Organic Acids Test (OAT) 101: Essential Information for the Practitioner New to the OAT


Kurt Woeller, DO, FMAPS


The Organic Acids Test (OAT) is profile essential in functional and integrative health assessment for most anyone dealing with a chronic health problem. The OAT measures various compounds that provide insight into candida overgrowth, bacterial infections, oxalate, mitochondrial dysfunction, neurotransmitter imbalances and much more. A one-day intensive seminar on the implementation of the OAT, and other more advanced lectures on OAT interpretation and clinical application are available. However, before taking part in these clinical trainings, unless you already have experience in OAT use, there are fundamental concepts that are critical to understand. This webinar by Kurt N. Woeller, DO is focused on the basics of the Organic Acids Test. You can consider this lecture to be an introduction or a 101-level lecture about the OAT.

Q: I’m new at testing and trying to figure out which tests are important to start using in my practice. I was doing gut testing but seems like OAT is more comprehensive.

A: I always start with the OAT, and then complement it with a stool analysis is possible.

Q: Can you share the top two to three tests you use on patients initially?

A: I use the OAT, MycoTOX Profile, and Hair Heavy Metals. I will often add the IgG Food MAP too if possible. If there are a lot of gut symptoms too then a comprehensive digestive stool analysis is worthwhile as well.

Q: Do you recommend a biofilm disruptor prior to the Organic Acids Test?

A: No

Q: Does low pyroglutamic acid (on far left of scale) indicate adequate GSH?

A: Yes. The report indicates that low pyroglutamic has no known clinical significance, only high pyroglutamic.


Q: How do you treat a fatty acid metabolism problem?

A: A simple approach is L-carnitine supplementation. However, to go deeper, and this may be necessary for certain people, you need to determine what are the reasons behind the elevated fatty acid markers.

Q: How much elevated out of range could be considered as bad or negative?

A: For most markers, as I mentioned in my lecture, above the 2nd standard deviation line. There are exceptions such as high normal pyroglutamic in the view of known or suspected environmental chemical exposures that can indicate a worsening trend in glutathione status. The nuances within the OAT and the respective sections and certain markers become more obvious overtime and experience. A good example of this would be high normal HVA and low VMA, but an elevated HVA/VMA ratio. Even though the HVA and VMA are within their “normal” range, the ratio elevation indicates a developing block of the dopamine beta-hydroxylase or existing underactivity of this enzyme.

Q: If #7 is high and #21 is high, do you need to address dietary oxalates at all or is it more likely the candida?

A: Make this judgement based on the clinical picture of the individual. Not everyone needs to do the exact same thing for high oxalate. If they are symptomatic of oxalate, then a more aggressive program can be implemented. If you are picking up on high oxalate and they are not symptomatic and the arabinose is high too, then all they may need to do is treat the candida. If they are consuming high oxalate foods and the arabinose is high then addressing the candida and having them reduce high oxalate foods will usually take care of the elevated oxalate.


Q: In the first bacteria section, what markers are considered beneficial?
When do you order stool comprehensive test?

A: I feel a stool analysis is complementary to the OAT. The stool test will provide different and additional information. I always start with the OAT, but I have no problem doing a stool test as well.

Q: Is the OAT test still effective if a patient is on numerous psychiatric medications and supplements?

A: Yes, however, the medications may alter the neurotransmitter section, so you need to be aware of this.


Q: How do you conduct an OAT test on someone who is taking several medications/natural supplements?

A: I just have them do the test and make sure they follow the test instructions on what to avoid. Other than that, I personally do not have them stop medications or supplements.

Kurt Woeller DO

About the Author

Kurt Woeller, DO, FMAPS

Kurt N. Woeller, DO, FMAPS, is a Doctor of Osteopathic Medicine, integrative and functional medicine physician, and biomedical Autism Treatment Specialist in clinical practice for over 25 years.

Dr. Woeller is the education director and main course developer for his Integrative Medicine Academy (https://integrativemedicineacademy.com), an online academy for health professionals. He is also the Organic Acids Test (OAT) seminar creator and presenter for Mosaic Diagnostics Laboratory (formally Great Plains Laboratory’s GPL Academy) Mosaic EDGE seminars and has been involved in monthly educational webinars for GPL/Mosaic Diagnostics, and other organizations for over a decade.

His private practice, Sunrise Functional Medicine (https://mysunrisecenter.com), focuses on specialized diagnostic testing and treatments for individuals with complex medical conditions like autism, autoimmune, gastrointestinal, certain neurological disorders, and other chronic health conditions. Dr. Woeller is a Fellow of the Medical Academy of Pediatric Special Needs (MAPS).

He has served as a clinical consultant for various laboratory companies, i.e., Great Plains Laboratory, BioHealth Laboratory, providing health practitioner education regarding functional and integrative medicine.

You can follow Dr. Woeller for ongoing education articles and videos through his Substack at https://drwoeller.substack.com/ and his YouTube channel for Integrative Medicine Academyhttps://www.youtube.com/@integrativemedicineacademy. Finally, listen to Dr. Woeller’s latest health professional interviews through his Functional Medicine Doc Talk Podcast – https://functionalmedicinedoctalk.com.