0290 Cardio/ION Profile

Similar documents
0091 Organix Comprehensive Profile Methodology: LC/Tandem Mass Spectroscopy, Colorimetric Summary of abnormal results:

Comprehensive Fatty Acids Panel - Serum

The Holman Omega 3 Test Report

The Holman Omega 3 Test Report

AMINO BALANCE PRODUCTS L-ARGININE PRODUCTS

I N T E R P R E T I V E G U I D E L I N E S. Amino Acids Analysis A S S E S S M E N T S N U T R I T I O N A L

Dietary Reference Intakes (DRIs): Estimated Average Requirements Food and Nutrition Board, Institute of Medicine, National Academies

Micronutrient. Functio. Vitamin A

VITAMIN. guide. It s time to simplify vitamins. Tips and advice from your pharmacist. Look inside for your free money-saving Vitamin Club Card.

PATIENT INFORMATION LEAFLET: CENTRUM. Read the contents of this leaflet carefully before you start using CENTRUM, because it

Product Information: PediaSure

SCOPE OF ACCREDITATION TO ISO/IEC 17025:2005

Human Tubal Fluid (HTF) Media & Modifi ed Human Tubal Fluid (mhtf) Medium with Gentamicin

After all, our children deserve the very best!

Item #3003 Item #3001. SRP: $ Tablets SRP: $ Capsules

Product Category: Similac

S.NO. COMPOSITION PACK TYPE AVAILABLE 1

Product Information: Glucerna 1.5 Cal

Blood Testing Protocols. Disclaimer

Rediscover What It Means to Be Full of Life

Elevated Cholesterol and Homocysteine

Interpretive Guide for Fatty Acids

Functional Vitamin, Mineral and Antioxidant Assessment. J.F. Crawford, PhD. SpectraCell Laboratories, Inc. Houston, TX

This Regulation shall be binding in its entirety and directly applicable in all Member States.

Copyright Mark Brandt, Ph.D. 35

Management of Fibromyalgia: Rationale for the use of Magnesium and Malic Acid. Journal of Nutritional Medicine

Trans Fatty Acids Labeling

Essentials of Anatomy and Physiology, 5e (Martini/Nath) Chapter 17 Nutrition and Metabolism. Multiple-Choice Questions

I The THREE types of LIPIDS

Product Category: Osmolite

Surthrival Colostrum. What 3rd Party Analysis Reveals

National Food Safety Standard Standard for nutrition labelling of prepackaged foods

DAILY MAXIMUM INTAKE LIMIT IN HEALTH FUNCTIONAL FOOD ACT

Nutrient Reference Values for Australia and New Zealand

Disease Specific Nutrition

Product Information: Promote

Product Information: Osmolite 1.2 Cal

Grow Taller 4 Idiots 2

CELLULAR HEALTH COMMUNICATIONS Volume 1, Number 1, 2001

Product Information: Jevity 1.2 Cal

Hill s Evidence-Based Clinical Nutrition for Dermatology Specialists

OMEGA 3 REPORT. Source: and

Your Vitamin and Mineral Needs Before and After Bariatric Surgery

WAITE LIPID ANALYSIS SERVICE

FROM START TO FINISH: AN INTEGRATIVE ONCOLOGY CASE STUDY. Tanya Wells

Glutathione and Oxidative Stress - Part I

The Under-Recognized Role of Essential Nutrients in Health and Health Care

TOTAL PROTEIN FIBRINOGEN

Nutrition After Weight Loss Surgery

Margarines and Heart Disease. Do they protect?

Product Information: Jevity 1.5 Cal

Chapter 16 The Citric Acid Cycle

Restore and Maintain treatment protocol

NUTRITION OF THE BODY

Rheumatoid Arthritis. Treating Inflammation. Sequoia Education Systems, Inc 1. How is RA Diagnosed?

Chapter 25: Metabolism and Nutrition

CHAPTER 15: ANSWERS TO SELECTED PROBLEMS

Examples of Gemini Pharmaceuticals Common Supplement Products

Why Take a High Concentrate Fish Oil?

Bariatric Patients, Nutritional Intervention for

Benefit Criteria for Vitamin and Mineral Products to Change for the CSHCN Services Program

Product Information: Jevity 1.5 Cal

Lecture 4 Sunday 30/9/2012

25-hydroxyvitamin D: from bone and mineral to general health marker

PATIENT INFORMATION LEAFLET. Forceval Junior Capsules

Why is a Comprehensive Metabolic Blood Chemistry panel included in the FNHP?

