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.

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.