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My nutreval results, expert comments needed

Discussion in 'Diagnostic Guidelines and Laboratory Testing' started by Thinktank, Jun 9, 2013.

  1. Thinktank

    Thinktank Senior Member

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    (Nutreval screenshots below)
    I got my nutreval results back a while ago and i'd really love to hear from some expert members. The value of knowledge shared on this board is unbelievable. I've learned more in one month by reading topics than from 10 years of consultations with socalled doctors in the Netherlands. Your comments on my nutreval results are therefore highly appreciated!

    Cognitive:
    Brain fog
    Depersonalization feeling
    Memory loss
    Speech impairment

    Physical:
    Muscle wasting
    Inability to gain weight
    Fatigue after exercise (especially the next day)
    Various gut problems
    Gynecomastia (Complete male hormones by genova diagnostics shows my hormones are way out of balance but estrogens are low!?)
    Shortness of breath, i often wake up at night having difficulty breathing
    Deteriorating eyesight / night blindness

    Nutreval results (I didn't take any supplements or medication at the time of testing)

    Krebs:
    Pyruvic acid kinda high but not extremely elevated
    Low succinic acid (none found)
    High Adipic acid (fat oxidation)
    High Suberic acid(fat oxidation)

    Toxins:
    High Alpha hydroxyisobutyric acid (2-HIBA) (MBTE)

    REPRESENTATIVENESS INDEX
    Low glutamine to high glutamate ratio

    Amino acids:
    Most borderline low except γ-Aminobutyric Acid (GABA) and Taurine and Glutamic acid which is high
    Low Valine
    Low Alanine
    Low cystine
    Low Glycine
    Low Ethanolamine
    Low proline
    High glutamic acid
    High taurine (compared to other amino acids)

    Glycine markers:
    Low Ethanolamine
    Low Phosphoserine

    Dietary peptides:
    Low Anserine

    Urea cycle markers:
    Low urea
    Low Ornithine

    Intermediatery metabolites:
    Low Cystathionine

    Fatty acids:
    High Linoleic acid
    Low DGLA
    low DGLA/arachidonic acid ratio
    Low Arachidonic acid (AA)
    High oleic acid
    High linoleic/DGLA ratio ratio
    Low Docosatetraenoic (DCA)
    Most saturated fats are borderline low

    Delta - 6 Desaturase Activity = IMPAIRED

    Metals etc:
    High mercury
    Low copper
    Low Zinc

    Most of the other markers are kinda borderline low or borderline high or close to being it.
    You'll need to take a look at the screenshots below to have a better understanding of it.

    krebs.jpg krebs1.jpg krebs3.jpg krebs4.png krebs5.jpg krebs6.jpg krebs7.jpg krebs8.jpg krebs9.jpg
     
  2. Valentijn

    Valentijn Activity Level: 3

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    Thinktank
    Your Krebs cycle looks quite normal. Some labs give 0 as the minimum range for succinic acid, so that's probably not an issue, especially since levels are normal before and after it in the cycle.

    Your fat metabolism looks odd, and suggests ketosis. Usually this would only happen on a low-carb diet or with diabetes. If neither of these apply, it might be a good idea to look into it more.

    Low RBC minerals might be a fairly typical problem. I had similar results inside the cells, though my serum was pretty normal. So probably an issue with transporting stuff into the cell. Supplementation might or might not help.

    Taking cysteine and glycine as mentioned on the other thread for high glutamate could also help your glutathione get into a more ideal range.
     
  3. caledonia

    caledonia

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    If you haven't already done so, I suggesting using the Nutreval Intrepretation Guide (see the link in my signature), which is a compilation of Rich Vank's interpretations. It will give you lots of insights.
     
