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.
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 metabolising 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 Disorders6,7
- Mitochondrial Dysfunction8
- Chronic Stress10
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 personalised 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)
- COMT (V158M)
- Organic Acids
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.
- 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.
- 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.
- 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.