Nutritional Supplement Guidance Based on the Organic Acids Test by MosaicDX
The Organic Acids Test (OAT) provides a broad biochemical snapshot of metabolic processes in the body. Many parents receive detailed OAT reports filled with biochemical data, yet are left unsure how those findings translate into real-life nutritional decisions. The true value of this test lies in professional interpretation and the ability to translate complex biochemical findings into clear, practical guidance for nutritional supplement use.
At the C.A.T. Center, we provide structured, in-depth nutritional supplement guidance based on laboratory findings, with a particular focus on the Organic Acids Test (OAT) from Mosaic Diagnostics (MosaicDX).
This guidance is provided by Tali Engor, a licensed pharmacist with a degree in pharmaceutical chemistry, and the mother of a child who was previously diagnosed on the autism spectrum. This unique combination of professional expertise and lived experience helps bridge the gap between laboratory data and the day-to-day decisions families face.
Matteo’s Family Noticed Meaningful Changes
Matteo’s Family Noticed Meaningful Changes
Within five months, Matteo demonstrated substantial improvements in communication, verbalization, and understanding, leading to meaningful changes in his daily functioning.
- C.A.T. is available worldwide and guided by advanced laboratory analysis tailored to each child’s unique metabolic profile.
Within five months, Matteo demonstrated substantial improvements in communication, verbalization, and understanding, leading to meaningful changes in his daily functioning.
- C.A.T. is available worldwide and guided by advanced laboratory analysis tailored to each child’s unique metabolic profile.
How We Work With the Organic Acids Test (OAT)
For families, we arrange the Organic Acids Test (OAT) kit from Mosaic Diagnostics. The kit is shipped directly to the family’s home and includes clear instructions for sample collection.
Once laboratory results are available, we conduct a comprehensive review of the OAT report, focusing on metabolic patterns rather than isolated values. Interpretation commonly considers key functional areas such as:
✔️ Gastrointestinal activity and the gut microbiome
✔️ Energy production and mitochondrial function
✔️ Pathways related to neurotransmitter metabolism
✔️ Metabolic load and internal detoxification processes
Based on this analysis, families receive personalized guidance for nutritional supplement use, tailored to the individual OAT findings and the broader biochemical picture.
Who This Service Is For
This service is intended for parents of children on the autism spectrum or with developmental challenges who wish to:
- Work with a professional who understands complex biochemical data and can translate it into practical, day-to-day nutritional supplement guidance.
- Gain a deeper understanding of Organic Acids Test (OAT) results
- Understand how nutritional supplement use can be tailored based on biochemical findings from laboratory testing
How We Interpret OAT Results for Supplement Guidance
At the C.A.T. Center, Organic Acids Test (OAT) results are reviewed as part of a structured process focused on nutritional supplement guidance. Rather than reviewing isolated values, we identify metabolic patterns and translate laboratory findings into practical, personalized supplement considerations for families.
If you would like to learn more about who we are, how we work with Organic Acids Test (OAT) results, and what the nutritional supplement guidance process looks like in practice, we invite you to explore our approach.
👉 Learn more about the C.A.T. Center and our lab-guided process
If you prefer to speak with our team directly, you can also schedule a free introductory call to discuss your situation and learn whether our OAT interpretation service may be appropriate for your child.
Organic Acids Test (OAT): What it Measures + How to Prepare
The Mosaic Diagnostics Organic Acids Test (OAT) is a urine-based laboratory assessment that measures 76 organic acid metabolites produced through normal human metabolism, as well as metabolites influenced by bacterial and fungal activity in the gastrointestinal tract. These metabolites are excreted in urine and can provide insight into biochemical activity across multiple metabolic pathways.
What Does the Organic Acids Test Measure
The OAT measures 76 urinary organic acid markers from a single urine sample. These markers are reviewed in functional categories that may help practitioners identify metabolic patterns rather than isolated abnormalities.
Key functional areas commonly reviewed
Microbial-related metabolites
Organic acids associated with yeast, fungal, and bacterial metabolism, including markers commonly reviewed in the context of gut microbial balance.
Energy and mitochondrial metabolism
Organic acid intermediates related to carbohydrate, fatty acid, and amino acid metabolism that participate in cellular energy production.