CODEX STANDARD FOR FOLLOW-UP FORMULA CODEX STAN This standard applies to the composition and labelling of follow-up formula.

Body Composition & Longevity. Ohan Karatoprak, MD, AAFP Clinical Assistant Professor, UMDNJ

Essential Nutrients, Phytochemicals and Human Brain Function

Product Information: Similac Human Milk Fortifier Hydrolyzed Protein Concentrated Liquid

CAT FOOD PREMIUM PREVENTION BY NUTRITION. krmivo-brit.cz

Chapter 7 The Pauling Therapy

PATIENT INFORMATION LEAFLET. Forceval Capsules

DEPRESSION. William J. Walsh, Ph.D.

Methyl groups, like vitamins, are

METHODS OF VITAMIN ANALYSIS

Why are Vitamin and Mineral Supplements so Important Before and after Bariatric Surgery? 6/4/2014 1

Dietary Reference Intakes: Vitamins

Benefit Criteria for Vitamin and Mineral Products to Change for Texas Medicaid

Why are Carlson FISH OILS (and Calamari Oils) important for me?

Nutritional Support of the Burn Patient

Nutrition Guide For Bobwhite Quail Production

Overview. Nutritional Aspects of Primary Biliary Cirrhosis. How does the liver affect nutritional status?

Pantesin Effective support for heart healthy cholesterol levels*

Amino Acids, Peptides, Proteins

Nutrition and Parkinson s Disease: Can food have an impact? Sarah Zangerle, RD, CD Registered Dietitian Froedtert Memorial Lutheran Hospital

Non Medicinal: cellulose, para amino benzoic acid, silicon dioxide, vegetable grade magnesium stearate (lubricant); Gelatin capsule.

Nutrition Requirements

USANA MICRO-NUTRITIONAL PRODUCTS KEY BENEFITS

Testing Services Catalog

Acne vulgaris, mental health and omega-3 fatty acids. Lipids in Health and Disease. October 13, 2008

Carlson Cod Liver Oil contains the important omega-3s, DHA & EPA.

Description and Composition of Flax

1. What has a higher stored energy potential per gram, glycogen or triglycerides? Explain.

February Best Foods for Athletes

Product Category: Vital

Transcription:

Ordering Physician: Metametrix 1234 Main St. Anywhere, GA 30096 Accession Number: Order Number: G1234567 Reference Number: Patient: Age: 51 Date Collected: Report Date: Telephone: Fax: Reprinted: Comment: Sex: 4/3/13 Date Received: 4/4/13 Female Date of Birth: 02/05/1962 4/16/13 7704464583 7704412237 7/17/13 0290 Cardio/ION Profile

Ordering Physician: Date Received: 4/4/2013 Date Reported: 4/16/2013 Cardiovascular Health Profile - Serum, Plasma & Erythrocytes Lipoprotein Factors Methodology: Automated Chemistry, Immunometric Assay,Competitive Immunology, HPLC, ICP-MS Reference Limits Total Cholesterol 394 H < 200 mg/dl HDL Cholesterol 105 >= 50 mg/dl LDL Cholesterol (Direct) 275 H < 130 mg/dl Triglycerides 74 < 150 mg/dl Lipoprotein (a) 45 H <= 37 mg/dl Lipoprotein Ratios LDL/HDL 2.6 <= 3.3 Total/HDL 3.8 <= 4.5 Chronic Inflammatory Markers Male Female LDL/HDL Total/HDL LDL/HDL Total/HDL Risk (*) 1.0 3.4 1.5 3.3 0.5xAverage 3.6 5.0 3.2 4.4 1.0xAverage 6.3 9.6 5.0 7.1 2.0xAverage 8.0 23.4 6.1 11.0 3.0xAverage *Adapted from the Framingham Heart Study Ferritin 59 6-159 ng/ml Fibrinogen 350 175-425 mg/dl c-reactive Protein (HS) 2.1 <= 3.0 mg/l Cardio CRP value (mg/l) CHD Risk Level * If the cardio CRP concentration exceeds 10 mg/l after repeat <1 Low testing, the patient should be evaluated for noncardiovascular 1-3 Average etiologies. >3 (up to 10)* High Other Important Indicators Insulin 4.1 2.0-12.0 µiu/ml Testosterone 30 <= 51 ng/dl Sex Hormone Binding Globulin 46 18-114 nmol/l Free Androgen Index (calc.) 2.3 <= 4.6 Magnesium Oxidant Stress Factors 44 44 95% Reference Interval 34-63 4.0 10.0 Homocysteine 10.8 H 3.0-14.0 nmol/ml Coenzyme Q10 0.80 0.64 2.16 0.48-3.04 mg/l alpha-tocopherol 12.5 9.8 25.1 6.8-31.7 mg/l gamma-tocopherol 0.67 0.26 2.06 0.06-2.99 mg/l 1.72 Lipid Peroxides 0.70 <= 2.60 nmol/ml ppm Fibrinogen performed by Southern Clinical Laboratory 405 West Pike St.,Suite A Lwrenceville, GA 30045 Lab Director: Dr. Robert David Page 1

