History
This patient presented with fatigue and mild depression.

Description of Results
The laboratory report images shown below are in the order of most recent (11 month follow up), intermediate (2-month follow up), and initial testing dates.

Several of her amino acid levels in plasma were low, indicating that her combination of intake, digestion, or utilization was inadequate to sustain the anabolic demands of her tissues. She started the custom amino acid formula as recommended in the Metametrix report. Within 30 days she reported improved sense of energy.

At six months she was very pleased with her sense of wellness. The amino acid pattern was significantly improved with only Phe and Orn significantly below their lower limits. She ordered the modified custom amino acid formula and continued to feel that the product helped her sustain a good energy level and normal function

On the third follow up test after another 5 months, her plasma levels were hovering around the low limits.

Recommendations
At the end of this course of testing and supplementation it was recommended that the patient be advised to keep a supply of balanced free form amino acids on hand to use as needed to sustain energy levels. Her difficulty in maintaining fasting plasma amino acid levels may be due to declining stomach acid or pancreatic enzyme output that is inhibiting full digestion of dietary protein.

Other Comments
This progression illustrates the changes that may be seen when a patient moves from an initial state of chronic inadequate amino acid supply to states of more sustained adequacy. Fasting plasma levels are governed by the balance of amino acid release from skeletal muscle (catabolic) and uptake by hepatic tissue for biosynthesis (anabolic). As new stimuli of catalytic cofactors (vitamins) or anabolic demands (exercise) are introduced plasma levels tend to be drawn down. When intake is balanced and digestive factors are improved, plasma levels move upward. In a person in relative high level wellness, these changes tend to produce a slow undulation of resultant amino acid levels in plasma, especially if digestion of dietary protein is incomplete.