Kimlik No İstek Yapan Doktor

Hasta Adı Tetkik İstem Tarihi 29.01.2024 09:34

Cinsiyet Numune Alım Tarihi 30.01.2024 09:52
Doğum Tarihi Numune Kabul Tarihi 31.01.2024 10:39
Rapor No Rapor Onay Tarihi 13.02.2024 13:37
Örnek No Dosya No
Numune Türü İdrar (spot), dondurulmuş Numune Alım Yeri

Test Sonuç Birim Referans Aralık Eski Sonuç

Metabolik Analiz Profili (organik

asitler)
Teste ait rapor ektedir.

Dr. İ. Zümrüt DUMAN

Biyokimya ve Klinik Biyokimya Uzmanı
7348

Dış Laboratuvar testleri Kaptanpaşa Mah. Piyalepaşa bulvarı No:73 Okmeydanı/Şişli/İstanbul. adresinde faaliyet gösteren İstanbul Merkez Laboratuvarımızda (Özel Synevo
Tıbbi Tahlil Laboratuvarı) çalışılmıştır.

Laboratuvar Ruhsat Numarası: 406-B Bu raporun tamamı 1 sayfadır. ( 1 / 1 ) Rapor Baskı Tarihi : 27.05.2024 16:00
Form No: [Link].143 Revizyon No:00 [[Link]].[00-50-56-AC-8F-52] Yayın Tarihi:13.01.2020
Patient: Order Number: T0020048 Istanbul Laboratories Trade A.S.
Reported: February 12, 2024 Gurkan Gelibolu MD
DOB: August 15, 2018 Received: February 02, 2024 Kaptanpasa Mah., Piyalepasa Bulvari
Sex: Collected: January 30, 2024
Ortadogu Plaza No: 73 D:9 Okmeydani
MRN: B000160320 Istanbul, 34384
Turkey
Organix ® #3301 - Urine
Results Overview

MITOCHONDRIAL TOXIC METHYLATION

DYSFUNCTION EXPOSURE IMBALANCE

Functional Imbalance Scores

Key : Minimal Need for Support : Moderate Need for Support : High Need for Support

Need for Need for Need for

Mitochondrial Support Reduced Exposure Methylation Support
Mitochondrial Dysfunction Toxic Exposure Methylation Imbalance

4 0 0
FIGLU α-Hydroxyisobutyric Acid Methylmalonic Acid
Methylmalonic Acid α-Ketophenylacetic Acid FIGLU
Glutaric Acid Pyroglutamic Acid Vanilmandelic Acid
Lactic Acid Orotic Acid Creatinine
Pyruvic Acid Citric Acid
Citric Acid cis-Aconitic Acid
cis-Aconitic Acid Isocitric Acid
Isocitric Acid Glutaric Acid
α-Ketoglutaric Acid
Succinic Acid
Malic Acid
Adipic Acid
Suberic Acid

© Genova Diagnostics · A. L. Peace-Brewer, PhD, D(ABMLI), Lab Director · CLIA Lic. #34D0655571 · Medicare Lic. #34-8475 3301.11
Patient: ID: T0020048 Page 2

Nutrient Need Overview

Nutrient Need Suggested Provider
DRI Recommendations Recommendations

Antioxidants
Glutathione

B-Vitamins
Thiamin - B1 0.6 mg 10 mg

Riboflavin - B2 0.6 mg 10 mg

Niacin - B3 8 mg 20 mg

Pyridoxine - B6 0.6 mg 10 mg

Biotin - B7 12 mcg 200 mcg

Folate - B9 200 mcg 300 mcg

Cobalamin - B12 1.2 mcg 10 mcg

Minerals
Magnesium 130 mg 150 mg

Manganese 1.5 mg 2.0 mg

Zinc 5 mg 5 mg

GI Support
Digestive Support/Enzymes 0 IU

Microbiome Support/Probiotics 5 billion CFU

Recommendations for age and gender-specific supplementation are set by The Nutrient Need Overview is provided at the request of the ordering
comparing levels of nutrient functional need to optimal levels as described in practitioner. Any application of it as a therapeutic intervention is to be
the peer-reviewed literature. They are provided as guidance for short-term determined by the ordering practitioner.
support of nutritional deficiencies only.

