Patient: Ima Sample Accession: OMXTest07

Collected: 11/5/2021 Received: 2/15/2022

DOB: 7/14/1977 Completed: 5/10/2022

Sex: Male Ordered by: Diane Farhi

5894 Shiloh Rd, Ste 101 | Alpharetta GA 30005
877.485.5336
METHODOLOGY: LC-MS/MS - OMX Urine + Plasma

The charts on this page are designed to give you a bird's-eye-view of your current metabolic
YOUR PERSONALIZED REPORT signature and help you get a general preview of the detailed report found on the following pages.

METABOLOMIC SIGNATURE
Identifying Impact of Functional Categories

Findings show that 5 of 6 Functional

Categories have markers beyond the
reference range.
0 10 20 30 40 50 60 70 80 90 100
Subcategories are identified below.
PERCENT OF MARKERS BEYOND THE REFERENCE RANGE

Identifying Impact of Subcategories PERCENT OF MARKERS BEYOND THE

REFERENCE RANGE

NOTE: Below is a list of the Functional Categories and the included subcategories. It lists the percentage 0-20% 21-60% 61-100%
of markers that are beyond the reference range so clinicians can better target areas of concern.
MINIMAL MODERATE HIGH

Metabolic Processing 23 % Nutrition 21 % Toxic Impacts 20 %

Subcategory Subcategory Subcategory

Glycolysis B-Complex (B1, B2, B3, B5, LA) Oxidative Damage

Krebs Cycle Vitamin B-12 Toxins
Fatty Acid Oxidation Folate Urea Cycle
Ketones Vitamin B6 Kidney Impacts
Biotin
Amino Acid & Protein Metabolism 43 % Microbial Metabolites 22 %
Plant Components
Subcategory Subcategory
Meat intake
Phenylalanine Metabolism Sugar Intake Amino Acid Microbial Metabolites
Branched-Chain Amino Acids Polyphenols Microbial Metabolites
Tryptophan Metabolism Stress & Mood 43 % Isoflavone Microbial Metabolite
Methionine Metabolism Subcategory Fungal Assessment
Histidine Metabolism Neurotransmitter
Threonine/Glycine/Serine Catecholamine Turnover
Lysine Metabolism Serotonin Turnover
Glutamate & Aspartate Steroid Hormone
Collagen Catabolism

The assays were developed and/or the performance characteristics determined

by Diagnostic Solutions Laboratory. The results are for research and not for
diagnostic purposes. |1
Patient: Ima Sample Accession: OMXTest07

1 - Metabolic Processing

Glycolysis Result Reference

Glucose < 15.2

8.0
mg/dL
Glucokinase

Pyruvic Acid < 47.2

53.4 H
nmol/mg Creatinine
Pyruvate dehydrogenase + B1, B2, B3, B5 LA

Lactic Acid 23.1 - 722.6

>739.9
nmol/mg Creatinine
Lactate dehydrogenase + B3

D-Lactic Acid < 20.00

>34.93
nmol/mg Creatinine
D-Lactate dehydrogenase

Alanine 271.5 - 730.0

1526.4 H
nmol/mL
Alanine transaminase + B6

Krebs Cycle Result Reference

Citric Acid > 356.2

694.1
nmol/mg Creatinine
Citrate synthase

cis-Aconitic Acid 91.3 - 363.1

192.6
nmol/mg Creatinine
Aconitase

Isocitric Acid < 415.6

245.2
nmol/mg Creatinine
Isocitrate dehydrogenase + B3

α-Ketoglutaric Acid < 157.2

19.5
nmol/mg Creatinine
alpha-Ketoglutarate dehydrogenase + B1, B2, B3, B5, LA

Succinic Acid 4.8 - 224.1

254.2 H
nmol/mg Creatinine
Succinic dehydrogenase + B2

Fumaric Acid 320.2 - 3375.5

840.8
nmol/mg Creatinine
Fumarase

Malic Acid < 21.5

4.2
nmol/mg Creatinine
Malate dehydrogenase + B3

KEY: < dl = Results below detection limit.

= Analyte measured in plasma.

