Clinical Significance: Primary Test Areas
Yeast & Bacteria
The OAT from The Great Plains Laboratory offers the most complete and accurate evaluation of intestinal yeast and bacteria available. It is the only OAT that distinguishes between beneficial and harmful bacteria. It also detects specific toxic metabolites of Clostridia bacteria, which are commonly missed by conventional culture methods, including unique markers for 4-cresol and HPHPA.
The toxins released by toxic Clostridia metabolites can inhibit key neurotransmitters in the brain, including the conversion of dopamine to norepinephrine, leading to or exacerbating the symptoms of a variety of neuropsychiatric and behavioral disorders, such as depression, bipolar disorder, and autism. Clostridia infection is also associated with gastrointestinal disorders, including irritable bowel syndrome, Crohn’s disease, and ulcerative colitis.
Overgrowth of Candida albicans, perhaps the most common form of yeast in the body, can build up toxins that are associated with fibromyalgia, migraines, chronic fatigue syndrome, poor concentration or “brain fog”, onset or magnification of symptoms of depression and psychosis. Candida can also become invasive, attaching to the intestinal wall, and causing “leaky gut” syndrome, which can magnify food allergies, impede absorption of vitamins and minerals, and cause a variety of intestinal disorders.
Factors which can cause intestinal yeast overgrowth include oral antibiotic use, excessive sugars in the diet, mold or other toxic environmental exposure, selective or combined immune deficiencies, and genetic irregularities. Excess Candida burdens mitochondrial function and produces elevated levels of oxalates.
Once any yeast or bacterial abnormalities are detected, there are a variety of treatment options available, including antifungal or antibacterial products, probiotic supplementation, vitamins, antioxidants, and dietary modification. Patients and physicians have reported significant improvement upon treatment, including decreased fatigue, regular bowel movements, increased energy and alertness, increased concentration, improved verbal skills, less hyperactivity, better sleep patterns, and decreased abdominal pain.
Vitamins & Antioxidants
The Organic Acids Test includes several nutritional markers, showing essential vitamin and antioxidant levels, including vitamins B12, B6, B5, B2, and C, Coenzyme Q10, N-Acetylcysteine, and Biotin (Vitamin H). Deficiencies of these vitamins and antioxidants are affiliated with a variety of chronic health issues.
A diet lacking in adequate nutrients affects our overall health. Many people with chronic illnesses and mental health disorders show significant deficiencies of important vitamins and other nutrients.
Malnutrition due to deficiencies in specific micronutrients impairs the immune system. The most consistent abnormalities are seen in cell-mediated immunity, complement system function, cytokine production, and antibody affinity.
Fatty Acid Metabolism
The Organic Acids Test measures eight specific ketones and fatty acid metabolites. Elevated levels of these fatty acids can be indicators of protein malnutrition, type I diabetes, severe GI Candida overgrowth, various genetic disorders, and cause hypoglycemia and lethargy.
The Organic Acids Test measures levels of HVA (homovanillic acid) and VMA (vanillylmandelic acid), the metabolites of the neurotransmitters, dopamine and epinephrine/norepinephrine. It also measures the ratio of the two metabolites. Elevated HVA and decreased VMA may be caused by Clostridia infection or lead toxicity. An elevated ratio is often the result of decreased conversion of dopamine to norepinephrine by the enzyme, dopamine beta-hydroxylase. This inhibition is commonly caused by Clostridia by-products, including HPHPA, 4-cresol, and 4-hydroxyphenylacetic acid, which are also measured in the OAT.
The Organic Acids Test also reports levels of quinolinic acid. Increased values of this marker may be caused by chronic inflammation from microbial infections, central nervous system degeneration, excessive tryptophan supplementation, and even exposure to phthalates. Quinolinic acid is considered neurotoxic at very high levels due to over stimulation of nerve cells, leading to premature nerve cell death.
Mitochondria are the energy factories in our body and contribute to metabolizing biochemicals needed for optimum health, such as synthesis of certain hormones, cholesterol metabolism, neurotransmitter metabolism and ammonia metabolism.
The Organic Acids Test has several markers for mitochondrial function, including six Krebs cycle metabolites and two specific amino acid metabolites. Increased values of these metabolites can indicate mitochondria energy pathway dysfunction and deficiencies in a variety of important vitamins and enzymes needed for optimal mitochondrial health.
Inborn Errors of Metabolism
The Great Plains Laboratory, Inc. is the only lab that includes markers for oxalate metabolism in the Organic Acids Test. Elevated oxalates may indicate the genetic diseases, hyperoxaluria type I and type II. Build-up of oxalates can cause kidney stones.
Oxalates can also deposit in the bones, eyes, thyroid gland, and other tissues. They may also cause pain and inflammatory conditions such as fibromyalgia and vulvodynia (vulvar pain). For information on possible treatments for oxalate issues, see the section in this book on oxalates. The OAT also includes markers for other inborn errors of metabolism, specifically for metabolites of the glycolytic cycle
Detoxification and Oxidative Stress
The Organic Acids Test includes important indicators of the body’s detoxification abilities, including those for glutathione levels. Glutathione is one of the most important and powerful antioxidants, and is often deficient in autism and other chronic conditions. When an individual is prone to oxidative stress, they are also more susceptible to opportunistic pathogens. These pathogens can hinder, either directly or indirectly, proper digestion and create further oxidative stress in the body. Unless addressed, this vicious cycle will continue to inhibit the various chemical pathways necessary for proper neurological and immune function.
Another important marker included in the Organic Acids Test for detoxification is orotic acid. High levels of orotic acid can be caused by dysbiosis. Elevations of this marker are most commonly associated with ammonia toxicity. Elevated ammonia may result from drug toxicity to the liver, viral liver infection, or inborn errors of ammonia metabolism. Ammonia excess affects brain tissue, causing symptoms such as headaches, insomnia, confusion, inability to concentrate, anxiety, and even delirium.