© Genova Diagnostics · A. L. Peace-Brewer, PhD, D(ABMLI), Lab Director · CLIA Lic. #34D0655571 · Medicare Lic. #34-8475 3301.12
Patient: ID: T0020048 Page 3

Interpretation At-A-Glance
Antioxidant Needs
Glutathione

0
Glutathione (GSH) is composed of cysteine, glutamine & glycine. GSH is a
source of sulfate and plays a key role in antioxidant activity and detoxification
of toxins.
GSH requirement is increased with high-fat diets, cigarette smoke, cystinuria,
chronic alcoholism, chronic acetaminophen use, infection, inflammation and
toxic exposure.
Deficiency may result in oxidative stress & damage, impaired detoxification,
altered immunity, macular degeneration and increased risk of chronic illness.
Food sources of GSH precursors include meats, poultry, fish, soy, corn,
nuts, seeds, wheat germ, milk and cheese.

KEY

Function of Nutrient Cause of Deficiency Complications of Deficiency Food Sources of Nutrient

© Genova Diagnostics · A. L. Peace-Brewer, PhD, D(ABMLI), Lab Director · CLIA Lic. #34D0655571 · Medicare Lic. #34-8475 3301.13
Patient: ID: T0020048 Page 4

Interpretation At-A-Glance
B-Vitamin Needs
Thiamin - B1 Pyridoxine - B6

9 8
B1 is a required cofactor for enzymes involved in energy production from food, B6 (as P5P) is a cofactor for enzymes involved in glycogenolysis & gluconeo-
and for the synthesis of ATP, GTP, DNA, RNA and NADPH. genesis, and synthesis of neurotransmitters, heme, B3, RBCs and nucleic acids.
Low B1 can result from chronic alcoholism, diuretics, digoxin, oral contracep- Low B6 may result from chronic alcoholism, long-term diuretics, estrogens (oral
tives and HRT, or large amounts of tea & coffee (contain anti-B1 factors). contraceptives and HRT), anti-TB meds, penicillamine, L-DOPA or digoxin.
B1 deficiency may lead to dry beriberi (e.g., neuropathy, muscle weakness), B6 deficiency may result in neurologic symptoms (e.g., irritability, depression,
wet beriberi (e.g., cardiac problems, edema), encephalopathy or dementia. seizures), oral inflammation, impaired immunity or increased homocysteine.
Food sources include lentils, whole grains, wheat germ, Brazil nuts, peas, organ Food sources include poultry, beef, beef liver, fish, whole grains, wheat germ,
meats, brewer's yeast, blackstrap molasses, spinach, milk & eggs. soybean, lentils, nuts & seeds, potato, spinach and carrots.

Riboflavin - B2 Biotin - B7

8 10
B2 is a key component of enzymes involved in antioxidant function, energy Biotin is a cofactor for enzymes involved in functions such as fatty acid synthesis,
production, detoxification, methionine metabolism and vitamin activation. mitochondrial FA oxidation, gluconeogenesis and DNA replication & transcription.
Deficiency may result from certain inborn errors, chronic intake of raw egg
Low B2 may result from chronic alcoholism, some anti-psychotic medications,
whites, long-term TPN, anticonvulsants, high-dose B5, sulfa drugs & other
oral contraceptives, tricyclic antidepressants, quinacrine or adriamycin.
antibiotics.
B2 deficiency may result in oxidative stress, mitochondrial dysfunction, low uric Low levels may result in neurologic symptoms (e.g., paresthesias, depression),
acid, low B3 or B6, high homocysteine, anemia or oral & throat inflammation. hair loss, scaly rash on face or genitals or impaired immunity.
Food sources include yeast, whole grains, wheat germ, eggs, cheese, liver,
Food sources include milk, cheese, eggs, whole grains, beef, chicken, wheat
meats, fish, wheat, nuts & seeds, avocado, raspberries, sweet potato and
germ, fish, broccoli, asparagus, spinach, mushrooms and almonds.
cauliflower.

