Historically, organic acids were measured to screen for inherited genetic disorders that led to enzymatic disruption and faulty metabolic pathways. Since then, organic acid testing utility has expanded, understanding that the information derived from an organic acids panel can be used to understand the complex workings of the body's many systems better.

Mosaic Diagnostics's (formerly known as Great Plains Laboratory) Organic Acids test (OAT) is a popular organic acid testing option on the market that provides insight into nutritional deficiencies, genetic polymorphisms, and toxic burdens that influence health and well-being. This article will discuss the intricacies of the OAT.

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What is the Organic Acids Test (OAT) from Mosaic Diagnostics?

Organic acids are byproducts of normal biochemical metabolic pathways of the body that generate cellular energy and other fundamental endproducts required for healthy cellular function. Nutrient deficiencies/insufficiencies, intestinal dysbiosis, environmental toxin overload, and medications can impair the efficiency of these pathways, leading to abnormal production and excretion of organic acids. Therefore, urinary organic acids can be measured to assess nutrient status and metabolic health.

The OAT provides a comprehensive metabolic analysis of a patient's health. Like other organic acid tests, it analyzes organic acid biomarkers specific to the intestinal microbiome, vitamin and mineral levels, oxidative stress, neurotransmitter levels, and oxalates. OAT results can be used to screen for intestinal dysbiosis, genetic disorders, nutritional deficiencies, and adverse effects of lifestyle and medications.

What Does the Organic Acids Test (OAT) from Mosaic Diagnostics Measure?

Using mass spectrometry analytical technique, the OAT measures 76 markers from a single urine sample. The analytes, divided into five main categories, reported on this test are listed below.

Gastrointestinal Fungal and Bacterial Overgrowth

The following markers are used to assess for intestinal overgrowth of beneficial, opportunistic, and pathogenic yeast and bacteria that may be missed with a stool culture: Citramalic, 5-Hydroxymethyl-2-furoic, 3-Oxoglutaric, Furan-2,5-dicarboxylic, Furancarbonylglycine, Tartaric, Arabinose, Carboxycitric, Tricarballylic, Hippuric, 2-Hydroxyphenylacetic, 4-Hydroxybenzoic, 4-Hydroxyhippuric, DHPPA, 4-Hydroxyphenylacetic, HPHPA, 4-Cresol, 3-Indoleacetic

Oxalate Formation and Mitochondrial Function

Glyceric, glycolic, and oxalic acids (oxalates) derived from diet, fungal exposure, and human metabolism have been implicated in the increased risk of kidney stone formation, chronic pain, metal toxicity, and autism.

Organic acids produced in mitochondrial metabolic pathways assess how efficiently the cells can utilize carbohydrates, fats, and protein to create energy. Abnormalities in these analytes can indicate insufficiencies in nutrient cofactors and genetic variations altering enzyme function: Lactic, Pyruvic, Succinic, Fumaric, Malic, 2-Oxoglutaric, Aconitic, Citric, 3-Methylglutaric, 3-Hydroxyglutaric, 3-Methylglutaconic, Uracil, Thymine, 3-Hydroxybutyric, Acetoacetic, Ethylmalonic, Methylsuccinic, Adipic, Suberic, Sebacic

Neurotransmitter Status

Organic acids produced through neurotransmitter synthesis and breakdown provide insight into stress pathways, dietary patterns, nutritional insufficiency, and the root cause of mood disorders: Homovanillic Acid (HVA), Vanillmandelic Acid (VMA), HVA/VMA Ratio, Dihydroxyphenylacetic (DOPAC), HVA/DOPAC Ratio, 5-Hydroxyindoleacetic (5-HIAA), Quinolinic, Kynurenic

Nutritional Profile (Vitamins, Minerals, Amino Acids)

The comprehensive functional profile of the patient's vitamin, mineral, and amino acid nutritional status includes the following markers: Methylmalonic (Vitamin B12), Pyridoxic (Vitamin B6), Pantothenic (Vitamin B5), Glutaric (Vitamin B2), Ascorbic (Vitamin C), 3-Hydroxy-3-methylglutaric (CoQ10), N-Acetylcysteine, Methylcitric (Biotin), 2-Hydroxyisovaleric, 2-Oxoisovaleric, 3-Methyl-2-oxovaleric, 2-Hydroxyisocaproic, 2-Oxoisocaproic, 2-Oxo-4-methiolbutyric, Mandelic, Phenyllactic, Phenylpyruvic, Homogentisic, 4-Hydroxyphenyllactic, N-Acetylaspartic, Malonic, 4-Hydroxybutyric, Phosphoric

Detoxification Markers

Pyroglutamic, 2-Hydroxybutyric, Orotic, and 2-Hydroxyhippuric assess antioxidant status and the body's ability to cope with toxic stress and burden.

