An organic acids test (OAT) measures small molecules that the body and gut microbes make as they process food, energy and neurotransmitters, using one urine sample. Raised or low markers point to possible nutrient cofactor needs, such as B12 or B6, or to yeast and bacterial by-products. Diet, supplements, hydration and gut microbes all shift the results, so treat them as indirect signals to confirm with other tests. Verified practitioners can order Nutripath’s OAT and its pollutant panels through Vively.
| Test type | Measured in a urine sample |
|---|---|
| Nutripath code | 4041, 4017, 4014 |
| Sample and collection | First morning spot urine, collected at home and posted to Nutripath |
| Preparation | First morning urine. Follow the kit’s food and supplement instructions, and check with the prescriber before pausing any medicine. |
| Turnaround | Nutripath estimates 14 business days for Metabolomic Mapping. The pollutant panels are batch tested, and Nutripath does not publish a turnaround for them. Allow extra days for postage. |
| Available through | Nutripath test ordered through Vively. You need to be a verified practitioner to refer it. |
| Pricing | Pricing in your practitioner account |
| Results | PDF report from Nutripath, filed in your client’s record and app beside their blood results |
Only practitioners can order this test. Ask your naturopath, nutritionist or dietitian whether they use Vively.
What does an organic acids test measure?
Organic acids are intermediates from pathways such as energy production, fat and amino acid breakdown, detoxification and neurotransmitter turnover. When a step slows, the compound before it can build up and spill into urine.
Lactate, pyruvate, citrate cycle intermediates, ketones and fatty acid breakdown markers such as adipic and suberic acid give a view of how fuel is being used.
Methylmalonic acid rises with low B12 activity, xanthurenic acid with low B6, and markers such as pyroglutamic acid with glutathione strain. These are signals to confirm with blood tests.
Homovanillic acid (HVA), vanillylmandelic acid (VMA) and 5-HIAA reflect turnover of dopamine, noradrenaline and serotonin, and are strongly affected by diet and medicines.
Markers such as arabinose and HPHPA are linked to yeast and clostridial activity, and the pollutant panels add metabolites of benzene, toluene, xylene, styrene and phthalates.
| Nutripath test | Code | Sample | Turnaround |
|---|---|---|---|
| Urinary Organic Acids Test (OAT), Metabolomic Mapping | 4041 | Spot urine | 14 business days |
| Organic Acids, Metabolic and Environmental Pollutant Panel | 4017 | Urine | Batch tested |
| Organic Acids, Environmental Pollutant Panel | 4014 | Urine | Batch tested |
How do you order an organic acids test through Vively?
- Get verified. You need to be a verified practitioner to refer tests. Practitioners with a recognised qualification or membership (ATMS, NHAA, ANTA, Dietitians Australia, NSA, CMA or Ahpra registration) can request free practitioner access.
- Build the order. Log in to the practitioner platform, choose the Nutripath test and add any blood tests or the $99 Baseline Health Check to the same order. Pricing shows in your account, and either your client or your practice can pay.
- Client collects at home. Nutripath sends your client the collection kit once the order is placed. Your client follows the kit instructions (a first morning urine sample into the tube provided) and posts the sample back to Nutripath in the packaging provided.
- Review the report. Nutripath’s PDF report is filed in your client’s record and app, next to their blood results, ready for the follow-up consult.
See every Nutripath test you can order on the Nutripath tests page.
Order an organic acids test with your client’s blood tests
Free access for verified naturopaths, nutritionists and dietitians. Order Nutripath tests and blood pathology in one place, and see every result in your client’s record.
What does an organic acids result tell you, and what does it not?
Organic acids testing has a solid base in medical genetics, where labs use it to find inherited metabolic disorders. Its use as a broad nutritional screen in adults is much less validated.
Food, gut bacteria, supplements, medicines and even sample handling can raise organic acids, so a single raised marker has several possible causes (Kumps et al., 2002).
A raised methylmalonic acid suggests checking B12, and raised pyroglutamic acid can follow paracetamol use. Confirm a suspected deficiency with a blood test before long term supplementation.
Inherited metabolic disorders are diagnosed through newborn screening and metabolic clinics, using medical tests and genetics. A strongly abnormal pattern in a child, or in an adult with unexplained symptoms, needs medical referral.
Hydration and the previous day’s food shift results, and the pollutant panels reflect recent exposure. Retest under the same conditions if you need to compare.
How does an organic acids test fit with blood work?
Use blood tests from the same order to confirm what the urine markers suggest. That is what tells you whether to treat.
