Mitochondrial Function Profile (Acumen Laboratories, Biolab) via Dr. Myhill

[eric_s]

Hi

I've recently had this test (http://www.drmyhill.co.uk/wiki/Mitochondrial_Function_Profile) and will post my results here. It would be interesting to compare with others, just to see what the picture is...

I would also like to know what other specialists for mitochondrial disease think about these tests and the value of the results and their interpretation. I will try to see one, when i get back to Switzerland, but maybe in the meantime others can share their experiences...



Here are my results:


Test, Reference Range, Result

ATP levels: 1.6-2.9nmol/10^6, 1.34 Deficient

Ratio ATP/ATPMg: >0.65, 0.56 Deficient

Oxidative phosphorylation: >60%, 46 Very slow due to deficiencies

Vitamin B3: 14 30g/ml, 10.8 Fairly marked deficiency

L-carnitine: 34 48 umol/l, 30.8 Low

Co-enzyme Q 10: 0.552.00 umol/L, 0.28umol/L

Translocator protein out: >35%, 22.7 Moderately blocked

Translocator protein in: 55 - 75%, 82.4 Rapid depletion of ATP

Mitochondrial function score: 1.00 - 3.00, 0.40 Very poor Equivalent to 40/100 on CFS clinical energy score

Cell free DNA: Up to 9.5ug DNA per litre, 18.5 Definite increase in cell degradation. Identify cause poor mito function, poor antioxidant status, poor pacing, toxic stress, immune activation (allergy, infection, autoimmunity)

SODase: (>40%), 43 Normal

Glutathione peroxidase: 67 90 U/gHb, 55 Very poor selenium status

Glutathione: 1.7 2.6 mmol/l, 1.95 Normal

 

[justy]

Hi Eric, i just spotted this. I have had the same test done and am interested to see your results. I haver family here at the moment and we are just getting ready to go out, so ill try and remember to write on here later or tommorrow.
Take care, Justy.

 

[eric_s]

Ok, Justy, thanks.

 

[unity47]

Hi Eric & Justy,

I had mito.tests done through Dr.Myhill, in March 2010. i have just spent 30 mins typing out results [i have no scanner] to add to comparisons, and then I lost them!! arrrrrrrrrgggggggggghhh. Technologically challenged! Will try again to post when energy permits.

Kind Regards

 

[eric_s]

Thanks. It will be interesting to compare.

 

[justy]

Hi Eric, sorry not to get back toyou sooner - so exhausted from family visiting - have had to take to my bed.
here are my results - we can talk more about it later when im up tp it if you like

level of ATP in cells: 1.66 (1.6-2.9nmol/106).
With endogenous Mg only the result is 0.96 (0.9-2.7nmol/106) with a ratio of 0.58 (>0.65). This result shows a poor ATP-related magnesium status
Krebs Citric Acid Cycle borderline slow at 62.5% (normal range >60%).
ATP to ADP conversion conversion efficiency is just about normal at 62.5%, she has 37% blocking of active sites. significant blockage of the active sites (i.e. complexes I,II,III,IV and V on inner mitochondrial membranes)
The red cell NAD shows a borderline B3 deficiency at 14.7g/ml (14 30).
L-Carnitine 28.2umol/l (34 48).
Co-enzyme Q10 0.39umol/l (0.55 2.0).
Movement of ATP and ADP across mitochondrial membranes Translocator protein out is a borderline result of 36.8% (normal range >35%). Translocator protein in is a poor result of 25.3% (normal range 55 - 75%)
Mitochondrial Function Score0.46 which equates to about 30/100

Cell free DNA result25.8ug DNA per litre (up to 9.5).
The SODase result is very poor at 37% (>40%). Zn/Cu form is 292 (240-410 enzyme units), the Mn form is 104 (125-208) and the EC (extra-cellular) form (another Zn/Cu SODase but not part of the functional SODase test) is 20 (28 70). This result shows a severe deficiency in manganese.

The gene studies show that the gene for Zn/Cu-SODase is normal, the gene for Mn-SODase is partially blocked with low enzyme activity, and the gene for the EC-SODase is normal with low enzyme activity
Red cell glutathione peroxidase (GSH-PX)
Red cell glutathione peroxidase (GSH-PX) - 53U/gHb (67 90) very poor result
Red cell glutathione (GSH) 1.78mmol/l (1.7 2.6) low normal result

 

[Sallysblooms]

Those tests are good for showing you if you need l Carnitine and Co Q10. They are great for the mitochondria.

 

[richvank]

Hi, eric (and the group).

I have seen the results of quite a few AcumenLab panels on people with ME/CFS, and the types of results you have received are very typical.

