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What Do The Following Test Reports Indicate?
Question: I recently had an Organic Acids Test, and some of the neurotransmitter metabolism markers were above or below expected ranges (see attached image). I'd like more information on what each these might mean:
VMA levels below the mean. I understand this may indicate lower production of norepinephrine or adrenaline. Would supplementation with precursors phenylalanine or tyrosine possibly help? I've also read that supplementation with enzyme cofactors like magnesium, B6 and biopterin may also help.
High HVA/VMA ratio. I understand this often indicates decreased conversion of dopamine to norepinephrine and epinephrine, and that this process is copper and vitamin C dependent. Might supplementation with copper or vitamin C help?
5-HIAA levels below the mean. I've read that this may indicate lower production of serotonin. Could supplementation with the precursor 5-HTP help?
High quinolinic acid / 5-HIAA ratio. I've read that this may be a sign of neural excitotoxicity. Because quinolinic acid wasn't high, I suspect this is related to low 5-HIAA levels. Is this a reasonable assessment of the ratio?
Thanks!
VMA levels below the mean. I understand this may indicate lower production of norepinephrine or adrenaline. Would supplementation with precursors phenylalanine or tyrosine possibly help? I've also read that supplementation with enzyme cofactors like magnesium, B6 and biopterin may also help.
High HVA/VMA ratio. I understand this often indicates decreased conversion of dopamine to norepinephrine and epinephrine, and that this process is copper and vitamin C dependent. Might supplementation with copper or vitamin C help?
5-HIAA levels below the mean. I've read that this may indicate lower production of serotonin. Could supplementation with the precursor 5-HTP help?
High quinolinic acid / 5-HIAA ratio. I've read that this may be a sign of neural excitotoxicity. Because quinolinic acid wasn't high, I suspect this is related to low 5-HIAA levels. Is this a reasonable assessment of the ratio?
Thanks!
Brief Answer:
Read below.
Detailed Answer:
I read your question carefully and I understand your concern faced with those tests results.
First I must say that the use of such tests is really questionable. Tests such as organic acids tests have not been approved by the FDA (or any other regulatory authority in other countries). They are tests created by certain laboratories and neither their accuracy nor their clinical significance has been proven. At times such tests are simply a means for these laboratories of making more money. The same goes for many supplements in the market. So while you could try all those supplements you mention, beware that it is often a commercial issue at stake, the value of some of those supplements you mention is unproven as taking them doesn’t mean that after ingestion they will travel to the cells and enzymatic pathways you intend them to.
Looking at those tests results and the reference ranges provided by that laboratory it seems to me that the values of the metabolites themselves are inside their normal range. The reference range for VMA is 0.53-2.2 and the value is 0.96, inside normal range. The same goes for homovanillic acid (1.5 value with a reference range of 0.39-2.2) and 5HIAA (0.18 value with <2.9 being normal).
Also values may be altered by many factors, in many links of the metabolic chain, low values in the urine doesn’t indicate the values at a cellular level in the brain and cerebrospinal fluid. So values (apart from the test validity issue) have a significance only when related to symptoms (of which you mention nothing).
Regarding the ratios, high HVA/VMA ratio may be caused by Clostridia by products, including HPHPA, 4-cresol, and 4-hydroxyphenylacetic acid, but you do not mention those to be altered, significance is questionable. Vitamin C is a cofactor of dopamine beta hydroxylase so it may be used as it also has plenty of other benefits, I am not aware of any benefit from copper.
High quinolinic acid / 5-HIAA ratio may be due to low 5-HIAA but may also be due to recurrent infections so if that is your case may be an alternative explanation.
Of those tests the one which may have some value is the 5-HIAA one. It is thought that low values may be found in depression, although again it is more a subject of study, not a conclusion. 5-HTP may be used for that purpose, there is some evidence about its benefit in depression.
I remain at your disposal for other questions.
Read below.
Detailed Answer:
I read your question carefully and I understand your concern faced with those tests results.
