A variety of metabolic profiles and micronutrient (vitamins, minerals, antioxidants) tests are available through direct-to-consumer websites and alternative practitioners. Often they are advertised as general screens for “metabolic abnormalities” or “nutritional deficiencies”. The actual tests carried out for each profile can vary considerably between retailers. They are often expensive and may cost upwards of £200 per profile.
These sorts of tests are frequently promoted by alternative practitioners, such as naturopaths and nutritionists, who use results to suggest that patients require supplements or other ‘alternative’ therapies to correct ‘nutritional/energy imbalances’ or micronutrient deficiencies. The types of profiles offered include:
- Amino acid profile
- Organic acid profile
- Micronutrient tests (vitamins and minerals)
- Essential fatty acid profile
- Antioxidant profiles
Many of these tests do have valid clinical uses in specific circumstances, for instance when investigating newborn babies for rare inherited diseases. Tests such as amino acid and organic acid profiles are highly specialised investigations that are used by medical specialists to diagnose and monitor rare conditions. Metabolic profiles like this are only used if a specific medical condition is suspected because a patient has signs or symptoms that would fit that diagnosis. Performing the tests and interpreting results requires highly trained and appropriately qualified staff. Read more about rare metabolic conditions and the screening tests used to detect them here.
Using amino acid and organic acid profiles for the assessment of nutritional status is not recommended because there is no evidence the tests provide any useful information. Using these tests in this way is likely to be misleading and may lead to an incorrect diagnosis and unnecessary treatment.
Micronutrient tests look at levels concentrations of vitamins and minerals in the body and are a valid assessment when a patient shows symptoms that suggest deficiency of a particular micronutrient. However, testing is generally only useful for a small number of micronutrients while analysis of others is rarely, if ever, useful. For the majority of micronutrients clinically significant deficiency is unlikely and only occurs in those that are severely malnourished or have specific conditions known to cause deficiency, a good example is Pernicious anaemia and vitamin B12 deficiency.
Nutrient tests that are frequently useful where risk of deficiency is high or patients show signs or symptoms of deficiency:
Vitamin B12, folate, vitamin D, iron, calcium, phosphate, magnesium, potassium, zinc
Nutrient tests that are useful but only in rare circumstances because clinically relevant deficiency is unlikely:
Selenium, copper, manganese, vitamin A, beta-carotene, vitamin E, some B vitamins (thiamine, pyridoxine), vitamin C.
Tests where there is very rarely any benefit in analysis:
Remaining B vitamins (riboflavin, pantothenic acid, niacin), vitamin K, iodine, chromium, manganese, molybdenum, all other trace elements.
Antioxidant profiles are also frequently offered alongside other micronutrient tests. Antioxidants are a broad range of compounds that play a role in helping the body manage oxidative stress, which is known to be associated with a wide range of diseases. The sorts of compounds that might be analysed include:
Tocopherols (including vitamin E)
Carotenes (including vitamin A)
Ascorbic acid (vitamin C)
Superoxide dismutase (SOD)
Antioxidant testing is often advertised as a way of assessing the body’s level of ‘oxidative stress’ or ‘antioxidant reserve’. Alternative practitioners frequently use results to suggest dietary modification or supplements to correct antioxidant status or ‘detox’ the body. However, large clinical trials have failed to show that antioxidant supplementation reduces risk of disease in the general population and there is evidence that some antioxidants (e.g. vitamin A, C, E and beta-carotene) may actually be harmful. It therefore follows that testing for antioxidants in this way is not clinically useful and may actually lead to harm. It is also common for patients to be offered a range of expensive but questionable ‘detox’ therapies and health regimes based on results of this testing. For more information see: http://www.senseaboutscience.org/pages/debunking-detox.html
Essential fatty acid testing or fatty acid profiling involves analysing specific types of fats in the blood stream. Commonly advertised are from fatty acids of the Omega-3 and Omega-6 groups. Whilst there is good evidence that modifying diet to include more ‘good’ fats (i.e. omega-3) is beneficial there is no evidence that testing fatty acids is able to provide any further information or health benefit. Alternative practitioners may use results to suggest specific types of fatty acid supplements but there is no evidence that this approach is any better than following standard dietary advice on fat and oily fish intake.