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Using the Organix, Organic Acids Testing, in Clinical Practice Dr. Rachel Marynowski.

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Presentation on theme: "Using the Organix, Organic Acids Testing, in Clinical Practice Dr. Rachel Marynowski."— Presentation transcript:

1 Using the Organix, Organic Acids Testing, in Clinical Practice Dr. Rachel Marynowski

2 Stages of Energy Extraction From Food Food CO 2 + H 2 O + Urea

3 1.Actual values – Examples include analytes such as lactate, sulfate etc. 2.Functional markers – These include analytes such as FIGLU, 5HIA The Organix Profile Looks at:

4 C A B B A Intermediary metabolite E n Enzyme Cofactor E1E1 E2E2 E2E2 © 2005 Metametrix Clinical Laboratory, Inc. Urine Functional Indicators of Nutrient Deficiency

5 Mitochondrial Function and Assessment B Complex Vitamin Markers Methylation Pathway Markers Neurotransmitters Metabolism Markers Oxidative Damage and Antioxidant Markers Detoxification Markers Intestinal Dysbiosis Markers General Breakdown

6 1.Mitochondrial Function and Assessment Fatty Acid Metabolism Carbohydrate Metabolism Energy Production (Citric Acid Cycle) Evaluation: Step 1

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9 If Pyruvate is elevated consider: B-vitamins: B1 and B5 Lipoic Acid Under-eating If Lactate is elevated consider: CoQ10 Biotin Lipoic Acid Excess Alcohol intake

10 Pyruvate dehydrogenase requires B-vitamin cofactors, thus an elevated pyruvate may be an indicator of a need for B-vitamins. - Naito et. Al., 1998 Eur J Pediatrics Co-enzyme Q10 supplementation has been found to be effective when lactate is elevated. - Sobreira, et. Al., 1997 Neurology Requirements…

11 Pyruvate Dehydrogenase Complex

12 High levels may suggest : 1.Low carbohydrate diet 2.Diabetic ketoacidosis 3.Reduced caloric consumption or Wasting diseases. 4.Insulin resistance (also look at high lactate/pyruvate)

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14 (acid) Buffer NH 4 Citrate 3- Proximal Tubular Cell NH 4 Citrate Isocitrate Cis-aconitase (Ammonia) Citrate, Isocitrate, Cis-Aconitase (Excreted in the urine)

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16 Elevated? Need for CoQ10

17 Mevalonic Acid Cholesterol Statins CoQ10 Hydroxymethylglutarate (HMG)

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19 1.Mitochondrial Function and Assessment 2.B Complex Vitamin Markers Thiamin (B1) Riboflavin (B2) Niacin (B3) Pantothenic acid (B5) Pyridoxine (B6) Lipoic Acid Biotin Evaluation Step 2

20 B-Complex (B1, B2, B3, B5)

21 Each of these uses a similar dehydrogenase enzyme to move on… Pyruvate a-ketoglutarate a-ketoisovalerate a-ketoisocaproate a-keto-β-methylvalerate The dehydrogenase enzyme requires vitamins: B1, B5, B2, B3 and lipoic acid

22 Vitamin B6 (Pyridoxine)

23 One of the earliest markers for B6 deficiency was the urinary excretion of xanthurenic acid, which is normally a minor tryptophan catabolite. The major pathway of tryptophan catabolism proceeds via the PLP-dependent kynureninase reaction. (Shane and Contractor, 1980) The DRI for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998 - IOM)

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25 Biotin

26 Excretion of β-hydroxyisovalerate (3-HIA) and biotin are early and sensitive indicators of biotin deficiency. (Mock et al., 2002) The indicators of biotin status that have been validated to the greatest extent are an abnormally decreased urinary excretion of biotin and an abnormally increased urinary excretion of 3-hydroxyisovaleric acid. (DRI Institute of Medecine 1998)

27 1.Mitochondrial Function and Assessment 2.B Complex Vitamin Markers 3.Methylation Pathway Markers Cyanocobalamin (B12) Folic Acid Evaluation Step 3

28 Methylmalonate Isoleucine Valine O3, O6, O9 B12 Urinary Excretion

29 Urinary MMA levels are a good indication of cobalamin distribution and function since they are directly related to a cobalamin-dependent metabolic pathway. -EJ Norman, 1982; 59(6): 11-28-1131 Methylmalonic acid (MMA) is increased in blood and urine of patients with vitamin B12 deficiency. -Clinical Chemistry. 2001;47:1993-2002 Methylmalonate was shown to be superior to serum B12

