Organic acids are cellular byproducts produced through metabolic processes that can be measured in the urine to test for cellular imbalances contributing to suboptimal health. Conventionally, organic acids have been used to screen for inherited disorders that can cause serious health repercussions. Organic acid testing utilization has been expanded within the functional medicine world to offer a more comprehensive health screening and is often ordered for patients seeking help with chronic illnesses.

Knowing which panel to order can be challenging with multiple panels on the market. While they share similarities, each functional lab differs slightly in how they measure and report organic acids. Read on to learn why you might choose one organic acid test over another.

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What is Organic Acid Testing?

Organic acid testing (OAT) helps assess nutritional deficiencies that can affect a patient's metabolic pathways. Organic acids are cellular byproducts produced through biochemical pathways required for survival, like energy production, protein and fatty acid metabolism, and detoxification. These pathways need sufficient vitamin and mineral levels to run efficiently; organic acid metabolites build up when insufficiencies or deficiencies occur. Additionally, the commensal microbes in the gastrointestinal tract have similar metabolic processes that produce organic acids, which are then absorbed into the circulation and excreted through urine. Hence, organic acids offer a snapshot of a person's nutritional status, metabolic efficiency, and microbiome balance.

Which Patients is the Organic Acids Test Best Used For?

OAT can be a beneficial first-line tool if you need clarification on the problem with which a patient is struggling. OAT can act as a single screening test that provides a snapshot into multiple aspects of a person's health, providing clues about the gut microbiome, nutrient deficiencies, neurotransmitter levels, and toxic exposure that could be underlying the cause of a patient's presenting disease or symptom.

OAT has also been researched for its utility in assessing specific disorders:

• Gastrointestinal overgrowth of Candida and Clostridia, inability to detoxify environmental toxins, and food sensitivities/allergies have been implicated in the pathophysiology of autism spectrum disorders (ASD). The OAT is designed to measure specific organic acids correlated with ASD severity, including oxalates and HPHPA, along with identifying markers indicative of nutritional deficiencies and methylation problems that can contribute to ASD.
• Nutrient deficiencies, neurotransmitter imbalances, and exposure to environmental and pathogenic toxins can all contribute to the development and severity of mood and behavior disorders like ADHD, anxiety, and depression. The OAT can identify elevated markers indicative of Candida and Clostridia overgrowth; norepinephrine, dopamine, and serotonin imbalances; and B vitamins and magnesium insufficiencies - all of which can negatively impact mood.
• Deficiency in an enzyme called Dopamine Beta-Hydroxylase (DBH) is linked to symptoms of neurocognitive decline seen in diseases like Parkinson's and Alzheimer's. Candida overgrowth, mold exposure, and nutritional deficiencies can contribute to this deficiency.
• Nutritional deficiencies, neurotransmitter imbalances, and oxalate deposition can all contribute to chronic pain.
• Some functional doctors argue that organic acids are the best screening method for intestinal fungal overgrowth, which is easily missed by conventional culture testing methods.

Rupa Heath's Top 3 Popular Organic Acid Profile Overview

All 3 of these options are fantastic. Take a look at the differences to choose the best option for each individual patient:

1. Organic Acids (OAT) by Mosaic Diagnostics

Functional doctors highly regard the Organic Acids test (OAT) by Mosaic Diagnostics as a comprehensive and accurate nutritional and metabolic health evaluation.

What Does This Organic Acids Test Measure?

The OAT measures 76 analytes. The test report is broken down into the following categories:

• Gastrointestinal Fungal and Bacterial Overgrowth measures analytes indicative of yeast, bacterial, and Clostridia overgrowth.
• Oxalate Formation and Mitochondrial Function comprehensively overview oxalic acid levels, cellular metabolic function, and nutritional status.
• Neurotransmitter Status measures organic acids produced in the metabolic pathways involved in neurotransmitter synthesis and breakdown, commonly implicated in mood and stress disorders.
• Nutritional Profile gives insight into the nutrient status of vitamins, minerals, antioxidants, and amino acids required for healthy cellular metabolism.
• Detoxification Markers assess antioxidant status and screen for toxic overload.

What Makes This Test Popular?

