Organic Acids Testing: Why You Should Consider Testing Your Metabolism

Organic Acids Testing or OATS is a simple urine test that can reveal how well your intestinal microbiota is functioning.

Our gastrointestinal tract (GIT) is filled with trillions of microorganisms – large communities of different species of bacteria, fungi and other microbes inhabit different parts of our GIT. These microbial communities live in equilibrium among themselves and with our own cells and play important roles in different aspects of our health.

The largest number and diversity of gut microbiota can be found in the large intestine, where they provide nourishment to our colonocytes (cells that make up the colon canal) and produce important chemicals, known as bacterial metabolites, that influence various immune and metabolic functions of our body.


Do you have a “healthy microbiota”?


The key to an optimally functioning and healthy intestinal microbiota is balance. While there are hundreds of bacterial species inhabiting your gut, they form stable communities that live in a state of balance. They interact among themselves and with our own cells, without causing harm.

At the heart of this balance, is a large repertoire of molecules, known as bacterial metabolites, produced by gut bacteria. These molecules interact with other gut microbes and with our own cells, influencing different aspects of our health. For example,

      • Certain gut bacterial species produce B vitamins, which our body needs, but cannot produce on its own1


      • Some of B vitamins and other chemicals produced by some gut bacteria influence the function of our immune system1


      • Certain vitamins and bacterial metabolites interact with enzymatic reactions and influence metabolic pathways in our body1


      • Certain bacterial metabolites, like Short Chain Fatty Acids, have important functions in our body, serving as fuel for colonic cells and influencing immune and metabolic functions2


Alteration to the optimal balance of our gut microbiota has been linked to type 2 diabetes, obesity, autoimmunity, cardiovascular health, gut disorders, neurological and metabolic diseases, among many other conditions3-8.

However, it remains challenging to detect when your gut microbiota might be out of balance. Detecting when specific groups of bacteria are overgrowing may help health practitioners make timely decisions about optimal treatments.



Organic Acids Testing


The bacteria living in your gut are constantly performing biochemical reactions, which leave chemical traces. This chemical trace includes a group of compounds called organic acids, which are a type of chemical by-product of the metabolism of dietary protein, fat, and carbohydrates. In other words, whenever our body and our gut microbes process these foods, traces of organic acids are produced, which are excreted.

Organic acids testing scrutinizes your urine to identify and measure the levels of organic acids being produced in your body. However, Organic Acids Testing goes beyond informing about the status of your gut microbiota. Our body’s metabolism performs billions of biochemical reactions every second, which leave chemical signatures that are excreted out of the body.

Organic acid testing of our urine can identify the presence of important chemical signatures, called biomarkers, that can inform a health practitioner about your health status.


Organic Acids Testing and your health

Some important examples of biological markers measured by Organic Acids Testing include:


      • Metabolic Analysis Markers

        Organic acids testing detects the presence and levels of various compounds that may indicate faulty processing of certain foods. For example:


      • Fat Metabolism

        Organic acids testing can detect the presence of Adipate, Suberate and Ethylmalonate. Finding these three compounds at high levels in your urine may indicate that fats are not being processed normally and that critically important micronutrients, such as carnitine or vitamin B2 are missing or at low levels.


      • Carbohydrate Metabolism

        Organic acids testing can also detect the presence of pyruvate and lactate, two chemicals formed during the carbohydrate metabolism. Abnormally high levels of these two chemicals may indicate a need for lipoic acids or B vitamins, which are important components of the Krebs cycle, a fundamental metabolic pathway used by the cells to gather energy.


      • Cellular Functioning

        Organic acids testing is an important tool to detect alteration to the optimal functioning of cells. For example:

            • Energy Production

              Multiple biomarkers are tested in this rubric, including citrate, succinate, fumarate, malate and others. Abnormal levels of these biomarkers may suggest enzymatic dysfunction, where specific enzymes cannot function properly due to a lack of micronutrients like B vitamins or minerals like magnesium, iron, and manganese.


            • Oxidative Stress

              This occurs when the cell is exposed to excessive chemicals known as “reactive oxygen species” or ROS, which are toxic to the cell. Organic acids testing can detect p-Hydroxyphenyllactate and 8-Hydroxy-2’-deoxyguanosine, two key biomarkers involved in oxidative stress. For example, when high levels of 8-Hydroxy-2’-deoxyguanosine are detected, this might be indicative of oxidative damage to the DNA in your cells.


      • Neurotransmitter Metabolites

        Our brain and nervous system is a complex network of neural cells that rely on specific chemicals called neurotransmitters. These chemicals help with the transmission of electrical impulses between neurons. Organic acids testing detects the presence and levels of vanilmandelate, homovanillate and 5-Hydroxyindoleacetate. These biomarkers are the by-product of the metabolic breakdown of specific neurotransmitters. For example, high levels of 5-Hydroxyindoleacetate indicate that there is a high metabolism of the neurotransmitter serotonin. Likewise, vanilmandelate is a by-product of the metabolism of neurotransmitters epinephrine and norepinephrine. If Organic acids testing detects high levels of vanilmandelate in your urine, your body might be metabolizing these two neurotransmitters more often than normal. Then, you might need to supplement your diet with micronutrients that serve as precursors for the synthesis of epinephrine and norepinephrine.


