Functional Diagnostic Nutrition® and the BioHealth Laboratory's BH101 Metabolic Assessment Profile The Utility of Urine Testing for Indican, Lipid Peroxides and Urinary Bile Acid Sulfates in Functional Assessments of Patients with Common Health Complaints Related to the Chronic Stress Response
Reed Davis, Clinical Advisor BH Laboratory
Introduction In functional medicine, we are aware that the patient's symptoms can be far removed from the actual cause. So, in order to help patients permanently resolve their health complaints, we must investigate underlying malfunctions as opposed to just treating the symptoms. Undoubtedly, an understanding of functional lab work is critical to identifying these hidden malfunctions and providing healing opportunities to each patient. Let's take a symptom like depression. Today, its common knowledge that people suffering from depression may find relief by supplementing with the amino acid l-tryptophan, the precursor to the neurotransmitter serotonin. Raise serotonin levels and they might feel better. So that's it? They have an l-tryptophan deficiency? The patient should just take pills for the rest of their life? Well, no. We now know this is only a temporary solution because when the real underlying cause is left to deteriorate, the symptoms will only reappear, often times more severe than when they first presented! Or some new symptom will appear, perhaps in a different area of the body. Then we're left playing the game of trial and error with additional supplements or resorting to the use of pharmaceuticals. We have identified countless situations where this methodology has led to harsh drugs, and eventually surgery in some cases. This allopathic approach of trying to find the right supplement is commonly used by nutritionists and alternative providers alike. Indican
Those providers who want to help patients truly resolve their health problems instead of just treating the symptoms must learn to look deeper. A useful tool in the case above is the BH#101 Metabolic Assessment Profile, a simple urine test that includes the marker indican. A positive indican indicates poor bacterial breakdown of protein into individual amino acids which then are not assimilated into corresponding neurotransmitters, such as serotonin.
2012 Reed Davis, Functional Diagnostic Nutrition®
In other words, with a positive indican you might have a patient that is eating a healthy diet, but in fact has a whole range of nutritional deficiencies, any one of which can lead to serious malfunctions and symptoms. So what are you going to do with people like this, keep supplementing until you cover every deficiency? Write a prescription? Or are you going to help them repair their digestion and assimilation problems? Without proper digestion and assimilation and other basic utilities, it is impossible to have optimum function, optimal health and (eventually) symptoms will appear. That's why we order functional labs like the BH#101 which show us which functions need improvement in order to restore health. They also allow us to monitor therapy and direct our investigation into deeper areas of malfunction or disease. Other values reported on the "101" include a marker for excessive oxidative stress called lipid peroxides, and another called urinary bile acid sulfates, which is a direct measurement of liver function. Like indican, these values identify healing opportunities, provide a way to monitor changes and focus the investigation, again, into causal factors.
Today's patients are crying out for providers to help them with the cause of their health problems. They want more than the typical treatment they've been trying for years - treating the symptoms. So if you're not using functional lab work, if you can't identify and resolve common health conditions at the causal level, they'll go to someone who can.
Lipid Peroxides Identifying healing opportunities is the name of the game. As we've discussed, functional lab work is designed to get to the root cause, or provide useful information about how a patient can improve health, instead of chasing his symptoms with one product or another. We've seen how the BH#101 Metabolic Assessment Profile provides such insights when indican is present in the urine. Likewise, the "101" reports lipid peroxide levels, which represent how much "oxidative stress" is present in the body. This marker is very useful in shaping and tracking therapeutic anti-oxidant strategies. And, moreover, finding elevated lipid peroxide levels helps us narrow the search for deeper layers of dysfunction, and other causal factors of many chronic degenerative conditions. Low lipid peroxide levels indicate a healthy balance between anti-oxidative elements vs. the pro-oxidative action of free radicals and toxins (oxidative stress). A healthy person with an excellent diet and digestion may be producing or processing adequate antioxidants to uphold this important equilibrium. Monitoring lipid peroxides could help preserve the balance.
