Nutritional Organic Acids (Urine) - DUTCH
Urine
Performed by: Precision Analytical (DUTCH)
The Nutritional Organic Acids section of the DUTCH test measures organic acids in urine that act as functional indicators of nutrient status.
When the body is low in certain vitamins, amino acids, or antioxidants at the cellular level, related organic acids can build up and be excreted in urine.
In some cases, these functional markers are more reliable than measuring the nutrient directly in blood, because they reflect how well your body is actually using the nutrient—not just how much is circulating.
Key Markers in This Category
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Methylmalonate (MMA)
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Marker for vitamin B12 status.
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High levels may indicate a cellular B12 deficiency, even if blood B12 appears normal.
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B12 is essential for nerve health, DNA synthesis, and red blood cell formation.
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Xanthurenate
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Linked to vitamin B6 status.
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Elevated levels suggest impaired B6-dependent enzyme function, often related to inflammation or poor amino acid metabolism.
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B6 is needed for neurotransmitter production and hormone balance.
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Kynurenate
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Also influenced by vitamin B6 status and tryptophan metabolism.
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Imbalances in kynurenate may reflect inflammation, immune activation, or mood-related changes.
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β-Hydroxyisovalerate
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Functional marker for biotin (vitamin B7) deficiency.
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Biotin supports energy metabolism, hair/skin health, and gene regulation.
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Pyroglutamate
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Associated with glutathione status.
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Low or high levels may indicate depletion of glutathione—the body’s “master antioxidant” important for detoxification, immune defense, and reducing oxidative stress.
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Indican
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Marker of gut microbial activity.
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Elevated levels can signal protein putrefaction in the gut, often due to dysbiosis or poor protein digestion.
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Why These Markers Matter
By measuring these organic acids, the DUTCH test can:
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Detect hidden nutrient deficiencies before they show up on standard blood tests.
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Identify metabolic imbalances linked to inflammation, poor detoxification, or gut dysbiosis.
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Provide actionable guidance for targeted dietary, supplement, and lifestyle interventions.
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Biomarkers included in this panel:
8-OHdG measures the effect of endogenous oxidative damage to DNA. The marker is used to estimate the risk for various cancers and degenerative diseases. Adjusting treatments and lifestyle to minimize the presence of 8-OHdG is a productive step t
Learn moreElevated b-hydroxyisovalerate is found as a result of biotin insufficiency. This issue often presents in patients as skin problems as well as hair loss. Look for this DUTCH test marker to assess biotin status and determine if intervention is required
Learn moreb-Hydroxyisovalerate is made when the body is deficient in biotin. This marker has an inverse relationship with biotin, therefore elevated levels represent deficiencies in biotin. Biotin is an important cofactor in mitochondrial function, metabolism
Learn moreHomovanillate (HVA) is the primary metabolite of dopamine, a brain and adrenal neurotransmitter that comes from tyrosine (with BH4 and iron as co-factors). Dopamine goes on to create norepinephrine and epinephrine (= adrenaline). Low levels of dop
Learn moreIndican is an indole produced when bacteria in the intestine act on the amino acid, tryptophan. Most indoles are excreted in the feces. The remainder is absorbed, metabolized by the liver, and excreted as indicanin the urine. Accumulated levels
Learn moreIndican is a byproduct of tryptophan putrefaction by microbes in the gut. Accumulated levels of indican in the urine suggest higher levels of tryptophan putrefaction from gastrointestinal dysbiosis or malabsorption. Production of indican occurs wh
Learn moreKynurenate is product of the metabolism of L-Tryptophan and appears in urine in Vitamin B6 deficiencies. Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein.
Learn moreKynurenate is product of the metabolism of L-Tryptophan and appears in urine in Vitamin B6 deficiencies. Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein. Inadequate vitamin B6 is one factor that leads to in
Learn moreThe measurement of elevated amounts of methylmalonic acid in the blood or urine serves as a sensitive and early indicator of vitamin B12 deficiency.
Learn moreThe measurement of elevated amounts of methylmalonic acid in the blood or urine serves as a sensitive and early indicator of vitamin B12 deficiency.
Learn morePyroglutamate (or Pyroglutamic acid) is an intermediate in the glutathione metabolism and a marker of glutathione deficiency.
Learn morePyroglutamate is an intermediate in glutathione recycling and production. Glutathione requires the amino acids cysteine, glycine and glutamate for production. If the body cannot convert pyroglutamate forward to glutathione, it will show up elevated i
Learn moreQuinolinate is a neurotoxin derived from tryptophan. Elevated quinolinate is seen in brain and nerve tissue damage, especially in disorders such as Alzheimer's disease, Parkinson's disease, Huntington's disease, motor neuron diseases
Learn moreVanilmandelate (VMA) is the primary metabolite of norepinephrine and epinephrine (adrenaline). The adrenal gland makes cortisol and DHEA (from the adrenal cortex) as well as norepinephrine and epinephrine (from the adrenal medulla). → Wh
Learn moreYour body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein. Inadequate vitamin B6 is one factor that leads to increased concentrations of kynurenate and xanthurenate in urine.
Learn moreYour body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein. Inadequate vitamin B6 is one factor that leads to increased concentrations of kynurenate and xanthurenate in urine.
Learn more