As most of the endogenous indoles have a side chain which prevents cleavage and are instead metabolized to skatole, the production of indicans (indoxyl potassium sulfate and indoxyl glucoronate) reflects bacterial activity in the small and large intestines. The table below lists conditions in which increased levels are found. Elevated levels are considered as an indicator of intestinal toxemia and overgrowth of anaerobic bacteria.
Conditions with Elevated Levels of Urinary Indican
· Inflammatory bowel disease
· Celiac disease
· Gastric ulcer
· Biliary and intestinal obstruction
· Jejunal diverticulosis
· Hartnup's disease
· Pancreatic insufficiency
· Diminished peristalsis
· Blue diaper syndrome
· Hypermotility of the small intestine
Detection of indicans depends upon its decomposition to indoxyl and subsequent oxidation to indigo blue. It is then concentrated into a layer of chloroform for easier measurement.
Urine color 0 (normal)
Light blue 1+ (low positive)
Blue 2+ (medium positive)
Violet 3+ (high positive)
Jet black 4+ (very high positive)
A positive test may indicate one of the diseases listed in table 1, hypochlorhydria, bacterial overgrowth in the small and/or large intestine, maldigestion and/or malabsorption of protein.
1. Todd J: Clinical Diagnosis and Management by Laboratory Methods. WB Saunders, Phil, Pa 1979. pp 592-3
2. Greenberger N, Saegh S, and Ruppert R: Urine indican excretion in malabsorption disorders. Gastroenterol 55:204-11, 1968
3. Curzon G and Walsh J: Value of measuring urinary indicant excretion. Gut 7:711, 1966
4. Asatoor A, London D, Craske J, and Milne M: Indole production in Hartnup's disease. Lancet i:126-8, 1963
· Sample required: 1 test tube of urine
· This single test may be used for initial diagnosing and follow-up, as well as a primary test for monitoring therapeutic digestive protocols.
· Lab reporting time: 7 - 10 business days
The Indican test uses a urine sample to test for the presence of indol, a metabolic byproduct of the action of intestinal bacteria on the amino acid tryptophan. The level of indican is an index of the efficiency of protein digestion.
The level of indican is an index of the efficiency of protein digestion. The indican scale measures the presence of indol, a metabolic byproduct of the action of intestinal bacteria on the amino acid tryptophan. Insufficient gastric hydrochloric acid, insufficient digestive enzymes, adverse food reactions, parasitic infection, fungal infection, overgrowth of bacteria that metabolize specific proteins, hypermotility of the small intestine, or other gastrointestinal dysfunction can compromise protein digestion.
Poor protein digestion also can result from the dietary intake of protein from a group of food proteins called lectins. A property common to lectins is that they agglutinate specific cell-surface antigens. Lectins have many beneficial effects, and some harmful ones. A beneficial example is the agglutination of cancer cells, which makes them easier for macrophages to phagocytize. Determining which lectins will cause agglutination, however, varies among individuals, possibly because of differing blood types. A commonly found lectin is gluten, which is present in various forms in several grains. In the intestines of some individuals, gluten can agglutinate with other food proteins, which makes complete digestion difficult or impossible. Ingestion of incompatible lectin-containing foodstuffs can lead to chronic subclinical agglutination, indigestion, and eventually, putrefaction.
Putrefaction is especially detrimental, because it can produce dozens of carcinogenic substances. These substances can enter the liver through the general circulation. Undigested protein also increases systemic toxicity, burdening the detoxification capacity of the liver. Poor protein digestion can lead to other problems, such as intestinal microbial overgrowth, which can lead to unfavorable pH changes and impaired absorption. These factors can prevent the synthesis of essential proteins and other compounds.
Eventually, the inability to digest protein can prevent proper glycemic control, and can lead to serious hormone imbalances. With poor protein digestion, eventually all absorption is adversely affected, including the absorption of water. This can be a prelude to chronic degenerative disorder including gastrointestinal disease and cancer. Without proper digestion, it is impossible to have optimal health.
This profile provides data relevant to a multitude of health disorders. Its findings are applicable in treating existing health concerns and in counseling for nutritionally based wellness and anti-aging programs. This lab test specifically assesses protein digestion.
Conditions assessed include a wide variety of GI symptoms and other vague, generalized symptoms.
Logical Sequence of Testing
The logical sequence of using this test as an initial or follow-up test is determined by a variety of individual considerations, including the patient's chief complaint, the array of signs and symptoms, the chronicity of the condition, the tests previously taken, and the judgment of the practitioner. Technical assistance is available from BioHealth Diagnostics' support staff.