Metabolomix+ : A Non-Invasive Personalized Nutritional 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 meet the precise needs of their patients.

Metabolomix+ is one of the most comprehensive functional and nutritional assessments available. It is designed to help practitioners identify root causes of dysfunction and provide a systems-based approach to help patients overcome chronic conditions and live a healthier life.

The Metabolomix+ report offers:

Nutrient recommendations for key vitamins, minerals, amino acids, fatty acids, and digestive support
Functional pillars with a built-in scoring system to guide therapy around needs for methylation support, toxic exposures, mitochondrial dysfunction, fatty acid imbalances, and oxidative stress
Interpretation-At-A-Glance pages for patient education
Dynamic biochemical pathway charts for clearer understanding

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.

* Genova’s organic acid testing is not intended for the diagnosis of neonatal inborn errors of metabolism.

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:

COMPONENTS

- Organic Acids (urine)
- Malabsorption and Dysbiosis Markers are metabolites produced by the gastrointestinal microbiome

Cellular Energy & Mitochondrial Markers are biomarkers of carbohydrate and fatty acid metabolism, and the citric acid (Kreb’s) cycle
Vitamin Markers are specific analytes used to assess functional levels of vitamin cofactors
Neurotransmitter Metabolites are downstream byproducts of epinephrine, norepinephrine, serotonin and dopamine
Toxin & Detoxification Markers relate to certain toxic metabolites and the body’s detoxification capacity
NEW Oxalate Markers relate to kidney stone formation, oxidative stress and metabolic dysfunction
Amino Acids (urine)

Essential Amino Acids must be derived from dietary sources
Nonessential Amino Acids are synthesized by the body
Intermediary Metabolites are byproducts of amino acid metabolism
Dietary Peptide Related Markers can indicate incomplete protein breakdown
Oxidative Stress Markers (urine) include the oxidative damage markers lipid peroxides and 8-OHdG

+ COMPONENTS

Essential and Metabolic Fatty Acids – Bloodspot (if selected as add-on profile)
Omega 3 Fatty Acids are essential for brain function and cardiovascular health and are anti-inflammatory
Omega 6 Fatty Acids are involved in the balance of inflammation
Omega 9 Fatty Acids are important for brain growth, nerve cell myelin, and reducing inflammation
Saturated Fatty Acids are involved in liproprotein metabolism and adipose tissue inflammation
Monounsaturated Fats include omega 7 fats and unhealthy trans fats
Delta-6 Desaturase Activity assesses efficiency of this enzyme to metabolize omega 6’s and omega 3’s
Cardiovascular Risk includes specific ratios and the Omega 3 Index
Nutrient and Toxic Elements – urine (if selected as add-on profile) assesses 20 toxic and 15 mineral elements
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

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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.
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.
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.
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.
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.
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.
Dimmock DP, Lawlor MW. Presentation and Diagnostic Evaluation of Mitochondrial Disease. Pediatr Clin North Am. 2017;64(1):161-171.
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.
Jeon SW, Kim Y-K. Inflammation-induced depression: Its pathophysiology and therapeutic implications. J Neuroimmunol. 2017;313:92-98.
Rao TSS, Asha MR, Ramesh BN, Rao KSJ. Understanding nutrition, depression and mental illnesses. Indian J Psychiatry. 2008;50(2):77-82.
O’Connell BS. Select vitamins and minerals in the management of diabetes. Diabetes Spectr. 2001;14(3):133-148.
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.
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.