30 (FIGLU) Degradation of histidine relies on assistance from folate

31 1.Mitochondrial Function and Assessment 2.B Complex Vitamin Markers 3.Methylation Pathway Markers 4.Neurotransmitters Metabolism Markers Evaluation Step 4

32 Iron and BH4 Magnesium Copper Vitamin B6 Iron and BH4

33 B6 Vit C, Cu Fe SAMe L-dopa Dopamine Norepinephrine Epinephrine Tyrosine Homovanillate (HVA) Vanilmandelate(VMA) Low levels of HVA and VMA are associated with depression, fatigue, sleep disturbance. Clinicians should consider stress and cortisol levels, and may consider adding amino acid supplements.

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35 B6 Fe Tryptophan 5-HTP Serotonin 5-HIA 5-Hydroxyindoleacetate (5-HIA) is a degradation product of Serotonin. _________________________________________________________________ 5-HIA will likely be elevated when L-Tryptophan, SSRIs or 5-HTP supplements are taken.

36 Interferon-gamma Inflammation Viral or bacterial source? Increased nociception Increased irritation Possible sleep disturbance NMDA agonist

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38 1.Mitochondrial Function and Assessment 2.B Complex Vitamin Markers 3.Methylation Pathway Markers 4.Neurotransmitters Metabolism Markers 5.Oxidative Damage and Antioxidant Markers Evaluation Step 5

39 P-Hydroxyphenyllactate is a marker for cellular mitosis. While a small amount of production is normal, indicating metabolic cell turnover, excessive production can indicate injury or possibly tumorogenesis. 8-Hydroxydeoxyguanosine (8-OHDG) is a residue resulting from free radical damage to guanosine in DNA. Levels correlate with the rate of DNA damage and repair.

40 1.Mitochondrial Function and Assessment 2.B Complex Vitamin Markers 3.Methylation Pathway Markers 4.Neurotransmitters Metabolism Markers 5.Oxidative Damage and Antioxidant Markers 6.Detoxification Markers Evaluation Step 6

41 Xylene exposure sources: Cigarette smoke New paint, spray paint, paint thinners New carpet New cars Dry cleaning products Fuel & Exhaust fumes

42 Excessive ammonia production: From gut-derived bacteria Elevated Amino Acid catabolism

43 Conjugation & Elimination Glucarate (remnant) Glucuronic Acid Glucose Phase I Phase II 1. Glucarate represents both accelerated Phase I activity… (This process requires intervention from Phase I, leaving Glucarate behind as a remnant.) 2. …and slow Phase II glucuronidation status Glucarate

44 Alpha-hydroxybutyrate, Pyroglutamate and Sulfate… 3 clues of glutathione status!

45 When pyroglutamate is being produced at a faster rate than it can be recycled, it will appear elevated on the Organix profile. Cysteine lost in the urine will appear as urinary sulfate With every molecule of cystathionine committed to making Glutathione, one molecule of α-Hydroxybutyrate is made. Glycine Glutamate

46 1.Mitochondrial Function and Assessment 2.B Complex Vitamin Markers 3.Methylation Pathway Markers 4.Neurotransmitters Metabolism Markers 5.Oxidative Damage and Antioxidant Markers 6.Detoxification Markers 7.Markers of Intestinal Dysbiosis – Yeast/Fungal Evaluation Step 7

47 TyrPheTrp Tryptophan is converted to Indole in the gut – and subsequently excreted as Indican. Candida yeast species overgrowth is indicated when, D-Arabinitol is high The conversion of Benzoate to Hippurate is a glycine conjugation step. Supplemental glycine may help with the conversion. The markers are compounds created by organisms in the small bowel, that are absorbed and excreted in the urine

48 Use of antibiotics Use of antacids Loss of digestive function Gastric, pancreatic, hepatic Dietary intake (sugar, alcohol, etc.) Jejuno-ileal bypass or resection Blind loop, physiological abnormality Celiac disease Causes of Dysbiosis

49 L-Glutamine N-acetyl Glucosamine Botanicals: Licorice Okra Aloe Leaf Slippery Elm Marshmallow MSM MUCIN Butyric Acid Zinc-carnosine Pre & Probiotics High Fiber diet Heal the GI Mucosal Lining

50 1. 2. Guide to Supplementation from Organix Profile

51 www.metametrix.com www.metametrixinstitute.org © 2012 Metametrix


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