August 8th, 2016: Understanding and Remembrance Day for Severe Myalgic Encephalomyelitis
Jody Smith joins with other ME voices in honor of Understanding and Remembrance Day for Severe Myalgic Encephalomyelitis.
Discuss the article on the Forums.

Help In Interpreting My Nutreval Results

Discussion in 'Diagnostic Guidelines and Laboratory Testing' started by Gavin, Dec 8, 2012.

  1. Gavin


    Hi all,

    Sorry to bother you all but I noticed that there were some good interpretations of peoples Nutreval results on this forum (Richvank & Valentijn, Caledonia among others) and I was wondering if I could get some help interpreting my own results. They are from 2010 but I still have the same symptoms so still valid I think although I will get a follow up.

    I have suffered anxiety and panic attacks since I was in my early teens and although i’m managing, it is still controlling my life and I feel it’s down to something being out of balance inside me. I’ve made massive improvements in recent years from diet and nutrition changes but it still plagues me and i’m needing help to put it behind me once and for all.

    MY main symptoms these days are:
    - Brain Fog
    - Panic Attacks
    - Anger
    - Restlessness
    - Pale Skin
    - Dry mouth during night
    - Fatigue
    - Low libido
    - Dandruff

    I think my diet is healthy with no processed foods or sugar, no dairy and no alcohol since August.

    I eat relatively low carb although do have potatoes in my diet at the moment to give me some carbs as low carb seems to make my symptoms worse these days.

    My results can be found in the following links but i’ve also included a summary below of all the things that seemed to be out of whack:

    Results -

    Food Allergen Test - Test.pdf

    Glycine = Low
    Keto Glutaric Acid = High
    Methylhistidine – Very High
    Leucine – High
    Cystathionine – High
    Sarcosine – High
    Aminoisobutyric Acid = High
    Taurine – High
    Methionine – High
    Citrulline – High
    Phosphoserine – High
    Omega 6 – Low
    Ethanolamine – High
    Lactic Acid – Low
    OH Butyric Acid (BHBA) – High
    Ketoglutaric Acid – High
    Histidine – Lowish
    Anserine – Low
    Alanine – Low
    Cysteine – High
    Glutamic Acid – High
    Glutamine – Low
    25 OH Vitamin D – Low

    If anyone could help me interpret these results and offer an y advice on the best way forward i’d appreciate it. Two things i’m thinking are Vitamin D and Glycine supplementation.

    Thanks all.

  2. Valentijn

    Valentijn Senior Member

    A few questions that might be helpful:
    Were you taking any vitamins or supplements?
    Was your diet high or low in meat consumption?
    Were you fasting when the sample was given?
    How long had you been ill?
    How active were you?

    These three combine to make glutathione. The good news is that you have plenty of that, but glutamate is an excitatory neurotransmitter, and having too much of it can cause your brain to feel like it's running around in circles all the time, even when you're trying to sleep. Supplementing Glycine might help bring the glutamate (and cysteine) down by using them up a bit to form more glutathione.

    Alpha-ketoglutaric Acid can be made from glutamate, so having that elevated isn't unexpected with your high glutamate levels. Bringing glutamate down may help bring your alpha-ketoglutaric acid down. And cystathionine is made from cysteine, so bringing cysteine down should bring down cystathionine. And Taurine is made from cysteine so should go down as a result as well. And as homocysteine can become either cysteine or return to methionine, using up more cysteine might allow methionine to go down as well.

    Anserine is broken down into 1-Methylhistidine and Beta-Alanine. Elevated 1-Methylhistidine combined with normal anserine and beta-alanine could mean you aren't digesting meats normally.

    This suggests catabolism (break down) of your muscles, possibly for amino acids to use a fuel source.

    Lactic Acid feeds into your Krebs Cycle, where ATP (energy) is produced. Having it low might indicate there is a problem, as it's used to regenerate NAD+, which creates more pyruvate to feed into Krebs Cycle - so maybe an abnormal amount is being drained for that purpose. The high BHBA suggests you're trying to compensate for it somewhat by burning fats, or possibly it was a fasting urine sample, in which case you'd still be breaking down fats due to not eating overnight.

    You also might be compensating by breaking down dietary protein and muscles, based on your methylhistidine results. The good news is that you seem to be compensating adequately so far (if that is what's happening), since your other Krebs Cycle values are normal. The bad news is that you can't break down your own muscles forever - so you might need a high-protein diet at some point.

