By
Melbourne Functional Medicine
Mark Payne
Medically reviewed by:
The most important role a functional medicine practitioner plays is the role of a detective, and one of the many tools in their detective toolkit is the organic acids test.
An Organic Acids Test (OAT) is like a comprehensive report card for your body's overall health. Just like a report card shows your performance in different subjects, an OAT assesses the levels of various organic acids in your urine, which can provide insight into the functioning of your metabolism and potential imbalances in your body.
Organic acids are chemicals that are produced when the body breaks down food or metabolises drugs, toxins or other biochemicals, or when the body carries out metabolic functions such as energy production or neurotransmitter synthesis. These compounds are then excreted in the urine as acidic waste products.
An organic acids test measures the levels of organic acids in a person's urine. By analysing the levels of organic acids in your urine, an OAT can provide a detailed picture of how well your body is metabolising nutrients, producing energy, eliminating toxins, and more. This information can help identify underlying health issues and guide personalised treatment plans to improve your overall well-being.
Think of your body as a classroom and different metabolic processes as individual subjects, like math, science, and language arts. Each subject has its own set of performance markers, just like each metabolic process has its own set of organic acids that it produces. Just as a low grade in maths may indicate that you need to study more or get extra help, abnormal levels of organic acids in your urine can indicate areas of your metabolism that need attention.
The organic acids test can be used to help diagnose a variety of conditions, including metabolic disorders, toxicity, the systemic effects of dysbiosis, or key nutrient deficiencies that are impacting how the body functions. It can also be used to monitor the progress of a disease or to evaluate the effectiveness of treatment.
An organic acids test measures the levels of metabolic waste products that are excreted in the urine after the body has performed a number of metabolic processes.
As such the organic acids test can be used to help diagnose and evaluate a variety of conditions, including:
Although the organic acids test provides a comprehensive assessment of numerous metabolic processes in the body, it does have certain limitations. While the test can identify elevated or decreased concentrations of certain organic acids, which may indicate an altered function of a particular metabolic pathway, further investigation may be necessary to pinpoint the exact issue and develop a targeted treatment plan.
The organic acids test is a urine test that is collected at home, first thing in the morning before consuming any food or fluids. Once collected the sample is frozen and sent off to the laboratory via courier.
For 48hrs prior to collection certain foods need to be avoided to ensure accuracy of the results. Some supplements may also need to stop prior to collection of the urine sample.
Once the sample has been sent to the laboratory for testing, the results will be sent to your functional medicine practitioner around 4 weeks later.
Certain medications can interfere with results, so a thorough evaluation by a trained functional medicine practitioner is important before undertaking the organic acids test.
Depending on the laboratory performing the test, a large number of markers are measured to provide information to your practitioner about:
Microbial markers:
Looks at organic acid markers for a number of beneficial, dysbiotic and pathogenic bacteria, yeasts and fungi like Candida albicans and certain strains of Clostridia. Clostridia species are normal inhabitants of the gut, but when they overgrow, they can produce harmful toxins that can lead to neurological symptoms.
Oxalate metabolites:
Elevated levels of oxalates derived from food, mould, yeasts (candida) and toxins can become deposited in tissues causing inflammation and damage, in particular to the brain, nerves, kidney and blood vessels. High levels of oxalates are associated with a number of health complaints just as joint pain, muscle pain and stiffness, fatigue and weakness, digestive issues and most obviously, kidney stones.
Glycolysis metabolites:
Evaluates how the body breaks down glycogen and glucose during the anaerobic production of energy. This is useful for people who experience fatigue related conditions.
Mitochondrial markers:
Looks at metabolites for the utilisation of carbohydrates, fatty acids and amino acids in the krebs cycle to produce energy. Mitochondrial markers can provide valuable information about the health and function of the mitochondria, which are the energy-producing organelles within cells. Mitochondrial dysfunction has been linked to a range of health conditions, including chronic fatigue syndrome, fibromyalgia, and neurological disorders.
Neurotransmitter metabolites:
Markers for the metabolism of a number of neurotransmitters including serotonin, dopamine, adrenalin and noradrenalin. The neurotransmitter metabolites can provide valuable insights into the function of the nervous system and can be helpful in diagnosing various neurological and psychiatric conditions.
