Metabolomix+

Metabolomix+ : A Non-Invasive Personalized Assessment

The Metabolomix+ is a unique combination of nutritional tests that provides an analysis of key nutritional biomarkers. A first morning void (FMV) urine collection, with optional add-on bloodspot finger stick and buccal swab, the Metabolomix+ nutritional test is a non-invasive, patient-friendly way to assess the functional need for antioxidants, B-vitamins, minerals, digestive support, fatty acids, and amino acids. Insights gained from the Metabolomix+ nutritional test allows clinicians to target nutritional therapies to the precise needs of their patients.

Additional markers are available for an even greater overview of a patient's nutritional status with easy to add modules based on a patient's unique needs.

What is a functional nutritional assessment?

Marked accumulation of organic acids in urine can signal a metabolic inhibition or block. The metabolic block may be due to a nutrient deficiency, an inherited enzyme deficit, toxic build-up, or drug effect.

Enzymes that are responsible for metabolizing organic acids are vitamin and mineral dependent. With this, elevations in organic acids can reflect a functional need for these nutrients on a cellular and biochemical level, even despite normal serum levels.^1-5 Recommendations for nutrient supplementation based on elevated organic acid results are generated using a literature-based proprietary algorithm.

Traditionally, urinary organic acid assessment has been used in neonatal/pediatric medicine to identify genetic inborn errors of metabolism, with severity depending on the degree and type of error.* In many cases of genetic inborn errors, the enzymatic defect may be compensated for by high doses of specific vitamin and mineral cofactors and/or dietary interventions. Intervention with higher-dose nutrient cofactors may also be effective in cases of decreased enzyme activity due to causes other than frank inborn errors.

Which patients might benefit from functional nutritional testing?

Common clinical indications for testing include:

• Mood Disorders^6,7
• Mitochondrial Dysfunction⁸
• Fatigue⁹
• Chronic Stress¹⁰
• Inflammation¹¹

Several diseases are associated with abnormal organic acid, amino acid, and fatty acid levels such as depression, anxiety, cardiovascular disease, neurocognitive decline, diabetes, cancer, anorexia, and many others.^12-15

About the Metabolomix+ Profile

The Metabolomix+ Profile report allows for easy interpretation and clinically actionable results. It includes a Suggested Supplement Schedule that provides personalized recommendations based on test results. The Interpretation-At-A-Glance section of the report provides facts related to nutrient function, causes and complications of their deficiencies, and dietary sources.

The Metabolomix+ Profile report categorizes results into several metabolic areas:

• Organic Acids
• Malabsorption and Dysbiosis
• Cellular Energy and Mitochondrial Metabolites
• Neurotransmitter Metabolites
• Vitamin Markers
• Toxin and Detoxification Markers
• Tyrosine Metabolism
• Amino Acids
• Nutritionally Essential Amino Acids
• Nonessential Protein Amino Acids
• Intermediary Metabolites
• Dietary Peptide Related Markers
• Oxidative Stress Markers
• Essential and Metabolic Fatty Acids - Bloodspot (if selected as add-on profile)
• Omega 3 Fatty Acids
• Omega 6 Fatty Acids
• Omega 9 Fatty Acids
• Saturated Fatty Acids
• Monounsaturated Fatty Acids
• Delta-6 Desaturase Activity
• Cardiovascular Risk
• Nutrient and Toxic Elements (if selected as add-on profile)
• Genomics (if one or more of the following SNPs are selected as add-ons)
• APO E (C112R + R158C)
• MTHFR Combined (A1298C + C677T)
• TNF-α
• COMT (V158M)

Genova's Methodology

Urinary organic and amino acids are measured via GCMS, LC/MS/MS and alkaline picrate. Fatty acids are measured via GCMS. Urinary oxidative stress markers are measured using colorimetric, thiobarbituric acid reactive substances (TBARS) and LC/MS/MS. Nutrient and toxic elements are measured using ICP-MS and Kinetic (Jaffe). Reference ranges are age and gender specific and are based on a questionnaire-qualified healthy cohort. Testing is not performed in patients under 2 years old.

References

1. Kałużna-Czaplińska J. Noninvasive urinary organic acids test to assess biochemical and nutritional individuality in autistic children. Clin Biochem. 2011;44(8-9):686-691.
2. Broquist HP, Luhby AL. Detection and isolation of formiminoglutamic acid from urine in folic acid deficiency in humans. Proc Soc Exp Biol Med. 1959;100(2):349-354.
3. Sun A-l, Ni Y-h, Li X-b, et al. Urinary methylmalonic acid as an indicator of early vitamin B12 deficiency and its role in polyneuropathy in type 2 diabetes. J Diab Res. 2014;2014.
4. Kwok T, Cheng G, Lai W, Poon P, Woo J, Pang C. Use of fasting urinary methylmalonic acid to screen for metabolic vitamin B12 deficiency in older persons. Nutrition. 2004;20(9):764-768.
5. Brown R, Thornton MJ, Price J. The effect of vitamin supplementation on the urinary excretion of tryptophan metabolites by pregnant women. J Clin Invest. 1961;40(4):617-623.
6. Lykouras L, Markianos M, Hatzimanolis J, Malliaras D, Stefanis C. Association of biogenic amine metabolites with symptomatology in delusional (psychotic) and nondelusional depressed patients. Prog Neuro-Psychopharmacol Biol Psych. 1995;19(5):877-887.
7. Frankenhaeuser M, Lundberg U, Von Wright MR, Von Wright J, Sedvall G. Urinary monoamine metabolites as indices of mental stress in healthy males and females. Pharmacol Biochem Behav. 1986;24(6):1521-1525.
8. Mitochondrial Medicine Society's Committee on D, Haas RH, Parikh S, et al. The in-depth evaluation of suspected mitochondrial disease. Mol Genet Metab. 2008;94(1):16-37.
9. Dimmock DP, Lawlor MW. Presentation and Diagnostic Evaluation of Mitochondrial Disease. Pediatr Clin North Am. 2017;64(1):161-171.
10. Wu H, Jiang K, Gu G, Wu Y, Yu S. [The relationship of occupational stress and the level of some hormone metabolites in urine]. Chin J Indust Hyg Occup Dis. 2014;32(2):83-86.
11. Jeon SW, Kim Y-K. Inflammation-induced depression: Its pathophysiology and therapeutic implications. J Neuroimmunol. 2017;313:92-98.
12. Rao TSS, Asha MR, Ramesh BN, Rao KSJ. Understanding nutrition, depression and mental illnesses. Indian J Psychiatry. 2008;50(2):77-82.
13. O'Connell BS. Select vitamins and minerals in the management of diabetes. Diabetes Spectr. 2001;14(3):133-148.
14. Harris WS. Omega-3 fatty acids and cardiovascular disease: a case for omega-3 index as a new risk factor. Pharmacol Res. 2007;55(3):217-223.
15. Spencer SJ, Korosi A, Layé S, Shukitt-Hale B, Barrientos RM. Food for thought: how nutrition impacts cognition and emotion. Sci Food. 2017;1(1):1-8.

Test Type: Urine Test
Add-Ons: Urine, Bloodspot, & Buccal Swab
Turnaround Time: 14 Days