A Comprehensive Test for Identifying Functional Nutritional Deficiencies and Insufficiencies.
Why Use the NutrEval FMV Profile?
The NutrEval FMV® is both a blood and urine test that evaluates over 125 biomarkers and assesses the body’s functional need for 40 antioxidants, vitamins, minerals, essential fatty acids, amino acids, digestive support, and other select nutrients. Personalized recommendations for nutrients are determined by using an algorithm based on the patient’s test findings. The NutrEval Plasma and NutrEval FMV (first morning void) differ based on which sample type is used to measure amino acids, plasma or urine.
When should testing for NutrEval FMV be considered?
According to the World Health Organization, every country in the world is affected by one or more forms of malnutrition. The term malnutrition addresses 3 broad groups of conditions:1
Undernutrition (wasting, stunting, underweight)
Micronutrient-related malnutrition from inadequate or excess vitamins or minerals
Overweight, obesity, and diet-related noncommunicable diseases (such as heart disease, stroke, diabetes and some cancers)
Proper nutrition is key to preventing a number of diseases. Nutrients are necessary to feed every cell and ensure all body systems are functioning properly. Testing can help clinicians and patients gain an understanding of how nutritional imbalances may be impacting their health. Certain conditions or dietary, genetic, and lifestyle factors may predispose a person to having nutrient imbalances.
Symptoms and conditions associated with nutrient imbalances
Obesity/ Insulin resistance/ Type 2 Diabetes9-12
Weight Issues/ Malnutrition/ Dietary Guidance
Increased nutrient demand in physical trauma/healing21
The NutrEval FMV Biomarkers
The biomarkers on the NutrEval are arranged as follows (seesample reportfor individual analytes):
Metabolic Analysis Markers (urine organic acids)
Malabsorption and Bacterial/ Yeast Dysbiosis Markersare metabolites produced by the gastrointestinal microbiome
Cellular Energy & Mitochondrial Metabolites are biomarkers of carbohydrate and fatty acid metabolism, and the citric acid (Kreb’s) cycle
Neurotransmitter Metabolitesare downstream byproducts of epinephrine, norepinephrine, serotonin and dopamine
Vitamin Markerare specific analytes used to assess functional levels of vitamin cofactors
Toxin & Detoxification Markersrelate to certain toxic metabolites and the body’s detoxification capacity
Amino Acids (urine)
Essential Amino Acidsmust be derived from dietary sources
Nonessential Amino Acids are synthesized by the body
Intermediary Metabolitesare byproducts of amino acid metabolism
B Vitamin Markersare involved in biochemical reactions that specifically require B vitamins
Urea Cycle Markersare byproducts associated with nitrogen detoxification
Glycine/Serine Metabolitesare involved in the choline to acetylcholine (neurotransmitter) pathway and the methylation pathways
Dietary Peptide Related Markerscan indicate incomplete protein breakdown
Essential and Metabolic Fatty Acids Markers (RBCs)
Omega 3 Fatty Acidsare essential for brain function and cardiovascular health and are anti-inflammatory
Omega 6 Fatty Acidsare involved in the balance of inflammation
Omega 9 Fatty Acidsare important for brain growth, nerve cell myelin, and reducing inflammation
Saturated Fatty Acidsare involved in liproprotein metabolism and adipose tissue inflammation
Monounsaturated Fatsinclude omega 7 fats and unhealthy trans fats
Delta-6 Desaturase Activityassesses efficiency of this enzyme to metabolize omega 6’s and omega 3’s
Cardiovascular Riskincludes specific ratios and the Omega 3 Index
Oxidative Stress Markersinclude antioxidants glutathione (whole blood) and Coenzyme Q10 (serum), as well as the oxidative damage markers lipid peroxides and 8-OHdG (urine)
Vitamin D (serum)measures a total of 25-hydroxyvitamin D3 (cholecalciferol) and 25-hydroxyvitamin D2 (ergocalciferol)
Nutrient Elementsare direct measurements of copper and zinc (plasma), magnesium and potassium (RBC), and manganese and selenium (whole blood)
Toxic Elements (whole blood)indicate exposure to lead, mercury, arsenic, cadmium or tin within approximately a 90-120 day timeframe
Add-on SNPs(buccal swab) include MTHFR, COMT, TNF-a, and APOE
What is the difference between plasma and urine amino acids?
