Hi, Calico 13.
Thank you for sending me your NutrEval pdf. I’ve looked it over, and have some comments to offer. Since my knowledge of your health history and symptoms is limited, there are a few issues that I will not be able to pin down unequivocally.
First, the results of this panel suggest that your digestive system is in fairly good condition. You appear to be able to absorb proteins and fats pretty well. I gather that you don’t eat a lot of peanuts! It would be helpful to know what your diet is like; i.e. is it more or less balanced, or is it a high protein diet? What are the main protein sources in your diet? Knowing these things would help me to interpret your amino acids levels better.
It looks as though your glycolysis pathway is working well. Your lactic acid is a little high, and since your citric acid is on the low side of normal, I suspect that you may have a slight deficiency in one or more of the B vitamins or lipoic acid, or mercury may be interfering with the flow of pyruvate into the Krebs cycle.
The high value for alpha ketoglutaric acid is striking, and there’s a big drop between it and succinic acid in the Krebs cycle. Again, the suspects are low B vitamins or perhaps the elevated mercury.
Adipic acid is a little high. This could be caused by low carnitine or low vitamin B2 or both. Since you have evidence of a partial methylation cycle block (see below), it’s likely that carnitine is low, because methylation is required to synthesize it, and also because lysine is somewhat low, and that is its precursor. If you tell me that you eat a lot of red meat, I may have to change this interpretation, because red meat contains a lot of carnitine.
Your vanilmandelic acid is a little low. Since your homovanillic acid is closer to mean normal, this could mean that your body is not able to make norepinephrine from dopamine as fast as normal, and that could be caused by low copper or low vitamin C, both of which are
possibilities in your case (see below).
Your whopping values for Figlu and methylmalonic acid are saying that it is very likely that you have a partial methylation cycle block.
I understand that you were treating for that. You were taking the right stuff (methyl B12 and 5-methyltetrahydrofolate), but your B12 dosage was probably not high enough. As you will see below, you have glutathione depletion. When that is the case, according to my hypothesis, the B12 loses its protection in the cells and is hijacked by toxins. In your case, mercury may be the main one that it hijacking the B12 (see below).
The somewhat elevated value for 2-hydroxyphenylacetic acid suggests that you may have some bacterial dysbiosis in your gut, but as I wrote earlier, there isn’t a lot of evidence for problems there.
The elevated alpha ketoadipic acid suggests low vitamin B6.
Pyroglutamic acid is low-normal, and that suggests low glutathione in the kidneys and/or the intestine.
You have high levels of several of the essential amino acids, including the branched-chain amino acids and some others. It would be helpful to know whether you have a high-protein diet, but I suspect that this is due to low vitamin B6 status.
The somewhat elevated 1-Methylhistidine suggests that you eat a lot of chicken. Is that true?
Your cysteine is high, while your glutathione is low (see below). This is a little puzzling, because cysteine is usually the rate-limiting amino acid for making glutathione. Perhaps the limiting amino acid in your case is glycine, which is low-normal. The elevated glutamic acid is consistent with the elevate alpha ketoglutaric acid, because they are related by reactions. The high ratio of glutamic acid to gamma-aminobutyric acid (GABA) suggests that you may be suffering from some excitotoxicity (can cause insomnia, anxiety, hypersensitivity of the senses, a “wired” feeling). Do you have any of these symptoms?
The high proline may suggest that your body has difficulty making collagen. Low vitamin C can cause that.
The elevated beta-aminoisobutyric acid suggests that thymine is being broken down at a higher than normal rate. Thymine is a component of DNA, so this suggests rapid cell turnover or excess production of thymine from uracil. I don’t think the latter is likely because of the condition of your folate metabolism (very high Figlu).
I think I would need to know more about your health status to interpret this result.
The elevated sarcosine is consistent with dysfunction of the folate metabolism, which is associated with a partial block in the methylation cycle.
The low phosphoethanolamine relative to ethanolamine suggests
low intracellular magnesium. This is consistent with glutathione depletion (see below).
The low-normal urea together with the low orotic acid suggests that your cells are not burning protein for fuel at a very high rate. This is consistent with your elevated branched-chain amino acids. It also means that you do not have gut bacteria that are producing a lot of ammonia, which is consistent with other markers suggesting that
there isn’t much bacteria dysbiosis in your gut.
The low glutamine to glutamate ratio again suggests B vitamins deficiency.
In your fatty acids analysis, your arachidonic acid is high. That can cause proinflammatory prostaglandins to be produced. Your omega-3 fatty acids index is low. This probably means that you are consuming vegetable oil, and not much flax oil. If I had more information about your diet and your weight history, I could probably do a better job of interpreting this part.
Getting to the toxic elements, it looks as though you have a mercury issue. Since mercury does not stay in the blood for more that several weeks, your elevated RBC mercury level suggests that you have an ongoing or recent exposure. I’m wondering if you have a significant number of amalgam fillings in your teeth, or if you eat a lot of fish that are near the top of the ocean food chain. It looks as though you are not a smoker. Do you drink water from plastic bottles? That might account for the antimony. It could also be coming from solder in water pipes. Lead sometimes comes from the water system, too. But the mercury is probably the one to focus on, because it could be inhibiting improvement in your methylation cycle function as well as accounting for Krebs cycle issues (above). It also torpedoes glutathione, which is low (see below).
On the nutrient elements, selenium is clearly low, and it is important in utilizing glutathione to combat oxidative stress, as well as in the conversion of the thyroid hormones from T4 to T3. The elevated mercury could be responsible for the low selenium, because mercury forms a very stable complex with selenium, and takes it out of biochemical availability. Copper is a little low, too, and that is needed for the conversion of dopamine to norepinephrine, as well as in the antioxidant system.
On the last page, the red blood cell total glutathione is somewhat low, and the lipid peroxides are high-normal. These are consistent with several of the other results, including the low-normal pyroglutamic acid, the elevated markers for a partial methylation cycle block, the low selenium, the low copper, and the elevated mercury. Coenzyme Q-10 is low normal. This is consistent with a partial methylation cycle block, because methylation is needed to make Co Q-10. It’s also consistent with the other markers of oxidative stress, because Co Q-10 is one of the network antioxidants.
I would say that the overall message from these results is that you have glutathione depletion and a partial methylation cycle block, as well as deficiencies in some of the vitamins and essential minerals.
Mercury toxicity is an important factor in your case.
You mentioned that you have diagnoses of POTS and adrenal insufficiency, and you also mentioned some tingling and numbness on your upper leg. You didn’t mention fatigue. Do you also suffer from fatigue?
I’m not sure why your B12 went so low in the past. Were you a vegetarian? I don’t know your age or whether you were healthy for the first part of your life.
Normally, when I study a case, I look at the health history and symptoms as described in responses to a lengthy questionnaire, as well as the results from a variety of lab tests. If you are interested in asking me to pursue this further, please email me again.