The assays were developed and/or the performance characteristics determined
by Diagnostic Solutions Laboratory. The results are for research and not for
diagnostic purposes. |2
Patient: Ima Sample Accession: OMXTest07

1 - Metabolic Processing

Fatty Acid Oxidation Result Reference

Adipic Acid 2.0 - 15.1

4.9
nmol/mg Creatinine
Saturated dicarboxylic acid

Sebacic Acid < 3.7

<DL
nmol/mg Creatinine
Fatty acid oxidation + Carnitine

Suberic Acid 3.0 - 29.4

11.0
nmol/mg Creatinine
Fatty acid oxidation + Carnitine

Pimelic Acid 5.9 - 31.8

17.9
nmol/mg Creatinine
Saturated dicarboxylic acids

Hexanoylglycine < 2.6

0.5
nmol/mg Creatinine
Medium-chain acyl glycines

Suberylglycine < 2.3

0.7
nmol/mg Creatinine
Medium-chain acyl glycines

3-Phenylpropionylglycine < 1.3

<DL
nmol/mg Creatinine
Medium-chain acyl glycines

Ethylmalonic Acid 5.0 - 43.3

14.2
nmol/mg Creatinine
Dicarboxylic acid

2-Methylsuccinic Acid 3.2 - 21.1

5.1
nmol/mg Creatinine
Dicarboxylic acid

Ketones Result Reference

β-Hydroxybutyric Acid < 60.5

2.1
nmol/mg Creatinine
beta-Hydroxybutyrate dehydrogenase + B3

KEY: < dl = Results below detection limit.

= Analyte measured in plasma.

The assays were developed and/or the performance characteristics determined
by Diagnostic Solutions Laboratory. The results are for research and not for
diagnostic purposes. |3
Patient: Ima Sample Accession: OMXTest07

2 - Amino Acid & Protein Metabolism

Phenylalanine Metabolism Result Reference

Phenylalanine 31.7 - 71.0

111.4 H
nmol/mL
Phenylalanine hydroxylase + BH4

Phenylacetic Acid 0.5 - 19.1

0.9
nmol/mg Creatinine
Aldehyde dehydrogenase

Tyrosine 27.8 - 84.5

113.7 H
nmol/mL
Tyrosine hydroxylase + BH4

Homovanillic Acid < 10.3

2.8
nmol/mg Creatinine
COMT + Magnesium & Monoamine oxidase + B2

Vannilylmandelic Acid 4.8 - 21.4

32.5 H
nmol/mg Creatinine
Monoamine oxidase + B2

4-Hydroxyphenylpyruvic Acid 35.5 - 1116.3

183.3
nmol/mg Creatinine
Tyrosine aminotransferase + B6

Homogentisic Acid 7.9 - 336.4

60.8
nmol/mg Creatinine
4-Hydroxyphenylpyruvate dioxygenase + Iron

Branched-Chain Amino Acids Result Reference

Total Branched Chain Amino Acids 211.9 - 577.3

725.7 H
nmol/mL
Branched-chain amino acid transaminase + B6

Valine 109.3 - 283.0

343.9 H
nmol/mL
Branched-chain amino acid transaminase + B6

α-Ketoisovaleric Acid < 11.9

<DL
nmol/mg Creatinine
Branched-chain keto acid dehydrogenase + B1, B2, B3, B5, LA

Isoleucine/allo-Isoleucine 35.5 - 112.4

128.8 H
nmol/mL
Branched-chain amino acid transaminase + B6

α-Keto-β-methylvaleric Acid < 11.9

0.9
nmol/mg Creatinine
Branched-chain keto acid dehydrogenase + B1, B2, B3, B5, LA

Leucine 57.1 - 187.5

253.0 H
nmol/mL
Branched-chain amino acid transaminase + B6

α-Ketoisocaproic Acid < 17.0

12.6
nmol/mg Creatinine
Branched-chain keto acid dehydrogenase + B1, B2, B3, B5, LA

KEY: < dl = Results below detection limit.

= Analyte measured in plasma.

