The landmark experiments of Schoenheimer and Rittenberg in the 1930s provided the scientific foundation for the ensuing development and application of stable isotope techniques in clinical diagnosis and research. Following intravascular or oral administration, the tracer is metabolically indistinguishable from the equivalent unlabelled compound of interest (tracee). The metabolic fate of the compound can be assessed qualitatively and quantitatively by measuring the relative abundance of tracer and tracee and/or their respective metabolites with time. The detectable mass diVerence of tracer and tracee allows the analysis of compounds, extracted from plasma, by gas chromatography-mass spectrometry (GC-MS, picogram sample size, analytical range 0.1-100 mole %, precision ±0.2 mole %).
5The detection limit is considerably less than 0.1 mole %, when tracers with multiple stable isotope labels (for example ring-D 5 phenylalanine) are used.6 Stable isotopes in breath ( 12 CO 2 and 13 CO 2 ) are analysed using an isotope ratio mass spectrometer (IRMS, microgram sample size, analytical range 0.0001-0.01 atom % excess, precision ±0.0001 atom %. Combustion IRMS has essentially the same analytical capabilities as IRMS but allows the combustion of tissue samples with subsequent analysis of gaseous isotope enrichment. 4 Stable isotopes of minerals are typically analysed by thermal ionisation mass spectrometry (TIMS) or inductively coupled plasma mass spectrometry (ICP-MS) with high precision and sensitivity.