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Husband's NutrEval Test Results!

Discussion in 'Diagnostic Guidelines and Laboratory Testing' started by Calico13, Sep 10, 2010.

  1. Calico13

    Calico13

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    Since I had one done and it showed a lot of issues, my husband decided to have one done too. My husband's main symptoms are POTS and fatigue with a lot of digestive problems (constipation). He is on a restricted diet (no gluten, egg, wheat, barley, oats and more ).

    If anyone has any insight on his results, I would much appreciate it. I find it interesting that my husband and I have almost completely different test results with similar symptoms. :Retro smile:

    Here's a list of what was out of range. I've also included the PDF, so I hope that works.

    Dihydroxyphenylpropionic Acid (DHPPA) 6.4 (<2.2) H

    Lactic Acid 3.5 (6.3-36.4) L

    Leucine 76 (25-77) Top of range
    Phenylalanine 63 (22-61) H
    Taurine 752 (80-545) H
    Threonine 210 (52-192) H
    Tryptophan 111 (23-88) H

    1-Methylhistidine 1786 (83-1008) H
    B-Alanine 39 (<17) H

    Asparagine 138 (37-134) H
    Cysteine 11 (19-70) L
    Cystine 22 (23-68) L
    Proline 15 (2-14) H

    a-Aminoadipic Acid 173 (11-73) H
    Cystathionine 7 (6-29) Low in range
    Phosphoserine 28 (26-64) Low in range
    3-Methylhistidine 299 (134-302) High in range
    Sarcosine 62 (<41) H

    Glutamine/Glutamate 12 (>12) Low in range
    Glutathione 1531 (>669) Very good

    Attached Files:

  2. richvank

    richvank Senior Member

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    Hi, Calico13.

    Here are some comments on your husband's NutrEval results:

    1. It looks as though he has both a bacterial dysbiosis and a yeast overgrowth in his gut. It would take a good comprehensive stool test to identify which bacteria are present in high populations.

    2. It appears that the glycolysis pathway is not running very fast. This could be due to a low-carb diet, as one possibility.

    3. Pyruvate is not flowing into the Krebs cycle as rapidly as it should. This suggests a partial block in the pyruvate dehydrogenase complex, which could be due to deficiniencies in B vitamins, lipoic acid and/or magnesium. It could also be due to mercury toxicity, in view of the high mercury level in his blood.

    4. The first part of his Krebs cycle is running slowly. This would account for his fatigue. The reason is probably no. 3 above.

    5. Alpha ketoglutarate is high relative to the metabolites in the Krebs cycle before and after it. This suggests that it is being fed by glutamate, which is also high, and that the flow from AKG to succinic acid is partially blocked. The latter could again be due to low magnesium or B vitamins, or to mercury toxicity.

    6. Succinic acid is relatively low, and malic acid is below the detection limit. Since the branched-chain fatty acids are high-normal, the problem seems to be that they are not being fed into the Krebs cycle. The explanation appears to be a functional deficiency in B12, given the high-normal methylmalonic acid. Again, the low succinic and malic acids will also contribute to low ATP production by the mitochondria, contributing to the fatigue.

    7. The ketone and fatty acids metabolites are somewhat elevated. This can be accounted for by the partially blocked access of pyruvate to the Krebs cycle, described above. This causes the cells to mobilize fatty acids, and they also appear to have difficulty entering the Krebs cycle, and are hence being shunted to omega oxidation. The cause could be low B2 and/or low carnitine.

    8. VMA is low relative to HVA. This is likely due to the low copper status, as found in the red blood cells, but low vitamin C could also be accounting for it.

    9. FIGlu and methylmalonate are both elevated. This is good evidence for a partial block in the methylation cycle. That would be consistent with a functional B12 deficiency and low tetrahydrofolate.

    10. The high-normal hydroxyphenylacetate is likely explained by bacterial dysbiosis, perhaps involving Proteus bacteria. Again a comprehensive stool test would be needed to identify the dysbiotic bacteria for sure.

