Cellular metabolism
Nutritional status (Metabolomix+).
A functional read on how your cells are actually using the nutrients you take in, from a urine sample collected at home.
By Genova Diagnostics · First morning urine, optional bloodspot and cheek swab
Why it matters
A normal blood level tells you a nutrient is present. It does not tell you whether your cells can use it. Metabolomix+ reads the difference. It measures the byproducts your metabolism leaves behind (organic acids), and those byproducts pile up when a biochemical step is stalling for lack of a specific vitamin or mineral cofactor. You can have a normal serum B12 and still be functionally deficient at the cellular level. This test catches that.
This is the panel I reach for when someone has fatigue, brain fog, low mood, or stalled metabolism and standard labs come back clean. It reads the engine directly: how well the mitochondria are turning food into energy, whether the B-vitamin machinery is keeping up, how the body is handling oxidative stress, and where amino acid and fatty acid balance has drifted. It is collected entirely at home from a first morning urine sample. This is a Genova specialty test; it is not run by LabCorp or Quest.
The result is not a list of deficiencies. It is a map of where your biochemistry is working hard and coming up short, and what specific nutrient will relieve the bottleneck.
What I read for
Oxidative stress first. It sets the context for everything else on the panel. Then the mitochondrial markers: are the energy pathways running clean, or are intermediates backing up because a cofactor is missing? The B-vitamin functional markers, which are some of the most clinically reliable readings on the test. Amino acid balance for protein status and methylation. Fatty acid ratios and the Omega-3 Index when the bloodspot is added.
I do not treat single markers. One abnormal value is a signal. Three related ones is a finding. A pattern that crosses sections is a mechanism, and that is what I act on. A handful of values move with diet and recent activity, so I read the whole picture before drawing a conclusion, then confirm before building a protocol around it.
What it measures
Metabolomix+ is built around a first morning urine collection, with optional add-on components that deepen the picture. Genova organizes the report into functional areas.
Organic acids (urine). The core of the panel. These metabolites read cellular energy and mitochondrial function (the citric acid cycle, carbohydrate and fatty acid metabolism), functional B-vitamin status, neurotransmitter turnover, detoxification capacity, oxalate status, and markers of bacterial and yeast imbalance in the gut.
Amino acids (urine). Essential and nonessential amino acids, plus the intermediary metabolites that flag specific B-vitamin needs, urea cycle (ammonia clearance) function, and the glycine and serine pathways tied to methylation.
Oxidative stress markers (urine). Direct measures of oxidative damage, including lipid peroxides and 8-OHdG (a marker of oxidative damage to DNA).
Functional imbalance scores. The report synthesizes the raw markers into readable scores across methylation, toxic exposure, mitochondrial function, fatty acid balance, and oxidative stress, with a nutrient need overview. I treat these as a starting screen, not the final word. The interpretation comes from the underlying markers.
See what it measures
Organic acids (first morning urine)
- Cellular energy and mitochondrial metabolites (citric acid / Krebs cycle, carbohydrate and fatty acid metabolism)
- Functional B-vitamin markers (B2, B6, B12, biotin, and others, read through the metabolites that depend on them)
- Neurotransmitter metabolites (downstream of dopamine, norepinephrine, epinephrine, and serotonin)
- Toxin and detoxification markers
- Oxalate markers (tied to oxidative stress, kidney stone risk, and metabolic function)
- Bacterial and yeast dysbiosis and malabsorption markers
Amino acids (first morning urine)
- Essential amino acids (must come from diet)
- Nonessential amino acids (made by the body)
- B-vitamin intermediary markers
- Urea cycle markers (ammonia detoxification)
- Glycine and serine metabolites (methylation and the serine-to-choline pathway)
- Dietary peptide markers (incomplete protein breakdown, meat intake)
Oxidative stress (first morning urine)
- Lipid peroxides
- 8-OHdG (oxidative DNA damage)
Report synthesis
- Functional imbalance scores: methylation, toxic exposure, mitochondrial function, fatty acid balance, oxidative stress
- Nutrient need overview: antioxidants, B-vitamins, minerals, essential fatty acids, digestive support, amino acids
- Interpretation-at-a-glance pages explaining each nutrient, why deficiency happens, and food sources
Optional add-ons (collected at home, decided with me)
- Essential and metabolic fatty acids (bloodspot finger stick): omega-3, omega-6, omega-9, saturated and monounsaturated fats, Delta-6 desaturase activity, cardiovascular risk ratios, and the Omega-3 Index
- Comprehensive urine elements: 18 toxic elements and 14 mineral elements
- Genetic SNPs (cheek swab): MTHFR, COMT, TNF-a, APOE
- IgG food antibodies (bloodspot): immune response to 87 foods
Who this is for
Metabolomix+ earns its place when symptoms point at the metabolic engine and routine bloodwork has not explained them, or when someone wants a real baseline on nutritional status rather than a guess.
