Essential Amino Acids

3425 Corporate Way Duluth, GA 30096 Patient: SAMPLE PATIENT DOB: Sex: MRN: 3100 ION Profile - Blood / Urine Amino Acids 20 Profile - Plasma Methodology: High Performance Liquid Chromatography s: Ages 13 and over. Limiting Amino Acids 1. 2. 3. Essential Amino Acids 117 203 Lysine 100 99-234 16 26 Methionine 14 14-30 35 59 Tryptophan 25 L 30-67 Branched Chain Amino Acids 4. 5. 6. 40 72 Isoleucine 30 L 33-89 80 137 Leucine 57 L 68-161 143 240 Valine 159 123-282 Other Essential Amino Acids 7. 8. 9. μmol/l 43 64 Phenylalanine 42 39-74 48 72 Histidine 62 41-82 76 151 Threonine 100 63-181 Conditionally Essential Amino Acids 48 96 10. Arginine 69 37-114 31 73 11. Taurine 89 26-100 162 348 12. Glycine 474 H 136-430 66 115 13. Serine 94 57-133 C0090.1

Amino Acids 20 Profile - Plasma Methodology: High Performance Liquid Chromatography s: Ages 13 and over. Vascular Function 14. 15. Neurotransmitters and Precursors 16. 17. 18. 19. 20. Sulfur Amino Acids (Glutathione - related) 21. 22. 23. 24. 25. 26. 27. 28. 30. μmol/l 48 96 Arginine 69 37-114 31 73 Taurine 89 26-100 43 64 Phenylalanine 42 39-74 38 70 Tyrosine 30 29-80 35 59 Tryptophan 25 L 30-67 29 95 Glutamic Acid 180 H 23-136 31 73 Taurine 89 26-100 16 26 Methionine 14 14-30 31 73 Taurine 89 26-100 Urea Cycle and Ammonia Detoxification 48 96 Arginine 69 37-114 20 38 Citrulline 48 H 15-44 32 81 Ornithine 45 23-109 30 49 Asparagine 25 L 26-56 4.8 9.7 Aspartic Acid 13.1 H 4.2-12.5 Ratios 29. Phenylalanine/Tyrosine 1.40 <= 1.44 31. Functional Categories 397 585 Glutamine 339 338-630 0.06 0.21 Glutamic Acid/Glutamine 0.53 H 0.05-0.35 Page 2 0.100 0.106 Tryptophan/LNAA* 0.079 L 0.095-0.106 *Large neutral amino acids (Leu+Ile+Val+Phe+Tyr) NR = Not Reportable C0090.2

Page 3 Methodology: Enzymatic Assay s: Ages 13 and over. Homocysteine Assay - Plasma 4.0 10.0 1. Homocysteine 20.7 H 3.0-14.0 nmol/ml Nutrient & Toxic Elements Profile - Blood Methodology: Inductively Coupled Plasma/Mass Spectrometry Erythrocytes (packed cells) 1. 2. 3. Nutrient Elements Potassium 2,519 2,303-3,374 ppm 44 Magnesium 38 34-63 ppm 44 Calcium* 31 24-65 ppm Plasma 815 4. Zinc 782 643-1,594 ppb 929 5. Copper 952 753-1,920 ppb Whole Blood 0.16 6. Selenium 0.17 0.13-0.32 ppm 2,672 Whole Blood Toxic Elements 7. Aluminum 26 <= 113 ppb 5.1 8. Arsenic 11.5 H <= 10.0 ppb 0.60 9. Cadmium 0.21 <= 1.10 ppb 18 10. Lead 22 <= 29 ppb 4.3 11. Mercury 3.8 <= 9.8 ppb 45 *Relevant to membrane permeability, not nutritional status. for whole blood toxic elements that are within normal limits do not rule out metal accumulation in other tissues. NR = Not Reportable C0090.3