    Alanine is formed from leucine, valine, and isoleucine, so having it low is rather odd. But alanine and lactate are both formed from pyruvate, and recombine to create more pyruvate. So either you weren't breaking pyruvate down in a normal manner, or too much alanine and lactate are being drained to form pyruvate to feed into the Krebs Cycle. There's an actual cycle involving those three, called the "Alanine Cycle". Yours seems to be malfunctioning somehow.
    This could indicate you're not producing a normal amount of propionyl CoA, which feeds into the Krebs Cycle. High Beta-aminoisobutyric acid is associated with several disease, so it might be good to rule those out. Though it looks like supplementing B6 and B12 might fix that. Definitely something to look into though, I think. One thing that might be of interest to ME/CFS patients is that high Beta-Aminoisobutyric Acid is associated with non-Hodgkins Lymphoma, which we're at increased risk of developing.

    Ornithine forms citrulline, which then results in aspartate or arginine. High citrulline with normal aspartate and arginine therefore might indicate a problem breaking down citrulline. The Nutreval interpretation suggestions taking Magnesium, so that might help with processing it.

    These results are a bit odd together, since they're in a loop together: Ethanolamine->Stuff->Sarcosine->Glycine->Serine->Ethanolamine. I think this suggests that you have trouble converting sarcosine into glycine, but that other mechanisms then intervene to make sure you have enough serine from alternate sournces. Nutreval says that's a methylation problem, in which case getting your B12 and Folate from active sources (methylcobalamin and methylfolate) might be helpful.

    High ethanolamine can also be due to low magnesium. In which case your phosphoethanolamine shouldn't be elevated. It's borderline high though, so it's hard to tell if it's just a magnesium deficiency or if there's also dysbiosis. Either way, magnesium is a good thing to try.

    It looks like a lot of things could cause this ... I think following their recommendations regarding supplements for it could be useful to see if it helps.

    Did you try following the Nutreval recommendations for vitamins (especially Bs and D) or minerals? Any difference in symptoms? And if so, have you had a more recent panel run?
  3. Gavin


    Hi Valentijn,

    Sorry its taken me a while to get back. Thanks so much for your detailed response. Its been really helpful as I wouldn’t have known 99% of it!!! Definitely given me some avenues to explore.

    To answer some of your questions:

    Were you taking any vitamins or supplements?
    Problem I have is that very poor memory is one of my main symptoms so its hard for me to remember if I was on supplements or not at the time but I believe I wasn’t on anything as I was advised to stop all supps a couple of weeks before so they wouldn’t throw the results.

    Was your diet high or low in meat consumption?
    Again, not 100% but probably high as I’ve always been a meat eater and with the majority of my approach being low carb then I think I would have been high in meat consumption

    Were you fasting when the sample was given?
    Don’t believe I was fasting.

    How long had you been ill?
    I’ve had these symptoms since I was maybe 9 years old albeit they have changed as time as gone on. I am now 34.

    How active were you?
    I have always been an active person and into my sports. At the time the test was taken, I was training for a long distance running event so was out regularly although not overdoing things.

    I’ve ordered some supplementary Glycine which should arrive in next couple of days so hopefully that will start to balance out a number of the highs and lows. I’ve also started taking Vitamin D again given I’m in Scotland which rarely sees daylight or sunshine these days J so hopefully that will help too. I don’t want to take too much at once though so will leave it at those two for now and see where I am in the New Year.

    Not sure what’s going on there with muscle breakdown. It certainly seems like I am breaking down muscle as I can see the effects in the mirror as time goes on but I’ve got a high protein diet so not sure what’s happening.

    Would I need to supplement B12 given I’m on a high protein diet which should provide me with B12? I ask because I’m sure I’ve read somewhere that there are different types of B12 in your system (blood and something else) so one might be up due to meat consumption but the other down???

    I’ve taken B vitamins before but they all seemed to excite me and bring on the anxiety more than help it. Especially the B6 if my memory serves me right (ha). I took B3 for a while also but didn’t see any real improvements. That was a good while ago though so may try introducing again in the new year. Haven’t supped with any minerals other than by natural seaweeds. IS there anything you would recommend?

    Thanks again for all the info. Your answer was very thorough and helped loads.


See more popular forum discussions.

Share This Page