0 5 10 Total Cholesterol Triglycerides Lipoprotein (a) LDL/HDL Total/HDL Ferritin Fibrinogen c-reactive Protein (HS) Coenzyme Q10 alpha-tocopherol gamma-tocopherol Lipid Peroxides Homocysteine Magnesium Insulin Free Androgen Index (calc.) Better Negative Effect on Cardiovascular Health Worse Most of the nutritional and metabolic measurements included in the Cardio/ION profile are associated to some degree with your cardiovascular health. However, those shown on the previous page of this report are ones that most strongly and specifically affect your cardiovascular health. Some factors are favorable for cardiac health when they are high, while others should be low. The chart above helps you to see where the most significant abnormalities are; the longest bars on the chart show the most abnormal results on a scale of increasing negative effects on cardiovascular health. The "Cardiovascular Index" chart below shows your test results with all of the factors summarized as a single index. Depending on your results, some steps that your doctor may want you to take to improve your cardiovascular health are shown in the tables of recommendations at the end of these pages. It is important that you follow your doctor's instructions to achieve the lowest index. Cardiovascular Index = 2.8 0 5 10 All Factors Favorable All Factors Unfavorable These guidelines are intended as a starting point for the clinician who requested the test and are based only on the laboratory results included in this report. Final recommendations should be implemented by the clinician with consideration of medical history and current clinical observations. These tests are not intended for the diagnosis of specific disorders. Page 2

Ordering Physician: Date Received:04/04/2013 Date Reported: 04/16/2013 Amino Acids 20 Profile - Plasma Methodology: High Performance Liquid Chromatography Ranges: Ages 13 and over. Essential Amino Acids Limiting Amino Acids 1 2 3 Lysine Methionine Tryptophan µmol/l 158 17 49 117 16 35 203 26 59 95% Reference Interval 99-234 14-30 30-67 Branched Chain Amino Acids 4 5 6 Isoleucine Leucine Valine 63 113 225 40 80 143 72 137 240 33-89 68-161 123-282 Other Essential Amino Acids 7 8 9 Phenylalanine Histidine Threonine 44 65 88 43 48 76 64 72 151 39-74 41-82 63-181 Conditionally Essential Amino Acids 10 11 12 13 Arginine Taurine Glycine Serine 65 49 300 114 48 31 162 66 96 73 348 115 37-114 26-100 136-430 57-133 Page 3

Ordering Physician: Date Received:04/04/2013 Date Reported: 04/16/2013 Amino Acids 20 Profile - Plasma Ranges are for ages 13 and over. Functional Categories Vascular Function µmol/l 48 14 Arginine 65 31 15 Taurine 49 Methodology: High Performance Liquid Chromatography 96 73 95% Reference Interval 37-114 26-100 Neurotransmitters and Precursors 43 16 Phenylalanine 44 38 17 Tyrosine 41 35 18 Tryptophan 49 29 19 Glutamic Acid 51 31 20 Taurine 49 64 70 59 95 73 39-74 29-80 30-67 23-136 26-100 Sulfur Amino Acids (Glutathione - related) 16 21 Methionine 17 31 22 Taurine 49 26 73 14-30 26-100 Urea Cycle and Ammonia Detoxification 48 23 Arginine 65 20 24 Citrulline 17 L 32 25 Ornithine 39 397 26 Glutamine 544 30 27 Asparagine 38 4.8 28 Aspartic Acid 7.0 96 38 81 585 49 9.7 37-114 15-44 23-109 338-630 26-56 4.2-12.5 Ratios 1.44 29 Phenyalanine/Tyrosine 1.07 0.06 0.21 30 Glutamic Acid/Glutamine 0.09 0.100 0.106 31 Tryptophan/LNAA* 0.101 *Large neutral amino acids (Leu+Ile+Val+Phe+Tyr) <= 1.44 0.05-0.35 0.095-0.106 Page 4

