How metabolic testing takes the guesswork out of candida treatment

From a naturopath’s point of view, the digestive tract is considered the cause of many health issues and not just those related to digestion: aching muscles, fluid retention, weight gain, slowed metabolism, joint pains, concentration, headaches and skin problems as well as depression can have their source in the gut.

One of the principles of naturopathic medicine is to address the underlying cause of a problem in order to get the best result long term. You can’t do that if you don’t know what the cause is. This article will explain how we were able to accurately identify and successfully treat a common G.I. infection caused by a yeast called Candida albicans.

The gut’s connection to other health issues

I recently saw Helen, a patient who had been suffering from chronic fatigue for six years. She had gone through all the medical tests: hormonal, blood, etc. but no cause had been identified.

Although, Helen was naturally a positive person she was suffering from depression and postpartum. Her body often ached especially her muscles, making exercise nearly impossible and as a result she had become overweight. It was clear that something was affecting Helen’s overall health – and it seemed Helen’s digestion was the root causes as there was bloating and discomfort too. I also wondered about allergies and whether there were any infections in her intestines causing her symptoms.

After such a long struggle, Helen was keen to find the underlying cause. We did a blood test to look for food intolerances and a urine test called the Organic Acids Test (OAT) t. The OAT test looks for yeast and fungal toxins as well as many other waste products of metabolism, giving a wider view of the internal functions.

When the results arrived, Helen had no food intolerances or allergies at all, which was unexpected. However, her urine test revealed the underlying issues: she was overwhelmed with toxins produced by yeast in her intestines. See her result here.

The usual Candida yeast sufferer has two or so of these toxins elevated. In Helen’s case: seven yeast toxins, several at extreme levels were causing her fatigue and mood disorders. Helen’s report was the worst I’ve seen and considering she was appeared to be coping well is owed to her positive spirit. If you look at the report 8 of the 9 yeast and fungal markers listed were elevated, some hundreds of times higher than normal.

It turned out Helen’s kitchen was also very moldy, especially in the fan system in the kitchen. Some of the fungal toxins identified in her OAT test (listed as 2, 3 and 4 on the report) were probably signs of black mould, Aspergillus, which she had been breathing in while cooking.

The markers 6 (Tartaric) and 7 (Arabinose) are the ones that Candida produces.

So Helen had a yeast infection from household mould exposure as well as Candida growing in her gut. All these fungal toxins put a tremendous load on her system.

Other findings from her Organic Acids Test showed her energy producing metabolism was messed up with high levels of lactic acid in her test result, which was causing her muscle aches and low tolerance to exercise.

Other parts of her test identified abnormalities in her mood-related neurotransmitters such as serotonin. Gut infections often cause a drop in serotonin levels, causing a secondary anxiety, and possibly also depression.

Helen’s case gives a clear insight into how gut infections can have metabolic effects, manifesting as many other symptoms seemingly unrelated to the gut.

Metabolic testing takes out the guesswork

The Organic Acid Test was able to help us in the accurate diagnosis for Helen. It is a urine test that provides a snapshot of the metabolism based on the byproducts the body discards through the urine. These discarded organic acid molecules can indicate disorders of metabolism including energy production, the presence of yeast (Candida) or bacterial overgrowth in the gut leading to toxicity and many other issues.

As Candida infections can be hard to identify—Helen had no outward signs of yeast infections at all—it is an accurate way to be certain of the issue, since the yeast has to be alive and active to produce the yeast toxins (in case of Candida Tartaric and arabinose are key markers). The same test can also point us to bacterial infections in the gut as well, which were only mildly elevated in Helen’s case.

Abnormally high levels of these intestinal microorganisms can cause or worsen behavior disorders, hyperactivity, depression, attention deficits and concentration issues, muscle pain and some movement disorders, fatigue and immune dysfunction.

Many people with chronic illnesses and neurological disorders often excrete several abnormal organic acids. The cause of these high levels could include: oral antibiotic use, high sugar diets, immune deficiencies, gluten intolerance, and genetic factors.

This one simple urine test can reveal:

  • High levels of intestinal yeast (Candida) overgrowth
  • High levels of bacterial and other toxins from the gut
  • Evaluation integrity of intestinal wall for leaky gut
  • Assessment neuro-transmitter levels relevant to anxiety, addiction or depression
  • Assessment central nervous system function for inflammation
  • Evaluation of energy production by the mitochondria
  • Detect nutritional and antioxidant deficiencies
  • Determine problems in fatty acid metabolism

On the first page of the sample report you will see “Yeast and Fungal Markers” and “Malabsorption and Bacterial Markers” markers.

The sample report there shows a yeast overgrowth problem clearly because of the elevated levels of tartaric and arabinose. Tartaric will cause fatigue and muscle weakness or pain, while arabinose causes attention and concentration issues and interferes with normal brain chemistry affecting the moods.

