Organic Acids Testing 

36 Organic Acids Profile Analytes

36 Organic Acids are analyzed to indicate key markers of metabolic health:

• Glycolysis Metabolites

  Glycolysis, the gateway for converting dietary carbohydrates into energy, revolves around pyruvate, a key molecule fueling subsequent pathways like the Citric Acid Cycle (CAC). The dynamic interplay between pyruvate and lactate offers insights into cellular health. Variations in their levels signal potential disruptions, guiding us in optimizing nutrition and lifestyle for vibrant well-being.

  The markers for Glycolysis include:
  

  • Pyruvate
  • Lactate

• Citric Acid Cycle Metabolites

  The Citric Acid Cycle (CAC) serves as the initial phase in the generation of adenosine triphosphate (ATP), the cellular energy currency vital for sustaining life. This cycle facilitates the transfer of high-energy electrons from carbon molecules found in dietary fats, carbohydrates, and proteins to cofactor molecules like nicotinamide adenine dinucleotide (NAD+ or NADH) and flavin adenine dinucleotide (FADH₂). Dysregulation of the Electron Transport Chain (ETC) can stem from various factors, necessitating targeted nutritional interventions, with discernible patterns observable in the Organic Acids Profile (OAP) results.

  Mitochondrial electron transport chain dysfunction may manifest in various patterns, necessitating targeted nutritional interventions. Shuttle mechanisms, such as the malate-aspartate shuttle, facilitate electron transfer to the ETC, influencing ATP production. Dysfunctions in these shuttles can result in metabolic imbalances, highlighting the intricate interplay within cellular metabolism.

  Markers for the Citric Acid Cycle Include:
  

  • Citrate
  • Cis-Aconitate
  • Isocitrate
  • Alpha-Ketoglutarate
  • Succinate
  • Fumarate
  • Malate

• Fatty Acid Oxidation

  Fatty acid oxidation pathways critical for energy production and metabolic regulation. Dietary fatty acids undergo alpha, beta, and omega oxidation, each playing distinct roles in cellular function. Alpha oxidation in peroxisomes breaks down specific fatty acids like phytanic acid, while beta oxidation in the liver generates acetyl-CoA for the citric acid cycle and ATP production. Defects in these pathways affect energy production and ketone body synthesis, crucial for brain and heart function.

  Omega oxidation, typically minor, becomes significant in conditions like carnitine deficiency. Elevated dicarboxylic acids levels indicate fatty acid oxidation defects.

  Markers for Fatty Acid Oxidation Include:
  

  • Adipate
  • Suberate
  • Ethylmalonate
  • Methylsuccinate

• Ketone Metabolites

  Ketone bodies, including beta-hydroxybutyrate, are crucial for cellular energy, particularly in the brain and heart. Produced in the liver's mitochondria, ketone bodies become significant energy sources when carbohydrate stores are depleted. Beta-hydroxybutyrate serves as a free-radical scavenger and promotes antioxidant mechanisms. Elevated levels of alpha-hydroxybutyrate are linked to diabetes and insulin-glucose dysregulation. Conversely, low levels may indicate enzyme inhibitions or nutritional deficiencies. Understanding these biomarkers aids in assessing metabolic health and guiding nutritional interventions.

   

  Ketone Markers Include:
  

  • Beta-Hydroxybutyrate

• Markers for Protein Metabolism

  Also known as Markers for Cofactor Needs.

  Dietary proteins and amino acids are essential for cellular function and energy production. Proteins are broken down into dipeptides and tripeptides during digestion, then absorbed in the small intestine, contributing to protein synthesis. During fasting, cells utilize their own proteins to produce glucose, fueling the Citric Acid Cycle (CAC). Additionally, various amino acids serve as precursors for metabolic pathways like glycolysis and ketogenesis.

  Genetic variations, medications, or liver disorders can impact amino acid metabolism, affecting ammonia detoxification and leading to symptoms like brain fog and confusion. Monitoring these pathways provides insights for personalized interventions to optimize metabolic health.

  Markers for Protein Metabolism include:

  • Alpha-Ketoisovalerate
  • Alpha-Ketoisocaproate
  • Alpha-Keto-Beta-Methylvalerate
  • Beta-Hydroxyisovalerate
  • Methylmalonate
  • Kynurenate
  • Hydroxymethylglutarate

• Markers of Neurotransmitter Metabolism

  Neurotransmitters are vital for transmitting chemical signals between nerve cells, and the Organic Acids Panel screens for issues in neurotransmission which can lead to various behavioral, psychiatric, or neurodegenerative disorders. The synthesis and breakdown of neurotransmitters depend on enzymes that require nutrient cofactors, with amino acids like tryptophan and phenylalanine being essential and obtained from the diet. The Organic Acids Panel assesses neurotransmitters processed by the liver and kidney, linking their function to neurotransmitter metabolite levels.

