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Need help interpreting Acumen mitochondrial functions tests ?

Discussion in 'General ME/CFS Discussion' started by GoodVibesOnly, Jul 26, 2015.

  1. GoodVibesOnly


    Hi everyone,

    I recently had the Acumen mito tests done through my nutritionist. We have since gone through the results together, however I am still not sure what the results mean?

    Was hoping someone who has had the tests previously could give some interpretation?

    I would be very grateful of any help anyone could offer. My head is swimming at the moment. I am hoping to use the results to help me formulate a plan of action.

    Many thanks

    ATP (Adenosine triphosphate) studies on neutrophils

    ATP whole cells:

    With excess Mg added: 1.34 (Ref range 1.6-2.9)

    Endogenous Mg only: 0.79 (Ref range 0.9 – 2.7)

    Ratio ATP/ATP 0.59 (Ref. 0.65)

    ADP to ATP conversion efficiency (whole cells):

    ATP (from above) 1.34 (Ref 1.6-2.9)

    ATP (inhibitor present) 0.06 (Ref <0.3)

    ATP (inhibitor removed) 0.67 (Ref >1.4)

    ADP to ATP efficiency 47.7% (Ref >60)

    Blocking of active sites 4.5% (Ref up to 14)


    Start 220 (Ref 290-700)

    TL out 272 (Ref 410-950)

    TL in 36 (Ref 140-330)


    Very low whole cell ATP

    Low ATP related Magnesium

    No significant blocking of active sites

    Very poor ADP to ATP re-conversion

    Very low mt-ATP and very poor provision of ATP

    Very-rapid depletion of ATP on increased energy demand

    Cell Free DNA in blood plasma

    7.6 (Ref up to 9.5)

    Mild incr = 9.6 to 12.4

    Niacin Status

    Red cell nicotinamide adenine dinucleotide = 12.4 (Ref 14.0 to 30.00)

    Mild deficiency = 12.5 to 13.9

    Moderate deficiency 11.0 – 12.4

    ***(See also SOD and DNA Adducts tables attached)***

    Attached Files:

  2. charles shepherd

    charles shepherd Senior Member

    I am not going to try and interpret your test results - this is something that should be done by the practitioner who ordered the tests and/or the laboratory that carried them out

    The interpretation of any test result has to be done in conjunction with the clinical history given by the patient, examination findings, especially in relation to any possible indication of a primary muscle disease with this sort of test, and the results of any other investigations that are relevant

    I'm responding because, as you may be aware, this commercial test has not been properly validated, and the MEA Ramsay Research Fund is now funding some research into this test in a department at the University of Newcastle that specialises in muscle and mitochondria disease:
    Plum and MEMum like this.
  3. lansbergen

    lansbergen Senior Member

    I am only interested in SOD2. I see it is low in your results.

    The immune modulator I use, is a superoxide scavenger
  4. Research 1st

    Research 1st Severe ME, POTS & MCAS.


    If you ordered this test from Dr Myhill, you should have received a letter from Dr Myhill with her comments. Did you? The Letter usually explains what to try next in terms of nutritional support. If not, see if you paid for 'interpretation', I forget if it's 'free' or not.

    Either way, I found this test useful, as it was one of many that show something unexpected is going on in my immune system, which is a very small part of proving a chronic disease state, and deflecting the currently xenophobic state approved message, that unexplained ME = imaginary = not needs to be researched and treated.

    In basic terms, your test result is potentially useful in a small way as it shows your white blood cell ATP (energy) is poor using a scale set by the assay designer of course. It doesn't explain why (could be infection), but it doesn't purport to either.

    One thing that caught my eye on your result is this:

    In this non specific ME test, your DNA oxidative stress levels are normal. This doesn't usually happen in ME or this specific test, as oxidative stress tends to be elevated in patients testing privately, including in published research such as on F2 Isoprostanes.

    If you want to look at your anti oxidant capacity in the UK (nb: not the same as a oxidative stress levels), you can buy tests yourself if funds allow. The NHS won't offer these tests to anyone. That's why private testing is a must
    with ME or CFS, because without access to private test, you won't a single piece of evidence you are sick at the time of diagnosis and may risk being abused by medical professionals who think they are helping you, by 'de medicalising' your illness!

