DUTCH OATs

The DUTCH OATs (Dried Urine Test for Comprehensive Hormones Organic Acids Test) is a lab test offered by Precision Analytical, designed to provide a comprehensive overview of a patient's metabolic, nutritional and hormonal health. 

By analyzing a unique combination of neurotransmitter metabolites, nutritional organic acids, oxidative stress markers, and melatonin levels through urine samples, the DUTCH OATs test offers valuable insights into various health aspects including nutritional deficiencies, hormone and neurotransmitter imbalances, and oxidative stress. This advanced diagnostic tool is instrumental for healthcare providers in developing targeted treatment strategies for their patients.

Lab Company

• Name: Precision Analytical (DUTCH)
• Certifications: The laboratory is CLIA Certified and CAP Accredited, ensuring high standards of quality and reliability in test results.

Test Details

• Sample Type: Urine
• Category: This test falls under Metabolic Function and Nutrition, highlighting its focus on assessing the body's metabolic pathways and nutritional status.
• Shipping Time: Samples are shipped via UPS and typically arrive at the lab within 3 to 5 days.
• Turnaround Time: The lab processes the test within 10 days, providing a relatively quick turnaround for comprehensive results.
• Test Preparation: Patients are advised to start preparation up to 3 days before sample collection.
• Collection Duration: The urine collection spans 2 days, ensuring a thorough assessment over a period.

Biomarkers Analyzed

The DUTCH OATs test evaluates an extensive list of biomarkers, including:

• Two neurotransmitter metabolites: HVA (Homovanillic Acid) and VMA (Vanillylmandelic Acid)
• Four nutritional organic acids: Kynurenic Acid, Quinolinic Acid, 3-Hydroxyisovaleric Acid, MMA (Methylmalonic Acid)
• Additional markers for health assessment: Xanthurenic Acid, Pyroglutamic Acid, Indican (a marker of gut dysbiosis), 8-OHdG (a marker of oxidative stress), and Melatonin (a hormone related to sleep and circadian rhythm).

Methods Used For Processing

• LC-MS/MS: The test employs Liquid Chromatography coupled with Tandem Mass Spectrometry, a highly sensitive and specific technique for detecting and quantifying metabolites.

Eligibility

• Age Restriction: The DUTCH OATs test is not available for patients under the age of 12, due to specific metabolic and hormonal considerations in younger individuals.

Who should receive a DUTCH OATs test?

Patients who are good candidates for the DUTCH OATs test typically present with symptoms or conditions that suggest underlying imbalances in hormones, nutritional deficiencies, metabolic dysfunctions, or oxidative stress. This comprehensive test can be particularly beneficial for individuals experiencing the following:

Hormonal Imbalances: Those with symptoms of hormonal disorders such as irregular menstrual cycles, menopause-related symptoms, fatigue, mood swings, or unexplained weight changes may benefit from the insights provided by the DUTCH OATs test.  For a more comprehensive assessment, these patients may also consider the DUTCH PLUS test. [8., 10.]

Mental Health Concerns: Individuals experiencing depression, anxiety, mood disorders, or cognitive impairments might find an organic acid analysis useful in identifying biochemical imbalances that could be contributing to their mental and cognitive health issues.  [2., 6.]

Chronic Fatigue Syndrome: This test can be helpful for patients who suffer from chronic fatigue syndrome (CFS) or fibromyalgia by identifying nutritional deficiencies or metabolic imbalances that may be at the root of their condition. [9., 10.]

Digestive Issues: Patients with unexplained digestive issues such as irritable bowel syndrome (IBS), chronic constipation, or diarrhea, might benefit from the test to explore potential nutritional deficiencies or imbalances contributing to their gastrointestinal symptoms. [2., 3., 5.]

Nutritional Deficiencies: Individuals with diets lacking in essential nutrients, or those with conditions that impair nutrient absorption such as celiac disease or Crohn’s disease, are potential candidates. The test can help in identifying specific deficiencies needing correction. [1., 4.]

Oxidative Stress: Patients with conditions associated with high oxidative stress levels, including chronic inflammatory diseases, autoimmune disorders, or those undergoing treatment for cancer, might find the oxidative stress marker analysis (e.g., 8-OHdG) valuable for monitoring and managing their condition.  [6., 8.]

Sleep Disorders: For individuals experiencing sleep disturbances, insomnia, or abnormal sleep patterns, measuring melatonin levels can provide insights into disruptions in circadian rhythms and guide appropriate interventions.  [7.]

Detoxification Issues: Patients concerned with or showing signs of poor detoxification such as frequent exposures to toxins, persistent fatigue, or sensitivity to chemicals might benefit from the insights into metabolic pathways provided by the test. [5.]

Preventive Health Measures: Individuals focused on preventive health and wellness who wish to optimize their metabolic, nutritional, and hormonal balance may also choose to undergo the DUTCH OATs test as part of a comprehensive health assessment. [1., 4.]

It's important for healthcare providers to evaluate each patient's individual health status, medical history, and symptoms to determine whether the DUTCH OATs test is an appropriate diagnostic tool. This test can be a powerful adjunct to other clinical assessments, providing a deeper understanding of the patient's health and guiding personalized treatment plans.

Practical applications in the clinic

Organic Acids Tests (OATs) are valuable diagnostic tools used in functional and integrative medicine to provide a comprehensive overview of a person's metabolic processes. 

