When it comes to feeling our best, there is no cookie-cutter, one-size-fits-all approach. Many patients, especially those interested in longevity and biohacking, now prefer to take a more proactive approach to health optimization. They want to figure out their risk factors and get quantifiable health feedback long before they develop a diagnosable condition.

 Omics-based precision medicine is the answer for such people. Its goal, as a field, is to create personalized strategies in both managing and treating disease [1]. 

 For decades, the field of medicine has used tests to measure specific metabolites to help guide diagnoses and treatment. For example, using blood sugar tests for diabetes, or cholesterol levels for heart disease. If you’re a functional medicine practitioner, you may be familiar with functional metabolomic tests such as the Metabolomix+ and MosaicDX tests. This article compares and contrasts key features, along with pros and cons of these tests against what Theriome offers.

What Is a Metabolomic Lab Test?

In metabolomics, the tests measure numerous metabolites and small molecules in a biological sample [2]. Ideally, the results should be interpreted together and in the context of a whole person.

In short, metabolomics offer a more complete picture of biological processes and metabolic pathways than traditional diagnostics, making it a powerful tool in precision medicine.

However, most metabolic tests on the market, including functional tests, simply test a list of metabolites. Reports provide their levels, involvement in metabolic pathways, and specific diet or supplementation to address the abnormal values.

Metabolomic testing have several applications, such as:

• Personalized and precision medicine, to help guide treatment decisions based on individual differences and metabolic profiles
• Nutritional assessments to evaluate nutrient metabolism and target specific dietary recommendations
• Disease diagnosis and monitoring, to help identify specific biomarkers linked to certain diseases, symptoms, and conditions
• In research and drug development, where it can help us better understand the ways that drugs are metabolized by the body and identify potential side effects and interactions

The applications of these tests are wide-ranging and important, but you need to know what you’re looking at and how to interpret it. It can offer you important clues into your current health status and disease risk. You’ll gain a better understanding of the biochemical processes occurring in your body and how they can help with managing your health at a molecular level.

Common factors among all of these metabolomic tests:

1. While a few individual metabolites are used to diagnose diseases, these metabolomic panels are not FDA-cleared or approved. These few metabolites include methylmalonic acid and creatinine, which are recognized diagnostic markers for certain nutrient deficiencies or diseases.
2. Most of them, except Genova’s, use gas chromatography with mass spectrometry, which are precise and accurate tools to measure metabolites.
3. Urine metabolomic tests are ideal for detecting functional nutrient deficiencies that may not be evident in serum analysis, which can help target supplementation.
   
   

Metabolomix+ vs NutrEval vs Theriome vs MosaicDX Comparisons

Now that we have a better understanding of what metabolomic tests can identify and what they have in common, let’s look at the various tests on the market. Each one has its pros and cons and some may be more useful than others depending on your health goals.

Metabolomix+ and NutrEval by Genova Diagnostics

Metabolomix+ and NutrEval Tests are comprehensive nutritional assessment tests similar to each other. The former assesses 131 biomarkers, while NutrEval measures 125 biomarkers, both with options to add red blood cell fatty acid levels, metallic element status tests, and genetic tests. These two very similar tests focus on identifying:

• Specific nutritional deficiencies and imbalances and their metabolism, providing insights that can help tailor nutrition to someone’s precise needs 
• Oxidative stress and toxicity levels
• Organic acids that indicate potential yeast overgrowth and certain aspects of the gut biome metabolism
• Neurotransmitter levels and metabolism
• Mitochondrial function

Specimen type: NutrEval requires a blood draw and a urine sample, while Metabolomix+ urine and optional fingerprick blood spot can be collected from home. 

Pros:

• The test covers a wide range of nutrition biomarkers, allowing you to get a detailed evaluation of your nutritional status.
• The Metabolomix+ samples can be collected entirely at home, making it accessible and patient-friendly.
• Additional tests can be added on, including fatty acid profiles and SNP genetic analysis, which can provide further insights.

Cons:

• Often, it requires a healthcare provider to order and interpret the results, as it needs a good understanding of biochemistry and metabolism to paint the full picture.
• Interpretations and recommendations are based on each single value or pathway, and not together as a system, which can make results seem redundant and overwhelming.
• Interpretations and recommendations rely on the expertise and experience of the ordering clinicians
• Often provides supplement recommendations over dietary and lifestyle options, which may not be sustainable
• The test is not recommended for those under two years of age, as they have unique metabolic and nutritional needs
• Requires fluid restriction the day prior to sample collection, which can create physical stress that skews the results
• Often requires a physician to order the testing kit and provide you with the results
• Utilizes ICP-MS, a technique typically reserved for elemental analysis and not metabolites, and currently not adaptable for multi-omic analysis

Best Used For:

This test can be beneficial for a diverse range of conditions, however, it is marketed specifically to those with mitochondrial dysfunction, mood disorders, chronic fatigue or stress, inflammatory conditions, or specific diseases including heart disease, endocrine disorders, and malnutrition.

Theriome Metabolomics Analysis

Theriome’s Aristotle Test is a comprehensive blood-based health assessment that analyzes 126 different metabolites across 68% of known metabolic pathways. The test is designed to give insights across multiple health domains, including inflammation, brain health, cardiovascular health, mitochondrial function, gut flora, reproductive health, and more. The company uses advanced machine learning algorithms to analyze results and Digital Twinning simulations to offer personalized health recommendations based on your unique data.

