Question

Susie G, is a 40 year old female with Metabolic Syndrome, Obesity, IBS (constipation predominant), Infertility, Fatigue, and PCOS. She has returned to you for a followup visit to discuss the results of her urinary Organic acid testing.

Organic Acids (only abnormal results are listed below, ALL OTHER RESULTS ARE NORMAL):

High Adipate and Suberate                        

High Beta-hydroxybutyrate                       

Low Hydroxymethylglutarate            

High Xanthurenate                                    

High Formiminoglutamate                        

Low Vanilmandelate                                    

Low 5-hydroxyindolacetate                        

High 8-hydroxy-2’-deoxyguanosine

High Glucarate                                    

High D-arabinitol   

Based upon the 10 abnormal results listed above:

1. a. What pathways are impaired from the abnormal results? What nutritional supplements would be warranted for each imbalance (ie. if high in adipate, supplement with what nutrients? Do this for each of the 10 abnormal results)? 1 point

1. b. What other dietary adjustments would you make to help offset these organic acid imbalances (ie. list foods that are high in the specific nutrients listed from 1. a. in case Susie would rather get her nutrients from food than supplements)? 1 point

2. Pick 1 of the following pathways below:

I. Catecholamine DEGRADATION Make sure to include MAO and COMT enzymes, cofactors, substrate and products. (Remember that catecholamine synthesis refers to the creation of dopamine, norepinephrine, and epinephrine while catecholamine DEGRADATION refers to the breakdown of dopamine, norepinephrine, and epinephrine into VMA and HVA).

OR

II. CNS Kynurenin pathway

2. a. DRAW OUT the pathway including substrates, products, enzymes, and cofactors from what you learned in the textbooks/PPTs. 1 point

Answer 1