Using the NutrEval® FMV by Genova Diagnostics in Your Clinic

Nutrient deficiencies are alarmingly common, affecting billions worldwide and contributing to a wide array of chronic diseases. These deficiencies can silently undermine overall well-being, making it challenging for healthcare practitioners to pinpoint the root causes of their patients' ailments. Traditional dietary and biochemical assessments often fall short in accurately identifying these subtle imbalances, leaving gaps in effective treatment strategies. 

Micronutrient testing is a comprehensive alternative that delves deep into the body's nutritional status, uncovering hidden deficiencies and insufficiencies to guide personalized interventions. The NutrEval® FMV by Genova Diagnostics is one such panel designed to extensively analyze essential vitamins, minerals, amino acids, and oxidative stress markers, empowering healthcare professionals to enhance patient care and improve health outcomes with precision and confidence.

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What Is NutrEval® FMV?

The NutrEval® FMV utilizes blood and urine samples to measure over 125 biomarkers, providing a comprehensive health assessment of nutritional status, oxidative stress, gut health, and toxic exposure.

NutrEval® FMV Panel Components

The NutrEval® report categorizes the analytes into the following families: 

• Organic acids
• Oxidative stress markers
• Amino acids
• Essential and metabolic fatty acid markers
• Elemental markers

How It Works

How does ordering a NutrEval® FMV test work?

1. A doctor orders a test kit for the patient.
2. The patient follows instructions in their test collection kit to activate the test.
3. The patient collects urine and blood samples. This test requires a blood draw and urine collection. Urine samples are collected at home before the fasting blood draw, which a lab professional must perform. Patients should follow test kit instructions carefully to prevent collection errors.
4. Patients ship collected specimens to the lab using the prepaid shipping materials provided in the test kit.
5. The Genova Diagnostics lab uses multiple methods to assess nutrient status, including intracellular, extracellular, direct, and functional measurements. 
6. Result turnaround times average around 14 days.
7. The user-friendly report allows for easy result interpretation, highlighting functional imbalance scores, a nutrient need overview, an "interpretation-at-a-glance," and visual graphics. 

Benefits of Using NutrEval® FMV in Your Clinic

What are the benefits of using NutrEval® FMV in your clinical practice? 

​​Comprehensive Nutritional Profiling

NutrEval® FMV offers an extensive analysis of over 100 biomarkers. This comprehensive profiling allows clinicians to identify hidden deficiencies and subtle imbalances that could be contributing to a patient's health issues, which might otherwise be missed with traditional testing methods.

Personalized Patient Care

By identifying each patient's unique nutritional needs, healthcare providers can more effectively tailor dietary and supplemental treatment plans and personalize interventions, which can lead to better patient adherence and improved health outcomes.

Enhanced Diagnostic Accuracy

Many conventional methods of screening for malnutrition are recognized as unreliable and inaccurate. They often reflect only short-term nutrient status and are easily influenced by factors like inflammation. 

The testing methods utilized by Genova Diagnostics measure nutrient status in the context of cellular function, enabling clinicians to assess long-term nutritional status and diagnose nutritional imbalances with greater accuracy.

Implementing NutrEval® FMV in Your Clinical Practice

Educating yourself and your clinical team on administering and interpreting the test is one of the most important aspects of implementing the NutrEval® FMV into clinical practice. Here are some key points of emphasis: 

• The test cannot be ordered for patients under two years old.
• Patients must collect a first-morning urine sample and have a fasting blood draw for this test.
• Patients need to fast for at least eight hours and limit their fluid intake to 48 oz for 24 hours before the urine collection.
• Patients need to fast for at least eight hours before the blood draw.

Genova Diagnostics provides training resources, including webinars, manuals, and customer support, to help you and your staff become proficient in using and integrating the test into patient care.

Rupa Health streamlines the integration of functional medicine testing into clinical practices by offering an intuitive platform for ordering, managing, and interpreting comprehensive lab tests.

Depending on your patient's insurance plan, the NutrEval® FMV may or may not be covered by insurance. Doctors should familiarize themselves with and be prepared to discuss billing and payment options with their patients before they order the test to avoid unexpected bills and out-of-pocket costs.

Lab Testing and Interpretation of NutrEval® FMV Results

The user-friendly report makes interpreting NutrEval® FMV results easy.

Understanding and Interpreting the Biomarkers

Organic acids are urinary metabolic byproducts that can provide insights into (4): 

• Protein digestion and absorption
• Gastrointestinal health and intestinal dysbiosis
• Mitochondrial energy production
• B vitamin levels
• Neurotransmitter status
• Toxic load and detoxification capabilities
• Oxalate metabolism

Oxidative stress occurs when the body's production of unstable, inflammatory molecules (free radicals) is greater than its ability to neutralize them. It can cause cellular damage and contribute to chronic disease. Increased oxidative stress can indicate excessive exposure to factors that promote free radical production and/or weakened antioxidant pathways. (10, 19) 

Amino acids are protein building blocks required for energy, neurotransmitter and hormone synthesis, growth and repair, immune function, and blood cell production. Imbalances in the amino acid analysis can indicate insufficient dietary protein intake, protein maldigestion, nutrient deficiencies, and chronic illness. (19) 

Fatty acids are measured in red blood cells, reflecting fatty acid status over the last 90-120 days. Fatty acid analysis can be beneficial in assessing dietary intake and the risk of various chronic diseases. (19) 

Elemental markers include nutrient and toxic elements. These are directly measured to assess mineral nutritional status and toxic exposure as they relate to disease and clinical symptoms. (19)  

Each biomarker has defined normal, abnormal, and optimal ranges. Interpreting results involves analyzing individual biomarker levels and identifying patterns or correlations associated with specific health issues.

