NutrEval FMV (Comprehensive Functional Nutritional Assessment)
The NutrEval FMV is a comprehensive proprietary functional nutritional assessment combining urinary organic acids on a first-morning-void specimen, amino acids, fatty acids, nutrient and toxic elements, oxidative-stress markers, and directly measured serum nutrients.
6
Biomarkers
Blood (serum)
Sample
10–20 business days
Turnaround
Yes — a fasting blood draw is typically required, with a first-morning-void urine collected the same morning; patients should follow Genova's pre-collection dietary and supplement restrictions
Fasting
What is the NutrEval FMV test?
The NutrEval FMV is a comprehensive proprietary functional nutritional assessment from Genova Diagnostics, combining urinary organic acids (on a first-morning-void specimen), amino acids, fatty acids, nutrient and toxic elements, oxidative-stress markers, and directly measured serum nutrients into a single report with derived nutrient recommendations. Its purpose is to provide a broad, pattern-based picture of nutritional and metabolic function to guide personalised dietary and supplementation strategies. Within nutritional assessment, the NutrEval is a functional and integrative tool rather than a standard diagnostic panel. It mixes analytes of differing evidentiary strength: some components — such as serum 25-OH vitamin D, homocysteine, the red-cell omega-3 index, methylmalonic acid, and whole-blood or urine toxic elements — have established clinical validity, while the broader functional interpretation of many organic acids, amino acids, and oxidative-stress markers, and the derived supplement recommendations, are not established in mainstream practice. It is therefore best used by practitioners familiar with the method, with the well-validated components interpreted conventionally and the exploratory components treated as supportive context rather than diagnostic findings. It does not replace targeted, validated testing when a specific deficiency or toxicity is being assessed.
What does the NutrEval FMV test measure?
Organic acids are intermediates and by-products of cellular metabolism excreted in urine. The panel reports markers relating to carbohydrate and fatty-acid energy metabolism, B-vitamin-dependent enzymatic steps, neurotransmitter metabolism, and detoxification-related pathways, measured on a first-morning-void urine specimen and normalised to creatinine.
Urinary organic acids are used in functional practice as indirect, functional indicators of metabolic and nutrient-cofactor status — for example, elevations in certain intermediates are interpreted as suggesting a functional need for the corresponding B-vitamin cofactor. Certain organic acids (such as methylmalonic acid for B12) have established clinical validity, while the interpretation of many others in this context is not established in mainstream practice and should be treated as exploratory.
Amino acids are the building blocks of protein and substrates for neurotransmitter, glutathione, and energy metabolism. The panel reports a broad amino-acid profile, including essential amino acids and intermediary metabolites, providing information on protein adequacy and specific metabolic pathways.
Amino-acid profiling is used in functional practice to assess protein adequacy, digestive and absorptive function, and substrate availability for neurotransmitter and detoxification pathways. Plasma amino acids have established use in diagnosing inherited metabolic disorders, but broader functional-nutrition interpretation of the profile is not established in mainstream practice and is interpreted as supportive context.
Fatty acids are structural components of cell membranes and precursors to eicosanoids and other signalling molecules. The panel reports omega-3, omega-6, omega-9, saturated, and trans fatty acids together with derived ratios, reflecting dietary intake and endogenous metabolism over the period represented by the specimen type.
Fatty-acid profiling informs dietary guidance regarding omega-3 intake and the omega-6-to-omega-3 balance. Certain measures, notably the red-cell omega-3 index, have a reasonable evidence base as markers of omega-3 status and cardiovascular risk, while broader interpretation of the full fatty-acid profile in functional practice is less well established.
Nutrient elements such as magnesium, zinc, copper, and selenium are enzymatic cofactors, while toxic elements including lead, mercury, arsenic, and cadmium reflect environmental or dietary exposure. The panel measures these in whole blood and/or urine depending on the element, using elemental analysis.
Element measurement supports assessment of nutrient status and toxic exposure. Whole-blood and urine measurement of toxic metals has established use in exposure assessment, whereas some nutrient-element measurements are more informative than others depending on the specimen — for instance, whole-blood or red-cell measurement differs materially from serum. Results should be interpreted with awareness of which specimen was used and its validity for that element.
Oxidative stress reflects the balance between reactive oxygen species and antioxidant defences. The panel reports markers of oxidative damage (such as 8-hydroxy-2-deoxyguanosine and lipid peroxides) alongside antioxidant status (such as glutathione, coenzyme Q10, and vitamin E).
Oxidative-stress markers are used in functional practice to indicate systemic oxidative burden and antioxidant capacity, informing nutritional and lifestyle guidance. The clinical validity and actionability of several of these markers are not firmly established, so they are treated as supportive context rather than diagnostic findings.
The panel includes directly measured serum nutrients and related markers, such as vitamin D (25-OH), fat-soluble vitamins, coenzyme Q10, and homocysteine, which have established physiology and clinical measurement conventions.
These directly measured markers carry the clearest clinical validity within the panel, with established interpretation — for example serum 25-OH vitamin D for vitamin D status and homocysteine as a functional marker of B-vitamin status. They anchor the panel's more exploratory functional markers and can be compared with conventional laboratory results.
