Assessment Profile - Complete Health Development · oxidative stress, also known as “free radical...

Metabolic Assessment Profile

BHD #101

Oxidative Stress Liver Function

Digestion

BioHealth Laboratorywww.biohealthlab.com

800-570-2000 (USA/Canada) 307-212-6600 (Worldwide)

IndicanIndican, a byproduct of bacterial metabolic action in the stomach and small intestine, helps in screening for: • Small intestine bacterial overgrowth (SIBO)

• Maldigestion and malabsorption

• Protein digestion/putrefaction

• Pancreatic insufficiency

Bile AcidsBile acids are generally very low in the urine of healthy individuals. Elevated bile acids may indicate dysfunction, such as:

• Liver impairment or disease

• Poor detoxification

• Hypermotility

• Cholestasis

Lipid PeroxidesElevated lipid peroxides are indicative of damage caused to cells by free radicals. It is a useful screen for:

• Oxidative stress

• Free radical damage

• Antioxidant therapy

General Information:• Test Fee: $155

• Sample Requirements: First morning urine.

• Shipping Requirements: Ship only on Monday, Tuesday, or Wednesday.

• Processing Time: 7-9 business days

T he Metabolic Assessment

Profile is a convenient and cost-effective screen of some of the most fundamental functional systems.

The profile provides valuable data that can guide you in the management of disorders related to chronic stress. It measures common impacts and sources of dysfunction, contributing to the investigation of a myriad of health complaints.

The three markers interrelate on many levels, influencing one another as well as all other body systems.

BioHealth Laboratory | 23900 Hawthorne Blvd #150, Torrance, CA 90505

800-570-2000 (USA/Canada) | 307-212-6600 | www.biohealthlab.com

The Metabolic Assessment Profile, BHD #101

The Metabolic Assessment Profile (BHD #101, Urine) is a convenient and cost-effective screen of some of the body’s most fundamental functional systems: detoxification, digestion, and antioxidant capacity. The profile provides valuable data that can guide in the management of disorders related to chronic stress. It measures common impacts and sources of dysfunction, contributing to the investigation of a myriad of health complaints.

The three markers (indican, bile acids, and lipid peroxides) interrelate on many levels, influencing one another as well as all other body systems.

INDICANConvenient screen for protein digestion and dysbiosis

Urinary indican is an effective screening tool for assessment of protein digestion, dysbiosis, small intestine bacterial overgrowth (SIBO), and malabsorption states. Also known as indoxyl sulfate, indican is produced when there is putrefaction of tryptophan from dietary protein by dysbiotic (imbalanced) bacteria in the gastrointestinal tract.

If the indican level is ‘1’ or higher, either dietary protein is not being adequately digested and/or an overgrowth of harmful bacteria exists in the intestine, where it is feeding off the protein before it can be digested. ‘High’ or ‘Very High’ indican levels may indicate hydrochloric acid (HCL) and/or protease enzymes insufficiency as well as hypermotility of the upper bowel, parasitic and bacterial infections (notably Helicobacter pylori), and food reactions.

Common symptoms of elevated indican include: Gas, diarrhea, constipation, bad breath, bloating, weight gain, allergies, asthma, arthritis, headaches, skin conditions, nervous system problems, and colon toxicity.

Protein Digestion and PutrefactionThe level of indican is an index of the efficiency of protein digestion. Compromised amino acid or protein digestion can be caused by insufficient gastric hydrochloric acid, insufficient digestive enzymes, adverse food reactions, parasitic infection, fungal infection, an overgrowth of bacteria that metabolize specific proteins, hypermotility of the small intestine, or other gastrointestinal dysfunction.

Putrefaction is especially important because it can produce dozens of types of carcinogens. These substances can enter the liver through the general circulation. Undigested protein also increases systemic toxicity, burdening the detoxification capacity of the liver. Poor protein digestion can lead to other problems, such as intestinal microbial overgrowth, which in turn can lead to unfavorable pH changes and impaired absorption.




Small Intestinal Bacterial Overgrowth (SIBO)Small intestinal bacterial overgrowth (SIBO) is a condition in which the small bowel contains excess bacteria, and is often thought to occur in patients with known anatomical or motility disturbances. It can be a cause of diarrhea, abdominal pain, or protein and fat malabsorption with vitamin deficiencies. In recent years, there has been renewed interest in SIBO since it has now been implicated in the pathophysiology of certain diseases previously not classically associated with overgrowth.

