This is the first in a blog series taking a deeper dive into some of the diagnostic tools I use with my Functional Medicine patients. Often these patients have been underserved or lost in the allopathic medical model, or are simply underwhelmed by their results, which generally focus on symptom management rather than addressing the root cause. Other times they are just seeking a more natural, holistic approach.

While reasons for seeking care are varied, the most common complaints I address with Functional Medicine include: chronic GI dysfunction (IBS, SIBO, bloating, constipation, food sensitivities, etc.), chronic fatigue or malaise, hormonal changes, mood complaints like anxiety/depression, immunity and autoimmunity issues (eczema, Hashimotos, Rheumatoid Arthritis, etc.) and generally not feeling as well as one “should” or has felt in the past. In children, complaints generally include attention and behavioral disorders.

The tools we have available are as varied as these complaints, but one of my favorite tests is called the Organic Acids Test (OAT) by Great Plains Laboratories. It is a simple urinalysis, completed at home upon waking and the wealth of information it provides is extensive.

What are Organic Acids?

Organic acids are byproducts of our body’s metabolism. These chemical compounds are found in urine at 100x the volume found in blood, so are much more easily detected there. There are over 1000 different organic acids have been found in urine since this testing started. Samples are measured using gas or liquid chromatography linked with mass spectrometry.

How are Organic Acids used in testing?

Testing urine for organic acids is analogous to testing the exhaust of a car, which helps you understand what’s happening inside the engine. If biochemical reactions in the body are incomplete or lack a necessary enzyme, the amount of organic acids in the urine will be altered. 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.

Altered levels of organic acids can clinically present as failure to thrive, mental and/or developmen­tal retardation, hypo- or hyperglycemia, encephalopathy, lethargy, hyperactivity, seizures, dermatitis, dysmorphic facial features, 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

A number of organic acids directly or indirectly indicate deficiencies of critical vitamins such as vitamin B12, pantothenic acid, biotin, and others. One of the most important uses of the organic acids test is as an indicator of dysbiosis, an abnormal overgrowth of yeast and bacteria in the intestinal tract. Some of these bacterial byproducts from the intestine enter the blood stream and may alter the metabolism of neurotransmitters such as dopamine. Many people with chronic illnesses often excrete several abnormal organic acids. If abnormalities are detected, treatment including lifestyle modification and supplements such as vitamins and minerals are indicated.

What does the OAT show?

The Organic Acids Test (OAT) offers a comprehensive metabolic snapshot of a patient’s overall health with 75 markers.  It provides an accurate evaluation of intestinal yeast and bacteria.  Abnormally high levels of these microorganisms can cause or worsen behavior disorders, hyperactivity, movement disorders, fatigue and immune function. Many people with chronic illnesses and neurological disorders often excrete several abnormal organic acids in their urine. The cause of these high levels could include oral antibiotic use, high sugar diets, immune deficiencies, acquired infections, as well as genetic factors.

The OAT also includes markers for vitamin and mineral levels, oxidative stress, neurotransmitter levels, and is the only OAT to include markers for oxalates, which are highly correlated with many chronic illnesses.

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.

Who Could Benefit from OAT?

Patients dealing with

  • Autism/ADD/ADHD
  • Neurological Conditions
  • Mitochondrial/Genetic Disorders
  • Chronic GI disorders
  • Chronic inflammatory disorders
  • Fungal/Mold Exposure

Symptoms like

  • Mood problems
  • Chronic digestive issues
  • Low energy
  • Known toxin or mold exposure
  • Behavioral issues in children

Check out a sample report here.

Questions? Want to learn more? Reach out here.