Intracellular Micronutrient Analysis
DESCRIPTION
“Micronutrients” is a collective term used to describe essential vitamins and minerals. Adequate intake of micronutrients is important to the maintenance of health. Clinical deficiency states (states occurring after prolonged consumption of a diet lacking the nutrient) have been reported for vitamins A, B1, B12, C and D, selenium, and other micronutrients. Classic nutritional deficiency diseases are uncommon in the United States; most individuals derive sufficient nutrition from their diets alone or in combination with over-the-counter multivitamins.
This policy addresses a novel laboratory test offered by commercial laboratories to evaluate intracellular levels of micronutrients (essential vitamins and minerals). Potential uses of this test include screening for nutritional deficiencies in healthy individuals or those with chronic disease and aiding in the diagnosis of disease in individuals with generalized symptoms. This testing is also called micronutrient testing and functional intracellular analysis. Advocates claim that intracellular nutrient status is superior to serum testing. The relationship between serum and intracellular levels of micronutrients is complex. The balance of intra- and extracellular levels depend on a number of factors, including the physiology of cellular transport mechanisms and the individual cell type.
POLICY
Intracellular micronutrient analysis/panel testing is considered investigational.
See also: Complementary and Alternative Medicine
IMPORTANT REMINDER
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern.
ADDITIONAL INFORMATION
This testing may also be referred to as functional intracellular analysis, essential metabolic analysis, leukocyte nutrient analysis as well as micronutrient testing.
Intracellular micronutrient testing is offered by companies SpectraCell and IntraCellular Diagnostics, which have Clinical Laboratories Improvement Amendments (CLIA) accredited laboratories.
No studies were identified that evaluate accuracy or clinical utility of intracellular micronutrient testing compared to serum testing for vitamin and mineral levels. There is limited data available in peer reviewed journals to evaluate the impact of this technology on health outcomes.
SOURCES
Bao, B, Prasad, A., Beck, F., Fitzgerald, J., Snell, D., Bao, G., et al. (2010). Zinc decreases C reactive protein, lipidperoxidation, and inflammatory cytokine in elderly subjects: A potential implication of zinc as an atheroprotective agent. American Journal of Clinical Nutrition, 91 (6), 1634-1641. (Level 2 Evidence - Independent study)
BlueCross BlueShield Association. Medical Policy Reference Manual. (7:2011). Intracellular Micronutrient Analysis (2.04.73). Retrieved September 13, 2011 from BlueWeb. (4 articles and/or guidelines reviewed)
Houston, M. (2010) The role of cellular micronutrient analysis, nutraceuticals, vitamins, antioxidants and minerals in the prevention and treatment of hypertension and cardiovascular disease. Therapeutic Advances in Cardiac Disease, 4 (3) 165-183.
Mueller, C., Compher, C., Druyan, M, and The American Society for Parenteral and Enteral Nutrition Board of Directors. (2011). Nutrition, screening, assessment, and intervention in adults. Journal of Parenteral and Enteral Nutrition, 35 (1), 16-24.
ORIGINAL EFFECTIVE DATE: 1/14/2012
MOST RECENT REVIEW DATE: 1/14/2012
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