Microbial Organic Acids Test (MOAT)

Microbial Organic Acids Test (MOAT)

Follow-Up to the OAT

Organic acids are substances that result from the metabolic processes in your body. Analyzing these metabolites from different metabolic pathways can immediately provide insight into important areas related to gut health. The Microbial Organic Acids Test (MOAT), included in the Organic Acids Test (OAT), specifically measures the metabolites produced by yeast and bacteria. Elevated values in the MOAT may indicate yeast or bacterial dysbiosis.

The MOAT is particularly useful as a follow-up to the OAT and may be recommended by practitioners looking for a specific abnormality, to monitor certain microbial balances, or to assess treatment efficacy. However, we strongly recommend that the full OAT be performed as the initial screening test.

Turnaround Time: 1-2 weeks

Turnaround times are estimates. Detailed order tracking is available in the MosaicDX Portal.

Microbial Organic Acids Test (MOAT)
* Available in English, Spanish, German, Portuguese, Japanese, Italian, French
Microbial Organic Acids Test (MOAT)

What Patients Might Benefit from the MOAT?

Detect imbalances in gut health that may be causing or amplifying certain symptoms and conditions.

  • Anxiety
  • Autism Spectrum Disorders
  • Depression
  • Fatigue
  • Fibromyalgia
  • Gastrointestinal symptoms
  • Neurological Disorders
  • Obesity
  • Optimizing Health


Why Use the Microbial Organic Acids Test (MOAT)?

The MOAT is a convenient and effective way to evaluate a patient’s gut health by analyzing 21 organic acids present in a single urine sample. These organic acids are metabolic byproducts that can help healthcare providers detect imbalances in gut health, including harmful bacteria, beneficial bacteria, Clostridia species, Candida species, yeast and fungal metabolites, and general markers of dysbiosis that may be impacting the patient’s overall health.

The MOAT is particularly useful for individuals experiencing chronic health issues that may be related to gut imbalances. Healthcare practitioners can use the MOAT to identify specific abnormalities, monitor microbial balances, or assess treatment efficacy. However, the full OAT is recommended as the initial screening test.

Learn More About the Microbial Organic Acids Test (MOAT): Explore FAQs


The MOAT measures 21 urinary organic acids (including creatinine) such as markers for beneficial bacteria, harmful bacteria, Clostridia species, Candida species, yeast and fungal metabolites, and general markers of dysbiosis from one, easy to collect, urine sample.

See full list of markers below:


  • Citramalic Acid
  • 5-Hydroxymethyl-2-furoic Acid
  • 3-Oxoglutaric Acid
  • Furan-2,5-dicarboxylic Acid
  • Furancarbonylglycine
  • Tartaric Acid
  • Arabinose
  • Carboxycitric Acid
  • Tricarballylic Acid
  • 2-Hydroxyphenylacetic Acid
  • 4-Hydroxyphenylacetic Acid
  • 4-Hydroxybenzoic Acid
  • 4-Hydroxyhippuric Acid
  • HPHPA (Clostridia marker)
  • 4-Cresol (C. difficile)
  • DHPPA (beneficial bacteria)
  • Hippuric Acid
  • 3-Indoleacetic Acid
  • 3-OH-3-Methylglutaric Acid (Vitamin Q10/CoQ10)
  • 2-Hydroxyhippuric Acid

Sample Reports

The Microbial Organic Acids Test report is a useful resource for practitioners who want to gain valuable insights into gut health, including harmful bacteria, beneficial bacteria, Clostridia species, Candida species, yeast and fungal metabolites, and general markers of dysbiosis that may be impacting the patient’s overall health.

Test Prep and Instructions

MosaicDX offers patient-friendly sample collection kits that simplify testing. Our kits include visual, step-by-step instructions for test preparation and sample collection, personalized shipping cards, and pediatric collection bags if needed. With MosaicDX, patients can easily collect samples for testing with confidence and accuracy.

