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Genova Metabolomix+ test - Will dilute urine impact test results?

Replenished

Senior Member
Messages
247
Hi guys,

I recently order the Metabolomix+ test from Genova to see if it might provide any answers to my ongoing health issues.

I've noticed the test asks you to limit fluid intake to 2 litres for the 24 hours prior to the test. This is so the urine for the samples is not too dilute. The problem is, one of my symptoms is frequent urination/dilute urine, to the point it was initially thought I had diabetes insipidus. More recent testing demonstrates this is not the case but there is a limited ability to concentrate urine.

I'm wondering how much a sample of dilute urine might impact the test results for Metabolomix+. I rang Geneva customer services and they said they are not medically trained so can't really answer and to ask my practitioner which I've done but am waiting for a response.

I do concentrate urine but less than a normal/fully healthy person and my urine is almost always clear or very pale yellow even when limiting fluids.

Does anyone have any knowledge on this urine testing? Even for the average healthy person there will be massive differences in the urine concentration for each sample, so how do they test the urine accurately?
 

vision blue

Senior Member
Messages
1,877
I have posted on this issue in this forum. I'll see if i can find the link to send it.
in the meantime, part of the answer depends on whether you did a 24 hour collection, or it's a first or second (or random) single collection.
 

Replenished

Senior Member
Messages
247
I have posted on this issue in this forum. I'll see if i can find the link to send it.
in the meantime, part of the answer depends on whether you did a 24 hour collection, or it's a first or second (or random) single collection.

It's 3 single samples at the same time in the morning. I really don't understand how they can get accurate results from urine either with normal urine centration fluctuations person to person, let alone someone who can barely concentrate urine.
 

vision blue

Senior Member
Messages
1,877
That may run you into run you into a problem. I've pasted below one of the posts i made on that in another thread. Different test, but same principle. Since its not a 24 hour urine specimin, they will take your creatinine levels and use it to correct your values on all the metabolites- so they may not be accurate. One workaround is to take the ratio of things that you are interested in and just focus on relative things whilst ignoring absolute numbers. The correction issue won't affect ratios, so you should ber good there. In your case, hard to figure out if the absoute values will be overestimated or underestimated because i don't know if your creatinine level will be an accurate measure of how dilute your urine really is (in eg. those that don't concentrate urine).

one good thing though is you can look at that number yoiurself- theyll provide it with the test resutls. If it's too low, in principle they should't run the test at all and they will tell you.

how did the samples look to you? clear like water or was it yellow? if the latter, you should be ok, though there's still issue as per the thread below. Did you save a sample for yourself? If so, test it with a test strip so you can see the specific gravity yourself.

i have trouble concentrating urine as well and they wouldn't believe me. i would even go and get urine and blood tests without having had anything to drink all morning - they still wohnt' beleive me and just figured i had alot of water to drink... I had had low urine output yet not conentrated. When i did a 24 hour urine test with doctors data, they refused to beleive it was a 24 hour sample (low output with low creatinine and low concentration)! I t's improved after i increased amount of protein i was eating.

post when you get your results. if i'm still alive

her'es my other post in its entirety though not all applies to you. if you want to find the whole thread you can search for "creatinine"
"
While there's no particular reason to suspect lab error, I'd vote for the possibility that the correction for creatinine levels may have artifactually inflated your results.

The mycotoxin test is a one-time urine sample so they use the amount of creatinine in the urine to estimate how dilute it is, which i turn greatly affects the final amount of toxins estimated. In fact, Great Plains lab boasts in their description of the test that the results can differ by 35 fold (!) depending on correction for creatinine. But the problem is that other things affect creatinine besides how much water you drank (dilution). The more muslces you have, the higher the creatinine level. So anyone with low muscle mass, be in from being a small woman, to weak muscles of any cause (deconditioning, atrophy), will have lower creatinine that then is assumed to be from a diluted sample - except that's an error! The end result is that the numbers show up as higher than they really are. Note that if you also have a kidney issue or your urine otherwise has low creatiine having nothing to do with how much water you drank (like some of us), there too, the low creatinine is blamed on water consumption and the results are overestimated. Very large men or those who have greater than average muscles will have the oppoiste problem- the numbers will show up as lower than they really are. Given that they can vary by 35 fold for different amounts of creatitine, they are potentially way way overestimated.

