What is an Organic Acids Test (OAT) Good for?

An Organic Acids Test (OAT) helps gain insight into stubborn symptoms like fatigue, brain fog, poor exercise tolerance, sugar cravings, bloating, recurrent yeast issues, headaches, mood and sleep changes. From one urine sample it maps mitochondrial energy output and how you process fats, carbohydrates, and proteins, plus detoxification roadblocks and other cellular level markers to guide targeted care.

How Symptoms Relate to Organic Acids Testing

When physical and mental energy is low, workouts wipe you out, or recovery is slow, the mitochondrial and macronutrient sections often light up. These show how well your “cell engines” turn food into energy (ATP) and how you break down fats, carbs, and proteins. If there are roadblocks in this chemistry, they will show up in the labs, and we can often support the chemistry with the nutrients or herbs needed to unblock these stuck patterns. As your Root Cause Health Detective, I pair those patterns with your story to decide food, lifestyle, and nutrient steps that fit real life based on this objective data.

Sugar cravings, bloating, or recurring yeast can surface in the microbial markers, while headaches, chemical sensitivity, or slow bounce back after illness can point to glutathione and detox strain. Mood, focus, and sleep shifts often trace through neurotransmitter pathway metabolites that are influenced by stress, inflammation, and gut health. Genetics set the blueprint, but OAT shows the house you actually built, your functional expression of your genetic variation today. Or put another way, your genes are not your destiny and a genetic test alone doesn’t necessarily show you to what degree those genes are expressing themselves.

6 Functional Insights Revealed by Organic Acids Testing

Here’s 6 of my favorite functional perspectives that an OAT grants with a single urine sample:

Mitochondrial energy and macronutrient handling

In many ways, insight into your mitochondrial function is the heart of the report. The Krebs cycle or citric acid cycle involves many steps that map the way your body breaks now nutrients (protein, fats, and carbs) to create energy. These markers may reveal “fuel” bottlenecks that can drive fatigue, brain fog, and poor exercise tolerance. Related markers reflect how you handle fats, beta oxidation, and carnitine needs, carbohydrates, glycolysis and lactate, and proteins, amino acid turnover. We adjust meal balance, timing, and nutrient cofactors to steady energy and stamina strategically.

B-vitamins and enzyme cofactors

Functional markers, for example methylmalonic acid for B12, help us see when enzymes lack enough of the specific helpers they need, even if basic blood tests look “normal.” This is “test, do not guess” at its finest.

Detoxification and oxidative stress

Pyroglutamic acid and related markers flag when the glutathione “cleanup crew” is overworked. People often describe headaches, chemical sensitivity, caffeine or alcohol intolerance, or slow recovery in general. We support the pathway gently and in phases so you feel better, not wired or drained. Sometimes supplementing glutathione alone isn’t enough because the roadblock happens further up in the chemistry when it comes to producing your own.

Gut microbial imbalance, including yeast like candida

Certain urinary metabolites rise with gut microbiome imbalances (dysbiosis) or candida activity. This can out-signal yeast issues when a stool test looks unremarkable, because stool tests notoriously miss yeast and mold overgrowths due to sampling limitation. If bloating, sugar cravings, skin sensitivities and rashes keep recurring, OAT can help us target the right inputs.

Neurotransmitter-related pathways

Dopamine, adrenaline, and serotonin metabolites give context for mood, focus, and sleep and the overall “rest and digest” nervous system tone and demands on the body. We read them together with stress and gut findings, then adjust protein timing, micronutrients, and lifestyle rhythms to support these pathways. This section can be particularly helpful when supporting anxiety or depression treatment when conventional medicine interventions like antidepressants or anxiolytics have too many side effects or stop working.

Functional gene expression clues

OAT does not read DNA, but it can show phenotype, or how the genetic potential is actually expressing itself. If a genetic variation (known as a SNP or single nucleotide polymorphism) slows an enzyme, you may see its actual effects show up on the OAT. That is more actionable than supplementing only from a gene report, since having a genetic variant doesn’t automatically mean that you’re expressing that gene functionally.

When to Order Organic Acids Testing

Yearly checkups and initial baseline visits: I especially love to use this test as a yearly maintenance check with my active patients since it gives us insight into many functional systems at a glance with a single urine sample. It’s both convenient and cost effective.
Fatigue, brain fog, “normal labs” where energy and B-vitamin sections guide next steps.
Difficulty losing weight by looking for roadblocks in carb and fat metabolism at the cellular level
Stubborn gut health or yeast patterns when stool testing is inconclusive.
Chemical sensitivity or slow recovery where glutathione support can help.
Mental health support such as anxiety and depression to help better understand potential chemical and neurotransmitter roadblocks.

At Dr. Kenny’s clinic we combine OAT with history and, when useful, advanced hormone mapping, expanded thyroid, or functional GI testing, then roll out care in phases that your body can tolerate.

Additional Resources:

To better understand how this fits into root-cause care, explore How functional medicine finds the root cause.
To see how a functional stool test might complement organic acids testing, review What a functional stool test actually shows.

Clinical studies report that urinary D-arabinitol ratios can indicate Candida overgrowth in high-risk patients, explaining why yeast signals may appear on OAT even when stool looks normal

If you want to start exploring what functional insight you might glean from organic acid testing

Book your 1-on-1 Health Mystery Map Call.

Answered by Dr. Kenny Mittelstadt, DACM, DC, IFMCP
Certified functional medicine practitioner specializing in advanced lab testing and personalized healing protocols to uncover root causes of health roadblocks.