Question: Is this a biotin deficiency?
Beta-hydroxyisovaleric acid is well-established to be the most sensitive marker of biotin status. And actually typically it's done after leucine challenge, which is, no one does that. And so, generally in my experience, the way they have the reference ranges set on that should, on the ones that do have it, so the ION panel has it, the Genova panel has it, and the way they set the reference ranges, I think it works without the leucine challenge. But, I prefer the Genova ION panel because it has more, I just had a spreadsheet made up of the different markers that I wanted and the ones that were on the different organic acid panels and the ION panel has the most that line up with what, what I was looking for.
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DISCLAIMER: I have a PhD in Nutritional Sciences and my expertise is in performing and evaluating nutritional research. I am not a medical doctor and nothing herein is medical advice.