Organic Acid Testing: An Innovative Preventive Health Test
by Dr. Joseph Debe

Whether you are struggling with a chronic disease or feel great and want to function at peak efficiency, you can benefit from a urinary organic acid analysis. The unparalleled range of information it provides makes it the single most valuable test in healthcare today. Organic acids are compounds produced within the body in the course of metabolism. Metabolism is the totality of biochemical reactions taking place to “run” your body. Organic acid analysis gives us insight into our metabolism. Our state of metabolism determines our state of health and is the result of an interplay of our genes, thoughts, beliefs, diet, lifestyle and other environmental factors.

Forty-seven organic acids are measured from a morning urine specimen. The laboratory’s test report groups the organic acids into three general areas: 1. nutrient markers, 2. cell regulation markers, and 3. toxicants and detoxification. Each of these areas is further subdivided. An organic acid analysis can reveal an individual’s metabolic strengths and weaknesses. What we see with this test is the end result of an interplay of the individual’s genetic make-up and environmental and lifestyle factors. The first use of urinary organic acid analysis was to detect inborn or genetic errors of metabolism in infants. A newborn that has a severe genetic error may totally lack a specific enzyme. This is seen by extreme elevation of the corresponding organic acid that is normally metabolized or broken down by the enzyme. These extreme cases of genetic errors are very serious and usually result in early death.

Probably the most widely known inborn error of metabolism, phenylketonuria, is alerted to on food products like Nutrasweet that contain the amino acid phenylalanine. People who lack the enzyme to metabolize phenylalanine must go to great lengths to avoid consuming it. For their bodies,’ phenylalanine is toxic. There are other genetic errors of metabolism that exist in different degrees of severity. In milder genetic variants, an individual’s enzyme may be less efficient. Enzymes catalyze biochemical reactions in the body, converting one compound to another. Enzymes need coenzymes, vitamins and minerals, in order to work. At a given tissue concentration of a vitamin, one person’s enzyme will be less active than that of another individual if it is not efficient in binding the vitamin. The end result is an impairment in metabolism signified by build-up of one biochemical and lowered levels of its breakdown product. In genetic errors of metabolism where the enzyme is not missing but simply does not bind efficiently to its vitamin coenzyme, it has been found that increasing the concentration of the vitamin through mega dosing can correct metabolism. This is the power of personally tailored nutrition and is a concept that applies to everyone.

Individuals with a particular genetic error require 500 times more vitamin B6 for normal enzyme activity and metabolism than do people who do not have the error! A study published in Science in 2001, found an average of 14 different variations per gene that could be inherited from one’s parents. It has been estimated that in total, the human genome may consist of 500,000 to 1.5 million variations! Therefore, all of us have some enzymes that are inefficient. In order to overcome this, we need to supplement with more of the vitamin or mineral cofactor that powers the enzyme. I personally was found, by organic acid analysis, to have less than optimal levels of vitamin B6 for proper metabolism, even though I was already supplementing with in excess of 50 times the recommended dietary intake. Mild genetic weaknesses become more pronounced with aging. Organic acid analysis can reveal a person’s metabolic Achilles’ heel, leading to proper treatment to strengthen that weak link in physiology. The essential nutrients that can be found lacking by organic acid analysis include the minerals chromium, magnesium, vanadium, and manganese; the amino acids arginine, aspartic acid, glutamine, glycine, taurine, tyrosine, and tryptophan; and vitamin C and the entire B vitamin family.

Organic acid analysis can reveal need for a variety of other types of nutrients. Many of these nutrients are very popular today, being taken by millions of people who learn about some purported health benefit of a particular nutrient, who then decide to take it in supplemental form. These include Coenzyme Q10, alpha lipoic acid, NADH, carnitine, glutathione, acidophilus, and others. The results of an organic acid analysis may reveal that an individual has an overgrowth of acidophilus. In this case, supplementing acidophilus can be harmful. Organic acid analysis is also valuable for assessing nutrients like Coenzyme Q10 that are basically non-toxic. One of my patients was spending hundreds of dollars a year on Coenzyme Q10 supplements. Organic acid analysis showed us that his body did not need any additional Coenzyme Q10; his body was making enough of its own to maintain normal metabolic function. Another patient heard of the health benefits of Coenzyme Q10 and had been taking a daily supplement for several years prior to consulting me. I ran an organic acid analysis, which revealed he was very deficient in Coenzyme Q10. The 60 milligrams of Coenzyme Q10 he was supplementing was supplying only a fraction of what his body needed. Carnitine is a compound manufactured within the body, which transports fatty acids into the part of the cell (mitochondria) where they are burned for energy. When carnitine levels are suboptimal, difficulty with weight loss is among the consequences. Three organic acids are measured that tell us about the degree of carnitine insufficiency.

