 Potassium 3,483 2,426-4,472 ppm 44 2 Magnesium ppm 44 3 Calcium* ppm Plasma Zinc Copper , ,920 ppb ppb Whole Blood Selenium ppm Toxic Elements Whole Blood 7 Aluminum 14 8 Arsenic Cadmium < Lead 3 11 Mercury < <= 140 <= 13.7 <= 1.50 <= 36 <= 13.8 ppb ppb ppb ppb ppb *Relevant to membrane permeability, not nutritional status. Toxic metals are flagged high when the result is above the 95%. for whole blood toxic elements that are within normal limits do not rule out metal accumulation in other tissues. This can be evaluated with urinary porphyrin or urine elements tests. Page 5

7 CoEnzyme Q10 Plus Vitamins Profile - Serum mg/l Date Received: 4/4/2013 Date Reported: 4/5/2013 Methodology: High Performance Liquid Chromatography 95% Coenzyme Q alpha-tocopherol gamma-tocopherol 2.11 H Vitamin A β-carotene Lipid Peroxide Assay - Serum Methodology: High Performance Liquid Chromatography nmol/ml Lipid Peroxides 0.70 <= 2.60 DNA/Oxidative Stress Marker Assay - Urine ng/mg creatinine Methodology: LC/Tandem Mass Spectroscopy, Colorimetric Hydroxy-2-deoxyguanosine 2.2 <= 7.6 Vitamin D Profile - Serum Methodology: LC/Tandem Mass Spectroscopy ng/ml Sufficient 8 25-Hydroxyvitamin D Optimal 9 25-Hydroxyvitamin D Hydroxyvitamin D Total 25-Hydroxyvitamin D is considered the best assessment of vitamin D status. The test reflects vitamin D from all sources (diet, supplements, and sun exposure). A 2011 Endocrine Society Clinical Practice Guideline suggested vitamin D deficiency be defined as < 20 ng/ml, insuffuciency as ng/ml, and sufficiency as ng/ml.¹ The Vitamin D Council has proposed ng/ml as optimal, and 100 ng/ml as an upper limit.² 25-Hydroxyvitamin D3 is from sun exposure, vitamin D-rich foods, or vitamin D3 supplements. 25-Hydroxyvitamin D2 is only from fortified foods or supplements. 1. Holick MF, Binkley, NC, Bischoff-Ferrari, HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. July 2011, 96(7): Vitamin D Council Conversion factors: nmol/l = ng/ml x 2.5 ng/ml = nmol/l x 0.4 * <DL = less than detection limit Page 6

8 Date Received: 4/4/2013 Date Reported: 4/5/2013 Fatty Acids Profile - Plasma Methodology: Capillary Gas Chromatography/Mass Spectrometry 95% µmol/l Polyunsaturated Omega Alpha Linolenic (18:3n3) 16 L Eicosapentaenoic (20:5n3) 8 L Docosapentaenoic (22:5n3) 11 L Docosahexaenoic (22:6n3) 26 L Polyunsaturated Omega ,669 5 Linoleic (18:2n6) 701 L 821-2, Gamma Linolenic (18:3n6) Eicosadienoic (20:2n6) Dihomogamma Linolenic (20:3n6) Arachidonic (20:4n6) Docosadienoic (22:2n6) <0.23 <= Docosatetraenoic (22:4n6) Polyunsaturated Omega Mead (20:3n9) 2.0 <= 8.3 Monounsaturated Myristoleic (14:1n5) Palmitoleic (16:1n7) Vaccenic (18:1n7) 36 L , Oleic (18:1n9) , Eicosenoic (20:1n9) 3.3 L Nervonic (24:1n9) <1.1 L Page 7

9 Fatty Acids Profile - Plasma Saturated Date Received: 4/4/2013 Methodology: Capillary Gas Chromatography/Mass Spectrometry 95% µmol/l Capric (10:0) Lauric (12:0) Myristic (14:0) , Palmitic (16:0) 1, , Stearic (18:0) Arachidic (20:0) 1.4 L Behenic (22:0) Lignoceric (24:0) 0.71 L Hexacosanoic (26:0) <0.27 <= 0.43 Odd Chain Pentadecanoic (15:0) 5.5 <= Heptadecanoic (17:0) 7.9 <= Nonadecanoic (19:0) <0.86 <= Heneicosanoic (21:0) 32 Tricosanoic (23:0) Trans 33 Palmitelaidic (16:1n7t) <0.38 <0.37 < <= 0.74 <= 0.78 <= Total C:18 Trans 45 H <= 59 Ratios LA/DGLA EPA/DGLA 0.23 L AA/EPA 30 H Triene/Tetraene <= Page 8

