Hi Gavman,
I doubt I can tell you anything Rich can’t, but I’d be happy to provide my amateurish views.
The urea cycle basically consists of ornithine, citrulline, and arginine in a cycle, and its basic function is to convert ammonia to urea for excretion. If the urea cycle doesn’t function properly, ammonia can build up, find other less desirable ways to convert to other stuff, or (as I understand it) spill over in urine. In your case, these core components are all pretty low, which (particularly the ornithine) I think suggests that your capacity to properly excrete ammonia is reduced. This wouldn’t be good.
Generally what seems to be recommended for this is arginine supplementation, I guess with the expectation that it converts to ornithine. For example, this is a common intervention for hyperammonemia in Pubmed. However, there’s concern among PWC’s that arginine assists viruses. My results show low arginine as well, and I’ve avoided supplementing it for that reason. But as soon as I do my own updated plasma amino acid test tomorrow, I’m going to start arginine supplementation. Besides the urea cycle, arginine is also used to make creatine, which as I recall is another thing missing for many PWC’s.
Urine amino acid tests (at least the one from Doctor’s Data) show ammonia excretion, which presumably is spillover from lack of conversion to urea, although I’ve seen other explanations, including chronic acidosis. If you’ve done a urine organic acids test, high ammonia might be indicated by unusually high citrate levels, or I think isocitrate as well, and also orotate. My diagnostic nutritionist wasn’t terribly excited about testing blood ammonia, because he said that modestly high levels may be difficult to interpret conclusively, compared to frank hyperammonemia, because he said levels vary quite a bit even under normal conditions. (although, if you have serious brain fog from it, your results may be more clearly high)
Interestingly, your lysine is also low. I’ve seen references (including Rich) to some kind of relationship between lysine and arginine. Specifically, the aforementioned virus issue is somehow helped by keeping your lysine:arginine ratio high. Further, carnitine is derived from lysine, so this may indicate your carnitine is low. Carnitine is required for burning fatty acids, which directly relates to the Krebs cycle and energy production. Metametrix actually suggests 1-2g of carnitine as a “near-term” intervention if you have low lysine, while simultaneously supplementing lysine to gradually build up your own production. Incidentally, carnitine is also recommended as a hyperammonemia intervention on Pubmed. (There’s some debate about carnitine’s effects on thyroid hormone, so if you’re hypo, you might want to look into that... And despite the ‘near-term’ description, most places I’ve seen say carnitine takes 4-8 weeks to have effect, if it’s going to have one.)
In general, most of your amino acids are on the low side. Maybe this means you’re on a low-protein diet; or maybe you have some malabsorption issues? I haven’t studied this area very deeply, but I think broad malabsorption could mean gut inflammation, dysbiosis, leaky gut, pancreatic issues, etc. The low glutamine may not be helping the situation, as glutamine is considered to be a primary factor in healing the gut.
The fact that the methyl-histidines are high seems to suggest you’re not on a low-protein diet... I’ve gotten the impression these are fairly indicative of chicken/turkey consumption. ?
Your glutamate seems somewhat balanced with your GABA, which is good (glutamate is excitatory, GABA is calming). But your glutamate, GABA, and glutamine (which can cross-convert quite a bit) are all low. To me this goes back to the absorption issue.
I’m not sure why valine would be selectively low, compared to the other two BCAA’s (leucine and isoleucine). Not that they’re particularly high either, but they are compared to valine. The BCAA’s seem to be primarily used for energy production, and lack of them is associated with resultant muscle wasting (i.e., burning muscle b/c there’s no BCAA’s to burn). Given valine’s frank lack, and the consequences, I would strongly consider specifically supplementing BCAA’s.
In short, if I were you (and again, I’m just an amateur)... I’d consider doing these near-term:
* supplement with arginine (unless you have confirmed viruses), glutamine, lysine, maybe carnitine, and BCAA’s.
* maybe pick up my protein intake a little (although this arguably will increase ammonia... There’s debate about how to handle this)
* make sure I was taking a good probiotic.
And I’d start looking into the cause of the malabsorption... a good stool test showing dysbiosis and pancreatic function; maybe an OAT that shows dysbiosis markers. If you can’t afford these, then maybe start rotating through some dysbiosis supplements – berberine seems to be a favorite on Pubmed the last few years, with many positive studies on its impact on gut flora and gut healing. Curcumin is an anti-fungal. Garlic, uva ursi, etc. etc. (Research this well, before you do it.) And then digestive aids – betaine HCl or lemon juice for stomach acid (maybe first try Rich’s baking soda test for low acid to see if it's necessary), and pancreatic enzymes for the intestines, to cover any deficiencies.
An OAT would also show functional nutrient deficiencies, which seem likely to me, given your possible amino acid malabsorption. I'm a big fan of testing (especially the OAT), because it's better than stabbing in the dark only on symptoms, and it can help track progress. But they cost money, and have to be balanced against symptoms.
Be sure to research all the supplements I mentioned... some have downsides in some situations. I.e., carnitine sounds great until you run into the thyroid discussion. I suggest searching this forum; I don’t care for PR’s search engine, so I type this into Google: “site:
http://forums.phoenixrising.me ______”, inserting my search terms. This applies Google only to these forums. Often I add the search term “Rich”, because I like what he has to say. ;-)
Vance
