The Organic Acid Test, commonly called the OAT test is one of my favorite functional medicine tests - this Great Plains Lab OAT test review will explain why.
The OAT test measures 70+ different markers looking at many aspects of your health, and the type of things that the OAT test measures cannot be tested with standard pathology tests.
So if you have a chronic illness, simply do not “feel quite right” or if you want to optimize your health and performance then the Organic Acid Test may be the right option for you. Especially if all of your standard pathology tests come back normal.
If you want to order the OAT test you can do that here or read my OAT test review and see if this test is the best option for you.
The best part is that it only requires a urine sample so it is easy to do with kids, or anyone with a needle phobia.
If you looked at an Organic Acid Test for the first time you could be forgiven for thinking that it is written in a different language - with names such as 5-Hydroxymethyl-2-furoic, Arabinose, and Methylmalonic Acid.
Essentially, organic acids are chemical compounds which are the breakdown products of metabolism in the body, they are excreted in the urine. A block in one of these chemical pathways can either lead to very high levels of organic acids (most common) or lower levels.
These chemical pathways are very important for energy production, neurotransmitter metabolism, fatty acid metabolism, detoxification, and nutritional status - this makes the OAT test invaluable at identifying dysfunction in these areas.
Organic acids are also produced by bacteria, yeast and molds so this is a way of detecting dysbiosis and gut issues, candida overgrowth or potential mold toxicity.
With the OAT test there are over 70 different markers and you cannot look at each one in isolation, as the results of one marker may influence the meaning of a different organic acid marker.
So while the Great Plains OAT test gives us a lot of information, what is even more important is that you have a doctor or naturopath who is skilled at interpreting the results and implementing a treatment plan.
The Organic Acid Test is a simple at-home test that only requires the collection of urine, and if you have a young child or a child with special needs the Great Plains lab can provide an easy solution for collection.
Your OAT test collection kit will include a urine collection cup and detailed instructions - you will need to collect 10mL of first-morning urine before any food or drink is consumed, and freeze this sample until it is ready to ship.
Certain compounds can increase a couple of the biomarkers and give false positives so following the instructions is important for accurate results. For 48 hours before you collect the urine sample, you should avoid apples, grapes, raisins, pears, cranberries, and the juice of these fruits. You should also avoid arabinogalactan, Echinacea, reishi mushrooms, and ribose supplements for 48 hours before collection.
I also recommend cutting out non-essential vitamins and minerals for the 48 hours before collection, in particular, the B vitamins as these are assessed in the Great Plains Lab OAT test.
The samples are sent back to the lab in the provided pre-paid postage box - shipping is included in the U.S and if you live in other countries contact us for shipping rates.
Let’s look at some of the key sections of the Organic Acid test to help you understand how to interpret the OAT test.
The first section of the test looks at 18 different markers that assess mold, fungal/ candida, and bacterial overgrowth.
Mold toxicity is associated with a whole range of chronic illnesses, and for many people, it can take years to diagnose.
Mold symptoms include Chronic fatigue, brain fog, fibromyalgia, recurrent infections, headaches, chronic digestive issues, and joint pain.
An Organic Acid Test can not only help to identify potential mold toxicity, but also assess whether there is also mitochondria damage which can also be contributing to the fatigue.
The Visual Contrast Sensitivity test and a Mycotoxin test are also beneficial when assessing for mold.
Several of the markers on the OAT test indicate mold toxicity.
Arabinose is the most common marker indicating the presence of Candida, this is a more sensitive test than stool tests like the G.I Map test which only assesses for candida overgrowth in the large intestine.
Arabinose is a metabolite of candida, and high levels of candida can cause fatigue, brain fog, digestive issues, and skin conditions.
High Tartaric Acid and Tricarballylic Acid can also be elevated with Candida, and it is always important to assess all of the OAT test markers as a whole before beginning a treatment plan for candida.
The Organic Acids test also evaluates intestinal bacteria, distinguishing between beneficial and harmful bacteria.