10 Date Received: 4/4/2013 Date Reported: 4/5/2013 Organix Comprehensive Profile - Urine NUTRIENT MARKERS mcg/mg creatinine Methodology: LC/Tandem Mass Spectroscopy, Colorimetric 95% Fatty Acid Metabolism (Carnitine & B2) Adipate 1.7 <= Suberate 1.2 <= Ethylmalonate 1.2 <= 6.3 Carbohydrate Metabolism (B1, B3, Cr, Lipoic Acid, CoQ10) Pyruvate <DL* <= L-Lactate β-hydroxybutyrate <DL* <= 9.9 Energy Production (Citric Acid Cycle) (B comp., Q10, Amino acids, Mg) Citrate Cis-Aconitate Isocitrate a-ketoglutarate <= Succinate 3.4 <= Fumarate <= Malate 0.5 <= Hydroxymethylglutarate 1.6 <= 5.1 B-Complex Vitamin Markers (B1, B2, B3, B5, B6, Biotin) a-ketoisovalerate 0.07 <= a-ketoisocaproate 0.09 <= a-keto-β-methylvalerate 0.14 <= Xanthurenate 0.05 <= β-hydroxyisovalerate 2.7 <= 11.5 Methylation Cofactor Markers (B12, Folate) Methylmalonate 0.6 <= Formiminoglutamate <DL* <= 2.2 Page 9

11 Date Received: 4/4/2013 Date Reported: 4/5/2013 Methodology: LC/Tandem Mass Spectroscopy, Colorimetric Organix Comprehensive Profile - Urine CELL REGULATION MARKERS mcg/mg creatinine 95% Neurotransmitter Metabolism Markers (Tyrosine, Tryptophan, B6, antioxidants) 22 Vanilmandelate Homovanillate Hydroxyindoleacetate 1.7 L Kynurenate 0.3 <= Quinolinate 1.6 <= Picolinate 2.5 L Oxidative Damage and Antioxidant Markers (Vitamin C and other antioxidants) p-hydroxyphenyllactate 0.23 <= Hydroxy-2-deoxyguanosine 2.2 <= 7.6 (Units for 8-Hydroxy-2-deoxyguanosine are ng/mg creatinine). TOXICANTS AND DETOXIFICATION Detoxification Indicators (Arg, NAC, Met, Mg and antioxidants) 30 2-Methylhippurate <= Orotate 0.14 <= Glucarate 2.3 <= a-hydroxybutyrate 0.2 <= Pyroglutamate Sulfate 614 L 958 2, ,988 Page 10

12 Date Received: 4/4/2013 Date Reported: 4/5/2013 Organix Comprehensive Profile - Urine Methodology: LC/Tandem Mass Spectroscopy, Colorimetric mcg/mg creatinine 95% COMPOUNDS OF BACTERIAL OR YEAST/FUNGAL Bacterial - general Benzoate <DL* <= Hippurate <= 1, Phenylacetate <DL* <= Phenylpropionate 1.08 H <= p-hydroxybenzoate 0.2 <= p-hydroxyphenylacetate 34 H <= Indican 50 <= Tricarballylate 0.26 <= 1.41 L. acidophilus / general bacterial D-Lactate 0.7 <= 4.3 Clostridial species 45 3,4-Dihydroxyphenylpropionate 0.39 H <= 0.05 Yeast / Fungal D-Arabinitol 10 <= 73 Creatinine = 244 mg/dl * <DL = less than detection limit ** >LIN = greater than linearity limit Page 11

