Research Biomarker Category Nutritional Organic Acids (Urine) - DUTCH

Nutritional Organic Acids (Urine) - DUTCH

These organic acids act as functional markers of nutrient deficiency. When the body has inadequate cellular levels of vitamin B12, vitamin B6 or glutathione, levels of their corresponding organic acid build up and spill into the urine. In some cases, these markers are more effective than measuring the nutrient directly.

8-OHdG (Waking) (Male)

Optimal range: 0 - 8.8 ng/mg

8-OHdG measures the effect of endogenous oxidative damage to DNA. The marker is used to estimate the risk for various cancers and degenerative diseases. Adjusting treatments and lifestyle to minimize the presence of 8-OHdG is a productive step toward health and longevity.

b-Hydroxyisovalerate

Optimal range: 0 - 12.5 ug/mg

Elevated b-hydroxyisovalerate is found as a result of biotin insufficiency. This issue often presents in patients as skin problems as well as hair loss. Look for this DUTCH test marker to assess biotin status and determine if intervention is required. Adequate biotin supply will yield a lower level of b-hydroxyisovalerate.

b-Hydroxyisovalerate (Male)

Optimal range: 0 - 18 ug/mg

b-Hydroxyisovalerate is made when the body is deficient in biotin. This marker has an inverse relationship with biotin, therefore elevated levels represent deficiencies in biotin. Biotin is an important cofactor in mitochondrial function, metabolism of fatty acids, glucose, and protein, as well as ROS production. Reactive oxygen species (= ROS) are generated during mitochondrial oxidative metabolism as well as in cellular response to xenobiotics, cytokines, and bacterial invasion. Oxidative stress refers to the imbalance due to excess ROS or oxidants over the capability of the cell to mount an effective antioxidant response.

Biotin deficiency has similar symptoms as other B-vitamin deficiencies but is most often associated with hair loss. Factors that influence biotin levels include inadequate dietary intake, long-term and high-dose B5 supplementation, dysbiosis/gut health, antibiotic use, medications, and biotinidase deficiency.

Homovanillate (HVA) (Male)

Optimal range: 4 - 16 ug/mg

Homovanillate (HVA) is the primary metabolite of dopamine, a brain and adrenal neurotransmitter that comes from tyrosine (with BH4 and iron as co-factors). Dopamine goes on to create norepinephrine and epinephrine (= adrenaline).

Low levels of dopamine are associated with depression, addictions, cravings, apathy, pleasure seeking behaviors, increased sleepiness, impulsivity, tremors, low motivation fatigue and low mood.

High levels of dopamine are associated with agitation, insomnia, mania, hyperactivity, hyper-focus, high stress, anxiety and addictions/ cravings/ pleasure seeking (to maintain high levels).

High Homovanillate (HVA) can be caused by the use of the following supplements, foods or medications within 72 hours of collecting urine samples: tyrosine, phenylalanine, mucuna, quercetin, bananas, avocados as well as parkinson's medications.

If these are being used, the HVA on the DUTCH test may not accurately reflect circulating dopamine levels and should be disregarded.

Indican

Optimal range: 0 - 100 ug/mg

Indican is an indole produced when bacteria in the intestine act on the amino acid, tryptophan. Most indoles are excreted in the feces.

The remainder is absorbed, metabolized by the liver, and excreted as indicanin the urine.

Accumulated levels of Indican in the urine may suggest gastrointestinal dysbiosis or malabsorption.

Indican (Male)

Optimal range: 0 - 131 ug/mg

Indican is a byproduct of tryptophan putrefaction by microbes in the gut. Accumulated levels of indican in the urine suggest higher levels of tryptophan putrefaction from gastrointestinal dysbiosis or malabsorption.

Production of indican occurs when tryptophan creates indoles in the colon. No other endogenous indoles are metabolized in this way, so when we see indican in the urine, it is directly related to gut production and a direct reflection of gut health. When there is concern of dysbiosis, there may be poor metabolism of sex hormones (including estrogen) along with chronic low-grade inflammation that can impact cortisol production and metabolism.

Kynurenate (Dutch)

Optimal range: 0.8 - 4.5 ug/mg

Kynurenate is product of the metabolism of L-Tryptophan and appears in urine in Vitamin B6 deficiencies. Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein.

