Beta-Human Chorionic Gonadotropin (β-hCG or BHCG) is a subunit of Human Chorionic Gonadotropin (hCG), a hormone primarily produced by the placenta during pregnancy. The beta subunit is unique to hCG and serves as the basis for pregnancy tests and certain medical evaluations.

Why Is β-hCG Measured?

β-hCG levels are commonly assessed for:

• Pregnancy Detection: Pregnancy tests measure β-hCG because it is exclusively produced in pregnancy, unlike the alpha subunit, which is similar to other hormones (LH, FSH, TSH).
• Monitoring Pregnancy Health: Abnormal β-hCG levels can indicate potential complications like ectopic pregnancy, miscarriage risk, or molar pregnancy.
• Cancer Diagnosis & Monitoring: Elevated β-hCG levels can be a tumor marker for certain cancers, including gestational trophoblastic disease (GTD), testicular cancer, ovarian cancer, and some other malignancies.
• Evaluating Fertility Treatments: β-hCG is used in assisted reproductive technology (ART) to confirm implantation and monitor early pregnancy.

ß-Hydroxybutyrate is a metabolic marker of blood sugar utilization and insulin function.

b-hydroxybutyrate is one of the ketone bodies. 

The term ketone body describes any of 3 molecules: acetoacetate, b-hydroxybutyrate, or acetone. Acetoacetate is produced by acetyl-CoA metabolism, b-hydroxybutyrate is the result of acetoacetate reduction, and acetone is produced by the spontaneous decarboxylation of acetoacetate.

Ketone bodies are fundamental for metabolic homeostasis during periods of prolonged starvation. The brain cannot use fatty acids for energy production and usually depends on glucose to meet its metabolic needs. In cases of fasting or starvation, ketone bodies become a major fuel for brain cells, sparing amino acids from being catabolized to gluconeogenesis precursors to be used to supply the brain with energy. After prolonged  starvation, ketone bodies can provide as much as two thirds of the brain's energy needs.

Ketone bodies are strong organic acids that fully dissociate in blood. When ketone body production becomes uncontrollable, the buffering systems are saturated, and blood pH drops; this is a condition known as ketoacidosis.

The two common clinical scenarios for ketoacidosis are diabetic ketoacidosis and alcoholic ketoacidosis.

Elevated b-hydroxyisovalerate is found as a result of biotin insufficiency. This issue often presents in patients as skin problems as well as hair loss. Look for this DUTCH test marker to assess biotin status and determine if intervention is required. Adequate biotin supply will yield a lower level of b-hydroxyisovalerate.

Elevated b-hydroxyisovalerate is found as a result of biotin insufficiency. This issue often presents in patients as skin problems as well as hair loss. Adequate biotin supply will yield a lower level of b-hydroxyisovalerate.

Until recently, biotin deficiency was very difficult to determine in humans because this vitamin deficiency affects health in ways that mimic many other conditions. Doctors were likely to overlook biotin deficiency until this test was discovered. Beta(ß)-hydroxyisovalerate is a specific and sensitive metabolic marker for functional biotin deficiency. As your biotin intake decreases, your ß-hydroxyisovalerate excretion increases.

b-Hydroxyisovalerate is made when the body is deficient in biotin. This marker has an inverse relationship with biotin, therefore elevated levels represent deficiencies in biotin. Biotin is an important cofactor in mitochondrial function, metabolism of fatty acids, glucose, and protein, as well as ROS production. Reactive oxygen species (= ROS) are generated during mitochondrial oxidative metabolism as well as in cellular response to xenobiotics, cytokines, and bacterial invasion. Oxidative stress refers to the imbalance due to excess ROS or oxidants over the capability of the cell to mount an effective antioxidant response.