Bacteria in the gut produce metabolites that can be assessed on the OAT test.
2-Hydroxyphenylacetic Acid (marker 11), 4 Hydroxybenzoic Acid (marker 12), and 4-Hydroxyhippuric Acid (marker 13) are all markers of intestinal bacterial overgrowth. Elevations in these markers are generally seen with digestion issues or the many different symptoms that dysbiosis of bacteria can cause.
Hippuric (marker 10) is a byproduct of phenylalanine breakdown and chlorogenic acid (coffee) breakdown (and this is why you have to stop coffee). High levels indicate intestinal bacterial overgrowth.
The OAT detects specific toxic metabolites of Clostridia bacteria. The toxins released by Clostridia metabolites can inhibit neurotransmitter metabolism in the brain, in particular, the breakdown of dopamine can be associated with anxiety, ADHD, increased autism symptoms and increased mental health issues in general.
Clostridia is associated with gut dysfunction including IBS symptoms, Crohn’s disease, and ulcerative colitis.
4-Hydroxyphenylacetic (marker 15) indicates C. difficile, C. stricklandii, C lituseburense & others. HPHPA (marker 16) and 4-Cresol (marker 17) are clostridia markers.
Candida and bacteria overgrowth often occur together and they need to be brought back into balance to improve overall health. Tests like the G.I Map test combined with the OAT test from Great Plain lab can help to work out the optimal way to treat these infections, as often treatment needs to be a specific step by step process rather than just taking high doses of herbs and doing a strict diet.
High oxalates are commonly associated with kidney stones, having high oxalate levels can increase your likelihood of having kidney stones, and people who have had kidney stones describe this as the most painful experience ever.
Oxalates can be found in many healthy foods like spinach, beet leaves, chocolate, peanuts, tea, berries, and nuts. These can all be very healthy foods so you don’t have to stop eating them, but if you have high levels of oxalates you may need to modify your consumption, especially if you have previously had kidney stones.
High oxalates can also be caused by mold or yeast overgrowth in the body, so you need to assess the levels of markers 1 to 9 on the Great Plains OAT test to assess if they could be contributing to your high oxalate levels.
A B6 deficiency can also contribute to high oxalate levels, this can also be assessed on the OAT test by checking the B6 marker as well as Kynurenic acid. Oxalates can also inhibit the absorption of key minerals like calcium, magnesium, iron, and zinc.
Besides oxalates being one of the main causes of kidney stones they are also implicated in heart disease and joint pain.
The mitochondria are like your cell batteries, and if they are not working optimally it can feel like you have a flat battery!
Markers 22 to 32 on the Great Plains Lab Organic Acid test assesses for mitochondria function.
Symptoms like learning difficulties, fatigue and fibromyalgia can be caused by problems with mitochondria function, but why do the mitochondria not work optimally? This can be caused by mold, yeast and bacteria overgrowth, infections from a virus such as EBV or CMV, or tick-borne infections like Lyme disease, heavy metals, and environmental toxins can also affect mitochondria.
The OAT test assesses the metabolites of the Citric Acid Cycle, which is the different steps that occur in the mitochondria to make ATP (energy).
High levels of the organic acid markers indicate dysfunction in one or more of these steps in the production of ATP, and this can indicate the need for more nutrients such as the B vitamins, Co-enzyme Q10, lipoic acid, or D-ribose.
It is important to look at the mitochondrial markers as a whole and not treat individual imbalances, you also need to affect the gut health markers along with fatty acid metabolism which is also important for energy production.
It is important to remember that when you are assessing the metabolites of the neurotransmitters dopamine, norepinephrine and serotonin on the OAT test these are not specifically assessing the levels of these neurotransmitters in the brain.
While these neurotransmitters are important in the brain the whole autonomic nervous system uses neurotransmitters, in fact, there is more serotonin produced in the gut than the brain.
But you can still use these markers, along with the OAT markers that assess gut function, mitochondria, and nutrient deficiencies to help treat health conditions that affect the nervous system and mental health in general.
