An Inexpensive Lab Test That Can Revolutionize Clinical Practice
Darren Schmidt, DC
WHAT YOU NEED TO KNOW
A new test is a novel, nuclear magnetic resonance (NMR) spectroscopy-based approach to evaluating mortality risk through the lens of metabolic dysfunction, malnutrition and inflammation.
MVX Plus has undergone extensive validation and, despite its very modest cost, is of extraordinary value for measuring, guiding and tracking human health.
This is a test with the potential to elevate the practice of integrative and functional medicine, and shift the paradigm away from drug-based therapies.
In 2025, a new blood test, developed by LabCorp, was released – the Metabolic Vulnerability Index or MVX Plus. The MVX Plus was established through research, aimed at quantifying combined metabolic and inflammatory vulnerability. It is a novel, nuclear magnetic resonance (NMR) spectroscopy-based approach to evaluating mortality risk through the lens of metabolic dysfunction, malnutrition and inflammation.1
Described initially in the context of chronic kidney disease, and later in heart failure, liver disease, rheumatoid arthritis, and cancer, excess mortality risk was attributed to a syndrome of combined muscle wasting, metabolic malnutrition and inflammation.3-4
MVX Plus has undergone extensive validation and, despite its very modest cost, is of extraordinary value for measuring, guiding and tracking human health. After running more than 1,500 of these tests in clinical practice, the information gleaned has made significant positive differences for the vast majority of patients.
Test Basics
The MVX score ranges from one to 100, with higher values indicating greater vulnerability and increased 1-5-year mortality risk. MVX scores are related to mortality risk irrespective of cause; it is independent of age, BMI or traditional risk factors, making it a powerful tool for early detection and personalized intervention.2,4 It has been shown to outperform many conventional risk factors in predicting five-year mortality, including smoking, diabetes, heart failure severity, and renal dysfunction.1
Validation of the MVX involved over 274,000 U.K. Biobank participants, showing it effectively predicts all-cause mortality over a median 13.7-year follow-up, highlighting its potential for identifying high-risk individuals.3
Additionally, 5,876 participants from the CATHGEN Biorepository and 2,888 from the Intermountain Heart Study were monitored, with a median follow-up of 6.2 years (IQR 4·4–8·9) in CATHGEN and 8·2 years (6·9–9·2) in the Intermountain Heart study. The six nuclear magnetic resonance biomarkers and MVX scoring made strong, independent contributions to five-year mortality risk prediction in both cohorts.1
The Six Factors of MVX Plus
The original purpose of MVX Plus was to predict mortality in the presence of disease, but it does much more than that. All six factors that contribute to the overall score provide therapeutic targets that can be addressed nutritionally to profoundly improve overall health and extend life. Progress and compliance, or the lack thereof, can be objectively evaluated.
The six factors of the MVX Plus blood test are the soil upon which chronic disease and mortality grow, with results significantly correlated with longevity. Perhaps the most important part of this test experience is that scores can routinely be improved in most cases.
1. GlycA: A measure of glycan residues from several acute-phase glycoproteins, reflecting systemic inflammation.1 It relates to infection, inflammation and trauma. When the score is above 300 umol/L, there is investigation and treatment to be performed, usually involving a chronic organism, poor diet, and/or the need for enzymes and other anti-inflammatory agents to lower inflammation.
2. Small HDL Particle Number: Typically associated with increased cardiovascular risk and metabolic issues like insulin resistance.2 The relevance here relates to particles that mediate protective functions of anti-inflammatory and immune-response proteins.1 When inflammation is high, small HDL particles are metabolized more readily; thus, reduced small HDL particles become a marker of higher inflammation and provide a loose measure of toxicity. If the score is below 18 umol/L, further testing and detoxing are indicated.
3. Citrate: A measure of mitochondrial function, it assists with proper function and prevents/reduces high levels of acidity. Elevated citrate levels may increase oxidative stress and pro-inflammatory prostaglandins. Both high and low values indicate the mitochondria are struggling – usually due to deficient nutrients, such as B vitamins, magnesium, Coenzyme Q10, iron, copper, antioxidants, and numerous factors necessary for optimal mitochondrial function.5 Ideally, the value should be 1.6-2.0 mg/dL.
4/5/6. Valine, Leucine and Isoleucine: These are the branched-chain amino acids (BCAAs). They represent diet, absorption of nutrients, digestive function, hypoglycemia, type 2 diabetes, metabolic syndrome, protein deficiency, and vitamin B1 status.
If the BCAAs are elevated, then the problem is generally insulin resistance and metabolic syndrome. A keto-type diet and B1 are key therapeutic interventions. If BCAAs are too low, then the person is likely malnourished and should consider an increase in dietary protein, preferably from animal sources, in addition to BCAA supplementation and attention to digestive organ function.
Two additional valuations are also included: inflammation vulnerability and metabolic malnutrition indices. These assist in further delineation of therapeutic targets.
Essentially, MVX Plus is measuring the five most important subjects regarding mitochondrial health: inflammation, infection, toxicity, malnourishment, and mitochondrial dysfunction.
Aligning Test Results With Clinical Care: The 7-Step BluePrint to Optimal Health
In 2018, I developed a “seven-step blueprint to optimal health.” [See Figure] These seven steps are in significant alignment with the MVX Plus results by detailing how to positively impact scoring step by step.
This test can assist in validation of therapies. There are no known medications to improve scoring, with the exception of antimicrobials. This is a test with the potential to elevate the practice of integrative and functional medicine, and shift the paradigm away from drug-based therapies in favor of a more natural approach.
References
Otvos JD, et al. Multimarkers of metabolic malnutrition and inflammation and their association with mortality risk in cardiac catheterization patients: a prospective, longitudinal, observational, cohort study. Lancet Healthy Longevity, Volume 4, Issue 2, e72 - e82
Kontush A. HDL particle number and size as predictors of cardiovascular disease. Front Pharmacol, 2015 Oct 5;6:218.
Li J, et al. The metabolic vulnerability index as a novel tool for mortality risk stratification in a large-scale population-based cohort. Redox Biol, 2025;81:103585.
Conners KM, et al. The Metabolic Vulnerability Index: a novel marker for mortality prediction in heart failure. JACC Heart Failure, 2024;12(2):290-300.
Du J, et al. The role of nutrients in protecting mitochondrial function and neurotransmitter signaling: implications for the treatment of depression, PTSD, and suicidal behaviors. Crit Rev Food Sci Nutr, 2016;56(15):2560-2578.
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