Page 4 Methodology: High Performance Liquid Chromatography s: Ages 13 and over. mg/l Coenzyme Q10 Plus Vitamins Profile - Serum 0.64 2.16 1. Coenzyme Q10 2.73 0.48-3.04 2. 3. 4. 5. 9.8 25.1 alpha-tocopherol 42.6 H 6.8-31.7 0.26 2.06 gamma-tocopherol 2.19 0.06-2.99 0.36 0.74 Vitamin A (Retinol) 1.39 H 0.29-1.05 β-carotene 0.15 1.70 0.47 0.10-2.71 Lipid Peroxides Assay - Serum Methodology: High Performance Liquid Chromatography nmol/ml 1.72 6. Lipid Peroxides 1.47 <= 2.60 Methodology: LC/Tandem Mass Spectrometry, Colorimetric s: Ages 13 and over. ng/mg creatinine 7. DNA/Oxidative Stress Marker (8-OHdG) Assay - Urine 8-Hydroxy-2-deoxyguanosine 4.9 <= 7.6 5.3 Vitamin D Profile - Serum Methodology: Chemiluminescent Reference ng/ml 8. 25-Hydroxyvitamin D 57.1 30.0-100.0 ng/m Deficiency: Insufficiency: Sufficient: Recommended: Excessive: <20 ng/ml 20-29 ng/ml 30-100 ng/ml 50-80 ng/ml >100 ng/ml There is no consensus in the literature regarding optimal levels of 25-Hydroxyvitamin D. Higher levels of 25-Hydroxyvitamin D may be concerning in some patient populations, such as renal failure. Levels below 30 ng/ml are considered insufficient by most medical associations.treatment is at the discretion of the treating clinician. Holick MF, et al. J Clin Endocrinol Metab. 2011;96(7):1911-1930. Vitamin D Council: https://www.vitamindcouncil.org/ <DL = less than detection limit NR = Not Reportable 25-Hydroxyvitamin D testing performed by Genova Diagnostics, Inc. 63 Zillicoa St., Asheville, NC 28801-0174. A. L. Peace-Brewer, PhD, D(ABMLI), Lab Director - CLIA Lic. #34D0655571 - Medicare Lic. #34-8475. C0090.5

Fatty Acids Profile- Plasma Methodology: Capillary Gas Chromatography/Mass Spectrometry s: Ages 13 and over 1. 2. 3. 4. μmol/l Polyunsaturated Omega-3 20 Alpha Linolenic (18:3n3) 25 13-80 17 Eicosapentaenoic (20:5n3) 29 5-210 16 Docosapentaenoic (22:5n3) 21 11-50 59 Docosahexaenoic (22:6n3) 110 31-213 Page 5 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. Polyunsaturated Omega-6 930 1,669 Linoleic (18:2n6) 1,275 821-2,032 7 33 Gamma Linolenic (18:3n6) 5 5-46 6.4 15.3 Eicosadienoic (20:2n6) 12.3 5.2-22.5 34 102 Dihomogamma Linolenic (20:3n6) 39 27-140 201 451 Arachidonic (20:4n6) 299 158-521 0.9 Docosadienoic (22:2n6) 0.8 <= 2.0 3.7 13.8 Docosatetraenoic (22:4n6) 5.3 2.6-18.1 Polyunsaturated Omega-9 5.3 Mead (20:3n9) 2.3 <= 8.3 Monounsaturated 1.2 6.1 Myristoleic (14:1n5) 1.9 0.8-9.7 40 155 Palmitoleic (16:1n7) 52 30-256 48 93 Vaccenic (18:1n7) 71 40-122 555 1,182 Oleic (18:1n9) 1,058 466-1,470 4.6 10.3 11-Eicosenoic (20:1n9) 7.6 3.7-18.1 1.1 2.2 Nervonic (24:1n9) 1.9 1.1-2.7 C0090.7

