Oxalates (Organic Acids Test)

The Organic Acids Test (OAT) detects Oxalates in urine, which are byproducts of daily cellular metabolism. This comprehensive panel accurately identifies conditions linked to genetic disorders, nutrient deficiencies, intestinal dysbiosis, and toxicity resulting from diet and prescription drugs.

Designed to provide a broad perspective on systems affected by inflammation, the Oxalates panel is precious for individuals experiencing symptoms related to gastrointestinal issues, neurological challenges, detoxification, toxic exposure, or other inflammatory conditions.

Importance of the Test:

According to the World Health Organization (WHO), chronic inflammatory diseases rank as the leading cause of death worldwide. Organic acid markers, derived from known metabolic pathways and enzyme-cofactor requirements, offer significant insights into the underlying causes of chronic symptoms. The Oxalates Test can help detect imbalances in metabolism, infection risk, impaired detoxification, nutrient deficiencies, toxicity, and inflammation in those with chronic or complex acute illnesses.

Understanding Genetic Disorders Linked to Elevated Oxalate Production

Genetic disorders leading to increased oxalate production primarily fall under the category of primary hyperoxaluria, which comprises two main types. Both types result in heightened oxalate levels in the body, manifesting through increased excretion in urine and the formation of kidney stones due to oxalate deposits.

Type I Primary Hyperoxaluria

• Defect in Glyoxalate Metabolism: The first type is marked by a disruption in the normal metabolism of glyoxalate, which results in an overproduction of oxalate.
• Consequences: Individuals exhibit elevated glyoxylic and glycolic acid levels in their urine.

Type II Primary Hyperoxaluria

• Rarity: This type is less common than Type I.
• Distinct Characteristics: It is characterized by increased urinary excretion of oxalic and L-glyceric acids, while glycolic acid levels remain unaffected.

Together, these disorders can lead to recurrent issues with kidney stones and complicate kidney function, emphasizing the need for awareness and timely diagnosis.

What Dietary Factors Can Influence Hyperoxaluria?

Hyperoxaluria is a condition where there is an excessive excretion of oxalate in the urine, often influenced by dietary choices. Here’s a breakdown of elements in your diet that can play a role:

1. Animal Proteins: Consuming high amounts of animal protein can contribute to increased oxalate levels.

2. Purine-Rich Foods: Foods high in purines, such as certain meats and seafood, affect oxalate metabolism.

3. Gelatin: This is another factor that might boost oxalate levels.

4. Calcium & Certain Vegetables: While calcium is important for bone health, combining it with certain oxalate-rich foods can increase risk. Rhubarb, beets, spinach, and even common ingredients like peppers and tomatoes are high in oxalate content.

5. Fruits and Chocolates: Strawberries, chocolate, and cocoa should be consumed in moderation due to their high oxalate content.

6. Beverages: Tea is also a significant contributor to dietary oxalate levels.

While dietary oxalate plays a role, it's important to note that the body produces oxalate by metabolizing substances like glycine and vitamin C (ascorbic acid). Despite their minimal animal protein intake, vegetarians may experience enhanced oxalate excretion due to reliance on plant-based foods often rich in oxalates.

Additionally, vitamin B6 (pyridoxine) deficiency has been linked with increased oxalate excretion. Therefore, maintaining a balanced diet along with the appropriate intake of B6 can be beneficial.

Being mindful of these factors can help manage oxalate levels and reduce the risk of complications associated with hyperoxaluria.

Symptoms Include

Insomnia at night or fatigue (sluggish, tired)

Anxiety or lack of concentration/Brain fog

Nausea or Diarrhea

 

Hyperactive (nervous energy)

 

Depression or forgetfulness

The Influence of Vitamin C on Oxalate Excretion and Kidney Stone Risk

Vitamin C, while beneficial for many health reasons, can affect oxalate excretion in the body, impacting kidney stone risk. When consumed in high doses, sometimes called 'megadoses,' vitamin C can increase the amount of oxalate expelled through urine. This rise in oxalate levels can be problematic for those predisposed to a type of kidney stone called calcium oxalate stones.

Understanding the Risk

• High Oxalate Levels: The body breaks down excess vitamin C into oxalate. Elevated urine oxalate may heighten the risk of stone formation.
• Identifying the Cause: A history of high vitamin C intake might explain increased oxalate excretion in stone formers.

