Hompes MethodLesson 29 –

Organic Acids – Part One

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Organic Acids - Introduction

• The ultimate tool for laboratory evaluations in nutritional medicine is a simple, sensitive test that can reveal evidence of functional inadequacy of specific nutrients. The promise of such a tool is found in profiling of organic acids in urine.

Organic Acids - Introduction

• Unlike minerals, amino acids and fatty acids, the category of compounds called organic acids contains no essential nutrients. Instead of tests that measure nutrient concentrations, abnormal concentrations of organic acids in urine provide functional markers for the metabolic effects of vitamin inadequacies, toxic exposure, neuroendocrine activity, and intestinal bacterial overgrowth.

Organic Acids - Introduction

• The term “organic acid” refers to a broad class of compounds used in fundamental metabolic processes of the body. If you want the technical jargon, read the Metametrix Lab Evaluations book (hardback or the PDF that appears to be publicly available in your resources section).

Organic Acids - Introduction

• All bodily functions are powered by the release of chemical energy. Each day, the energy content of the food for an average person could raise the temperature of about seven gallons of water to the boiling point. The energy is released through a process of controlled oxidation where chemical bonds are broken and energy is released.

Organic Acids - Introduction

• Fats, carbohydrates, and amino acids are converted into carboxylic acids before they flow on to the final conversion to carbon dioxide The organic acids that are formed as intermediates in this process are normally absent from urine or present at very low concentrations.

Organic Acids - Introduction

• When specific reactions are blocked due to the absence of sufficient enzyme or cofactor, the intermediates that precede the blocked step accumulate and spill into urine.

Vitamin B6

A--------||--------B-----------------C

Urine

Organic Acids - Introduction

• Overt nutrient deficiencies are one reason for metabolic inefficiency. Variations in enzyme structure that lead to decreased cofactor binding are another major cause of nutrient deficiencies. Individuals with faulty enzyme binding can have increased nutrient needs that will not be revealed by measures of vitamin concentrations in blood.

Organic Acids - Introduction

“Metabolism is the process in which your body converts the food you eat into energy and new structures. The

study of human metabolism has revealed how vitamins and minerals are used to perform those hundreds of

necessary chemical reactions.”

Metametrix Organix Interpretive Guide

Organic Acids - Introduction

“Many of the weaknesses can be overcome by increasing your intake of a vitamin or other essential nutrient. Some of the measurements show nerve or detoxification functions. The final set of compounds

shows disturbances in the balance of bacteria that may grow from food residues in your digestive system.”

Metametrix Organix Interpretive Guide

Organic Acids - Introduction

“By correcting problems shown in your Organix test results, your doctor is improving your body’s ability to

heal and stay healthy. This approach has been shown to improve treatments for conditions ranging from

childhood autism to adult chronic fatigue syndrome.”

Metametrix Organix Interpretive Guide

Organic Acids - Introduction

“It also can help people reduce their risk of heart disease, obesity, fatigue, or many other conditions.

When your main imbalances are corrected, you may be able to make simple diet changes to achieve the balance that lets you sustain health as you age.”

Metametrix Organix Interpretive Guide

Organic Acids - Introduction

• 46 Specific markers in these categories:

– Fatty acid oxidation

– Carbohydrate metabolism

– Energy production (citric acid cycle)

– B-complex vitamin markers

– Neurotransmitter metabolism

– Oxidative damage and antioxidant markers

– Detoxification indicators

– Dysbiosis markers

Organic Acids - Introduction

• We can’t possibly cover all the sections in a single lesson – there’s a lot of incredibly helpful and clinically relevant information to get through and I need to teach you some of the main metabolic pathways so you understand the imbalances!

Organic Acids - Introduction

• Because we’re going to focus heavily on cellular energy production for a couple of lessons, I’d like to begin by sharing an analogy I use with clients that helps them better understand how the body makes

energy.

Everything Depends on Energy

• Chronically unwell patients & clients often have problems with energy production at the cellular level. If energy is not being produced optimally at the cellular level, tissue, organ and systemic health is simply not possible.

Everything Depends on Energy

• Body • Systems• Organs• Tissues• Cells – energy production required here • Organelles – energy production required here• Molecules• Atoms• Sub-atomic• Mathematical probability

Energy and the “Car” Analogy

1. In order for a car to move, it first has to have petrol in the petrol tank.

2. The petrol comes from the pump, via the hose.

3. Once in the tank, the petrol has to be “injected” into the engine (fuel injection).

4. The engine has to the right components to burn the fuel and create the energy needed for the car to move.

5. To switch the whole process on, the key needs to fit in the ignition and be turned.

Energy and the “Car” Analogy

1. The food on your plate is the fuel in the pump and the hose is your digestive system.

2. The fuel is stored in your body within the cells as fatty acids, amino acids and glucose.

3. It has to be transported / injected into the mitochondria (cellular engines).

4. The mitochondria have to have the right components to burn the fuels (nutrients).

5. None of this works without the keys in the cellular ignition, which happen to be hormones.

Energy and the “Car” Analogy

• The energy production process can be compromised or blocked at any stage:– Poor food choices and digestion (fuel pump)

– Cant get fuel into stores (circulatory problems, insulin resistance)

– Can’t inject fuels into mitochondria (nutrient deficiencies, oxidative stress)

– Mitochondria can’t burn fuels (nutrient deficiencies)

– Ignition doesn’t switch on (low hormones – e.g. thyroid)

This Lesson

Next Lesson

Energy Production Pathways

• THREE main stages:

• Stage I – Oxidation of main fuels (cytoplasm).