Specimen: Bloodspot finger prick

Then, Theriome’s algorithms analyze the metabolites together, ideally in the context of health history, current health regime, and symptoms.  

Pros:

• Covers a wider range of health domains than other tests on the market, providing a detailed snapshot of your overall health
• Provides specific advice on not only supplements, but also nutrition, exercise, and lifestyle tailored to your unique needs
• Unbiased approach, as the company does not sell supplements, ensuring their recommendations are solely based on what is best for your health
• AI analysis incorporates the latest research to derive insights and recommendations
• Only product on the market that uses “Digital Twinning” for highly accurate and personalized insights that can minimize time spent on trial and error
• Testing can be done entirely at home, and does not need a physician to sign off on testing
• Doesn’t require patients to restrict fluids or stop supplements before testing, so the results reflect the effects of current protocols
• Optional consult with PhD expert who can help guide you through your results
• Focused on wellness and optimal health more than diseases
• Adaptable for multi-omic integration, such as with microbiome and genetic tests

Cons:

• Not intended for use as a formal diagnostic tool, whether for mainstream or integrative medicine
• May require users to learn to think more holistically rather than reductionistically
• Ideally, it’s still best when combined with a clinician’s expertise 

Best Used For:

This test is designed to monitor overall health across multiple domains, so is suitable for those looking to get a comprehensive overview of their health picture. It is also made to identify subtle actions that could indicate potential health issues down the line, allowing for early intervention. It is ideal for people who are interested in customized health strategies based on their unique metabolic profile, and provides specific indices on aging, nutrition, and inflammation for those focused on longevity and nutrient optimization.

MosaicDX Organic Acids Test 

Mosaic Diagnostics, formerly Great Plains Laboratories, has been around since 1996. Based in Kansas, the company serves over 100 countries worldwide and specializes in tests related to metabolic, genetic, mitochondrial, and environmental factors significant in the diagnosis of chronic illness. MosaicDX's Organic Acids Test (OAT), is one of their many test options that assesses 76 organic acids in a single urine sample. They also have separate panels for mold toxins, heavy metals, environmental toxins, and more. This test can provide insight into various metabolic pathways, revealing potential imbalances and nutrient deficiencies.

Specimen: Urine sample 

Pros:

• Evaluates a wide range of organic acids, which can offer detailed insights into metabolic function, nutrient needs, and potential toxic exposures 
• Overall, the company is more specialized for health conditions impacted by stealth toxins like mold and glyphosate. They provide research-based educational materials on how these toxins may be linked to conditions like ADHD, PANS/PANDAS, and psychiatric conditions.
• Covers multiple health aspects, including gut microbial balance, mitochondrial function, neurotransmitter metabolism, and detoxification pathways
• Requires only a single urine sample, so it is non-invasive and can be done completely at home  
• Results categorized into clinically relevant areas can provide health providers with actionable data to help guide nutrition, supplementation, and other therapeutic interventions

Cons:

• Results can be too complex to interpret without specialized knowledge, and often requires a skilled healthcare provider to interpret results for a proper analysis.
• As with the other tests, the OAT test can be quite costly ($270.00) and may not always be covered by insurance which can limit accessibility for patients.
• Often requires a physician to order a testing kit and provide you with the results
• Results and recommendations are presented based on each specific marker and do not provide clues into health as a whole.
• This test measures 76 markers, fewer than other tests that measure well over 120 markers
• The test is less geared towards wellness and optimal health. Rather, it’s more geared towards identifying dysfunctions and removing them, such as by detoxification, to treat certain diseases. 
• Recommendations often focus on supplementation, without providing nutritional guidance or lifestyle recommendations.
• No multi-omic integration and not adaptable to multi-omic integration
  
  

Best Used For:

The MosaicDX organic acids test is most commonly intended for those with chronic illness and neurological disorders, as it can help identify metabolic blocks, toxicities, and nutrient deficiencies that can contribute to their symptoms. It can also be a good tool for assessing metabolic dysfunctions such as mitochondrial issues, oxidative stress, and imbalances in gut microflora.

 

Final Notes

In closing, metabolomic testing can provide detailed and personalized assessments into your overall health and risk factors. Although no metabolomic tests are FDA-approved for disease treatments, Genova and MosaicDX’s tests are more geared towards identifying and removing specific dysfunctions. Prescribing complex supplement and diet protocols based on these tests are the typical approaches in functional medicine. Such protocols can have limited compliance levels and it’s unclear which component is the most efficacious. 

While all metabolomic tests provide health scores in each category, Theriome’s Aristotle test also incorporates evidence-based AI analysis tools and digital twinning simulation to deduce the best supplement, diet, and exercise for optimal health. Based on these powerful AI and holistic analysis, we believe Aristotle can be a money and time-saving game changer both for functional medicine doctors and end consumers. 

1 Delpierre, C. and Lefèvre, T. (2023) Precision and personalized medicine: What their current definition says and silences about the model of health they promote. Implication for the development of personalized health. Front. Sociol., Front Sociol 8, 1112159 https://doi.org/10.3389/fsoc.2023.1112159

2 Clish, C. B. (2015) Metabolomics: an emerging but powerful tool for precision medicine. Cold Spring Harb. Mol. Case Stud., Cold Spring Harbor Laboratory 1, a000588 https://doi.org/10.1101/mcs.a000588