• Notorious within the functional medicine world for being the original organic acids panel that is accurate and well-backed by research.
• The test report includes graphical representations of patient values so you can easily interpret the degree of abnormal results.
• Biochemical pathways are included in the test report, making the application of test results to your patient easy.
• A test interpretation at the end of the report thoroughly explains the reasons for abnormal results and suggests treatment recommendations.

When Should You Consider This Test?

• You need an extensive organic acids profile that provides a nutritional and metabolic snapshot into your patient's health, and cost is not an inhibiting factor for the patient.
• You like guidance and visual graphics to help interpret test results.

2. Organix® By Genova Diagnostics

The Organix® test is another popular profile ordered through Rupa Health. While it measures less analytes than the OAT by Mosaic Diagnostics, it is still a thorough option in terms of biomarkers.

What Does This Organic Acids Test Measure?

Genova's test measures 51 urinary organic acids categorized into the following areas of metabolic health:

• Malabsorption & Dysbiosis Markers markers indicate the overgrowth of yeast, beneficial bacteria, and level of digestive enzymes.‍
• Vitamin Markers act to functionally assess the status of B vitamins and antioxidants in the body.‍
• Cellular Energy & Mitochondrial Markers assess how efficiently the mitochondria can utilize carbohydrates, amino acids, and fatty acids to generate ATP (AKA cellular fuel). Additionally, abnormal levels of organic acids within this category can indicate nutritional insufficiencies leading to poor cellular metabolism.‍
• Neurotransmitter Metabolites assess how the body can synthesize and break down neurotransmitters.‍
• Toxin & Detoxification Markers can indicate poor glutathione levels; excess exposure to ammonia, aspartame, and salicylates; and intestinal bacterial overgrowth.‍
• Oxalate Markers assess exposure to and the elimination of oxalates from the body.

What Makes This Test Popular?

• This utilizes the highly sensitive methodology of gas chromatography-mass spectrometry (GC-MS) and liquid chromatography, followed by mass spectrometry in tandem (LC/MS/MS), meaning this test uses the most thorough combination of testing methods.
• The Genova report is user-friendly, combining charts and graphics to present patient results. It is easy to interpret results and understand how the organic acids play into an individual's biochemistry.

When Should You Consider This Test?

• You need a comprehensive screening evaluation of mitochondrial biochemical pathways, intestinal microbiome, neurotransmitter levels, and micronutrient status.
• You are a visual learner and like to see an overview of the results presented right on the first page to draw your attention to the most important findings.

3. Organic Acids Profile by US BioTek

The Organic Acids Profile by US BioTek is the least comprehensive but most affordable organic acids test available for order through Rupa Health.

What Does This Organic Acids Test Measure?

The Organic Acids Profile measures 36 organic acids related to energy production, neurotransmitter status, and bacterial overgrowth. The test is broken down into the following categories:

• Mitochondrial Function as assessed by glycolytic, citric acid cycle, fatty acid oxidation, protein, and ketone metabolites. These organic acids are produced through the mitochondrial metabolism of carbohydrates, fatty acids, and amino acids to generate cellular energy.
• Markers of Detoxification assess the efficiency of detox pathways and screen for exposure to environmental toxicants.
• Markers of Bacterial Metabolism indicate bacterial overgrowth. This test does not measure organic acids specific to fungus/yeast and Clostridia.

What Makes This Test Popular?

• This test is the least expensive organic acids testing option on the market.
• There is plenty of helpful education for interpreting this test. For example, a 136 page interpretation guide and free clinical consultations are available for providers who have ordered the test.

When Should You Consider This Test?

• Your patient is unable to spend excess money on functional testing.
• You do not need to measure organic acids related to oxalates, fungal and Clostridia overgrowth, or nutrient markers.

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Summary

Rupa Health offers access to multiple functional labs that measure urinary organic acids. The three most popular specialty tests ordered through the Rupa portal are OAT by Mosaic Diagnostics, Organix® By Genova Diagnostics, and Organic Acids Profile by US BioTek. Cost, number of test analytes, and style of the test report are all factors to consider when choosing the best organic acids option for your patient. You can view an easy comparison guide for the three tests here.