Functional Diagnostics

Transcription

1 IC No. Your Ref. No. Patient Tel Date Receive / Report Cellular Ene rgy Production Markers Methodology : LC-MS/MS Fatty Acid Metabolism (L-Carnitine and B2) 2. Suberate Ethylmalonate Result ug/mg cr Percentile Ranking By Quintile 20% 40% 60% 80% 95% 1. Adipate Carbohydrate Metabolism (B-complex, Cr, CoQ10, Lipoic Acid) 4. Pyruvate Lactate BHBA Cellular Energy Production (B-Complex, Mg, CoQ10, Lipoic Acid, Amino acid ) 7. Citrate Cis-aconitate Isocitrate AKA Succinate Fumarate Malate HMG Markers (Nutrient Requirements) Result ug/mg cr. Percentile Ranking By Quintile 20% 40% 60% 80% 95% 1. ITEM Data RR Quintile rankings are a percentile breakdown of population results. These are obtained arranging all the test results in a reference population from lowest to highest. These are then divided into 5 groups of equal numbers. The lowest 20% of results comprise the 1st quintile. Those results in the next 20% to 40% range are the 2nd quintile, and so forth. The 5th quintile would be the highest 20% of the results. This percentile ranking by quintile has proved useful in medical research by providing insight as to how test results in populations might relate to particular illnesses.

2 IC No. Your Ref. No. Patient Tel Date Receive / Report B-Complex Vitamin Status Makers Methodology : LC-MS/MS Percentile Ranking By Quintile B-Complex Vitamin Status (B-complex and Biotin) Result ug/mg cr. 20% 40% 60% 80% 95% 15. AKIV AKIC AKBM Xanthurenate BHIVA Methylation Cofactor (B12, B6, Folate, TMG) 20. MMA FIGLU Neurotransmitter Metabolism Markers Methodology : LC-MS/MS Percentile Ranking By Quintile Neurotransmitter Metabolism (Tyrosine, Tryptophan, 5-HTP, B6) Result ug/mg cr. 20% 40% 60% 80% 95% 22. HVA VMA HIAA Kynurenate Picolinate Quinolinate

3 IC No. Your Ref. No. Patient Tel Date Receive / Report Toxicants and Detoxification Methodology : LC-MS/MS Toxicants and Detoxification (Glycine, NAC, Sodium Glucuronate, Taurine, Magnesium sulfate, Phytochemicals) Result ug/mg cr. Percentile Ranking By Quintile 20% 40% 60% 80% 95% MetHip 29. Mandalate 30. PGA 31. Glucarate 32. AHBA 33. Pyroglutamate Orotate Gut Dysbiosis Markers Methodology : LC/MS/MS Gut Dysbiosis Markers (Probiotics, Anti-microbials, Digestive enzyme, S. boulardii) 35. Benzoate 36. Hippurate 37. PAA 38. PPA Yeast / Fungal Markers (Herbal antibiotics, Anti-fungal) HBA HPAA IAA DHPPA 43. Tricarballylate Citramate Tartarate 46. Arabinitol Result ug/mg cr Percentile Ranking By Quintile 20% 40% 60% 80% 95%

4 Cellular Energy Production Markers Stage 1 DIGESTION & ASSIMILATION Fats Carbohydrates Protein Stage 2 INTERMEDIARY METABOLISM Fatty acid Pyruvate #1 Mg β-oxidation Adipate B-Comp. CoQ10 #2 Suberate #3 Ethylmalonate Cofactor #13 Malate α -Oxidation #12 Fumarate #4 Oxaloacetate #11 Succinate Citric Acid Cycles 輔酶 Q10 鎂 CoQ10 Acetyl-CoA Succinyl CoA #5 Lactate Arginine #7 Citrate #10 AKA Amino Acids #6 BHBA #8 Cis-aconitate #9 Iso-citrate Inhibitor NADH, FADH 2 Stage 3 ELECTRON TRANSPORT Acetyl-CoA #14 HMG Cholesterol Electron Transport System O 2 CoQ10 Energy ATP H 2 O

5 Neurotransmitter Metabolism Tyrosine Tryptophan #22 HVA Dopamine 5-HTP Serotonin Tyr B-Comp. #24 5-HIAA #23 VMA Epinephrine Norepinephrine Melatonin Tryptophan Kynurenin 3-OH Kynurenine #25 Kynurenate #18 Xanthurenate B6 Mg 3-amino-3-carboxynuconate #26 Picolinate In urine #27 Quinolinate Inflammation Niacin

