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How the Organic Acids Test Provides Insights into Toxic Exposures 

This blog from our TOXDetective Series explores our Organic Acids Test (OAT). The OAT is a powerful tool that measures downstream products of metabolism in the body. Evaluation of metabolites from various metabolic pathways can provide key insights related to gut health, mitochondrial function, neurotransmitter pathway and nutritional status. In addition to these metabolic processes, the OAT can also help identify potential exposures to various toxic substances, including mycotoxins, heavy metals, pesticides, and other environmental toxicants.

Presenter

Lindsay Goddard, MS, RD, LD/N

Publish Date

November 13, 2024

Specific Toxic Substances and the OAT  

Mold Exposure

Mold exposure, often an overlooked influence on chronic illness, can be challenging to detect. The OAT can further assist in this detection process by looking at fungal activity and mycotoxin metabolism versus exclusive excretion of mycotoxins.  

Specific organic acid markers such as 5-Hydroxymethyl-2-furoic acid (HMFA), Furan-2,5-dicarboxylic acid, and Furancarbonylglycine, are byproducts of Aspergillus sp. mold, and can give potential insights into its activity.1,2,3 Humans can encounter Aspergillus commonly through contaminated food and water-damaged buildings, as well as outdoor environments.4  

Fusarium mold exposure can also be indicated on the OAT. Tricarballylic acid, can increase due to exposure to fumonisins, a type of mycotoxin produced by Fusarium mold, which is commonly found in corn products.5 Additional effects, such as influences on dopamine metabolism, as well as dysbiosis, can result from mycotoxin exposure; yet, due to the numerous other variables that can influence these markers, assessing them from a mold standpoint should be done in the context of an exposure.6,7,8 

Additionally, both citramalic and tartaric acid have also been reported to be Aspergillus byproducts and thus may reflect exposure.9,10,11,12 However, since other fungi can also produce these markers, they should be used in conjunction with other mold-related markers for further insight when assessing mold exposure.13,14 

Heavy Metals

Heavy metals are pervasive sources of toxin exposure, and the OAT may reflect this exposure through specific organic acids.  

Although there are a number of reasons why homovanillic (HVA) or vanillylmandelic acid (VMA) can be elevated, toxic metal exposure has been shown to be one causation.15,16 Similarly, pyruvic acid can be elevated by several metals such as arsenic, cadmium, mercury, and antimony.17,18,19, 20 Citric acid, specifically can be elevated due to arsenic exposure due to arsenics ability to decrease the activity of the enzyme aconitase, which converts cirate to isocitrate.21  

Pesticides, Phthalates, Solvents, and Other Toxicants

These environmental toxicants can additionally be reflected through abnormalities in organic acid markers.

Pesticides, for example, can have a direct effect on dopamine metabolism, resulting in altered levels of HVA and DOPAC (3,4-dihydroxyphenylacetic acid).21 They can also impact our microbiome by reducing beneficial bacteria contributing to occurrences of pathogenic dysbiosis.22,23 Both glyphosate and organophosphates have been shown to influence Clostridia bacteria, measured on the OAT by 4-hydroxyphenylacetic acid, HPHPA (3-(3-hydroxyphenyl)-3-hydroxypropionic acid), 4-cresol, and 3-Indolacetic acid.24,25  

Phthalates, which are endocrine disruptors found in numerous products throughout our environment, can raise quinolinic acid (QA) levels by inhibiting the enzyme that allows QA to convert to nicotinamide.26 This backup in the pathway can produce excessive levels of QA, causing neuroinflammation.27 

Solvents such as styrene and toluene can also be reflected through organic acid values. Styrene, a neurotoxin used in the production of various materials and products, can lead to elevated levels of mandelic acid, which is a metabolite involved in the phenylalanine to dopamine pathway.28,29 Hippuric acid, associated with dysbiosis on the OAT, is a major metabolite to identify exposures to toluene, a reproductive toxin found in crude oil and various manufactured products.30 Oxalic acid has a known relationship with foods and fungus; however, it can reflect exposures to ethylene oxide, a compound used in plastics, textiles, and antifreeze. 31  

Parabens, a toxicant used as a preservative, can be measured by 4-Hydroxybenzoic and 4-Hydroxyhippuric acids, which are additionally used as a dysbiosis marker on the OAT. 32,33,34   

It should be noted that neither toluene nor parabens are currently available on TOXDetect Profile, however testing may still be valuable to assess for other toxic burdens, as it is common to have multiple exposures. 

