Gut Health Series – Organic Acid Test v Stool Test to Identify Dysbiosis in IBS
Stool testing has long been established for its importance in identifying gut issues that could be the route cause of IBS. While these tests are incredibly informative and I use them alot in clinic. There are circumstances when an Organic Acid test can reveal a whole lot more. In particular, when we are dealing with dysbiosis, or imbalanced gut bacteria. This is because a stool test doesn’t reveal the situation in the small intestine, and there is also increasing evidence that the fecal microbiota does not mirror the colonic situation. (1)
Organic Acid profiling for dysbiosis measures the end products of microbial metabolism excreted in urine, and hence can detect disease causing microbial overgrowth. (2)
The Organic Acid test looks at general bacteria, pathogenic bacteria, yeasts and fungus. Malabsorption and dysbiosis. High levels of organic acids in your urine can indicate what nutrient insufficiencies may be affecting your health, as well as toxins you have been exposed to, and also how your body is dealing with those toxins. This information helps to ensure the correct treatment plan is put in place.
In order to understand how organic acid testing works, we can think about how our internal systems work. In order for the body to work optimally, we need to have a full complement of vitamins and minerals. This is our fuel. Same as a car uses petrol, plants use sunlight, we use vitamins and minerals, along protein, carbohydrates and fats. We get these from food. That’s if we eat a well balanced nutritionally dense diet.
When we have all these nutrients in place, the processes in our bodies work really well. Enzymatic, chemical reactions need to occur in order to keep us in good health. However if we don’t have basic nutrition then these processes fail.
For instance we need B5 and glycine to eliminate benzoic acid from the body. What happens if we’re deficient in one or both of these? We’d end up with high benzoic acid which is a marker of dysbiosis.
The Organic acid test would show a high reading. There are other things that can cause high levels of this acid, therefore a high reading would prompt further investigation to identify the route cause. Benzoate is used as a food preservative in convenience foods. Another reason to eat a healthful diet.
Elevated Hippurate is another marker of bacterial overgrowth, which could be associated with elevated levels of benzoate, due to excessive intake through food, or low stomach acid leading to malabsorption of phenylalaline.
Indican if elevated is linked with poor protein digestion, and would indicate bacterial overgrowth in the small intestine. There are lots of things that can inhibit protein digestion; low stomach acid, low digestive enzymes, adverse food reactions, parasites, fungus, hypermotility of the small intestine, as well as other gastrointestinal dysfunctions.
Tricarballylate is an interesting marker, often elevated after antibiotics or acid blocking drugs. Tricarballylate binds to calcium, magnesium and zinc, reducing these levels. These are essential minerals needed for so many fundamentally important processes in the body. We definitely do not want to be low in any of them.
High levels of Lactobacillus acidophilus in the small intestine can be the result of carbohydrate malabsorption, an overgrowth can produce toxic amounts of D-lactate.
There are many other markers of dysbiosis which the test would reveal. Ruling out the causes of these is a crucial way to re-establish a healthy gut.
(1) (2) Functional Medicine Training Program. Insiders Guide. Organic Acids – Dysbiosis Interpretation and Treatment, 2008 sequoia Educational Systems, Inc