      • Vitamin Markers

        Vitamins have essential roles in the optimal functioning of cells. Abnormal levels of certain vitamins, either too much or too little of them can have adverse effects on your health. For example, thiamine (Vitamin B1) helps convert food into energy through cellular metabolic pathways. Abnormal levels of this vitamin can affect the health of your skin, hair, blood and brain. Check out this list, published by Harvard University in the USA, for a large list of important vitamins, their sources and how they affect our health.


Organic acids testing detects levels of biomarkers like α-Ketoisovalerate, α-Ketoisocaproate, α-Keto-β-methylvalerate, xanthurenate and β-Hydroxyisovalerate. These chemicals are by-products of amino acids metabolism and, under normal conditions, are processed by enzymatic reactions into other components. High levels of these biomarkers indicate enzymes are not functioning properly, like due to missing micronutrients, such as B-complex vitamins.


      • Presence of Toxins

        Organic acids testing can provide your health practitioner with evidence of toxic chemicals present in your body. Biomarkers like glucarate, if found in your urine through organic acids testing, would suggest your body has been exposed to toxic chemicals like pesticides, herbicides, fungicides, petrochemicals, or toxins produced by gut dysbiosis. Other biomarkers detected by organic acids testing include 2-Methylhippurate, Orotate, α-hydroxybutyrate, Pyroglutamate and Sulfate. Each of these biomarkers is associated with specific metabolic pathways and may help your health practitioner identify potential toxins in your body.


      • Gut Dysbiosis

        Organic acids testing can detect more than 10 different biomarkers associated with intestinal microbial imbalance, or dysbiosis. Alterations to the optimal balance of intestinal microorganisms can result in harmful species proliferating and producing high levels of potentially toxic chemicals. Biomarkers assessed by organic acids testing include benzoate, Hippurate, phenylacetate, phenylpropionate, p-Hydroxybenzoate, p-Hydroxyphenylacetate, indicant, tricarballylate, D-Lactate, 3,4-Dihydroxyphenylpropionate and D-Arabinitol. These biomarkers are normally not found or found at low levers in the urine of healthy people. Identifying high levels of these markers can provide your health practitioner with evidence of gut dysbiosis caused by specific microbes.


Modern Functional Medicine Australia is a comprehensive and promising approach to treat conditions linked to the outcome of Organic acids testing.


Table 1. Metabolic pathways and biomarkers tested by the Organic Acids Test.

Metabolic pathway Biomarker detected Associated conditions
Fat Metabolism Adipate, Suberate and Ethylmalonate atherosclerosis, heart disease, metabolic diseases
Carbohydrate Metabolism pyruvate and lactate Impaired insuline production, diabetes,
Cellular Energy production citrate, cic-Aconitate, isocitrate, a-ketoglutarate, succinate, fumarate, malate and Hydroxymethylglutarate mithochondrial dysfunction, vitamin deficiencies
Neurotransmitter metabolism vanilmandelate, homovanillate and 5-Hydroxyindoleacetate stress, HPA axis dysfunction, altered mood, appetite, and sleep.
Vitamin markers α-Ketoisovalerate, α-Ketoisocaproate, α-Keto-β-methylvalerate, xanthurenate and β-Hydroxyisovalerate immune dysfunction, poor toxin removal, impaired enzyme function
Detoxification pathways glucarate, 2-Methylhippurate, Orotate, α-hydroxybutyrate, Pyroglutamate and Sulfate diseases related to oxidative stress, like liver disease or disorders related to tyrosine metabolism.
Gut Dysbiosis benzoate, Hippurate, phenylacetate, phenylpropionate, p-Hydroxybenzoate, p-Hydroxyphenylacetate, indicant, tricarballylate, D-Lactate, 3,4-Dihydroxyphenylpropionate and D-Arabinitol. Metabolic disorders, mental health problems, intestinal disorders, immune-related diseases, among many other conditions.


What Functional Medicine Australia and Organic Acids Testing do for you?


Multiple conditions are influenced by metabolic dysfunctions. Mitochondrial dysfunction and inflammation are common problems associated with metabolic problems. Also, conditions like mood disorders, fatigue, and chronic stress, among many others can be supported using Organic acids testing.

Organic Acids Testing is a central aspect of the approach taken by Functional Medicine Australia at our centre. This test is employed in conjunction with standard medical testing to build a comprehensive picture of the underlying problems behind your symptoms. Based on the results obtained from these tests and data from Organic acids testing we can create a personalised treatment plan that includes all the micronutrients you need to supplement your metabolic needs.



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