A person’s ability to metabolize carbohydrates is also seen with this test. Insulin resistance is one of the impairments of carbohydrate metabolism revealed by organic acid analysis. Insulin resistance refers to inefficiency of this important blood sugar-regulating and anabolic hormone. Insulin resistance contributes to obesity and is probably responsible for more ill health than any other metabolic factor in industrialized nations. It is treated with diet, lifestyle, nutritional supplements, exercise, stress reduction, weight loss and medications.

Carbohydrate and fatty acid metabolism are part of the process of converting our food into energy. The organic acid analysis gives us further insight into this critical aspect of metabolism. All bodily functions are powered by the release of energy as chemical bonds in food are broken down. With organic acid analysis, we actually get a glimpse into the workings of the mitochondria of cells, where 95% of the body’s energy is produced as food and oxygen are combined to produce ATP and other energy compounds. Organic acids are produced in the series of biochemical steps called the citric acid cycle that turns food into energy. Low levels of these particular organic acids indicate deficiencies of precursor compounds like amino acids, which come from dietary protein. Elevations of these organic acids reveal metabolic blocks due to various nutrient deficiencies, toxicity, inflammation, or insulin resistance. Fatigue is not the only consequence of impaired cellular energy production. All organs and bodily functions require energy. Therefore, any condition (including aging) may be impacted by poor cellular energy production. Targeted treatments result from analyzing the individual’s pattern of organic acid abnormalities.

The organic acids related to neurotransmitter metabolism give us information about the balance of epinephrine, norepinephrine, serotonin and dopamine. Imbalances are seen in cases of anxiety, depression, stress, insomnia, schizophrenia, attention deficit and behavioral disorders, carbohydrate craving, constipation, obesity, chronic fatigue syndrome, fibromyalgia and addictions. Inflammation that may be impacting the brain is associated with elevations of a particular organic acid.Free radical damage to DNA is also revealed with this test by measurement of an organic acid called 8-OHdG. Damage to DNA can predispose to cancer cell formation. Elevations of 8-OHdG are seen in a variety of chronic conditions including elevated blood cholesterol levels. Fifty percent of the 8-0HdG measured comes from the brain. Neuropsychiatric conditions such as ADHD, schizophrenia and autism are associated with increased free radical damage. Organic acid analysis measures another compound, which is involved in regulation of cell growth. Its elevation is associated with growth of malignant cells including breast cancer cells.Very high doses of vitamin C help to lower this compound.

This test also gives insight into the body’s toxin exposure and its ability to rid itself of toxins. Environmental toxins, such as xylene, and endogenous (made within the body) toxins such as ammonia, are seen with this test. Ammonia toxicity can result from some combination of genetic predisposition, nutrient deficiencies, and excess dietary protein. Another important source of ammonia toxicity revealed by organic acid testing is overgrowth of bacteria within the intestinal tract. This is a common condition often resulting from overuse of antacids and antibiotics.The organic acid analysis test report includes a personalized supplement recommendation chart. Based upon the test results, a computer-generated list of needed nutritional supplements and their daily dosage is given.

Due to the fundamental information it provides about an individual’s metabolism, organic acid analysis can benefit people with any ailment. This test is also ideal for people who are healthy and want to fine-tune their metabolism to achieve peak performance and delay and prevent degenerative conditions.
I’ll leave you with a quote from the textbook, Laboratory Evaluations in Molecular Medicine: “Instead of tests that measure nutrient concentrations, abnormal concentrations of organic acids in urine provide functional markers for the metabolic effects of vitamin inadequacies, toxic exposure, neuroendocrine activity, and intestinal bacterial overgrowth. The ultimate tool for laboratory evaluation in nutritional medicine is a simple, sensitive test that can reveal evidence of functional inadequacy of specific nutrients. The promise of such a tool is found in profiling of organic acids in urine.”

Dr. Joseph Debé is a chiropractor and board certified nutritionist practicing in North Shore Fitness in Great Neck. Tel. 516-829-1515. By mid November, he hopes to also be practicing in D.R.E.A.M. Wellness in the Lake Grove Bally Total Fitness. Tel. 631-737-3600. Visit