As you may know, I believe that the origin of the mito dysfunction that is so well documented by these tests is the vicious circle mechanism involving glutathione depletion, a functional B12 deficiency, a partial block of the methylation cycle, and loss of folates.

Dr. Howard does do a glutathione measurement, but it is a red blood cell total glutathione measurement. While many PWMEs have a low value from this measurement, many are only low-normal or even normal. The problem here, as I see it, is that this type of test is not very reflective of the levels of reduced glutathione in the tissue cells. First of all, it is run on the red blood cells, which are normally producers and net exporters of glutathione. They can thus be expected to have a better glutathione status than cells that do not have this capability. Second, total glutathione includes oxidized glutathione, and it is a liability rather than an asset in maintaining the redox status of the cells.

As far as I know, only the European Laboratory of Nutrients in the Netherlands and its subsidiary, the Health Diagnostics and Research Institute in New Jersey, USA, have the capability to measure both reduced and oxidized glutathione in blood plasma, which is more reflective of the situation in tissue cells. Most PWMEs are found to have low reduced glutathione with this testing.

In the clinical study of methylation treatment that Dr. Nathan and I performed, the patients reported a statistically significant increase in energy level on a visual analog rating scale. I think this indicates that methylation treatment improved the function of their mitochondria, since the mitochondria are mainly responsible for producing the ATP that powers biochemical reactions, including the contraction of the muscles.

I think that the theoretical basis for this connection between the vicious circle mechanism and mito dysfunction is also pretty solid. Oxidative stress, which is associated with glutathione depletion, is known to inhibit mito function. Carnitine, coenzyme Q10, phosphatidylcholine, and creatine are all needed by the mitochondria and the ATP system, and all of them require methylation for their synthesis. When glutathione goes down, toxins build up, as are found in the mitochondria in ME/CFS. When there is a shortage of ATP, due to mito dysfunction, the proper levels of essential minerals cannoth be maintained in the cells, because sufficient energy is not available for the cell membrane ion pumps.

Based on all of this, I believe that the methylation treatment is necessary to bring the mitochondria back to full normal operation. I hope this is helpful.

Best regards,

Rich

 

[eric_s]

Thanks for your inputs. Don't worry, Justy, i will have to travel tomorrow anyway, so i can't be around a lot, but it's interesting to see the results of other people. It would be very intersting to see the results of healthy persons as well, but probably not a lot of them have taken the test.

 

[Abha]

Hi Eric and all....Thanks for sharing.
My results are from 2008(may be worse now as I'm more housebound/physical/brain problems)
My Mitochondrial Function Test results(Dr Myhill/Acumen Lab) were as follow:
Low levels ATP 1.50(1.6-2.9nmol/10to sixth)
Magnesium status low...0.94(0.9-2.7nmol/10to sixth)with a ratio of 0.63(>0.65)
ADP to ATP.....This is going very slow at 56.3%(normal range>60%)with a 25% blockage of the active sites with a poor rate of conversion of ADP to ATP
REd Cell NAD shows a marked deficiency at 8.9ug/ml(14-30)
Co-enzyme Q10 is a borderline result at 0.55umol/L(0.55-2.0)
Translocator protein out...poor result....26%(normal range>35%)
Translocator protein in.....76.6%(normal range...55-75%)with rapid depletion on energy demand.
Mild(25%)blocking of active sites leading to reduced ADP to ATP re-conversion.Poor provision of ATP by the mitochondria and rather rapid depletion on energy demand.
Cell-free DNA...14.2ugDNA per litre plasma...Ref Range up to 9.5..Comments some increase in cell degradation...
SODase result is poor at 39%(<40%)
Red cell glutathione(GSH)...1.80 mmol/L (1.7-2.6)
Red cell glutathione peroxidase(GSH-PX)...57 U/gHb(67-90)
My score was 0.85(although this score is rather skewed by the 76.6%for translocator protein in)which equated to 45/100 on the CFS(Disabilty Scale/Dr Myhill)

Later results 2010(Acumen Lab/Mitochondrial membrane TL protein studies) show
Mitochondria numbers of....Low-Norm
High Mitochondrial clumping...6.4
High Mt-DNA fluorescence(220)
Diolein....Trace
Aldehydes...Mild inc.

Chemicals on TL sites(see below)
High Cadmium(Cd.actin binding)
Calcium moderate(probable Ca-actin binding)
Pentachlorophenol...trace
Low intracellular pH(6.4)(anaerobic shift,2nd to TL-blocking
Mt membrane K.....low-norm)
Mt membrane Mg...very low
Mt membrane Zn... low

 

[November Girl]

Unity,

It's possible that if you open a reply window again, you may find your post saved as something that you can recall. Sometimes if I want to type in a lot of info, I do it in a Notepad or Word document that I then cut and paste. I hate losing all that work!

