Metabolic Fingerprinting Report

GENOROOTLaboratory Findings

Xxxx Xxxx Xxxx

Thu, 10 Jul 2014

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Report Summary

GENOROOTMetabolic Fingerprinting

Conditions of Reporting

The analysis of urine sample is done by GC/MS Method at PreventiNe Life Care - Navi Mumbai, India The metabolites and health conditions mapping is not mutually unique and there can be other forms in which an abnormality may be apparent. Similarly, a particular health condition may not exclusively be an outcome of the disorder(s) in consideration. Isolated laboratory investigations do not confirm the final diagnosis of a disease. They help in arriving at a diagnosis in conjunction with clinical presentation and other related investigations. It is important to monitor your health and take a proactive approach should there be any unhealthy condition(s) within or beyond scope of this test. GenoROOT - Metabolic Fingerprinting test analyzes a sample for limited metabolites/markers and their effects on human health. It is presumed that the specimen belongs to the person named or identified in the Test Request Form.All investigations have their limitations which are imposed by the limits of sensitivity and specificity of individual assay procedures as well as the quality of specimen received by the laboratory. A possibility of 1% error is there leading to a false positive or a false negative result.GenoROOT test is not intended to replace the medical advice and/or treatment obtained from a qualified healthcare practitioner.

A test requested might not be performed for the following reasons: a. Specimen quantity insufficient (inadequate collection/ pilferage in transit) b. Specimen quality (contaminated, fungal growth) c. Incorrect specimen type.

GFM630491 Thu, 10 Jul 2014

Patient Name Collected On Thu, 26 Jun 2014

Age Received On Thu, 3 Jul 2014

Date of Birth

Xxxx Xxxx Xxxxxx17 years 7 months 6 days Wed, 20 Nov 1996 Report Date Thu, 10 Jul 2014

Benzoic acid and Phenylacetate levels are elevated in the present urine sample. In gut metabolism whether the

source is dietary intake or jejunal bacterial metabolism, benzoate is expected to rapidly convert into hippurate

by conjugation with glycine. Glycine and pantothenic acid (Vit B5) can be limiting factors in this process.

Elevated benzoate is suggestive of inadequacy of glycine or pantothenic acid(Vit B5) for conjugation reactions

in the detoxification system.

Abnormalities of urinary benzoate reveal significant detoxification or dysbiosis issues or intestinal bacterial

overgrowth of various origins which may or may not be clinically significant in the present case. It is

recommended to optimize the anti-gastroesophageal reflux therapy currently taken. Introduction of probiotics is

recommended in the present case. The findings need to be correlated with other clinical and diagnostic findings.

It is recommended to repeat the test in 3 months time after lifestyle and clinical intervention mentioned above

to monitor the gut metabolism.

Reviewed By Approved By

Dr. Mahesh Hampe Dr. Pramod Ingale

MBBS , MD (Biochemistry) MBBS , MD (Biochemistry)

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Understanding your report

Your GENOROOT Report has TWO Sections:

Understanding the Graphical Representation

Metabolite Markers - Metabolic Markers are “indicators” measured in your sample. They characterize your state of health or disease and help make inference(s) in case of non-specific health conditions which can be an outcome of problems with your metabolism.

Control Values - The normal range within which the value of the metabolic marker should ideally fall.

Your Value - The actual value of a Metabolic Marker in your sample. This is represented by a Blue Dot in the risk bar.

Risk Bar - The pictorial representation in form of a horizontal bar with Green at left end and Red at right end. It signifies that if your value (blue dot) is more towards red end, it is a problem situation and if it is more towards green end, it is a normal situation. If it is in the overlap zone, you may consider consulting your family doctor.

Safe Zone - If the value of a marker measured in your sample falls in this region, you can relax and maintain the lifestyle you have.

Medium Zone - If the value of a marker measured in your sample falls in this region, you may consider getting counseled by your family physician or a metabolism expert. You may need to bring minor changes in your lifestyle for a better health. There is not much reason to worry though.

Risk Zone - If the value of a marker measured in your sample falls in this region, it will be a matter of concern. You must consult your family physician or a metabolism expert.

Section A - The technical report which gives you a graphical representation of various metabolic markers in your sample.

Section B - A general guide for quick reference on nutritional component in various dietary sources.

Definitions

In the technical report section, you will see the representation of test which was conducted and interpreted by our metabolic experts and scientists. In this section you will get to study a short explanation on various elements used in the analysis. This section will also enable external metabolic experts to review the analysis results and confirm the diagnosis or give further advises.

