4-Hydroxyphenylacetic Acid

Optimal result: 43.1 – 528.1 nmol/mg Creatinine

High 4-Hydroxyphenylacetic acid may be associated with small intestinal bacteria overgrowth (SIBO) due to its production by:

- C. difficile

- C. stricklandii

- C. lituseburense

- C. subterminale

- C. putrefaciens

- C. propionicum

C. difficile can be distinguished from the other species by its production of 4-cresol. No other Clostridia species produce 4-cresol.

Elevated values of 4-hydroxyphenylacetic acid are common in:

- Celiac disease

- Cystic fibrosis

- Jejuna web

- Transient lactose intolerance

- Giardia infection

- Ileal resection

- Ileo-colic intersusseception

- Septicemia

- Projectile vomiting.

Elevations of 4-hydroxyphenylacetic acid in celiac disease and cystic fibrosis are common enough to suggest that these Clostridia bacteria may play a role in these illnesses.

4-Hydroxyphenylacetate is a tyrosine metabolic product of certain Clostridia bacteria. Elevated levels are associated with Clostridia overgrowth, small intestinal bowel overgrowth (SIBO), or small bowel disease. May also indicate celiac disease.

For individuals with normal, healthy intestinal function, the compound p-Hydroxyphenylacetate should not appear as more than background concentrations in urine.

Measurement of 4-hydroxyphenylacetic acid excretion in urine is useful in screening for diseases of the small intestine associated with bacterial overgrowth.

- 4-Hydroxyphenylacetic acid is primarily a tyrosine breakdown product. Acinetobacter, Clostridium, Klebsiella, Pseudomonas, and Proteus act on food high in tyrosine or tyramine (fermented foods, such as sausages, marmite, soybean products, fish sauce, beers, and wine). C. difficile is known to decarboxylate 4-hydroxyphenylacetic acid to produce p-cresol.

- 4-Hydroxyphenylacetic acid is found higher in olives, American cranberries, grape wines; lower in corn, beers, oats, cocoa beans, milk (cow), evening primrose. 4-Hydroxyphenylacetic acid was higher in the urine of those adhering to a Mediterranean diet.

- If elevated, evaluate protein intake, digestion, and gut bacteria. Quercetin has been proposed to reduce radicals of 4-hydroxyphenylacetic acid.

- Though the perfect test for small bowel bacterial overgrowth (SIBO) has yet to be devised, limited research has correlated 4-hydroxyphenylacetic acid with SIBO.

References:

- http://www.hmdb.ca/metabolites/HMDB0000020

- https://www.ncbi.nlm.nih.gov/pubmed/476929

4-Hydroxyphenylacetic Acid
Healthmatters dashboard showing biomarker trend graph

Every lab result you’ve ever had, charted and explained.

Healthmatters is a tracker for your lab results. Upload a report from any lab, any country — every marker charted and explained.

Start with my report →
Beyond 4-Hydroxyphenylacetic Acid — 10,000+ markers explained
One 4-Hydroxyphenylacetic Acid result tells you where you are. Your history tells you where you’re heading. Upload your past lab reports and see this marker — and every marker on them —every marker charted against your own lab’s ranges.
Start with this report →
Healthmatters timeline preview showing biomarker trends over time
Clinical Sources & References

All our content is backed by peer-reviewed studies, academic research, and trusted medical sources. We’re committed to accuracy and transparency — see our editorial policy for details.

Article Review Log
Written by Healthmatters Editorial Team
Healthmatters Lifetime Plan

Pay $250. Track your health forever

One payment. No renewals. Yours for life.

10,000+ biomarkers explained · trends over time

See other plans →
Secure checkout via Stripe · GDPR & HIPAA
We accept results from any lab
LabCorp Quest Diagnostics Genova Diagnostics DUTCH Test Doctor's Data Vibrant America ZRT Laboratory Cyrex Labs + any other lab

What members are saying

★★★★★ 10,000+ happy members
★★★★★

"Watching my numbers move over the years — instead of forgetting last time's results — completely changed how I manage my health."

Daniel
Member since 2022
★★★★★

"Living across several countries made keeping my lab results organized a real challenge. Healthmatters brought my results from the USA, Spain, and Germany together — 20 years of history, with long-term trends instead of scattered reports."

Ben
Member since 2021 · tracks across countries
★★★★★

"Standard lab ranges are too wide for how I practice — 'normal' isn't optimal. I set my own bands, so a client sees yellow before a marker goes officially out of range. That's the conversation I want to be having."

Dr. Alexandra
Functional medicine · 6 yrs on Pro