Mosaic Diagnostics

Organic Acids Test (OAT) - Nutritional and Metabolic Profile

243 biomarkers Sample: Urine Peer-reviewed

Biomarkers in this category

243 biomarkers · optimal ranges shown

3-Indoleacetic (Males Under Age 13)

Understand what elevated 3-Indoleacetic acid means in males under 13. Learn how this OAT marker reflects gut bacteria, tryptophan metabolism, and digestive health, plus common causes and next steps.

Optimal range 0.6 – 14 mmol/mol creatinine Learn more
Aconitic

Mitochondrial marker / krebs cycle metabolite

Optimal range 6.8 – 28 mmol/mol creatinine Learn more
Adipic

Fatty acid metabolite

Optimal range 0.04 – 3.8 mmol/mol creatinine Learn more
Carboxycitric

A metabolites of yeast/fungi and general indicator of gastrointestinal dysbiosis

Optimal range 0 – 29 mmol/mol creatinine Learn more
Citramalic

Metabolite of yeast or anaerobic bacteria, including Clostridia.

Optimal range 0 – 3.6 mmol/mol creatinine Learn more
Citric

Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs cycle.

Optimal range 0 – 507 mmol/mol creatinine Learn more
Ethylmalonic

Metabolite of the omega fatty acid pathway.

Optimal range 0.44 – 2.8 mmol/mol creatinine Learn more
Ethylmalonic (Males Age 13 and Over)

What is Ethylmalonic Acid? Ethylmalonic acid (EMA) is an organic acid that appears in urine when certain metabolic pathways are disrupted, particularly those involving fatty acid oxidation and mitochondrial energy production. Under normal conditions, the body efficiently breaks down fatty acids to produce energy. However, when this process is impaired, intermediate byproducts—including ethylmalonic acid—can build up and spill into urine. In clinical practice, elevated EMA is considered a marker of mitochondrial stress, impaired fat metabolism, or nutrient deficiencies that affect energy production. Why is Ethylmalonic Acid Measured on an Organic Acids Test? The Organic Acids Test (OAT) is designed to evaluate how well the body is producing and utilizing energy at a cellular level. EMA is included because it is a sensitive indicator of: Fatty acid metabolism – how well the body is breaking down fats for fuel. Mitochondrial function – since mitochondria are responsible for converting fatty acids into usable energy (ATP). Nutrient status – certain vitamins and cofactors are needed for proper fat oxidation; deficiencies may elevate EMA. Possible inborn errors of metabolism – in rare cases, very high EMA may signal genetic conditions affecting energy metabolism. By analyzing EMA along with other organic acids, clinicians can better understand whether symptoms like fatigue, weakness, or developmental issues may be related to underlying energy deficits. Several biological and lifestyle factors can affect EMA results: Nutrient deficiencies – particularly riboflavin (B2) and carnitine Mitochondrial health – genetic or acquired dysfunction Dietary intake – very high-fat diets may stress fat oxidation pathways in vulnerable individuals Oxidative stress – increases metabolic strain on mitochondria Age – mitochondrial efficiency naturally declines with aging Supporting Healthy Ethylmalonic Acid Balance If EMA is elevated, supportive strategies may include: Riboflavin supplementation – correcting vitamin B2 deficiency can normalize fatty acid metabolism. Carnitine support – oral carnitine may help improve fatty acid transport into mitochondria. Mitochondrial nutrients – coenzyme Q10, alpha-lipoic acid, and niacin may enhance energy production. Balanced diet – ensuring adequate but not excessive dietary fat and supporting overall macronutrient balance. Reducing oxidative stress – antioxidants and lifestyle interventions (exercise, sleep, stress management) can protect mitochondria. Because EMA abnormalities may reflect deeper metabolic issues, especially when significantly elevated, results should be interpreted by a healthcare provider in the context of symptoms and other organic acid markers. Key Takeaway Ethylmalonic acid is a key mitochondrial biomarker on the Organic Acids Test (OAT). Elevated levels point to impaired fatty acid metabolism, often related to nutrient deficiencies (riboflavin, carnitine), mitochondrial dysfunction, or—in rare cases—genetic metabolic conditions. Identifying and addressing these issues can improve energy levels, muscle function, and overall cellular health.

Optimal range 0.13 – 2.7 mmol/mol creatinine Learn more
Fumaric

supports energy and detoxification

Optimal range 0 – 0.94 mmol/mol creatinine Learn more
Glutaric

A breakdown product of lysine and/or tryptophan

Optimal range 0.04 – 0.36 mmol/mol creatinine Learn more
Glyceric

Marker for Genetic Disease and Oxalate Metablolism

Optimal range 0.77 – 7 mmol/mol creatinine Learn more
Glycolic

Indicator of genetic disease of oxalate metabolism

Optimal range 16 – 117 mmol/mol creatinine Learn more
Hippuric

a conjugate of glycine and benzoic acid

Optimal range 0 – 613 mmol/mol creatinine Learn more
Homogentisic

A breakdown product of 4-Hydroxyphenylpyruvic Acid (4-HPPA)

Optimal range 0 – 2 mmol/mol creatinine Learn more
HPHPA

an abnormal phenylalanine metabolite of Clostridia spp

Optimal range 0 – 208 mmol/g creatinine Learn more
HVA/ DOPAC Ratio (Males Under Age 13)