Phenylalanine 4.934 ND

Metabolite Control Value Observed Value Representation

Observed value

Safe Zone

Medium Zone

Risk Zone

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Metabolite Control Value Observed Value Representation

Section A - Metabolite Markers and Their Values

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Fatty Acid Metabolism

Adipate 0.110-2.763 1.255

Suberate 0.000-2.330 1.034

EMA 0.000-7.677 0.000

Sebacate 0.000-0.100 0.020

Me-succinate 0.000-0.100 0.043

Carbohydrate Metabolism

Pyruvate 0.000-4.237 0.000

Lactate 1.100-208.080 80.970

2KG 0.000-0.100 0.035

3HB 0.000-0.100 0.009

Neurotransmitter Metabolism

HVA 0.080-5.174 2.038

VMA 0.030-2.955 0.658

Qinolinate 0.000-3.599 1.527

Kynurate 0.000-4.484 2.004

5HindoleAA 0.000-0.100 0.046

Vitamin B12 and Folic Acid Metabolism

MethylMalonate 0.000-10.406 4.851

Uracil 0.000-4.065 1.816

Formiminoglutamate 1.100-208.080 69.447

Detoxification Profile

Pyroglutamate 0.660-8.555 2.662

2Hydroxy Butyrate 0.000-0.100 0.025

Mandelate 0.000-16.057 0.560

Orotate 0.000-19.302 0.000

Energy Production Markers

Citrate 0.000-4.118 0.695

Malate 0.030-6.086 1.311

succinate 0.030-2.684 1.038

cisaconate 0.000-2.948 1.177

isocitric acid 0.000-0.100 0.041

Hydroxy Methyl Glutarate 0.000-3.763 0.517Page No. 4 of 9

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Oxalate Metabolism

Glycolate 0.160-3.967 1.017

Glycerate 0.020-2.360 0.039

Oxalate 0.000-17.517 6.758

Vitamin Metabolism Markers

VitC 0.000-14.084 1.163

Vit B5 0.000-0.100 0.043

Xanthurenic acid 1.100-208.080 86.530

3HIV 0.000-4.479 0.596

4AB 0.000-0.100 0.008

Glutarate 0.000-14.146 0.686

4HPA 0.130-8.657 1.335

Kynurate 0.000-4.484 0.489

succinate 0.030-2.684 1.003

Fumarate 1.100-208.080 11.999

Glutamin 0.000-4.544 0.515

Leucine 0.000-2.980 1.322

Hydroxy Methyl Glutarate 0.000-3.763 0.517

Pyruvate 0.000-4.237 0.000

Adipate 0.110-2.763 1.255

Malate 0.030-6.086 1.311

Suberate 0.000-2.330 1.034

EMA 0.000-7.677 0.000

Kynurate 0.000-4.484 2.004

succinate 0.030-2.684 1.038

Isoleucine 0.000-4.277 1.311

Pyruglutamate 0.660-8.555 3.607

Me-citrate 0.000-5.260 1.438

Nutritional Markers

Leucine 0.000-2.980 1.322

glycine 0.120-7.719 1.923

Lysine 0.000-3.878 1.151

Isoleucine 0.000-4.277 1.311

Histidine 0.000-7.096 0.180

Phenylalanine 0.000-7.910 1.220

Beta-alanine 0.000-11.312 5.059

serine 0.320-14.260 0.242

threonine 0.000-4.531 1.999

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Dysbiosis Markers

2HIC 0.000-0.100 0.041

4-Hydroxy Benzoate 0.000-3.635 3.210

Phenyl acetate 0.000-1.851 2.780

4HPL 0.000-0.100 0.039

Hippurate 0.000-13.815 5.321

Benzoate 0.000-3.780 4.680

3-Indole acetate 0.000-0.100 0.037

2-Hydroxy Hippurate 1.100-208.080 69.040

Tartarate 0.000-0.100 0.045

Arabinose 0.000-5.917 0.974

Citramallic 1.100-208.080 96.928

4-Hydroxyhippurate 1.100-208.080 71.965

4-hydroxyphenylacetate 0.130-8.657 1.048

3HP3HPA 0.000-4.354 1.047

5HM2F 0.000-4.362 1.455

2HPA 0.000-0.100 0.045

Technical Details

The reference ranges for metabolic markers were established using samples collected from typical individuals of all ages

and both the genders.The individuals were known to be with no known physiological or psychological disorders. The

ranges were determined by calculating the mean and standard deviation (SD) and are defined as +/-2SD of the mean.

Reference ranges are age and gender specific. They have been calculated for Male Adult (>14 years), Female Adult (>14

years), Male Child (<14 years), and Female Child (<14 years).The graph represents whether the value of the patient is

within the reference (normal) range, defined as the mean plus or minus two standard deviations.