Recommendations

• Monitor Vitamin C Intake: If you are prone to forming kidney stones, regulating vitamin C consumption is advisable.
• Assess Changes: If reducing vitamin C intake decreases urine oxalate levels, additional treatments might not be necessary to prevent stone recurrence.

Keeping vitamin C intake within recommended levels can be an important step in managing and potentially reducing the risk of kidney stones.

Benefits of the At-Home Test:

Perform the Oxalates Test in the comfort of your home, experiencing simple testing with robust results. Our proprietary technology utilizes 11 different subpanels, ensuring unparalleled specificity and sensitivity in detecting various markers, including those related to intestinal microbial overgrowth, detoxification, mitochondrial function, neurotransmitter metabolism, glutathione status, fatty acid metabolism, and inborn errors of metabolism.

Validated and accredited, our science-backed testing and analysis are grounded in ongoing research by clinical experts.

Test Preparation:

To prepare for the Oxalates Test, avoid apples, grapes, pears, cranberries, juices or products, mushrooms, and ribose supplements for 48 hours before urine collection. Fasting is not required. For optimal test performance, collect the first urine upon awakening. Do not collect urine if you urinate overnight. Avoid drinking more than 8 oz of water 1 hour before urine collection, as a sample that is too diluted may be rejected.

Understanding Oxalate Level Reference Intervals

When assessing oxalate levels, it's essential to know the typical reference intervals, which vary by age and sex.

Children

• Under 7 years: Reference intervals are generally not established for children in this age group.
• Ages 7 to 14: Normal oxalate levels range from 13 to 38 mg over 24 hours.

Adults

• Men: Expected levels are between 7 and 44 mg per 24 hours.
• Women: The typical interval ranges from 4 to 31 mg per day.

These intervals serve as a guideline for healthcare professionals to evaluate oxalate levels and ensure they fall within a healthy range. Always consult with a healthcare provider for interpretations specific to individual cases.

Additional Resources

Organic Acids One Pager.pdf

 

Organic Acids Markers.pdf

 

How it works

 

1. Order Your Test. 

 

5. Receive your personalized report within 2-3 weeks.

 

Methodology for Oxalate Urine Test

The oxalate urine test typically uses an enzymatic method to measure oxalate levels in the urine. This approach provides accurate results for diagnosing various medical conditions related to oxalate metabolism.

Steps Involved:

1. Sample Collection: A 24-hour urine sample is collected to comprehensively evaluate oxalate excretion over a full day.

2. Enzyme Reaction: The test employs specific enzymes that react with oxalate present in the urine. This reaction facilitates the breakdown of oxalate into measurable byproducts.

3. Quantification: Oxalate breakdown produces a change in color or another detectable signal. This change is measured using spectrophotometry, which allows for precise quantification of oxalate concentration.

4. Result Analysis: The quantified oxalate levels are then compared to standard reference ranges to determine if they fall within normal limits.

This methodology is favored for its precision and reliability in assessing urinary oxalate, a crucial factor in diagnosing conditions like kidney stones or metabolic disorders.

Specimen Requirements for the Oxalate Test

When preparing a specimen for the oxalate test, it’s important to follow precise guidelines to ensure accurate results.

Type of Specimen

• Urine: Collect over 24 hours.

Required Volume

• Optimal Volume: Submit a 10 mL aliquot for testing.
• Minimum Volume: A 2.5 mL aliquot is acceptable, but this may be insufficient for repeat testing if needed.

Collection Container

• Use a durable plastic container specifically designed for 24-hour urine collection, equipped with an appropriate preservative, such as 6N HCl.

Collection Instructions

1. Start Time: The collection begins after voiding at 8 a.m. Or 8 p.m., discarding the initial sample.

2. Collection Period: Collect all urine output for the next 24 hours, including the final specimen voided at the end of this period.

3. Labeling: Label the container with the patient's name and the dates and times the collection started and ended.

4. Total Volume Recording: Measure and document the total volume of urine collected.

5. Mixing and pH Level: Mix the specimen thoroughly, ensuring the pH is ≤3. If it is not, adjust accordingly.

Preservative Use

• While the preservative isn’t necessary during the initial collection, it must be added to the urine within 24 hours to maintain sample stability.

By adhering to these guidelines, the specimen should meet the standards necessary for an effective oxalate test.

