Organic Acids Test (OAT) — Comprehensive Metabolic & Microbial Marker Panel
What it is: The Organic Acids Test (OAT) from Mosaic Diagnostics is a comprehensive at-home urine test that measures 76 metabolic markers in a single first-morning sample. It gives you a full-body snapshot of how your cells, gut microbiome, mitochondria, neurotransmitter pathways, and detoxification systems are actually functioning.
Why it matters: Organic acids are the byproducts of every major metabolic pathway in your body. When something is off (yeast overgrowth, B vitamin deficiency, mitochondrial dysfunction, sluggish detox, neurotransmitter imbalance), it shows up here before it shows up on a standard blood panel. The OAT explains the "why" behind symptoms that look normal on conventional labs.
Who it's for: Women dealing with chronic fatigue, brain fog, mood instability, recurring gut issues, stubborn sugar cravings, stalled hormone protocols, or symptoms that don't add up. The OAT is the test we run when you've already done the basics and still don't have answers.
What the OAT measures (76 biomarkers across 9 functional categories)
1. Intestinal Microbial Overgrowth Markers. Identify candida activity, clostridia bacteria toxins, potential mold exposure, and bacterial imbalances in the gut. Key markers: Arabinose, Tartaric Acid, 3-Indoleacetic Acid, 4-Hydroxyphenylacetic Acid, Hippuric Acid, Citramalic Acid, 4-Cresol, Furan-2,5-dicarboxylic Acid, Furancarbonylglycine, Dihydroxyphenylpropionic Acid, 3-(3-hydroxyphenyl)-3-hydroxypropionic Acid, 5-Hydroxymethyl-2-furoic Acid.
2. Oxalate Metabolites. Reveal oxalate levels from gut organisms or dietary intake. Elevated oxalates contribute to joint pain, kidney stones, and chronic inflammation. Key markers: Glyceric Acid, Glycolic Acid, Oxalic Acid.
3. Glycolytic Cycle, Krebs Cycle, and Mitochondrial Markers. Evaluate how efficiently your cells produce energy from glucose and amino acids. Critical for women experiencing chronic fatigue, burnout, or stalled metabolism. Key markers: Lactic Acid, Pyruvic Acid, Citric Acid, Aconitic Acid, 2-Oxoglutaric Acid, Succinic Acid, Fumaric Acid, Malic Acid, Methylsuccinic Acid, Ethylmalonic Acid, Carboxycitric Acid.
4. Neurotransmitter Metabolites. Measure phenylalanine, tyrosine, and tryptophan metabolism. Reveal imbalances in dopamine, serotonin, norepinephrine, and epinephrine pathways. Often the missing piece in mood, motivation, anxiety, and sleep struggles. Key markers: Vanillylmandelic Acid (VMA), Homovanillic Acid (HVA), 5-Hydroxyindoleacetic Acid (5-HIAA), Quinolinic Acid, Kynurenic Acid, Dihydroxyphenylacetic Acid (DOPAC), HVA/VMA Ratio, HVA/DOPAC Ratio, Phenyllactic Acid, Phenylpyruvic Acid, 2-Hydroxyphenylacetic Acid.
5. Pyrimidine Metabolites, Ketones, and Fatty Acid Oxidation. Insight into folate status, cellular turnover, and how well your mitochondria are burning fats for fuel. Relevant for energy, focus, and metabolic flexibility. Key markers: Thymine, Uracil, Acetoacetic Acid, 3-Hydroxybutyric Acid, 4-Hydroxybutyric Acid, Adipic Acid, Suberic Acid, Sebacic Acid.
6. Nutritional Markers. Measure sufficiency of B vitamins, antioxidants, and metabolic pathway cofactors that fuel every other function in the body. Key markers: Methylmalonic Acid (B12 status), Pyridoxic Acid (B6), Pantothenic Acid (B5), Ascorbic Acid (Vitamin C), N-Acetyl Cysteine, 4-Hydroxybenzoic Acid, Mandelic Acid.
7. Detoxification Indicators. Assess glutathione sufficiency, methylation capacity, and oxidative stress. Tells us whether your detox pathways are keeping up with your toxic load. Key markers: Pyroglutamic Acid, 2-Hydroxybutyric Acid, Orotic Acid.
8. Amino Acid Metabolites. May indicate functional nutrient deficiency or genetic metabolic variations. Key markers: 2-Hydroxyisocaproic Acid, 2-Hydroxyisovaleric Acid, 2-Oxoisocaproic Acid, 2-Oxoisovaleric Acid, 2-Oxo-4-methiolbutyric Acid, 3-Methyl-2-oxovaleric Acid, 3-Methylglutaconic Acid, 3-Methylglutaric Acid, 3-OH-3-Methylglutaric Acid, 3-Oxoglutaric Acid, 3-Hydroxyglutaric Acid, Glutaric Acid, Malonic Acid, Methylcitric Acid, N-Acetylaspartic Acid, 2-Hydroxyhippuric Acid, 4-Hydroxyhippuric Acid, 4-Hydroxyphenyllactic Acid, Tricarballylic Acid, Homogentisic Acid.
9. Mineral Metabolism Marker. Reflects dietary phosphate intake and gives insight into Vitamin D status. Key marker: Phosphoric Acid.