Ordering Physician: Homocysteine Assay - Plasma nmol/ml Date Received: 4/4/2013 Date Reported: 4/16/2013 Methodology: Competitive Immunoassay 95% Reference Interval 4.0 10.0 Homocysteine 10.8 H 3.0-14.0 Page 5

Ordering Physician: Date Received: 4/4/2013 Date Reported: 4/16/2013 Nutrient & Toxic Elements Profile - Blood Methodology: Inductively Coupled Plasma /Mass Spectroscopy 95% Reference Interval Nutrient Elements Erythrocytes (packed cells) 1 Potassium 3,157 3,055 2,426-4,472 ppm 44 2 Magnesium 44 34-63 ppm 44 3 Calcium* 33 24-65 ppm Plasma 815 4 Zinc 1,207 929 5 Copper 773 L Whole Blood 0.16 6 Selenium 0.21 Toxic Elements Whole Blood 45 7 Aluminum 13 5.1 8 Arsenic <2.34 0.60 9 Cadmium <0.39 18 10 Lead 9 4.3 11 Mercury 6.0 643-1,594 753-1,920 0.13-0.32 <= 140 <= 13.7 <= 1.50 <= 36 <= 13.8 ppb ppb ppm ppb ppb ppb ppb ppb *Relevant to membrane permeability, not nutritional status. Toxic metals are flagged high when the result is above the 95% Reference Interval. for whole blood toxic elements that are within normal limits do not rule out metal accumulation in other tissues. This can be evaluated with urinary porphyrin or urine elements tests. Page 6

Ordering Physician: CoEnzyme Q10 Plus Vitamins Profile - Serum Date Received: 4/4/2013 Date Reported: 4/16/2013 Methodology: High Performance Liquid Chromatography mg/l 95% Reference Interval 0.64 2.16 1 Coenzyme Q10 0.80 0.48-3.04 9.8 25.1 2 alpha-tocopherol 12.5 6.8-31.7 0.26 2.06 3 gamma-tocopherol 0.67 0.06-2.99 0.36 0.74 4 Vitamin A 0.82 H 0.29-1.05 0.15 1.70 5 β-carotene 0.35 0.10-2.71 Lipid Peroxide Assay - Serum 6 Methodology: High Performance Liquid Chromatography nmol/ml 1.72 Lipid Peroxides 0.70 <= 2.60 DNA/Oxidative Stress Marker Assay - Urine Ranges are for ages 13 and over. ng/mg creatinine Methodology: LC/Tandem Mass Spectroscopy, Colorimetric 5.3 7 8-Hydroxy-2-deoxyguanosine 2.0 <= 7.6 Vitamin D Profile - Serum ng/ml Methodology: LC/Tandem Mass Spectroscopy Reference Interval 8 25-Hydroxyvitamin D 56.3 Sufficient 30.0-100.0 30 50 80 100 Optimal 9 25-Hydroxyvitamin D2 10 25-Hydroxyvitamin D3 0.4 55.9 Total 25-Hydroxyvitamin D is considered the best assessment of vitamin D status. The test reflects vitamin D from all sources (diet, supplements, and sun exposure). A 2011 Endocrine Society Clinical Practice Guideline suggested vitamin D deficiency be defined as < 20 ng/ml, insuffuciency as 21-29 ng/ml, and sufficiency as 30-100 ng/ml.¹ The Vitamin D Council has proposed 50-80 ng/ml as optimal, and 100 ng/ml as an upper limit.² 25-Hydroxyvitamin D3 is from sun exposure, vitamin D-rich foods, or vitamin D3 supplements. 25-Hydroxyvitamin D2 is only from fortified foods or supplements. 1. Holick MF, Binkley, NC, Bischoff-Ferrari, HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. July 2011, 96(7):1911-1930. 2. Vitamin D Council http://www.vitamindcouncil.org. Conversion factors: nmol/l = ng/ml x 2.5 ng/ml = nmol/l x 0.4 * <DL = less than detection limit Page 7