2012 Reed Davis, Functional Diagnostic Nutrition®
Elevated lipid peroxide values indicate cellular membrane damage caused by free radicals and worse, damage to the membranes of organelles within the cells. If not terminated fast enough, runaway free radical damage is mutagenic and carcinogenic, possibly leading to atherosclerosis, coronary artery disease and cancer, the leading causes of death in the United States. We know that chronic degenerative disease, not infectious disease is what's killing most people these days. Patients presenting with a wide variety of health complaints including serious conditions such as Parkinson's disease, heart failure, myocardial infarction, Alzheimer's, Schizophrenia, Bipolar disorder, Syndrome X and chronic fatigue syndrome (CFS) may benefit from an assessment for excessive oxidative stress. Free radical control is a crucial component of restoring and maintaining good health or bolstering the patient's overall wellness to a point where they get by on the least amount of medical treatment. Here, the 101 has shown to be an excellent monitoring tool and guide for patients following antioxidant therapy. And, more importantly (like all good functional lab work), the lipid peroxide values help sort out the hidden stressors at the root of the patient's unwanted health condition. Oxidative stress can result from exposure to toxins, chemicals, metals, pathogens and their excretions - yes, bug pooh. So not only do we identify an area to improve upon, the anti-oxidative vs. pro-oxidative balance, we also get a clue about the next level of investigation. In this case, we would order a BH#304 Intestinal Barrier Screen and the BH#401H GI Pathogen screen, and consider an investigation into heavy metals exposure. The ease, economy and utility of urine assessments make the BH#101 Metabolic Assessment Profile a must-have in every health detective's tool box. As we already know, functional labs should identify healing opportunities and help narrow the search for additional areas of malfunction. The final marker on the 101 is urinary bile acid sulfates (UBAS), a direct measurement of liver function. Urinary Bile Acid Sulfates
For as much as the liver is a filter, it is also a detoxifying organ. If it isn't filtering efficiently it is unlikely to be carrying out its detoxification and conjugation duties very well either. This kind of functional information can be incredibly useful in our investigation into underlying causes of disease and assessment of a patient's poor health condition. It's this line of thinking that presents us with healing opportunities instead of just treating symptoms and often leads to complete resolution of patient's complaints. The BH#101 Metabolic Assessment Profile measures a patients urinary bile acid sulfates (UBAS), which is a direct indicator of liver congestion and a window into its (in)efficiency at handling toxins and other metabolically undesirable compounds or
2012 Reed Davis, Functional Diagnostic Nutrition®
MUC. While the liver can be supported with a number of excellent supplements, even liver "flushes," the 101 provides information on the liver's status as an efficient detoxifier and the extent of liver therapy to recommend. This can be very useful when investigating a patient's otherwise inexplicable test results or complaints. For instance, in a patient with elevated estrogen levels with low precursor hormone levels and no exogenous hormone exposure, we may have a (simple) hormone detoxification problem. Normally a potent detoxifier of excess estrogens in the system, a congested liver can be the reason for the elevated estrogen levels and symptoms associated with elevated estrogen. The utility of UBAS testing should be quite clear in cases where toxicity may be an issue. Blood tests for liver enzymes are designed to detect liver diseases such as hepatitis, loss of cellular integrity and medical conditions linked to the biliary tract. UBAS is essentially an indicator of the efficiency of the liver in its role as a filter, independent of any diagnosis of hepatitis or cirrhosis, etc. This difference in testing is important for the tremendous number of people whose liver enzymes look "normal" on a blood test, but in fact have serious liver dysfunction revealed by the UBAS test. In the latter patient, we'd be inclined to offer liver support therapy, possibly some liver flushing, and use the test to monitor the effectiveness of the therapy. We'd also have fixed our eyes on the prize, the origin of the congestion and malfunction such as overuse of OTC medication, prescription drugs, antigen load and immune complex proliferation. Other sources and signs of congestion include both indican and lipid peroxides levels, as these are considered to be metabolically undesirable compounds (MUC). MUC can cause problems for our livers and other detoxifying organs and, in the end, increase bile acid spillover from the liver into the blood stream. Similar to how dust may spew into the air when a vacuum cleaner bag gets filled, UBAS will become elevated when the liver is congested. A buildup of toxic substances will damage liver cells and other organs, glands and systems in the body, leading to increased risk for cancer and a variety of other degenerative diseases. In today's toxic world, with the prevalence of drug use, chemicals, exogenous hormones and pollution, it's hard to imagine a case where the liver is not involved to some extent. With the BH#101, we collect highly relevant information on digestive and detoxification functions and other data that refines our impression about the patient we are trying to help. By working at this functional level we may leverage the body's innate desire to be healthy with natural healing strategies that improve clinical outcomes to a new level of satisfaction. This is true for the patient and the practitioner alike.