Additional Insights Indicating Toxic Exposure 

Gut Health

Arabinose, an indicator of Candida overgrowth, can be influenced by toxic environmental compounds.35,36 Both mycotoxins and toxicants can disrupt the gut microbiome, weaken the intestinal epithelial barrier, and influence the immune system, all of which can increase the likelihood of Candida overgrowth.37,38,39,40   

Mitochondrial Stress

While many factors, including toxic chemicals, can affect mitochondria, one enzyme is especially vulnerable: succinate dehydrogenase. This enzyme, responsible for converting succinate to fumarate, has been shown to be inhibited by various toxic substances such as chemical toxicants, mycotoxins, and heavy metals.41,42,43,44,45 Succinate is an important part of the connection between the Krebs cycle and the Electron Transport Chain (ETC) and can significantly influence energy production.46 

Detoxification Pathways

The OAT can also offer insight into detoxification processes, which can be influenced by toxic chemical exposure.  

Pyroglutamic acid is a metabolite that reflects glutathione (GSH) status, and when elevated, it can indicate insufficient glutathione levels, or a high demand for glutathione.47 Exposures to toxicants, heavy metals, and mycotoxins can influence glutathione levels, either through oxidative stress, increased demands on detoxification, or even by blocking GSH pathways, all of which can lead to potential insufficiencies.48,49,50 

2-Hydroxybutyric acid, an intermediate metabolite of homocysteine metabolism, can allude to potential toxicity.51 When elevated, it may infer homocysteine is favoring the transsulfuration pathway due to either; a high demand for cysteine to support glutathione levels, or decreased functionality of the methylation pathway, both of which can potentially be induced by toxic chemical overload.52 

Summary

The OAT provides a comprehensive overview of multiple metabolic pathways and can be a valuable tool in identifying potential exposures to various environmental toxins. Once the OAT reveals potential exposures to toxin burden, further testing can be done to quantify specific toxin exposures. MosaicDX offers several tests such as TOXDetect Profile, MycoTOX Profile, Glyphosate Test, and Metals tests to evaluate specific toxicants.   

It is important to remember that any abnormalities should be discussed with a healthcare professional to understand their potential implications and to determine appropriate steps for mitigation. 

OAT and Toxic Exposure Crosswalk 

The following chart focuses on organic acids that have a relationship with toxic exposures.  

Download the Charts as a Printable PDF
Download the Charts as a Printable PDF

Summary 

TOXDetect Profile offers a comprehensive approach to evaluating environmental toxicant exposures, complemented by a thorough environmental exposure history intake. This combination equips practitioners with insights needed to understand how toxicants influence patient health and to implement evidence-based avoidance strategies, address health impacts, and tailor personalized therapeutic interventions. Our goal is to empower you to proactively mitigate the effects of environmental toxicants, fostering long-term health and well-being for both you and your patients.  

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References 

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About the Author

Lindsay Goddard, MS, RD, LD/N

Lindsay Goddard is a Registered and Licensed Dietitian (RD, LD/N), with a Master’s in Nutrition, and a Bachelor’s in Biology with a concentration in Human Physiology and Ecology. She also has advanced training in Toxicology from the University of South Florida and is certified in Integrative and Functional Nutrition.

She has worked in a variety of settings such as hospitals, universities, and outpatient clinics, specializing in gastroenterology, pediatrics, genetics, and physiatry, integrating both functional and conventional approaches. After years of being in the field, she decided to shift gears and work for a laboratory to help support and educate providers from a different avenue. She has been with MosaicDX for over 5 years and enjoys shedding light on the connections and interactions between the body, the environment, and nutrition.

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