A Comprehensive Test for Identifying Nutritional Deficiencies and
Insufficiencies
Featuring Plasma Amino Acid Analysis
The NutrEval Plasma®
is both a blood and urine test that evaluates over 125 biomarkers and
assesses the body's functional need for 40 antioxidants, vitamins,
minerals, essential fatty acids, amino acids, digestive support, and
other select nutrients. Personalized recommendations for nutrients are
determined by using an algorithm based on the patient's test findings.
The NutrEval Plasma and NutrEval FMV (first morning void) differ based
on which sample type is used to measure amino acids, plasma or urine.
NutrEval is the most comprehensive functional and nutritional
assessment available. It is designed to help practitioners identify root
causes of dysfunction and provide a systems-based approach to help
patients overcome chronic conditions and live a healthier life.
The NutrEval report offers:
- Nutrient recommendations for key vitamins, minerals, amino acids, fatty acids, and digestive support
- Functional pillars with a built-in scoring system to guide
therapy around needs for methylation support, toxic exposures,
mitochondrial dysfunction, fatty acid imbalances, and oxidative stress
- Interpretation-At-A-Glance pages for patient education
- Dynamic biochemical pathway charts for clearer understanding
When should testing for NutrEval Plasma be considered?
According to the World Health Organization, every country in the
world is affected by one or more forms of malnutrition. The term
malnutrition addresses 3 broad groups of conditions:1
- Undernutrition (wasting, stunting, underweight)
- Micronutrient-related malnutrition from inadequate or excess vitamins or minerals
- Overweight, obesity, and diet-related noncommunicable diseases (such as heart disease, stroke, diabetes and some cancers)
Proper nutrition is key to preventing a number of diseases. Nutrients
are necessary to feed every cell and ensure all body systems are
functioning properly. Testing can help clinicians and patients gain an
understanding of how nutritional imbalances may be impacting their
health. Certain conditions or dietary, genetic, and lifestyle factors
may predispose a person to having nutrient imbalances.
Symptoms and conditions associated with nutrient imbalances
- Mood disorders2-7
- Cardiovascular disease8,9
- Obesity/ Insulin resistance/ Type 2 Diabetes10-13
- Fatigue14-17
- Weight Issues / Dietary Guidance13, 18
- Malnutrition often observed in the elderly19, 20
- Maldigestion/Malabsorption
- Increased nutrient demand in athletes21, 22
- Increased nutrient demand in physical trauma/healing16, 23, 24
The NutrEval Plasma Biomarkers
The biomarkers on the NutrEval are arranged as follows (see sample report for
individual analytes):
- Organic Acids (urine)
- Malabsorption and Dysbiosis Markers are metabolites produced by the gastrointestinal microbiome
- Cellular Energy & Mitochondrial Markers are biomarkers of carbohydrate and fatty acid metabolism, and the citric acid (Kreb's) cycle
- Vitamin Markers are specific analytes used to assess functional levels of vitamin cofactors
- Neurotransmitter Metabolites are downstream byproducts of epinephrine, norepinephrine, serotonin and dopamine
- Toxin & Detoxification Markers relate to certain toxic metabolites and the body's detoxification capacity
- NEW Oxalate Markers relate to kidney stone formation, oxidative stress and metabolic dysfunction
- Oxidative Stress Markers include antioxidants
glutathione (whole blood) and Coenzyme Q10 (serum), as well as the
oxidative damage markers lipid peroxides and 8-OHdG (urine)
- Amino Acids (plasma)
- Essential Amino Acids must be derived from dietary sources
- Nonessential Amino Acids are synthesized by the body
- Intermediary Metabolites are byproducts of amino acid metabolism
- B Vitamin Markers are involved in biochemical reactions that specifically require B
vitamins
- Urea Cycle Markers are byproducts associated with nitrogen detoxification
- Glycine/Serine Metabolites are involved in the serine-to-choline pathway and the
methylation pathways
- Dietary Peptide Related Markers can indicate incomplete protein breakdown
- Essential and Metabolic Fatty Acids Markers (RBCs)
- Omega 3 Fatty Acids are essential for brain function and cardiovascular health and are
anti-inflammatory
- Omega 6 Fatty Acids are involved in the balance of inflammation
- Omega 9 Fatty Acids are important for brain growth, nerve cell myelin, and reducing
inflammation
- Saturated Fatty Acids are involved in liproprotein metabolism and adipose tissue
inflammation
- Monounsaturated Fats include omega 7 fats and unhealthy trans fats
- Delta-6 Desaturase Activity assesses efficiency of this enzyme to metabolize omega 6's and
omega 3's
- Cardiovascular Risk includes specific ratios and the Omega 3 Index
- Elemental Markers
- Nutrient Elements are direct measurements of copper and zinc (plasma), magnesium and potassium (RBC), and manganese and selenium (whole blood)
- Toxic Elements (whole blood) indicate exposure to lead, mercury, arsenic, or cadmium within approximately a 90-120 day timeframe
- Add-on Vitamin D (serum) measures a total of 25-hydroxyvitamin D3 (cholecalciferol) and 25-hydroxyvitamin D2 (ergocalciferol)
- Add-on Genomic SNPs (buccal swab) include MTHFR, COMT, TNF-a, and APOE
Watch the NutrEval Report Review Now
What is the difference between plasma and urine amino acids?