Complete biomarker list (all 76)
2-Hydroxybutyric Acid, 2-Hydroxyhippuric Acid, 2-Hydroxyisocaproic Acid, 2-Hydroxyisovaleric Acid, 2-Hydroxyphenylacetic Acid, 2-Oxo-4-methiolbutyric Acid, 2-Oxoglutaric Acid, 2-Oxoisocaproic Acid, 2-Oxoisovaleric Acid, 3-(3-hydroxyphenyl)-3-hydroxypropionic Acid, 3-Hydroxybutyric Acid, 3-Hydroxyglutaric Acid, 3-Indoleacetic Acid, 3-Methyl-2-oxovaleric Acid, 3-Methylglutaconic Acid, 3-Methylglutaric Acid, 3-OH-3-Methylglutaric Acid, 3-Oxoglutaric Acid, 4-Cresol, 4-Hydroxybenzoic Acid, 4-Hydroxybutyric Acid, 4-Hydroxyhippuric Acid, 4-Hydroxyphenylacetic Acid, 4-Hydroxyphenyllactic Acid, 5-Hydroxyindoleacetic Acid (5-HIAA), 5-Hydroxymethyl-2-furoic Acid, Acetoacetic Acid, Aconitic Acid, Adipic Acid, Arabinose, Ascorbic Acid (Vitamin C), Carboxycitric Acid, Citramalic Acid, Citric Acid, Dihydroxyphenylacetic Acid (DOPAC), Dihydroxyphenylpropionic Acid, Ethylmalonic Acid, Fumaric Acid, Furan-2,5-dicarboxylic Acid, Furancarbonylglycine, Glutaric Acid, Glyceric Acid, Glycolic Acid, Hippuric Acid, Homogentisic Acid, Homovanillic Acid (HVA), HVA/DOPAC Ratio, HVA/VMA Ratio, Kynurenic Acid, Lactic Acid, Malic Acid, Malonic Acid, Mandelic Acid, Methylcitric Acid, Methylmalonic Acid (MMA), Methylsuccinic Acid, N-Acetyl Cysteine, N-Acetylaspartic Acid, Orotic Acid, Oxalic Acid, Pantothenic Acid (Vitamin B5), Phenyllactic Acid, Phenylpyruvic Acid, Phosphoric Acid, Pyridoxic Acid (Vitamin B6), Pyroglutamic Acid, Pyruvic Acid, Quinolinic Acid, Sebacic Acid, Suberic Acid, Succinic Acid, Tartaric Acid, Thymine, Tricarballylic Acid, Uracil, Vanillylmandelic Acid (VMA).
How it works
Order the test. Kit ships to your door in 3 to 5 business days.
Prep for 48 hours before collection (see avoidance list below).
Collect 10 mL of first-morning urine upon waking, before any food or drink.
Mail back in the prepaid envelope. Ship Monday through Thursday only.
Results delivered in 10 business days with a comprehensive written report from Mosaic Diagnostics.
What to avoid 48 hours before collection
Apples and apple juice
Grapes (including raisins) and grape juice
Pears and pear juice
Cranberries and cranberry juice
Echinacea
Reishi mushrooms
Arabinogalactan supplements
Ribose supplements
Additional notes: Do not collect while menstruating. If you are taking antibiotics, finish the course of medication and wait 48 hours before collecting your sample.
What's included
At-home Mosaic Diagnostics OAT collection kit
Prepaid return shipping label
Lab processing and analysis
Comprehensive written report with biomarker analysis, reference ranges, and clinical context
Want a personalized walkthrough? Add a 1:1 lab review consult with Zeinab, Certified FDN Practitioner, as a separate booking.
State restrictions
The Organic Acids Test cannot be ordered if you are located in Hawaii, Rhode Island, New Jersey, New York, or Pennsylvania due to state lab regulations.
Frequently asked questions
Is the Organic Acids Test the same as a stool test? No. A stool test like the GI-MAP measures the actual organisms living in your gut. The OAT measures the metabolic byproducts those organisms produce, plus markers for mitochondria, neurotransmitters, detoxification, and nutritional status. They answer different questions. Many practitioners run both for a complete picture.
How long does it take to get results? 10 business days from when Mosaic Diagnostics receives your sample.
Do I need to fast before collecting my sample? No fasting required. Collect first-morning urine upon waking, before any food or drink.
Who manufactures the test? The Organic Acids Test (OAT) is manufactured and processed by Mosaic Diagnostics, formerly known as Great Plains Laboratory. It is one of the most widely used functional medicine tests in clinical practice.
Can I order from anywhere in the United States? The OAT cannot be ordered if you live in Hawaii, Rhode Island, New Jersey, New York, or Pennsylvania.
How is the OAT different from a routine blood panel? A standard blood panel tells you what is in your bloodstream at one moment in time. The OAT tells you how well your metabolic machinery is actually running, what byproducts your cells are making, and which pathways are struggling. It is the test that explains the "why" behind symptoms that look normal on conventional labs.
What conditions or symptoms is the OAT most useful for? Chronic fatigue, brain fog, mood disorders, anxiety, depression, gut dysbiosis, candida overgrowth, mitochondrial dysfunction, methylation issues, oxidative stress, B vitamin deficiency, neurotransmitter imbalance, and unexplained metabolic symptoms.
Who reads my results? Your report comes from Mosaic Diagnostics with detailed reference ranges and clinical interpretations. To go deeper, book a 1:1 lab review with Zeinab, a Certified FDN Practitioner specializing in women's hormone and metabolic health.
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