Ordering Physician: Date Received: 4/4/2013 Date Reported: 4/16/2013 Fatty Acids Profile - Plasma Ranges: Ages 13 and over. µmol/l Methodology: Capillary Gas Chromatography/Mass Spectrometry 95% Reference Interval Polyunsaturated Omega-3 20 1 Alpha Linolenic (18:3n3) 18 L 13-80 17 2 Eicosapentaenoic (20:5n3) 10 L 5-210 16 3 Docosapentaenoic (22:5n3) 11 L 11-50 59 4 Docosahexaenoic (22:6n3) 32 L 31-213 Polyunsaturated Omega-6 930 1,669 5 Linoleic (18:2n6) 642 L 821-2,032 7 33 6 Gamma Linolenic (18:3n6) 11 5-46 6.4 15.3 7 Eicosadienoic (20:2n6) 5.1 L 5.2-22.5 34 102 8 Dihomogamma Linolenic (20:3n6) 35 27-140 201 451 9 Arachidonic (20:4n6) 209 158-521 0.9 10 Docosadienoic (22:2n6) <0.23 <= 2.0 3.7 13.8 11 Docosatetraenoic (22:4n6) 4.6 2.6-18.1 Polyunsaturated Omega-9 5.3 12 Mead (20:3n9) 2.9 <= 8.3 Monounsaturated 1.2 6.1 13 Myristoleic (14:1n5) 2.0 0.8-9.7 40 155 14 Palmitoleic (16:1n7) 28 L 30-256 48 93 15 Vaccenic (18:1n7) 26 L 40-122 555 1,182 16 Oleic (18:1n9) 561 466-1,470 4.6 10.3 17 11-Eicosenoic (20:1n9) 2.6 L 3.7-18.1 1.1 2.2 18 Nervonic (24:1n9) <1.1 L 1.1-2.7 Page 8

Ordering Physician: Fatty Acids Profile - Plasma Date Received: 4/4/2013 Methodology: Capillary Gas Chromatography/Mass Spectrometry Ranges: Ages 13 and over. Saturated 95% µmol/l Reference Interval 1.4 4.0 19 Capric (10:0) 4.8 H 0.7-6.2 3.3 14.5 20 Lauric (12:0) 6.9 2.2-27.3 20 87 21 Myristic (14:0) 34 15-139 792 1,794 22 Palmitic (16:0) 924 667-2,526 294 511 23 Stearic (18:0) 367 250-629 1.5 3.2 24 Arachidic (20:0) 1.7 1.3-4.7 0.8 2.0 25 Behenic (22:0) 0.9 0.6-2.9 0.84 1.66 26 Lignoceric (24:0) 0.86 0.63-2.45 0.36 27 Hexacosanoic (26:0) <0.27 <= 0.43 Odd Chain 14.5 28 Pentadecanoic (15:0) 7.8 <= 20.6 19.3 29 Heptadecanoic (17:0) 9.7 <= 24.4 1.51 30 Nonadecanoic (19:0) 0.91 <= 1.89 0.50 31 Heneicosanoic (21:0) 32 Tricosanoic (23:0) Trans <0.38 <0.37 0.62 <= 0.74 <= 0.78 0.4 33 Palmitelaidic (16:1n7t) <0.4 <= 1.8 42 34 Total C:18 Trans 35 <= 59 Ratios 30 35 LA/DGLA 18 11-46 0.24 36 EPA/DGLA 0.29 0.07-5.98 20 37 AA/EPA 21 H 1-57 0.016 38 Triene/Tetraene 0.014 <= 0.023 Page 9

Ordering Physician: Date Received: 4/4/2013 Date Reported: 4/16/2013 Organix Comprehensive Profile - Urine Ranges: Ages 13 and over. Nutrient Markers mcg/mg creatinine Methodology: LC/Tandem Mass Spectroscopy, Colorimetric 95% Reference Interval Fatty Acid Metabolism (Carnitine & B2) 6.2 1 Adipate 1.0 <= 11.1 2.1 2 Suberate 1.0 <= 4.6 3.6 3 Ethylmalonate 2.1 <= 6.3 Carbohydrate Metabolism (B1, B3, Cr, Lipoic Acid, CoQ10) 3.9 4 Pyruvate <DL* <= 6.4 12.6 5 L-Lactate 6.9 1.6-57.1 2.1 6 β-hydroxybutyrate <DL* <= 9.9 Energy Production (Citric Acid Cycle) (B comp., Q10, Amino acids, Mg) 601 7 Citrate 618 H 56-987 8 Cis-Aconitate 46 51 18-78 98 9 Isocitrate 70 39-143 10 a-ketoglutarate 6.9 19.0 <= 35.0 11.6 11 Succinate 15.5 H <= 20.9 12 Fumarate 0.64 H 0.59 <= 1.35 1.4 13 Malate 0.7 <= 3.1 3.6 14 Hydroxymethylglutarate 2.5 <= 5.1 B-Complex Vitamin Markers (B1, B2, B3, B5, B6, Biotin) 0.25 15 a-ketoisovalerate 0.18 <= 0.49 0.34 16 a-ketoisocaproate 0.05 <= 0.52 0.38 17 a-keto-β-methylvalerate 0.08 <= 1.10 0.34 18 Xanthurenate 0.10 <= 0.46 7.6 19 β-hydroxyisovalerate 3.4 <= 11.5 Methylation Cofactor Markers (B12, Folate) 1.7 20 Methylmalonate 0.8 <= 2.3 1.2 21 Formiminoglutamate <DL* <= 2.2 Page 10

