Personalized Functional Nutrition Testing

I am passionate about health optimization in all areas: from movement to neurology to metabolism and nutrition. I want to share with you a recent functional medicine test I took to look deeper into my blood chemistry and help fine-tune my health. At the end of this article, I will show you my personal results and what I need to work on to optimize my health.

The test is called NutrEval from Genova Diagnostics, the same lab I like to use for stool panels.

NutrEval is a nutritional profile which may help identify root causes of dysfunction and treat clinical imbalances which impact your health. This is a much deeper dive than the typical Comprehensive Metabolic Panel at your yearly check-up.

What I love about this test, is that while analyzing blood levels of every vitamin, mineral, and amino acid, it also analyzes organic acid metabolites and intermediaries which indicate blocks in key metabolic pathways that may be due to nutrient deficiencies, inherited enzyme deficits, toxic build up or drug effects. This gives a much more complete picture than just directly measuring nutrients alone. This is because homeostatic mechanisms make it it is possible to have normal blood levels while still exhibiting signs of deficiency.

The data obtained gives insight into everything from fat and carbohydrate metabolism to neurotransmitter levels, antioxidant status, heavy metal exposure and even the health of your gut microbiome.

This kind of information is critical in understanding your unique health expression; to identify and correct trends which may be contributing to chronic disease and even reverse imbalances before they become clinical.

Whether you want more information on how to help treat a disease, prevent one or simply optimize your health, NutrEval may offer further insight into a variety of conditions such as mood disorders, cardiovascular disease, diabetes and metabolic syndrome, fatigue, weight issues, malnutrition, maldigestion and malabsorption, cognitive decline, athletic performance and increased nutrient demand due to genetic variation.

The test is divided into five functional pillars of metabolic health:

·      Oxidative Stress

·      Mitochondrial Dysfunction

·      Omega Imbalance

·      Toxic Exposure

·      Methylation Imbalance

Each of these pillars is given a functional imbalance score so you can prioritize your need for support.

Oxidative Stress. This refers to free radicals produced during normal metabolic processes. Free radicals damage cells walls, and protein structures like organelles and DNA. This is essentially what causes us to age. Antioxidants are the compounds which quench free radicals, taking the bullet so our tissues aren’t injured.

Mitochondrial Dysfunction. Mitochondria are the key cellular organelle for energy production, they “burn” our fat, carbohydrates, and protein with oxygen to create ATP, the currency of cellular energy. Mitochondrial dysfunction and reduction in the synthesis of ATP is the underlying cellular characteristic of aging and essentially all chronic diseases such as Alzheimer’s, Parkinson’s, ALS, cardiovascular disease, autoimmune diseases such as MS, and even neurobehavioral and psychiatric diseases.[i]

Omega Imbalance. This reflects the intake and metabolism of essential fatty acids which play a role in many important processes including inflammation, cell membrane fluidity and cellular signaling and especially neuronal health. The Standard American Diet is marked by high intake of omega-6’s and low intake of omega-3’s. Imbalances here can contribute to depression, cognitive decline, cardiovascular disease, and diabetes. [ii]

Toxic Exposure. This measures short exposure to toxic elements like mercury, cadmium, aluminum, arsenic, and lead. These compounds dramatically disrupt our health and exposure may be at the root cause of many mystery ailments.

Methylation Imbalance.

Methylation is a critical biochemical process that is involved in numerous systemic processes.Methylation is needed to create DNA and RNA and regulate gene expression. Methylation is involved in basic energy production, fat metabolism, immune responses, vascular health, and cell membrane repair. It produces and metabolizes neurotransmitters to regulate mood. Methylation also works to neutralize toxins and hormones. Methylation defects are associated with many conditions such as cancer, autism, ADHD, congenital neural tube defects, cognitive decline, cardiovascular disease and mood and mental health disorders. [iii][iv]

Our Individual Metabolism is a complex process revealing how vitamins, minerals, protein, fats, and carbohydrates are used to perform thousands of critical biochemical reactions. The valuable information gained from this test allows us to quickly identify areas of increased metabolic demand and nutrient insufficiencies which lead to biochemical disturbances affecting healthy cellular and tissue function, potentially leading to disease. There may be deficiencies in our diet, malabsorption factors, increased nutrient demand and even genetic variations which require a focused dietary change, nutritional supplementation, or detox protocol.  

My report was overall very good but shows a few key areas where I can improve:

My antioxidant status is great! This means I am in a good position to minimize the negative effects on cells and DNA by things like UV light, air pollution, toxins, infections, decreased oxygen, and excess exercise.