    11. The high AKAA suggests a B6 deficiency.

    12. The low-normal pyroglutamate indicates glutathione depletion in the kidneys and/or intestinal cells, which would be consistent with a partial methylation cycle block and with vitamin C deficiency. Note that the high glutathione measurement shown later in the report is a whole blood total glutathione measurement. This is the easiest glutathione measurement to make, but it does not reflect the level of reduced glutathione in tissue cells. The elevated lipid peroxides shown in the oxidative stress markers is further evidence suggesting low glutathione, since selenium is in the normal range in the RBCs, though a genomic variation in the glutathione peroxidase would be another possible explanation.

    13. The low-normal creatinine would be consistent with a partial methylation cycle block. since methylation is needed to make creatine, its precursor.

    14. Several of the essential amino acids are high. This is probably partly due what is discussed in number 6 above, partly due to low B6, and partly due to a slow rate of conversion of amino acids into neurotransmitters, which could be due to low tetrahydrobiopterin, resulting from the methylation cycle/folate cycle block, or due to low iron.

    15. The elevated diet peptide related markers suggest that your husband has a high-meat diet. The high beta-alanine could be causing the high wasting of taurine in the urine, since they compete for the same reabsorption transporters in the kidneys.

    16. The high alpha aminoadipic acid is likely due to a B6 deficiency. A B6 deficiency could be causing some of the other nonessential amino acids to be high. B6 is needed by the transaminase enzymes, which convert one amino acid to another, and thus facililitate feeding them into the Krebs cycle.

    17. The fairly high ammonia and urea suggest that he is burning protein for fuel at a higher than normal rate. This is likely due to the problems in feeding both carbs and fats into the Krebs cycle, discussed above.

    18. The high sarcosine is consistent with a methylation cycle/folate cycle partial block.

    19. The high ratio of glutamic acid to GABA suggests that your husband may be experiencing some excitotoxicity, which can cause anxiety, insomnia, a "wired" feeling, and hypersensitivity of the senses.

    20. The high EPA and DHA suggests that your husband is consuming a lot of fish or fish oil.

    21. I'm not sure why gondoic acid is high. Maybe your husband eats a lot of olive oil.

    22. The low palmitic acid suggests that your husband is not converting a lot of carbs to stored fat. Since he's not burning them and not storing them, I'm guessing that he's not intaking many carbs.

    23. The high stearic acid would be consistent with a high-meat diet.

    24. I don't know the reason for the high tricosanoic acid.

    25. The low-normal arachidic suggests that he doesn't eat many peanuts.

    26. He has high mercury and tin in his red blood cells, and somewhat elevated antimony. Mercury stays in the blood only for several weeks, so an elevated value means recent or ongoing mercury exposure. Since tin is high also, I suspect that amalgam fillings may be responsible. This is a pretty high mercury level, compared to what I've seen on this test on others in the past. Mercury can block many enyzmes in the body.

    27. Copper and zinc are low, and manganese is somewhat low. All three of these are needed by superoxide dismutase enzymes, so the low levels could be contributing to oxidative stress, which would also be consistent with glutathione depletion, elevated lipid peroxides, perhaps low vitamin C, and low-normal conzyme Q-10. Note that the last is consistent with a partial methylation cycle block, because methylation is needed to make Co Q-10.

    28. Because zinc and B6 are low, manganese is somewhat low, and biotin could be low, I think it would be worthwhile to consider KPU (more properly called HPU) in your husband's case. Dr. Klinghardt has reported finding a lot of this, and it would account for these deficiencies as well as inhibiting the methylation cycle. The Health Diagnostics and Research Institute in New Jersey offers a KPU test. I would recommend following Dr. Klinghardt's advice about sample collection and handling.

    I hope this is helpful.

    Best regards,

    Rich
  3. xchocoholic

    xchocoholic Senior Member

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    Hi Calico and Rich,

    I got my NutrEval test results back but I've been feeling great lately so I've opted to do some much needed yard work, housework, etc etc etc instead of focusing on this. This was collected on August 11 and at that point I still had company and was incredibly busy and eating out regularly. Meaning, I was exposed to gluten which causing me to produce antibodies and always makes me more tired than I am without it.

    I just copied most of this in from another board ... If I knew how to scan in my results, I would but I have too much to do to learn how to do that right now ...

    I'm actually too busy still to post all of this but I did test positive for too much mercury and since I had to look this up today, I wanted to put those links here. Mine was an 8 out of 10 which indicates my mercury is high.