Page 6 Fatty Acid Profile - Plasma Methodology: Capillary Gas ChromatographyMass Spectrometry s: Ages 13 and over μmol/l 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. Saturated 1.4 4.0 Capric (10:0) 1.3 0.8-6.2 3.3 14.5 Lauric (12:0) 4.7 2.2-27.3 20 87 Myristic (14:0) 26 15-139 792 1,794 Palmitic (16:0) 1,339 667-2,526 294 511 Stearic (18:0) 545 250-629 1.5 3.2 Arachidic (20:0) 3.0 1.3-4.7 0.8 2.0 Behenic (22:0) 0.9 0.6-2.9 0.84 1.66 Lignoceric (24:0) 1.31 0.63-2.45 0.36 Hexacosanoic (26:0) 0.35 <= 0.43 Odd Chain 14.5 Pentadecanoic (15:0) 9.5 <= 20.6 19.3 Heptadecanoic (17:0) 18.3 <= 24.4 1.51 Nonadecanoic (19:0) 1.83 <= 1.89 0.50 Heneicosanoic (21:0) 0.38 <= 0.74 0.62 32. Tricosanoic (23:0) 0.80 H <= 0.78 33. 34. 35. 36. 37. 38. Trans 0.4 Palmitelaidic (16:1n7t) 1.0 <= 1.8 42 Total C:18 Trans 21 <= 59 Ratios 30 LA/DGLA 33 11-46 0.24 EPA/DGLA 0.74 0.07-5.98 20 AA/EPA 10 1-57 0.016 Triene/Tetraene 0.008 <= 0.023 NR = Not Reportable C0090.9

Organix Comprehensive Profile - Urine Methodology: LC/Tandem Mass Spectrometry, Colorimetric This report is not intended for the diagnosis of neonatal inborn errors of metabolism. s: Ages 13 and over mcg/mg creatinine Nutrient Markers Fatty Acid Metabolism (Carnitine & B2) 6.2 1. Adipate 7.8 <= 11.1 2.1 2. Suberate 0.9 <= 4.6 3.6 3. Ethylmalonate 7.9 H <= 6.3 Carbohydrate Metabolism (B1, B3, Cr, Lipoic Acid, CoQ10) 3.9 4. Pyruvate <DL <= 6.4 8.5 5. L-Lactate 8.6 0.6-16.4 2.1 6. β-hydroxybutyrate 2.5 <= 9.9 Energy Production (Citric Acid Cycle) (B comp., CoQ10, Amino Acids, Mg) 601 7. Citrate 570 56-987 51 8. Cis-Aconitate 35 18-78 98 9. Isocitrate 91 39-143 19.0 10. α-ketoglutarate <DL <= 35.0 11.6 11. Succinate 21.0 H <= 20.9 0.59 12. Fumarate <DL <= 1.35 1.4 13. Malate 1.1 <= 3.1 3.6 14. Hydroxymethylglutarate 3.6 <= 5.1 B-Complex Vitamin Markers (B1, B2, B3, B5, B6, Biotin) 15. α-ketoisovalerate 16. 17. 18. 19. α-ketoisocaproate α-keto-β-methylvalerate 0.25 <DL <= 0.49 0.34 <DL <= 0.52 0.38 <DL <= 1.10 0.34 Xanthurenate <DL <= 0.46 7.6 β-hydroxyisovalerate 4.5 <= 11.5 Page 7 C0090.11