A patient with a report like this could be classified as suffering “Gut and Psychology Syndrome” or GAPS for short. He/she would be put on a low fermentation, low sugar diet along with anti-fungals and probiotics to correct the mood and concentration issues.

Treatment options in naturopathic medicine

If abnormalities are detected using the OAT, treatments can include anti-microbial herbs or medications, or supplements, such as probiotics, vitamins and antioxidants, or dietary modification.

Upon treatment, both the patients and IMI practitioners have reported significant improvement, such as decreased fatigue, regular bowel function, increased energy and alertness, increased concentration, improved verbal skills, less hyperactivity, and decreased abdominal pain.

I recommend the OAT as the initial screening test, especially for the following:

  • Fatigue
  • Anxiety
  • Asperger’s Syndrome
  • Autism Spectrum Disorders
  • Chronic Fatigue
  • Colitis and Crohn’s Disease
  • Depression
  • Fibromyalgia
  • Gastrointestinal Disorders, Irritable Bowel Syndrome, Diarrhea or Constipation
  • Learning Disabilities
  • Movement Disorders – including muscle pain and muscle fatigue
  • Multiple Sclerosis
  • Obsessive Compulsive Disorder
  • Recurrent Infections such as cystitis or sinusitis
  • Tic Disorders and Tourette Syndrome
  • Common symptoms indicating gut infections may include: Gas-bloating, Flatulence, Abdominal discomfort, Diarrhea or constipation, Anal fistula, Steatorrhea or floating smelly stools, Weight loss
  • Features associated with micronutrient deficiencies – needs for extra vitamin B12 and folate are well indicated for example.


Organic Acid Test – A Few Markers Explained

A yeast metabolite causes functional Vitamin B deficiencies, affecting the brain, nerves (neurotransmitter production) and energy production. Depletes the cellular defense systems (enzymes such as glutathione and SOD) causing increased and multiple chemical sensitivity. Interferes with normal sugar metabolism.

4-Cresol – Marker for Bacteria Including Selected Clostridia
Indicates a possible overgrowth of intestinal bacteria that are specific p-cresol producers including selected Clostridia. 4-Cresol is a phenolic product poorly metabolized in children with autism. High-potency multi-strain probiotics may help rebalance GI flora.

DHPPA – Marker for Beneficial Bacteria
Harmless or beneficial bacteria mediate the breakdown of chlorogenic acid to 3,4-dihydroxyphenylpropionic acid (DHPPA). High values of DHPPA are associated with increased amounts of bacteria in the gastrointestinal tract.

5-Hydroxyindoleacetic (5-HIAA)
Gives some indication of Serotonin levels in the body

Quinolinic Acid – Marker for Inflammation and Neurotoxicity
This acid derived from the amino acid tryptophan and can be neurotoxic at high levels. Quinolinic acid can over stimulate nerve cells, causing the cells to die. Brain toxicity due to this acid has been implicated in Alzheimer’s disease, autism, Huntington’s disease, stroke, dementia, depression, HIV-associated dementia, and schizophrenia.

Quinolinic Acid/5-HIAA Ratio – Marker for Neurotoxicity and Inflammation
A high ratio of quinolinic acid to the metabolite 5-hydoxyindole-acetic acid indicates excessive inflammation, which will age and damage the brain. High levels of these markers could be due to recurrent infections, including persistent infections in the gut, immune overstimulation, too high tryptophan intake, excessive adrenal production of cortisol (stress), sleep deprivation, and frequent exposure to phthalates (chemical used in plastics and many household items).

Malic Acid – Marker for Mitochondrial Dysfunction
When malic acid is elevated simultaneously with citric, fumaric, and alpha-ketoglutaric acids, it may cause Cytochrome C Oxidase Deficiency, a metabolic disorder disrupting energy production.

Tartaric acid
Tartaric acid and other yeast byproducts are also elevated in urine samples of adults with the disorder fibromyalgia, a debilitating disease associated with muscle and joint pain, depression, foggy thinking, and chronic fatigue. The Tartaric acid made by Candida also has the ability to cause sugar cravings and low blood sugar levels through blocking the Krebbs Cycle for energy production in our cells.

Indicates folate deficiency

Indicates Vitamin B 12 deficiency

If you would like to find out whether the OAT is right for your symptoms, please contact IMI’s Integral Health Advisor,, or make an appointment with one of IMI’s Naturopathic Medicine practitioners by calling 2523 7121.

About Graeme Bradshaw

Graeme is a highly respected Naturopath and Homeopath with over 30 years in clinical practice. He is widely recognised as one of the pioneers who brought naturopathic medicine to Hong Kong in the 90s. His expertise includes gut-brain issues, DNA assessment for disease prevention, and clinical detox programs.

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