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Vitamins, minerals and amino acids · Blood

Leucine

One of the three branched-chain amino acids (BCAAs) from protein-rich food; important for building muscle protein.

At a glance

  • Measured in blood
  • In 1 test panel
  • Check the preparation

Leucine

  • Explanation
  • Result
  • Reliability
  • Who it is for
  • Test panels
  • Sources

Explanation

Leucine: what is measured?

Leucine is an essential amino acid and one of the three branched-chain amino acids (BCAAs), together with isoleucine and valine. It has to come from food, mainly from meat, fish, dairy and eggs. Leucine signals the muscles to make protein and also serves as fuel. This test measures leucine in the blood.

What can it detect?

  • A snapshot of amino acids in blood or urine, which mainly reflects recent protein intake, fasting and supplements
  • Sometimes a clue to too little protein in the diet or malnutrition, which can only be assessed together with other tests
  • Rarely: an inborn metabolic disease affecting the breakdown, production or transport of amino acids; in the Netherlands this is usually already found through the heel prick or in childhood

Result

What does the result mean?

Leucine too high

A raised leucine value is usually caused by a protein-rich meal or supplements containing branched-chain amino acids (BCAAs) shortly before the sample collection. In research, people with overweight or insulin resistance (reduced sensitivity to insulin) have higher BCAA values on average, but the measurement cannot be used to establish this in an individual person. A slightly raised value does not cause symptoms by itself. Rarely, a strongly raised value of all three branched-chain amino acids fits the inborn disease MSUD (maple syrup urine disease), which is detected through the heel prick.

Leucine too low

A low value is often caused by fasting, a low-protein meal, strenuous exercise or normal fluctuations during the day. Eating little or little protein for a long time, malnutrition, serious illness and pregnancy can lower several amino acids at once. A low value of one amino acid does not mean you need that amino acid as a supplement. Rarely, a low value fits an inborn disorder in the production of an amino acid.

After an abnormal result

A slightly abnormal value in someone without symptoms usually does not lead to further tests; the GP looks at diet, supplements, medicines and the circumstances of the sample collection, and has the test repeated while fasting if needed. With strongly abnormal values or an abnormal pattern together with matching symptoms, the GP consults, or refers you to, an internist (specialist in internal medicine) or pediatrician with experience in metabolic diseases.

Reliability

How reliable is the test?

In the Netherlands, amino acids are mainly measured in specialized laboratories for metabolic diseases, at the request of a specialist when an inborn metabolic disease is suspected or to monitor its treatment and diet. According to the American laboratory standard (ACMG), blood plasma, preferably collected while fasting, is the recommended sample; urine is less reliable as a first test, because the kidneys take back most amino acids and medicines can interfere with the measurement. As a 'functional' profile for finding deficiencies or tailoring supplements in adults without symptoms, the test has not been validated.

What can affect the result?

  • Food, especially a protein-rich meal, and supplements shortly before the sample collection shift the values strongly; a fasting sample gives a more reliable picture.
  • Blood must be centrifuged quickly and kept cool or frozen; otherwise some amino acids break down (including glutamine) or are released from blood cells. With home sample collection or shipping, this is a real risk.
  • Time of day, exercise, age, pregnancy, kidney function and medicines (such as some epilepsy medicines) affect the result.
  • Laboratories use different methods and reference values; results from different laboratories are hard to compare.

Preparation

  • Do the finger prick in the morning before breakfast: do not eat for 12 hours before and drink only water. After a meal with protein, amino acids are temporarily higher.

Who it is for

Who is the test useful for?

Useful for

In hospitals, a specialist uses this test when a metabolic disorder is specifically suspected, or to monitor a known metabolic disease and the diet that goes with it. For adults without symptoms, to find nutritional deficiencies or to choose supplements, the test is not useful according to current knowledge. If you use protein supplements or single amino acids, you get a result that mainly shows that intake.

How common is it?

Inborn disorders of amino acid metabolism are rare. In the Netherlands, the heel prick finds on average about 12 children with PKU (phenylketonuria) per year and about 1 child with MSUD (maple syrup urine disease) or tyrosinemia type 1. There are no Dutch figures on abnormal amino acid values in adults without symptoms.

RIVM, heel prick screening (pns.nl)

Get tested

Leucine: test panels

Leucine is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.

  • Amino Acids (Blood spot test)

    Fingerstick

    Amino Acids (Blood spot test)

    Amino acids (Blood spot test)

    € 135,00

Evidence

Sources

This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.

More about risks and results
  • UMC Utrecht, Bepalingenwijzer: Aminozuren
  • ACMG technische standaard: Laboratory analysis of amino acids, 2018 revision (Sharer e.a., Genetics in Medicine)
  • Erfelijkheid.nl: Stofwisselingsziektes
  • RIVM, Hielprik: ziekten die de hielprik opspoort

More explanations

Other tests: Vitamins, minerals and amino acids

  • AC/FC ratio
  • Acylcarnitine
  • Alanine
  • Antibodies against intrinsic factor
  • Arginine
  • Calcium
  • Calcium (albumin-corrected)
  • Carnitine, free
  • Carnitine, total
  • Coenzyme Q10
  • Copper
  • Folic acid
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