If the test is 24 hour urine, then there's no problem becasue they just measure how much is present int he urine- no calculation based on creatinine is done. But they don't. Also, some labs calculate body surface area and used that in the calculation for one time urine samples, but GPL does not do hat. Another way to get around the issue is to look at ratios rather than absolute amounts works for things like if youre measureing say magnesiusm and potassium, or different amino acids - you can take a ratio. But a ratio is useless in the mycotoxin test.

GPL is expanding their testing of mold related issues. My cynical guess is that they are following the money. Mold/mycotoxin testing is a big money maker for both functional medicine doctors and alternative lab testing companies. So many people, healthy or not, have mold show up. So it's something visible that the practioners can say AHA! - and show the patient the out of range number, which looks impressive. The leads to more testing, and treatments, and retesting - the $$ add up for all involved. Becasue the numbers are often wildly elevated (again, think back to the 35 fold difference based on corrections. as well as high sensitivity of the test) - this gets attention of patient - oh wow- looks more impressive than a borderline high lab result one never knows what to do with it. While some chronically ill do have an issue with mold, i don't think you can tell from these tests who does despite the high numbers.

sorry that got preachy- just trying to get a point across and the words aren't flowing properly.

One test that may be helpful is a test that's second most on my list of alternative tests that have been of value. its the comphrensive stool analysis. Although it's not PCR (so not senstitive to the max), they both culture for fungus and look microscopically. If you ask the folks/counsselors/nurses at great plains lab (using the 30 minute free consult you get for doing a test ) why there was 0 mold growth on the stool analysis and 0 evidence on microscopy, they say the OAT (in this case I asked about OAT) is much more sensitive and will show up before the stool analysis. But too much more sensitive perhaps? does that predict that eventually will show up in stool analysis? If it were really bad, wouldn't it colonize gut? (don't know, perhaps just in respitory system)? .

one other quick thing about this thread. someone mentioned Vit. C level on the OAT and that their result was zero or near zero indicating defiiency. Actually, even the great plains folks in their webinars (free for all) say that it's commonly zero or near zero and does not mean a deficiency; its just that vit c is metabolized very quickly or some such and in no way indicates a deficiency.
 
Last edited:

Replenished

Senior Member
Messages
247
That may run you into run you into a problem. I've pasted below one of the posts i made on that in another thread. Different test, but same principle. Since its not a 24 hour urine specimin, they will take your creatinine levels and use it to correct your values on all the metabolites- so they may not be accurate. One workaround is to take the ratio of things that you are interested in and just focus on relative things whilst ignoring absolute numbers. The correction issue won't affect ratios, so you should ber good there. In your case, hard to figure out if the absoute values will be overestimated or underestimated because i don't know if your creatinine level will be an accurate measure of how dilute your urine really is (in eg. those that don't concentrate urine).

one good thing though is you can look at that number yoiurself- theyll provide it with the test resutls. If it's too low, in principle they should't run the test at all and they will tell you.

how did the samples look to you? clear like water or was it yellow? if the latter, you should be ok, though there's still issue as per the thread below. Did you save a sample for yourself? If so, test it with a test strip so you can see the specific gravity yourself.

i have trouble concentrating urine as well and they wouldn't believe me. i would even go and get urine and blood tests without having had anything to drink all morning - they still wohnt' beleive me and just figured i had alot of water to drink... I had had low urine output yet not conentrated. When i did a 24 hour urine test with doctors data, they refused to beleive it was a 24 hour sample (low output with low creatinine and low concentration)! I t's improved after i increased amount of protein i was eating.

post when you get your results. if i'm still alive

her'es my other post in its entirety though not all applies to you. if you want to find the whole thread you can search for "creatinine"
"
While there's no particular reason to suspect lab error, I'd vote for the possibility that the correction for creatinine levels may have artifactually inflated your results.