  Understanding neurotransmitter levels is crucial for interpreting symptoms. For instance, low levels of dopamine can manifest in movement disorders or depression, while high levels may lead to obsessive-compulsive behaviors or schizophrenia. Additionally, the Organic Acids Panel measures quinolinate, associated with neuroinflammation, and considers the interplay between kynurenate and quinolinate levels for neuroprotective purposes. Conditions like celiac disease or inflammatory bowel disease affecting nutrient absorption are also considered, emphasizing the importance of comprehensive assessment and tailored support for patients.

  Markers for Neurotransmitter Metabolism include:
  

  • Vanilmandelate
  • Homovanillate
  • 5-Hydroxyindoleacetate
  • Quinolinate

• Markers of Detoxification

  Understanding detoxification markers is crucial for assessing liver health and overall well-being. The liver's role in metabolizing toxins from both internal and external sources is vital for maintaining health. By examining biomarkers linked to detoxification pathways, we gain insights into how efficiently the liver processes toxins.

  Identifying deficiencies or impairments in detoxification pathways allows for targeted interventions to support liver function. Nutritional deficiencies or genetic variations affecting enzyme activity can hinder detoxification processes. Addressing these issues and providing specific nutritional support optimizes liver function and promotes overall health. Thus, comprehending detoxification markers is essential for guiding personalized health strategies and optimizing well-being.

  Markers For Detoxification Include:
  

  • Para-Hydroxyphenyllactate
  • Orotate
  • Alpha-Hydroxybutyrate
  • Pyroglutamate
  • Benzoate
  • Hippurate

• Markers of Bacterial Metabolism

  The assessment of Markers for Bacterial Metabolism provides invaluable insights into the intricate balance of the gut microbiome and its impact on overall health. These markers offer a window into the activity of the gastrointestinal microbiota, revealing how factors like diet, stress, and antibiotic use influence bacterial metabolism. Dysbiosis, whether characterized by insufficiency or overgrowth, can significantly alter these markers, indicating disruptions in gut health.

  Markers For Bacterial Metabolism Include:
  

  • Para-Hydroxybenzoate
  • Para-Hydroxyphenylacetate
  • 2-Hydroxyphenylacetate
  • 3-Indoleacetate
  • Tricarballylate

   

   

• Ketone/Fatty Acid Metabolites

  Fatty acid oxidation pathways critical for energy production and metabolic regulation. Dietary fatty acids undergo alpha, beta, and omega oxidation, each playing distinct roles in cellular function. Alpha oxidation in peroxisomes breaks down specific fatty acids like phytanic acid, while beta oxidation in the liver generates acetyl-CoA for the citric acid cycle and ATP production. Defects in these pathways affect energy production and ketone body synthesis, crucial for brain and heart function.

  Omega oxidation, typically minor, becomes significant in conditions like carnitine deficiency. Elevated dicarboxylic acids levels indicate fatty acid oxidation defects.

  • Adipic Acid
  • Suberic Acid
  • Ethylmalonic Acid
  • Pimelic Acid
  • Methyl-Succinic Acid

• Carbohydrate Metabolism/Glycolysis

  Dietary carbohydrates are broken down into glucose and other sugars where carbohydrate breakdown products, pyruvic acid and lactic acid are formed. Pyruvic acid enters the krebs cycle via dehydrogenase enzymes which require vitamin B1 (thiamine), vitamin B2 (riboflavin), vitamin B3 (niacin), vitamin B5 (pantothenic acid) and lipoic acid to function correctly. In the absence of these nutrients, lactic acid builds up leading to lactic acidosis. Elevated pyruvic acid and lactic acid can indicate a need for lipoic acid.

  • Pyruvic Acid
  • Lactic Acid
  • b-OH-Butyric Acid
  • Glucose (OA)

• Citric Acid Cycle Metabolites

  Citric acid cycle is the pathway for energy released from food components and the source of anabolic molecules to support organ maintenance and neurological function. Therefore, the citric acid cycle serves both anabolic and catabolic functions representing the crossroads of food conversion and utilization. Low levels of citric acid, isocitric acid and cis-aconitic acid may occur due to pathways that draw intermediates away for biosynthesis such as heme synthesis by succinate.

