· CoQ10 – Coenzyme Q10 is essential for mitochondrial function and cellular energy production. CoQ10 may be depleted in certain acute and chronic disease states; thus concentration levels can be a useful biomarker for oxidative stress. CoQ10 deficiencies may be linked to cardiomyopathy, neurodegenerative diseases (Parkinson’s, Alzheimer’s, and Muscular Dystrophy), metabolic disease, and malnutrition.
· Vitamin B1 (Thiamine) – Vitamin B1 is required for branched-chain amino acid and carbohydrate metabolism. Vitamin B1 deficiency is most often due to alcoholism or chronic illness. In the early stage, patients with Vitamin B1 deficiency exhibit anorexia, irritability, apathy and generalized weakness.
· Vitamin B2 (Riboflavin) – Vitamin B2 is involved in metabolism of fats, carbohydrates, and protein. The clinical manifestations of deficiency are non-specific.
· Vitamin B6 – Vitamin B6 is a cofactor in many metabolic pathways including heme synthesis (necessary for red blood cell production). Vitamin B6 deficiency may be observed in patients with metabolic disorders, secondary to therapeutic drug use, or alcoholism. Deficiency will also affect the function of the immune system.
· Selenium – Selenium is an element of parental nutrition. Monitoring the Selenium concentration is useful in assessing parental nutrition, especially recent intake. A deficiency in selenium may contribute to the development of a form of heart disease, hypothyroidism, and a weakened immune system.
· Niacin (B3) – Niacin can be used to block the breakdown of fats in adipose tissue and can be used to reduce VLDL levels, which are a precursor of LDL or “bad” cholesterol levels. A severe deficiency of niacin in the diet will cause the disease pellagra, whereas a mild deficiency slows the metabolism and cause a decreased tolerance of the cold.
· Beta Carotene- Beta Carotene, a fat soluble nutrient, is a precursor to Vitamin A. Deficiencies may lead to Vitamin A deficiency. Excessive Vitamin A intake may lead to headaches, loss of appetite, nausea and diarrhea, skin changes, and potentially birth defects.
· Vitamin A – Vitamin A is critical for vision, growth and many cell functions. High concentrations of Vitamin A are seen with renal failure, but this is not associated with toxicity, and excessive ingestion. High concentrations are associated with bone fractures. Low concentrations of Vitamin A are consistent with fat malabsorption and rarely due to inadequate diet.
· Vitamin E – Deficiency of vitamin E may cause extensive neuropathy in young children and, in addition, is suspect as a possible cause of motor and sensory neuropathy in older children and in adults. One likely cause of vitamin E deficiency is intestinal malabsorption, resulting from bowel disease, pancreatic disease, or chronic cholestasis. Other causes of malabsorption of vitamin E include celiac disease, cystic fibrosis, and intestinal lymphangiectasia.
· Zinc - Zinc is an essential element involved in a myriad of enzyme systems including wound healing, immune function, and fetal development. Zinc measurements are used to detect and monitor industrial, dietary, and accidental exposure to zinc. Also, Zinc measurements may be used to evaluate health and monitor response to treatment.
· Manganese – Manganese is an essential trace metal. Toxicity that can result from excessive exposure can cause serious organ damage.
· Vitamin D, 25-Hydroxy, LC/MS/M – Measurement of serum 25-OH vitamin D concentrations provide a good index of circulating vitamin D activity in patients not suffering from renal disease. Lower than normal 25-OH vitamin D levels can result from a dietary deficiency, poor absorption of the vitamin or impaired metabolism of the sterol in the liver. A 25-OH vitamin D deficiency can lead to bone diseases such as rickets and osteomalacia. Above normal levels can lead hypercalcemia.
· Vitamin B12 – Vitamin B12 is an essential co-factor for methionine synthase and methylalonyl-CoA synthase. Vitamin B12 is required for proper red blood cell formation, tissue and cellular repair and DNA synthesis. A B12 and/or folate deficiency reflects a chronic shortage of one or both of these vitamins. Since the body stores 3 to 5 years worth of B12 and several months’ supply of folate in the liver, deficiencies and their associated symptoms can take months to years to manifest in adults. Over time, a deficiency in either B12 or folate can lead to anemia.