    My fillings were removed in 1990 - 1992 when I first got sick with CFS/ME/FM so my best guess is that it's from all the fish I've been eating but I needed to look this up. I was eating it several times a day as my only meat. It's the easiest meat for me to digest ...

    I saw that some salmon is higher than others but I'm not sure where mine came from ... other than it was wild and from BJ's ... I was told to very slowly start using chlorella for this. I stopped eating fish right away so I hope that helps. I still have to buy the chlorella.

    http://www.mnn.com/food/healthy-eating-recipes/questions/is-there-such-a-thing-as-mercury-free-fish

    http://www.edf.org/page.cfm?tagID=17694

    I also still have dysbiosis and will be doing a CDSA asap. I started taking NAC last week, but I still need to get Magnesium (test showed 8 out of 10), antioxidants like A, E, and Carotene, Borage oil, and B6. According to this test, I'm low on B12 but hopefully the new MB12 and ADB12 that I started in July will take care of that.

    My Taurine was 1118 on a scale of 68 - 538. I was taking it for energy ... obviously I don't need that one ...

    My DHPPA (dysbiosis marker) was 3.2 on a scale of <=2.2 ... and my arabinose was 71 on a scale of <=42.3.

    My 5-OH-indoleacetic Acid was 127 on a scale of 1.1 - 6.5. I'm assuming this is from taking 100 mg 5HTP at bedtime so I've backed off the dosage to 50 mg and I'm taking 3 Country life probiotics with this at bedtime. I read that this indicates an inability to digest 5HTP.

    For those who are up on this my FIGlu was 4.9 on a scale of <=12.1. And my methylmalonic acid was 15.4 on a scale of <=19. These are both in the good range ...

    My 1-methylhistidine was 2295 on a scale of 92 - 1,046.

    I hope this didn't confuse the issue ... gotta run ... tc ... X

    PS. In case you're wondering my new found energy is from some new supplements that I started back in July including pregnenolone, DHEA, testosterone, ADB12, MB12 and folate ...
    I also take more Bs, NAC and Himalayan Liver care now ... and this new probiotic drink is still controlling my myoclonus. It's just juice + 3 Country Life dairy free + 1 Megaflora probiotic capsules + sugar and let it sit out for 24 hours.
  4. richvank

    richvank Senior Member

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    Hi, xchoc.

    I'm glad to hear that you are doing so well! That's wonderful!

    I'm also glad that you are including the B12's and folate in your supplement regimen. I realize that the values you got for FIGlu and MMA were within the "green" range on the Genova NutrEval panel. However, these values are actually higher than normal, and they suggest that you do (or did) have a partial methylation cycle block. Unfortunately, the lab reference ranges from specialty labs are not always very accurate. My understanding is that they are often determined just by looking at the results from the people who use their lab, rather than from testing a known healthy cohort. Since the people who use these labs are usually not well, this can skew the choices of reference ranges.

    If you have time, I would be interested in knowing what your pyroglutamic acid level was, and also what the values were for citric acid and the two Krebs metabolites that follow it. Also, what was the value for glutathione?

    Thanks.

    Rich
  5. xchocoholic

    xchocoholic Senior Member

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    Thanks Rich,

    I really don't understand what you're saying about the FIGlu and MMA and methylation block yet but I'll take the time to research this someday ... I did test positive via Spectracell for a detox problem about 2 years ago. I'm supposed to be taking vitamin E but haven't found one that didn't have soy yet and soy gives me phlegm right away.

    My citric acid was high - 606.1 on a scale of 21.9 - 475.1, my Cis-Aconitic Acid was 49 on a scale of 1.4 - 76.8, my Isocitric Acid was 53 on a scale of 3.7 - 87.4 and my glutathione was 1,015 on a scale of >= 669. Is it possible that my citric acid is high from all the cranberry juice I drink ? I do this because I have a history of kidney stones and an ongoing oxalate problem. I drink a lot of Kombucha tea now too .. oh and I drink lemon water ... I read where this was good for preventing kidney stones.

    All this makes no sense to me as of yet but someday I hope to have the time to learn this. AFTER I've caught up on my yard work, etc and had some fun ... lol ... tc ... X
  6. richvank

    richvank Senior Member

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    Hi, xchoc.