Organix Comprehensive Profile - Urine Methodology: LC/Tandem Mass Spectrometry, Colorimetric This report is not intended for the diagnosis of neonatal inborn errors of metabolism. s: Ages 13 and over mcg/mg creatinine Methylation Cofactor Markers (B12, Folate) 20. 21. Neurotransmitter Metabolism Markers (Tyrosine, Tryptophan, B6, Antioxidants) 22. 23. 24. 25. 26. 27. Cell Regulation Markers 1.6 3.9 Vanilmandelate 3.8 1.2-5.3 1.9 5.7 Homovanillate 4.3 1.4-7.6 2.1 5.6 5-Hydroxyindoleacetate 6.8 1.6-9.8 1.0 Kynurenate 1.1 <= 1.5 4.0 Quinolinate 2.6 <= 5.8 8.0 Picolinate 5.6 2.8-13.5 Oxidative Damage and Antioxidant Markers (Vitamin C and Other Antioxidants) 28. 29. p-hydroxyphenyllactate 0.47 <= 0.66 5.3 8-Hydroxy-2-deoxyguanosine 4.9 <= 7.6 (Units for 8-hydroxy-2-dexoyguanosine are ng/mg creatinine) Detoxification Indicators (Arg, NAC, Met, Mg, Antioxidants) 30. 31. 32. 33. 34. 35. Toxicants and Detoxification 0.39 2-Methylhippurate 0.111 <= 0.192 0.69 Orotate 0.57 <= 1.01 6.3 Glucarate 9.9 <= 10.7 α-hydroxybutyrate Nutrient Markers Methylmalonate 0.6 <= 2.3 1.2 Formiminoglutamate 0.5 <= 2.2 59 Pyroglutamate 67 28-88 958 2,347 Sulfate 1,531 690-2,988 0.084 0.3 <DL <= 0.9 1.7 Page 8 C0090.13

Organix Comprehensive Profile - Urine Methodology: LC/Tandem Mass Spectrometry, Colorimetric This report is not intended for the diagnosis of neonatal inborn errors of metabolism. s: Ages 13 and over mcg/mg creatinine Bacterial - General 36. 37. 38. Compounds of Bacterial or Yeast/Fungal Origin Benzoate <DL <= 9.3 548 Hippurate 709 <= 1,070 0.11 Phenylacetate 0.17 <= 0.18 0.6 Page 9 39. 40. 41. 42. 43. Phenylpropionate <DL <= 0.06 1.1 p-hydroxybenzoate 0.5 <= 1.8 19 p-hydroxyphenylacetate 10 <= 34 64 Indican 93 H <= 90 0.73 Tricarballylate <DL <= 1.41 L. acidophilus / General Bacterial 44. D-Lactate 0.2 <= 4.1 2.0 Clostridial Species 45. 3,4-Dihydroxyphenylpropionate <DL <= 0.05 Yeast / Fungal 46. D-Arabinitol 40 <= 73 36 Creatinine = 48 mg/dl <DL = less than detection limit >UL = greater than upper linearity limit NR = Not reportable C0090.15

Page 10 Commentary The Diasorin Liaison 25-Hydroxyvitamin D Total Assay is certified by the CDC Vitamin D Standardization-Certification Program (CDC VDSCP). The performance characteristics of all assays have been verified by Genova Diagnostics, Inc. Unless otherwise noted with, the assay has not been cleared by the U.S. Food and Drug Administration. COVAT

Page 11 3100 ION Profile - Blood / Urine 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 or appears when the patient result is outside the fourth quintile of the analytes used to calculate the degree of significance. An population. 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 results provide the detail upon which these thermometers are based. Arginine Coenzyme Q10 Homocysteine alpha-tocopherol Cardiovascular System Calcium gamma-tocopherol Magnesium Lipid Peroxides 8-OHdG* AA/EPA Isoleucine Magnesium α-ketoglutarate Methylmalonate Leucine Coenzyme Q10 Succinate Formiminoglutamate Fatigue Phenylalanine Adipate Malate Valine Suberate Xanthurenate Magnesium Palmitic (16:0) β-hydroxybutyrate Metabolic Syndrome (Syndrome X) β-hydroxyisovalerate Stearic (18:0) α-hydroxybutyrate *8-OHdG = 8-Hydroxy-2-deoxyguanosine C0090.16