- ConfirmRaised methylmalonic acid
Suggests reduced B12 activity. Check active B12, total B12 and RBC folate, and refer if B12 is low with anaemia or nerve symptoms.
- ContextRaised ketones and fatty acid markers
Common after fasting, low carbohydrate eating or hard exercise. If the client was eating normally, check glucose control.
- ContextRaised Krebs cycle intermediates or lactate
Can reflect cofactor needs such as magnesium and B vitamins, or simply exercise and sample timing. Check magnesium and iron before acting on it.
- ContextRaised yeast or bacterial markers, normal stool markers
A possible gut contributor. Confirm with a stool test before an antimicrobial plan.
What can affect an organic acids result?
- Food in the 24 to 48 hours before, especially fruit, juice and anything high in benzoate or salicylate
- Supplements such as B vitamins, carnitine, CoQ10, probiotics and amino acids
- Medicines such as paracetamol, antibiotics and antifungals, and some psychiatric medicines
- Fasting, very low carbohydrate eating or hard exercise the day before
- How dilute the urine is, and delays before the sample reaches the lab
When should you refer the client to their GP?
- A child with a strongly abnormal pattern, poor growth, developmental concerns or vomiting episodes
- Very high methylmalonic acid, or low B12 with anaemia, numbness or tingling
- High ketones in a client with diabetes, thirst or weight loss
- Pollutant markers that suggest heavy workplace or home exposure
- Any result that conflicts with symptoms or with the client’s blood tests
How should a client prepare for an organic acids urine test?
Copy or print this to send to your client. Follow the instructions in the Nutripath kit if they differ.
Preparing for your organic acids urine test
- Collect the first urine of the morning, before eating or drinking, using the kit Nutripath sends you.
- Follow the kit instructions on any foods, drinks or supplements to avoid in the day or two before. Your practitioner will tell you which supplements to pause.
- Don’t stop prescribed medicines without asking your doctor. Tell your practitioner about everything you take, including paracetamol.
- Eat and exercise as you normally do the day before. Avoid fasting or a very low carbohydrate day unless your practitioner says otherwise.
- Fill and label the tube as the kit describes, and post it back the same day in the packaging provided, early in the week.
- Your practitioner will receive the report and go through it with you.
What does the organic acids report look like?
Nutripath publishes sample reports on its website. They open in a new tab.
How do practitioners use the organic acids test with clients?
It is most useful as a broad screen when fatigue, mood or gut symptoms have no clear cause and routine blood tests are normal. Take a full supplement and medicine history before ordering, add B12, folate, magnesium and ferritin to the same order, and treat the report as a list of leads. Confirm the important ones with blood or stool tests, and retest under the same conditions to see change.
Organic acids test (OAT) FAQs
Can a naturopath, nutritionist or dietitian order an organic acids test through Vively?
Yes. You need to be a verified practitioner to refer it. Add Nutripath’s organic acids kit to an order in the Vively practitioner platform, on its own or with blood tests. Pricing shows in your account. No account yet? Request free access.
Which Nutripath organic acids test should I order?
Metabolomic Mapping is the broad nutritional OAT, with children’s reference ranges. The Metabolic and Environmental Pollutant Panel combines several organic acid panels with pollutant metabolites, and the Environmental Pollutant Panel looks at exposure to benzene, toluene, xylene, styrene and phthalates on its own.
Does an organic acids test diagnose yeast overgrowth or nutrient deficiencies?
No. Markers such as arabinose or methylmalonic acid are indirect and can be raised by diet, gut bacteria and supplements. Use them as leads and confirm with stool or blood tests.
Is an organic acids test useful for children?
Nutripath reports Metabolomic Mapping with children’s reference ranges. A child with an abnormal pattern, poor growth or developmental concerns needs a GP, who may refer to a metabolic clinic.
How long do organic acids results take?
Nutripath estimates 14 business days for Metabolomic Mapping. The pollutant panels are batch tested, and Nutripath does not publish a turnaround for them. Add a few days for postage.
References
- Kumps A, Duez P, Mardens Y. Metabolic, nutritional, iatrogenic, and artifactual sources of urinary organic acids: a comprehensive table. Clinical Chemistry. 2002.
- Lord RS, Bralley JA, eds. Laboratory evaluations for integrative and functional medicine. 2nd edition. Metametrix Institute. 2008.
- Nutripath. Spot urine collection instructions (V4.0). nutripath.com.au.
- Nutripath. Organic Acids Metabolomic Mapping (4041), Metabolic and Environmental Pollutant Panel (4017) and Environmental Pollutant Panel (4014). nutripath.com.au, checked 1 October 2026.