Why is the NutrEval FMV test ordered?
- Practitioners undertaking a broad functional nutritional assessment to inform personalised dietary and supplementation strategies
- Comprehensive evaluation of patients with complex, multi-system or nutrition-related presentations where a wide survey may help prioritise targeted testing
- Assessment combining established markers (vitamin D, homocysteine, omega-3 index, toxic elements) with a broader functional profile in a single collection
- Evaluation of suspected nutrient inadequacy alongside metabolic and oxidative-stress context in integrative practice
- Assessment of fatty-acid status and the omega-6-to-omega-3 balance to guide dietary fat recommendations
- Screening for toxic-element exposure alongside nutritional assessment, with confirmatory testing where indicated
- Monitoring of response to a comprehensive nutritional intervention over time, using consistent methodology
Sample collection and turnaround
Sample type
Blood (serum), Urine (first morning void), Blood (whole blood)
Fasting required
Yes — a fasting blood draw is typically required, with a first-morning-void urine collected the same morning; patients should follow Genova's pre-collection dietary and supplement restrictions
Collection method
Venipuncture at patient service centre
Turnaround
10–20 business days
Collection notes
Collect the first-morning-void urine on the same morning as the fasting blood draw, per kit instructions. Follow Genova's pre-collection dietary, supplement, and medication restrictions, as recent intake affects organic acids, amino acids, and nutrient levels. All three specimen types must be collected and handled correctly, as errors invalidate the corresponding report components.
Specimen requirements
Serum, whole blood, and a first-morning-void urine specimen per the Genova NutrEval FMV kit; volumes and tube types as specified. Follow the laboratory's stability, storage, and shipping requirements for each specimen type.
What can affect NutrEval FMV results?
The panel combines analytes with established clinical validity (e.g. vitamin D, homocysteine, toxic elements) with functional markers whose interpretation is not established, so results must not be treated as uniformly reliable and claims should be calibrated per analyte.
Organic acids are measured on a first-morning-void urine and normalised to creatinine, so an incorrect collection, extremes of hydration, or altered creatinine excretion (from muscle mass or renal function) affect the reported values.
Recent food intake and nutrient supplements influence organic acids, amino acids, fatty acids, and directly measured nutrients, so dietary and supplement intake should be documented and any pre-collection restrictions followed.
Medications and intercurrent metabolic or renal conditions can alter organic-acid excretion, amino-acid profiles, and nutrient levels, complicating interpretation. A full history is required.
Because urinary analytes are creatinine-corrected, significant renal impairment or unusual muscle mass distorts the correction and therefore the reported concentrations.
The panel requires serum, urine, and whole blood collected and handled per protocol; errors in any specimen type can invalidate the corresponding components of the report.
What do NutrEval FMV results mean?
Elevated
Interpretation is analyte-specific. Elevated toxic elements prompt exposure assessment and confirmatory testing. Elevated homocysteine or a low vitamin D carry established meaning. Elevated functional organic acids are interpreted in the report as suggesting a functional cofactor need, but for most such markers this interpretation is exploratory rather than diagnostic.
Normal
Results within the method's intervals suggest no flagged abnormality on this panel. Because much of the panel's functional interpretation is not clinically validated, a normal profile neither confirms nutritional adequacy nor excludes a deficiency that targeted, validated testing might identify.
Reduced
Again analyte-specific. A low serum 25-OH vitamin D or a low omega-3 index carries established meaning and prompts conventional management. Low functional markers of uncertain validity should not by themselves drive diagnosis or supplementation without corroboration.
Note: The NutrEval combines analytes of very different evidentiary strength — some validated and conventionally interpretable, many functional and exploratory — so results must be read analyte by analyte rather than as a uniformly reliable whole. The derived supplement recommendations are proprietary and not clinically validated. Urinary results depend on correct first-morning-void collection and creatinine correction, and the multi-specimen requirement makes handling critical. It does not replace targeted validated testing where a specific deficiency or toxicity is suspected.
Frequently asked questions
It combines urinary organic acids on a first-morning-void specimen, amino acids, fatty acids, nutrient and toxic elements, oxidative-stress markers, and directly measured serum nutrients into a single comprehensive functional nutrition report.
How to access the NutrEval FMV test
The NutrEval FMV reference page is free and open to all practitioners. Create a free practitioner account to see pricing, save tests to your list, and generate requisition forms. Verification takes 1–2 business days.
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Published: June 2, 2026
Last reviewed: June 2, 2026
- Shenkin A. Micronutrients in health and disease. Postgrad Med J. (2006)
- Elmadfa I, Meyer AL. Developing suitable methods of nutritional status assessment: a continuous challenge. Adv Nutr. (2014)
- Harris WS, Von Schacky C. The Omega-3 Index: a new risk factor for death from coronary heart disease? Prev Med. (2004)
- Jones DP. Redox theory of aging. Redox Biol. (2015)
This content is for licensed healthcare practitioners only and does not constitute medical advice. Clinical decisions should be based on the full clinical picture and not on any single test result.
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