Metabolism

Metabolic Assessment Profile
A popular urine screen of basic metabolic processes.

The Metabolic Assessment Profile (BHD #101, Urine) is a convenient and cost-effective screen of 3 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 Metabolic Profiles

 

Indican

Convenient 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.

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.

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.