The mycotoxin test is a one-time urine sample so they use the amount of creatinine in the urine to estimate how dilute it is, which i turn greatly affects the final amount of toxins estimated. In fact, Great Plains lab boasts in their description of the test that the results can differ by 35 fold (!) depending on correction for creatinine. But the problem is that other things affect creatinine besides how much water you drank (dilution). The more muslces you have, the higher the creatinine level. So anyone with low muscle mass, be in from being a small woman, to weak muscles of any cause (deconditioning, atrophy), will have lower creatinine that then is assumed to be from a diluted sample - except that's an error! The end result is that the numbers show up as higher than they really are. Note that if you also have a kidney issue or your urine otherwise has low creatiine having nothing to do with how much water you drank (like some of us), there too, the low creatinine is blamed on water consumption and the results are overestimated. Very large men or those who have greater than average muscles will have the oppoiste problem- the numbers will show up as lower than they really are. Given that they can vary by 35 fold for different amounts of creatitine, they are potentially way way overestimated.

If the test is 24 hour urine, then there's no problem becasue they just measure how much is present int he urine- no calculation based on creatinine is done. But they don't. Also, some labs calculate body surface area and used that in the calculation for one time urine samples, but GPL does not do hat. Another way to get around the issue is to look at ratios rather than absolute amounts works for things like if youre measureing say magnesiusm and potassium, or different amino acids - you can take a ratio. But a ratio is useless in the mycotoxin test.

GPL is expanding their testing of mold related issues. My cynical guess is that they are following the money. Mold/mycotoxin testing is a big money maker for both functional medicine doctors and alternative lab testing companies. So many people, healthy or not, have mold show up. So it's something visible that the practioners can say AHA! - and show the patient the out of range number, which looks impressive. The leads to more testing, and treatments, and retesting - the $$ add up for all involved. Becasue the numbers are often wildly elevated (again, think back to the 35 fold difference based on corrections. as well as high sensitivity of the test) - this gets attention of patient - oh wow- looks more impressive than a borderline high lab result one never knows what to do with it. While some chronically ill do have an issue with mold, i don't think you can tell from these tests who does despite the high numbers.

sorry that got preachy- just trying to get a point across and the words aren't flowing properly.

One test that may be helpful is a test that's second most on my list of alternative tests that have been of value. its the comphrensive stool analysis. Although it's not PCR (so not senstitive to the max), they both culture for fungus and look microscopically. If you ask the folks/counsselors/nurses at great plains lab (using the 30 minute free consult you get for doing a test ) why there was 0 mold growth on the stool analysis and 0 evidence on microscopy, they say the OAT (in this case I asked about OAT) is much more sensitive and will show up before the stool analysis. But too much more sensitive perhaps? does that predict that eventually will show up in stool analysis? If it were really bad, wouldn't it colonize gut? (don't know, perhaps just in respitory system)? .

one other quick thing about this thread. someone mentioned Vit. C level on the OAT and that their result was zero or near zero indicating defiiency. Actually, even the great plains folks in their webinars (free for all) say that it's commonly zero or near zero and does not mean a deficiency; its just that vit c is metabolized very quickly or some such and in no way indicates a deficiency.

Very interesting. I'm not very confident on the test being accurate now.

Also I've never really found anyone else with low urine output and low urine concentration, which is what I typically have. As though I can retain urine to a degree at times, but it's still dilute. Which going go most standards, makes no sense?

I assume you've been tested for Diabetes Insipidus? Water deprevation test? Although it doesn't sound like you have that anyway with the low output.

In regards to the test and creatinine. My blood creatinine is always slightly high or high end of normal. I actually had a separate blood test on the day I did the Genova urine samples to send off and my blood Creatine was 115 umol/L, which is high/out of normal range. Likely slightly higher than normal because I'd tried to limit my fluid intake to a degree through the night so I'd at least have my urine concentrate a little.

Maybe that might help me interpret the urine results knowing what my blood creatinine was. How does blood creatinine correlate with urine creatinine?
 

Replenished

Senior Member
Messages
247
Sorry I didn't answer the question on the urine colour. It wasn't completely clear, once in the sample tubes it had some colour, straw like. But to how dehydrated I felt, it should be dark orange. No I didn't keep a sample for myself and don't have any of the test strips to hand anyway.

