Organic acids are metabolic byproducts of cellular metabolism, biochemical reactions that produce cellular energy. Defects in a particular metabolic pathway can result in the accumulation or depletion of certain byproducts. Therefore, measuring the levels of these byproducts helps identify problem areas of metabolism, and patterns in the results can narrow the root cause of compromised function. Organic acid testing provides insight into the efficiency of metabolic pathways and the nutritional requirements of an individual.

There are many organic acid tests available for order through specialty labs. The Organic Acids test through Vibrant Wellness is one of the most popular organic acid panels ordered by providers through Rupa Health. Read on to learn about the features of this panel and how to utilize it for your patients in clinical practice.

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What is the Organic Acids Test from Vibrant Wellness?

Vibrant Wellness's Organic Acids Test measures 76 analytes through gold-standard mass spectrometry evaluatory technique to provide an in-depth evaluation of intestinal dysbiosis, inflammation, nutritional sufficiency, neurotransmitter balance, and overall mitochondrial function.

Little patient preparation is required for the test, which may involve minor modifications to their standard medication, supplemental, and dietary routine. The patient collects a single urine collection, and result turnaround time is typically about 14 days from when the lab receives the patient's sample.

What Does the Organic Acids Test from Vibrant Wellness Measure?

The urinary metabolites analyzed on this test can be grouped under the following categories:

Intestinal Microbial Overgrowth

• Yeast and Fungal Markers: citramalic acid, 5-hydroxymethyl-furoic acid, 3-oxoglutaric acid, furan-2,5-dicarboxylic acid, furancarbonylglycine, tartaric acid, arabinose, carboxycitric acid, tricarballylic acid
• Bacterial Markers: hippuric acid, 2-hydroxyphenylacetic acid, 4-hydroxybenzoic acid, 4-hydroxyhippuric acid, DHPPA
• Clostridia Bacterial Markers: 4-hydroxyphenylacetic acid, HPHPA, 4-cresol, 3-indoleacetic acid

Indicators of Detoxification

• Glutathione: pyroglutamic acid, 2-hydroxybutyric acid
• Ammonia Excess: orotic acid
• Aspartame, Salicylates, or GI Bacteria: 2-hydroxyhippuric acid

Mitochondrial Markers

• Kreb Cycle Metabolites: succinic acid, fumaric acid, malic acid, 2-oxoglytaric acid, aconitic acid, citric acid
• Amino Acid Metabolites: 3-Methylglutaric Acid, 3-Methylglutaconic, 3-Hydroxyglutaric acid, 2-Hydroxyisovaleric Acid, 3-Methyl-2-oxovaleric Acid, 2-Hydroxyisocaproic Acid, 2-Oxoisocaproic Acid, 2-Oxo-4-methiolbutyric Acid, Mandelic Acid, Phenyllactic Acid, Phenylpyruvic Acid, Homogentisic Acid, 4-Hydroxyphenyllactic Acid, N-Acetylaspartic Acid, Malonic Acid
• Tryptophan Metabolites: Glyceric acid, glycolic acid, oxalic acid
• Ketone and Fatty Acid Oxidation: 3-Hydroxybutyric Acid, Acetoacetic Acid, 4-Hydroxybutyric Acid, Adipic Acid, Suberic Acid, Sebacic Acid, Ethylmalonic Acid, Methylsuccinic Acid
• Glycolytic Metabolites: lactic acid, pyruvic acid
• Pyrimidine Metabolites (Folate Metabolism): uracil, thymine
• Mineral Metabolites: phosphoric acid
• Nutritional Markers: N-acetylcysteine acid, methylcitric acid, methylmalonic acid (vitamin B12), pyridoxic acid (vitamin B6), pantothenic acid (vitamin B5), glutaric acid (vitamin B2), ascorbic acid (vitamin C)

Analyzed together, the results from this test provide insight into "the big picture" of metabolic health. Result pattern recognition aids in narrowing down the root cause of dis-ease at the cellular level.

When to Consider The Organic Acids Test from Vibrant Wellness

Organic acid testing is a tremendous single tool that can identify many imbalances associated with genetic disorders, nutrient deficiencies, intestinal dysbiosis, and toxic exposures.

Allopathic medical doctors most commonly utilize organic acid testing to screen for inborn errors of metabolism in newborns. These rare diseases are caused by inherited or spontaneous gene mutations that result in defective metabolic pathways and errors in the breakdown and storage of carbohydrates, fatty acids, and proteins.

The scope of organic acid testing reaches beyond this screening purpose in the functional medicine world. Understanding that the results from this test can offer "big picture" insight into metabolic health and function, doctors may choose to order this test for assessment of a variety of disease states and symptoms, including:

• Anemia of chronic disease (ACD)
• Blood sugar dysregulation (e.g., insulin resistance, type 2 diabetes)
• Chemical sensitivity
• Chronic fatigue
• Cognitive and memory decline (e.g., dementia)
• Difficult concentration (e.g., ADD/ADHD)
• Digestive symptoms: abdominal pain, diarrhea, constipation, bloating, nausea
• Insomnia
• Mental and developmental delays (e.g., autism spectrum disorder)
• Mood disorders (e.g., anxiety, depression, bipolar disorder)
• Muscle weakness
• Neurological disorders (e.g., Parkinson's disease, epilepsy)
• Skin conditions
• Unexplained weight loss/gain

How to Use the Organic Acids Profile from Vibrant Wellness in Clinic

Physicians should be well-versed in patient collection instructions before ordering this test to avoid collection mistakes that could cause inaccurate results. Testing details are available on the Rupa portal. Key collection details include:

• This test requires the patient to collect a first-morning urine sample.
• The patient should not collect their sample while menstruating.
• The patient does not need to be fasting (although it is preferred) to collect their urine sample; however, they should avoid the following foods for 48 hours before urine collection: apples, grapes, pears, cranberries, mushrooms, and ribose-containing supplements.
• The patient should drink no more than 8 ounces of water one hour prior to collecting their urine sample.

Organic acid test results can be complex and challenging to interpret. An abnormal level of a single organic acid can point to multiple deficiencies. Therefore, using pattern recognition to identify themes within the results is generally more important than focusing on individual abnormal results to guide treatment recommendations.

These results can help doctors to counsel their patients on dietary modifications and supplement recommendations specific to report findings and patient presentation that focus on restoring specific nutrient levels to provide the necessary cofactors for efficient energy production, detoxification, and neurotransmitter synthesis. Repeat testing is generally recommended 3-6 months after implementing the protocol to monitor patient response.

Organic acid results may indicate the need for additional testing to pin down more specific answers regarding a highlighted imbalance. For example, if there is a trend of elevated intestinal dysbiosis markers, a comprehensive stool analysis may be warranted to identify exact strains of bacteria/yeast that have overgrown. Vibrant tests complementary to their organic acids panel include:

• Micronutrients Panel
• Fungal Antibodies
• Gut Zoomer 3.0
• Environmental Toxins

Summary

Complex, chronic diseases may require evaluation at the cellular level to identify root-cause imbalances. Doctors commonly order the Organic Acids test from Vibrant Wellness when they desire a single test that comprehensively screens for metabolic dysfunction or if they still have unanswered questions after their preliminary diagnostic workup. By measuring 76 organic acid biomarkers, this panel aids in pattern recognition indicative of energy and neurotransmitter imbalances, oxidative stress and inflammation, intestinal dysbiosis, and nutritional insufficiencies synergistically influencing a person's health status.