The assays were developed and/or the performance characteristics determined
by Diagnostic Solutions Laboratory. The results are for research and not for
diagnostic purposes. |4
Patient: Ima Sample Accession: OMXTest07

2 - Amino Acid & Protein Metabolism

Tryptophan Metabolism Result Reference

Tryptophan 36.9 - 87.1

17.6 L
nmol/mL
Tryptophan hydroxylase + BH4

5-Hydroxyindoleacetic Acid 6.3 - 28.7

4.6 L
nmol/mg Creatinine
Aldehyde dehydrogenase + B3

Kynurenine < 4.4

6.5 H
nmol/mL
Kynurenine mono-oxygenase (KMO) + B2

KT Ratio
0.368 H 0.018 - 0.101
Kynurenine / Tryptophan

Hydroxykynurenine < 12.1

18.8 H
nmol/mg Creatinine
Kynureninase + B6

Xanthurenic Acid < 9.5

10.9 H
nmol/mg Creatinine
Kynurenine transaminase + B6

Anthranilic Acid < 11.8

<DL
nmol/mg Creatinine
Kynureninase + B6

Picolinic Acid < 4.0

<DL
nmol/mg Creatinine
Non-enzymatic conversion

Kynurenic Acid 2.1 - 18.5

15.7
nmol/mg Creatinine
Kynurenine transaminase + B6

Quinolinic Acid 9.0 - 105.7

56.0
nmol/mg Creatinine
Non-enzymatic conversion

KEY: < dl = Results below detection limit.

= Analyte measured in plasma.

The assays were developed and/or the performance characteristics determined
by Diagnostic Solutions Laboratory. The results are for research and not for
diagnostic purposes. |5
Patient: Ima Sample Accession: OMXTest07

2 - Amino Acid & Protein Metabolism

Methionine Metabolism Result Reference

Methionine 12.1 - 38.5

25.9
nmol/mL
Methionine adenosyltransferase

Homocystine < 2.2

<DL
nmol/mL
Methionine synthase + B12

Cystathionine < 0.3

15.3 H
nmol/mL
Cystathionine gamm-lyase + B6

Sulfocysteine < 1.4

<DL
nmol/mL
Sulfite oxidase (SOX) + Mo

Taurine 25.9 - 107.2

51.5
nmol/mL
Hypotaurine dehydrogenase

Cystine 13.4 - 51.9

59.1 H
nmol/mL
Oxidation

α-Hydroxybutyric Acid 10.6 - 62.6

72.5 H
nmol/mg Creatinine
Dehydrogenase + B3

α-Ketobutyric Acid < 7.2

<DL
nmol/mg Creatinine
Lactate dehydrogenase + B3

Pyroglutamic Acid < 72.7

88.9 H
nmol/mg Creatinine
5-Oxoprolinase

Histidine Metabolism Result Reference

Histidine 61.2 - 104.7

80.1
nmol/mL
Histidine decarboxylase + B6

3-Methylhistidine < 26.9

14.6
nmol/mL
Myofibrillar Breakdown

β-Alanine < 0.7

<DL
nmol/mL
Carnosine synthase

KEY: < dl = Results below detection limit.

= Analyte measured in plasma.

The assays were developed and/or the performance characteristics determined
by Diagnostic Solutions Laboratory. The results are for research and not for
diagnostic purposes. |6
Patient: Ima Sample Accession: OMXTest07

2 - Amino Acid & Protein Metabolism

Threonine/Glycine/Serine Result Reference

Threonine 51.4 - 184.9

29.9 L
nmol/mL
Glycine C-acetyltransferase + B6

Glycine 154.2 - 582.7

119.8 L
nmol/mL
Glutathione synthetase

Serine 54.2 - 207.4

39.0 L
nmol/mL
Cystathionine beta-synthase + B6, Iron

Sarcosine < 10.4

<DL
nmol/mL
Sarcosine dehydrogenase + B2

Ethanolamine < 16.9

8.2
nmol/mL
Ethanolamine kinase

Phosphoethanolamine < 6.3

<DL
nmol/mL
Phosphoethanolamine cytidylyltransferase

Lysine Metabolism Result Reference

Lysine 210.6 - 498.2

277.2
nmol/mL
alpha-Aminoadipic semialdehyde synthase

α-Aminoadipic Acid < 4.8

<DL
nmol/mL
Aminotransferase + B6

Glutaric Acid < 4.5

0.8
nmol/mg Creatinine
Glutaryl-CoA dehydrogenase + B2

KEY: < dl = Results below detection limit.

