Seeking differential diagnosis and opinions

[Wobblywheel]

Hi

I went to my doctor and asked for the tests. He ordered a serum Urea test, according to him it's the same as Urrc acid. Is this correct?

Thanks

[jimmylegs]

check out these two searches, and tell me which result you'd rather have on hand when you go looking for studies to help you interpret your results ;)
serum urea and ms
http://scholar.google.ca/scholar?q=%22s ... 5&as_vis=1
serum uric acid and ms
http://scholar.google.ca/scholar?hl=en& ... 5&as_sdtp=

[Scott1]

Urea is normally measured as part of serum biochemistry tests. Uric Acid is separate from those studies.

If the test he has prescribed is a Urine Urea Test then he will be testing the function of your kidneys to determine how well you are processing protein. When you break down protein one of the waste products is ammonia. The ammonia contains nitrogen which combines carbon, hydrogen and oxygen to form urea. The urea is excreted by your kidneys when you urinate. A common test is a blood urea nitrogen test. Ultimately it’s a test about kidney function.

Uric acid is the final oxidation product of purine metabolism. Purines are broken down into uric acid in the liver. Most uric acid dissolves in blood and travels to the kidneys where it is passed out of the body.

Uric acid may be a marker of oxidative stress and can act as both an antioxidant or prooxidant depending on a range of factors. Elevated uric acid can led to gout.

They are not the same thing.

[Wobblywheel]

Thanks again jimmylegs.

Urea tested at 5.2 mol/L Ref range 2.5 – 8.0
Urate tested at 0.21 mol/L Ref range 0.18 – 0.47

[Wobblywheel]

Thanks for the explanation Scott1.

The previous results were from liver and kidney function tests.

[Scott1]

Hi again,

Given what you said about being low in the amino acid reading despite supplements, I'd be looking for mycoplasmas. Buhners book has a section (chapter 3 "Healing Lyme disease coinfections "- A technical look at Mycoplasma and its cytokine cascade (57 pages)) that is just about scavenging that would give you some ideas.

Regards

[jimmylegs]

urate may work http://www.fscanltd.com/10.html but first are you sure that result is in mol/l? is it possible it's mmol/l? b/c if so then .21 mmol/L would convert to 210 umol/L, which would means level are low, which is consistent with ms patients (who are average at 194, in the 160s in relapse, and in the 230s during remission). for comparison, healthy control serum ua levels sit around 290-300. if you are interested, you can check the wikipedia page on uric acid - i edited it a few years ago including links to the relevant studies.

in my case it turned out low zinc was the missing link. i tried for years to correct my ms average ua with food but it was only after i tested deficient for zinc and repaired it, that my serum ua bounced up closer to 300. or in your case you'd be aiming for .29-.30. IF that result is actually mmol/L. gout risk isn't a problem until you're closer to .36 or higher. studies have shown that gout and ms are mutually exclusive. very few people would have gout and ms at the same time. the only time i ever had anything that was even a hint of gout since i was diagnosed, it was not from uric acid - it was from oxalic acid related to higher than normal intake of rhubarb, along with my already high intake of dark leafy greens, when i was working on using up the previous season's rhubarb out of the freezer.

proteins, amino acids, the urea cycle, and serum ammonia levels as well as zinc and uric acid status are all interconnected. will be very interesting to see serum zinc results, see how much correction might be needed, and what effects on amino acid status might be observed with that correction (assuming one is needed, based on the low uric acid status, which depends on your confirming those units!).

Efect of Low Zinc Intakes on Basal Metabolic Rate, Thyroid Hormones and Protein Utilzation in Adult Men1
http://jn.nutrition.org/content/116/6/1045.full.pdf

[Wobblywheel]

Thanks again jimmylegs and Scott1.

Yes, the units are mmol/L. So currently urate is 210 umol/L. Previous rates started at 270 two years ago then 240 six months ago. I have been taking high dose zinc for the last 12 months. I now believe I have an absorption problem. I will read Buhners book regarding mycoplasmas.

I have also done an intestinal permeability (leaky gut) test and am awaiting the results.