These tests measure the levels of organic acids in urine, which are byproducts of metabolism that can give insights into how the body's cellular processes are functioning. The practical applications of OATs are diverse, offering clinicians a way to identify underlying causes of various health issues and guide treatment strategies. Here are some of the key practical applications:

Assessing Nutritional Deficiencies: OATs can help identify deficiencies in vitamins and nutrients by showing abnormalities in metabolic pathways that depend on these nutrients. For example, high levels of certain organic acids in the DUTCH OAT test can indicate deficiencies in B vitamins. [1., 4.]

Identifying Detoxification Issues: Some organic acids are markers for the body's detoxification processes. Elevated levels can indicate an increased toxic burden or impaired detoxification pathways, which may contribute to symptoms like fatigue, headaches, and sensitivity to chemicals. [5.]

Detecting Oxidative Stress: Certain organic acids serve as indicators of oxidative stress, a condition that can damage cells and is linked to various chronic diseases, aging, and cancer. Identifying oxidative stress through OATs can lead to targeted antioxidant therapies. [3., 6., 8.]

Diagnosing Gastrointestinal Dysbiosis: OATs can detect markers for bacterial overgrowth in the intestine such as indican, which is elevated in cases of dysbiosis. This information can guide interventions to restore gut microbiome balance.  [2., 5.]

Monitoring Neurotransmitter Metabolism: Organic acids related to the metabolism of neurotransmitters can provide insights into mental health conditions, including depression, anxiety, and ADHD. Abnormal levels may indicate imbalances that could be addressed through diet, lifestyle, or supplementation. [3.]

Understanding Amino Acid Metabolism: By measuring metabolites related to amino acid processing, OATs can help in amino acid metabolism, assessing protein digestion, and tailoring amino acid supplementation. [3., 10.]

Personalizing Treatment Plans: Overall, the comprehensive nature of OATs allows for the development of personalized treatment plans based on the unique metabolic profile of each individual. This may include recommendations for diet, supplements, lifestyle changes, and detoxification support.

Preventive Health Care: OATs can be used in preventive health care to identify early metabolic imbalances before they develop into more serious health conditions. This proactive approach supports the optimization of health and wellness.  [1., 4.]

By offering insights into these and other aspects of health, Organic Acids Tests can play a crucial role in the early detection, diagnosis, and treatment of a wide range of conditions, thereby supporting a holistic approach to patient care.

References

[1.] Brown MJ, Ameer MA, Daley SF, et al. Vitamin B6 Deficiency. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470579/

[2.] Cassani E, Barichella M, Cancello R, Cavanna F, Iorio L, Cereda E, Bolliri C, Zampella Maria P, Bianchi F, Cestaro B, Pezzoli G. Increased urinary indoxyl sulfate (indican): new insights into gut dysbiosis in Parkinson's disease. Parkinsonism Relat Disord. 2015 Apr;21(4):389-93. doi: 10.1016/j.parkreldis.2015.02.004. Epub 2015 Feb 13. PMID: 25707302.

[3.] Chen LM, Bao CH, Wu Y, Liang SH, Wang D, Wu LY, Huang Y, Liu HR, Wu HG. Tryptophan-kynurenine metabolism: a link between the gut and brain for depression in inflammatory bowel disease. J Neuroinflammation. 2021 Jun 14;18(1):135. doi: 10.1186/s12974-021-02175-2. PMID: 34127024; PMCID: PMC8204445.

[4.] Langan RC, Goodbred AJ. Vitamin B12 Deficiency: Recognition and Management. Am Fam Physician. 2017 Sep 15;96(6):384-389. PMID: 28925645.

[5.] Leong SC, Sirich TL. Indoxyl Sulfate-Review of Toxicity and Therapeutic Strategies. Toxins (Basel). 2016 Nov 30;8(12):358. doi: 10.3390/toxins8120358. PMID: 27916890; PMCID: PMC5198552.

[6.] Lugo-Huitrón R, Ugalde Muñiz P, Pineda B, Pedraza-Chaverrí J, Ríos C, Pérez-de la Cruz V. Quinolinic acid: an endogenous neurotoxin with multiple targets. Oxid Med Cell Longev. 2013;2013:104024. doi: 10.1155/2013/104024. Epub 2013 Sep 5. PMID: 24089628; PMCID: PMC3780648.

[7.] St Hilaire MA, Lockley SW. Measuring Urinary 6-Sulphatoxymelatonin in Humans. Methods Mol Biol. 2022;2550:21-28. doi: 10.1007/978-1-0716-2593-4_4. PMID: 36180673.

[8.] Turathum B, Gao EM, Yang F, Liu YB, Yang ZY, Liu CC, Xue YJ, Wu MH, Wang L, Grataitong K, Chian RC. Role of pyroglutamic acid in cumulus cells of women with polycystic ovary syndrome. J Assist Reprod Genet. 2022 Dec;39(12):2737-2746. doi: 10.1007/s10815-022-02647-1. Epub 2022 Nov 2. PMID: 36322230; PMCID: PMC9790836.

[9.] Wyant GA, Yu W, Doulamis IP, Nomoto RS, Saeed MY, Duignan T, McCully JD, Kaelin WG Jr. Mitochondrial remodeling and ischemic protection by G protein-coupled receptor 35 agonists. Science. 2022 Aug 5;377(6606):621-629. doi: 10.1126/science.abm1638. Epub 2022 Aug 4. PMID: 35926043; PMCID: PMC9639781.

[10.] Zhen D, Liu J, Zhang XD, Song Z. Kynurenic Acid Acts as a Signaling Molecule Regulating Energy Expenditure and Is Closely Associated With Metabolic Diseases. Front Endocrinol (Lausanne). 2022 Feb 24;13:847611. doi: 10.3389/fendo.2022.847611. PMID: 35282457; PMCID: PMC8908966.

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