6 Toxicants and Detoxification Xylene F a t - s o l u b l e To x i n s Polycyclic Aromatic Hydrocarbons Rubber products Gas Exhaust gas Coatings Varnish Degreaser Paints Styrene Paints Cigarette Plastic bag Food containers Varnish Exhaust gas Areca Beer Hand cream Nitrosamine Hot Dog Cigarette Tire BBQ Cigarette Hard Cheese Ham Cured meat Salted fish Phase I Detoxification CYP450 Oxidation #28 2-MetHip Xylene Phase I Detoxification #29 Mandalate #30 PGA Styrene Glycine Conjugation #35 Banzoate #36 Hippurate #31 Glucarate Xenobiotics GSH Conjugation Glucuronidation #32 AHBA Glutathione(GSH) NAC #33 Pyroglutamate Renal amino acid Recovery Disposal of ammonia (Urea Cycle) #34 Orotate

7 Preservation in foods (Benzoic acid) Gut Dysbiosis Phe-rich foods Bacteria #35 Benzoate #36 Hippurate Preservation in cosmetics Phenylalanine Preservation (4-HBA) Clostridia Anaerobic #37 PAA #38 PPA Tyr-rich foods Bacteria #39 4-HBA Try-rich foods Polyphenolrich foods Sugar-rich foods Tyrosine Tryptophan Polyphenol Aerobic Candida #40 4-HPAA Giardia Lamblia #41 Clostridia IAA Clostridia #42 DHPPA #43 Tricarballyate Candida #44 Citramate #45 Tartarate 4R Digestive Health Program: 1R: Remove Herb antibiotics 2R: Replace Betaine HCl Pepsin Bromelain Papain 3R: Reinoculate 4R: Repair Glutamine NAG Grapes, Raisins, Wine, Cream of tartar Arabinose #46 Arabinitol Candida Joint inflammation Apples, Plums, Cherries, Grapes

8 1073 Function Profile Summary Category I: Cellular Energy Marker Efficient Fatty acid Metabolism: Your test results show reveal optimal ability to metabolize and burn fats. Inefficient Carbohydrate Metabolism: Your test results reveal inefficiency in your carbohydrate metabolism. This may result in: Alcohol, toxic chemical exposure, or anemia Hypoxia Excessive accumulation of Lactic Acid (e.g., during prolonged exercise) Low energy Inefficient Cellular Energy Production: Your test results reveal inefficiency in your cellular energy production. This is a critical process that occurs within all cells and sub-optimal energy production may result in: Fatigue and lack of vitality Ammonia toxicity Confusion and poor memory Increase oxidative stress Accelerated aging Low energy Lack of concentration and memory CoQ10 insufficiency Childhood developmental retardation Category II: B-Complex Vitamin Status Makers B-Vitamin Efficiency: Your test results show indications optimal B-vitamin status. Category III: Neurotransmitter Metabolism Markers Inefficient Neurotransmitter: Your test results show inefficient neurotransmitter, which may result in: Mood imbalances and mild depression Fatigue and lack of vitality Increased perception of pain and chronic pain Constipation Category IV: Toxicants and Detoxification Detoxification insufficiency: Your test results reveal sub-optimal ability to detoxify internal and external chemicals and toxins. Elevated body burden of toxin may result in: Styrene exposure Increase oxidative stress Increased risk for many chronic disease (e.g. heart disease, stroke, and cancer) Lack of concentration and memory Category V: Gut Dysbiosis Markers Intestinal Dysbiosis: Your test results Show a dysbiosis or lack of beneficial bacteria, which can result in: Intestinal bacteria overgrowth Increased risk for many chronic disease (e.g. heart disease, stroke, and cancer) Low HCl in stomach Detoxification insufficiency: Your test results reveal sub-optimal ability to detoxify internal and external chemicals and toxins. Elevated body burden of toxin may result in: Yeast and other vaginal infections Muscle and joint pain Depending on the result of your test, the nutritional requirements as follows: Consider amino acid supplementation Considerα-KG, tyrosine, aspartic acid supplementation Consider glycine, N-Acetyl-L-Cysteine(NAC), taurine, supplementation. Consider B2(riboflavin), B5(pantothenic acid), B6(pyridoxine), supplementation. Consider Mg, supplementation. Consider CoQ10 supplementation. Consider betine HCl and pepsin supplementation. Consider probiotics and prebiotics supplementation. Restricted carbohydrate diet. Yeast free diet. Avoid excess intake of exogenous sodium benzoate (preserved, packaged foods and some natural ingredient foods): Pickles, Soda, Lunchmeats, plums, prunes, rhubarb, and cranberries. Rule out tartaric acid-containing foods (fruits, especially grapes, raisins or wine; also as cream of tartar in some soft drinks & baked goods). Rule out arabinose containing foods (apples, plums, cherries, grapes).