    Here's a few tests to compare to your DNA damage test:

    DNA Oxidative Damage in Urine (Doctors Data)

    Antioxidant Profile (Doctor's Laboratory)
    Serum Cerulplasmin, Serum Copper, Red Cell GSH-PX, Red Cell Copper, Red Cell Fragility, Functional SODase Inhibition, Platelet aggregation, 1um ADP, 2um ADP, 5um ADP

    Advanced Oxidative Stress (Dunwoody Labs)
    SOD 1, SOD 11, Reduced Glutathione, Total Glutathione, F2-Isoprostane, 8-OHdG, Glutathione Peroxidase

    Antioxidant Profile (Biolab)
    Ceruloplasmin, Copper, Copper (Red Cell), GSHPx-1, GSHPx-3, Red Cell Fragility (H202), Superoxide Dismutase

    If you are severely affected, or chronically ill with an inflammatory disease, oxidative stress can be high, but yours is low! If you want the best chance to recover, this is good though, it may even be problematic because it would imply you may not have ME. Yet ME in the UK is CFS and CFS is CF and CFS doesn't need anything ever to be wrong with you. So it's all a muddle.

    Whenever I can, I always recheck abnormal tests, and also I make sure with the lab that the sample got there within the usual 24hr time limit.

    Your test may be pointing to an ME type disease (Poor ATP cell function - of one cell type), or may not at all. This is the unfortunate consequence of a fatigue based diagnosis, that has no screening test, and is often diagnosed by lazy doctors who tell practically anyone with unexplained symptoms they have ME or CFS, just to get them out of their doctor's office hoping they don't return - aka Heart Sink patients.

    Meanwhile the patient is left thinking what on earth to do next, who to turn to and can be influenced positively and negatively by reports of good and bad tests.

    Lastly, we are then in the problem area of assay usefulness over promotion, or denial, because you chose to be independent and went outside the NHS system that doesn't offer anything of a biomedical nature. (Oxidative stress tests in my opinion are well established as showing evidence of Free Radical Production) and thus a form of inflammation that shouldn't be there if found at high levels when no taken after exercise.

    I would say your test is useful, but it's not diagnostic - however, it doesn't claim to be. All it does is measure the level of ATP in a type of white blood cell, on one moment it was taken out of your arm. This was clearly abnormal.

    Personally speaking, I would wait a few months, and re-test to see if you get similar or indeed
    divergent test results.

    The problem with having an ME or CFS diagnosis and keeping with the NHS system:

    1) You have no idea what subset you are in, or evidence how disabled you are compared to other with 'CFS/ME'
    2) No idea what chronic infections you may have (not tested for).
    3) No idea of levels of inflammation (not tested for)
    4) No idea of what your autonomic nervous system is doing (not tested for).
    5) No idea of cardiac output/Vo2 Max/Lactate threshold.
    6) No idea of cognitive dysfunction as know psychometric testing is performed (Tests that include IQ)
    7) No idea if you suffer from low blood volume
    8) No idea if you have undiagnosed osteoporosis or arthritis causing pain.

    The list is endless.

    So you have two choices. Go with the state approved voice of no need to test as there is no 'ME test', or keep to some ideas (based on CFS biomedical research) and test for more 'exotic' finding that can show some odd findings.

    That's why I approve of private tests, backed by research.

    Yours and mine and everyone else's positive ACUMEN mitochondrial lymphocyte test, doesn't show you have 'classical' mitochondrial disease, but the ATP test, like yours and so many other PWME, is very poor and this could possibly tie in with explanations or theories of INFECTIONS leading to White blood cell infiltration/autoimmunity/inflammation.

    Such as this paper:

    PLoS One. 2013 Nov 28;8(11):e81155. doi: 10.1371/journal.pone.0081155. eCollection 2013.
    Epitopes of microbial and human heat shock protein 60 and their recognition in myalgic encephalomyelitis. Elfaitouri A1, Herrmann B, Bölin-Wiener A, Wang Y, Gottfries CG, Zachrisson O, Pipkorn R, Rönnblom L, Blomberg J.

    Your ACUMEN test result is indeed not mind blowing, but it might be worth filing in safe place, if it ties in with future, more influential research to do with ATP dysfunction in ME or CFS.

    I'd stick with that view point, rather than getting into a skirmish with an NHS doctor, who naturally won't know what ATP is never mind think it's associated to someone with a 'belief' in ME, which they think is chronic fatigue.
    GoodVibesOnly and Plum like this.
  5. charles shepherd

    charles shepherd Senior Member

    Comment from Prof Norman Booth on the MEA website:

    2 thoughts on “New award from the MEA Ramsay Research Fund for further mitochondrial research | 21 July 2015”
    1. [​IMG]HOPEJuly 21, 2015 at 9:09 am
      This sounds very exciting and good news that it has the backing and funding to carry it forward.

      Thank you Ramsay Research, MEA and all involved. Newcastle are certainly leading the way in many diseases. It’s good to know the North East has great things to offer.

      Thank you

      Log in to Reply
    2. [​IMG]Norman_BoothJuly 24, 2015 at 3:59 pm
      I am very pleased that finally, another group has decided and been funded to check the Acumen measurements of ATP concentrations in human cells and other aspects of the function or dysfunction of their mitochondria. It is very important to assay mitochondrial dysfunction in a way that is straightforward and which yields the most physiologically relevant, unambiguous and informative results.