Neurotransmitter-related metabolites
Urinary metabolites associated with dopamine, serotonin, and norepinephrine/epinephrine pathways.
Detoxification and oxidative stress markers
Metabolites related to glutathione status, oxidative stress, and detoxification pathways.
Nutritional and micronutrient-related patterns
Direct and indirect markers that may reflect functional demand for B-vitamins, antioxidants, minerals, and other micronutrients.
See Johnny’s Progress
What started as quiet, gradual changes slowly grew into moments that reshaped daily life — interactions, learning, and growing confidence that Johnny’s family now cherishes deeply.
What started as quiet, gradual changes slowly grew into moments that reshaped daily life — interactions, learning, and growing confidence that Johnny’s family now cherishes deeply.
When Are Results Available
Test results are typically delivered to the ordering practitioner within 5–10 business days after the laboratory receives the sample. Results are reviewed and interpreted by a qualified healthcare practitioner in the context of clinical history and other findings.
Parent’s Guide: Understanding the Organic Acids Test (OAT) Metabolites
The Organic Acids Test (OAT) provides a broad metabolic overview based on 76 specific urinary metabolites.
Each metabolite reflects a biochemical process related to gut health, nutrient status, energy production, neurotransmitter metabolism, or detoxification.
Below is a clear explanation of each metabolite, organized by functional category.
1. Intestinal Microbial Overgrowth
(Yeast and Fungal Metabolites)
These metabolites evaluate yeast and fungal activity in the gastrointestinal tract.
Metabolite 1: Citramalic Acid
Often produced by yeast such as Saccharomyces. Elevated levels suggest yeast overgrowth in the gut.Metabolite 2: 5-Hydroxymethyl-2-furoic Acid
Associated with Aspergillus mold activity in the digestive tract.Metabolite 3: 3-Oxoglutaric Acid
Indicates possible yeast overgrowth in the gastrointestinal system.Metabolite 4: Furan-2,5-dicarboxylic Acid
A fungal metabolite commonly linked to Aspergillus species.Metabolite 5: Furancarbonylglycine
May reflect mold exposure or fungal overgrowth.Metabolite 6: Tartaric Acid
A metabolic by-product of Candida. Elevated levels may contribute to fatigue and cognitive “fog.”Metabolite 7: Arabinose
A key sugar produced by Candida yeast and a primary metabolite associated with yeast overgrowth.Metabolite 8: Carboxycitric Acid
Another indicator of yeast or fungal metabolic activity.Metabolite 9: Tricarballylic Acid
A mold-related compound that may interfere with magnesium absorption.
2. Bacterial Metabolites
These metabolites help assess bacterial balance and dysbiosis in the gut.
Metabolite 10: Hippuric Acid
May indicate bacterial overgrowth; can also be influenced by diet (tea, coffee, fruits).Metabolite 11: 2-Hydroxyphenylacetic Acid
Associated with bacterial overgrowth, particularly in the small intestine.Metabolite 12: 4-Hydroxybenzoic Acid
Linked to gut dysbiosis and sometimes to exposure to paraben preservatives.Metabolite 13: 4-Hydroxyhippuric Acid
Often elevated due to dietary factors or preservative exposure.Metabolite 14: DHPPA (Dihydroxyphenylpropionic Acid)
Elevated levels are generally considered beneficial and reflect healthy bacterial activity and antioxidant intake.
3. Clostridia Bacterial Metabolites
Certain Clostridia species produce compounds that may affect neurological function.
Metabolite 15: 4-Hydroxyphenylacetic Acid
Associated with Clostridia overgrowth or celiac-related gut imbalance.Metabolite 16: HPHPA
A key metabolite of Clostridia activity; elevated levels may interfere with dopamine metabolism.Metabolite 17: 4-Cresol
Produced by C. difficile and may disrupt neurotransmitter balance.Metabolite 18: 3-Indoleacetic Acid
Reflects altered tryptophan metabolism related to bacterial activity.
4. Oxalate Metabolites
Oxalates can contribute to inflammation and physical discomfort.
