*** Hi, Big.
***Thanks for the feedback. My comments are at the asterisks below.
Quote Originally Posted by richvank View Post
1. It looks as though he has both a bacterial dysbiosis and a yeast overgrowth in his gut. It would take a good comprehensive stool test to identify which bacteria are present in high populations.
Ya, this was not a surprise. I've suffered from intestinal issues since childhood. I've done just about every detox, yeast treatment, exclusion diet out there over the years as well as loads of probiotics without any real improvement. I don't doubt this could be the core of my problem. I've been underweight most of my life.
***O.K. Gut problems are a basic issue for many people. Those who have the most success in treating them seem to be the ones who do repeated stool testing, and change the treatment with time to match what they are finding. It can take quite a while to get the gut back into good operation.
2. It appears that the glycolysis pathway is not running very fast. This could be due to a low-carb diet, as one possibility.
My diet is very low carb to due gluten/grain avoidance.
***O.K., that fits.
3. Pyruvate is not flowing into the Krebs cycle as rapidly as it should. This suggests a partial block in the pyruvate dehydrogenase complex, which could be due to deficiniencies in B vitamins, lipoic acid and/or magnesium. It could also be due to mercury toxicity, in view of the high mercury level in his blood.
I believe the high mercury level is an anomaly due to my error. I ingested fish on the day before the test which I was told not to do. I've had all my amalgams removed years ago and done multiple rounds of chelation. I recently did a 24 hour challenge test which showed comparable levels of my other heavy metals but nearly zero mercury.
***O.K., I think that could do it, especially if it was a big fish pretty high up in the marine food chain.
4. The first part of his Krebs cycle is running slowly. This would account for his fatigue. The reason is probably no. 3 above.
5. Alpha ketoglutarate is high relative to the metabolites in the Krebs cycle before and after it. This suggests that it is being fed by glutamate, which is also high, and that the flow from AKG to succinic acid is partially blocked. The latter could again be due to low magnesium or B vitamins, or to mercury toxicity.
6. Succinic acid is relatively low, and malic acid is below the detection limit. Since the branched-chain fatty acids are high-normal, the problem seems to be that they are not being fed into the Krebs cycle. The explanation appears to be a functional deficiency in B12, given the high-normal methylmalonic acid. Again, the low succinic and malic acids will also contribute to low ATP production by the mitochondria, contributing to the fatigue.
7. The ketone and fatty acids metabolites are somewhat elevated. This can be accounted for by the partially blocked access of pyruvate to the Krebs cycle, described above. This causes the cells to mobilize fatty acids, and they also appear to have difficulty entering the Krebs cycle, and are hence being shunted to omega oxidation. The cause could be low B2 and/or low carnitine.
This is interesting. I take large amounts of B vitamins orally as well as injection and carnitine. I wonder if I'm truly still deficient or simply stopping supplementation before the nutreval (5 days as instructed) was enough to raise certain markers again. For example, I was taking 100mg of B6 daily along with 100mg of P5P- that's a large dose of B6 yet I'm still showing deficiency symptoms.
***Hmmm. If you're getting enough B vitamins and carnitine, perhaps it is just due to the loose regulation of fatty acids metabolism. If there were more carbs to burn, these values might be lower.
8. VMA is low relative to HVA. This is likely due to the low copper status, as found in the red blood cells, but low vitamin C could also be accounting for it.
I have recent tests showing very low levels of norepinephrine which I believe is causing my POTS along with fatigue. Sometimes ingesting coffee/caffeine will improve my symptoms although I don't do that often. This matches. I also tested low in ceruloplasmin, serum copper was at the very bottom 2% of lab range. I believe the dopamine beta hydroxalase is probably downregulated.
***O.K.
9. FIGlu and methylmalonate are both elevated. This is good evidence for a partial block in the methylation cycle. That would be consistent with a functional B12 deficiency and low tetrahydrofolate.
I take b12 injections along with methylfolate, but discontinued that prior to the test as instructed. Perhaps that was enough time to raise these markers again?
***I would guess that it's more likely that the treatment had not yet succeeded in lifting the partial block. I don't know what your B12 and methylfolate dosages and dose frequencies were, but maybe they were too low or not of long enough duration. B12, in particular, sometimes needs to be pretty high and long to overcome the hijacking of B12 by toxins when glutathione is too low to protect it effectively.
10. The high-normal hydroxyphenylacetate is likely explained by bacterial dysbiosis, perhaps involving Proteus bacteria. Again a comprehensive stool test would be needed to identify the dysbiotic bacteria for sure.
Ya, looks like it again. I'm not sure where to get a good stool test. Metametrix looks the best but I don't have the $500 or so for the full panel right now.
***You might also consider the Diagnos-Techs Expanded GI Panel. It requires a doctor's order. I don't know what your insurance situation is, but it might be cheaper. It's pretty comprehensive.
11. The high AKAA suggests a B6 deficiency.
Again strange considering how much B6 I was ingesting.
***That's puzzling to me, too. It's possible to run a specific test for B6 activity, such as at Health Diagnostics and Research Insistute in New Jersey.
12. The low-normal pyroglutamate indicates glutathione depletion in the kidneys and/or intestinal cells, which would be consistent with a partial methylation cycle block and with vitamin C deficiency. Note that the high glutathione measurement shown later in the report is a whole blood total glutathione measurement. This is the easiest glutathione measurement to make, but it does not reflect the level of reduced glutathione in tissue cells. The elevated lipid peroxides shown in the oxidative stress markers is further evidence suggesting low glutathione, since selenium is in the normal range in the RBCs, though a genomic variation in the glutathione peroxidase would be another possible explanation.
