Adrenal Stress – Biotin Pattern

Summary

Interesting combination of test markers link cortisol level to biotin deficiency and small bowel bacterial overgrowth.

This content was created by the Metametrix Institute

History

Chronic complaints of bloating, constipation, flatulence and diet cravings are reported by this 41 y/o woman. Her fingernails chip easily, she has cravings for sweets, and she can’t lose weight.

Age

41

Gender

Female

Description of Results

Adrenal Stress Profile

Her pattern of cortisol output is not severely abnormal, but she displays a pattern of delayed morning cortisol elevation that is typical of failure of the normal ACTH signaling at waking. Levels later in the day are sustained too high to allow proper shifting to anabolic metabolism at night, so the normal tissue repair processes are lacking. Under these conditions, the energy deficit tends to produce carbohydrate cravings, further fueling the cortisol-insulin degenerative cycle in a feed-forward manner.

The more quantitatively demanding flow of cholesterol to DHEA has slipped to abnormal low values of DHEAS, indicating the chronic nature of the stress response, although normal sIgA shows that the magnitude of the cortisol elevation in the recent past has not been great enough to suppress immunoglobulin synthesis. A slight development of leaky gut, however, is indicated by the mildly elevated anti-gliadin antibody level.

Organix Profile

Her Organix report shows a distinct elevation of the biotin-dependent marker, beta-hydroxyisovalerate. Biotin is required for biosynthetic processes, so inadequacy is likely to exacerbate (possibly having preceded) the catabolic state shown in the hormonal profile. Note also the specific isoleucine flux increase indicated by elevated a-keto-b-methylvalerate. This may be associated with the skeletal muscle catabolic enhancement initiated by sustained cortisol elevation in late evening hours.

The cause of the biotin insufficiency may be revealed in the pattern of organic acids produced by intestinal microbial metabolism. She has a marked elevation of phenylpropionate that signals significant overgrowth of a specific strain of bacteria. Although the genus and species can not be specified, it is likely that the disrupted bacterial populations in the small intestine are disrupting the normal bacterial synthesis of biotin that contributes to biotin supply.

Recommendations

The hormonal profile is typical of that which leads to the development of insulin insensitivity or Syndrome X, and carbohydrate restricted diet is recommended. Small bowel bacterial overgrowth (SBBO) is indicated, so use of probiotics with courses of bacteriostatic agents should be considered while supplementing dietary biotin intake.

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