How to Collect a 24-Hour Urine Sample for Your Test

Collecting a 24-hour urine sample is a straightforward process, but it requires careful attention to detail. Here's what you need to do:

1. Start the Collection:

   • On the first day, empty your bladder and discard this initial urine at 8 a.m. or 8 p.m. This step marks the official start of your 24-hour collection period.

2. Collect Throughout the Day:

   • For the next 24 hours, gather every bit of urine you produce in a designated container. Keeping the container in a cool place, like a refrigerator, is crucial to ensure the sample remains suitable for analysis.

3. Complete the Collection:

   • Void once more and add this final specimen to the container at exactly the same time the next day (8 a.m. or 8 p.m.).

4. Label and Prepare:

   • Clearly label the container with your name, alongside the date and time you began and ended the collection.

5. Measure and Record:

   • Check the total volume of urine collected and note this measurement. This information is important for the lab’s analysis.

6. Mix the Sample:

   • Thoroughly mix the urine to ensure consistency throughout the sample.

7. Check pH Levels:

   • Ensure the urine sample has a pH level of 3 or less. Although adding a preservative isn’t necessary while collecting the sample, it should be added within 24 hours if recommended.

By following these steps, you will ensure that your urine sample is collected correctly, providing accurate test results.

Stability Requirements for Urine Samples

When handling urine samples for testing, adhering to specific stability guidelines is essential to ensure accurate results. Here’s an overview of how to manage these samples under various temperature conditions:

• Room Temperature:

  • Maintain urine samples at room temperature for up to 7 days.

• Refrigeration:

  • Samples can be refrigerated to extend their stability, remaining viable for 7 days.

• Freezing:

  • For longer preservation, freeze samples can be stored for up to 8 weeks.

• Freeze/Thaw Cycles:

  • Samples can withstand up to three freezing and thawing cycles without compromising stability.

By following these guidelines, you can ensure that the integrity of urine samples is maintained across different storage conditions.

Required Specimen Volume

A 10 mL sample is required for accurate testing. This volume ensures the lab has enough material to perform all necessary tests and any potential repeats.

Minimum Specimen Volume

If sample availability is limited, a 2.5 mL specimen is the lowest acceptable quantity. However, this amount only covers a single test and does not allow for repeated testing.

How to Store Collected Urine Specimens

To ensure the integrity of the collected urine specimen, follow these storage guidelines:

• Keep It Acidified: Add an acid to the urine. This step is crucial as it prevents the formation of crystals and stops the conversion of vitamin C (ascorbate) into oxalate, which could alter test results.

• Room Temperature Storage: Store the acidified urine at room temperature. Avoid refrigerating or freezing unless specifically instructed by your healthcare provider, as these conditions can affect the sample's composition and lead to inaccurate analysis.

By adhering to these instructions, you'll maintain the specimen’s quality for accurate testing.

Recommended Container for Urine Sample Collection

For collecting a 24-hour urine sample, it's essential to use a specialized container designed for this purpose. Opt for a durable plastic container that includes a preservative to maintain the integrity of the sample throughout the collection period.

Key Features:

• Material: A robust plastic construction to prevent leaks and damage.
• Size: Adequately sized to accommodate the full volume of urine collected over 24 hours.
• Preservative: It is equipped with a 30 mL 6N hydrochloric acid (HCl) preservative to ensure the sample remains stable during and after collection. This is crucial for accurate test results.

These containers are typically available through medical supply providers, ensuring they meet the necessary specifications for laboratory testing.

Information and Documents Associated with Urine Specimens

When dealing with urine specimens, it's important to consider related information and relevant documents to ensure accurate procedures and results.

Key Information:

• Urine Specimens: It is crucial to understand the handling, collection, and storage of urine specimens. This includes details on collecting samples to maintain integrity and avoid contamination properly.

Essential Documentation:

• Sample Report: This document typically outlines the results obtained from the analysis of urine specimens. It's vital for interpreting findings and making informed decisions based on collected data.

These components are a foundational reference for anyone working with urine specimens, ensuring a thorough approach to the process.

Please consult with your health provider or schedule an appointment with one of our naturopathic doctors to discuss whether to continue or discontinue any other dietary supplements or medications before your test. All sales are final, and no refunds will be given, and you waive any rights to charge back your purchase with your credit card processor.