    Thanks for the numbers. You had a pretty big drop between citric acid and the next two, and that is usually a marker for glutathione depletion. Yes, high cranberry intake could account for elevating citric acid, and I can't say for sure if this negates the usual marker. You didn't mention your pyroglutamic level, but if that is either low or high, even low-normal or high-normal on this panel, that is usually another marker for glutathione depletion.

    The reason I asked about these is that glutathione depletion usually occurs together with the partial methylation cycle block.

    As you may know, a lot of oxalate normally comes in from the diet. If calcium is taken with food, the calcium will bind oxalate in the gut, so that it is not absorbed into the body, but goes out in the stools. Calcium oxalate is a very low-solubility compound. Oxalate can also be generated in the body, and that's another problem.

    Best regards,

    Rich
  7. xchocoholic

    xchocoholic Senior Member

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    Thanks Rich,

    Sorry about that. I forgot the pyroglutamic acid .. mine was 38.7 on a scale of 21.7 - 105.3. So, it's a low normal. I thought my glutathione was good though ? ? It's way over in the green area.

    BTW. My aminoisobutyric acid was 490 on a scale of 22 - 192 and my ornithine was 181 on a scale of 4 - 21. Those are the only other ones I see that are way off ... I can see from talking to you though that seeing the whole test would be more meaningful. I didn't pick up on the low normals, etc ... My doc plans on going over this some more with me too, she just wants me to do the CDSA first. This test is unbelievably thorough ... : ) .. are there a lot of PWCs having this done ?

    I really should be better at taking calcium prior to eating oxalates at this point, but I'm not ... lol ... I take Kreb's cycle chelates (Calcium is FMSA chelate) 3 - 4 times a day so I'm hoping that helps.

    So, it looks like I'm dealing with a partial methylation block ? Can you give me a quick reference / link to that ? JSYK, I still feel best if I lay down for an hour every few hours, but I have to make myself stay down when I lay down now. Where before the end of July / first of August, I was struggling to stand up most of the time. I just wish my brain would catch up.

    Thanks ... X
  8. richvank

    richvank Senior Member

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    ***Hi, xchoc.

    Sorry about that. I forgot the pyroglutamic acid .. mine was 38.7 on a scale of 21.7 - 105.3. So, it's a low normal. I thought my glutathione was good though ? ? It's way over in the green area.

    ***It's better than quite a few I've seen, but I'd say it's still a little low.

    BTW. My aminoisobutyric acid was 490 on a scale of 22 - 192 and my ornithine was 181 on a scale of 4 - 21. Those are the only other ones I see that are way off ... I can see from talking to you though that seeing the whole test would be more meaningful. I didn't pick up on the low normals, etc ... My doc plans on going over this some more with me too, she just wants me to do the CDSA first. This test is unbelievably thorough ... : ) .. are there a lot of PWCs having this done ?

    ***The high beta-aminoisobutyric acid can be due to a genetic deficiency of an enzyme, but if you have this deficiency, it doesn't cause any problems. This deficiency occurs, for example, in 40% of Asian populations.
    On the other hand, it can also be caused by B6 insufficiency, but if you have that, it should show up in other places. So I think I would need to see the rest of the data to make a better guess at which it is. On the ornithine, that's in the urea cycle, and I think I would have to see the rest of the urea metabolites, as well as ammonia, to suggest what's causing that.

    ***Getting the CDSA is a good idea, and it should give you some specifics about what's going on in your gut. Sounds as though you have a good doctor.

    ***Yes, this panel does a pretty good job of looking at the overall metabolism. It seems as though more PWCs are running it lately. Some people just do parts of it, but it's helpful to have the whole set of tests. Depending on a person's insurance situation, it can be pretty pricey for many people's budgets. It's sort of equivalent to the battery of tests that Amy Yasko uses, primarily in autism, but they are not one-to-one exactly.

    I really should be better at taking calcium prior to eating oxalates at this point, but I'm not ... lol ... I take Kreb's cycle chelates (Calcium is FMSA chelate) 3 - 4 times a day so I'm hoping that helps.

    ***I hope so, too. If it has calcium in it, it is probably helping.

    So, it looks like I'm dealing with a partial methylation block ?

    ***Yes, that's true of most people who have CFS. A total methylation cycle block would not be consistent with staying alive.