Niacin - B3 Folate - B9

6 6
B3 is used to form NAD and NADP, involved in energy production from food, Folate plays a key role in coenzymes involved in DNA and SAMe synthesis,
fatty acid & cholesterol synthesis, cell signaling, DNA repair & cell methylation, nucleic acids & amino acid metabolism and RBC production.
differentiation.
Low folate may result from alcoholism, high-dose NSAIDs, diabetic meds, H2
Low B3 may result from deficiencies of tryptophan (B3 precursor), B6, B2 or Fe
blockers, some diuretics and anti-convulsants, SSRIs, methotrexate,
(cofactors in B3 production), or from long-term isoniazid or oral contraceptive
trimethoprim, pyrimethamine, triamterene, sulfasalazine or cholestyramine.
use.
B3 deficiency may result in pellagra (dermatitis, diarrhea, dementia), neurologic Folate deficiency can result in anemia, fatigue, low methionine, increased
symptoms (e.g., depression, memory loss), bright red tongue or fatigue. homocysteine, impaired immunity, heart disease, birth defects and CA risk.

Food sources include poultry, beef, organ meats, fish, whole grains, peanuts, Food sources include fortified grains, green vegetables, beans & legumes.
seeds, lentils, brewer's yeast and lima beans.

Cobalamin - B12

3
B12 plays important roles in energy production from fats & proteins,
methylation, synthesis of hemoglobin & RBCs, and maintenance of nerve
cells, DNA & RNA.
Low B12 may result from alcoholism, malabsorption, hypochlorhydria (e.g., from
atrophic gastritis, H. pylori infection, pernicious anemia, H2 blockers, PPIs),
vegan diets, diabetic meds, cholestyramine, chloramphenicol, neomycin or
colchicine.
B12 deficiency can lead to anemia, fatigue, neurologic symptoms (e.g.,
paresthesias, memory loss, depression, dementia), methylation defects or
chromosome breaks.
Food sources include shellfish, red meat, poultry, fish, eggs, milk and cheese.

KEY

Function of Nutrient Cause of Deficiency Complications of Deficiency Food Sources of Nutrient

© Genova Diagnostics · A. L. Peace-Brewer, PhD, D(ABMLI), Lab Director · CLIA Lic. #34D0655571 · Medicare Lic. #34-8475 3301.14
Patient: ID: T0020048 Page 5

Interpretation At-A-Glance
Mineral Needs
Magnesium Manganese

0 6
Magnesium is involved in >300 metabolic reactions. Key areas include energy Manganese plays an important role in antioxidant function, gluconeogenesis,
production, bone & ATP formation, muscle & nerve conduction and cell the urea cycle, cartilage & bone formation, energy production and digestion.
signaling.
Impaired absorption of Mn may occur with excess intake of Fe, Ca, Cu, folic
Deficiency may occur with malabsorption, alcoholism, hyperparathyroidism, acid, or phosphorous compounds, or use of long-term TPN, Mg-containing
renal disorders (wasting), diabetes, diuretics, digoxin or high doses of zinc. antacids or laxatives.
Low Mg may result in muscle weakness/spasm, constipation, depression, Deficiency may result in impaired bone/connective tissue growth, glucose &
hypertension, arrhythmias, hypocalcemia, hypokalemia or personality changes. lipid dysregulation, infertility, oxidative stress, inflammation or hyperammonemia.

Food sources include dark leafy greens, oatmeal, buckwheat, unpolished Food sources include whole grains, legumes, dried fruits, nuts, dark green leafy
grains, chocolate, milk, nuts & seeds, lima beans and molasses. vegetables, liver, kidney and tea.

Zinc

0
Zinc plays a vital role in immunity, protein metabolism, heme synthesis,
growth & development, reproduction, digestion and antioxidant function.

Low levels may occur with malabsorption, alcoholism, chronic diarrhea,

diabetes, excess Cu or Fe, diuretics, ACE inhibitors, H2 blockers or digoxin.