= Analyte measured in plasma.

The assays were developed and/or the performance characteristics determined
by Diagnostic Solutions Laboratory. The results are for research and not for
diagnostic purposes. |7
Patient: Ima Sample Accession: OMXTest07

2 - Amino Acid & Protein Metabolism

Glutamate & Aspartate Result Reference

Glutamine 352.4 - 1017.1

227.2 L
nmol/mL
Glutaminase

Glutamic Acid 38.3 - 251.2

286.9 H
nmol/mL
Glutamate cysteine ligase

Glutamine / Glutamate Ratio 2.1 - 21.7

0.8 L
Glutaminase

Asparagine 15.6 - 62.7

33.0
nmol/mL
Asparaginase

Aspartic Acid 5.4 - 21.5

11.4
nmol/mL
Asparagine synthase

Collagen Catabolism Result Reference

Proline 117.2 - 411.9

223.4
nmol/mL
Prolyl hydroxylase + Vitamin C

Hydroxyproline < 30.6

9.3
nmol/mL
4-Hydroxyproline oxidase

Glycylproline < 2.6

<DL
nmol/mL
Dipeptide of Glycine + Proline

3 - Nutrition

B-Complex (B1, B2, B3, B5, LA) Result Reference

Branched Chain Alpha-Keto Organic Acids < 28.3

13.5
nmol/mg Creatinine
Branched-chain keto acid dehydrogenase + B1, B2, B3, B5, LA

α-Ketoglutaric Acid < 157.2

19.5
nmol/mg Creatinine
alpha-Ketoglutarate dehydrogenase + B1, B2, B3, B5, LA

Pyruvic Acid < 47.2

53.4 H
nmol/mg Creatinine
Pyruvate dehydrogenase + B1, B2, B3, B5, LA

Vitamin B-12 Result Reference

Methylmalonic Acid 2.7 - 25.9

14.4
nmol/mg Creatinine
Methylmalonyl-CoA mutase + B12

KEY: < dl = Results below detection limit.

= Analyte measured in plasma.

The assays were developed and/or the performance characteristics determined
by Diagnostic Solutions Laboratory. The results are for research and not for
diagnostic purposes. |8
Patient: Ima Sample Accession: OMXTest07

3 - Nutrition

Folate Result Reference

Formiminoglutamic Acid < 0.4

0.05
nmol/mg Creatinine
Glutamate formimino-transferase + Folate

Vitamin B6 Result Reference

Pyridoxic Acid < 111.9

<DL
nmol/mg Creatinine
Aldehyde oxidase

Xanthurenic Acid < 9.5

10.9 H
nmol/mg Creatinine
Kynurenine transaminase + B6

Biotin Result Reference

β-Hydroxyisovaleric Acid 25.1 - 223.4

78.5
nmol/mg Creatinine
Methylcrotonyl-CoA carboxylase + Biotin

Plant Components Result Reference

Quercetin > 2.7

5.3
nmol/mg Creatinine
Polyphenol: Flavonoid

Tartaric Acid > 1.8

5.0
nmol/mg Creatinine
Plant component

Meat intake Result Reference

1-Methylhistidine < 16.0

<DL
nmol/mL
Dietary meat & fish

Carnosine < 2.7

2.7
nmol/mL
Carnosinase

Anserine < 18.4

<DL
nmol/mL
Anserinase

Sugar Intake Result Reference

Fructose < 4.7

5.4 H
nmol/mg Creatinine
Fructokinase

KEY: < dl = Results below detection limit.

= Analyte measured in plasma.