9 1073 Function Profile Summary Depending on the result of your test, the food source of nutrients as follows: Protein Protein Cysteine Tyrosine Catalog Aspartic acid Glycine Taurine Carbohydrate Carbohydrate Vitamin B2(riboflavin) B5(pantothenate) B6 (pyridoxine) Mineral Mg Others CoQ10 Lifestyle & Health: Decrease stress (cortisol) emotional and physical. Reduce alcohol consumption. Food Sources Egg, milk, corn, pulses, whole grains, oatmeal, peanuts. Peppers, onions, garlic and wheat, poultry, oatmeal, dairy products. Meat (fish, chicken, and pork), whole grains (wheat and oats), dairy products (milk, cheese and yogurt), fruits (avocados and bananas), legumes and nuts (almond, lima beans, sesame seeds) and pumpkin seeds. Meat, sugar beets, oat, avocado and asparagus. Soybean, dairy products, egg and meat Eggs, seafood (fish, oysters and shellfish), meats and dairy products (milk). Soybean, nuts, seeds, fish and corn oils. Liver, whole grains (wheat flour and bread), yeast, milk, egg, nuts (almonds). Liver and kidney, yeast, egg yolk, broccoli, fish, shellfish, chicken, milk, yogurt, legumes, mushrooms, avocado, and sweet potatoes. Crude rice, wheat bran, garlic, liver, fish (tuna, salmon, and cod), sunflower and sesame seeds. Green leafy vegetables (e.g., Spinach), unrefined grains and nuts (oat bran and almonds), meats and milk. Meat, poultry, fish, soybean, canola oils, and nuts. Reduce toluene exposure (e.g., paints, paint thinner, perfume, fingernail polish, lacquers, adhesives). Maintan a good living habits. Testing and Treatment Guidelines: Adrencortex Stress Profile (#1070). Cardiometabolic Health Profile (#807). Address any joint inflammation. Have a functional medical exam every 3-6 months to make sure that you are getting enough nutrition and activity is recommended.

10 Functional Medicine Individualized Nutrition Formula With knowledge of a patient's full medical history and concerns, the Function Profile laboratory results may be used to help create an individualized nutrition formula. 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. Nutrients listed in this section are normally contained in a multi-vitamin preparation. Customized preparations of the multi-vitamin/mineral formula shown below may be produced by compounding pharmacies. Powder; Capsule Vitamin Dosage Per Day Vitamin Dosage Per Day Vitamin A (as Vitamin A Palmitate) IU 2500 Vitamin B2 (as Riboflavine 5 Phosphate) mg 6.25 Vitamin A (as Beta Carotene) IU 5000 Vitamin B3 (as Niacin) mg 50 Vitamin C (as Ascorbic Acid) mg 300 Niacinamide mg 15 Vitamin C (as Ascorbyl palmitate) mg 20 Vitamin B6 (as Pyrodoxine HCl) mg 50 Vitamin D3 (as Cholecalciferol) IU 1000 Vitamin B6 (as Pyrodoxal-5-Phosphate) mg 6.25 Vitamin E (as d-alpha Tocopherol) IU 75 Folic Acid (as L-5-MTHF) mcg 600 Vitamin E (as Mixed Tocopherols) IU 25 Vitamin B12 (as Methylcobalamin) mcg 800 Vitamin K1 mcg 100 Biotin mcg 400 Vitamin B1 ( as Thiamine Mononotrate) mg 25 Vitamin B5 (as Calcium Pantothenate) mg 25 Vitamin B2 (as Riboflavine) mg 50 Mineral Dosage Per Day Mineral Dosage Per Day Calcium (as Calcium Carbonate) mg 250 Manganese (as Manganese Glycinate) mg 5 Iodine (as Potassium Iodide) mcg 75 Chromium (as Chromium Picolinate) mcg 200 Magnesium (as Magnesium Glycinate) mg 300 Molybdenum (as Sodium Molybdate) mcg 100 Zinc (as Zinc Picolinate) mg 25 Boron (as Boron Citrate) mg 1 Selenium (as L-Selenomethionine) mcg 50 Sulfate (as Magnesium Sulfate) mg 150 Copper (as Copper AA Chelate) mg 1 Amino Acid & Phytonutrient Dosage Per Day Amino Acid & Phytonutrient Dosage Per Day Citric Acid mg 500 Glycine mg 500 Malic Acid mg 100 Tyrosine mg 1000 Betaine HCl mg 100 Taurine mg 250 Pepsin (1:10000) mg 20 Calcium-D-glucurate mg 150 CoQ10 mg 30 Milk thistle mg 150 N-Acetyl-L-Cysteine mg 250 Tumeric (curcuma longa) mg 150 OA03 Other suggested products but not included in the Individualized Nutrition Formula. Nutrient Products Dosage Herbal bacteriostatic agents Biocidin 2#qd Probiotics-Saccharomyces boulardii Co-biotic 1#qd Gastrointestinal restoration Inte-Guard 1#qd Essential Amino Acid Mixture based on the results of Amino Acid Testing