Metabolite 19: Glyceric Acid
Typically elevated only in rare genetic metabolic conditions.Metabolite 20: Glycolic Acid
May be influenced by diet or genetic factors.Metabolite 21: Oxalic Acid
The primary oxalate metabolite; influenced by diet, vitamin C intake, and fungal overgrowth.
5. Glycolytic & Mitochondrial Metabolites
(Energy Production)
These metabolites reflect cellular energy efficiency.
Metabolite 22: Lactic Acid
Elevated levels suggest inefficient energy production.Metabolite 23: Pyruvic Acid
Indicates difficulty converting carbohydrates into energy.Metabolite 24: Succinic Acid
May reflect toxin exposure or increased need for vitamin B2 or CoQ10.Metabolite 25: Fumaric Acid
Associated with the need for CoQ10, biotin, or carnitine.Metabolite 26: Malic Acid
Often linked to niacin (vitamin B3) and CoQ10 requirements.Metabolite 27: 2-Oxoglutaric Acid
May indicate deficiencies in B-vitamins such as B1, B2, or B5.Metabolite 28: Aconitic Acid
Suggests increased demand for glutathione.Metabolite 29: Citric Acid
May reflect yeast activity or reduced antioxidant capacity.Metabolite 30–32: Amino Acid Metabolites
Help assess protein metabolism and certain metabolic patterns.
6. Neurotransmitter Metabolites
(Brain Chemistry)
These metabolites reflect dopamine, serotonin, and stress-related pathways.
Metabolite 33: HVA (Homovanillic Acid)
A dopamine breakdown product.Metabolite 34: VMA (Vanillylmandelic Acid)
Reflects adrenaline and norepinephrine metabolism.Metabolite 35: HVA / VMA Ratio
Assesses balance between dopamine and stress hormones.Metabolite 36: DOPAC
Indicates dopamine enzyme activity.Metabolite 37: HVA / DOPAC Ratio
Reflects how efficiently dopamine is utilized.Metabolite 38: 5-HIAA
A serotonin metabolite.Metabolite 39: Quinolinic Acid
A metabolite associated with neuro-inflammation.Metabolite 40: Kynurenic Acid
A neuroprotective metabolite influenced by inflammation and vitamin B6 status.
7. Pyrimidine Metabolites
(Folate Metabolism)
Metabolite 41: Uracil
Elevated levels suggest impaired folate metabolism.Metabolite 42: Thymine
May be associated with inflammation or B-vitamin imbalance.
8. Ketone & Fatty Acid Oxidation Metabolites
These metabolites evaluate fat metabolism.
Metabolite 43: 3-Hydroxybutyric Acid
A ketone body elevated during fasting or ketogenic states.Metabolite 44: Acetoacetic Acid
Another metabolite of ketone production.Metabolite 45–49: Fatty Acid Metabolites
Elevated levels suggest difficulty metabolizing fats, often related to carnitine or vitamin B2 status.
9. Nutritional Metabolites
(Cellular-Level Nutrient Status)
Metabolite 50: Methylmalonic Acid
The most reliable metabolite for assessing vitamin B12 deficiency.Metabolite 51: Pyridoxic Acid
Reflects vitamin B6 status.Metabolite 52: Pantothenic Acid
A metabolite reflecting vitamin B5 status.Metabolite 53: Glutaric Acid
Suggests riboflavin (vitamin B2) deficiency.Metabolite 54: Ascorbic Acid
Reflects vitamin C levels.Metabolite 55: 3-Hydroxy-3-methylglutaric Acid
May indicate CoQ10 deficiency or yeast activity.Metabolite 56: N-Acetylcysteine (NAC)
Reflects antioxidant and glutathione-related status.Metabolite 57: Methylcitric Acid
Indicates biotin deficiency.
10. Detoxification Metabolites
Metabolite 58: Pyroglutamic Acid
Reflects glutathione status.Metabolite 59: 2-Hydroxybutyric Acid
Increases during oxidative stress.Metabolite 60: Orotic Acid
Suggests elevated ammonia burden.Metabolite 61: 2-Hydroxyhippuric Acid
Often linked to artificial sweeteners or salicylates.
11. Amino Acid Metabolites
These metabolites assess amino acid metabolism and rare genetic conditions.