Understanding the HVA/DOPAC Ratio The HVA/DOPAC ratio is a biomarker measured through an Organic Acids Test (OAT) that provides insight into dopamine metabolism and neurotransmitter balance in the body. Dopamine, a crucial neurotransmitter, influences mood, focus, motivation, attention, and reward-driven behavior. When dopamine is broken down, two primary metabolites form: HVA (Homovanillic Acid): Produced mainly via the COMT enzyme pathway. DOPAC (3,4-Dihydroxyphenylacetic Acid): Produced primarily via the MAO enzyme pathway. The balance between these metabolites, expressed as the HVA/DOPAC ratio, reflects how effectively dopamine is being processed and broken down. What Does the HVA/DOPAC Ratio Indicate? Elevated HVA/DOPAC Ratio: Suggests dopamine is predominantly metabolized by the COMT pathway, which may reflect lower MAO activity or higher COMT activity. This pattern can be associated with symptoms like hyperactivity, inattention, anxiety, or mood fluctuations, often seen in conditions such as ADHD. Low HVA/DOPAC Ratio: Suggests dopamine is primarily metabolized by the MAO pathway, indicating potential variations in neurotransmitter regulation affecting mood and behavior. Factors Influencing the HVA/DOPAC Ratio: Genetics: Variations in genes encoding MAO and COMT enzymes. Nutrition: Deficiencies in essential vitamins and minerals (e.g., vitamins B2, B6, magnesium, zinc, copper). Gut Health: Imbalances in gut microbiota or inflammation affecting neurotransmitter metabolism. Stress and Inflammation: Increased stress and oxidative stress can alter dopamine pathways. Recommendations if Abnormal: Optimize dietary nutrients supporting neurotransmitter metabolism. Evaluate gut health and address microbial imbalances. Consider genetic testing to personalize support strategies. Seek guidance from healthcare professionals experienced in neurotransmitter balance. Regular monitoring of the HVA/DOPAC ratio can assist healthcare providers in personalizing treatment approaches to improve mood, attention, and behavioral health.

Optimal range 0.37 – 3.3 mmol/mol creatinine Learn more
Kynurenic

A product of the metabolism of L-Tryptophan.

Optimal range 0 – 2.2 mmol/mol creatinine Learn more
Malic

Marker for mitochondrial dysfunction

Optimal range 0.06 – 1.8 mmol/mol creatinine Learn more
Malonic

associated with malonyl-CoA decarboxylase deficiency

Optimal range 0 – 9.7 mmol/mol creatinine Learn more
Methylcitric

Elevation usually indicates a biotin deficiency (Vitamin H)

Optimal range 0.19 – 2.7 mmol/mol creatinine Learn more
Methylmalonic

To help detect early and/or mild vitamin B12 deficiency

Optimal range 0 – 2.3 mmol/mol creatinine Learn more
Orotic

Associated nutrients: Arginine, Magnesium

Optimal range 0.06 – 0.54 mmol/mol creatinine Learn more
Orotic (Males Under Age 13)

Understanding Orotic Acid Orotic acid is a biomarker assessed through an Organic Acids Test (OAT), offering insights into the body's ammonia metabolism, urea cycle function, and nutritional status, particularly concerning vitamin B12 and folate. What Does Orotic Acid Indicate? Elevated Orotic Acid Levels: Usually suggest impairment or stress on the urea cycle, the body's primary mechanism for removing ammonia. Increased levels may be associated with ammonia buildup, indicating potential deficiencies in essential nutrients such as vitamin B12, folate, or magnesium. Low Orotic Acid Levels: Typically have no known clinical significance but can reflect efficient ammonia processing and adequate nutritional status. Factors Contributing to Elevated Orotic Acid: Nutrient Deficiencies: Vitamin B12, folate, or magnesium deficiency can impair ammonia detoxification. Urea Cycle Dysfunction: Genetic or acquired conditions affecting ammonia removal. Gut Dysbiosis: Imbalances in gut bacteria producing excessive ammonia. Liver Dysfunction: Reduced liver function impairs ammonia metabolism, leading to elevated orotic acid. Symptoms Associated with Elevated Orotic Acid: Fatigue, weakness, or low energy Cognitive impairment or brain fog Digestive disturbances Neurological or behavioral changes, particularly in children Recommendations if Elevated: Supplementation or dietary enhancement of nutrients like vitamin B12, folate, and magnesium. Evaluation and improvement of gut health to reduce ammonia production. Consultation with a healthcare professional to assess liver function and urea cycle efficiency. Regular follow-up testing to monitor nutrient levels and metabolic function. Monitoring orotic acid can significantly contribute to identifying underlying nutritional and metabolic issues, allowing personalized interventions for improved overall health.

Optimal range 0.04 – 0.8 mmol/mol creatinine Learn more
Oxalic

the most acidic organic acid in body fluids

Optimal range 6.8 – 101 mmol/mol creatinine Learn more
Phosphoric

a marker of vitamin D and calcium

Optimal range 1000 – 5000 mmol/mol creatinine Learn more
Pyroglutamic

This is a functional marker of glutathione status

Optimal range 10 – 33 mmol/mol creatinine Learn more
Pyruvic

Anaerobic energy production.

Optimal range 0 – 9.1 mmol/mol creatinine Learn more
Quinolinic

A neurotoxic substance produced by our own bodies and a metabolite of tryptophan.

Optimal range 0.85 – 3.9 mmol/mol creatinine Learn more
Sebacic

breakdown product of fatty acids.

Optimal range 0 – 0.24 mmol/mol creatinine Learn more
Succinic

Krebs Cycle Mitochrondrial Metabolite

Optimal range 0 – 9.3 mmol/mol creatinine Learn more
Thymine

Pyrimidine Metabolites - Folate Metabolism

Optimal range 0 – 0.56 mmol/mol creatinine Learn more
Tricarballylic

Marker for exposure to certain fungal contamination in foods.

Optimal range 0 – 0.44 mmol/mol creatinine Learn more
Uracil

a marker of folate metabolism

Optimal range 0 – 9.7 mmol/mol creatinine Learn more