13. The low-normal creatinine would be consistent with a partial methylation cycle block. since methylation is needed to make creatine, its precursor.
14. Several of the essential amino acids are high. This is probably partly due what is discussed in number 6 above, partly due to low B6, and partly due to a slow rate of conversion of amino acids into neurotransmitters, which could be due to low tetrahydrobiopterin, resulting from the methylation cycle/folate cycle block, or due to low iron.
The nutreval listed a need for iron, but I know that's incorrect. In fact, at times my iron has been too high. My ferritin is usually around 160 with my full iron panel indicating levels towards the top-end of what my doctor considers safe. I assume this is because the nutreval is determining that based on my other nutrient levels it must be iron causing a deficiency but they are wrong on that one.
***Yeah, they don't directly measure iron or ferritin, they just infer that it might be low, based on other measurements. The problem is that there is more than one possible cause for many of the abnormal values. This is a pretty nice panel, but there are still ambiguities if these are the only data one has. I usually use a comprehensive questionnaire to help narrow down the possible interpretations, but sometimes it takes additional specific testing to figure out for sure what's going on.
15. The elevated diet peptide related markers suggest that your husband has a high-meat diet. The high beta-alanine could be causing the high wasting of taurine in the urine, since they compete for the same reabsorption transporters in the kidneys.
I eat a low carb diet, not sure if I'd consider it high meat but it could be a factor.
***O.K. The data seem to suggest that, but other factors can be involved, too. Gut bacteria can affect some of these peptide values.
16. The high alpha aminoadipic acid is likely due to a B6 deficiency. A B6 deficiency could be causing some of the other nonessential amino acids to be high. B6 is needed by the transaminase enzymes, which convert one amino acid to another, and thus facililitate feeding them into the Krebs cycle.
Again, really strange considering my prior B6 intake.
***Right. The B6 issue seemed to keep popping up, though. Might be worthwhile to test for it specifically.
17. The fairly high ammonia and urea suggest that he is burning protein for fuel at a higher than normal rate. This is likely due to the problems in feeding both carbs and fats into the Krebs cycle, discussed above.
This would probably explain the underweight/gut connection.
***Maybe so. I don't know what your total daily caloric intake is, but that, combined with how well your gut is absorbing nutrients, will impact your weight balance. Also, if protein is being burned for fuel, it won't be available for building muscle.
18. The high sarcosine is consistent with a methylation cycle/folate cycle partial block.
19. The high ratio of glutamic acid to GABA suggests that your husband may be experiencing some excitotoxicity, which can cause anxiety, insomnia, a "wired" feeling, and hypersensitivity of the senses.
20. The high EPA and DHA suggests that your husband is consuming a lot of fish or fish oil.
I have been eating fish pretty regularly, looks like it's time to cut down a little and add in some omega 6.
***Yeah, looks like you have plenty of omega-3 fatty acids on board. Also, there's the mercury factor, at least with the big fish.
21. I'm not sure why gondoic acid is high. Maybe your husband eats a lot of olive oil.
Hmm, not really.
***That was kind of a shot in the dark, since your oleic acid level wasn't all that high. There may be some food that is particularly high in gondoic acid, or maybe there is a deficiency in a particular enzyme that's involved in metabolizing it. I just don't know. Couldn't find a lot of info on gondoic.
22. The low palmitic acid suggests that your husband is not converting a lot of carbs to stored fat. Since he's not burning them and not storing them, I'm guessing that he's not intaking many carbs.
23. The high stearic acid would be consistent with a high-meat diet.
24. I don't know the reason for the high tricosanoic acid.
25. The low-normal arachidic suggests that he doesn't eat many peanuts.
Kind of funny, I eat peanuts all the time! I used to eat almonds but found them listed as an allergy so I switched back to peanuts.
***Guess I struck out on that one! Peanuts have quite a bit of arachidic acid in them. Guess you must be burning it.
26. He has high mercury and tin in his red blood cells, and somewhat elevated antimony. Mercury stays in the blood only for several weeks, so an elevated value means recent or ongoing mercury exposure. Since tin is high also, I suspect that amalgam fillings may be responsible. This is a pretty high mercury level, compared to what I've seen on this test on others in the past. Mercury can block many enyzmes in the body.
Again, I feel the mercury can be explained by recent fish ingestion...the tin I'm not sure where it is coming from. I have no amalgams.
***O.K. I don't know how to explain the high tin, either. Could be from corrosion of solder in water pipes, maybe. Do you drink tap water?
27. Copper and zinc are low, and manganese is somewhat low. All three of these are needed by superoxide dismutase enzymes, so the low levels could be contributing to oxidative stress, which would also be consistent with glutathione depletion, elevated lipid peroxides, perhaps low vitamin C, and low-normal conzyme Q-10. Note that the last is consistent with a partial methylation cycle block, because methylation is needed to make Co Q-10.
Again I think this could also explain my low catecholamine levels.
***O.K., I think it could, too.
28. Because zinc and B6 are low, manganese is somewhat low, and biotin could be low, I think it would be worthwhile to consider KPU (more properly called HPU) in your husband's case. Dr. Klinghardt has reported finding a lot of this, and it would account for these deficiencies as well as inhibiting the methylation cycle. The Health Diagnostics and Research Institute in New Jersey offers a KPU test. I would recommend following Dr. Klinghardt's advice about sample collection and handling.
I've had this test done, my levels were right in the middle of normal- not even mildly elevated. I admit it was a surprise to me.
***I'm glad you had that checked out. I think it was worth doing, in view of what Dr. Klinghardt has been finding.
***Thanks again for the feedback, and I hope you get some benefit out of running this panel.
***Best regards,
***Rich