Ordering Physician: Date Received: 4/4/2013 Date Reported: 4/16/2013 Methodology: LC/Tandem Mass Spectroscopy, Colorimetric Organix Comprehensive Profile - Urine Ranges: Ages 13 and over. Cell Regulation Markers mcg/mg creatinine 95% Reference Interval Neurotransmitter Metabolism Markers (Tyrosine, Tryptophan, B6, antioxidants) 22 Vanilmandelate 1.0 L 1.6 3.9 1.2-5.3 23 Homovanillate 1.4 L 1.9 5.7 1.4-7.6 24 5-Hydroxyindoleacetate 2.1 2.1 5.6 1.6-9.8 1.0 25 Kynurenate 0.3 4.0 <= 1.5 26 Quinolinate 2.3 8.0 <= 5.8 27 Picolinate 2.8 2.8-13.5 Oxidative Damage and Antioxidant Markers (Vitamin C and other antioxidants) 0.39 28 p-hydroxyphenyllactate 0.19 <= 0.66 5.3 29 8-Hydroxy-2-deoxyguanosine 2.0 <= 7.6 (Units for 8-Hydroxy-2-deoxyguanosine are ng/mg creatinine). Toxicants and Detoxification Detoxification Indicators (Arg, NAC, Met, Mg and antioxidants) 0.084 30 2-Methylhippurate 0.087 H <= 0.192 0.69 31 Orotate 0.16 <= 1.01 6.3 32 Glucarate 1.1 <= 10.7 0.3 33 a-hydroxybutyrate 0.2 <= 0.9 59 34 Pyroglutamate 34 28-88 35 Sulfate 938 L 958 2,347 690-2,988 Page 11

Ordering Physician: Date Received: 4/4/2013 Date Reported: 4/16/2013 Organix Comprehensive Profile - Urine Methodology: LC/Tandem Mass Spectroscopy, Colorimetric Ranges: Ages 13 and over. mcg/mg creatinine Compounds of Bacterial or Yeast/Fungal Origin Bacterial - general 0.6 36 Benzoate 5.2 H <= 9.3 548 37 Hippurate 8 <= 1,070 0.11 38 Phenylacetate <DL* <= 0.18 39 Phenylpropionate <DL* <= 0.06 1.1 40 p-hydroxybenzoate 0.6 <= 1.8 19 41 p-hydroxyphenylacetate <DL* <= 34 64 42 Indican 5 <= 90 0.73 43 Tricarballylate 0.56 <= 1.41 L. acidophilus / general bacterial 44 1.9 1.9 D-Lactate <= 4.3 Clostridial species 45 3,4-Dihydroxyphenylpropionate <DL* <= 0.05 Yeast / Fungal 36 46 D-Arabinitol 12 <= 73 Creatinine = 200 mg/dl * <DL = less than detection limit ** >LIN = greater than linearity limit Page 12

