11 Comments

I understand that you support continuing supplements before functional testing, and I do the same with my patients. However, I’m curious about your thoughts on B6 supplementation before testing. Some of my patients are on a methylated multivitamin containing 75 mg of Vitamin B6 (as pyridoxine HCl and pyridoxal 5'-phosphate), and their fasting B6 levels often come back significantly elevated—sometimes double the upper limit. This causes concern for them. What are your thoughts on this?

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In general I don't think elevated B6 is useful as a marker of neuropathy. The presence of neuropathy is useful as a marker of neuropathy. If they stop the supplement for a week and the level is normal, what insight did you gain?

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I will try that and see what comes up having them remove supplements for a week before testing. I understand that pyridoxine HCl has a much shorter half life than pyridoxal 5'-phosphate (hours vs weeks). I guess that if the levels come back to normal in a week, then their p5p clearance is working pretty fast and that I would need to reduce their P5P daily intake. What do you think?

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I would think if reducing P5P resolved neuropathy, the P5P was the cause of the neuropathy, and the testing is a waste of time.

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Hi Chris,

From CheatSheet 3: 'Free copper index: subtract (ceruloplasmin * 3.15 in mcg/L) from serum copper in mcg/L. This is the free copper. Divide this by the serum copper to yield the % free copper. If free copper is above 15 or the % free copper is above 15%, see Elevated Free Copper below.'

My ceruloplasmin is 19.3 mg/dL and serum copper is 13.2 µmol/L;

Conversion: ceruloplasmin 193,000 µg/L; serum copper 838.8072 µg/L; I used unitslab.com for conversion of copper.

Calc: 19.3 µg/L x 3.15 = 607950 µg/L;

838.8072 µg/L - 607950 µg/L= -607,111.1928 µg/L -> free copper

-607,111.1928 µg/L : 838.8072 µg/L = ~ -723,78 %

This makes no sense - but I can't find the mistake

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free copper as calculated by the lab is 2.87 µmol/L

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If someone wants to get their nutrients tested but is on a feeding tube for part of their nutrition, would the vitamins added to the formula impact lab test results?

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Some of them, but not in a way that makes testing not useful.

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Hi Chris, Multiple times in your cheat sheet you recommend the Genova ION + 40 Amino Acids test (test #3102). Going to the provided link at https://www.gdx.net/nutrition, I don't see that test anywhere!

Has it been discontinued? If so, what test(s) do you recommend instead? I was about to order one.

thanks.

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Doctors can order it inside their portal and DTC companies like truehealthlabs should allow you to order it. If all else fails get the NutrEval.

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Chris, I believe you used to live in New York & are likely familiar with the legal limitations around Genova testing in this state. Do you have any recommendations for how a New Yorker could get a blood draw for the NutrEval, i.e. via a physician in New Jersey or Connecticut, potentially?

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