    Can you give me a quick reference / link to that ?

    ***Yes, take a look at the slides of my most recent talk, which are posted at www.cfsresearch.org by clicking on CFS/M.E. and then on my name. It's the last item in the list.

    JSYK, I still feel best if I lay down for an hour every few hours, but I have to make myself stay down when I lay down now. Where before the end of July / first of August, I was struggling to stand up most of the time. I just wish my brain would catch up.

    ***O.K. I think that jibes pretty well with your test results. It sounds as though you've improved the state of your metabolism some, but there is still some to go. It sounds as though your Krebs cycle is functioning fairly well, though I haven't seen all the values, and I think that accounts for your having some energy now. As you continue to improve your methylation cycle function, which will raise your glutathione some more, your brain function should improve, too.

    ***Best regards,

    ***Rich
  9. Big

    Big

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    I'm the husband in question. :Retro smile::Retro smile:

    I've added some of my feedback below...

    Ya, this was not a surprise. I've suffered from intestinal issues since childhood. I've done just about every detox, yeast treatment, exclusion diet out there over the years as well as loads of probiotics without any real improvement. I don't doubt this could be the core of my problem. I've been underweight most of my life.

    My diet is very low carb to due gluten/grain avoidance.

    I believe the high mercury level is an anomaly due to my error. I ingested fish on the day before the test which I was told not to do. I've had all my amalgams removed years ago and done multiple rounds of chelation. I recently did a 24 hour challenge test which showed comparable levels of my other heavy metals but nearly zero mercury.

    This is interesting. I take large amounts of B vitamins orally as well as injection and carnitine. I wonder if I'm truly still deficient or simply stopping supplementation before the nutreval (5 days as instructed) was enough to raise certain markers again. For example, I was taking 100mg of B6 daily along with 100mg of P5P- that's a large dose of B6 yet I'm still showing deficiency symptoms.

    I have recent tests showing very low levels of norepinephrine which I believe is causing my POTS along with fatigue. Sometimes ingesting coffee/caffeine will improve my symptoms although I don't do that often. This matches. I also tested low in ceruloplasmin, serum copper was at the very bottom 2% of lab range. I believe the dopamine beta hydroxalase is probably downregulated.

    I take b12 injections along with methylfolate, but discontinued that prior to the test as instructed. Perhaps that was enough time to raise these markers again?

    Ya, looks like it again. I'm not sure where to get a good stool test. Metametrix looks the best but I don't have the $500 or so for the full panel right now.

    Again strange considering how much B6 I was ingesting.

    The nutreval listed a need for iron, but I know that's incorrect. In fact, at times my iron has been too high. My ferritin is usually around 160 with my full iron panel indicating levels towards the top-end of what my doctor considers safe. I assume this is because the nutreval is determining that based on my other nutrient levels it must be iron causing a deficiency but they are wrong on that one.

    I eat a low carb diet, not sure if I'd consider it high meat but it could be a factor.

    Again, really strange considering my prior B6 intake.

    This would probably explain the underweight/gut connection.

    I have been eating fish pretty regularly, looks like it's time to cut down a little and add in some omega 6.

    Hmm, not really.

    Kind of funny, I eat peanuts all the time! I used to eat almonds but found them listed as an allergy so I switched back to peanuts.

    Again, I feel the mercury can be explained by recent fish ingestion...the tin I'm not sure where it is coming from. I have no amalgams.

    Again I think this could also explain my low catecholamine levels.

    I've had this test done, my levels were right in the middle of normal- not even mildly elevated. I admit it was a surprise to me.
  10. richvank

    richvank Senior Member

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    *** Hi, Big.

    ***Thanks for the feedback. My comments are at the asterisks below.


    Quote Originally Posted by richvank View Post
    1. It looks as though he has both a bacterial dysbiosis and a yeast overgrowth in his gut. It would take a good comprehensive stool test to identify which bacteria are present in high populations.
    Ya, this was not a surprise. I've suffered from intestinal issues since childhood. I've done just about every detox, yeast treatment, exclusion diet out there over the years as well as loads of probiotics without any real improvement. I don't doubt this could be the core of my problem. I've been underweight most of my life.