Additionally, the results should be interpreted within the context of the patient's medical history, health concerns, medications, supplements, and dietary habits.

Creating Treatment Plans

The comprehensive data obtained from this test allows clinicians to develop targeted treatment plans aligned with the patient's identified needs. For example:

• Nutrient Deficiencies: Prescribe appropriate supplements or dietary changes
• Oxidative Stress: Introduce antioxidant-rich therapies and reduce toxic exposures
• Gut Health Issues: Implement probiotics, nutritional adjustments, or other gut-healing protocols

In addition to dietary modifications and supplemental protocols, lifestyle changes like stress management, sleep habits, smoking cessation, and moderating alcohol consumption should be incorporated into a holistic treatment plan to optimize patient results. 

In some cases, the test results may highlight the need for additional testing to investigate the causes of the identified imbalances further.

Clinical Applications of NutrEval® FMV

You could consider ordering the NutrEval® FMV for a patient for many reasons. Micronutrient analysis can be beneficial in detecting nutritional and metabolic imbalances contributing to the following health concerns (5, 11):

• Autoimmune disease
• Mood disorders
• Cardiovascular disease
• Metabolic diseases, such as obesity, insulin resistance, and type 2 diabetes
• Fatigue
• Infertility
• Long-term dietary restrictions
• Digestive disorders
• Cognitive decline
• Physical injuries
• Athletic performance
• Disease prevention

When to Order the NutrEval® FMV Over the NutrEval® Plasma

Different amino acid analytes are measurable in blood versus urine. While NutrEval® FMV measures amino acids in urine, the plasma version of the test measures them through the provided blood sample. The NutrEval® FMV will measure 40 amino acid analytes, whereas the NutrEval® Plasma can only measure 36. The tests are otherwise identical.

Urinary amino acids are more variable and reflective of recent dietary protein intake compared to plasma. The NutrEval® FMV test is appropriate for patients with consistent daily protein intake and normal kidney function.

Best Practices for Maximizing the Use of NutrEval® FMV

Adopting strategic approaches can help healthcare providers enhance patient care, streamline workflows, and achieve optimal health outcomes.

Patient Education and Engagement

Educate patients on the importance of nutritional testing and how the NutrEval® FMV can benefit their health. Allocate ample time during appointments to discuss the results in detail, explaining how they relate to the patient's overall health and specific symptoms. Clear explanations and resources can significantly enhance patient engagement and adherence to recommended interventions.

Collaborative Care Models

Work collaboratively with dietitians, nutritionists, and other healthcare specialists as needed to develop comprehensive and integrative treatment plans. A multidisciplinary approach ensures that all aspects of a patient's nutritional health are addressed. 

Continuous Monitoring and Follow-Up

Regular assessments using NutrEval® FMV can track a patient's progress and adjust treatment plans as needed. Continuous monitoring helps maintain optimal nutritional status and prevents the recurrence of deficiencies.

Potential Challenges and Solutions

Despite the importance of micronutrient testing, doctors may face challenges when first learning how to use the NutrEval® FMV. Here are some solutions for common obstacles:

Managing Abnormal Results

Tips for managing abnormal results include:

• Review and Interpret: Assess abnormal biomarkers in the context of the patient's medical history and identify patterns or clusters of related imbalances.
• Consult: Discuss unfamiliar findings with other professionals or Genova Diagnostics' support staff to decipher complex results.
• Prioritize: Identify the abnormalities most strongly correlating to the patient's symptoms and health goals when developing and implementing a treatment plan.
• Investigate: Order additional testing to confirm and investigate abnormal results as needed.

Adherence and Follow-Up

Tips for overcoming challenges related to patient adherence and follow-up include:

• Clearly explain test results and their importance to patients.
• Build a strong patient-provider relationship by establishing trust with your patients, actively listening to their concerns, and practicing personalized medicine. 
• Provide patients with treatment plans that include easy-to-follow instructions.
• Schedule follow-up visits before the patient leaves the office and utilize automatic reminders to remind patients of upcoming appointments.

Cost and Accessibility Issues

Out-of-pocket costs can be a barrier for individuals. Doctors can help manage the financial burden associated with specialty testing by working with insurance companies to confirm coverage, clearly explaining Genova's billing policies with patients before ordering the test kit, and presenting alternative payment options when possible.

Resources for Further Information

• Ready to order the NurEval® FMV through Rupa Health? Click this link!
• Preview a NutrEval® FMV sample report here
• Watch Rupa Health's free class: The NutrEval: The Intersection of Micronutrient Testing and Cellular Health
• Additional resources can be found on Genova Diagnostics' website

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Key Takeaways

For healthcare practitioners seeking to elevate their practice and embrace a more detailed approach to nutritional assessment, the NutrEval® FMV by Genova Diagnostics can be an invaluable resource. 

Highlights of this panel include:

• In-depth nutritional assessment of over 125 vitamins, minerals, antioxidants, amino acids, fatty acids, organic acids, markers of oxidative stress, and indicators of gut health and toxic exposure
• Advanced analytical techniques of blood and urine samples for accurate and reliable test results
• A user-friendly results report that includes simplified scoring systems, graphics, and personalized suggestions