What do you think on the high blood creatine? I think it demonstrates i'm dehydrated, yet urine is still clear. So i'm thinking this had to skew the urine result, the urine they are going to test is going to test as that of a hydrated person with dilute urine, when in fact it's from a dehydrated person with dilute urine. Problem?
 

vision blue

Senior Member
Messages
1,877
ojk so to begin to answer your question on how creatinine urine and blood are related, the short answer is it depends on how well your kidneys are working. In your blood test, go to the line that says eGFR. That stands for estimated glomular filtration rate. It's an estimate as to how good a job kidneys are doing at filtering waste (like creatinine). Normal is 100 percent. for some people, the estimate does not do a good job of real filtration rate- i'm one of those people- i'll get back to that. But for you, the fact your creatinine is on the high side, coupled with your dilute urine, suggests to me that you could have a kidney problem. Getting docs to listen to you is anothe rmatter (more on that later too, if i don't run out of energy).
Unless you are very large or have tons of muscles, your creatinine should not be high.

it's absolutely wonderful that you did the blood test and urine test to send on the same day! That's because basically you've created your own "Creatinine clearance test". This is a test not done much now, which is a shame cause its a great test. instead, they use the eGFR instead becasue they are lazy sons of bitches and the 10 percent of people not well estimated by the eGFR jsut get squeezed out of getting any care. Anyway, the point of the creatinine clearance test is to measure both blood levels and urine levels at the same time. Then you compare them (well i guess maybe 24 hour collectoin better, but still will be very useful). The way you compare them gets back to the issue of how the two are related. (the genove test you did should inclued the meaured creatine in your urine- see a sample report to check if it does.)

so typically, if kidneys are working well, then they have succeeded at removing waste and creatinine in blood low and in urine high (that's an oversimilification- there's a forumla)
if kidneys not working well, creatinine accumulates in blood so that's high, while in urine is low (since kidneys could not excrete it).
but again, there's a formula. once you get your value from urine , can enter it and we can discuss again.

ok, stil more to say, so guess will tell you about me some other time. To get back to the accuracy of your new urine test, what youve told me so far is that your creatinine in urine will be lower than it shoujld. This means that the test will overestimate your true values. That is, for every value, your REAL level is lower than the test results will show. HOw much lower is pretty hard to determine. You can use that tt help inteprpet your results. So if you're low normal on some parameter, you may actually be too low and out of range even if doen'st show up. ANd if you hare too high, even out of range, you may not be because your real value is lower. As i said before, easist way to deal with it is to take ratios of your results and see if the ratios are normal. But knowing it overestimates will be helfpul in interpreting.

Quick thing on me is same urinary thiong as you, but my creatiinne in blood does not show up as high enough to get their attention. that's only becasue i have VERY low muscle mass. they just ignore me. theyre busy. they believe their crap tests even though they are not one size fits all. so my eGFR turns out normal because they base it on the AVERAGE person of my age and gender- and i'm hardly average. And as for urine properites, as i mentioned above, they don't beeleive me that i collected for 24 hours or don't beleive me that I wan't drinking water. I calculated my own creatiine clearnace and it was not good- suggested kidneys only working at i can't reember maybe 40 percent. AT the time, i trusted what i thought was a smart doc, but he didn't like my DIY medicine and blew me off. I"m dumping him as a doc, but meantime i don't hae the energy to go through it all with anotehr doc. My only hope is that i've noticed my urine properties are more normal - hoping the prior poor kidney function isn't somethign i have 100 percent of time.

hope this helps...

update. editied to add- to answer what i think of your high creatinine levels, i think it could mean kidney "disease" - so check the eGFR for starters as i say above.
 

Replenished

Senior Member
Messages
247
ojk so to begin to answer your question on how creatinine urine and blood are related, the short answer is it depends on how well your kidneys are working. In your blood test, go to the line that says eGFR. That stands for estimated glomular filtration rate. It's an estimate as to how good a job kidneys are doing at filtering waste (like creatinine). Normal is 100 percent. for some people, the estimate does not do a good job of real filtration rate- i'm one of those people- i'll get back to that. But for you, the fact your creatinine is on the high side, coupled with your dilute urine, suggests to me that you could have a kidney problem. Getting docs to listen to you is anothe rmatter (more on that later too, if i don't run out of energy).
Unless you are very large or have tons of muscles, your creatinine should not be high.