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Vitamin E

Vitamin B1 (Thiamin)

Vitamin B3 ( Niacin )

Vitamin C

Vitamin B2 (Riboflavin)

Vitamin B5 (Pantothenic Acid)

Source

Source

Source

Source

Source

Source

Source

Source

Needed for vision, healthy skin and mucous membranes, bone and tooth growth, immune system health

An antioxidant. It helps to slow down processes that damage cells.

Needed for healthy skin, hair, eyes, and liver. They also help the nervous system function properly, and are needed for good brain function.

Plays an important role in maintaining muscle tone along the digestive tract.

Food containing live bacteria which have health benefitting properties.

Needed for the growth and repair of tissues

Works as an antioxidant by fighting damaging particles in the body known as free radicals which damage cells and DNA, and may contribute to the aging process.

Helps treat dietary deficiencies.

Liver and fish liver oil, egg yolks, whole milk, cream, butter

Cold-pressed vegetable, seed and nut oils, wheat germ oil, whole grains, soybeans, uncooked green peas, spinach, asparagus, kale, cucumber

Whole or enriched grain products, brown rice, brewers yeast, blackstrap molasses, spinach, cauliflower, most nuts, sunflower seeds, peanuts, peas, beans, avocado, pork.

Synthesized from the amino acid tryptophan, Liver and other organ meats, poultry, fish, peanuts, brewer’s yeast, dried beans and peas, wheat germ, whole grains, avocado, dates.

Kefir, yogurt, fermented vegetables, branded-supplements

Citrus fruits, strawberries, mango, papaya, watermelon, tomatoes, broccoli. Brussels sprouts, cauliflower, cabbage, spinach

Whole or enriched grain products, brewer’s yeast, organ meats, mackerel, trout, shad, eggs, shellfish, millet, wild rice, dried peas, beans, sunflower seeds, asparagus, collards, broccoli, spinach, mushrooms, avocado

Organ meats, chicken, beef, brewer’s yeast, egg yolks, fish, chicken, whole grains, cheese, peanuts, dried beans, sweet potato, green peas, broccoli, avocado, cauliflower.

Vitamin A

Probiotics

Vitamin B6 (Pyridoxine)

Vitamin K

Vitamin B12

Folic Acid

Source

Source

Source

Source

Helps the body make neurotransmitters. These are chemicals that carry signals from one nerve cell to another and are needed for normal brain development and function.

Is necessary for normal blood clotting and synthesis of proteins found in plasma, bone and kidneys.

Is important for metabolism and helps in the formation of red blood cells and maintenance of the central nervous system.

Folate promotes normal digestion; essential for development of red blood cells.

Liver and other organ meats, fish, poultry, egg yolk, whole wheat, wheat germ, soybeans and other dried beans, peanuts, wal- nuts, banana, prunes, potatoes, cauliflower, cabbage, avocado

Whole grains, organ meats, trout, herring, mackerel, crab, oysters, egg yolk, yogurt, tempeh

Spinach, kale, beet greens, beets, chard, asparagus, broccoli, liver, brewer ' s yeast, whole grains

Synthesized by intestinal bacteria, dark leafy greens, blackstrap molasses, liver, milk, yogurt, egg yolks, fish liver oils

Section B - Food Source Guide

A

E C

B1 B2

B3 B5

B6 B12

K

Folic

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L-Carnitine

Magnesium

L-Phenylalanine

L-Glutamine Taurine

Glycine

Source

Source

Source

Source Source

Source

Helps the body produce energy. It is important for heart and brain function, muscle movement, and many other body processes.

Contributes to the structural development of bone. Plays role in active transport of calcium and potassium ions across cell membranes, a process that is important to nerve impulse conduction, muscle contraction and normal heart functioning.

Contraindicated with concomitant use of MAO inhibitors or Tricyclic antidepressants

Can minimize breakdown of muscle and improve protein metabolism.

An amino acid which helps in anxiety control and stress management. It lowers cortisol levels.

An amino acid, a building block for protein. Used for treating schizophrenia, stroke and some rare inherited metabolic disorders.

Synthesized by the liver and kidneys, red meats, fish.

Dark green vegetables, almonds, pecans, cashews, brazil nuts, seeds, legumes, soy products, wheat bran and germ, millet, brown rice, avocado, dried apricots

Beef, pork, poultry, lamb, fish, eggs, cheese. Vegetarian sources of proteins must be combined to maintain adequate levels of essential amino acids - whole grains, legumes, nuts and seeds.

Abundant in both animal and vegetable protein. Lean meats, fish.

