High FIGLU And Low Folate Urine, But Blood Folate Ok

Nick21

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Hi, I'm confused by recent results I obtained. I took a Genova urine test which indicates excess FIGLU and a folate deficiency. However, a blood test revealed the folate is ok and contradicted the urine result. Is the Genova urine folate result tied to the FIGLU measurement, or do they measure the folate directly. If that is the case, and the folate is fine according to the blood sample which would I suspect is a direct measurement, what does excess FIGLU indicate if reliably measured. Or can someone have a blood folate measure which is fine, and a urine one which is not.
 

Mito

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High FIGLU would indicate a probable deficiency of tetrahydrofolate. Blood tests for folate can be either serum or redblood cell (RBC). If you got a serum folate blood test, that measures 5-methyl tetrahydrofolate.
 

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Nick21

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Hi Mito, interesting, I will call them Monday and inquire which blood test was performed. On the broader topic, do you think the Genova urine-based folate measurement is tied to their urine FIGLU measurement? Or are they separate measures. Also, in your experience, have the Genova based results been reliable?
 

Mito

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Hi Mito, interesting, I will call them Monday and inquire which blood test was performed. On the broader topic, do you think the Genova urine-based folate measurement is tied to their urine FIGLU measurement? Or are they separate measures. Also, in your experience, have the Genova based results been reliable?
According to their guide yes the folate is tied to FIGLU https://www.gdx.net/core/interpretive-guides/ION-IG.pdf

I don’t have any info on reliability of their testing.
 
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Nick21

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According to their guide yes the folate is tied to FIGLU https://www.gdx.net/core/interpretive-guides/ION-IG.pdf

Hi, thanks, but could you point out which page/section specifically indicates that their folate determination stems directly from FIGLU, and is not an independent measure. If the folate value they provide is scaled from FIGLU I could then maybe hypothesize that the blood test showing normal B9 is indeed correct, and not contradicting the urine result, and then the question becomes what else causes excess FIGLU.
 

Mito

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Page 4:
Vitamin B12 and Folic Acid
The most common dietary deficiency leading to homocysteine elevation and the associated increase in heart disease risk involves vitamin B12 and folic acid. You can have normal blood levels of these vitamins but still not have enough for your body’s enzymes to function properly. Dietary deficiency of vitamin B12 and folic acid are associated with increased
risk of many diseases, including anemia and the associated chronic fatigue. Methylmalonate is a sensitive functional marker for vitamin B12; high levels of methylmalonate indicate vitamin B12 deficiency (Fig. 1). The odd numbered fatty acids containing 15, 17, 19, or 21 carbon atoms (heptadecanoic acid, nonadecanoic acid, tricosanoic acid, pentadecanoic acid) accumulate in vitamin B12 deficiency. Formiminoglutamate (abbreviated FIGLU) is a compound made from the amino acid histidine (Fig. 2). Insufficiency of folic acid leads to high urinary FIGLU. Folic acid is especially critical for prenatal and childhood development. It is important for lowering your risk of cardiovascular disease and cancer.
B9ED0A23-FFC7-4187-B512-29CCE08BE017.jpeg
 
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Nick21

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Hi Mito, thanks, but that does not imply that they did not make separate measurements of folate and FIGLU, or whether they determined the folate estimate using FIGLU as a proxy. My attempts to get an answer from the company has not yet been successful.
 

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