Case Name: All-normal Abiosis
Case # 394

Summary:
When large multi-parameter profiles are used, sometimes we can read beyond the usual abnormal indications and look for patterns of data in normal ranges that give clues consistent with the picture from patient history and physical examination.

gastrointestinal symptoms

K91 Urine Organix Profile

30

M

10/21/2003

History Because of a history of g.i. complaints, this 30 y/o male patient had been advised to go on a high fiber diet and to add polyunsaturated oils to the diet. He reacted negatively to these changes, showing a worsening of symptoms. Then the profile of organic acids in urine was ordered. Description of Results Not a single finding was reported out as abnormal. Any profile of 47 analytes is statistically unlikely to show everything normal for any given individual. The clinician in this case expected to see dysbiosis and detoxification markers out of range. Recommendations Since there was no known milk intolerance or allergy, this is a case where the significant enhancement of colonization of L. acidophillus, etc. by lactose can be utilized. Have the patient maintain an active culture of yogurt and consume it multiple times daily. Regarding dietary fiber, the clinician was uninformed about the champion food source of fiber - beans. Many patients have the idea that a high fiber diet means eataing bran muffins and all-bran cereal, etc. The best all-round advice for increasing pro-biotic fiber is to eat beans multiple times per week. Any kind of colored beans will do since they all have great combinations of soluble and insoluble fiber. Finally, the reported adverse response to polyunsaturated dietary oils can be a sign that antioxidant protection is insufficient for lipid oxidative challenges. We note that the DNA-damage marker, 8-hydroxy-2'-deoxyguanosine is not elevated, but that there still mat be a specific lipid oxidative damage challenge. Therefore, we recommend a high potency, mixed antioxidant source along with recommendation to include berries and colored vegetables as tolerated. Other Comments First, we note the favorable result that may be reported to the patient. Normal levels for the entire set of sensitive markers for thiamin, riboflavin, carnitine, pyridoxine, biotin, vitamin B12, and folic acid allow us to rule out overt vitamin insufficiency as the origin of the symptoms. Next, however, we look closely and find that all but one of the thirteen markers for intestinal bacteria and yeast growth are in the first or second quintile, meaning that they are below the mean for the patient population. This unusual finding may escape detection because there are no "Low" limits for the microbial markers. There are reported incidences, however, of states of abiosis, or lack of sufficient small intestinal populations. This condition is usually preceeded by multiple courses of wide-spectrum antibiotics. On questioning the clinician, it was found that this patient had, indeed, been on multiple powerful antiobiotics in the past few months. Apparently there has been very poor intestinal repopulation following the killing of large groups of specie by the pharmacological agents.

Lab Data Figure . All-normal OAU 01.gif Figure . All-normal OAU 02.gif