Increased indican by dysbiosis or intestinal diseases
The Indican value in the urine provides a simple and reliable assessment of the disturbed colonization of bacteria in the gut (Dysbiosis), of the protein breakdown or of tissue breakdown due to a local oxygen deficiency. With the aid of determining the amount of Indican in the urine, abnormal functions of the intestinal flora can be diagnosed because this is accompanied by an increased excretion. The increased excretion always indicates an incomplete removal of the amino acid tryptophan in the intestine, as a result of which micro-organisms in the large and small intestine will convert tryptophan into indole, skatool and / or tryptamine.
The presence of a fermentation-causing intestinal flora is mainly caused by a high meat consumption or tryptophan rich diet. Indole is then not only excreted via the urine but also partially resorbed. Through the portal vein (enterohepatic cycle) it reaches the liver.
Another source of increased indican level is increased tryptophan degradation by microorganisms in the gut due to impaired uptake by elevated blood levels of phenylalanine (phenylketonuria). In the liver indole is oxidized by natural detoxification processes and esterified with sulfuric acid or glucuronic acid and excreted in the urine as an indicator (potassium salt of indoxylsulfuric acid). Even if this detoxification process is no longer optimal, serum and urine produce an abnormal increase in the intermediate indoxyl, which can be detected after the conversion to indican.
Indole is produced as a tryptophan degradation product in chronic inflammatory bowel disease (caused by Proteus or Clostridia), by fungal overgrowth (diseases caused by fungi such as Candida, Geotrichem etc.), constipation (constipation), after full bowel obstruction, by central disintegrating tumors, tooth and almond hearths and in pernicious anemia. Kidney failure (uremia) and certain rare inherited metabolic disorders (for ex.phenylketonuria) can still be detected in the urine in this way.
Indican can therefore be used for monitoring and following the treatment of specific diseases. It can give an indication of the effectiveness of the particular measures, such as oxygen therapy, the diet of the patient, the level of intestinal failure and the improvement of the intestinal flora. Indican values up to 20 mg per 24 hours of urine production are considered normal. The amount of the indican is usually measured semi-quantitatively in the urine with the help of the Obermayer reagent. A pink color of the solvent is normal; in pathological processes the color changes to blue.