    ***O.K. Gut problems are a basic issue for many people. Those who have the most success in treating them seem to be the ones who do repeated stool testing, and change the treatment with time to match what they are finding. It can take quite a while to get the gut back into good operation.

    2. It appears that the glycolysis pathway is not running very fast. This could be due to a low-carb diet, as one possibility.
    My diet is very low carb to due gluten/grain avoidance.

    ***O.K., that fits.

    3. Pyruvate is not flowing into the Krebs cycle as rapidly as it should. This suggests a partial block in the pyruvate dehydrogenase complex, which could be due to deficiniencies in B vitamins, lipoic acid and/or magnesium. It could also be due to mercury toxicity, in view of the high mercury level in his blood.
    I believe the high mercury level is an anomaly due to my error. I ingested fish on the day before the test which I was told not to do. I've had all my amalgams removed years ago and done multiple rounds of chelation. I recently did a 24 hour challenge test which showed comparable levels of my other heavy metals but nearly zero mercury.

    ***O.K., I think that could do it, especially if it was a big fish pretty high up in the marine food chain.

    4. The first part of his Krebs cycle is running slowly. This would account for his fatigue. The reason is probably no. 3 above.

    5. Alpha ketoglutarate is high relative to the metabolites in the Krebs cycle before and after it. This suggests that it is being fed by glutamate, which is also high, and that the flow from AKG to succinic acid is partially blocked. The latter could again be due to low magnesium or B vitamins, or to mercury toxicity.

    6. Succinic acid is relatively low, and malic acid is below the detection limit. Since the branched-chain fatty acids are high-normal, the problem seems to be that they are not being fed into the Krebs cycle. The explanation appears to be a functional deficiency in B12, given the high-normal methylmalonic acid. Again, the low succinic and malic acids will also contribute to low ATP production by the mitochondria, contributing to the fatigue.

    7. The ketone and fatty acids metabolites are somewhat elevated. This can be accounted for by the partially blocked access of pyruvate to the Krebs cycle, described above. This causes the cells to mobilize fatty acids, and they also appear to have difficulty entering the Krebs cycle, and are hence being shunted to omega oxidation. The cause could be low B2 and/or low carnitine.
    This is interesting. I take large amounts of B vitamins orally as well as injection and carnitine. I wonder if I'm truly still deficient or simply stopping supplementation before the nutreval (5 days as instructed) was enough to raise certain markers again. For example, I was taking 100mg of B6 daily along with 100mg of P5P- that's a large dose of B6 yet I'm still showing deficiency symptoms.

    ***Hmmm. If you're getting enough B vitamins and carnitine, perhaps it is just due to the loose regulation of fatty acids metabolism. If there were more carbs to burn, these values might be lower.

    8. VMA is low relative to HVA. This is likely due to the low copper status, as found in the red blood cells, but low vitamin C could also be accounting for it.
    I have recent tests showing very low levels of norepinephrine which I believe is causing my POTS along with fatigue. Sometimes ingesting coffee/caffeine will improve my symptoms although I don't do that often. This matches. I also tested low in ceruloplasmin, serum copper was at the very bottom 2% of lab range. I believe the dopamine beta hydroxalase is probably downregulated.

    ***O.K.

    9. FIGlu and methylmalonate are both elevated. This is good evidence for a partial block in the methylation cycle. That would be consistent with a functional B12 deficiency and low tetrahydrofolate.
    I take b12 injections along with methylfolate, but discontinued that prior to the test as instructed. Perhaps that was enough time to raise these markers again?

    ***I would guess that it's more likely that the treatment had not yet succeeded in lifting the partial block. I don't know what your B12 and methylfolate dosages and dose frequencies were, but maybe they were too low or not of long enough duration. B12, in particular, sometimes needs to be pretty high and long to overcome the hijacking of B12 by toxins when glutathione is too low to protect it effectively.

    10. The high-normal hydroxyphenylacetate is likely explained by bacterial dysbiosis, perhaps involving Proteus bacteria. Again a comprehensive stool test would be needed to identify the dysbiotic bacteria for sure.
    Ya, looks like it again. I'm not sure where to get a good stool test. Metametrix looks the best but I don't have the $500 or so for the full panel right now.