Certain amino acids are measurable in blood versus urine and sample type selection depends on the clinical concern. The key differences between plasma and urine amino acids are summarized below.22,23
Plasma Amino Acids (Fasting)
Urine Amino Acids (First Morning Void)
Fasting sample represents “steady state” pool of amino acids; not affected by short-term diet fluctuations
Represents recent dietary intake and metabolism – more variable compared to plasma
Useful for mood disorders, or uncontrolled diets
Useful for controlled diets, to assess protein maldigestion, oxidative stress, vitamin/mineral cofactors affecting amino acid metabolism
Amino acid levels influenced by abnormal kidney function; preferred if patient has proteinuria
Amino acid levels influenced by abnormal kidney function; urine testing dependent on healthy kidney function (biomarkers ratioed to urine creatinine)
Requires a blood draw
Requires a urine sample
What advantage does the NutrEval FMV offer compared to other diagnostics?
The NutrEval FMV is one of the most comprehensive nutritional profiles available assessing a broad array of macronutrients and micronutrients, as well as markers that give insight into digestive function, toxic exposure, mitochondrial function, and oxidative stress.
Genova provides a user-friendly report with clinically actionable results including:
Suggested digestive support and vitamin, mineral, and fatty acid recommendations based on an algorithmic calculation of functional need for cofactors in the body’s metabolism
Suggested amino acid recommendations based on patient’s direct amino acid measurements
Interpretation-At-A-Glance pages provide educational information on nutrient function, causes and complications of deficiencies, and dietary sources
A Functional Nutritional Assessment
There are various methods of assessing nutrient status, including intracellular and extracellular direct measurement, and measuring biochemical pathway markers that require specific nutrient cofactors for proper metabolism. The NutrEval uses a combination of these methods and synthesizes the information via an algorithm that determines personalized nutrient needs. The algorithm is based on functional markers shown in the literature to be associated with a need for a particular nutrient.
Functional evaluation of nutritional status assesses metabolic intermediates produced in enzymatic pathways of cellular energy production, detoxification, neurotransmitter breakdown, and amino acid metabolism. Specific metabolites outside of reference range may signal a metabolic inhibition or block. This abnormality may be due to a nutrient deficiency, an inherited enzyme deficit, toxic build-up, or drug effect. It is possible for an individual to have normal blood levels of a vitamin in order to maintain homeostasis, while exhibiting signs of insufficiency/deficiency for that vitamin. For this reason, direct testing of individual nutrients alone does not provide a complete picture.
Other methods of assessing nutrient status, such as intracellular lymphocyte testing, has limited literature support.
Conventional nutritional panels include tests such as complete blood count, comprehensive metabolic panel, iron, ferritin and other select nutrients. The NutrEval is not meant to be a substitute for this important testing, but rather a complement by providing additional information.
What can clinicians and patients expect from NutrEval FMV testing?
Personalized recommendations for amino acids, fatty acids, vitamins, minerals, digestive support, and other nutrients are provided for each patient. Additionally, exposure to select toxic substances and oxidative stressors may need to be addressed. Comprehensive stool testing or SIBO breath testing may be appropriate to investigate the possible cause for maldigestion/malabsorption and dysbiosis.
You may consider trying
The entire contents of this website are based upon the opinions of Dr. Justin Marchegiani unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Justin and his community. Dr. Justin encourages you to make your own health care decisions based upon your research and in partnership with a qualified healthcare professional. These statements have not been evaluated by the Food and Drug Administration. Dr. Marchegiani’s products are not intended to diagnose, treat, cure or prevent any disease. If you are pregnant, nursing, taking medication, or have a medical condition, consult your physician before using any products.