Patient Resources

Assets for practitioners to support patients in understanding organic acids and MosaicDX’s OAT, enhancing their patients’ comprehension, decision-making, and overall health journey.

Frequently Asked Questions

The ordering process for MosaicDX tests starts with your healthcare practitioner assessing your symptoms and recommending the most appropriate test.

Once a test has been recommended, collection kits can be conveniently ordered and delivered straight to your doorstep. If you already have a collection kit, you can register your test and begin the process at your convenience.

It is important to carefully follow the collection instructions and include all required information about yourself and your specimens when registering your test. When your specimens are collected, you can use the prepaid shipping materials provided in your kit to ship them to MosaicDX. Your results will be accessible online via the MosaicDX portal. We recommend scheduling an appointment with your healthcare practitioner to discuss your results and develop a plan for your healthcare

If you are located outside of the U.S., our customer service team can assist you in finding a distributor in your country. In countries where a distributor is not required, you can place an order through our international patient ordering site. Please note that all international shipping costs must be paid prior to shipping the kit.  

The OAT or MOAT is typically not affected by antibiotics or antifungal medications, unless they contain certain fruits like apples, grapes, pears, or cranberries. However, it’s important for both the patient and practitioner to consider the purpose of the test when deciding whether to avoid these medications. For instance, if the practitioner is interested in evaluating the effectiveness of a particular therapy, it may be acceptable for the patient to continue taking the medication during the test. On the other hand, if the patient wants to determine their metabolic condition without any influence from medication, it’s advisable to discontinue the antibiotics or antifungals for a period of 1-2 weeks before the test. 

Yes, it is possible to conduct multiple urine tests using a single urine sample, provided that the volume requirement for each test is met. The urine collection container typically holds around 50 mL of urine. However, for timed and 24-hour urine tests, a specialized collection jug or bag is necessary. 

Different states have regulations that define the scope of practice for practitioners. It is the practitioner’s responsibility to abide by these rules. Check with your state board of health to determine any restrictions related to laboratory testing. Please note, Mosaic Diagnostics does not offer testing in New York. 

Once you have opened your account, you have the options of ordering kits to stock in your office or drop-ship kits directly to your patients through your MosaicDX portal.   

Watch our short tutorial videos on how to conveniently  

Already have a kit? Watch this video on how to place an order for your patient using a kit from your inventory.   

To ensure optimal results, it is recommended to ship urine specimens to the laboratory immediately after collection as they start degrading in quality soon after. In case immediate shipping is not possible, here are some guidelines for specimen stability: Urine samples can be stored in the refrigerator for up to 5 days, and for extended periods in the freezer. This applies to all urine tests performed at MosaicDX, except for the Kryptopyrrole test, for which urine must be frozen immediately and received within 24 hours of collection for accurate results. 

Please refer to your test’s specific Test Preparation and Instructions for more information regarding the potential effects of medications, foods, and supplements on this test. 

You make also consult your healthcare provider prior to making any changes to your medications.

Visit the payment information page for an overview of payment options and procedures along with insurance coverage overview.

NOTE: Insurance coverage for testing is based on several factors such as the type of procedure, diagnosis, and insurance policy guidelines. Patients are encouraged to contact their insurance company to check for coverage and to provide the procedure codes (CPT codes) and diagnostic codes (ICD-10 codes). The CPT codes can be found on the billing information page, while ICD-10 codes are provided by the practitioner.

Mosaic Diagnostics offers written interpretations within test reports and complimentary consultations with our clinical educators for qualified practitioners. To schedule a consultation, simply sign in to your MosaicDX account and book a consultation online. 

We encourage all patients to discuss results with your practitioner.

Our Resources tab also contains educational materials that you may find useful, we also offer MosaicEDGE workshops for qualified practitioners to better understand the fundamentals of lab testing.

MosaicDX offers pediatric collection bags with adhesive tape for pediatric patients who have not been toilet trained. These bags can be used to collect urine from infants or young children. To request pediatric collection bags, please contact our Customer Service team

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Clinical References