LindsayI think I intended to discuss micronutrient testing for the past three or four posts , but was sidetracked by other issues. Finally crossing it off my list.
Micronutrients
Your body needs two types of nutrients: macronutrients and micronutrients. Macronutrients are those nutrients you need in large quantities, like carbohydrates, fats, and protein. Nutrients you need in smaller quantities, such as water and fat soluble vitamins, and minerals.
Micronutrient testing examines the levels of those micronutrients in your white blood cells. In addition to the above markers, the NutraEval test I completed also includes toxic metals, amino acid analysis, and essential and fatty acid analysis. Micronutrient testing is thought to provide a more accurate picture of levels as it tests what is actually being absorbed, rather than just what is circulating. However, I should note its usefulness is often questioned by traditional doctors.
Micronutrient Testing
For the test, you are given a kit with a bunch of vials for the blood draw, a urine cup, an ice pack, bags in which to return the samples, and a bunch of paperwork. Once the blood and urine samples are obtained, they are shipped to the micronutrient testing lab for processing.
Micronutrient testing is conducted by a few different labs. My doctor ordered the Genova Diagnostics NutraEval test, but I know SpectraCell Laboratories also conducts micronutrient testing. I think they’re all fairly similar, but I should note that in preparing to write this post, I found a bunch of complaints online about Genova’s billing practices. I haven’t had a billing issue yet, but will update if I do.
I received the NutraEval test kit from my doctor’s office. The kit included a number of blood vials, some paperwork, hazard bags and shipping packaging, and if you read my previous post, you know about the in-home lab service that obtains the blood and urine needed for the test (and the shitshow that ensued). I believe you can also take it to an independent lab, like Quest Diagnostics, for labwork.
Once the samples are processed, your doctor is provided a report of the results, which you can also access on their website through your account. You can view a sample report by clicking here.
My doctor called me in for an appointment once the results were received and, as I expected, and as so often occurs with me, my tests came back showing a lot of abnormalities. In fact, when I showed up for my appointment, the first thing she said to me, even before “hello”, was “you’re a complex case.” Not the first time I have received that particular compliment, and honestly, it’s one I kind of take pride in. I’d hate to be boring.
We sat down and went over my test results together for an entire hour. The report provides a status level for each micronutrient: normal, borderline, or high need. “Borderline” means you’re a little low, and “high need”, like the name suggests, means you are very low. Overall, I had a pretty even mixture of normal, borderlines, and high needs that I won’t bore you with. What was significant, and what I will bore you with, is my B-vitamin results.
B-Vitamins
All but one of my B vitamins is either borderline or high need, with the majority in the “high need”. Only my B7 (Biotin) is normal. This is significant because low B vitamins, particularly B1 (thiamin), B6 (pyridoxine), and B12 (cobalamin), can cause nerve damage. B1, B6, and B12 help maintain proper nervous system functions and are often recommended for those with neuropathy.
Other than folate and B12, I have never had my B-vitamins tested. My recent standard folic acid lab was extremely high – about double the top of the range. However, as I wrote about in a recent post, I had suspicions that I don’t absorb man-made folic acid, but instead need the natural folate. The micronutrient test confirmed that, while my folic acid may be high, my folate is actually very low. 
My recent B12 standard lab came back initially within the normal range (although normal is 200-900 pg/mL, which is a huge range). On the advice of a doctor, I started supplementing with B12. A month later my B12 was very high, at 2200. I started only taking B12 once a week, and a month later, it dropped to 1120. So while some of the vitamins I take are clearly being absorbed into my bloodstream, it doesn’t seem that much is being absorbed into the cells.
I have been reading all about B vitamins and their role in promoting proper functions, especially our neurological system, and will probably post more about that later. As someone who has neurological health issues (both POTS and small fiber neuropathy), and who comes from a family with some neurological issues, I expect B-vitamins will play an important role in managing my health.
Pros of Micronutrient Testing
- I love that micronutrient testing analyzes so many markers at once. I would have had to order hundreds of separate labs to receive all of this information.
- The report was very detailed and not only showed where my levels fall in the recommended range, but also suggest a daily intake for those in which I am low.