Biotin deficiency has similar symptoms as other B-vitamin deficiencies but is most often associated with hair loss. Factors that influence biotin levels include inadequate dietary intake, long-term and high-dose B5 supplementation, dysbiosis/gut health, antibiotic use, medications, and biotinidase deficiency.

b-­Hydroxyisovaleric Acid [aka 3-Hydroxyisovaleric Acid (3-HIA)] is formed from the metabolism of the branched-chain amino acid leucine. Methylcrotonyl-CoA carboxylase catalyzes an essential step in this pathway and is biotin dependent. Reduced activity of this enzyme leads to an alternate pathway of metabolism resulting in 3-hydroxyisovaleric acid.

b-Hydroxypropionate (aka 3-Hydroxypropionic Acid, 3-HPA) is a major urinary metabolite of propionic acid. Propionic acid is derived from dietary branched-chain amino acids, oddchain fatty acids, and can be produced in the gut by bacterial fermentation of fiber. The biotin-dependent enzyme propionyl CoA carboxylase is responsible for metabolizing propionic acid to methylmalonyl CoA, which is subsequently isomerized to succinyl CoA. Decreased activity of this enzyme shunts propionyl CoA into alternative pathways which form 3-HPA.

β-hydroxy-β-methylglutaric acid (HMG) is a precursor to cholesterol and coenzyme Q10 (CoQ10) synthesis. It is a product of hydroxymethylglutaryl-coenzyme A (HMGCoA). HMGCoA- reductase is a rate limiting enzyme in cholesterol production. Medications that interfere with this enzyme may result in elevated HMG and subsequent low levels of cholesterol and CoQ10. CoQ10 is important for cellular energy production in the mitochondrial respiratory chain.

Hydroxymethylglutarate (HMG) is the precursor to Coenzyme Q10 (CoQ10) production, and when it is elevated it may indicate that the body is trying to increase its production of CoQ10.

Hydroxymethylglutarate (HMG) is the precursor to Coenzyme Q10 (CoQ10) production, and when it is elevated it may indicate that the body is trying to increase its production of CoQ10.

β-hydroxybutyrate is a ketone body. During periods of fasting, exercise, and metabolic disease, ketone bodies are generated in the liver and become an energy source instead of glucose.

β-hydroxybutyrate is a ketone body. During periods of fasting, exercise, and metabolic disease, ketone bodies are generated in the liver and become an energy source instead of glucose.

b-Pregnanediol is a metabolite of the molecule of progesterone, which is important for fertility and for menstruation. Pregnanediol levels increase after ovulation and when the placenta releases the hormone. Low progesterone symptoms include hot flashes, vaginal dryness, mood instability, low sex drive, sleep problems, brain fog, hair loss, loss of muscle mass and strength, weight gain and anxiety.

Pregnanediol is a metabolite of the molecule of progesterone, which is important for fertility and for menstruation. Pregnanediol levels increase after ovulation and when the placenta releases the hormone.

Progesterone itself is not readily found in the urine. Instead, this test measures pregnanediol (a progesterone metabolite). Pregnanediol is well-established in research literature as a reliable marker for progesterone levels.

Pregnanediol is a metabolite of the molecule of progesterone, which is important for fertility and for menstruation. Pregnanediol levels increase after ovulation and when the placenta releases the hormone.

Pregnanediol is a metabolite of the molecule of progesterone, which is important for fertility and for menstruation. Pregnanediol levels increase after ovulation and when the placenta releases the hormone.

This ratio is helpful when both E2 and Pg are within range, yet the patient continues to have symptoms. It is not expected to be normal or used clinically when either E2 and/or Pg are outside of their expected ranges or if the patient does not have clinical symptoms.

B-Tetrahydrocortisol [aka 5-beta-Tetrahydrocortisol (5b-THF)] is a metabolite of cortisol.

Tetrahydrocortisone, Tetrahydrocortisol and Allo-Tetrahydrocortisol are cortisol metabolites that reflect approximately 50% of daily cortisone synthesis. These will often reflect a chronic adrenal picture if levels are out of normal limits.

Urine contains free cortisol, but it also contains many cortisol metabolites, like cortisone or 5-alpha- tetrahydrocortisol, 5-beta-tetrahydrocortisol, tetrahydrocortisone, etc.