Plasma/Urine amino acid panel results.

[Hindi1989]

Hi folks,

Recently I had an amino acid panel done using both plasma and urine sample on the same day. The plasma results seem normal yet the urine results are quite abnormal and in line with abnormalities found in some CFS patients.

Provided the urine samples were not at fault what would cause such discrepancies? Here are some of the sample results. Brackets are the reference range provided by the lab.

Urine sample:
1) lysine 2 (2-63)
2) Ornithine 12 ( 1-4)
3) leucine 2 ( 3-10)
4) isoleucine 1 ( 1-7)
5) alanine 70 ( 10-57)
6) Arginine 30 (0-5)
7) glutamine 162 ( 20-92)
8) asparagine 10 ( 11-56)
9) Glutamic acid 5 ( 9-47)
10) aspartic acid 2 ( 4-29)

Plasma sample:
1) lysine 210 (83-238)
2) Ornithine 95 ( 28-110)
3) leucine 142 ( 75-175)
4) isoleucine 63 ( 37-98)
5) alanine 383 ( 210-661)
6) Arginine 62 (21-138)
7) glutamine 525 ( 369-711)
8) asparagine 40 ( 30-69)
9) Glutamic acid 32 ( 14-192)
10) aspartic acid 11 ( 0-24)

Also recommendation for supplements and further tests are most welcome.

 

[vision blue]

I also arranged to take both urine and blood AA on the same day so its always interesting to see others comparisons as well.

They may not be as entirely desrpentt as it first seems; e.g. ornithine maybe stands out. It's both high in urine and on the high end in plasma. Makes me wonder about the urea cycle. Has that been on your radar at all?

urine AA is tricky because sometimes you see spillover (i.e body burden high) but other times you see "wasting" reflecting loss in urine (i.e. body burden too low). Remember also that blood levels usually are regulated by homeostasis , but urine levels are not. So the urine levels can vary more widely and also reflect a bunch of different processes all lumped together- only see final output and can be tricky to disentangle. but of course can alert to peculiar or non optimal pathways that would take much longer, if ever, to show up in the blood.

sometimes theres a reversal of glutimine to glutimate (glutimic acid) between urine and blood because of urine degradation and glutimine gets converted to glutimate in the urine- but that didn't happen with you.

Some backround thigns that may help intepret:

Are you taking any supplements? (might cause some of those high urine levels and possibly trends in blood levels); anything that might have lysine or ornithine in them?

Was the urine AA done as a 24 hour or first morning collecton? (f first morning, its going to be corrected values based on body surface area and creatine levels). What was the creatinine level?

i'll guess the blood AA was done fasting?

Is your BMI on the high side or low side? How about your muscle mass? are you petitie or large? (changes how to think about the low values and their significance0 . When things are low, they can be hard to measure accurately for example

are you primarily vegeatarian with low meat consiumption (vegeatarian diet going ti get low leucine, isoluecine, maybe valine for example).

How was the ammonia level in the urine? (speaks to degradation issues, but i don't see evdience oft that; but may also speak to urea cycle).

On blood tests, comphrenesive metabolic panel, what is your ALT and AST levels? (these are liver markers but ALT is the transferace enzyme involved in convertine alanine which is atypical in your resutls

There's some guides on the web, like the one from genova, that an be helpful to interpret patterns of results in urine AA. But use only as a starting point, since could mean other things than what they say too. (blood should be in normal range, as yous basically are, even when urine AA points to derangements).

Of course tests breed more tests, if you think urea cycle worth looking into the OAT test from great plains does a good job with that and some others too.

what test lab did you use for the urine AA?

oh, and could you aslo post the taurine in both urine and plasma? And any other additional results to get the full context.

 

[bread.]

my results are very similar in pattern but way more out of range. I guess there could be something similar going on.

I try to put it in a nutshell:

Urine 24 h sample:

All to high:

Glutamic Acid
Alanine
Valine
Leucine
Isoleucine
Arginine


Blood (in a fasted state):

All too high:

Ornithine
Glutamine
Glutamic Acid
Alanine (very high)
(Pyruvate)


I also had Dr. thinking UCD, but genetics (whole exome sequencing) are negative, I wonder if there could be a form of secondary UCD?


Context:

I am very severe and bedridden for 2 years. Had a deteoriating course of disease, probably was never fully healthy. Also have EDS, MCAD, SFNP.