  4. Thinktank

    Thinktank Senior Member

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    Valentijn, Genova diagnostics comments on my low succinic acid is as follows:

    I did have low B12 levels 6 months ago so i received a 6 weeks course of intramusculair injected B12 + folic acid supplementation. Folate was normal. B12 got retested a month after injections and it was in the high range.
    Unfortunately the B12 injections didn't alleviate my CFS symptoms or cognitive impairment. I'm awaiting the results from 23andme and Yasko so i know which form of B12 and folate to supplement with. I've tried several oral / sublingual forms but they all sent me into a crash.

    Could the fat oxidation be caused by low carnitine? Unfortunately Carnitine has not been tested on the nutreval panel.
    I eat loads of meat but due to my inflamed guts and malabsorption problems it won't surprise me if carnitine is low.

    I will be supplementing glycine and maybe cysteine soon.

    caledonia, I downloaded the summary of Rich's nutreval interpretations a few weeks ago but i'll give it another look! I've also watched your video's on youtube about methylation, nice work! :)
    Rich's / yasko's methylation protocol is absolutely something i want to do soon but i need to cool down the gut inflammation before proceeding. Hopefully the transdermal Low Dose Naltrexone will help me with that....
     
  5. Thinktank

    Thinktank Senior Member

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    Ok guys, i received my new nutreval results yesterday, this time the amino acids are from blood plasma instead of first morning urine. The second test was taken 5 weeks later.

    A few days before i took the test i had a session of intravenously injected L-glutamine and NAC. I also supplemented with Zinc and Magnesium and was 1 week into using diflucan for my candida overgrowth. GAPS protocol for 2 or 3 weeks.

    Surprisingly in just 5 weeks the blood plasma levels look totally different from the FMV results.So i'm wondering, do urine levels really reflect blood plasma levels as they say? Or is all this testing not as reliable as we may think?
    I wonder if the GAPS protocol and supplementation did so much healing in that short timeframe.
    Or does my body perhaps not utilize the nutrients well enough so they are normal in blood plasma but out of balance in urine excretion?

    The only thing that's consistent is the fat metabolism problems. Both show high adipic and suberic acid. β-OH-butyric Acid is elevated in blood serum as well.
    The krebs cycle looks quite normal in blood plasma, it even shows normal succinic acid which was missing the FMV.
    All vitamins are back into normal range except B2 and B3 which show a borderline need. Minerals in RBC are high.
    Toxic exposure has lowered.

    Zinc:
    FMV = very low
    Blood plasma = very high

    Succinic acid:
    FMV = non-existent
    Blood plasma = normal

    Amino acids:
    FMV = mostly low
    Blood plasma = mostly normal

    Glutamic acid:
    FMV = high
    Blood plasma = normal

    Mercury (Explanation for this???):
    FMV = high
    Blood plasma = non-existent
     
  6. Valentijn

    Valentijn Activity Level: 3

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    Thinktank
    Urine is measuring what you get rid of. Levels might reflect getting rid of an excess to keep blood levels normal, or a problem with getting rid of too much of something you need. So for mercury it's possible your intake of it is too high, but you're very effective at getting rid of it.

    The urine sample might not have been properly preserved, allowing chemical reactions to continue for a while. Then normal levels of succinic acid might turn into the next substance in the Krebs cycle, or GABA might turn into glutamate, etc.

    Interesting that your fat metabolism seems abnormal in both samples. You're not on a low-carb or calorie restricted diet?

    Zinc can be a problem, because high levels of it can cause too much copper to be bound and unusable. Not sure why your body would be holding onto it.
     
  7. Thinktank

    Thinktank Senior Member

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    Valentijn, Thanks for the explanation, makes sense.
    What's your prefered method of testing amino acids? FMV or plasma?

    I'm not on a low-carb diet. I'm on the GAPS protocol but theoretically it's not ketogenic at all. I do have difficulties digesting most vegetables so i'll get some ketosticks to test for ketones in urine, just to be sure.