Metabolite 62–67: Branched-Chain Metabolites
May indicate vitamin B1 deficiency or metabolic stress.Metabolite 68: Mandelic Acid
Influenced by dietary phenylalanine or environmental exposure.Metabolite 69: Phenyllactic Acid
Reflects phenylalanine metabolism.Metabolite 70: Phenylpyruvic Acid
May indicate PKU carrier status or dietary intake.Metabolite 71: Homogentisic Acid
Related to tyrosine breakdown.Metabolite 72: 4-Hydroxyphenyllactic Acid
Associated with liver stress or amino acid imbalance.Metabolite 73: N-Acetylaspartic Acid
Screens for rare neurological conditions.Metabolite 74: Malonic Acid
Usually not clinically significant unless markedly elevated.Metabolite 75: 4-Hydroxybutyric Acid
A rare genetic metabolic metabolite.
12. Mineral Metabolism
Metabolite 76: Phosphoric Acid
Reflects dietary phosphate intake and vitamin D status.
Frequently Asked Questions
🟦 Is the Organic Acids Test a diagnostic test?
No. The Organic Acids Test is a laboratory assessment tool and is not designed to diagnose medical conditions on its own.
🟦 Is the OAT a urine or blood test?
The Organic Acids Test is a urine-based test.
🟦 Do I need to stop medications or supplements?
Always consult your healthcare provider before stopping medications. Temporary discontinuation of supplements prior to collection is commonly recommended unless otherwise directed.
🟦 How Is the Organic Acids Test Collected
The Organic Acids Test is collected using a first-morning urine sample. Specific preparation steps are recommended to reduce dietary and supplement influence and to support accurate interpretation.
Preparation before collection
- Plan to collect the first urine of the morning
- Limit fluid intake after 6:00 PM the night before collection
- Empty the bladder before bedtime and collect the sample upon waking, before eating or drinking
- Ensure at least 6 hours have passed since last urination
- Minimum required sample volume: 10 mL
Dietary and supplement considerations
For 48 hours before collection, avoid:
- Apples, grapes, pears, raisins, cranberries, and their juices or products
- Supplements containing arabinogalactan, echinacea, reishi mushrooms, or ribose
If antibiotics were recently used, wait at least 48 hours after completing the course before collecting the sample.
Storage and shipping
- Label the specimen clearly according to kit instructions
- Freeze the urine sample for a minimum of 4 hours
- Ship samples Monday–Thursday (outside the U.S.: Monday or Tuesday.
Important Notice
The information on this page is provided for educational purposes only and is not intended as medical advice, diagnosis, or treatment. Laboratory tests should always be interpreted by a licensed healthcare practitioner within the context of an individual’s medical history and clinical presentation.
References
- Mosaic Diagnostics. Organic Acids Test (OAT): Test description, markers measured, and urine collection requirements.
Available at: https://mosaicdx.com/test/organic-acids-test/ - Persico AM, Napolioni V. Urinary p-cresol (4-cresol) in autism spectrum disorder. Neurotoxicology and Teratology. 2012;36:82–90.
- Sivsammye G, Sims HV. Presumptive identification of Clostridium difficile by detection of p-cresol (4-cresol) in prepared peptone yeast glucose broth supplemented with p-hydroxyphenylacetic acid. Journal of Clinical Microbiology. 1990;28(8):1851–1853.
- Ruijter GJG, van de Vondervoort PJI, Visser J. Oxalic acid production by Aspergillus niger: an oxalate-non-producing mutant produces citric acid at pH 5 and in the presence of manganese. Microbiology. 1999;145:2569–2576.
- Kohmani EF. Oxalic acid in foods and its behavior and fate in the diet. Journal of Nutrition. 1939;18(3):233–246.
- Weissman JR, Kelley RI, Bauman ML, et al. Mitochondrial Disease in Autism Spectrum Disorder Patients: A Cohort Analysis. PLoS ONE. 2008;3(11):e3815. doi:10.1371/journal.pone.0003815.
- Oliveira G, Diogo L, Oliveira CR, et al. Mitochondrial dysfunction in autism spectrum disorders: A population-based study. Developmental Medicine & Child Neurology. 2005;49(10):726–733.