Deficiency can result in hair loss and skin rashes, also impairments in growth &
healing, immunity, sexual function, taste & smell and digestion.

Food sources include oysters, organ meats, soybean, wheat germ, seeds,
nuts, red meat, chicken, herring, milk, yeast, leafy and root vegetables.

KEY

Function of Nutrient Cause of Deficiency Complications of Deficiency Food Sources of Nutrient

© Genova Diagnostics · A. L. Peace-Brewer, PhD, D(ABMLI), Lab Director · CLIA Lic. #34D0655571 · Medicare Lic. #34-8475 3301.15
Patient: ID: T0020048 Page 6

Interpretation At-A-Glance
Microbiome & Digestive Support
Microbiome Support/Probiotics Digestive Support/Enzymes

0 0
Probiotics have many functions. These include: production of some B Pancreatic enzymes are secreted by the exocrine glands of the pancreas and
vitamins and vitamin K; enhance digestion & absorption; decrease severity of include protease/peptidase, lipase and amylase.
diarrheal illness; modulate of immune function & intestinal permeability.
Pancreatic exocrine insufficiency may be primary or secondary in nature. Any
Alterations of gastrointestinal microflora may result from C-section delivery, indication of insufficiency warrants further evaluation for underlying cause (i.e.,
antibiotic use, improved sanitation, decreased consumption of fermented foods celiac disease, small intestine villous atrophy, small bowel bacterial
and use of certain drugs. overgrowth).

Some of the diseases associated with microflora imbalances include: IBS, A high functional need for digestive enzymes suggests that there is an
IBD, fibromyalgia, chronic fatigue syndrome, obesity, atopic illness, colic and impairment related to digestive capacity.
cancer.
Determining the strength of the pancreatic enzyme support depends on the
Food sources rich in probiotics are yogurt, kefir and fermented foods. degree of functional impairment. Supplement potency is based on the lipase
units present in both prescriptive and non-prescriptive agents.

Functional Imbalances

Mitochondrial Dysfunction Need for Methylation

4 0
Mitochondria are a primary site of generation of reactive oxygen species. Methylation is an enzymatic process that is critical for both synthesis and
Oxidative damage is considered an important factor in decline of physiologic inactivation. DNA, estrogen and neurotransmitter metabolism are all dependent
function that occurs with aging and stress. on appropriate methylation activity.

Mitochondrial defects have been identified in cardiovascular disease, fatigue

B vitamins and other nutrients (methionine, magnesium, selenium) functionally
syndromes, neurologic disorders such as Parkinson's and Alzheimer's disease,
support catechol-O-methyltransferase (COMT), the enzyme responsible for
as well as a variety of genetic conditions. Common nutritional deficiencies can
methylation.
impair mitochondrial efficiency.

Toxic Exposure

0
Methyl tert-Butyl Ether (MTBE) is a common gasoline additive used to
increase octane ratings, and has been found to contaminate ground water
supplies where gasoline is stored. Inhalation of MTBE may cause nose and
throat irritation, as well as headaches, nausea, dizziness and mental
confusion. Animal studies suggest that drinking MTBE may cause
gastrointestinal irritation, liver and kidney damage and nervous system
effects.

Styrene is classified by the US EPA as a "potential human carcinogen," and is

found widely distributed in commercial products such as rubber, plastic,
insulation, fiberglass, pipes, food containers and carpet backing.

Levels of these toxic substances should be examined within the context of the
body's functional capacity for methylation and need for glutathione.

KEY

Function of Nutrient Cause of Deficiency Complications of Deficiency Food Sources of Nutrient

© Genova Diagnostics · A. L. Peace-Brewer, PhD, D(ABMLI), Lab Director · CLIA Lic. #34D0655571 · Medicare Lic. #34-8475 3301.16
Patient: ID: T0020048 Page 7