it's absolutely wonderful that you did the blood test and urine test to send on the same day! That's because basically you've created your own "Creatinine clearance test". This is a test not done much now, which is a shame cause its a great test. instead, they use the eGFR instead becasue they are lazy sons of bitches and the 10 percent of people not well estimated by the eGFR jsut get squeezed out of getting any care. Anyway, the point of the creatinine clearance test is to measure both blood levels and urine levels at the same time. Then you compare them (well i guess maybe 24 hour collectoin better, but still will be very useful). The way you compare them gets back to the issue of how the two are related. (the genove test you did should inclued the meaured creatine in your urine- see a sample report to check if it does.)

so typically, if kidneys are working well, then they have succeeded at removing waste and creatinine in blood low and in urine high (that's an oversimilification- there's a forumla)
if kidneys not working well, creatinine accumulates in blood so that's high, while in urine is low (since kidneys could not excrete it).
but again, there's a formula. once you get your value from urine , can enter it and we can discuss again.

ok, stil more to say, so guess will tell you about me some other time. To get back to the accuracy of your new urine test, what youve told me so far is that your creatinine in urine will be lower than it shoujld. This means that the test will overestimate your true values. That is, for every value, your REAL level is lower than the test results will show. HOw much lower is pretty hard to determine. You can use that tt help inteprpet your results. So if you're low normal on some parameter, you may actually be too low and out of range even if doen'st show up. ANd if you hare too high, even out of range, you may not be because your real value is lower. As i said before, easist way to deal with it is to take ratios of your results and see if the ratios are normal. But knowing it overestimates will be helfpul in interpreting.

Quick thing on me is same urinary thiong as you, but my creatiinne in blood does not show up as high enough to get their attention. that's only becasue i have VERY low muscle mass. they just ignore me. theyre busy. they believe their crap tests even though they are not one size fits all. so my eGFR turns out normal because they base it on the AVERAGE person of my age and gender- and i'm hardly average. And as for urine properites, as i mentioned above, they don't beeleive me that i collected for 24 hours or don't beleive me that I wan't drinking water. I calculated my own creatiine clearnace and it was not good- suggested kidneys only working at i can't reember maybe 40 percent. AT the time, i trusted what i thought was a smart doc, but he didn't like my DIY medicine and blew me off. I"m dumping him as a doc, but meantime i don't hae the energy to go through it all with anotehr doc. My only hope is that i've noticed my urine properties are more normal - hoping the prior poor kidney function isn't somethign i have 100 percent of time.

hope this helps...

update. editied to add- to answer what i think of your high creatinine levels, i think it could mean kidney "disease" - so check the eGFR for starters as i say above.

Hey, here in the UK any eGFR above 60 is classed as normal/sufficient. Mine ranges from 70 to 90. Not even sure they measure higher than 90. But yet mine is always in this range. It's never been below 70. But yet my creatine is always slightly high and I feel dehydrated. I hold a bit of muscle but I'm an average sized guy so it couldn't be due to high muscle mass.

I'll be interested in hearing your thoughts on the results and the 'Creatinine clearance test' I've knowingly created. If they give me the creatinine levels in the urine hopefully we can work that out.
 

vision blue

Senior Member
Messages
1,877
Since you are high in muscle mass, hopefully thats the only reason why your numbers are high

No one looks at somewhat impaired kidney function (the cutoffs you me tion) because one still has a long time tnd chancez are something else will kill you first. Theres too many people for med system to spend resources on preventative measures- its more efficient apparently to treat when function drops so low that can no longer be ignored

Ihigh muscle mass by the way would give you the exact opposite miss estimation issue in the urine test- But you will get lucky and they will balance out

Do Genova sample reports show that they provide you with the creatinine number? Some companies will also correct data for body mass and not just creatine level which is a good thing I’m not familiar enough to know if Genova does

Makes sebse for you to have hrine strips around. See if theres any protein in urine among can keep better track of concentration
 

Replenished

Senior Member
Messages
247
Since you are high in muscle mass, hopefully thats the only reason why your numbers are high