Kynurenate (Male)

Optimal range: 1 - 6.6 ug/mg

Kynurenate is product of the metabolism of L-Tryptophan and appears in urine in Vitamin B6 deficiencies. Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein. Inadequate vitamin B6 is one factor that leads to increased concentrations of kynurenate and xanthurenate in urine. These products of amino acid breakdown cannot be further metabolized in the absence of vitamin B6.

Methylmalonate (MMA)

Optimal range: 0 - 2.5 ug/mg

The measurement of elevated amounts of methylmalonic acid in the blood or urine serves as a sensitive and early indicator of vitamin B12 deficiency.

Methylmalonate (MMA) (Male)

Optimal range: 0 - 3.5 ug/mg

The measurement of elevated amounts of methylmalonic acid in the blood or urine serves as a sensitive and early indicator of vitamin B12 deficiency.

Pyroglutamate

Optimal range: 28 - 58 ug/mg

Pyroglutamate (or Pyroglutamic acid) is an intermediate in the glutathione metabolism and a marker of glutathione deficiency.

Pyroglutamate (Male)

Optimal range: 38 - 83 ug/mg

Pyroglutamate is an intermediate in glutathione recycling and production. Glutathione requires the amino acids cysteine, glycine and glutamate for production. If the body cannot convert pyroglutamate forward to glutathione, it will show up elevated in the urine. High pyroglutamate is an established marker for glutathione deficiency. Remember that glutathione is one of the most potent antioxidants in the human body and is especially important in getting rid of toxins including the reactive quinone species formed by 4-OH-E1 and 4-OH-E2. This reactive species can damage DNA if not detoxified by either methylation or glutathione.

Quinolinate (Male)

Optimal range: 0 - 12.5 ug/mg

Quinolinate is a neurotoxin derived from tryptophan. Elevated quinolinate is seen in brain and nerve tissue damage, especially in disorders such as Alzheimer's disease, Parkinson's disease, Huntington's disease, motor neuron diseases, multiple sclerosis, epilepsy, amyotrophic lateral sclerosis, and major depressive disorder. We can also see elevated quinolinate due to low serotonin and need for vitamin B3 (niacin). The causes of elevated quinolinate include neuroinflammation, general inflammation, infection, phthalate exposure, and/or oral tryptophan use.

Vanilmandelate (VMA) (Male)

Optimal range: 2.5 - 7.5 ug/mg

Vanilmandelate (VMA) is the primary metabolite of norepinephrine and epinephrine (adrenaline). The adrenal gland makes cortisol and DHEA (from the adrenal cortex) as well as norepinephrine and epinephrine (from the adrenal medulla).

→ When adrenal hormone output is low, Vanilmandelate (VMA) levels may be low.

→ If Homovanillate (HVA) levels are significantly higher than Vanilmandelate (VMA), there may be a conversion problem from dopamine to norepinephrine. This case can be caused by a copper or vitamin C deficiency.

→ The enzymes COMT (methylation of catechols) and MAO are needed to make HVA and VMA from dopamine and norepinephrine respectively. If these enzymes are not working properly, HVA and/or VMA may be low in urine, when circulating levels of dopamine and/or norepinephrine/epinephrine may not be low.

→ Low levels of norepinephrine/epinephrine are associated with addictions, cravings, fatigue, low blood pressure, low muscle tone, intolerance to exercise, depression, and loss of alertness.

→ High levels of norepinephrine and epinephrine are associated with feelings of stress, aggression, violence, impatience, anxiety, panic, excess worry/hypervigilance, insomnia, paranoia, increasing tingling/burning, loss of memory, pain sensitivity, high blood pressure and heart palpitations.

Xanthurenate

Optimal range: 0.12 - 1.2 ug/mg

Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein. Inadequate vitamin B6 is one factor that leads to increased concentrations of kynurenate and xanthurenate in urine.

Xanthurenate (Male)

Optimal range: 0.2 - 1.9 ug/mg

Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein. Inadequate vitamin B6 is one factor that leads to increased concentrations of kynurenate and xanthurenate in urine.