13 ION Analyte Pattern Analysis A multi-analyte report can provide greater insight about health risks and special nutrient needs. Patterns of abnormalities can reinforce the degree of significance indicated by a single measurement. Analytes from the various profiles in the ION report are combined below into categories associated with clinical/metabolic conditions. The categories included cover the most common areas of concern relevant to these profiles. Above each thermometer are listed the analytes used to calculate the degree of significance. An H or L appears when the patient result is in the fifth quintile (80%) of the population. An additional X next to an analyte indicates that the patient result is outside the 95% reference interval for that analyte. The thermometer advances to the right as the number and severity of relevant abnormalities increases. The longer the filled bar, the greater the degree of significance or likelihood that a health threat may exist in that category. The preceeding laboratory reports provide the detail upon which these thermometers are based. Cardiovascular System Arginine Homocysteine H Calcium Magnesium CoQ10 a-tocopherol g-tocopherol Lipid Peroxides 8-OHdG AA/EPA H Low significance Fatigue Isoleucine Leucine Phenylalanine Valine Magnesium CoQ10 Adipate Suberate AKG Succinate Malate Xanthurenate MeMalonate FIGLU Low significance Metabolic Syndrome (Syndrome X) Magnesium Palmitic Stearic AHB BHB BHiVal Low significance Mental/Emotional Tryptophan Tyrosine Magnesium EPA L DHA X L Xanthurenate MeMalonate FIGLU VMA 5-HIA L Low significance Page 12

14 ION Analyte Pattern Analysis Intestinal Bacterial Metabolites PhAc PhProp X H pohbenz pohphac H Indican Tricarb D-Lactate 3,4-DHPP X H Low significance Intestinal Yeasts / Fungal Metabolites D-Arabinitol Low significance Digestion/Absorption Arginine Histidine Isoleucine Leucine Lysine Methionine Phenylalanine Threonine Tryptophan Valine Selenium Low significance Toxic Exposure Aluminum Arsenic Cadmium Lead Mercury Palmitelaidic C18TrFa H Citrate Cis-Aconitate Isocitrate Quinolinate 2-MeHipp Orotate Glucarate Low significance Detoxification Impairment Methionine Glycine Serine Taurine Glutamine Pyroglutamate Sulfate X L Benzoate Low significance Page 13

15 ION Analyte Pattern Analysis Oxidative Stress/Antioxidant Insufficiency Taurine Selenium Lead Mercury a-tocopherol g-tocopherol Vitamin A b-carotene Lipid Peroxides 8-OHdG pohphlac Sulfate X L Low significance Mitochondrial Functional Impairment Magnesium CoQ10 Adipate Suberate Ethylmalonate Pyruvate L-Lactate AHB BHB Succinate Fumarate Malate Low significance Amino Acid Insufficiency Arginine Histidine Isoleucine Leucine Lysine Methionine Phenylalanine Threonine Tryptophan Valine AKG Succinate Sulfate X L Low significance Essential Fatty Acid Insufficiency AA ALA L LA X L GLA DGLA Palmitoleic Triene/Tetraene EPA L DHA X L Low significance Disordered Methyl Group (Single carbon) Transfer Homocysteine H Pentadeca Heptadeca Nonadecanoic Tricosanoic Xanthurenate MeMalonate FIGLU Kynurenate Low significance Page 14

16 ION Analyte Pattern Analysis Disordered Tryptophan Metabolism Tryptophan Xanthurenate 5-HIA L Quinolinate Indican Low significance Kynurenate Abbreviation 2-MeHipp 5-HIA 8-OhdG AA/EPA AHB akbmeval AKG akicap akival ALA a-tocopherol BHB BHiVal C18TrFa CoQ10 DGLA DHA 3,4-DHPP EPA Analyte Name 2-Methylhippurate 5-Hydroxyindoleacetate 8-Hydroxy-2-deoxyguanosine Arachidonic (20:4n6)/Eicosapentaenoic (20:5n3) a-hydroxybutyrate a-keto-ß-methylvalerate a-ketoglutarate a-ketoisocaproate a-ketoisovalerate Alpha Linolenic (18:3n3) alpha-tocopherol ß-Hydroxybutyrate ß-Hydroxyisovalerate Total C:18 Trans Coenzyme Q10 Dihomogamma Linolenic (20:3n6) Docosahexanoic (22:6n3) 3,4-Dihydroxyphenylpropionate Eicosapentaenoic (20:5n3) Abbreviation FIGLU g-tocopherol GLA Heptadeca Hcys HVA HMG LA MeMalonate Pentadeca PhAc PhProp phbenz phphac phphlac Total C:18 Tricarb Triene/Tetraene VMA Analyte Name Formiminoglutamate gamma-tocopherol Gamma Linoleic (18:3n6) Heptadecanoic (17:0) Homocysteine Homovanillate Hydroxymethylglutarate Linoleic (18:2n6) Methylmalonate Pentadecanoic (15:0) Phenylacetate Phenylpropionate p-hydroxybenzoate p-hydroxyphenylacetate p-hydroxyphenyllactate Total c:18 Trans Tricarballylate Mead/Arachidonic Ratio Vanilmandelate Page 15

