Cholic acid (CA), Chenodeoxycholic acid (CDCA), Deoxycholic acid (DCA), Lithocholic acid (LCA) are the major bile acids related to gut microbiome.

Bile Acids are natural products of cholesterol synthesis that aid in the emulsification and absorption of dietary fats in the small intestine. Elevated total fecal bile acid is indicative of a diagnosis of bile acid malabsorption. Quantification of fecal bile acids aids in diagnosis for IBS and identification of patients with chronic diarrhea who may benefit from bile acid sequestrant therapy. There is a connection between the liver health, fecal bile acid concentrations, and gut microbiota composition. Bile acids have both direct antimicrobial effects on gut microbes and indirect effects through FXR-induced antimicrobial peptides.

Cholic acid is a primary bile acid synthesized in the liver from cholesterol. It plays a crucial role in the emulsification and absorption of dietary fats and fat-soluble vitamins in the small intestine. Cholic acid is also involved in regulating cholesterol levels and maintaining the integrity of the intestinal mucosa.

Choline is an essential nutrient involved in various physiological processes, including cell membrane structure, lipid metabolism, and neurotransmitter synthesis. When measured in a urine sample as choline (mg/g creatinine), this biomarker can provide valuable insights into an individual's choline status and overall metabolic health. The measurement of choline in urine is often normalized to creatinine levels to account for variations in urine concentration, making the value more reliable and comparable across different samples and individuals. Interpreting choline levels in urine requires considering dietary intake, as choline is obtained from foods such as eggs, meat, fish, and certain vegetables.

Choline is an essential nutrient that is part of cell membranes and is used by nerves to send impulses. Choline is known to be essential for mammals, and is essential for human cell growth. A dietary requirement for choline in humans has not been proven, although recent data on infants and dietary choline depletion in adults suggests that choline is an essential nutrient. Historically, choline is considered as a lipotrope and member of the B vitamin complex.

Choline has several distinct functions. First, choline serves as a source of one-carbon units (methyl groups) for biosynthesis of other compounds. Interactions with methionine, Vitamin B12, folate, ethanolamine, and betaine allow choline to partially replace, or be replaced by other constituents in one-carbon metabolism. Second, choline is a component of phosphatidyl choline, the major component of cell membranes. Lecithin is a commercial name for phospholipids containing 10-35% phosphatidyl choline. Phosphatidyl choline has interactions with cholesterol and lipoprotein metabolism.

Choline is a nutrient that supports various bodily functions, including cellular growth and metabolism. The body makes some choline, but the majority comes from dietary sources.

Physiological Function:

Choline is metabolized within cellular mitochondria resulting in production of trimethylglycine; TMG plays a role in supporting methyl donation processes either directly (methylating homocysteine) or indirectly through supporting production of S-adenosyl methionine (SAMe). Choline is converted into acetylcholine (ACh).

Common food sources:

Beef liver, eggs, soybeans, scallops, chicken breast

Serum cholinesterase is a blood test that looks at levels of 2 substances that help the nervous system work properly. They are called acetylcholinesterase and pseudocholinesterase. Your nerves need these substances to send signals.

Acetylcholinesterase is found in nerve tissue and red blood cells. Pseudocholinesterase is found primarily in the liver.

Serum cholinesterase, also known as pseudocholinesterase (PCHE), is a type of cholinesterase found in the blood that plays a crucial role in the breakdown of certain chemicals, including acetylcholine. It is distinct from acetylcholinesterase, found at nerve endings, and it has a different substrate specificity.

Serum cholinesterase is often measured through blood tests and is utilized as a biomarker for various health conditions, particularly those related to the liver's synthetic function.

Abnormal levels of serum cholinesterase can be indicative of liver dysfunction and can be monitored for acute poisoning detection. Its measurements are valuable in assessing liver function and overall health.

Typically, normal pseudocholinesterase values range between 8 and 18 units per milliliter (U/mL) or 8 and 18 kilounits per liter (kU/L).

Note: Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results.

Help to diagnose drug-induced lupus (DIL) and systemic lupus erythematosus (SLE). Antibodies to both chromatin and histones have been found in patients with procainamide-induced lupus; however, patients with lupus induced by drugs such as quinidine, penicillamine, methyldopa, and acebutolol have antibodies to chromatin but not antihistone. Antichromatin antibodies are found in 50% to 90% of SLE patients and have been linked with proteinuria in SLE patients.

Antichromatin antibodies are more sensitive than anti-dsDNA antibodies in detecting active SLE.

A high hair chromium (Cr) level is likely to indicate excess exposure to Cr. Hair Cr levels do not appear to be affected by permanent solutions, dyes, or bleaches, but external contamination is possible. Trivalent Cr is considered to be an essential trace element with a low order of toxicity. Cr toxicity via oral ingestion is not likely. However, it is noteworthy that excessive self-supplementation has been reported to be associated with insomnia and increased unpleasant dream activity in some individuals (J. Nutr. Med.; 3(43), 1992).