The small intestine too has a plethora of normal bacteria, but in SIBO there is an occurrence that allows certain large-intestine bacteria to migrate into the small intestine. Once in the small intestine these bacteria proliferate and feed off carbohydrates from food, creating fermentation gases, specifically methane and hydrogen.

The Indican Lab TestThe urinary indican (Obermeyer) test on urine reveals color changes in the chloroform layer, which are then compared to a standard guide of colors corresponding to five different concentrations of indican. The five possible results are:

1. ‘0’ – Normal

2. ‘1’ – Low Positive

3. ‘2’ – Medium Positive

4. ‘3’ – High Positive

5. ‘4’ – Very High Positive

Elevated indican readings prompt further lab testing as well as lifestyle modifications and nutritional supplementation. Digestive enzymes and natural liver support, along with diet modification (such as reduced meat intake) are common therapeutic approaches.

BILE ACIDS

Urinary assessment of liver health

At the center of detoxification within the digestive system complex is the liver, and damage to liver cells will compromise health. A healthy diet is central to a healthy lifestyle, but a sick and under-functioning digestive system, including poor liver function, will unfortunately compromise a quality diet and maintain a stimulus for chronic stress. Therefore, performing bile acid testing is important in any functional medicine practice.




Large amounts of bile are secreted into the intestines on an ongoing basis, but only small amounts are expelled from the body. The main reason for this is that the vast majority of bile that is distributed in the duodenum (the first section of the small intestine) is then reabsorbed from the last part of the small intestine, called the ileum. The blood supply from this region of the small intestine is taken back through the liver where liver cells (hepatocytes) reabsorb the bile to resupply the bile acid pool.

If damage has occurred to the liver cells by infection, inflammation, and so on, much of this bile acid is leached into the general circulation. The bile acids can then be detected through urine testing as excess bile acid filters through the kidneys. Therefore, assays on bile acid in urine can be used clinically as a sensitive indicator of liver dysfunction.

Common symptoms of elevated bile acids include: Unstable blood sugar levels, inability to lose weight, sluggish metabolism, elevated LDL, reduced HDL, elevated triglycerides, indigestion, intolerance to alcohol and fats, recurrent headaches, depression, irritability, putrid body odor, and hormonal imbalance.

The Bile Acids Lab Test

Sophisticated ELISA testing on urine using fluorimetric wavelengths is a means to measure total bile acids in biological samples. In the assay, 3α-hydroxysteroid dehydrogenase reacts with all twelve bile acids, converting NAD to NADH, which reduces a probe to a highly fluorescent product.

Elevated bile acid readings prompt further lab testing as well as lifestyle modifications and nutritional supplementation. Common nutrients for assisting with liver repair and reduction of toxic load include: milk thistle seed extract, l-methionine, taurine, reduced l-glutathione, n-acetyl-l-cysteine, and bioflavonoids.

Long-standing intestinal disease (such as IBD), malabsorption, persistent diarrhea, and starvation can all lower bile acid readings.

The reference range for BioHealth’s urinary bile acids is 11.0 - 34.0 umol/g measured in units of creatinine concentration.

LIPID PEROXIDES Oxidative stress evaluation on urine

Lipid peroxidation is a well-established mechanism of cellular injury and is used as an indicator of oxidative stress, also known as “free radical damage.”

The elevation of lipid peroxides serves as an early warning of the potential long-term effects of oxidative stress. The outcome of long-term oxidative stress is chronic degenerative disease, an example being the peroxidation of low-density lipoproteins contributing to atherosclerosis.




Oxidative stress can result from exposure to toxins or pathogens, inappropriate lifestyle - such as over-exercising or smoking - or byproducts of normal metabolism.

The degree of lipid peroxide elevation can be used as a guideline for lifestyle modification and further testing. It can also help to determine antioxidant supplementation for helping to boost resistance to free radical damage. A slight elevation would require a less aggressive approach using minimal/maintenance levels of antioxidants. Moderate to extreme elevations would necessitate a more aggressive antioxidant regime, particularly in the short term, until follow-up testing indicates a return to normal levels.