When to Consider the Organic Acids Test (OAT) from Mosaic Diagnostics

OAT results provide insight into how a person's body responds on a metabolic level to any condition or symptoms from which they suffer. This means that the OAT is appropriate for essentially any patient.

Generally, the OAT is often considered for patients with chronic anxiety, depression, stress, fatigue, digestive symptoms, and pain. Organic acids have been extensively studied in the application of mental health and chronic neurodegenerative diseases. Elevations of organic acids measured on this panel have been associated with increased severity of mood disorders, suicidal ideation, Alzheimer's disease, and Huntington's disease, to name just a few.

Other diseases associated with increased organic acid levels include:

• ADHD
• Autism spectrum disorders
• Cancer
• Cardiovascular disease
• Diabetes
• Insulin resistance
• Metabolic syndrome
• Parkinson's disease

Per the Mosaic Diagnostics's website, the OAT helps achieve the following goals:

• Understand vitamin and hormone metabolism
• Determine capacity to generate energy
• Evaluate intestinal wall integrity and reveal excessive levels of gastrointestinal yeast and bacteria
• Assess the performance of the central nervous system
• Evaluate muscle function
• Detect nutritional or antioxidant deficiencies
• Determine problems in fatty acid metabolism
• Identify oxalate imbalances

How to Use the Organic Acids Test (OAT) from Mosaic Diagnostics in Clinic

Patient instructions for sample collection can be found on Rupa's website. These are the key points that should be emphasized to patients to ensure correct sample collection:

• A first-morning urine sample is required for this test. Patients should collect at least 10 mL of urine upon waking before eating or drinking.
• Patients should avoid all food and juice products containing apples, grapes, raisins, pears, and cranberries for 48 hours before collecting their urine sample.
• Patients should avoid all supplements containing arabinogalactan, reishi mushroom, echinacea, and ribose for 48 hours before collecting their urine sample.

Test results are typically available 10-14 days after the facility has received the patient's test kit.

The OAT can be ordered as an initial screening test to offer a snapshot of the patient's metabolic health, applicable to patients with chronic illness or those seeking preventive medical support. Alternatively, the OAT is often ordered by practitioners feeling perplexed by complex cases after the initial history-taking and preliminary diagnostic evaluation have been insufficient in providing conclusive information.

The results of the OAT can guide the ordering practitioner with recommendations for nutrient supplementation, typically including a combination of vitamins, minerals, amino acids, antioxidants, and antimicrobials. Dietary and lifestyle modifications can also be utilized to achieve desired results. Recommendations should be guided by result patterns indicating trends in dysbiosis, toxin exposure, and nutrient deficiency. OAT interpretation can be challenging, and additional training may be beneficial to learn key diagnostic patterns as you first implement the OAT in your practice. Rupa University offers multiple free classes specific to organic acid test interpretation.

Additional Mosaic Diagnostics tests that complement the OAT to gather additional information specific to imbalances highlighted on the OAT screen may include:

• Advanced Cholesterol Profile
• Comprehensive Stool Analysis
• DNA Methylation Pathway Profile
• Heavy Metals Urine Test
• Hormones Profile
• MycoTOX Profile
• Repeat OAT to monitor patient progress is recommended 3-6 months after baseline testing

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Summary

Organic acid testing is an excellent diagnostic tool that evaluates for metabolic imbalances due to nutritional insufficiencies, intestinal dysbiosis, and environmental toxins leading to mitochondrial dysfunction and chronic health disorders. Mosaic Diagnostics's Organic Acids (OAT) test is one of Rupa Health's most popular organic acid panel testing options. It can be ordered to help with the diagnostic process for anyone dealing with a complicated health concern or wanting to optimize metabolic health.