11 Function Profile The Function Profile is like an emission test performed on your car: the exhaust is examined to see how efficiently the engine is burning fuel. Similarly, certain compounds in your urine called organic acids reveal the efficiency of your body s machinery. Many organic acids result from the metabolic pathways, or chemical reactions, your body uses to transform food into energy, growth, maintenance, and repair of body tissue. Like spark plugs that ignite fuel in a car engine, vitamins and other essential nutrients are necessary for these chemical reactions that power your metabolic machinery. Thousands of these reactions occur in your body every second and are the basis of your level of health and vitality. The figure below illustrates a well-functioning metabolic pathway. Molecule A is converted to Molecule B by the enzyme AB. Molecule B is converted to Molecule C by the enzyme BC and so on, all the way down the metabolic pathway. Many enzymes require nutrient co-factors such as specific vitamins and minerals in order to perform their functions in converting one molecule to another. A B C D Enzyme AB with sufficient nutrient Enzyme BC Enzyme BC If one or more of these specific nutrients are not available in adequate amounts, important reactions cannot occur as well as they should. The illustration below shows what happens when the nutrient is not present in adequate amounts so that enzyme AB functions inefficiently. A small amount of Molecule A is converted to Molecule B and the remainder builds up and spills into the urine. Notice that Molecules C through D downstream are also affected. Block caused by vitamin insufficiency A B C D Enzyme AB with sufficient nutrient Enzyme BC Enzyme CD A In Urine Visualize this process as a dam blocking a stream very little water flowing downstream and an overflow occurring upstream. The Function Profile measures the overflow of certain organic acids in your urine to determine what blockages may be occurring in your metabolic pathways due to nutrient insufficiencies or other issues. High levels of many organic acids on your report can indicate which nutrient insufficiencies may be affecting your health. Other organic acids come from toxins you have been exposed to, and still others show how your body is responding to toxins. When these are high on your Function Profile, you may benefit from therapies that support your body s detoxification processes.

