Hi, Sparrow.
Here are some comments on your organic acids panel:
The high 3-Oxoglutaric acid and the elevated Arabinose indicate that you have an intestinal yeast overgrowth.
The elevated 4-Hydroxyphenylacetic acid, high 4-Hydroxybenzoic acid, and elevated Hippuric acid indicate that you have intestinal bacterial dysbiosis. It would require
a comprehensive stool analysis to determine the details of this, to decide on treatment.
The high succinic acid could be partly due to intestinal dysbiosis, but see below.
I dont know the significance of the high Glycolic acid in the presence of a normal Oxalic acid level.
The low Pyruvic acid indicates low flow through the glycolysis pathway. This could be due to a low carbohydrate diet, or to low magnesium.
Because of the low availability of Pyruvate, your cells have gone into ketosis. Fatty acids are being mobilized, but they are not being burned at a very high rate in the Krebs cycle, perhaps because of low carnitine or low B2, and some are being diverted to omega oxidation. There are several markers indicating ketosis and also omega oxidation of fatty acids.
The drop from Aconitic acid to 2-Oxoglutaric acid could be due to aluminum toxicity or
to a deficiency of B3, magnesium or manganese.
The high Succinic, Fumaric and Malic acids together could be due to low coenzyme Q10,
or to low B2 and B3 together.
The drop from HVA to VMA is likely due to low copper, since vitamin C looks good.
The high ratio of Uracil to Thymine indicates low folate, which would be consistent
with a partial block of methionine synthase.
Ive already discussed the ketone and fatty acid oxidation markers.
The high Methylmalonic acid indicates a B12 deficiency. In view of the glutathione
deficiency (see below), it could be a functional B12 deficiency. The B12 deficiency together with the high ratio of Uracil to Thymine suggest are consistent with a partial block in the methylation cycle at methionine synthase.
The high Pantothenic acid suggests recent supplementation with B5.
The high Glutaric acid indicates deficiency in B2.
The high Ascorbic acid suggests recent supplementation with vitamin C.
The low Methylcitric acid indicates a deficiency in biotin.
The low Pyroglutamic acid indicates glutathione depletion.
The low Orotic acid indicates that the urea cycle is not being challenged, which suggests a low rate of burning of amino acids. Together with the above results, this indicates
that none of the three main fuels (carbohydrates, fats, and amino acids) are being burned at a high rate. This is consistent with fatigue.
The first four amino acid metabolites are very low. This is likely due to low B2 and
possibly also low B6 (these cannot be distinguished on this panel). It means that the
branched-chain amino acids are not being fed to the Krebs cycle at a significant rate,
and that means that the high Succinic acid is not due to amino acids burning, and
must be due to intestinal dysbiosis.
The elevated Mandelic acid could be due to exposure to styrene, or it could be due
to supplementation with phenylalanine.
The high 4-Hydroxyphenyllactic acid is likely due to gut bacterial metabolism of tyrosine.
I dont know the significance of the somewhat elevated levels of N-Acetylaspartic acid
or 3-Methylglutaric acid.
The low phosphoric acid could be caused by a low phosphate intake in the diet, or to a deficiency in Vitamin D.
You asked me specifically about your BH4 in the light of the high 4-Hydroxyphenyllactic acid. I think the latter could just be due to intestinal bacterial dysbiosis breaking down your tyrosine in the gut, before it can be absorbed. Your BH4 could indeed be low. It's difficult to say for sure from the available data, since your SNPs are such that they tend to compensate each other in terms of the formation and the breakdown of the neurotransmitters.
I would recommend avoiding folic acid for other reasons beside whether you have the MTHFR C577T SNP. We don't know what your DHFR SNPs look like, nor do we know what your NADPH level is, and those are both important for utilization of folic acid. Methylfolate is still important for supporting BH4 as well as the methylation cycle block. You could try adding folinic acid if you would like. That would probably help to normalize your thymine/uracil ratio, which would be good for making new DNA for new cells.
I hope this helps.
Best regards,
Rich