New Markers
Quinolinic Acid – Marker for Inflammation and Neurotoxicity
Quinolinic acid is an organic acid derived from the amino acid tryptophan and can be neurotoxic at high levels. Excitotoxic substances like quinolinic acid may stimulate nerve cells so much that the nerve cells die. Brain toxicity due to quinolinic acid has been implicated in Alzheimer’s disease, autism, Huntington’s disease, stroke, dementia from old age, depression, HIV-associated dementia, and schizophrenia.
Inorganic Phosphate – Marker for Bone Function / Vitamin D Deficiency
Low phosphate is associated with hypoparathyroidism, pseudohypo-parathyroidism, low nutritional phosphate intake, parathyroidectomy, and vitamin D deficiency.
4-Hydroxybenzoic Acid – Marker for Exposure to Parabens
4-Hydroxybenzoic acid is a metabolite of methylparaben, an anti-fungal agent, and a popular preservative in food and cosmetics. Parabens may be linked to mitochondrial failure due to depletion of cellular ATP through uncoupling of oxidative phosphorylation. They may also be produced from microbial metabolism of polyphenols in the diet. Parabens have been found at high levels in breast cancer samples, but a definitive relationship with breast cancer has not been demonstrated.
4-Hydroxyhippuric Acid – Marker for Exposure to Parabens
4-Hydroxyhippuric, a glycine conjugate of 4-hydroxybenzoic acid, is a metabolite of methylparaben. This compound is increased from intake of fruits containing polyphenols rich in anthocyanins, flavonols, and hydroxycinnamates, which are metabolized by gastrointestinal bacteria. 4-Hydroxyhippuric acid has been found to be an inhibitor of Calcium-ATPase in end-stage renal failure.
Malic Acid – Marker for Mitochondrial Dysfunction
When malic acid is simultaneously elevated with citric, fumaric, and alpha-ketoglutaric acids, it strongly suggests cytochrome C oxidase deficiency, indicating dysfunction in the mitochondrial energy pathways.
DHPPA – Marker for Beneficial Bacteria
Harmless or beneficial bacteria such as Lactobacilli, Bifidobacteria, and E. coli mediate the breakdown of chlorogenic acid to 3,4-dihydroxyphenylpropionic acid (DHPPA). High values of DHPPA are associated with increased amounts of these bacteria in the gastrointestinal tract.
N-acetylcysteine (NAC) – Marker for Glutathione Precursor & Chelating Agent
N-acetylcysteine is a powerful antioxidant that acts to increase the glutathione reserves in the body. It is found in body fluids but is also used as a nutritional supplement. N-acetylcysteine reduces the toxicity of drugs like acetaminophen (Tylenol) and protects against toxicity of mercury and other heavy metals. Low levels could indicate a glutathione deficiency.
Quinolinic Acid / 5-HIAA Ratio – Marker for Neurotoxicity and Inflammation
A high ratio of quinolinic acid to the tryptophan metabolite 5-hydroxyindole-acetic acid, indicates excessive inflammation due to recurrent infections, excessive tryptophan intake, immune overstimulation, excessive adrenal production of cortisol, or excessive exposure to phthalates.
Other Important Markers
Besides the new markers, the OAT still evaluates other important compounds including Krebs cycle and neurotransmitters. This reliable test detects the overgrowth of yeast and a bacteria species, Clostridia, commonly missed by conventional culture methods. These organisms and their metabolites can produce or magnify symptoms of many medical conditions. Identification of a yeast or bacterial overgrowth paired with a successful treatment can increase the chance of recovery.
Yeast: Intestinal growth of yeast & fungi, including Candida, are measured via by-product. High levels indicate an overgrowth.
Bacterial: Intestinal growth of bacteria, including Clostridia species, is measured via by-product. High levels indicate an overgrowth.
Oxalates: Elevations may indicate an excess of foods high in oxalates or Vitamin C, digestive disease, B6 deficiency, or intestinal yeast growth. Genetic markers indicate possible hyperoxaluria.
Glycolysis: Elevations may result from infection, exercise, or B vitamin deficiency. Very high levels may result from genetic metabolic disorders.
Krebs cycle: Abnormalities may result from nutrient deficiencies, microbial overgrowth, or glutathione (GSH) deficiency.
2-oxoglutaric: Low levels may result from regeneration of amino acids to remove excess ammonia.
Neurotransmitters: Metabolites of dopamine, norepinephrine, adrenaline, and serotonin are measured. Abnormalities may result from stress or poor detoxification, depression, toxic metal exposure, and rarely, specific tumors.
Pyrimidines: Slight elevations occur from folic acid deficiency. Significant abnormalities can indicate possible genetic dysfunction.
Fatty acids: Abnormalities can occur from ketogenic diets or fasting, intake of medium chain triglycerides, carnitine deficiency, or genetic disease.
Toxic indicators: Abnormalities can occur from deficiency of glutathione, excess ammonia, and aspartame ingestion.
Vitamin indicators: Abnormalities involving B12, B6, biotin, ascorbic acid are measured.
Amino acids: Abnormalities indicate a possible genetic error.
Miscellaneous: Abnormalities can indicate GI microbial activity or genetic disease.
Clinical Usefulness
 | Understand vitamin and hormone metabolism
|
| Determine capacity to generate energy |
| Evaluate intestinal wall integrity |
| Assess performance of the central nervous system |
| Evaluate muscle function |
| Reveal excessive levels of GI yeast |
| Reveal excessive levels of GI bacteria |
| Detect nutritional or antioxidant deficiencies |
| Determine problems in fatty acid metabolism |
| Determine oxalate imbalances |
Recommendations
Depending on test results, follow-up may include:
| Diet modification
|
| Probiotic supplementation |
| Nutritional supplementation |
| Oral anti-fungal or anti-bacterial medications |
| Increase antioxidants |
| Initiate detoxification protocols |
| Follow-up genetic testing |