Certain amino acids are measurable in blood versus urine and sample
type selection depends on the clinical concern. The key differences
between plasma and urine amino acids are summarized below.25,26
| Plasma Amino Acids (Fasting) |
Urine Amino Acids (First Morning Void) |
| Fasting sample represents "steady state" pool of amino acids; not affected by short-term diet fluctuations |
Represents recent dietary intake and metabolism - more variable compared to plasma |
| 36 analytes |
40 analytes |
| Useful for mood disorders, or uncontrolled diets |
Useful for controlled diets, to assess protein maldigestion,
oxidative stress, vitamin/mineral cofactors affecting amino acid
metabolism |
| Amino acid levels influenced by abnormal kidney function; preferred if patient has proteinuria |
Amino acid levels influenced by abnormal kidney function; urine
testing dependent on healthy kidney function (biomarkers ratioed to
urine creatinine) |
| Requires a blood draw |
Requires a urine sample |
What advantage does the NutrEval Plasma offer compared to other diagnostics?
The NutrEval Plasma is one of the most comprehensive nutritional
profiles available assessing a broad array of macronutrients and
micronutrients, as well as markers that give insight into digestive
function, toxic exposure, mitochondrial function, and oxidative stress.
Genova provides a user-friendly report with clinically actionable results including:
- Suggested digestive support and vitamin, mineral, amino acid, and
fatty acid recommendations based on an algorithmic calculation of
functional need for cofactors in the body's metabolism
- Functional pillars with a built-in scoring system to guide therapy
for methylation support, toxic exposures, mitochondrial dysfunction,
fatty acid imbalances, and oxidative stress
- Interpretation-At-A-Glance pages provide educational information on
nutrient function, causes and complications of deficiencies, and
dietary sources
A Functional Nutritional Assessment
There are various methods of assessing nutrient status, including intracellular and extracellular direct measurement,
and measuring biochemical pathway markers that require specific nutrient cofactors for proper metabolism. The
NutrEval uses a combination of these methods and synthesizes the information via an algorithm that determines
personalized nutrient needs. The algorithm is based on functional markers shown in the literature to be associated
with a need for a particular nutrient.
Functional evaluation of nutritional status assesses metabolic intermediates produced in enzymatic pathways of
cellular energy production, detoxification, neurotransmitter breakdown, and amino acid metabolism. Specific
metabolites outside of reference range may signal a metabolic inhibition or block. This abnormality may be due to a
nutrient deficiency, an inherited enzyme deficit, toxic build-up, or drug effect. It is possible for an individual
to have normal blood levels of a vitamin in order to maintain homeostasis, while exhibiting signs of
insufficiency/deficiency for that vitamin. For this reason, direct testing of individual nutrients alone does not
provide a complete picture.
Other methods of assessing nutrient status, such as intracellular lymphocyte testing, has limited literature support.
Conventional nutritional panels include tests such as complete blood
count, comprehensive metabolic panel, iron, ferritin and other select
nutrients. The NutrEval is not meant to be a substitute for this
important testing, but rather a complement by providing additional
information.
What can clinicians and patients expect from NutrEval Plasma testing?
Personalized recommendations for amino acids, fatty acids, vitamins,
minerals, digestive support, and other nutrients are provided for each
patient. Additionally, exposure to select toxic substances and oxidative
stressors may need to be addressed. Comprehensive stool testing or SIBO
breath testing may be appropriate to investigate the possible cause for
maldigestion/malabsorption and dysbiosis.
Genova's Methodology
Urinary organic acids are measured via GCMS,
LC/MS/MS and alkaline picrate. Plasma amino acids are measured via
LC/MS/MS. Fatty acids are measured via GCMS. Urinary oxidative stress
markers are measured using colorimetric, thiobarbituric acid reactive
substances (TBARS) and LC/MS/MS. CoQ10 is measured via HPLC. Glutathione
is measured using colorimetric. Nutrient and toxic elements are
measured using ICP-MS and Kinetic (Jaffe). Reference ranges are age and
gender-specific and are based on a questionnaire-qualified healthy
cohort. Testing is not performed in patients under 2 years old.
References
- WHO. Malnutrition. Fact sheets
2018; Accessed April 15, 2019.
- Baranyi A, Amouzadeh-Ghadikolai O, von Lewinski D, et al. Branched-Chain Amino Acids as New Biomarkers of
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