The assays were developed and/or the performance characteristics determined
by Diagnostic Solutions Laboratory. The results are for research and not for
diagnostic purposes. |9
Patient: Ima Sample Accession: OMXTest07

4 - Stress & Mood

Neurotransmitter Result Reference

γ-Aminobutyric Acid < 1.5

<DL
nmol/mL
gamma-Aminobutyric acid aminotransferase + B6

Catecholamine Turnover Result Reference

Homovanillic Acid < 10.3

2.8
nmol/mg Creatinine
COMT + magnesium & monoamine oxidase + B2

Vannilylmandelic Acid 4.8 - 21.4

32.5 H
nmol/mg Creatinine
Monoamine oxidase + B2

Serotonin Turnover Result Reference

5-Hydroxyindoleacetic Acid 6.3 - 28.7

4.6 L
nmol/mg Creatinine
Aldehyde dehydrogenase + B3

Steroid Hormone Result Reference

Cortisol < 82.0

90.7 H
mcg/g Creatinine
11-beta-Hydroxysteroid dehydrogenase + B3

Cortisone < 665.0

92.9
mcg/g Creatinine
11-beta-Hydroxysteroid dehydrogenase + B3

Aldosterone < 2.5

<DL
mcg/g Creatinine
Steroid 5-beta reductase

5 - Toxic Impacts

Oxidative Damage Result Reference

8-Hydroxy-2'-deoxyguanosine < 8.4

14.8 H
nmol/mg Creatinine
DNA oxidation

KEY: < dl = Results below detection limit.

= Analyte measured in plasma.

The assays were developed and/or the performance characteristics determined
by Diagnostic Solutions Laboratory. The results are for research and not for
diagnostic purposes. |10
Patient: Ima Sample Accession: OMXTest07

5 - Toxic Impacts

Toxins Result Reference

2-Methylhippuric Acid < 2.1

1.2
nmol/mg Creatinine
Xylene exposure

Mandelic Acid < 4.6

1.3
nmol/mg Creatinine
Styrene exposure

Benzoylform < 4.3

2.9
nmol/mg Creatinine
Styrene exposure

Glucaric Acid 3.6 - 25.8

7.7
nmol/mg Creatinine
Glucuronic Acid Pathway

Urea Cycle Result Reference

Arginine 36.9 - 112.2

24.9 L
nmol/mL
Arginase & Nitric oxide synthase

Citrulline 13.8 - 59.7

16.2
nmol/mL
Argininosuccinate synthase

Ornithine 39.0 - 132.1

82.3
nmol/mL
Ornithine transcarbamylase

Homocitrulline < 3.4

<DL
nmol/mL
Argininosuccinate synthase

Arginosuccinic Acid < 14.2

<DL
nmol/mL
Argininosuccinate lyase

KEY: < dl = Results below detection limit.

= Analyte measured in plasma.

The assays were developed and/or the performance characteristics determined
by Diagnostic Solutions Laboratory. The results are for research and not for
diagnostic purposes. |11
Patient: Ima Sample Accession: OMXTest07

5 - Toxic Impacts

Kidney Impacts Result Reference

Orotic Acid 0.7 - 6.0

7.0 H
nmol/mg Creatinine
Uridine monophosphate synthase

Microalbumin < 130.4

<DL
mcg/g Creatinine
Blood protein

Phosphate 11.2 - 192.4

145.0
mg/dL
Charged particle (ion)

Creatinine 29.3 - 296.8

150.0
mg/dL
Creatine breakdown

Oxalic Acid < 1532.5

533.3
nmol/mg Creatinine
Divalent metallic cations

KEY: < dl = Results below detection limit.

= Analyte measured in plasma.

The assays were developed and/or the performance characteristics determined
by Diagnostic Solutions Laboratory. The results are for research and not for
diagnostic purposes. |12
Patient: Ima Sample Accession: OMXTest07