For example, imbalances in neurotransmitter metabolites such as homovanillic acid (HVA) and vanillylmandelic acid (VMA) can be indicative of problems with dopamine and norepinephrine function, respectively. Abnormal levels of these metabolites have been associated with conditions such as attention deficit hyperactivity disorder (ADHD), depression, and anxiety.
Other neurotransmitter metabolites measured in the OAT include 5-hydroxyindoleacetic acid (5-HIAA) and quinolinic acid (QUIN). Elevated levels of 5-HIAA have been linked to serotonin imbalances and may be helpful in diagnosing conditions such as depression, while high levels of QUIN have been associated with neurodegenerative disorders such as Alzheimer's disease.
Pyrimidine metabolites:
Involved in the metabolism of folate, an important nutrient for blood cell production, cell replication and growth, and nervous system development. Abnormal levels of these metabolites can be indicative of certain genetic or acquired disorders that affect pyrimidine metabolism.
Pyrimidine metabolites are important building blocks of nucleic acids, which are essential for DNA and RNA synthesis. The OAT measures several pyrimidine metabolites, including orotic acid, uracil, and thymine.
Elevated levels of orotic acid can be indicative of a rare genetic disorder called Orotic Aciduria, which is characterized by impaired pyrimidine synthesis and can lead to megaloblastic anaemia and growth retardation. High levels of uracil and thymine in the urine can be indicative of a group of disorders known as the "pyrimidine degradation disorders", which are characterised by the inability to break down pyrimidine nucleotides, leading to the accumulation of toxic metabolites that can cause neurological symptoms and developmental delays.
Therefore, the pyrimidine metabolites measured in an OAT can help diagnose certain genetic or acquired disorders that affect pyrimidine metabolism, which can inform targeted treatment plans and management strategies.
Nutritional markers:
A number of key nutritional markers for important metabolic cofactors are measured including B-group vitamins, and antioxidants. These markers can help identify deficiencies or excesses of certain nutrients, as well as issues with nutrient absorption or utilisation.
The nutritional markers measured in an OAT include markers for B vitamins, such as markers for vitamin B1 (thiamine), vitamin B2 (riboflavin), vitamin B3 (niacin), and vitamin B6 (pyridoxine). Abnormal levels of these markers can be indicative of deficiencies or insufficiencies of these important vitamins, which can impact energy production, metabolism, and neurological function.
The OAT also measures markers for antioxidants such as vitamin C, vitamin E, and coenzyme Q10. Low levels of these markers can indicate deficiencies in these important antioxidants, which can impact cellular health and increase the risk of oxidative stress and chronic diseases.
Additionally, the OAT measures markers for amino acids, which are the building blocks of proteins. Abnormal levels of these markers can indicate issues with protein metabolism, such as deficiencies or excesses of certain amino acids.
Overall, the nutritional markers measured in an OAT can help identify some nutrient deficiencies, insufficiencies, or excesses, as well as issues with nutrient absorption or utilisation, which can guide targeted interventions and support optimal health and well-being.
Detoxification markers:
A number of markers involved in methylation and detoxification of metabolic waste and environmental toxins are included. The markers also include markers for glutathione, a powerful antioxidant and key player in the body's detoxification processes. Low levels of glutathione and its metabolites can indicate deficiencies in this important compound, which can impact the body's ability to detoxify and eliminate toxins.
People with suboptimal or overburdened detoxification pathways can experience a range of health issues, from digestive and neurological disorders to autoimmune conditions and chronic fatigue.
As mentioned above, the organic acids test is a useful tool that can be used to identify underlying problems such as bacterial and fungal overgrowth. including how metabolites from these microorganisms can interfere with cellular function.
As an example, the results from an organic acids test may show an elevation in arabinose, a marker for overgrowth of yeast often found in the gastrointestinal tract. Given candida actually produces oxalates, if arabinose is elevated in combination with one of the markers for oxalates, the combination of these two markers together indicates a high probability of opportunistic overgrowth of candida. Enzymes derived from candida can affect the krebs cycle and interfere with cellular energy production leading to fatigue and systemic inflammation.
The organic acids test is a helpful tool that can be used to diagnose a variety of conditions. If you’re considering having the test, talk to your practitioner about whether the OAT is right for you.
At Melbourne Functional Medicine, we can help you interpret your results and develop a treatment plan that is right for you. We offer a comprehensive approach to health care, and our team of experts will work with you to address your individual needs. Contact us today to learn more about how we can help you achieve optimum health.