High-protein foods, fish, meat and dairy. Vegetarian glycine sources include soybeans, spinach, kale, cauliflower, cabbage, pumpkin, banana, kiwi fruit, cucumber and beans.

L-Tyrosine

Iron

Source

Source

Used in the synthesis of structural proteins, used in the production of neurotransmitters.

Needed to make part of blood cell and also make up part of many proteins in the body.

Synthesized from the amino acid phenylalanine, soy products, chicken, fish, almonds, avocado, bananas, dairy products, limabeans, pumpkin seeds, sesame seeds

Beef, liver, kidney, pork, lamb, chicken, clams, oysters, egg yolks, salmon, whole wheat, millet, oats, brown rice, lima beans, soybeans, kidney beans, green peas, almonds, brazil nuts, walnuts, pine nuts, pumpkin seeds, sesame seeds, sunflower

Selenium

Mangnese

Source

Source

Helps the body with making special proteins, called antioxidant enzymes, which play a role in preventing cell damage

Helps the body form connective tissue, bones, blood clotting factors, and sex hormones. Plays a role in fat and carbohydrate metabolism, calcium absorption, and blood sugar regulation. Also necessary for normal brain and nerve function.

Brewer's yeast, wheat germ, barley, oats, brown rice, whole wheat, liver, butter, scallops, lobster, shrimp, clams, crab, oysters, lamb, garlic, onions, mushrooms, broccoli, Swiss chard, radishes

Pecans, almonds, whole grains, egg yolks, seeds, peas, beans, spinach

Chromium Copper

Source Source

Important in the metabolism of fats and carb. Stimulates fatty acid and cholesterol synthesis, which are important for brain function and other body processes. Important in the breakdown of insulin.

Works with iron to help the body form red blood cells. It also helps keep the blood vessels, nerves, immune system, and bones healthy.

Brewer's yeast, beef, liver, whole wheat, wheat germ, rye, fresh chillies, oysters, potatoes, green peppers, eggs, chicken, apples, butter, bananas, spinach

Buckwheat, whole wheat, shrimp, liver, brazil nuts, almonds, hazelnuts, walnuts, pecans, soybeans, dark leafy greens, prunes, cocoa

Cr Cu

Fe Mg

SeMn

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We welcome all questions and concerns. The Medical Questions pertaining to your analysis shall be answered by our experts.

You may post your queries on - . Please mention your Name, Date of genoroot@preventine.comBirth and the Customer ID in the query.

Customer satisfaction is our core goal. It is important for us to learn about what our customers think about our service and how we can improve it. If you have any suggestion or complaint, whatsoever, we request you to contact us and report it on:

Email: info@preventine.com Contact: +91-22-61980000

This report contains confidential medical information and genetic data. The report is for exclusive use by the person whose test has been conducted and the associated registered health practitioner.

Inositol

Source

Helps balance certain chemicals in the body to help conditions such as panic disorder, depression and polycystic ovary syndrome.

Synthesized from glucose, liver, lecithin, whole grains, wheat germ, lima beans, peanuts, brewer’s yeast, cabbage, citrus fruits ( Except lemons ) , cantaloupe, raisins, unrefined molasses

Biotin

Source

Supports healthy skin through proper fat production, helsp body make efficient use of sugar and maintain an energy supply in the nerve cells.

Egg yolks, liver, brewer’s yeast, nuts, milk, unpolished rice

The supplements mentioned above do not represent a complete list of all that is required by the human body. The need of protein and essential nutrients depends on several factors like: age, weight, health, body composition and physical activities being undertaken. It is important to maintain a balanced diet, healthy lifestyle, enough of sleep and exercises in order to ensure a good metabolism.

1. Goodman SI, Markey SP: Diagnosis of organic acidemias by gas chromatography-mass spectrometry. New York, Alan R Liss, 19812. Sweetman L: Organic acid analysis. In Techniques in Diagnostic Human Biochemical Genetics. Edited by FA Hommes. Wiley-Liss, New York, 1991, pp 143-1763. Lehotay DC, Clarke JT: Organic acidurias and related abnormalities. Crit Rev Clin Lab Sci 1995;32:377-4294. Seashore MR: The Organic Acidemias: An Overview. Available from http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&part=oa-overview Reviewed December 22, 20095. Part 9, Organic Acids. In Scriver CR, Beaudet AL, Sly WS, et al, eds. The Metabolic and Molecular Basis of Inherited Disease. 8th ed. New York, NY: McGraw-Hill, Inc; 2001:2109-2260.6. Kushnir MM, Komaromy-Hiller G. Rapid screening for urine organic acids by GC-MS. Clin Chem. 1999;45:A21.

References

Note:

GENOROOTMetabolic Fingerprinting

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