ION Analyte Pattern Analysis A multi-analyte report can provide greater insight about health risks and special nutrient needs. Patterns of abnormalities can reinforce the degree of significance indicated by a single measurement. Analytes from the various profiles in the ION report are combined below into categories associated with clinical/metabolic conditions. The categories included cover the most common areas of concern relevant to these profiles. Above each thermometer are listed the analytes used to calculate the degree of significance. An H or L appears when the patient result is in the fifth quintile (80%) of the population. An additional X next to an analyte indicates that the patient result is outside the 95% reference interval for that analyte. The thermometer advances to the right as the number and severity of relevant abnormalities increases. The longer the filled bar, the greater the degree of significance or likelihood that a health threat may exist in that category. The preceeding laboratory reports provide the detail upon which these thermometers are based. Cardiovascular System Arginine Homocysteine H Calcium Magnesium CoQ10 a-tocopherol Lipid Peroxide 8-OHdG AA/EPA H Low significance Fatigue Isoleucine Leucine Phenylalanine Valine Magnesium CoQ10 Adipate Suberate AKG Succinate H Malate Xanthurenate MeMalonate FIGLU Low significance Metabolic Syndrome (Syndrome X) Magnesium Palmitic Stearic AHB BHB BHiVal Low significance Mental/Emotional Tryptophan Tyrosine Magnesium EPA L DHA L Xanthurenate MeMalonate FIGLU VMA L X 5-HIA Low significance Page 13

ION Analyte Pattern Analysis Intestinal Bacterial Metabolites PhAc PhProp pohbenz pohphac Indican Tricarb D-Lactate 3,4-DHPP Low significance Intestinal Yeasts / Fungal Metabolites D-Arabinitol Low significance Digestion/Absorption Arginine Histidine Isoleucine Leucine Lysine Methionine Phenylalanine Threonine Tryptophan Valine Selenium Low significance Toxic Exposure Aluminum Arsenic Cadmium Lead Mercury Palmitelaidic C18TrFa Citrate H Cis-Aconitate Isocitrate Quinolinate 2-MeHipp H Orotate Glucarate Low significance Detoxification Impairment Methionine Glycine Serine Taurine Glutamine Pyroglutamate Sulfate L Benzoate H Low significance Page 14

ION Analyte Pattern Analysis Oxidative Stress/Antioxidant Insufficiency Taurine Selenium Lead Mercury H a-tocopherol g-tocopherol Vitamin A b-carotene Lipid Peroxide 8-OHdG pohphlac Sulfate L Low significance Mitochondrial Functional Impairment Magnesium CoQ10 Adipate Suberate Ethylmalonate Pyruvate L-Lactate AHB BHB Low significance Succinate H Fumarate H Malate Amino Acid Insufficiency Arginine Histidine Isoleucine Leucine Lysine Methionine Phenylalanine Threonine Tryptophan Valine AKG Succinate H Sulfate L Low significance Essential Fatty Acid Insufficiency AA ALA L LA L X GLA DGLA Palmitoleic Triene/Tetraene EPA L DHA L Low significance Disordered Methyl Group (Single carbon) Transfer Homocysteine H Pentadeca Heptadeca Nonadecanoic Tricosanoic Xanthurenate MeMalonate FIGLU Kynurenate Low significance Page 15

ION Analyte Pattern Analysis Disordered Tryptophan Metabolism Tryptophan Xanthurenate 5-HIA Kynurenate Quinolinate Indican Low significance Abbreviation 2-MeHipp 5-HIA 8-OhdG AA/EPA AHB AKG akbmeval akicap akival ALA a-tocopherol BHB BHiVal C18TrFa CoQ10 DGLA DHA 3,4-DHPP EPA Analyte Name 2-Methylhippurate 5-Hydroxyindoleacetate 8-Hydroxy-2-deoxyguanosine Arachidonic (20:4n6)/Eicosapentaenoic (20:5n3) a-hydroxybutyrate a-ketoglutarate a-keto-ß-methylvalerate a-ketoisocaproate a-ketoisovalerate Alpha Linolenic (18:3n3) alpha-tocopherol ß-Hydroxybutyrate ß-Hydroxyisovalerate Total C:18 Trans Coenzyme Q10 Dihomogamma Linolenic (20:3n6) Docosahexanoic (22:6n3) 3,4-Dihydroxyphenylpropionate Eicosapentaenoic (20:5n3) Abbreviation FIGLU g-tocopherol GLA Heptadeca Hcys HVA HMG LA MeMalonate Pentadeca PhAc PhProp phbenz phphac phphlac Total C:18 Tricarb Triene/Tetraene VMA Analyte Name Formiminoglutamate gamma-tocopherol Gamma Linoleic (18:3n6) Heptadecanoic (17:0) Homocysteine Homovanillate Hydroxymethylglutarate Linoleic (18:2n6) Methylmalonate Pentadecanoic (15:0) Phenylacetate Phenylpropionate p-hydroxybenzoate p-hydroxyphenylacetate p-hydroxyphenyllactate Total c:18 Trans Tricarballylate Mead/Arachidonic Ratio Vanilmandelate Page 16