Though not necessarily present in most patients, symptoms of elevated lipid peroxides include: Fatigue, memory loss, brain fog, muscle and/or joint pain, wrinkles, impaired eyesight, headaches, and susceptibility to infections.

Elevated lipid peroxide readings prompt further lab testing as well as lifestyle modifications and nutritional supplementation. Antioxidant intake, in the form of foods and nutritional supplements, is often indicated, with the most common nutrients being: Coenzyme Q10, alpha lipoic acid, vitamin E, B12, grapeseed extract, and vitamin D.

The Lipid Peroxides Assay

Lipid peroxides, derived from polyunsaturated fatty acids, are unstable and decompose to form a complex series of compounds, which include reactive carbonyl compounds, such as malondialdehyde (MDA). MDA can be quantified through a controlled reaction with thiobarbituric acid, generating thiobarbituric acid reactive substances (TBARS). The TBARS assay is a well-recognized, established method for quantifying these lipid peroxides, especially on urine in which there are few significant interfering substances. Steps are employed in the assay procedure to further reduce interference, rendering it a reliable measure of lipid peroxidation.

The reference range for BioHealth’s lipid peroxides assay is <4.0 umol/g measured in units of creatinine concentration.

Parameter Result Reference Range Units

Metabolic Assessment Profile - 101

Urinary Indican Negative

POS (+1) = LOW; POS (+2) = MODERATE; POS (+3) = HIGH; POS (+4) = VERY HIGH

Urinary Indican is an effective screening tool for assessment of protein digestion, dysbiosis, SIBO, andmalabsorption states. Also known as indoxyl sulfate, indican is produced when there is putrefaction oftryptophan from dietary protein by dysbiotic bacteria in the gastrointestinal tract. Problems with proteindigestion are often caused by the following factors: Helicobacter pylori, parasite infections, dysbiosis, a lack ofdigestive enzymes, and liver dysfunction. Inability to digest protein can lead to bowel putrefaction, adverseeffects on glycemic control, and hormone imbalance.

Urinary Lipid Peroxides 2.79 <4.0 umol/g

Lipid peroxidation is a mechanism of cellular injury and is used as an indicator of oxidative stress. Theelevation of lipid peroxides serves as an early warning of the potential long-term effects of oxidative stress.Oxidative stress can result from exposure to toxins or pathogens, inappropriate lifestyle - such asover-exercising and smoking - or byproducts of normal metabolism. Lipid peroxides are unstable anddecompose to form a series of compounds, such as malondialdehyde (MDA). MDA can be quantified througha controlled reaction with thiobarbituric acid, generating Thiobarbituric Acid Reactive Substances (TBARS).* Reference range updated 3/31/2016 *

Urinary Bile Acids 25.6 11.0 - 34.0 umol/g

Bile acids are synthesized by liver cells from cholesterol. They are then stored in the gallbladder afterconjugation. After entering the intestinal lumen subsequent to gallbladder contraction, bile acids arereabsorbed in the ileum and cleared from the portal circulation on the first pass through the liver. Elevated bileacids in urine represent bile acids that were not cleared by the liver, indicating liver dysfunction. A low level ofbile acids is suggestive of inflammatory bowel disease, chronic malabsorption, diarrhea, or starvation.* Reference range updated 3/31/2016 *

Urinary Creatinine 55.2 20 - 300 mg/dL

Creatinine is formed as the end product of creatine metabolism. Creatinine is transported through thebloodstream to the kidneys where it is secreted into urine. Urine creatinine is used as a guide for evaluation ofsample concentration in order to normalize other urine chemistry tests performed on the same sample.

Lipid Peroxides and Bile Acids are measured in units of creatinine concentration. For research purposes only.

Directors: Manuel Baculi, MD - CLIA ID: 05D0982456

BioHealth Laboratory - 23900 Hawthorne Blvd, Suite 150, Torrance CA 90505 USA

Phone: 800-570-2000 | 307-426-5060 FAX: 800-720-7239 ONLINE: biohealthlab.com

BioHealth Laboratory/Timmins 23900 Hawthorne Blvd, Suite #150 Torrance, CA 90505

Authorizing Provider:

USA

T085112

Sex:

Test PatientPatient:

Date Received:

Report Date:

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Date Collected:

04/25/2016

04/25/2016

04/25/2016

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