What is Organic Acids Testing (OATs)?
The Organic Acids Test, commonly known as OATs, measures the levels of organic compounds in urine that are produced in the body as a part of many vital biochemical pathways. The test provides an accurate metabolic snapshot of what is going on in the body. Besides offering the most complete and accurate evaluation of intestinal yeast and bacteria, it also provides information on important neurotransmitters, nutritional markers, glutathione status, oxalate metabolism, and much more.
The test includes 76 urinary metabolite markers that can be very useful for discovering underlying causes of chronic illness. Patients and physicians report that treating yeast and bacterial abnormalities reduces fatigue, increases alertness and energy, improves sleep, normalizes bowel function, and reduces hyperactivity and abdominal pain.
If abnormalities are detected using the OAT, treatments can include supplements, such as vitamins and antioxidants, or dietary modification. Upon treatment, patients and practitioners have reported significant improvement such as decreased fatigue, regular bowel function, increased energy and alertness, increased concentration, improved verbal skills, less hyperactivity, and decreased abdominal pain. The OAT is strongly recommended as the initial screening test.
Clinical Uses of OATs
Evaluate energy production and Mitochondrial dysfunction
Reveal high levels of GI yeast/fungal and bacteria overgrowths
Assess Neurotransmitter Levels
Detect nutritional and antioxidant deficiencies
Identify excess oxalate
Determine problems in fatty acid metabolism
Who Might Benefit From Organic Acid Testing?
The test may be revealing for people that haven’t been able to identify of explain their symptoms through other blood work, stool tests, or urinary hormone tests.
Additionally, any individual with a chronic health condition where you suspect that metabolic imbalances and/or toxins may be a causative or contributing factor, including:
Mental health disorders
It helps provide a bigger picture of mitochondrial function, nutrient deficiencies, neurotransmitter metabolism, antioxidant status, detoxification abilities, and gut health, which trained and experienced clinicians can use to dig deeper.
Why test here?
Many genetic disorders are caused by the production of an inefficient enzyme that reacts at a slower than usual rate, resulting in an accumulation of a metabolic intermediate.
Organic acidemias are disorders of intermediary metabolism that lead to the accumulation of toxic compounds that derange multiple intracellular biochemical pathways including glucose catabolism (glycolysis), glucose synthesis (gluconeogenesis), amino acid and ammonia metabolism, purine and pyrimidine metabolism, and fat metabolism. The accumulation of an organic acid in cells and fluids (plasma, cerebrospinal fluid, or urine) leads to a disease called organic acidemia or organic aciduria.
Clinical presentations of organic acidemias vary widely and may include failure to thrive, intellectual development disorders, hypo- or hyperglycemia, encephalopathy, lethargy, hyperactivity, seizures, dermatitis, dysmorphic facial features, microcephaly, macrocephaly, anemia and/or immune deficiency with frequent infections, ketosis and/or lactic acidosis, hearing, speech, or visual impairment, peripheral neuropathy, sudden cardiorespiratory arrest, nausea and coma.
Urine: 10 mL of first morning urine before food or drink is suggested. Patient should avoid apples, grapes (including raisins), pears, cranberries and their juices 48 hours prior to specimen collection. Avoid arabinogalactan, echinacea, reishi mushrooms, and ribose supplements for 48 hours before collection.
Individual organic acids can be falsely elevated by diet, medications, or other factors, so proper test prep and working with an experienced practitioner is vital.
What People are saying
"After identifying a low serotonin level on an Organic Acid Test (a hallmark functional medicine test), A severely depressed and suicidal man began taking 100mg of 5htp twice a day (5htp is the direct precursor to serotonin). After 2 days, he said his depression virtually disappeared and he was no longer suicidal. I love when I can identify a biochemical glitch and someone can have such a profound emotional turn around."
–Dr. Josh Friedman of Integrative Psychotherapy of Omaha
"The Organic Acids Test has brought new meaning to my specialized practice in women's health. This test has allowed me to investigate more deeply the chronic issues that contribute to female related conditions like PMS, uterine fibroids, endometriosis, chronic UTIs and vulvodynia. I have had a great deal of success in treating complicated PMS cases that didn't respond to typical female hormone balancing therapies. Since utilizing the OAT, it has provided me with a variety of information to determine the underlying cause of female related issues. Some of the markers that I find valuable for women's health issues are the bacterial and yeast metabolites, oxalates, B vitamins, vitamin C, and pyroglutamic acid. I have been so impressed by this test that I can't help but want to spread the word about its uses for various women's health conditions!"
Should the patient refrain from supplements prior to the Organic Acid Test (OAT)?
The OAT is designed to measure various metabolites in the body so that an understanding of the overall function can be assessed. It's up to you and your doctor to determine if you want an assessment of the body under the current metabolic conditions with supplements or without the aid of supplementation. Supplements themselves do not directly interfere with the OAT unless they contain apples, grapes, pears, or cranberries.
It is important to note that the body can take weeks to reestablish its metabolic functions after supplementation has been removed or introduced. If the supplements have recently been added or removed, the OAT will give a picture of the metabolism in transition and is difficult to assess from a clinical standpoint. If you determine that you want to cease or add supplementation, two weeks is the recommended period of time to wait before testing.
Are antibiotics and/or antifungals going to interfere with the Organic Acid Test (OAT)?
Antibiotics and antifungal will not directly interfere with the OAT unless they contain apples, grapes, pears or cranberries. It is important that the patient and practitioner consider why the test is being administered in order to determine whether or not the patient should refrain from antibiotics and antifungals. For example, a practitioner may want to know if a certain therapy is effective. In this example, it would be perfectly acceptable to remain on the therapy during collection. Separately, a patient may want to understand their metabolic condition without the aid of therapy. In this case, it is best to remove the antibiotics or antifungals for 1-2 weeks prior to testing.