Supplement Recommendation Summary With knowledge of a patient's full medical history and concerns, the ION Profile laboratory results may be used to help create an individually optimized nutritional support program. Based strictly on the results from this test, the summary table below shows estimates of nutrient doses that may help to normalize nutrient-dependent metabolic functions. Customized Vitamin and Mineral Formulation Nutrients listed in this section are normally contained in a multi-vitamin preparation. "Base" amounts may be used to ensure health even when no abnormalities are found. Customized preparations of the multi-vitamin/mineral formula shown below may be produced by compounding pharmacies. Base Daily Amounts Units Added Vitamin A B-Carotene 2500 IU 5500 IU Vitamin C 250 mg 500 mg Vitamin D 400 IU Vitamin E (Mixed Tocopherols) 100 IU 200 IU Vitamin K* Thiamin (B1) 100 mcg 5 mg Riboflavin (B2) 5 mg 10 mg Niacin (B3) 25 mg Pyridoxine (B6) 15 mg 50 mg Folic Acid (or 5-Methyl-THF) 400 mcg 500 mcg Vitamin B12 50 mcg 800 mcg Biotin 100 mcg 600 mcg Pantothenic Acid (B5) Calcium Citrate Iodine* 25 mg 500 mg 75 mcg Magnesium 250 mg 200 mg Zinc 15 mg Selenium 100 mcg 50 mcg Copper 1 mg 2 mg Manganese* Chromium Molybdenum* Boron* 5 mg 200 mcg 25 mcg 1 mg * Nutrients with an asterisk are not modified based on the ION test results. MM02 Page 17

Other Items Indicated for Individual Supplementation Various conditionally essential nutrients and other potentially beneficial interventions appear in this section only if relevant abnormalities are present. These ingredients are not included in the customized vitamin formula on the previous page. Amino acids listed on this page result from functional markers of individual amino acid insufficiency and do not reflect amino acids measured in plasma. Item Amount Arginine 500 mg Coenzyme Q10 60 mg Fish Oil 6 gm Glycine 3000 mg N-Acetylcysteine 400 mg Page 18

Ordering Physician: Customized Free-Form Amino Acids The table below shows a customized amino acid formula based on the results of your laboratory profile. The formula is optimized by adding amounts shown in the Grams Added column according to the relative positions of results found. Directions: Adults mix 1 and 1/2 measuring teaspoon (5g) in juice or water 2 times daily between meals as a dietary supplement, or as directed by a health care provider. Children under 12 years old: 3/4 teaspoon 1-2 times daily between meals. Children under 5 years old: Use 1/4 teaspoon, 1-3 times daily; adjust for body weight. Grams Added % of Formula Active mg/day L-Arginine HCl (80% active) 1 10.65 852 L-Histidine HCl (74% active) 0 11.99 887 L-Isoleucine 0 8.25 825 L-Leucine 0 11.33 1,133 L-Lysine HCl (80% active) 0 10.32 826 L-Methionine 2 7.43 743 L-Phenylalanine 4 12.66 1,266 Taurine 0 0.00 0 L-Threonine 2 7.78 778 L-Tryptophan 0 1.94 194 L-Valine 0 9.92 992 Pyridoxal-5-phosphate 0 0.27 26 Alpha-ketoglutaric acid 0 7.69 746 Total grams added 9 Base Formula amount 291 Total Weight 300 L-5-Hydroxytryptophan 0 0.65 39 This formula is intended to optimize essential and conditionally essential amino acid intake. Other non-essential amino acids can be produced in human tissues. Pyridoxal-5-phosphate (an active form of vitamin B6) and alpha-ketoglutaric acid are key factors needed for the body's utilization of amino acids. The formula may be ordered as a powder that dissolves easily in beverages or may be added to foods such as applesauce. Other forms of supplemental dietary protein or amino acids may need to be restricted while using your customized formula. If enhanced energy levels prevent sleep, avoid bedtime use. This formula is provided as a starting point that may guide decisions about medical treatment based on the test results. It is derived only from the laboratory results included in this report. Final recommendations should be based on consideration of the patient's medical history and current clinical condition. In addition to the above customized amino acid formula, this patient may benefit from further use of single amino acids, as evidenced by profiles other than plasma amino acids. See the category, "Other Indicated Nutrients" on your Supplement Recommendation Summary Page. Page 19