3100 ION Profile - Blood / Urine Mental/Emotional Tryptophan Docosahexaenoic Vanilmandelate Tyrosine Xanthurenate 5-Hydroxyindoleacetate Magnesium Methylmalonate Eicosapentanoic Formiminoglutamate Page 12 Phenylacetate Phenylpropionate Indican Intestinal/Bacterial Metabolites p-hydroxybenzoate Tricarballylate D-Lactate p-hydroxyphenylacetate 3,4-DHPP* D-Arabinitol Intestinal Yeasts/FungalMetabolites Arginine Lysine Tryptophan Histidine Methionine Valine Digestion/Absorption Isoleucine Phenylalanine Selenium Leucine Threonine *3,4-DHPP = 3,4-Dihydroxyphenylpropionate C0090.17

3100 ION Profile - Blood / Urine Page 13 Toxic Exposure Aluminum Arsenic Mercury Palmitelaidic (16:1n7t) Cis-Aconitate Isocitrate Orotate Glucarate Cadmium Lead Total C:18 Trans Citrate Quinolinate 2-Methylhippurate Methionine Glycine Glutamine Pyroglutamate Detoxification Impairment Serine Sulfate Taurine Benzoate Taurine alpha-tocopherol Lipid Peroxides Oxidative Stress/Antioxidant Insufficiency Selenium Lead gamma-tocopherol Vitamin A (Retinol) 8-OHdG* p-hydroxyphenyllactate Mercury β-carotene Sulfate Magnesium Ethylmalonate β-hydroxybutyrate Coenzyme Q10 Pyruvate Succinate Mitochondrial Functional Impairment Adipate L-Lactate Fumarate Suberate α-hydroxybutyrate Malate *8-OHdG = 8-Hydroxy-2-deoxyguanosine C0090.18

3100 ION Profile - Blood / Urine Page 14 Arginine Lysine Tryptophan Histidine Methionine Valine Amino Acid Insufficiency Isoleucine Phenylalanine Sulfate Leucine Threonine Essential Fatty Acid Insufficiency Arachidonic Alpha Linoleic Eicosapentaenoic Docosahexaenoic Linoleic Gamma Linolenic Dihomogamma Linolenic Palmitoleic Triene/Tetraene Homocysteine Tricosanoic Kynurenate Disordered Methyl Group (Single Carbon) Transfer Pentadecanoic Heptadecanoic Nonadecanoic Xanthurenate Methylmalonate Formiminoglutamate Tryptophan Xanthurenate Quinolinate Indican Disordered Tryptophan Metabolism 5-Hydroxyindoleacetate Kynurenate C0090.19

Page 15 3100 ION Profile - Blood / Urine Additional Considerations This page 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. Nutrient Nutrient Need Clinician Recommendations Vitamin C Vitamin B-1 (Thiamin) Vitamin B-2 (Riboflavin) Vitamin B-3 (Niacin) Vitamin B-5 (Pantothenic Acid) Vitamin B-6 (Pyridoxine) Vitamin B-12 (Cobalamin) Folic Acid Magnesium Zinc Black Current Oil/Evening Primrose Oil Carnitine Coenzyme Q10 Lipoic Acid N-Acetylcysteine Need for other antioxidants L-Glutamine L-Isoleucine L-Leucine L-Lysine L-Methionine L-Phenylalanine L-Tryptophan L-Tyrosine Low: 250-500 mg Optional: 0-10 mg Low: 10-25 mg Optional: 0-10 mg Optional: 0-10 mg Moderate: 25-50 mg Moderate: 250-500 mcg Low: 250-500 mcg Moderate: 200-300 mg Optional: 0-10 mg Optional Low: 100-250 mg Moderate: 60-100 mg Optional: 0-100 mg Optional: 0-200 mg Optional Low: 500-1000 mg Moderate: 500-750 mg Moderate: 1000-2000 mg Low: 500-1000 mg Low: 250-500 mg Low: 250-500 mg Moderate: 500-1000 mg Low: 250-500 mg Various conditionally essential nurients and other potentially beneficial interventions appear in this section only if relevant abnormalities are present. C0090.20