• Stage II – Citric Acid Cycle in mitochondria.

• Stage III – Electron transport chains ad final ATP production.

Stage I – Fat and Carb Metabolism

Fatty Acid Oxidation

• Fatty acid metabolism by mitochondrial β-oxidation (beta-oxidation) is a critically important energy-yielding pathway in most tissues. Carnitine is required as a carrier for the transport of fatty acids from the cytosol into the mitochondria for beta-oxidation. This is the dominant pathway used to derive energy from fat in most cells.

Fatty Acid Oxidation

• When carnitine is inadequate to keep up with demand, the degradation of fatty acids takes place through an alternate, less efficient pathway known as Ω-oxidation (omega oxidation). Adipate and suberate are products of incomplete oxidation in the omega-oxidation pathway and indicate a functional carnitine deficiency.

Fatty Acid Oxidation

• Ethylmalonate, which comes from the breakdown of butyrate from intestinal bacteria, also has a carnitine-dependent pathway and can accumulate with an insufficient amount of carnitine.

Fatty acids go into the mitochondria via a carnitine-dependent shuttle to be metabolised. If there is not enough carnitine, the fatty acids cannot get into the mitochondria. Instead they get metabolisedby the peroxisomes outside the mitochondria. The by-products are adipate, suberate and ethylmalonate.

Fatty Acid Oxidation

Fatty Acid Oxidation

• The biochemical relationship between these two nutrients can explain this effect. Carnitine is required to allow fatty acids to enter into mitochondria, but fatty acids cannot undergo oxidative metabolism without riboflavin coenzymes.

Fatty Acid Oxidation

• The use of aspirin can change the interpretation of results for the three marker compounds because salicylic acid is an inhibitor of fatty acid β-oxidation and may lead to elevated markers.

Fatty Acid Oxidation –Sample Report

• In the report below you can see how adipate and ethylmalonate are both elevated.

Fatty Acid Oxidation - Intervention

• The body can make carnitine from L-lysine, it’s often low in vegetarians and people who have digestive issues. Supplementation of carnitine and B2 is indicated when any of the three are elevated.

Carbohydrate Metabolism

Carbohydrate Metabolism

• Carbohydrate metabolism has to go through a complex set of reactions known as glycolysis BEFORE we get to the end products pyruvate or lactate. This series of reactions is known as glycolysis.

http://biochem.co/2010/02/glycolysis/

Carbohydrate Metabolism

• Abnormalities of urinary excretion of pyruvate and lactate provide useful insight to basic metabolic factors due to their position in the energy production process. Pyruvate is the anaerobic breakdown product of glucose. Its further conversion to acetyl-CoA requires the pyruvate dehydrogenase enzyme complex.

Carbohydrate Metabolism

• Pyruvate enters the Krebs cycle (next lesson) via a dehydrogenase enzyme that requires, B1 (thiamin), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), and lipoic acid to function correctly. If these nutrients are not available then pyruvate may become elevated in the urine.

Carbohydrate Metabolism

• Lactate, also known as lactic acid, is a principal product of glucose oxidation in skeletal muscle. Lactate accumulates when there is a block in the final oxidative stage of energy production in the Krebs cycle. Coenzyme Q10 supplementation is effective when lactate is elevated and energy production is interrupted.

Carbohydrate Metabolism

• Lactate builds up when the Krebs cycle is not working efficiently (toxicity, oxidative stress, insulin resistance, nutrient deficiency) or when capacity for oxidative phosphorylation is exceeded (e.g. exercise).

• * Krebs cycle is the same as citric acid cycle.

Carbohydrate Metabolism

• β-Hydroxybutyrate is a primary ketone body. It builds up in urine when someone is on a low carbohydrate diet or fasting. It is a “textbook” ketone body feature of metabolic acidosis due to failure of glucose utilization as with diabetes.

Carbohydrate Metabolism

• Individuals with normal blood glucose response to insulin do not produce high concentrations of ketone bodies because their production of energy from glucose is well controlled. Elevations of β-hydroxybutyrate in an overnight urine collection may indicate inefficient utilization or mobilization of glucose.

Carbohydrate Metabolism

• Ketone body production increases in diabetes because the oxidation of free fatty acids is stimulated, and excess acetyl-CoA is converted to the four-carbon acids, β-hydroxybutyrate. It will also build up in someone with impaired insulin function.

Carbohydrate Metabolism

Carbohydrate Metabolism

• Chromium and vanadium have been shown to help regulate insulin functions and may be helpful. The major function of chromium and vanadium is to help insulin act on your cells to regulate blood sugar. Excessive fatigue on exertion is the most common symptom associated with ketosis.

Carb Metabolism – Sample Report

• Supplementation with B-complex, lipoic acid, CoQ10 may help with high pyruvate and lactate, respectively; or Chromium/vanadium for high β-hydroxybutyrate.

Carbohydrate Metabolism

Organic Acids - Summary

• Organic acids are produced by normal metabolic processes.

• The accumulation of organic acids in the urine indicates blockages that are often attributable to the presence of toxins or nutrient deficiencies.

• Several areas of metabolism are investigated in the Organix profile (46 different markers).

• Fatty acid and carbohydrate metabolism can be effectively analysed by determining suberate, adipate, ethylmalonate, pyruvate, lactate and β-hydroxybutyrate.

Thank You!

• Thanks a million for tuning in. I appreciate your time and I appreciate you choosing me as one of your teachers. In the next lesson we’ll look at how the Organic Acids profiles can assist in the next step of cellular energy production – the Krebs Cycle.