Oxidative Stress & Mitochondrial Dysfunction

Fatty Acids Carbohydrates Proteins

Adipic Acid

Suberic Acid
Pyruvic Acid ▲ Lactic Acid

β-Oxidation Acetyl-CoA Amino Acids

Ketogenesis Citric Acid ▼

Oxaloacetic Acid

Malic Acid ▲ cis-Aconitic Acid

β-OH-Butyric Acid
Citric Acid Cycle

Fumaric Acid Isocitric Acid

Succinic Acid α-Ketoglutaric Acid

Coenzyme Q10 Glutathione

Lipid Peroxides 8-OHdG

Electron Transport Chain

© Genova Diagnostics · A. L. Peace-Brewer, PhD, D(ABMLI), Lab Director · CLIA Lic. #34D0655571 · Medicare Lic. #34-8475 3301.17
Patient: ID: T0020048 Page 8
All biomarkers reported in mmol/mol creatinine unless otherwise noted.

Organic Acids
Malabsorption & Dysbiosis Markers Vitamin Markers
Reference Reference
Malabsorption Markers Range Branched-Chain Catabolites (B1, B2, B3, ALA) Range
1.6 0.9
Indoleacetic Acid <= 4.2 α-Ketoadipic Acid <= 2.1
0.08 0.98
Phenylacetic Acid <= 0.15 α-Ketoisovaleric Acid <= 0.85
0.56
Dysbiosis Markers α-Ketoisocaproic Acid <= 0.91
2.0 2.4
Dihydroxyphenylpropionic α-Keto-β-Methylvaleric <= 2.3
<= 7.0
Acid (DHPPA) Acid
3.3 0.65
3-Hydroxyphenylacetic <= 9.2 Glutaric Acid <= 0.92
Acid
11 2.3
4-Hydroxyphenylacetic <= 37 Isovalerylglycine <= 5.4
Acid
0.04
Benzoic Acid <= 0.10 Methylation Markers (Folate, B12)
<dl 2.6
Hippuric Acid <= 921 Formiminoglutamic Acid <= 2.7
(FIGlu)
1.6
Yeast / Fungal Dysbiosis Markers Methylmalonic Acid <= 2.2
74
D-Arabinitol <= 51
Biotin Markers
3.6 19
Citramalic Acid <= 5.3 3-Hydroxypropionic Acid 6-23
<dl 39
Tartaric Acid <= 20 3-Hydroxyisovaleric Acid <= 38

Cellular Energy & Mitochondrial Markers Neurotransmitter Metabolites

Reference Reference
Fatty Acid Metabolism Range Kynurenine Markers (Vitamin B6) Range
1.4 6.9
Adipic Acid <= 5.0 Kynurenic Acid <= 9.2
1.6 11.3
Suberic Acid <= 4.2 Quinolinic Acid <= 11.6
0.61
Carbohydrate Metabolism Kynurenic / Quinolinic >= 0.46
Ratio
52 1.27
Pyruvic Acid 12-39 Xanthurenic Acid <= 1.07
9.7
Lactic Acid 3.7-14.6 Catecholamine Markers
0.55 4.1
α-Hydroxybutyric Acid <= 0.80 Homovanillic Acid 1.8-8.6
1.7 3.0
β-OH-Butyric Acid <= 3.4 Vanilmandelic Acid 1.5-5.0
7 0.18
β-OH-β-Methylglutaric <= 19 3-Methyl-4-OH- 0.07-0.41
Acid phenylglycol
Energy Metabolism Serotonin Markers
140 30.8
Citric Acid 62-648 5-OH-indoleacetic Acid 6.4-24.3
22 Reference
cis-Aconitic Acid 13-33 Toxin & Detoxification Markers Range
72 39
Isocitric Acid 38-97 Pyroglutamic Acid 22-64
20 0.28
α-Ketoglutaric Acid 12-55 α-Ketophenylacetic Acid <= 0.50
(from Styrene)
1.9 8.2
Succinic Acid 0.8-10.4 α-Hydroxyisobutyric Acid <= 8.7
(from MTBE)
1.7 0.70
Malic Acid <= 2.7 Orotic Acid 0.38-0.91

