Organic Acids Test (OAT)

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 following tests provide valuable insight into metabolism, nutrient needs, food sensitivities and metal toxicity.

• IgG Food Map with Candida + Yeast
• Heavy Metals Hair
• Organic Acids Test

The Organic Acids Test by Mosaic Diagnostics evaluates levels of oxalates in urine. Oxalate (and its acid form, oxalic acid), is an organic acid that is primarily derived from three sources: the diet, fungus (such as Aspergillus and Penicillium), possibly Candida, and also human metabolism. Oxalic acid is the most acidic organic acid in body fluids and is used commercially to remove rust from car radiators. Antifreeze (ethylene glycol) is toxic primarily because it is converted to oxalate in the body. Two different types of genetic diseases are known in which oxalates are high in the urine, hyperoxalurias type I and type II, which can also be determined from the Organic Acids Test. 

Foods especially high in oxalates are often foods thought to be otherwise healthy, including spinach, beets, chocolate, peanuts, wheat bran, tea, cashews, pecans, almonds, berries, and many others. People now frequently consume “green smoothies” in an effort to eat “clean” and get healthy, however, they may actually be sabotaging their health. The most common components of green smoothies are spinach, kale, Swiss chard, and arugula, all of which are loaded with oxalates. These smoothies also often contain berries or almonds, which have high amounts of oxalates as well. Oxalates are not found in meat or fish at significant concentrations. Daily adult oxalate intake is usually 80-120 mg/d. A single green smoothie with two cups of spinach contains about 1,500 mg of oxalate, a potentially lethal dose. 

High Oxalate Food List

External sources of oxalates include ethylene glycol, the main component of antifreeze. Antifreeze is toxic mainly because of the oxalates formed from it. In addition, some foods also contain small amounts of ethylene glycol. Vitamin C (ascorbic acid or ascorbate) can be converted to oxalates but the biochemical conversion system is saturated at low levels of vitamin C so that no additional oxalate is formed until very large doses (greater than 4 g per day) are consumed. The high correlation between arabinose and oxalates indicate that intestinal yeast/fungal overgrowth is likely the main cause for elevated oxalates in the autistic spectrum population. The deposition of oxalates in critical tissues such as brain and blood vessels, the oxidative damage caused by oxalate salts, and the deposition of oxalate mercury complexes in the tissues.

Almost all organic acids used for human testing are measured by a combination of gas or liquid chromatography linked with mass spectrometry. Organic acids are most commonly analyzed in urine because they are not extensively reabsorbed in the kidney tubules after glomerular filtration. Thus, organic acids in urine are often present at 100 times their concentration in the blood serum and thus are more readily detected in urine. This is why organic acids are rarely tested in blood or serum. The number of organic acids found in urine is enormous. Over 1,000 different organic acids have been detected in urine since this kind of testing started.

Use of organic acids to provide insight into functional metabolic imbalances has evolved from historic diagnostic testing to investigate inborn errors of metabolism (IEM).

While the OAT is not designed specifically to diagnose classically defined IEMs, persistent marked elevations in OAs noted on the profile may indicate an undiagnosed underlying metabolic pathway defect. As such, further clinical investigation via an individual patient’s clinical presentation and the results of complementary laboratory tests may be warranted to guide more specific testing.

IEM are a class of inborn errors of metabolic pathways that are marked by accumulation (and usually toxic) organic acid metabolites in blood (i.e., organic acidemias) and increased excretion of organic acids in urine (i.e., organic acidurias). While individual IEMs are rare that typically become apparent clinically during the newborn period or early infancy, though milder – and even asymptomatic – forms may emerge in adolescence and adulthood.

Because of the life-threatening metabolic disturbances (acidosis and ketosis) that are associated with IEMs, an entire field of preconception and postnatal screening has arisen. Current newborn screening includes assessment of 34 core conditions which allows for early treatment intervention should a positive finding result.

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. 

The Microbial Organic Acids Test (MOAT) is ideal for a follow-up to the OAT and is often recommended by practitioners looking for a specific abnormality, to monitor certain microbial imbalances, or to assess treatment efficacy.

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  

• Order kit for your inventory  
• Drop-ship a kit to your patient  
• Re-order a follow-up test for your patient.    

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. 

Together they provide necessary information about mycotoxin burden, nutritional need, mitochondrial function and detox capability in one, easy, urine sample.