By Dr. Shawna Darou, ND
The Organic Acid Test is one of my favourite tests, especially for patients with complex conditions when standard lab testing like bloodwork and ultrasound comes back looking very normal. I sometimes call it “the test where I find what I wasn’t looking for,” because often the reason for running the test is not the main finding in the end. Conditions I will often consider an organic acid test include chronic fatigue, post-viral syndromes, fibromyalgia, migraines, chronic pain syndromes, fatigue when standard energy markers like iron, B12 and thyroid are normal, autism, ADHD, cognitive decline, among others.
What is an Organic Acid Test?
Basically, an organic acid test measures the end product from many biochemical reactions in the body. Using a simple first-morning urine sample, it’s a way to look at biochemistry in reverse. For example if there is an abundance of oxalates in the urine, we know that either there is high intake of oxalate-rich foods, or a condition such as intestinal yeast overgrowth or mold exposure producing more oxalates. High oxalates are associated with kidney stones, and also muscular body pains and vulvadynia. Another example is finding high urine lactic acid levels in someone who is not exercising intensely can arise from anemia or mitochondria dysfunction and is common in people with fatigue and exercise intolerance. It is a “direction-pointer” test that gives us information about how to best support your health.
There are many categories to the results on an organic acid test, but I wanted to explain five of the main findings and reasons I like to run this test.
We talk a lot about the gut microbiome, as it has become more and more evidence with research over the past decade that the balance of microorganisms in the gut can have a profound impact on health – in areas ranging from inflammation and autoimmunity, to mood and neurotransmitters.
It may sound strange that we can learn about the gut microbiome from a urine sample, but bacteria, yeast and fungus in the gut produce certain chemicals which are then metabolized in the body. Two of the main categories that we find information from this test are with fungal overgrowth like Candida, and specific strains of bacteria in the Clostridia family. Yeast overgrowth is significant in that it impacts weight, cravings, bloating, constipation and oxalate production. Markers of Clostridia bacteria overgrowth are most associated with changes in neurotransmitter production, specifically conversion of Dopamine to Norepinephrine. I’ll talk more about this below. (You’re probably more familiar with C. difficile, the Clostridia species know to cause serious diarrhea infections especially in hospitals or after taking antibiotics. There are many Clostridia species!).
Mold toxins, or “mycotoxins” are a cause of chronic health issues that I am identifying more and more. Mold exposure most often comes from water-damage in a building – leaks or floods, and also poor drainage in a basement or bathroom. High mold in the body can cause many different symptoms, often energy-related, and neurological (nerve pain, brain fog, anxiety, metallic taste, difficulty regulating temperature and chronic sinus congestion, to name a few. Mold toxins are also associated with cognitive decline, which in someone who is genetically sensitive can be very rapid and somewhat reversible. The organic acid test shows some markers that are highly suggestive of mold colonization, especially from Aspergillus, the most common mold found in water-damaged buildings. Identifying mold exposure and mycotoxins can be an a huge find in dealing with a chronic health issue, which can be reversed with an appropriate plan to clear out mold from the body, and especially prevent ongoing exposure.
Seeing markers of mitochondria stress and damage is probably my favourite aspect of the organic acid test, because we don’t have any other accessible way to do this. Your mitochondria are the energy centres or batteries in your cells, and they can become damaged by exposure to toxins (chemicals, metals, mold), and also from chronic high stress. Symptoms of mitochondria dysfunction include fatigue, exercise intolerance, brain fog, muscle pain and migraines. There are at least 10 markers of mitochondria function on the organic acid test, and depending on what category is out of balance we can support mitochondria function with specific nutrients like Coenzyme Q10 and L-Carnitine, and most importantly determine the cause of why the mitochondria are struggling.
I strongly believe that mood issues are not all in our heads. Your physiology can have a profound effect on your mood. For example a simple iron-deficiency can cause anxiety and insomnia. With the organic acid test, we get a snapshot of levels of a dopamine, serotonin and norepinephrine, all of which are important for mood regulation and motivation.
The context that this test is most useful for is one related to the microbiome described above. When there is an overload of Clostridia bacteria in the gut, causing low levels of dopamine beta hydroxylase (DBH) enzyme that converts dopamine to norepinephrine. When the body is in this state, common symptoms can include fatigue, exercise intolerance, low blood pressure (and fainting), ADHD, depression, as well as more serious mood disorders like schizophrenia.
What’s important to know is that this is a mircobiome imbalance, and by treating high Clostridia levels, usually with very specific probiotics, and occasionally with antibiotics, the conversion of dopamine to norepinephrine increases and the symptoms improve.
You have probably heard me talk about ‘methylation’ before which simply means adding a methyl group to another molecule. Methylation is important for detoxification, gene expression and utilization of certain nutrients. Issues with methylation are associated with heart attacks, dementia, migraines, miscarriages, cancer, birth defects, depression, autism, and more. There are many genes associated with the methylation process, and probably the most studied one is the MTHFR gene, however there are many more genes related to this process.
In the organic acid test, we see signs poor methylation with some markers, and indicators of low absorption of vitamin B12, B6, B2 and folate, all of which are essential for the methylation process. Correcting nutrient levels and determining causes of poor methylation (genes or toxins), can greatly impact current and future health.
If you want to learn more about how this test, or are interested in how we can use this to understand how to support your health better, please ask during your next appointment.