12 Category I: Cellular Energy Marker Carbohydrate Metabolism: B-complex, Cr, CoQ10, Lipoic Acid 4. Pyruvate is aerobic/anaerobic energy production. Low pyruvate indicates impaired production form glycogen (glycogenolysis), carbohydrates (glycolysis), or protein (gluconeogenesis). 5. Lactate is a product of muscle use, so it is constantly produced in normal daily activity. High Lactate can cause muscle cramping, fatigue and brain fog. It indicates insufficiency of coenzyme Q10 (CoQ10), a nutrient that enables the body to use oxygen to generate large amounts of energy. It is important for athletes in order to maintain intense muscular activity. CoQ10 is also a potent antioxidant helping to slow the aging process and prevent a variety of degenerative diseases. Risk for certain kinds of heart disease, cancer, and hypertension are increased when CoQ10 is insufficient. Cellular Energy Production: B-Complex, Mg, CoQ10, Lipoic Acid, Amino acid 7 and 8. Citrate, or cis-aconitate is metabolites of acetyl CoA, precursors of isocitate. Low Citrate, or Cis-aconitate can indicate a need for essential amino acids, especially arginine. 10. Alpha-ketoglutaric Acid (AKA) is metabolite of isocitrate, also glutamate; precursor of succinate. Low AKA can be caused by weakness of isocitrate dehydrogenase, the citric acid cycle enzyme that forms it from isocitric acid. This enzyme requires vitamin B3 as NAD, magnesium and manganese, and it is strongly inhibited by aluminum. Alpha-ketoglutaric acid is a scavenger of amino groups and ammonium ions in the body. Adding an amino group to alpha-ketoglutaric acid results in glutamate formation. 11. Succinate is used in the body s metabolic pathway that generates cellular energy the Citric Acid Cycle. This cycle critically supports organ maintenance and neurological function. High succinate may occur if succinate dehydrogenase is weak or rate-limited. This enzyme requires ferrous iron (Fe +2 ) and vitamin B2 as FAD, and is inhibited by excessive levels of malonate. If α-ketoglutarate is elevated along with succinate, malate, and fumarate, you may need additional CoQ10, a nutrient that enables the body to use oxygen to generate large amounts of energy. Category III: Neurotransmitter Metabolism Markers Neurotransmitter Metabolism: Tyrosine, Tryptophan, 5-HTP, B6 23. Vanilmandelate(VMA)is norepinephrine metabolite. Low VMA indicates your body is not making enough of epinephrine and norepinephrine neurotransmitters. Symptoms associated with this condition are depression, sleep disturbances, anxiety and fatigue. Treatments to improve digestion, along with supplementation of tyrosine, can help improve the ability to keep up with demand for these neurotransmitters.

13 25. Kynurenate is tryptophan catabolism and precursor to quinolinate.(see #27). High kynurenate indicates an insufficiency of vitamin B6, especially when xanthurenate (see #18) is high. Vitamin B6 deficiency symptoms are consistent with fatigue, irritability, GI distress, neuritis and neuropathy. Category IV: Toxicants and Detoxification Makers Detoxification: Glycine, NAC, Sodium glucuronate, Taurine, Magnesium sulfate, Phytochemicals 33. Pyroglutamate is product of gamma-glutamyl pathway required for renal amino acid recovery and small intestinal amino acid absorption. High Pyroglutamate indicates the body is using up glutathione to keep from losing amino acids. Glutathione is important for protection of cells from oxidation. Various amino acids, especially methionine and glycine, can help rebuild total body glutathione. Pyroglutamate elevation can also indicate a glycine insufficiency; supplementation with this amino acid may be indicated. Category V: Gut Dysbiosis Markers Gut Health: Probiotics, Anti-microbials, Digestive enzyme, S. boulardii 35. Benzoate is produced by intestinal bacteria. High Benozate: It can also occur in the urine because of exposure to foods that contain benzoate as a preservative, such as pickles and lunchmeats. The amino acid glycine and vitamin B5 are required to eliminate benzoate from your body. When benzoate is high, regardless of the source, these nutrients will help to lower the level. Yeast / Fungal Markers: Probiotics, Antibiotics, Anti-fungal agent 45.Tartaric Acid is breakdown product of hyaluronic acid, also contained in certain foods. Widely distributed in fruits, tartaric acid is particularly high in grapes, raisins, and in wine. It may also be found in some soft drinks and baked goods (as "cream of tartar"). High Tartaric Acid: The elevation of tartaric acid may be due to recent ingestion of higher than usual amounts of some of these foods. Aside from dietary sources, elevated urine tartrate can be the result of (intestinal) yeast overgrowth. Elevations also may be possible joint inflammation, leading to release of hyaluronic acid. 46. Arabinose is breakdown product of hyaluronic acid, also contained in certain foods. High Arabinose: Elevations may be indicate ingestion of arabinose-rich foods (apples, plums, cherries, grapes), and in juices made from these fruits. Elevations also may be possible joint inflammation, leading to release of hyaluronic acid. A finding of high arabinose, without dietary intake of the above-mentioned fruits, suggests a stool analysis or other tests/examinations for Candida overgrowth. *** The above suggestions are for doctor s reference only ***