  • Citric Acid
  • cis-Aconitic Acid
  • Isocitric Acid
  • a-Ketoglutaric Acid
  • Succinic Acid
  • Fumaric Acid
  • Malic Acid
  • b-OH-b-Methylglutaric Acid

• B-Complex Vitamins & Amino Acid Markers

  B-complex vitamin markers are metabolic intermediates in the degradation of amino acids. When hepatic enzymes remove branched-chain amino acids, they form keto acids. B-complex vitamins are essential for many in metabolic functions in the body used to extract energy from cellular health, remove toxins, and maintain the immune system. B- complex vitamin deficiencies produce symptoms associated with homocysteinemia effects or mitochondriopathy-associated symptoms which include periodic weakness, nausea, fatigue, attention deficit or Reye Syndrome. 

  • a-Ketoisovaleric Acid
  • a-Ketoisocaproic Acid
  • a-Keto-b-Methylvaleric Acid
  • Xanthurenic Acid
  • beta-Hydroxyisovaleric Acid

• Methylation Cofactors

  Methylmalonic acid (MMA) and formiminoglutamic acid (FIGLU) represent utilisation of vitamin B12 and folic acid in the krebs cycle. Consider testing for methylation profile or advanced methylation genetics to identify all methylation pathways including the SAMe and folate pathways.

  • Methylmalonic Acid
  • Formiminoglutamic Acid

• Neurotransmitter Metabolism

  Neurotransmitter metabolites of dopamine is measured as HVA; catecholamines as VMA and serotonin as 5HIAA. Consider neurotransmitter analysis for detailed analysis of all neurotransmitters with neurotransmitter extensive, intermediate or advanced panels.

  • Homovanillic Acid (HVA)
  • Vanillylmandelic Acid (VMA)
  • 5-Hydroxyindoleacetic Acid (5HIAA)
  • Kynurenic Acid
  • Quinolinic Acid (OA)
  • Picolinic Acid
  • Cortisol (OA)

• Oxidative Damage/AntiOxidant Markers

  The assessment of protection from oxidant and ammonia challenge should be of priority when detoxification requirement is suspected. Oxidative stress has been associated with a variety of diseases like diabetes, cancer, neurodegenerative disorders, and aging.

  • ParaHydroxyphenyllactate
  • 8 OH-deoxyguanosine

• Detoxification Indicators

  Detoxification status and biotransformation capacities are identified as organic acids which serve as distinct markers of the detoxification system, providing insight about both exogenous toxin accumulation and endogenous detoxification processes. Elevations in toxicant and detoxification markers reveal aspects of xenobiotic exposure, endogenous toxins and detoxification functions.

  • 2-Methylhippuric Acid
  • Orotic Acid
  • Glucaric Acid
  • a-OH-Butyric Acid
  • Pyroglutamic Acid

• Bacterial Dysbiosis Markers

  The abnormal overgrowth of microflora in the small and large intestine is referred to as gut dysbiosis. Undigested dietary polyphenols are the predominant substrate for growth of most intestinal microbes.

  When there is intestinal dysbiosis due to poor diet, inadequate digestion, or leaky gut due to an immune reaction, there may be an overgrowth of unfavorable microflora. The products produced include: benzoate, hippurate, phenylacetate, phenylpropionate, p-hydroxybenzoate, p- hydroxyphenyl-acetate, indican and tricarballylate. 

  • Benzoate (OA)
  • Hippurate (OA)
  • Phenylacetate
  • Phenylpropionate
  • ParaHydroxyBenzoate
  • p-HydroxyPhenylacetate
  • Indoleacetic Acid
  • Tricarballylate
  • D-Lactate

• Clostridial Species

  Transamination to form para-hydroxy-phenylacetic acid and decarboxylation to p-cresol are carried out by clostridia. Unassimilated dietary tyrosine is metabolised by P.Vulgaris and clostridia difficile.

  • Dihydroxyphenylpropionic Acid
  • 4-Cresol
  • 3-OH-Proprionic Acid

• Yeast/Fungal Dysbiosis Markers

  Markers that could indicate an overgrowth of opportunistic yeast and fungus in the gut, including Candida and Clostridia.

  • Arabinitol
  • Citramalic Acid
  • Tartaric Acid

• Oxalate Metabolites

  Oxalate markers are primarily known for its formation of calcium oxalate kidney stones. Maintaining high magnesium and citrate can be helpful to avoid oxalate crystal deposition.

  • Oxalic Acid
  • Glyceric Acid
  • Glycolic Acid

• Nutritional Markers

  Some of the essential nutrient to support the krebs cycle in ATP production are measured as a guide of sufficiency. Consider amino acid analysis and vitamin status analysis.

  • Pyridoxic Acid (Vit B6)
  • Pantothenic Acid (Vit B5)
  • Glutaric Acid (Vit B2)
  • Ascorbic Acid (Vit C)
  • CoEnzyme-Q10 (CoQ10)
  • N-Acetylcysteine (NAC)