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Urine Metabolism Tests

Urine Metabolism

Indican (Indoxyl Sulfate)

  • Turn-around time = 5 to 7 days
  • A urine test for diagnosis and monitoring intestinal or digestive problems

Indican originates from bacterial growth, often in the small intestine. Indican is an indole produced by bacterial action on an amino acid, Tryptophan, in the intestine. Most of indole is excreted in the feces. The remainder is absorbed and metabolized and excreted as indican in the urine.

In normal urine, the amount of indican excreted is small. It is increased with high protein diets or inefficient protein digestion. If not digested properly, or if the wrong type of proteins are ingested, bowel putrefaction can occur. Problems with protein digestion can be caused by overgrowth of anaerobic bacteria, intestinal obstruction, stomach cancer, low stomach acid, parasitic infections, malabsorptive syndromes (sprue, etc.), fungal infections, lack of digestive enzymes, or liver problems. In the rare condition, Hartnup disease, amino acids are poorly absorbed from the intestine. This allows bacterial decomposition to take place. The inability to digest protein can have adverse affects on glycemic control, hormone balance and water balance.

Urine Indican Test (Obermeyer test - Indoxyl Sulfate)

Following absorption, indole is converted to 3-hydroxy indole (indoxyl potassium sulfate and indoxyl glucoronate, or indicans, in the liver.

Indole (oxidized) ⇒ indoxyl + H2O2 ⇒ indoxyl sulfuric acid K + indoxyl potassium sulfate (indican)

Specimen requirements: No special patient preparation required. Minimum of 5.0 mL of urine required. If the assay is not run immediately, place sample in labeled plastic tube and freeze.

Detection of indican in the urine depends upon its decomposition and subsequent oxidation of indoxyl to indigo blue and its absorption into a chloroform layer. The resulting color is visually compared to a color chart and graded as follows:

Negative (Normal)=     Clear or blue tinge
1+ (Normal)=     Slight blue, yellow, mint green
2+ (Positive)=     Dark blue, light green, golden brown
3+ (High Positive)=     Violet, indigo, dark brown
4+ (Very High Positive)=     Jet black

References are available upon request.

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