2012 Reed Davis, Functional Diagnostic Nutrition®
Conclusion
Using functional lab tests to investigate underlying malfunctions provides us with the tools to evaluate function in the body and identify many healing opportunities that our patients are looking for to resolve their health complaints - at the root cause. Efficient protein digestion, balanced antioxidant to pro-oxidation levels, and healthy liver function are some of the many critical areas we can easily assess. The BH#101 Metabolic Assessment Profile, which measures indican, lipid peroxides and urinary bile acid sulfates, give us specific targets for therapy and ways to improve health, as well as insights into deeper layers of malfunction and likely causes of disease and symptomology. The fact that it is easy to use and economical, along with the stability of shipping urine specimens from great distances, makes the 101 a great addition in any functional medicine practice the world over. Reed Davis has been the Clinical Nutritionist and Case Manager at a Wellness Center in Southern California for over twelve years and has been teaching Functional Diagnostic Nutrition® for about four three years. He has extensive training, knowledge and experience in functional lab work and has helped over ten thousand people with a wide range of health problems. Reed is a Clinical Advisor for BioHealth Laboratory, helping doctors around the country to interpret lab test results and integrate functional lab work into their practices. For more information on learning opportunities visit www.FDNmanager.com or call 858-451-7774 or email support@FDNmanager.com
2012 Reed Davis, Functional Diagnostic Nutrition®
ANTIBIOTICS A. Antibiotic Concentrations. 1 The solid form of the antibiotics can be added directly to sterilized media that has been cooledto approximately 55°C. If kept at 4°C tetracycline, chloramphenicol, and streptomycin platesare usually good for several months, but kanamycin plates and ampicillin plates may only lastfor several weeks. A sensitive and resistant control should always
Patients whose GP knows complementary medicine tend to havelower costs and live longerReceived: 15 November 2010 / Accepted: 27 May 2011 / Published online: 22 June 2011Ó The Author(s) 2011. This article is published with open access at Springerlink.comand longer lives are unlikely to be related to differences incomplementary and alternative medicine (CAM) as an areaselection (e.g. people wit
Functional Diagnostic Nutrition® 
In other words, with a positive indican you might have a patient that is eating a healthy diet, but in fact has a whole range of nutritional deficiencies, any one of which can lead to serious malfunctions and symptoms. So what are you going to do with people like this, keep supplementing until you cover every deficiency? Write a prescription? Or are you going to help them repair their digestion and assimilation problems? Without proper digestion and assimilation and other basic utilities, it is impossible to have optimum function, optimal health and (eventually) symptoms will appear. That's why we order functional labs like the BH#101 which show us which functions need improvement in order to restore health. They also allow us to monitor therapy and direct our investigation into deeper areas of malfunction or disease. Other values reported on the "101" include a marker for excessive oxidative stress called lipid peroxides, and another called urinary bile acid sulfates, which is a direct measurement of liver function. Like indican, these values identify healing opportunities, provide a way to monitor changes and focus the investigation, again, into causal factors.
Today's patients are crying out for providers to help them with the cause of their health problems. They want more than the typical treatment they've been trying for years - treating the symptoms. So if you're not using functional lab work, if you can't identify and resolve common health conditions at the causal level, they'll go to someone who can.
Elevated lipid peroxide values indicate cellular membrane damage caused by free 
MUC. While the liver can be supported with a number of excellent supplements, even liver "flushes," the 101 provides information on the liver's status as an efficient detoxifier and the extent of liver therapy to recommend. This can be very useful when investigating a patient's otherwise inexplicable test results or complaints. For instance, in a patient with elevated estrogen levels with low precursor hormone levels and no exogenous hormone exposure, we may have a (simple) hormone detoxification problem. Normally a potent detoxifier of excess estrogens in the system, a congested liver can be the reason for the elevated estrogen levels and symptoms associated with elevated estrogen. The utility of UBAS testing should be quite clear in cases where toxicity may be an issue. Blood tests for liver enzymes are designed to detect liver diseases such as hepatitis, loss of cellular integrity and medical conditions linked to the biliary tract. UBAS is essentially an indicator of the efficiency of the liver in its role as a filter, independent of any diagnosis of hepatitis or cirrhosis, etc. This difference in testing is important for the tremendous number of people whose liver enzymes look "normal" on a blood test, but in fact have serious liver dysfunction revealed by the UBAS test. In the latter patient, we'd be inclined to offer liver support therapy, possibly some liver flushing, and use the test to monitor the effectiveness of the therapy. We'd also have fixed our eyes on the prize, the origin of the congestion and malfunction such as overuse of OTC medication, prescription drugs, antigen load and immune complex proliferation. Other sources and signs of congestion include both indican and lipid peroxides levels, as these are considered to be metabolically undesirable compounds (MUC). MUC can cause problems for our livers and other detoxifying organs and, in the end, increase bile acid spillover from the liver into the blood stream. Similar to how dust may spew into the air when a vacuum cleaner bag gets filled, UBAS will become elevated when the liver is congested. A buildup of toxic substances will damage liver cells and other organs, glands and systems in the body, leading to increased risk for cancer and a variety of other degenerative diseases. In today's toxic world, with the prevalence of drug use, chemicals, exogenous hormones and pollution, it's hard to imagine a case where the liver is not involved to some extent. With the BH#101, we collect highly relevant information on digestive and detoxification functions and other data that refines our impression about the patient we are trying to help. By working at this functional level we may leverage the body's innate desire to be healthy with natural healing strategies that improve clinical outcomes to a new level of satisfaction. This is true for the patient and the practitioner alike.
2012 Reed Davis, Functional Diagnostic Nutrition®
Conclusion