    Sorry, i read the values wrongly. Zinc is normal and copper is just slightly below normal in blood serum. I have some serious gut problems like colitis, gastritis, ileitis etc. Maybe that's why my body is holding on to it? Needing it for regeneration?
    Nutreval plasma states there's no high need for Zinc supplementation, but again i supplemented with 30mg zinc for a few days before the test, although i'm not sure how long it takes to change the level in blood plasma. I'll post the blood plasma results later on.

    I guess i really need to dig deeper into the whole fat oxidation and low saturated fats problem. Do you perhaps know the effects of prolonged fat oxidation and low levels of saturated fats?

    I have a condition in my liver called von meyenburg complex which is basicly the formation of innumerable small cysts. It's a benign condition so they say but i believe it might be blocking bile flow. I have to undergo a bile flow / motility study to confirm. Bile is needed for fat emulsification, so low bile might cause problems in fat metabolism?
    I also have ileitis which is inflammation of the ileum, with nodular lymphoid hyperplasia (like in Dr. Andrew wakefield's study). The ileum reabsorbs bile acids
     
  8. LaurieL

    LaurieL Senior Member

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    When you receive them, will you post your 23andme SNP data here as well please?
     
  9. LaurieL

    LaurieL Senior Member

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    Your results have been nagging me for the last 24hours. o_O Something that really jumps out at me is your delta 6-desaturase enzyme. Your enzyme activity is impaired, and this is also an enzyme that they are finding in the Autism circles to be impaired as well (as an aside). Delta 6-desaturase isn't much talked about in the ME/CFS circles, so my learning has come from the Autism circles.

    Take your results and read them along with this post.

    In the Autistic, this enzyme is needed to convert long chain linoleic acid (LA) into gamma linolenic acid (GLA) and is severely inhibited creating a marked deficiency in GLA. What results is a build up of unconverted Omega 6, and the overbalance of Omega 6 to Omega 3, and tends to produce arachidonic acid (AA) and the inflammatory PGE2. PGE2 being found to be associated with Crohn's, diabetes, food allergies, MS, and etc.

    Eicosanoids made from Omega 3 are considered more neutral than those of Omega 6. Production of beneficial and detrimental eicosanoids all begins with LA, an Omega 6. With Carnitine as the delivery vehicle. Without Delta 6-desaturase, no eicosanoids can be produced. PGE1 is beneficial, PGE2 is an inflammatory marker.

    Any intake of trans-fatty acids, saturated fats, excess ALA, found in high amounts in flax seed, flax seed oil, and walnuts, high carb meals (increases insulin), acetylaldehydes from candida, alcohol, exhaust fumes, and cigarette smoke, stress responses ( increases in adrenaline and cortisol), and esp. viral infections, all interfere with Delta 6-desaturase, as well as vitamin deficiencies in Vitamin B6 (P5P), niacin, magnesium, and zinc. The fact that you took zinc prior to your testing may skew not only your zinc levels reflected but the fatty acid profile and your Omega profiles. With that said, in your blood results compared with your urine results, the fatty acid dysfunction is still present, and really needs to be explored further. If your zinc levels were normal to start with, then because of your intake of zinc prior to testing, they should not have been reflected in the test as normal. It would have been a higher normal, to a high reading.

    Zinc deficiency leads to an inhibition of prostagladin synthesis (PGE), either by blocking linoleic acid desaturation to GLA, or by inhibiting the mobilization of dihomo-GLA from the tissue membrane stores. You can see your results reflect this. It also leads to an impairment of Vitamin A metabolism. A very definite connection to your night blindness you mentioned.

    Are you taking any herbs? Herbs such as Angelica, Licorice, Turmeric, Ginger, Milk Thistle, Pau D' Arco, Royal Jelly, Sheep Sorrel, carrageenans (found in coffee creamers and other food products), and Ginko Biloba can reduce Omega3's and Omega 6's. This can then lead to reductions in GLA and EPA, leading to health problems such as asthma, eczema, rosacea, dry skin and hair, weight problems, muscle loss, energy loss, and a suppressed immune system.