17 Supplement Recommendation Summary With knowledge of a patient's full medical history and concerns, the ION Profile laboratory results may be used to help create an individually optimized nutritional support program. Based strictly on the results from this test, the summary table below shows estimates of nutrient doses that may help to normalize nutrient-dependent metabolic functions. Customized Vitamin and Mineral Formulation Nutrients listed in this section are normally contained in a multi-vitamin preparation. "Base" amounts may be used to ensure health even when no abnormalities are found. Customized preparations of the multi-vitamin/mineral formula shown below may be produced by compounding pharmacies. Base Daily Amounts Units Added Vitamin A B-Carotene Vitamin C Vitamin D Vitamin E (Mixed Tocopherols) Vitamin K* Thiamin (B1) Riboflavin (B2) Niacin (B3) Pyridoxine (B6) Folic Acid (or 5-Methyl-THF) Vitamin B12 Biotin Pantothenic Acid (B5) Calcium Citrate Iodine* Magnesium Zinc Selenium Copper Manganese* Chromium Molybdenum* Boron* 2500 IU 5500 IU 250 mg 400 IU 100 IU 100 mcg 5 mg 5 mg 25 mg 15 mg 400 mcg 50 mcg 100 mcg 25 mg 500 mg 75 mcg 250 mg 15 mg 100 mcg 1 mg 5 mg 200 mcg 25 mcg 1 mg 50 mg 500 mcg 800 mcg 600 mcg * Nutrients with an asterisk are not modified based on the ION test results. MM01 Page 16

18 Other Items Indicated for Individual Supplementation Various conditionally essential nutrients and other potentially beneficial interventions appear in this section only if relevant abnormalities are present. These ingredients are not included in the customized vitamin formula on the previous page. Amino acids listed on this page result from functional markers of individual amino acid insufficiency and do not reflect amino acids measured in plasma. Item Potential to Benefit from Probiotics Fish Oil N-Acetylcysteine S. boulardii Amount Medium 6 gm 400 mg As needed Page 17

19 Customized Free-Form Amino Acids The table below shows a customized amino acid formula based on the results of your laboratory profile. The formula is optimized by adding amounts shown in the Grams Added column according to the relative positions of results found. Directions: Adults mix 1 and 1/2 measuring teaspoon (5g) in juice or water 2 times daily between meals as a dietary supplement, or as directed by a health care provider. Children under 12 years old: 3/4 teaspoon 1-2 times daily between meals. Children under 5 years old: Use 1/4 teaspoon, 1-3 times daily; adjust for body weight. Grams Added % of Formula Active mg/day L-Arginine HCl (80% active) L-Histidine HCl (74% active) L-Isoleucine L-Leucine ,152 L-Lysine HCl (80% active) L-Methionine L-Phenylalanine ,219 Taurine L-Threonine L-Tryptophan L-Valine ,009 Pyridoxal-5-phosphate Alpha-ketoglutaric acid Total grams added 4 Base Formula amount 296 Total Weight 300 L-5-Hydroxytryptophan This formula is intended to optimize essential and conditionally essential amino acid intake. Other non-essential amino acids can be produced in human tissues. Pyridoxal-5-phosphate (an active form of vitamin B6) and alpha-ketoglutaric acid are key factors needed for the body's utilization of amino acids. The formula may be ordered as a powder that dissolves easily in beverages or may be added to foods such as applesauce. Other forms of supplemental dietary protein or amino acids may need to be restricted while using your customized formula. If enhanced energy levels prevent sleep, avoid bedtime use. This formula is provided as a starting point that may guide decisions about medical treatment based on the test results. It is derived only from the laboratory results included in this report. Final recommendations should be based on consideration of the patient's medical history and current clinical condition. In addition to the above customized amino acid formula, this patient may benefit from further use of single amino acids, as evidenced by profiles other than plasma amino acids. See the category, "Other Indicated Nutrients" on your Supplement Recommendation Summary Page. Page 18

0490 ION with Amino Acids 40 Profile

Accession Number: Order Number: Number: Patient: Age: Sex: Date of Birth: Date Collected: Report Date: Telephone: Fax: Reprinted: Comment: 0490 ION with Amino Acids 40 Profile Amino Acids 40 Profile -