Common reasons I order it
- Fatigue and low energy with normal standard labs
- Brain fog, low mood, anxiety, or depression
- Stalled metabolism, weight that will not move, blood sugar concerns
- Suspected B-vitamin or mineral insufficiency despite a reasonable diet
- High oxidative stress, accelerated aging concerns, recovery from illness or trauma
- Athletic performance and recovery optimization
- Building a precise, data-driven supplement plan instead of a generic stack
It is also a foundational longevity test. Reading your metabolism against optimal ranges tells us where to intervene before a deficiency becomes a symptom.
How collection works
- 1
We decide it is the right test.
I review your history and confirm Metabolomix+ answers your question, and we settle which add-ons (fatty acids, elements, SNPs) are worth including.
- 2
You collect at home.
The core sample is a first morning urine, collected after an overnight fast with water allowed. If we added the bloodspot, it is a simple finger stick. The SNP panel is a cheek swab. Instructions and a collection video are included.
- 3
You ship it back.
Use the prepaid FedEx materials provided.
- 4
We read it together.
Results come to me, and we sit down with them to translate the findings into a specific plan: which nutrients, in which active forms, at what doses, and what to recheck.
How to prepare
The cleanest reading comes from a steady baseline. A few foods, supplements, and medications shift specific markers, so some are paused before collection. Never stop a medication you need without clearing it with me first.
Diet and timing
Eat your normal diet: in the days before. Avoid extreme diets, loading up on any single food, or hard endurance efforts like a long race, which can transiently move energy and neurotransmitter markers.
Collect first morning urine after an overnight fast: water only. The reference ranges were built on a fasted population.
Watch fluid intake the day before: stay under roughly 48 ounces, since over-hydration dilutes the sample and skews the creatinine-adjusted values.
Certain foods move specific markers: bananas, pineapple, kiwi, plums, avocado, and some nuts can raise a serotonin metabolite; polyphenol-rich foods (wine, grapes, chocolate, tea, berries) can elevate gut dysbiosis markers; seafood with trace metals can transiently raise toxic element readings.
Supplements and medications (hold only if medically appropriate, after checking with me)
Targeted nutrient supplements: many clinicians pause about 4 days before to establish a true baseline. Krebs-cycle and chelated mineral forms (citrate, malate, succinate, glycinate, alpha-ketoglutarate) can directly raise the corresponding markers.
Berberine: interferes with two organic acid readings (IAA and 5-HIAA).
Acetaminophen, valproic acid, NAC: acetaminophen interferes with several organic acids. Valproic acid interferes with one. NAC can falsely lower the add-on cholesterol and triglyceride readings.
Vitamin C: can raise urinary oxalate.
Antibiotics, antifungals, probiotics, digestive enzymes, and acid blockers: shift the gut dysbiosis and malabsorption markers.
Antidepressants and other centrally acting medications: affect the neurotransmitter metabolites; statins and red yeast rice, oral contraceptives or estrogen, steroids, diuretics, and fibrates each touch specific markers. We account for whatever you stay on.
A few exclusions: testing is not done under age 2, is not recommended with known kidney dysfunction, and the reference ranges were not built for pregnancy (though the test can still be useful in that setting with standard precautions).
What you get
A results review with me, and a written Precision Health Plan that turns the panel into a specific, sequenced set of actions. Not a printout of metabolites. The plan names which nutrients you actually need, in which active forms (the form matters: methylated B-vitamins where indicated, the right mineral chelates, ubiquinol over plain CoQ10), at what doses, and how we will confirm it worked on a recheck.
Nutritional status is one of the most responsive systems you can measure. The right targeted nutrient relieves a biochemical bottleneck in weeks, and the recheck shows it on paper. We measure, compare to optimal, rebalance, and verify. That is the whole point of reading the engine directly instead of guessing at a supplement stack.
Questions
The core test is a first morning urine sample. The optional fatty acid and food antibody add-ons use a simple finger-stick bloodspot, and the SNP add-on is a cheek swab. All of it is collected at home.
A blood panel tells you how much of a nutrient is circulating. Metabolomix+ tells you whether your cells can actually use it, by reading the metabolic byproducts that accumulate when a vitamin or mineral cofactor is in short supply. You can look normal on serum testing and still be functionally short at the cellular level.
About 14 days after the lab receives your sample.
Not always. The urine core stands on its own. I add the fatty acid bloodspot when cardiovascular or inflammatory balance matters, the element panel when toxic exposure or mineral status is in question, and the SNP panel when methylation genetics would change the plan. We decide together.
This is a cash-pay test ordered through the practice. Genova provides CPT codes you can submit to a commercial insurer for possible reimbursement, but coverage varies and is not guaranteed.
Yes, from age 2 and up, with age-appropriate reference ranges. Testing is not available under age 2.
Metabolomix+ covers the same functional ground as Genova's NutrEval with the advantage of being collected entirely at home rather than requiring a blood draw. For most of my patients, that is the right tradeoff.
How to order this
Part of the Precision Partnership baseline. Lab fee at vendor cost. I interpret the results into your written Plan.