Methodology: GCMS, LC/MS/MS, Alkaline Picrate, Colorimetric Organic Acid Reference Ranges are Age Specific
© Genova Diagnostics · A. L. Peace-Brewer, PhD, D(ABMLI), Lab Director · CLIA Lic. #34D0655571 · Medicare Lic. #34-8475 3301.18
Patient: ID: T0020048 Page 9
Methodology: Colorimetric, Alkaline Picrate, GC/MS, LC/MS/MS

Organic Acids
Reference Reference
Oxalate Markers Range Creatinine Concentration Range

14.0 10.6
Glyceric Acid 4.0-19.8 Urine Creatinine ◆ 3.1-19.5
110 mmol/L
Glycolic Acid <= 101
34
Oxalic Acid <= 101

All biomarkers reported in mmol/mol creatinine.

Oxidative Stress Markers

Reference
Oxidative Damage Range

6
8-OHdG (urine) <= 15
mcg/g Creat.

The Oxidative Stress reference ranges are based on an adult population.

Pathways
Methylation Markers

Methylmalonyl CoA Methylmalonic Acid FIGLU ▲

MMA Mutase Glutamate

Formiminotransferase

Succinic Acid Glutamic Acid

Branch-Chain Amino Acid Metabolism

Valine α-Ketoisovaleric Acid ▲

Leucine α-Ketoisocaproic Acid Branched Chain

a-Ketoacid Dehydrogenase
Isoleucine α-Keto-β-Methylvaleric Acid ▲

Acetyl-CoA
Krebs
Succinic Acid
Cycle

© Genova Diagnostics · A. L. Peace-Brewer, PhD, D(ABMLI), Lab Director · CLIA Lic. #34D0655571 · Medicare Lic. #34-8475 3301.19
Patient: ID: T0020048 Page 10

Commentary
For more information regarding Organic Acids clinical interpretation, please refer to the Organic Acids Support
Guide at [Link]/nutrevalguide.

<dl = less than detection limit; >ul = greater than upper linearity limit; NR = Not Reportable.

Lab Comments
The Reference Range is a statistical interval representing 95% or 2 Standard Deviations (2 S.D.) of the reference
range population. One Standard Deviation (1 S.D.) is a statistical interval representing ~68% of the reference
population. Values between 1 and 2 S.D. are not necessarily abnormal. Clinical Correlation is suggested.

The performance characteristics of all assays have been verified by Genova Diagnostics, Inc. Unless otherwise noted
with ◆, the assay has not been cleared by the U.S. Food and Drug Administration.

© Genova Diagnostics · A. L. Peace-Brewer, PhD, D(ABMLI), Lab Director · CLIA Lic. #34D0655571 · Medicare Lic. #34-8475 3301.20
 Lipid Peroxides (Urine)

Patient: Order Number: T0020048 Istanbul Laboratories Trade A.S.

Reported: February 12, 2024 Gurkan Gelibolu MD
DOB: August 15, 2018 Received: February 02, 2024 Kaptanpasa Mah., Piyalepasa Bulvari
Sex: M Collected: January 30, 2024
Ortadogu Plaza No: 73 D:9 Okmeydani
MRN: B000160320 Istanbul, 34384
Turkey

Lipid Peroxides (Urine)

Reference Range
Urine Lipid Peroxides 10.4 <= 10.0 umol/g Creat.

Lab Comments

The performance characteristics of all assays have been verified by Genova Diagnostics, Inc. Unless otherwise
noted with , the assay has not been cleared by the U.S. Food and Drug Administration.

Commentary is provided to the practitioner for educational purposes, and should not be interpreted as diagnostic or
as treatment recommendations. Diagnosis and treatment decisions are the practitioner's responsibility.

Urine lipid peroxides is a marker of free radical damage in the body. An elevated level may reflect excess free
radical production and/or insufficient antioxidants. Free radical damage is thought to underlie many processes such
as atherosclerosis, chronic fatigue syndrome, cancer, cardiovascular disease, Parkinson's disease, Alzheimer's, and
aging.

© Genova Diagnostics · A. L. Peace-Brewer, PhD, D(ABMLI), Lab Director · CLIA Lic. #34D0655571 · Medicare Lic. #34-8475
ULIP1 RMS 101 Rev 2