      In our first paper [1] we showed that 70% of ME/CFS patients had below normal levels of ATP in their neutrophils and all had some degree of mitochondrial dysfunction. In our second paper [2] we found (actually to our own amazement) that for about ½ of both treated and untreated patients, a substantial fraction of their ATP was being produced, not by the electron transfer chain or anaerobic glycolysis, but by another process. We have since then determined that this other process is also anaerobic (no oxygen uptake). In the early days of Dr Sarah Myhill using tests carried out by Dr John McLaren-Howard the functionality of certain enzymes (or complexes) in the mitochondrial electron transfer chain were measured. It was found that the results did not correlate with clinical ability, and over several years the present ATP Profile and other tests were developed. In a recent review of the techniques for assessing mitochondrial function in cells, Brand and Nicholls (reference [11] of our second paper) concluded that the amount of cellular ATP does not necessarily report mitochondrial function because there can be pathways which try to compensate for any dysfunction [3]. In fact, the most likely compensatory pathway (the adenine nucleotide pathway) not only explains the effects that we reported, but also predicts post-exertional malaise, the prime symptom of ME/CFS, on the timescale of a few days [4].

      Brand and Nicholls also point out that measuring the functionality of individual mitochondrial respiratory complexes, as planned by Dr Boulton, is not very useful because no single complex is rate limiting [3]. Also, function depends upon the integrity of many processes. The chain as a whole has to function, but it is more like an assembly line – and don’t forget the doors that let the essential parts and co-factors come in, or the door that lets out the final product, ATP.

      Many medical doctors use the Acumen ATP Profile and auxiliary tests. It is important that as a first step a second party replicates some of these so that results from the same blood samples can be compared. Where necessary improved techniques can be implemented.

      The Acumen measurements take place in vitro but they study blood cells that are still alive. Some of the tests are on mitochondria isolated from the cells, but the mitochondria are still functional.

      Ideally, we would like to measure cells in vivo in different parts of the body, for example in skeletal muscle. This is now possible using near infrared spectrometry (NIR) and sophisticated electronics [5] but this technique has not yet been used on ME/CFS patients. It may take some time but I look forward to having an APP on my smart phone to receive and analyze the signals from NIR sensors taped onto my muscles. In the meantime I wish Dr Boulton every success in this new project.

      1. Myhill, S., N.E. Booth, and J. McLaren-Howard, Chronic fatigue syndrome and mitochondrial dysfunction. Int J Clin Exp Med, 2009. 2(1): p. 1-16.
      2. Booth, N.E., S. Myhill, and J. McLaren-Howard, Mitochondrial dysfunction and the pathophysiology of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). International Journal of Clinical and Experimental Medicine, 2012. 5(3): p. 208-220.
      3. Brand, M.D. and D.G. Nicholls, Assessing mitochondrial dysfunction in cells. Biochemical Journal, 2011. 435(2): p. 297-312.
      4. Lengert, N. and B. Drossel, In silico analysis of exercise intolerance in myalgic encephalomyelitis/chronic fatigue syndrome. Biophysical Chemistry, 2015. 202(0): p. 21-31.
      5. Binzoni, T., et al., A new method to measure local oxygen consumption in human skeletal muscle during dynamic exercise using near-infrared spectroscopy. Physiological Measurement, 2010. 31(9): p. 1257-1269.
  6. Plum

    Plum Senior Member

    I find this post very interesting. I have also recently received my results and have similarish results to @GoodVibesOnly .

    I have been considering co-infections and wondering what I might have and what I would like to do about them! I really like @Research 1st 's comments as well as suggestions.

    I personally have found that I have to try my best to keep an open mind and remember that none of these tests will show the whole picture. At the end of the day I am the only 1 who really understands how I feel - I find this particularly important when trying out various Dr/Naturopath/Alternative Practitioner recommendations.
  7. GoodVibesOnly



    Hi @Plum - I have since investigated these results further and think I may have found some of the underlying reasons for the results. I think you may be on the right path in considering co-infections as I have in my case having also carried out very comprehensive stool sampling which revealed a whole host of nasties. I too am grateful for @Research 1st comments. I however disagree as regards not showing any oxidative stress. My results clearly show that I have very low levels on my MnSOD2 gene studies.

    MnSOD is very important for detoxification which in my case makes a lot of sense as I have a lot of sense in relation to my gut and liver. I am now trying to focus on overall health as well as working on detoxification.

    Please PM me if you want to chat further. It would be good to get your thoughts also.
  8. GoodVibesOnly


    @Research 1st I have been trying to PM you but notice that the website is not allowing me to do so. Would it be possible to speak to you about some of the points you have highlighted above?

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