6 - Microbial Metabolites

Amino Acid Microbial Metabolites Result Reference

4-Hydroxyphenylacetic Acid 85.8 - 902.3

175.5
nmol/mg Creatinine
Disordered tyrosine metabolism

Indoleacetic Acid < 13.7

1.3
nmol/mg Creatinine
Disordered tryptophan metabolism

Polyphenols Microbial Metabolites Result Reference

3,4-Dihydroxyhydrocinnamic Acid < 1490.3

<DL
nmol/mg Creatinine
Polyphenol metabolite

3,5-Dihydroxybenzoic Acid < 277.1

299.8 H
nmol/mg Creatinine
Microbial metabolite

4-Hydroxybenzoic Acid < 14.9

2.6
nmol/mg Creatinine
Hydroxybenzoic acid derivative

Benzoic Acid < 488.0

<DL
nmol/mg Creatinine
Glycine N-benzoyltransferase

Hippuric Acid < 291.9

184.9
nmol/mg Creatinine
Glycine conjugate of benzoate

Isoflavone Microbial Metabolite Result Reference

Equol < 12.8

17.3 H
nmol/mg Creatinine
Isoflavone metabolite

Fungal Assessment Result Reference

Arabinitol < 9.0

2.8
nmol/mg Creatinine
Dehydrogenase

KEY: < dl = Results below detection limit.

= Analyte measured in plasma.

The assays were developed and/or the performance characteristics determined
by Diagnostic Solutions Laboratory. The results are for research and not for
diagnostic purposes. |13
Patient: Ima Sample Accession: OMXTest07

PERSONALIZED METABOLOMIC RECOMMENDATIONS

Note: Nutrient supplementation is up to the treating clinician's discretion with full understanding of the patient's medical history and
current clinical condition.

MICRONUTRIENTS Support Required Recommendations Food Sources

B-Complex None No Additional Support Mixed diet

Thiamin (B1) None 1.2 mg* Rice, wheat germ, lentils, peas, pork, whole wheat bread, spinach
Riboflavin (B2) None 1.3 mg* Milk, almonds, eggs, salmon, chicken, broccoli, spinach
Niacin (B3) None 16 mg* Chicken, tuna, turkey, cereal, peanuts, lentils, coffee
Cobalamine (B12) None 2.4 mcg* Clams, mussels, mackerel, crab, beef, salmon, milk, eggs
Folate (B9) None 400 mcg DFE* Lentils, garbanzo beans, spinach, asparagus, lima beans, orange juice
Biotin (B7) None 30 mcg* Eggs, liver, salmon, avocado, raspberries, cauliflower, bread
CoQ10 Moderate 60+ mg Beef, herring, chicken, canola oil, Rainbow trout, peanuts, pistachio nuts,
brocolli
Magnesium None 420 mg* Beef, pork, milk, cod, chicken, avocado
Carnitine None 10+ mg Beef, pork, milk, cod, chicken, avocado
Copper None 0.9 mcg Eastern oysters, crab meat, clams, cashews, sunflowers, hazelnuts,
almonds

* DV or Daily Values, are the recommended amounts of nutrients per day for a healthy, non-deficient adult.

PROTEIN Findings Suggested Recommendation

Phenylalanine High Assess protein intake; evaluate inflamation, risk of diabetes, mood disorders (schizophrenia), hyperactivity
Isoleucine/allo-Isoleucine High
Assess protein intake; consider metabolic conditions and BMI; check B6 level and alpha-ketoglutaric acid
levels
Leucine High Assess protein intake; evaluate metabolic conditions; check B6 and alpha-ketoglutaric acid
Valine High
Assess protein intake; consider metabolic conditions and BMI; check B6 level and alpha-ketoglutaric acid
levels
Tryptophan Low
Assess calorie and protein intake; evaluate digestion; check inflammation, kidney function and mood
disorders; check pathways (kynurenine, serotonin, indoles)
Methionine Adequate No Additional Support
Threonine Low Assess calorie and protein intake; evaluate gut bacteria, glycine status (benzoate and hippurate).
Lysine Adequate No Additional Support
Histidine Adequate No Additional Support
Arginine Low
Assess protien intake; evaluate digestions, glycine, ornitine, citruline status; consider glucose, hypertension,
eGFR, renal or small intestine dysfunction
Glycine Low Evaluate toxin exposoure, IBD; check glutathione and B6 level; add glycine and lipoic acid
Taurine Adequate No Additional Support

ADDITIONAL SUPPORT Support Required Suggested Recommendation

Glutathione Need None No Additional Support

Inflammation None No Additional Support
Liver Parameters None No Additional Support
Kidney Parameters None No Additional Support

The assays were developed and/or the performance characteristics determined

by Diagnostic Solutions Laboratory. The results are for research and not for
diagnostic purposes. |14