    I mention all the skin problems because Omega 6 regulates water loss, and a deficiency in GLA is often indicated by dry skin and hair, brittle nails, dandruff, excessive thirst and urination, and rough skin, second only to hypothyroidism.

    Biotin deficiency and Delta 6-desaturase, another consideration for you...

    Biotin -dependent carboxylases are important metabolic catalysts of fatty acid synthesis, and deficiencies severely inhibit long-chain elongation and desaturation of linoleate to AA. Biotin deficiency is also common in Autism. I observe and comment that your AA levels are actually low, with high LA levels. If you see ridges on your nails, I would explore this avenue further.

    Additionally, a deficiency in biotin can cause hypoglycemia and excess ammonia. A biotin deficiency interferes with desaturase enzymes as it serves as a carrier of CO2.

    Biotin deficiency can be caused by long term antibiotics, which in turn kill the bacteria in the intestine in which produce biotin. Also, if you eat a high amount of grains, such as wheat, sorgum, and cereal grains, biotin deficiencies can be induced as well. Biotin deficiency can also be induced by yeast and fungal infections of the intestine. (Do not take biotin without balancing with innositol, to avoid fatty liver complications).

    There is a close association between insulin, excitotoxins, free radicals, and eicosanoid production. Glutamate acts primarily to open the calcium channel of a cell, allowing calcium to enter the cell. Intracellular calcium in high concentrations initiates the wnzymatic release of AA, where it then goes to either COX or LOX pathways. These two pathways, COX and LOX, produce free radicals and the detrimental eicosanoids.

    (magnesium and manganese counter the undesirable flood of calcium into cells)

    Insulin can trigger the production of harmful eicosanoids. Not only simple sugars trigger its release, but the amino acids leucine, alanine, and taurine are also powerful triggers of insulin. Of which your taurine is also high end.
     
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  10. LaurieL

    LaurieL Senior Member

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    I am also nagged by your proline results. :D

    Are you a vegan?
     
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  11. LaurieL

    LaurieL Senior Member

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    Low Arginine of which proline is made in one of two pathways.
    Is quoted by metametrix as a reflection of poor quality protein in the diet. Deficiencies can have effects on the cardiovascular system, as NO production is derived from arginine.

    The other pathway being from glutamic acid, of which your result is abnormally high, so investigation into the conversion to proline should be furthered pursued?

    Your histadine result is also a low, but normal, and this is also a reflection of protein intake and malabsorption when other AA's are low. As in your case.
     
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  12. Thinktank

    Thinktank Senior Member

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    LaurieL, thanks for all the info! I'll re-read it tomorrow morning because i'm in zombiemode right now. :)
    I'll post all of my results tomorrow side-by-side for comparison or in a spreadsheet.

    And no, i'm not a vegan! I'm a hardcore carnivore lol. The protein i eat is all high quality.
     
  13. aprilk1869

    aprilk1869 Senior Member

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    You also need thyroid hormones for delta 6 desaturase activity. Hypothyroidism could also be causing all/many of the symptoms you describe. This could be caused by various nutritional deficiencies such as iodine, selenium and B12.

    I highly recommend you read the links in this document:-

    http://tinyurl.com/iodine-references
     
  14. Thinktank

    Thinktank Senior Member

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    LaurieL, you gave me a lot of stuff to process haha.
    So things have turned out i might have a problem with mast cell activation disorder (degranulation of inflammatory mediators) -> PGE2 problems... -> due to impaired D6D -> Zinc deficiency????
    SO based on your findings i should supplement a good dose of Zinc and maybe a form of GLA like primrose oil + EPA / DHA to offset PGE2 and increase PGE1 and PGE2 ?
     
  15. Thinktank

    Thinktank Senior Member

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    I don't know what's up with the system but i can't edit my posts.
    I mean to say, take GLA + EPA / DHA to offset PGE2 and increase PGE1 and PGE3.
     

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