    ***You might also consider the Diagnos-Techs Expanded GI Panel. It requires a doctor's order. I don't know what your insurance situation is, but it might be cheaper. It's pretty comprehensive.

    11. The high AKAA suggests a B6 deficiency.
    Again strange considering how much B6 I was ingesting.

    ***That's puzzling to me, too. It's possible to run a specific test for B6 activity, such as at Health Diagnostics and Research Insistute in New Jersey.

    12. The low-normal pyroglutamate indicates glutathione depletion in the kidneys and/or intestinal cells, which would be consistent with a partial methylation cycle block and with vitamin C deficiency. Note that the high glutathione measurement shown later in the report is a whole blood total glutathione measurement. This is the easiest glutathione measurement to make, but it does not reflect the level of reduced glutathione in tissue cells. The elevated lipid peroxides shown in the oxidative stress markers is further evidence suggesting low glutathione, since selenium is in the normal range in the RBCs, though a genomic variation in the glutathione peroxidase would be another possible explanation.

    13. The low-normal creatinine would be consistent with a partial methylation cycle block. since methylation is needed to make creatine, its precursor.

    14. Several of the essential amino acids are high. This is probably partly due what is discussed in number 6 above, partly due to low B6, and partly due to a slow rate of conversion of amino acids into neurotransmitters, which could be due to low tetrahydrobiopterin, resulting from the methylation cycle/folate cycle block, or due to low iron.
    The nutreval listed a need for iron, but I know that's incorrect. In fact, at times my iron has been too high. My ferritin is usually around 160 with my full iron panel indicating levels towards the top-end of what my doctor considers safe. I assume this is because the nutreval is determining that based on my other nutrient levels it must be iron causing a deficiency but they are wrong on that one.

    ***Yeah, they don't directly measure iron or ferritin, they just infer that it might be low, based on other measurements. The problem is that there is more than one possible cause for many of the abnormal values. This is a pretty nice panel, but there are still ambiguities if these are the only data one has. I usually use a comprehensive questionnaire to help narrow down the possible interpretations, but sometimes it takes additional specific testing to figure out for sure what's going on.

    15. The elevated diet peptide related markers suggest that your husband has a high-meat diet. The high beta-alanine could be causing the high wasting of taurine in the urine, since they compete for the same reabsorption transporters in the kidneys.
    I eat a low carb diet, not sure if I'd consider it high meat but it could be a factor.

    ***O.K. The data seem to suggest that, but other factors can be involved, too. Gut bacteria can affect some of these peptide values.

    16. The high alpha aminoadipic acid is likely due to a B6 deficiency. A B6 deficiency could be causing some of the other nonessential amino acids to be high. B6 is needed by the transaminase enzymes, which convert one amino acid to another, and thus facililitate feeding them into the Krebs cycle.
    Again, really strange considering my prior B6 intake.

    ***Right. The B6 issue seemed to keep popping up, though. Might be worthwhile to test for it specifically.

    17. The fairly high ammonia and urea suggest that he is burning protein for fuel at a higher than normal rate. This is likely due to the problems in feeding both carbs and fats into the Krebs cycle, discussed above.
    This would probably explain the underweight/gut connection.

    ***Maybe so. I don't know what your total daily caloric intake is, but that, combined with how well your gut is absorbing nutrients, will impact your weight balance. Also, if protein is being burned for fuel, it won't be available for building muscle.

    18. The high sarcosine is consistent with a methylation cycle/folate cycle partial block.

    19. The high ratio of glutamic acid to GABA suggests that your husband may be experiencing some excitotoxicity, which can cause anxiety, insomnia, a "wired" feeling, and hypersensitivity of the senses.

    20. The high EPA and DHA suggests that your husband is consuming a lot of fish or fish oil.
    I have been eating fish pretty regularly, looks like it's time to cut down a little and add in some omega 6.

    ***Yeah, looks like you have plenty of omega-3 fatty acids on board. Also, there's the mercury factor, at least with the big fish.

    21. I'm not sure why gondoic acid is high. Maybe your husband eats a lot of olive oil.
    Hmm, not really.

    ***That was kind of a shot in the dark, since your oleic acid level wasn't all that high. There may be some food that is particularly high in gondoic acid, or maybe there is a deficiency in a particular enzyme that's involved in metabolizing it. I just don't know. Couldn't find a lot of info on gondoic.