Phytates decrease oral assimilation of Cr+3, whereas nicotinic acid and vitamin C increase absorption of Cr+3, zinc, vanadium and iron compete with Cr for absorption. In contrast, hexavalent Cr compounds are considerably more toxic and are primarily absorbed via inhalation as a result of industrial exposure. Industrial exposure to high amounts of Cr has been reported to be associated with allergic dermatitis, skin ulcers, bronchitis, and lung and nasal carcinoma. Elevated hair Cr levels have also been observed in patients with cerebral thrombosis and cerebral hemorrhage.

A high hair chromium (Cr) level is likely to indicate excess exposure to Cr. Hair Cr levels do not appear to be affected by permanent solutions, dyes, or bleaches, but external contamination is possible. Trivalent Cr is considered to be an essential trace element with a low order of toxicity. Cr toxicity via oral ingestion is not likely. However, it is noteworthy that excessive self-supplementation has been reported to be associated with insomnia and increased unpleasant dream activity in some individuals (J. Nutr. Med.; 3(43), 1992).

Phytates decrease oral assimilation of Cr+3, whereas nicotinic acid and vitamin C increase absorption of Cr+3, zinc, vanadium and iron compete with Cr for absorption. In contrast, hexavalent Cr compounds are considerably more toxic and are primarily absorbed via inhalation as a result of industrial exposure. Industrial exposure to high amounts of Cr has been reported to be associated with allergic dermatitis, skin ulcers, bronchitis, and lung and nasal carcinoma. Elevated hair Cr levels have also been observed in patients with cerebral thrombosis and cerebral hemorrhage.

Chromium (Cr) is essential for proper metabolism of glucose in humans. It potentiates the action of insulin via glucose tolerance factor (GTF) which is Cr+3 bound in a dinicotinic acid-glutathione complex. Other functions of Cr include aiding in lipid metabolism and assisting with HDL/LDL cholesterol balance.

Chromium is an essential trace mineral that plays an important role in optimizing insulin function and the regulation of blood glucose levels. Chromium may also be anti-atherogenic and assist in lowering cholesterol.

Chromium is ubiquitous in foods at low low concentrations. Derived from processing of food with stainless steel equipment. Also present in tobacco smoke, chrome, plating, dyes and pigments, leather tanning, and wood preserving and is deposited into air, water, and soil.

Blood distribution of chromium appears to be equally divided between plasma and RBCs, whole blood chromium the sample type for total chromium measurement. Chromium (VI) is more concentrated in the RBCs, while chromium (III) does not enter the RBCs. Therefore, it is possible to distinguish sources and types of exposure to indicate toxic  (Cr VI) exposure versus benign (Cr III) by measuring RBC chromium. Chromium rapidly clears from the blood and measurements relate to recent exposure. Urinary chromium excretion reflects absorption of the previous one to two days.

Chromium, when measured in whole blood as part of a Toxic and Essential Elements panel, provides valuable insights into the body's chromium status, which is pivotal for various physiological functions. Chromium is a trace element essential for human health, primarily recognized for its role in enhancing the action of insulin, a hormone critical to the metabolism and storage of carbohydrate, fat, and protein. Its presence in whole blood reflects both recent dietary intake and the body's stores of the mineral. Chromium exists in several forms, but the trivalent chromium (Cr3+) is the biologically active form, considered safe and necessary for human health, while hexavalent chromium (Cr6+) is toxic and carcinogenic. The measurement of chromium in whole blood can be crucial for evaluating nutritional status, particularly in populations at risk of chromium deficiency, such as those with unbalanced diets, the elderly, and individuals with impaired glucose tolerance.

Chromium is ubiquitous in foods at low low concentrations. Derived from processing of food with stainless steel equipment. Also present in tobacco smoke, chrome, plating, dyes and pigments, leather tanning, and wood preserving and is deposited into air, water, and soil.

Blood distribution of chromium appears to be equally divided between plasma and RBCs, whole blood chromium the sample type for total chromium measurement. Chromium (VI) is more concentrated in the RBCs, while chromium (III) does not enter the RBCs. Therefore, it is possible to distinguish sources and types of exposure to indicate toxic (Cr VI) exposure versus benign (Cr III) by measuring RBC chromium. Chromium rapidly clears from the blood and measurements relate to recent exposure. Urinary chromium excretion reflects absorption of the previous one to two days.

Chromium is an essential trace mineral crucial for carbohydrate metabolism and insulin sensitivity. It plays a role in stabilizing blood sugar levels and is involved in lipid and protein metabolism. Hair analysis offers a long-term view of chromium status, reflecting dietary intake, environmental exposure, and overall mineral balance.