“Ketones and fatty acids reveal how efficiently your body burns fat for fuel and how well your mitochondria are handling the load.”

 

In an Organic Acid Test (OAT), the section “Ketones and Fatty Acids Metabolism” evaluates how well the body is metabolising fats for energy, particularly when glucose is low or during fasting, ketogenic diets, or metabolic stress. It gives insight into mitochondrial beta-oxidation (fat breakdown) and ketone utilisation.

Lab comment: “The isolated increase in Suberic acid is likely dietary in origin and not suggestive of compromised beta-oxidation capacity.” 

Dr Lindeberg comments: Increased levels of Suberic acid would indicate the need for mitochondrial/ energy production support.

What Are Ketones and Why Are They So Important for Your Health? – http://www.youtube.com/@MedicalCentric 

 

🔬 Common Metabolites Measured in this Section:

🧪 1. 3-Hydroxybutyric Acid (β-Hydroxybutyrate)

• A main ketone body produced during fat metabolism.

• Elevated in:

  • Ketogenic diets or prolonged fasting

  • Diabetes (especially ketoacidosis)

  • Impaired glucose metabolism

  • Mitochondrial dysfunction

🧪 2. Acetoacetic Acid

• Another primary ketone body.

• Works alongside β-hydroxybutyrate to supply energy when carbs are low.

• Elevated in:

  • Ketosis (nutritional or pathological)

  • Diabetes

  • High-fat, low-carb diets

🧪 3. Adipic Acid

• A dicarboxylic acid is produced when fat oxidation is abnormal.

• Elevated in:

  • Impaired mitochondrial beta-oxidation

  • Fatty acid oxidation disorders

  • Carnitine deficiency

  • Excessive fat intake with poor metabolism

  • Toxin exposure inhibits fat metabolism

🧪 4. Suberic Acid

• A byproduct of fatty acid metabolism, especially under oxidative stress or carnitine deficiency.

• Elevated in:

  • Mitochondrial dysfunction

  • Carnitine transport issues

  • Organic acidurias (rare metabolic disorders)

• This is a very interesting acid, as it can indicate someone was fasting overnight or AN INCREASE IN OIL USE.

  The reason why I said that this result is interesting is that we have been struggling with Alex to gain weight. We started to give Alex food with a higher fat content, like full cream yoghurt and margarine with 70% more fat.  Also, and I know this is maybe THE reason why this acid is so elevated, is that his chicken patties and French fries have been fried, even if it is only a little bit of oil, and not baked.

🧪 5. Sebacic Acid

• Indicates omega-oxidation, a secondary fat breakdown pathway that kicks in when beta-oxidation is compromised.

• Elevated in:

  • Mitochondrial dysfunction

  • Carnitine insufficiency

🧪 6. Ethylmalonic Acid

• Marker of short-chain fatty acid oxidation problems.

• Elevated in:

  • Mitochondrial stress

  • Riboflavin (B2) or carnitine deficiency

  • Genetic issues like SCAD (Short-Chain Acyl-CoA Dehydrogenase deficiency)

🧬 Summary Interpretation:

• High ketones (3-hydroxybutyrate, acetoacetate) = fat burning or ketoacidosis

• High dicarboxylic acids (adipic, suberic, sebacic) = impaired fatty acid oxidation or mitochondrial dysfunction

• Carnitine-related markers (ethylmalonic, suberic) = may indicate a need for carnitine, B2, or mitochondrial support

✅ Clinical Significance:

This section helps evaluate:

• Fatty acid metabolism efficiency

• Mitochondrial function

• Nutritional status (especially carnitine, riboflavin)

• Risk of ketoacidosis, especially in diabetes

• Whether the body is over-relying on fat for fuel

Elevated levels of Adipic acid (adipate), suberic acid (suberate) and sebacic acid can be seen in:

• Supplementation with medium-chain triglycerides, found in coconut and palm oil 
• Excessive consumption of jello, gelatin, and custards
• Vitamin B2 (riboflavin) deficiency – Vitamin B2 is needed for fatty acid breakdown 
• Diabetes 
• Inborn errors of metabolism, such as acyl-CoA dehydrogenase deficiency 
• Other rare inherited disorders, such as adrenoleukodystrophy and Zellweger syndrome
• Some people are taking valproic acid (Convulex, Depakote, Epilim, Stavzor)

If you want to read more about Ketones, follow the link here.

Many dieticians or functional medicine practitioners have suggested the Ketogenic diet for Autistic people. Read more here.

Can Ketogenic Therapy Transform ADHD and Autism in Kids? – metabolicmind.org/blog

 

PLEASE NOTE: ANY VIEWS REGARDING THE RESULTS ARE MY UNDERSTANDING AND DO NOT SERVE AS PROFESSIONAL ADVICE. THE TREATMENT RECOMMENDATION IS STRICTLY RELATING TO ALEX’S RESULTS AND IS NOT MEANT FOR SELF-TREATMENT. ALWAYS SPEAK TO YOUR HEALTHCARE PROVIDER BEFORE STARTING ANY TREATMENTS.

Updated 30/09/2023 @ 19:05