    22. The low palmitic acid suggests that your husband is not converting a lot of carbs to stored fat. Since he's not burning them and not storing them, I'm guessing that he's not intaking many carbs.

    23. The high stearic acid would be consistent with a high-meat diet.

    24. I don't know the reason for the high tricosanoic acid.

    25. The low-normal arachidic suggests that he doesn't eat many peanuts.
    Kind of funny, I eat peanuts all the time! I used to eat almonds but found them listed as an allergy so I switched back to peanuts.

    ***Guess I struck out on that one! Peanuts have quite a bit of arachidic acid in them. Guess you must be burning it.

    26. He has high mercury and tin in his red blood cells, and somewhat elevated antimony. Mercury stays in the blood only for several weeks, so an elevated value means recent or ongoing mercury exposure. Since tin is high also, I suspect that amalgam fillings may be responsible. This is a pretty high mercury level, compared to what I've seen on this test on others in the past. Mercury can block many enyzmes in the body.
    Again, I feel the mercury can be explained by recent fish ingestion...the tin I'm not sure where it is coming from. I have no amalgams.

    ***O.K. I don't know how to explain the high tin, either. Could be from corrosion of solder in water pipes, maybe. Do you drink tap water?

    27. Copper and zinc are low, and manganese is somewhat low. All three of these are needed by superoxide dismutase enzymes, so the low levels could be contributing to oxidative stress, which would also be consistent with glutathione depletion, elevated lipid peroxides, perhaps low vitamin C, and low-normal conzyme Q-10. Note that the last is consistent with a partial methylation cycle block, because methylation is needed to make Co Q-10.
    Again I think this could also explain my low catecholamine levels.

    ***O.K., I think it could, too.

    28. Because zinc and B6 are low, manganese is somewhat low, and biotin could be low, I think it would be worthwhile to consider KPU (more properly called HPU) in your husband's case. Dr. Klinghardt has reported finding a lot of this, and it would account for these deficiencies as well as inhibiting the methylation cycle. The Health Diagnostics and Research Institute in New Jersey offers a KPU test. I would recommend following Dr. Klinghardt's advice about sample collection and handling.
    I've had this test done, my levels were right in the middle of normal- not even mildly elevated. I admit it was a surprise to me.

    ***I'm glad you had that checked out. I think it was worth doing, in view of what Dr. Klinghardt has been finding.

    ***Thanks again for the feedback, and I hope you get some benefit out of running this panel.

    ***Best regards,

    ***Rich
  11. dannybex

    dannybex Senior Member

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    Seattle
    Hi Rich,

    I have a quick question about high meythylhistidine levels...

    Is methylhistidine related in any way to methylhistamine? I've been increasingly itchy -- and irritable -- two of many, many symptoms of salicylate intolerance, which is connected to elevated methylhistamine levels. I've also realized I've been eating A LOT of high-salicylate foods for the past 6-9 months if not longer...

    My methylhistidine levels are elevated, but I didn't see anything about methylhistamine in the test results.

    ???

    Many thanks,

    Dan
  12. xchocoholic

    xchocoholic Senior Member

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    Florida
    Hi everyone ... sorry to drop the ball here but I accidently ate way too much xylitol on 9/8 and haven't been the same since. I'll get back to this once I've recovered ... thanks ... X
  13. richvank

    richvank Senior Member

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    Hi, Dan.

    As far as I know, there is no connection between these two. The methylhistidines result primarily from the breakdown of muscle fibers. 3-methylhistidine in human urine comes both from eating the meat of animals and from breakdown of human muscle fiber protein. 1-methylhistidine comes primarily from meat in the diet. Neither of these can be metabolized in the human body, and are thus excreted. They are produced by post-translational methylation of muscle fiber proteins. In other words, the methyl group is added after the histidine has been incorporated in the amino acid chain of the protein. So when the protein is broken down, the methylhistines are "odd balls," and cannot be recycled and reused like the other amino acids. That makes it possible to use these as approximate markers of meat intake and muscle protein breakdown rate. Another "odd ball" of this sort is hydroxyproline, which is a post-translational product in collagen protein. It can be used to gauge the rate of collagen breakdown in the body.

    Best regards,

    Rich

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