[jimmylegs]

how high dose each day with the zinc again? you may have driven something else out of balance and that could be pushing the uric acid levels lower. iron for example:
Inhibition of Iron Absorption by Zinc: Effect of Physiological and Pharmacological Doses: TL015
http://www.nature.com/pr/journal/v60/n5 ... 6364a.html
The association between serum ferritin and uric acid in humans.
http://www.ncbi.nlm.nih.gov/pubmed/15788238
that said - when i take zinc, it's usually 50mg w 2mg copper, and last time i tested my ferritin levels were actually higher than i wanted (150). i eat plenty of iron rich foods with vit C though, so your situation may not be quite the same.

[Wobblywheel]

Test results
Vit D: 85 nmol/L Deficiency < 50
Vit B12: 1073 pmol/L
Active B12: 128 pmol/L Reference range: 23 - 100
Copper: 18.0 umol/L Reference range: 10.0 – 22.0
Zinc : 20.6 umol/L Reference range: 9.0 – 18.0
Magnesium: 0.89 Reference range: 0.70 – 1.10

[jimmylegs]

great all good to know.
d3 could stand to be higher but is likely linked to your lower serum mag. see if you can increase se mg to at least 0.95 mmol/L. ms risk is reduced when serum d3 levels are above 100 nmol/L.
b12 looks fine
your copper zinc ratio looks good, a.though both are slightly on the high side.
magnesium and d3 seem to be the big ticket items here!

[lyndacarol]

Test results
Vit D: 85 nmol/L Deficiency < 50
Vit B12: 1073 pmol/L
Active B12: 128 pmol/L Reference range: 23 - 100
Copper: 18.0 umol/L Reference range: 10.0 – 22.0
Zinc : 20.6 umol/L Reference range: 9.0 – 18.0
Magnesium: 0.89 Reference range: 0.70 – 1.10

Your vitamin B12 test result of 1073 pmol/L is a great result; but, as you know, it is not an accurate test for deficiency as it measures total serum B12 (regardless of the particular protein the B12 is bound to). You were wise to have the Active B12 test done as well. The newer, more reliable test, the HoloTranscobalamin (HoloTc) blood test, measures HoloTranscobalamin II, which is the only protein transporter that can deliver B12 to the cells. I am not well-versed in the results, but according to your lab's reference range, your result for Active B12 is fine. My previous reading had turned up the following regarding deficiency:

Plasma concentrations of HoloTranscobalamin II can provide an early end sensitive measurement of negative vitamin B-12 balance. Vitamin B-12 is rapidly depleted from holotranscobalamin II when vitamin B-12 status is low.

The researcher V. Herbert found in his patient population that a serum HoloTranscobalamin II level below 29.6 pmol/L (40 pg/mL) was associated with an inadequate vitamin B-12 consumption for a clinical problem of the stomach, pancreas, or ileum.

HoloTranscobalamin II concentrations of <30 pmol/L were considered vitamin B-12 deficient. According to Herbert et al., HoloTranscobalamin II concentrations of <15 pmol/L would indicate that no vitamin B-12 is being absorbed.

If you are up for further blood tests, the only additional test I might suggest would be for methylmalonic acid (MMA), which is known to damage myelin.

[Wobblywheel]

The Leaky Gut test was positive.

[jimmylegs]

bummer. also, that is just weird. you and your good zinc level. ;) i will have to dig deeper into the lit on nutrition for membrane integrity... in the morning.

well, that said, one quick thought..: since we can see that mag is on the low side anyway, i thought i would check if mag also has something going on when it comes to membrane integrity.

found this so far:
Role of magnesium in genomic stability
http://www.sciencedirect.com/science/ar ... 0701000744
As evident from animal experiments and epidemiological studies, magnesium deficiency may decrease membrane integrity and membrane function and increase the susceptibility to oxidative stress, cardiovascular heart diseases as well as accelerated aging.

[Wobblywheel]

Thanks again jimmylegs.

I suspected for some time that the gut was leaky. I had been taking action to correct it – paleo type diet & supplements. I am now changing the supplements – n-acetyl glucosamine, glutamine, slippery elm, aloe vera juice etc.

You may be interested to know that I recently did an IgA/IgE /IgG Food Senility test. Awaiting results and credit card statement.

I changed to magnesium glycinate two weeks ago, but have not noticed any difference yet.

Cheers