January 1, 2019 at 9:24 pm #1276
I have 14 years old son with Autism.
His OAT showed HVA of2.3 andHVA/VMA ratio of1.7 ,both elevated.The rest Of neurotransmitera are normal.
His ketone ne and fatty acid oxidation showed 3-hydroxybutyric of 2.5 and ethylmalonic of2.9 ,both elevated.
On nutritional markets his B6 is low dispite supplementation.Ascorbic acid is zero as well as N-Acetylcysteine-NAC.
90%of his Amino Acid Metabolites are 0: 2-Hydroxyisovaleric ,2-Oxoisovaleric 3-Hydroxyisocaproic,Mandelic ,Phenyllactic ,Homogenistic are all 0!!!
I do not know how to interpret this labs.
Can you ,please help?
ThanksJanuary 1, 2019 at 10:14 pm #1277
Dr Woeller, would it be OK if I chimed in here, and contributed to this answer?
By all means, feel free to correct any of my comments.
Aida, what I would do is I would start with the easiest thing to fix, and that’s the vitamin markers. I would start working with the vitamin C, B6, and NAC first, simply because they could be as easy and just correcting the supplementation. The supplements Dr Woeller suggests have always worked for me. I would go with the Liposomal vitamin C, and to me it seems like oxidation levels are high, so adding more vitamin C in the Lipo form might work best.
The B6 levels being low with supplementation is something I have seen often. I think Dr Woeller would have far more info than me on this. But what I have seen is that the formulation, brand, frequency of dosing, and b-vitamin Co-factors all play roles. B6 may be more effectively absorbed in the p-5-p form, and when combined with other b-vitamins, I have found in my experience that it is utilized more effectively.
I hope I didn’t step on toes here. Just trying to help out from what I have seen, and hoping that I got some of this right 🙂January 2, 2019 at 7:59 am #1278
Michael – thanks for your thoughts!
1 – The high HVA and ratio is common with clostridia bacteria, e.g. HPHPA and 4-Cresol. However, the HVA can also be high with polymorphisms in the dopamine beta-hydroxylase converting enzyme that converts dopamine to norepinephrine. Great Plains Laboratory is looking to add a genetic test for this in the near future.
2 – both the fatty acid markers are just mildly high. This is not uncommon and don’t appear that significant. These markers can appear high when yeast and/or bacteria are present. The use of L-Carnitine at 500mg twice daily can help.
3 – B6 and Vitamin C are water soluble compounds and often show up low to low normal if not being used multiple times throughout the day. I typically have these dosed at least twice daily if possible. I like Michael’s suggestion on Liposomal Vitamin C. The P5P is a controversial topic between regular B6 and P5P. Dr. Shaw from Great Plains has shown that P5P likely gets converted back into pyridoxine HCL form as it crosses through the digestive lining. Sometimes it is hard to know for sure what is happening. It may not be a bad idea to just use a combination of B6 and P5P.
4 – The NAC is commonly low and indicates good conversion to glutathione. I am assuming the Pyroglutamic is normal? If so, than the NAC is doing its job in supplying glutathione production.
5 – Only high amino acid metabolites are abnormal. Low values have no known clinical significance.
I hope this information is helpful.
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