QUESTION: I have a compound heterozygous patient with SIBO, sulfur sensitivity and extremely low weight etc. I have ordered 23 and me genetic testing for her to further evaluate CBS pathway etc. For now I am having her test her urine for sulfur levels. She purchased quantofix sulfite analytical strips and her AM urine is 10, but she is barely eating anything and has eliminated most sulfur/thiol containing foods. My thinking is to have her test her urine similar to blood sugar after meals with more sulfur containing foods to see if the levels change.

My questions:

    1. Have you ever used this test strip? Can I trust the levels?
    2. Do you know optimal timing after eating to see accurate sulfur levels?
    3. Do you think that 24 hour sulfur testing (urine) and test strips give a similar result?

ANSWER: Compound hetero’s are the worst as far as odd reactions.

  1. Yes. it is an intra-sample level so as tested by her baseline will show highs or lows fairly reliably.
  2. 30 min minimum, probably optimal at 45-90 min
  3. 24 hr sulf. will show gross highs and lows better. The strips will be better for “per-meal” excretion.

Have you tried to add molybdenum to aid sulfite oxidase? I’d assume slow sulfite oxidase regardless, but it is really going to depend what SNP’s she has.

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