Metabolic Organic Acids Test

Metabolic Organic Acids Test measures for > 55 organic compound levels in urine produced by the body as a part of many vital biochemical pathways including nutritional imbalances, gastrointestinal dysbiosis, detoxification or any toxic exposure. Measuring these markers can help identify the compromised or impaired metabolic process.

9,900.00 60 minutes

    Patient preparation

  • 3 days prior to urine collection, discontinue all non-essential medications and dietary supplements. If not possible, specify the list and dosage of medications and supplements the patient is taking.

  • 1 day prior to urine collection, decrease fluid intake to avoid excessive dilution of the urine. For adults, restrict intake to three 8 oz. glasses or less. Make sure that no more than 8 oz. is consumed after 8:00 PM.

  • Do not collect urine during menstruation.


This organic acids test measures more than 55 organic compound levels in urine produced by the body as part
of many vital biochemical pathways. A defect in a particular pathway can result in either accumulated or
reduced levels of its byproducts. Thus, measuring these markers can help identify the compromised or
impaired metabolic process.

Test results categorize organic acids into major metabolic areas and concerns:

✔ Gastrointestinal dysbiosis or yeast and bacterial overgrowth markers

✔ Energy production

✔ Carbohydrates, protein, and fat metabolism

✔ Nutritional imbalances and methylation indicators

✔ Detoxification or toxic exposure

✔ Neurotransmitter metabolites

Clinical Indications

  1. Identify metabolic disruptions resulting from nutritional imbalances, vitamin deficiencies, gut dysbiosis, poor
    detoxification, toxin exposure, and oxidative stress.
  2. Check for rare genetic defects of metabolism, commonly as a follow-up test for positive newborn screen result.


  • Reference ranges are age- and gender-specific, based on published scientific articles from healthy cohort.
  • Abnormal levels of a single organic acid are non-specific indicator and can point to multiple anomalies.
    Combination of markers are often used to narrow down the potential root cause. The focus is identifying the
    overall pattern, rather than individual abnormalities.
  • Results should be interpreted in the context of the bigger picture and should correlate with other laboratory tests, signs, and symptoms, as well as medical history and lifestyle of the patient.


Methodology: LC-MS/MS

Specimen: 20 ml midstream urine (24-hour or first morning)

Turnaround Time: 10 working days from receipt of sample

Specimen Viability: Store at -20ºC (freezer) upon collection and ship on ice. Stable for 3 months.

Patient Preparation:

    ▸Limit water intake to 8 glasses on the day of collection.

    ▸Avoid high intake of apples, grapes (or raisins), pears, cranberries, or their juices for 2 days prior to
    specimen collection.

    ▸Stop supplementation 3 days before urine collection.

    ▸If supplements cannot be stopped, or if patient has taken antibiotic 30 days before the test, please
    indicate on the test request form.:


Bouatra S, Aziat F, Mandal R, Guo AC, Wilson MR, Knox C, et al. (2013) The Human Urine Metabolome. PLoS ONE 8(9): e73076.
Lord, Richard & Bralley, J. (2008). Clinical applications of urinary organic acids. Part I: Detoxification markers. Alternative medicine review : a journal of clinical therapeutic. 13. 205-15.

Ramsay, Morton, Norris, Kanungo. Organic Acid Disorders. Annals of Translational Medicine. 2018;6(24):472
Sharma, Prakarti & Kumar, Parikshit & Tyagi, Mayurika & Sharma, Rachna & Dhot, Paramjit. (2018). Prevalence of Inborn Errors of Metabolism in Neonates. Journal of Clinical and Diagnostic
Research. 12. BC07-BC13. 10.7860/JCDR/2018/30035.11515.

S. Kolker, Organic Acid Disorders. Encyclopedia of the Neurological Sciences (Second Edition) 2014, Pages 688-693

Wishart DS, Feunang YD, Marcu A, Guo AC, Liang K, et al., HMDB 4.0 — The Human Metabolome Database for 2018. Nucleic Acids Res. 2018. Jan 4;46(D1):D608-17. 29140435.