No one looks at somewhat impaired kidney function (the cutoffs you me tion) because one still has a long time tnd chancez are something else will kill you first. Theres too many people for med system to spend resources on preventative measures- its more efficient apparently to treat when function drops so low that can no longer be ignored

Ihigh muscle mass by the way would give you the exact opposite miss estimation issue in the urine test- But you will get lucky and they will balance out

Do Genova sample reports show that they provide you with the creatinine number? Some companies will also correct data for body mass and not just creatine level which is a good thing I’m not familiar enough to know if Genova does

Makes sebse for you to have hrine strips around. See if theres any protein in urine among can keep better track of concentration

Hey. The results have just come back. I think I need some help in interpreting them. Everything in the urine tests is supposedly relatively normal. Although we know my urine is dilute so how will that have impacted the results? My blood fats/omegas is the thing that's come back most obviously out of range. That's the only part of the test done via blood.

The creatine level which I was concerned about, was verging on high in this urine test, as well as being high in the separate blood test I mentioned I had at the same time. Does that make any sense? I'll attach the results in next post.
 

vision blue

Senior Member
Messages
1,877
This link shows the formula for calculating clearance based on both bloid and 24 hour urinre
https://wikicali.com/wiki/how-to-calculate-creatinine-clearance/

Since u didnt have 24 hours , youd need to calculate based on first morning urine sampke which us doable but probqbly not worth effort because your urine creatinine turned out on high side

Do you have evidence from another test result that urine creatinibe was low? Just asking because i once sent same sample to two labs and they were very different! Ea h used a different methodology but still shoukd have come up with ssme vue- but did not. In fact they were at oppoaite extremes. I knew the low one was correct. Anyway in our case maybe the not drinking much water paid off

Until you get a 24 hour sampke , you can use blood to do a better calculation than the doc labs do especially if have your BUN too

http://www.medcalc.com/gfr.html


https://www.mcw.edu/calculators/creatinine-clearance

Hard to tell with you if genova over or underestimated and as i mentioned hopefully will balance out given what i said in previous messages

Did you by any chance save the urine from the sample? I just sent a urine trst off this morning by the way and froze a littke sample in case i need to double check any value.

I rememver that lab with the false high creatinine using different nethodology, threw out result, disnt use the lab again, and got a recund. I gave them a hard time and had several conversations with lab manager. Popular test in executive physicaks for isoprodtanes and if i had the energy i woukd have notified i stitutions paying alot of monet for this test (i did not have exe utice physical, just ordered on my own )
z
 

vision blue

Senior Member
Messages
1,877
Ps maybe tour file didnt open properly on mobile but i didnt see any numbers, just goofy qualatative summaries in boxes
 

Replenished

Senior Member
Messages
247
This link shows the formula for calculating clearance based on both bloid and 24 hour urinre
https://wikicali.com/wiki/how-to-calculate-creatinine-clearance/

Since u didnt have 24 hours , youd need to calculate based on first morning urine sampke which us doable but probqbly not worth effort because your urine creatinine turned out on high side

Do you have evidence from another test result that urine creatinibe was low? Just asking because i once sent same sample to two labs and they were very different! Ea h used a different methodology but still shoukd have come up with ssme vue- but did not. In fact they were at oppoaite extremes. I knew the low one was correct. Anyway in our case maybe the not drinking much water paid off

Until you get a 24 hour sampke , you can use blood to do a better calculation than the doc labs do especially if have your BUN too

http://www.medcalc.com/gfr.html


https://www.mcw.edu/calculators/creatinine-clearance

Hard to tell with you if genova over or underestimated and as i mentioned hopefully will balance out given what i said in previous messages

Did you by any chance save the urine from the sample? I just sent a urine trst off this morning by the way and froze a littke sample in case i need to double check any value.

I rememver that lab with the false high creatinine using different nethodology, threw out result, disnt use the lab again, and got a recund. I gave them a hard time and had several conversations with lab manager. Popular test in executive physicaks for isoprodtanes and if i had the energy i woukd have notified i stitutions paying alot of monet for this test (i did not have exe utice physical, just ordered on my own )
z

No i've never had urine creatine tested previously. No I didn't keep some urine spare. Just have to go with the results I have a go based on the things that appear lower than the rest of the markers. Just not sure where to start.