 

[unity47]

Hello , I finally managed to type out results over last few days, thanks for the advice November Girl.

Apologies for very long post, I also have difficulty reading long texts.



ATP[adenosine triphosphate], studies on neutrophils.

ATP whole cells:with excess Mg added 1.49mmol [1.6-2.9]

endogenousMg only 0.94[0.9-2.7]

ratio ATP/ATPmg 0.63....[<0.65

ADP to ATP conversion efficiency[ whole cells]

ATP mg 1.49

ATPmg inhibitor present 0.55 <0.3


ATPmg inhibitor removed 0.94 <1.4

ADP toATP efficiency = 41.5 % < 60


Blocking of active sites = 37 % up to 14



ADP-ATP TRANSLOCATOR[TL]mitochondria,not whole cells]:

Start ATP 249 [290-700]

TL"out" 325 [410-950] change% 30.5 over 35% increase

TL "in" 199 [140-330] change% 20 55 to 75% decrease


Comments: Low whole cell ATP Rather poor ATP-related magnesium.

37% blocking of active sites leading to: Very poor ADP to ATP re conversion.

Low mt-ATP and poor provision of "new" mt-ATP. Very restricted access to ATP secondary to the 37% blocking of translocator function.

This score is just 0.19 which equates to about 25/100 on ability scale.





CELL FREE DNA in blood plasma.

Patient's result 22.2ug DNA per litre plasma ref.range up to 9.5


Comments:Highly significant = over 20


mild increase =9.6 to 12.4

some increase =12.5 to 14.9

Definite increase =15.0 to 20.0

Highly significant = over 20



SUPEROXIDE DISMUTASE AND GLUTATHIONE PEROXIDE.


Blood test results:

Functional test.......result 38 ref.range Over 40 [mostly 41-47

Zn/Cu-SOD 209 ref.range 240-410
Mn-SOD 117 .. 125-208
EC_SOD 34 .. 28-70


Gene studies-

sod form Zn/Cu-SOD chromosome21 .....Normal...Low enzyme activity
.. Mn-SOD chromosome 6 .......Probably normal ...Low enzyme activity.
.. EC-SOD chromosome4.......Normal enzyme activity.


Glutathione peroxidase {GSH-PX]

Red cell Glutathione peroxidase[GSH-PX] 69 U/gHb 67-90 - low normal result

Red cell Glutathione 1.49 mmol/l 1.7 -2.6 - very poor result


Serum L-carnitine. = 40.5 umol/l [ 34-48]

Comment: Normal L-carnitine availability.

[This result surprised me,as I hadn't eaten meat in the previous 8 months.

Is this result dietarily related??? ]

Niacin Status B3

Red cell Nicotinamide dinucleotide = 14.3ug/ml [14-30]


Kindest Regards.

 

[justy]

Hi, its interesting to compare the different results. My ATP availability isnt too bad but i have very poor antioxidant status and a very high cell free DNA, i wonder why this is. in the main the results are all following a similar trend.

Abha - i had the translocator protein studies done as i had a high degree of blocking of active sites on mito test. I havent really found the results useful though - i really dont understand them or the implications of my results, so it feels a bit like a waste of my money.
I understand the idea of supplementing to get better function from mitos and increase antioxidant status - but this isnt showin gus what is causing the problem or really fixing it.
All the best, Justy.

 

[jonnyboy]

I agree Justy, and will post my results up here when I get a chance.
The ATP profile seems very good at determining the level of fatigue (just how bad you are), and it doesnt seem possible to be a healthy person, and have a low score in this test, but I dont think fixing this is the real issue. There is most likely some mechanism that causes the mitos to get all blocked up in the first place. I think Rich Vank is probably onto something is this regard, and in my case I think dysautonomia is my biggest problem rather than just fatigue. Taking supplements for me hasnt made a blind bit of difference, either positively or negatively.

 

[Jenny]

Here's a summary of my Acumen test results. They were done in 2008 and I'm rather worse now. Breakspear suggested I have the test again but I don't see the point as the only treatments suggests were about 15 mitochondrial support supplements, and I haven't had any improvement from these after taking some of them for years, and all of them for the last 9 months. Also no-one there seems able to properly explain to me what these results mean. I agree with jonnyboy - we need to get to the root of all this.

Low-normal whole cell ATP
Rather poor ATP-related magnesium
32% blocking of active sites leading to poor ADP-ATP re-conversion
Low mt-ATP and poor provision of 'new' mt ATP. Somewhat restricted access to mt-ATP secondary to the 3/10 blocking of translocator sites.

EC-SOD gene normal but low enzyme activity.