Markers 33 to 40 on the Great Plains Organic Acid Test help with the understanding of the neurotransmitters.
Quinolinic and kynurenic are tryptophan metabolites, low B6 can be a factor in reducing tryptophan conversion to 5HTP and serotonin, and can increase the conversion of tryptophan to quinolinic acid and kynurenic acid which are both neuroinflammatory.
High levels of these metabolites are seen in autism, ADHD, depression, anxiety, and dementia.
This makes the Great Plains Lab Organic Acids Test one of the best options for assessing the underlying causes of learning difficulties, behavioral problems and mental health issues.
Markers 42 to 49 on the Great Plains Organic Acid Test assess for the levels of ketones and fatty acid oxidation.
These markers assess whether you are in ketosis, which is a good thing if you are doing a ketogenic diet, and not a good thing if you are not as you may have issues metabolizing fats.
They also assess how well you are converting fatty acids into energy, this can be a great source of energy for our mitochondria and why a ketogenic diet can sometimes be a good idea when people have issues converting carbohydrates into energy in the mitochondria.
High levels of the fatty acid metabolites can indicate inflammation, oxidative stress or a deficiency in the amino acid carnitine or Vitamin B2.
The ketogenic diet has become very popular these days, for many years it has been used to treat conditions such as epilepsy. Now more and more people are doing the keto diet for weight loss, improve brain function, mental energy and preventing chronic health issues
The OAT test can help to determine if you are in ketosis and how effective you are at converting fatty acids into energy.
The Organic Acid test can be a good way to assess for specific nutrient deficiencies, in particular, the B vitamins.
Markers 41 and 42 on the Great Plains OAT test indicate a possible folate or vitamin B1 deficiency. High levels of Uracil can indicate a folate deficiency, it can also indicate methylation problems and this is more likely to be an issue for people with the MTHFR gene mutation.
Markers 50 to 57 on the OAT test can indicate deficiencies in other B vitamins, plus coenzyme Q10 and Vitamin C.
Methylmalonic acid is a specific marker for B12 deficiency, sometimes your blood test may show adequate levels of B12 in the blood, but the OAT test measures if you have a B12 deficiency at a cellular level. Sometimes blood tests can show normal levels, yet you still have a clinical B12 deficiency because it is not getting to the cells.
Once you have done the OAT test how do you implement changes, especially when you have so much information about your health?
Because the test can indicate deficiencies in particular nutrients this is often the first thing people address, and end up walking away with a pile of supplements, which may or may not work.
This is where it is important to assess the results as well as get a complete history of symptoms, diet, lifestyle and other factors to find out what the underlying cause of the imbalance is - rather than just taking a lot of supplements.
I like to address the gut function, potential yeast or mold overgrowth first because this can be the underlying cause of why the other markers are out of balance on the OAT test.
If fatigue is a major issue then looking at the mitochondrial markers and neurotransmitter metabolites is going to be important too, while the imbalance may be caused by gut issues it is often helpful to get energy production working and clients feeling better as a priority.
Lifestyle factors like diet, sleep and stress reduction is also important, supplements won’t replace a lack of sleep or a diet high in processed refined foods. Diet and lifestyle improvements should be the basis of any health program.
The cost of the OAT test is $345, or if you order the OAT test through Planet Naturopath and include a one-hour consultation the cost is $445.
The OAT test is a good value considering how many different aspects of health that it can assess, plus you can find out information that you cannot check for on the standard pathology tests.
This does not replace doing a pathology test as this can still give valuable information, but for many people, the results come back “fine” and they are told everything is ok, even though they know something is wrong
This is why the Organic Acids test is so valuable when you are optimizing your health.
If you have any questions about the Great Plains Lab Organic Acids Test review leave a comment below, or if you have any questions about ordering the OAT test contact us.
Michael is head consultant at Planet Naturopath - Functional Medicine and Nutrition Solutions. As Seen