B-vitamins need some attention, specifically B1, B3 and B6. I should be on top of this because I know I am a carrier of the MTHFR gene variant (subject of another article), and that I need to pay extra attention to my B-vitamin status. I usually take methylated B9 and B12, but I was unaware that B6 was an issue. Looking further down the report on page 4 we see that B6 deficiency (of which I am clinically low) leads to things like irritability, depression, seizures, oral inflammation, impaired immunity and increased homocysteine. This needs to be addressed right away.

Minerals are ok, but deserve a tweak. Magnesium is a little low, and that is no surprise. A 2012 study found 48% of Americans consumed less than the required amount of magnesium.[v] Magnesium is used in over 900 enzymatic reactions, many of which are neurological. Magnesium is easy to supplement and low in cost. It helps us to relax our muscles, destress and even helps us poop.

Manganese is also low. This can contribute to impaired connective tissue growth, fat and sugar dysregulation inflammation and oxidative stress. Luckily, Manganese is easily obtained from dark leafy greens, legumes, nuts, and organ meats. Personally, I will try to eat more variety of dark leafy greens and add some grass-fed beef liver to my diet.

Omega-3’s was a little surprise for me. I started supplementing with fish oils several years ago and noticed a dramatic effect on my mood and mental clarity. Fish oil, especially DHA has been a cornerstone of my supplementation. I generally take around 1,500 mg/ day of EPA and DHA, but with this data I am going to double that to 3,000 mg and make sure to eat cold water and tinned fish at least 2 times per week to get those numbers up. Fish oils are more expensive, especially DHA, but are critical for cardiovascular and neurological health. They are called “essential” fatty acids, because we require them from our diet; our bodies can’t manufacture them. If you don’t have enough omega-3’s, your body will substitute an inferior fat molecule which will literally stiffen our cell walls. If you don’t eat fish or are disgusted by fish oils, Omega-3’s can be obtained from flax and certain algae.

Microbiome and digestive support is another area for me to focus on. I was surprised to see some pancreatic enzyme deficiency. These are the enzymes which break macronutrients down into their small absorbable components. This can be addressed with digestive enzymes and more chewing, but warrants looking deeper in to things like small intestinal bacterial overgrowth and villous atrophy (aka celiac disease, which does run in my family). Microbiome imbalance makes sense as well, as I haven’t been focusing on it leately. Increasing fermented foods, eating a brightly colored spectrum of fresh vegetables and taking a probiotic will help. Interestingly, many of the B-vitamins are synthesized in the gut by bacteria. This may also be one of the root causes of my imbalance.

I’m happy to see there is no need for methylation support, toxic exposure, or mitochondrial dysfunction. I attribute that to clean living, vigorous exercise and regularly supporting glutathione, the body’s master antioxidant.  

What I will do going forward is implement these dietary and supplement changes into my routine and then retest in 6-12 months. Because of the gut dysbiosis, it would behoove me to run further tests such as a stool panel and a small intestinal bacterial overgrowth breath test.

If you have any questions about your health, NutrEval or other functional medicine labs, please reach out.

In service and in health,

Dr. Peter Leopold

[i] Nicolson GL. Mitochondrial Dysfunction and Chronic Disease: Treatment With Natural Supplements. Integr Med (Encinitas). 2014 Aug;13(4):35-43. PMID: 26770107; PMCID: PMC4566449.

[ii] Grosso G, Galvano F, Marventano S, Malaguarnera M, Bucolo C, Drago F, Caraci F. Omega-3 fatty acids and depression: scientific evidence and biological mechanisms. Oxid Med Cell Longev. 2014;2014:313570. doi: 10.1155/2014/313570. Epub 2014 Mar 18. PMID: 24757497; PMCID: PMC3976923.

[iii] Troesch B, Weber P, Mohajeri MH. Potential Links between Impaired One-Carbon Metabolism Due to Polymorphisms, Inadequate B-Vitamin Status, and the Development of Alzheimer's Disease. Nutrients. 2016 Dec 10;8(12):803. doi: 10.3390/nu8120803. PMID: 27973419; PMCID: PMC5188458.

[iv] Refsum H, Ueland PM, Nygård O, Vollset SE. Homocysteine and cardiovascular disease. Annu Rev Med. 1998;49:31-62. doi: 10.1146/annurev.med.49.1.31. PMID: 9509248.

[v] Rosanoff A, Weaver CM, Rude RK. Suboptimal magnesium status in the United States: are the health consequences underestimated? Nutr Rev. 2012 Mar;70(3):153-64. doi: 10.1111/j.1753-4887.2011.00465.x. Epub 2012 Feb 15. PMID: 22364157.