High intracellular calcium (390 umol/l)
High diamino and/or diazo compounds (probably hair dye - so stopped this!)
High glutathione conjugates (anyone know what this means?)

DNA adducts - diamino/diazo compound 12 ng/ml. Synthase enzyme activity is partly inhibited by the diamino or diazo chemical that is affecting some TL sites. This is reducing the efficiency of the cytochrome C-CL gating complex and that will have efffects on the proton-gradient and electron transport.

Strontium on chromosome 6 close to glutathione-S-transferase A1 gene - 15 ng/ml. Might reflect increase in bone turnover.

Cell free DNA 11.7 ug DNA per litre plasma - mild increase in cell degradation

Low-normal % cardiolipin

Jenny

 

[JayBO]

Hi, I'm interested in getting this test done but I live in the U.S. and would have to have the specimen shipped overseas. I'm not clear how to go about that, are there labs (Quest, for example) that will draw blood and then turn it over to you so you can send it via Fedex or DHL? Or does the lab send it out on your behalf? It seems like a lot of logistics to coordinate, if anyone can shed some light I would appreciate.

Also, do you guys recommend this test at all, has it helped with your treatment in a way that makes it worth the expense?

Thanks for any info and feedback!

 

[Mary]

@JayBO - I had this done 5 years ago (I'm in California). As I recall, either Dr. Myhill's office or her lab sent me the test kit. I then took the kit to my local hospital lab and they drew the blood according to the kit directions. It was up to me to get the samples shipped to the UK - I used FedEx. I think it was around $90 (the shipping only). I'm sure Quest could draw the blood as well - I don't know what their charge would be. The hospital did it for free.

I think the test itself was around $600, maybe a little more.

My results were similar in many ways to others posted above, they showed definite abnormalities. However, the testing didn't make a real difference in my treatment. I was already taking most of the mito supplements Dr. Myhill recommends. The only thing she recommended that I wasn't doing was magnesium injections. My doctor here wouldn't order them. I later had an Exatest done which showed normal intracellular magnesium levels.

That's a good question, whether or not the test actually helped someone's course of treatment. It was very interesting to see the results, black and white evidence of this illness -- but they haven't translated into doing anything differently. You might just try Dr. Myhill's recommendations for CFS treatment which she posts on her website.

Have you checked to see if Dr. Myhill is taking new U.S. patients? She stopped for awhile last year (overloaded with patients) although she had said she hoped to be able to resume some time in the future.

 

[JayBO]

@Mary, Thanks for the info about drawing blood from a hospital, I didn't realize one could have that done and receive the sample from them. Dr Myhill isn't taking new patients but it seems she is offering interpretations of this test.

On the one hand, I would love to see a test that actually pinpoints a physical underlying reason for what I'm going through...but on the other hand I will likely be the only one to see it. I can't think of any doctor I could show it to who would know what to do with it or want to treat based on it. And as you said, treatment involves much the same supplements that everyone is already trying, more or less. It would be for my own purposes I suppose so I have to decide if its worth the cost.

While mitochondrial dysfunction is surely a big part of it (my main symptom is really just PEM at this point), who can know if that dysfunction is the actual cause or triggered by something different in another area (such as viral and autoimmune issues). No one seems to know the answer to this question yet, and so there are no true treatments, only individual remedies that seem to help people here and there.

 

[justy]

I had it done some years ago and while it proved I was ill to people who may not have believed it was biological it doesn't prove wht you are ill WITH. I suspect most really ill people would have similar results. I don't believe it is worth the hassle or money really - although it did send me down the rabbit hole of biological treatments, rather than accepting my psych diagnosis.

 

[Mary]

@JayBO - FWIW, if you ever do need blood drawn for a test you're sending off somewhere, be sure to ask the lab or hospital if they will give you the blood samples they draw. Someone said they don't all do that. And also just ask the cost - I recently had some drawn (a different hospital) which charged $18 but it was cheaper than Quest. And then Medicare ended up paying for the blood draw after all.

Re PEM: Here are a couple of threads you might find interesting: http://forums.phoenixrising.me/inde...a-sam-e-catalase-no-pem-after-exercise.34446/
http://forums.phoenixrising.me/index.php?threads/bcaas-reducing-pem.34719/

I did the thread re BCAAs. They have reduced my PEM recovery time significantly and also my stamina has increased some, but unfortunately I still crash. I've been taking them since November, so I'm hoping maybe I will continue to improve, only time will tell.

And baking soda does help too. Read the threads.

Have you looked into a methylation protocol? There's a lot of info here about it, and this also helped with energy (although not PEM for me): http://forums.phoenixrising.me/index.php?threads/active-b12-protocol-basics.10138/