2-Hydroxyphenylacetate is a key intermediary in the metabolism of phenylalanine, an essential amino acid, and tyrosine, a conditionally essential amino acid. Elevated levels of 2-Hydroxyphenylacetate can signal underlying metabolic disturbances or genetic abnormalities in phenylalanine and tyrosine metabolism, such as phenylketonuria (PKU) or tyrosinemia. Monitoring 2-Hydroxyphenylacetate levels as part of the Organic Acids Profile can be instrumental in diagnosing and managing these metabolic disorders, facilitating early intervention and personalized treatment strategies for affected individuals.
Low levels of 2-hydroxyphenylacetate may occur if the patient is on a low-protein diet or if an iron deficiency is present that prevents synthesis of the analyte from its precursor phenylalanine.
The use of antibiotics may decrease the populations of bacteria that convert phenylalanine into 2-hydroxyphenylacetate. Environmental stress or chronic psychological stress may also decrease the number of bacteria in the gut microbiome. The inheritance of low-activity enzymes on the phenylalanine breakdown pathway may result in low levels of 2-hydroxyphenylacetate and higher levels of phenylalanine in the bloodstream. In rare cases, the adult onset of an inborn error of metabolism may occur and present with neurological symptoms resembling dementia and Parkinson’s disease. Other neurological symptoms, such as motor incoordination, cognitive difficulties, or behavioral problems may also be present.
- Consider a stool test or other evaluation of the gut microbiome. Environmental or chronic psychological stress can not only decrease the number of beneficial bacteria in the gut, but it can increase the levels of neurotransmitter metabolites (vanilmandelate, homovanillate, 5-hydroxyindoleacetate), para-hydroxyphenyllacetate, and hippurate.
High levels of 2-hydroxyphenylacetate may occur if the patient is on a high-protein diet or if there are digestive disorders present. Disorders such as protein malabsorption can increase the amount of undigested protein in the gut lumen, which are then metabolized into 2-hydroxyphenylacetate by the gut bacteria.
Consider a stool test or other evaluation of the gastrointestinal microbiome.
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