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Microbial Organic Acids Testing: Reveal the Gut’s Hidden Imbalances

The Microbial Organic Acids Test (MOAT) is a precision tool used to assess gut microbial imbalances that contribute to systemic inflammation, mood disorders, fatigue, cognitive issues, and more. As a subsection of the larger Organic Acids Test (OAT), the MOAT focuses specifically on bacterial and yeast overgrowth markers — offering a targeted look at how gut dysbiosis may be impacting your health.

Used in functional psychiatry and chronic illness workups, the MOAT panel helps uncover stealth infections, toxic microbial metabolites, and hidden digestive imbalances that might otherwise go undiagnosed.

Not sure where this fits? See our Pathology Testing Packages & Pathways to choose your starting point → /pathology-testing-packages.

Your Testing Journey: From Ordering to Results

STEP 1

STEP 1

Your Test Kit Arrives
Your kit is mailed after payment and includes all forms and instructions.
STEP 2

STEP 2

Collect Your Sample
At home (urine, saliva, or blood spot) follow kit instructions. Or at a collection centre bring your kit and request form.
Test instructions will confirm which collection method applies
STEP 3

STEP 3

Return Your Sample
Use the reply-paid envelope or courier satchel provided. Some centres or couriers send directly for you.
All kits include return packaging and instructions nothing extra to arrange.
STEP 4

STEP 4

Results Ready
Once your sample reaches the lab, testing begins. We’ll contact you to book your results consultation.
Some test results may be available within a week, while others (especially complex profiles) may take up to 3 weeks.

  1. The MOAT panel analyses urinary metabolites associated with microbial overgrowth, divided into four key categories:

    🧫 Yeast & Fungal Overgrowth

    • Citramalic
    • Tartaric
    • Arabinose
    • Carboxycitric
    • Furan-2,5-dicarboxylic
    • Furancarbonylglycine
    • 5-Hydroxymethyl-2-furoic
    • 3-Oxoglutaric

      Elevated markers may indicate the presence of Candida or other fungal species that can produce neurotoxins or trigger immune and neurological symptoms.

      🦠 Bacterial Overgrowth

      • Hippuric
      • 2-Hydroxyphenylacetic
      • 4-Hydroxybenzoic
      • 4-Hydroxyhippuric
      • DHPPA(a marker associated with beneficial flora)

      These metabolites help assess dysbiosis and the overgrowth of harmful bacteria in the intestines.

      ⚠️ Clostridia Species

      • 4-Hydroxyphenylacetic
      • HPHPA
      • 4-Cresol
      • 3-Indoleacetic

      These specific compounds are associated with pathogenic Clostridia species like C. difficile and C. sporogenes, known to produce neurotoxins that affect behaviour, cognition, and mood (often seen in ASD, OCD, and PANDAS/PANS cases).

      🔁 Additional Markers

      • 3-Hydroxy-3-methylglutaric— linked to mitochondrial dysfunction
      • 2-Hydroxyhippuric— associated with salicylates, artificial sweeteners, and tyrosine metabolism

     

What’s Included in Your Kit:
  • Sterile Urine Collection Cup
  • Urine Transfer Pipette
  • Freezer-Safe Transport Tube
  • Stabilising Agents (if applicable)
  • Prepaid Courier Satchel
  • Full Collection Instructions (step-by-step below)

1️⃣ Preparation Before Collection

  • 🕒Fasting is required:Fast overnight (minimum 8 hours) before collecting your sample.
  • 🚫Avoid taking high-dose supplements (especially Vitamin C and NAC) 48 hours prior, unless advised otherwise by your practitioner.

 

2️⃣ Collecting the Urine Sample

  • 🚽On the morning of the test, collect your first morning urineinto the provided sterile collection cup.
  • Fill the cup at least halfway to ensure a sufficient sample volume.

 

3️⃣ Transferring the Sample

  • 🧪Use the provided pipette to transfer urine into the freezer-safe transport tube.
  • Fill the tube as per the fill-line indicator. 🚫Do not overfill.

 

4️⃣ Stabilising the Sample (if applicable)

  • 🧴If stabilising agents are included, add the required drops into the sample tube as per the instructions.

 

5️⃣ Freezing the Sample

  • ❄️Immediately place the filled transport tube into your home freezer.
  • Freeze for a minimum of 4 hours, preferably overnight.

 

6️⃣ Packing the Sample for Return

  • 📦Once frozen, place the transport tube into the provided courier satchel.
  • 📋Include your completed requisition form, ensuring all personal details are correct and legible.

 

7️⃣ Shipping the Sample

  • 📮Book a courier pickup or drop off the satchel at your local express post facility.
  • 🕒Ship samples on Monday or Tuesday onlyto avoid weekend transit delays.

 

💡 Important Collection Facts:

  • 🕒Fasting overnight ensures accurate metabolic readings.
  • 🚽First morning urine captures concentrated metabolites for optimal testing.
  • ❄️Freezing immediately after collection is essential for sample stability.
  • 🚫Avoid high-dose supplements (Vitamin C, NAC) for 48 hours prior.
  • 💧Do not over-hydrate the evening before — excessive fluid intake can dilute metabolites.

 

⚠️ Common Mistakes to Avoid:

  • ❌Not fasting overnight — invalidates results.
  • ❌Failing to freeze the sample promptly after collection.
  • ❌Incomplete or illegible requisition forms — delays processing.
  • ❌Posting samples later in the week (Wednesday onwards) — risk of spoilage.
  • ❌Over-hydrating the night before — dilutes the sample and can skew results.

MOAT testing reveals the hidden microbial imbalances that fuel anxiety, fatigue, and brain fog — making it a powerful first step in targeted gut-brain healing

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