Cons of Micronutrient Testing
- I don’t know if this is specific to the NutraEval test or all micronutrient testing, but it didn’t give my actual numerical result for a lot of the markers. For example, I know I am very low in B2, but I don’t actually know my number. That makes it difficult to track improvement as I begin to supplement.
- It is mostly utilized by functional medicine doctors, so finding a prescribing doctor may be difficult.
- It is often not covered by insurance and can get expensive.
If you have had micronutrient testing, or other non-standard testing, I would love to hear about it.
“Any fool can know. The point is to understand.”
―
Smell ya later.
– Linds
Did your doc actually say hello after remarking on how complex a case you are? I agree though, better to not be boring 😂
I’ve been low on lots of micronutrients and still am, it’s a pain in the ass. The B bits are a big one. I’ve got Pernicious Anaemia but the treatment in the UK is pretty poor at one jab every 3 months, which just isn’t enough. Hence some of us here end up buying online and self-injecting. My folic was also low, but since doing supplements most of last year it seemed to go up and stabilise a bit. Are you going to supplement for folate?
Did these tests also cover Vit D? That’s another I was chronically low on before (apparently next to nothing in my blood) and yet it’s something the docs never seem to check for. They only bothered because they found I had thin bones at 28. Hopefully Vit D was covered in your tests too.
Really helpful post for others, and I’m really glad you’ve been able to have these tests done, Linds!
Caz xx
Hi Caz! Eventually she did say hello 🙂 In fact, one of the reasons I love her is that she says more than hello. She asks how my husband is, how my dog is doing, everytime I see her.
I accidentally joined a UK based pernicious anemia message board when I found out I was low in B12 and regularly read the messages about how difficult it is to get B12 there! Apparently some of the board members have to use a German website to get B12 to self inject – that must be so frustrating! Do you self inject?
I have been taking folate for probably about 6 weeks. It’s a combined B12/folate sublingual pill. I’m not sure what to think yet – sometimes I feel like the folate makes my nerve pain worse, but I think I need to test that theory more. The micronutrient test did not test vitamin D, but I have a long history of Vit D deficiency and already take supplements. I think my number is back up in the normal range now after taking very high Vit D doses weekly, but if I stop them it plummets again. Are you deficient in ferritin? That’s another one I’m chronically low in.
Thanks for your comments on my blog – I always look forward to reading them because you are so supportive, Caz!
Linds, you could never be boring, medically or otherwise! I’m pretty sure it’s the curse of all good dysautonomiacs. 😆 It sounds like moving to methylated vitamins is very smart. Amazing what we can change when we have a bigger view and this testing sounds great! I switched to methylated vitamins a few months ago, since MTHFR mutation seems pretty likely for the genetic trainwreck that I am. Not to mention my long history of supplementing insane levels and still coming out lacking. If I can help make the transition for you easier, let me know. I’m happy to help. They really do make a difference! Xx
Thank you! I just recently started a methylated folate and B12 sublingual. What other methylated vitamins do you take?
So sorry. Meant to come back later when I could look at my meds! I take a pure encapsulations B complex plus with bioavailable B2, B6 and methylfolate. I also switched to a methylated vitamin d cream and try to take easy to digest liquids and powders over pills for the rest. I don’t think I digest most pills very well anymore, like I use magnesium powder and epsom salt baths. Now I need to find some zinc. Apparently, I’m deficient there, too. Was zinc one you were deficient in? I’m wondering if it’s more common than realized.
Thank you! That’s very helpful.
I am deficient in zinc, too. I was deficient years ago and took zinc for about a year, then stopped because my numbers were back up in the normal range. Apparently I should have continued to take zinc because I’m low again. I’m afraid we’ll be on supplements forever.
Interesting. To my knowledge, I haven’t had this type of testing. B12, yes, but not the rest. I keep my B12 levels in normal range (but lower than they’d like) with sublingual’s. Hoping you are able to find a balance with your levels. It seems like so many of us deal with this odd malnutrition even though we eat healthy. So odd…
It is odd! I know part of my absorption issues are due to using proton pump inhibitors and H2 blockers for so many years. Other medications I have taken in the past, including POTS meds and birth control pills, interfere with the absorption of specific vitamins. And unfortunately I didn’t find out about any of that until I was already pretty deficient. I wish it was included as a warning on the bottle!