First I must say that the use of such tests is really questionable. Tests such as organic acids tests have not been approved by the FDA (or any other regulatory authority in other countries). They are tests created by certain laboratories and neither their accuracy nor their clinical significance has been proven. At times such tests are simply a means for these laboratories of making more money. The same goes for many supplements in the market. So while you could try all those supplements you mention, beware that it is often a commercial issue at stake, the value of some of those supplements you mention is unproven as taking them doesn’t mean that after ingestion they will travel to the cells and enzymatic pathways you intend them to.
Looking at those tests results and the reference ranges provided by that laboratory it seems to me that the values of the metabolites themselves are inside their normal range. The reference range for VMA is 0.53-2.2 and the value is 0.96, inside normal range. The same goes for homovanillic acid (1.5 value with a reference range of 0.39-2.2) and 5HIAA (0.18 value with <2.9 being normal).
Also values may be altered by many factors, in many links of the metabolic chain, low values in the urine doesn’t indicate the values at a cellular level in the brain and cerebrospinal fluid. So values (apart from the test validity issue) have a significance only when related to symptoms (of which you mention nothing).
Regarding the ratios, high HVA/VMA ratio may be caused by Clostridia by products, including HPHPA, 4-cresol, and 4-hydroxyphenylacetic acid, but you do not mention those to be altered, significance is questionable. Vitamin C is a cofactor of dopamine beta hydroxylase so it may be used as it also has plenty of other benefits, I am not aware of any benefit from copper.
High quinolinic acid / 5-HIAA ratio may be due to low 5-HIAA but may also be due to recurrent infections so if that is your case may be an alternative explanation.
Of those tests the one which may have some value is the 5-HIAA one. It is thought that low values may be found in depression, although again it is more a subject of study, not a conclusion. 5-HTP may be used for that purpose, there is some evidence about its benefit in depression.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for the thorough and easy-to-understand answer. I should've mentioned my symptoms and the reason for getting the organic acids test in the first place.
About three years ago, I began to suffer from spasmodic dysphonia (SD). Around that same time, I also had an MRI indicating scattered mild white matter disease. Since then, I've been researching SD on PubMed and other online sources to understand current thinking about the etiology (which I know is not well understood).
The reason I took the organic acids test was admittedly a reach. The goal was to see if any neurotransmitter metabolism markers might indicate potential abnormalities in the dopaminergic pathways (which apparently are sometimes seen in other focal dystonias).
This is just one of many small steps I'm taking to try and understand what may have caused the onset of SD.
Thank you again for your thorough answer. I really appreciate it!
XXXX
About three years ago, I began to suffer from spasmodic dysphonia (SD). Around that same time, I also had an MRI indicating scattered mild white matter disease. Since then, I've been researching SD on PubMed and other online sources to understand current thinking about the etiology (which I know is not well understood).
The reason I took the organic acids test was admittedly a reach. The goal was to see if any neurotransmitter metabolism markers might indicate potential abnormalities in the dopaminergic pathways (which apparently are sometimes seen in other focal dystonias).
This is just one of many small steps I'm taking to try and understand what may have caused the onset of SD.
Thank you again for your thorough answer. I really appreciate it!
XXXX
Brief Answer:
Read below
Detailed Answer:
Thank you for the additional information.
The mechanisms of dystonia are still not that clear, even in our modern days medicine. Yes there are a few which are influenced by dopamine. However I doubt that taking precursors of the dopamine pathway will help. That is because it is not the lack of substrate which is the cause, it is thought to be genetic defects in certain enzymes or channels, so whether one adds supplements or not shouldn't be of much use if the pathway is defective it won't be able to use them.
Even in those forms sensitive to dopamine we administer the end product directly in the form of levodopa, there is no medication to correct the genetic defects. I hope that I am being understandable.
Let me know if I can further assist you.
Read below
Detailed Answer:
Thank you for the additional information.
The mechanisms of dystonia are still not that clear, even in our modern days medicine. Yes there are a few which are influenced by dopamine. However I doubt that taking precursors of the dopamine pathway will help. That is because it is not the lack of substrate which is the cause, it is thought to be genetic defects in certain enzymes or channels, so whether one adds supplements or not shouldn't be of much use if the pathway is defective it won't be able to use them.
Even in those forms sensitive to dopamine we administer the end product directly in the form of levodopa, there is no medication to correct the genetic defects. I hope that I am being understandable.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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