Metabolomix+ (Urine Nutritional & Metabolic Profile)
Metabolomix+ is a functional nutritional and metabolic profile built around a first-morning urine organic acids analysis, assessing markers of gut microbial balance, mitochondrial energy metabolism, functional B-vitamin status, neurotransmitter turnover, and oxidative stress. It is used in functional and integrative practice to guide individualised nutrient strategies.
5
Biomarkers
Urine (random)
Sample
10–15 business days
Turnaround
First-morning urine; specific preparatory dietary restrictions usually apply # REVIEWER FLAG: Confirm fasting/preparatory-diet requirements with Genova.
Fasting
What is the Metabolomix+ test?
Metabolomix+ is a broad functional nutritional and metabolic profile built around a first-morning urine organic acids analysis, assessing markers across several domains — gut microbial and malabsorption patterns, mitochondrial and cellular energy metabolism, functional B-vitamin status, neurotransmitter metabolite turnover, and oxidative stress and detoxification. It is used to build a wide-ranging picture of an individual's functional nutritional status from a single urine specimen, with optional bloodspot add-ons extending the profile to amino acids, fatty acids, and other markers. In the diagnostic landscape, the profile sits within functional and integrative nutritional medicine and is used to guide individualised nutrient, dietary, and lifestyle interventions rather than to make formal disease diagnoses. Some of its components have recognised validity — urinary methylmalonate for B12 status, for instance — while many organic-acid markers are interpreted in a functional-medicine framework whose clinical validity is not established in mainstream practice. Practitioners order it for a comprehensive nutritional evaluation in patients with non-specific symptoms such as fatigue or in those pursuing personalised nutritional optimisation, interpreting the validated and exploratory markers with appropriately different weight.
What does the Metabolomix+ test measure?
These organic acids derive in part from bacterial and yeast metabolism in the gut, with compounds absorbed and excreted in urine. Patterns are interpreted as indirect reflections of microbial activity and carbohydrate malabsorption rather than direct microbial counts.
Elevations in this group are interpreted in functional practice as suggestive of bacterial or yeast dysbiosis or malabsorption, prompting consideration of gut-directed assessment. The markers are indirect and non-specific, and interpretation is functional-medicine-oriented rather than diagnostic. # REVIEWER FLAG: Clinical validity of urinary dysbiosis markers is contested — reviewer to confirm positioning.
These include citric acid cycle intermediates and related metabolites reflecting mitochondrial energy production. Accumulation of specific intermediates is taken to indicate points of relative metabolic blockage or cofactor need within energy metabolism.
Patterns in this group are used in functional assessment to infer mitochondrial and energy-metabolism efficiency and potential nutrient cofactor needs. They are interpretive markers rather than diagnostic tests for defined mitochondrial disease, which requires specialist evaluation. # REVIEWER FLAG: Confirm positioning relative to formal mitochondrial diagnostics.
Specific organic acids accumulate when B-vitamin-dependent enzymatic steps are under-supported — for example methylmalonate in relation to B12, formiminoglutamate (FIGLU) in relation to folate, and xanthurenate in relation to B6. Elevations indicate functional insufficiency at the cellular level.
These functional markers are interpreted as indicators of cellular B-vitamin adequacy, complementing direct serum vitamin measurement. Methylmalonate in particular has recognised validity for B12 status, while other markers are more functional-medicine-oriented. # REVIEWER FLAG: Distinguish validated (e.g. MMA) from exploratory markers.
These include catecholamine and serotonin metabolites such as vanilmandelate (VMA), homovanillate (HVA), and 5-hydroxyindoleacetate (5-HIAA), excreted in urine as breakdown products of neurotransmitter turnover.
Patterns are used in functional practice to infer neurotransmitter turnover and related nutrient needs. Urinary metabolite levels are influenced by diet and many factors and are not a validated measure of central neurotransmitter status. # REVIEWER FLAG: Strongly emphasise the limited validity of inferring CNS neurotransmitter status from urine.
Markers such as pyroglutamate (relating to glutathione status) and sulphate (relating to sulphation capacity) reflect aspects of antioxidant defence and detoxification pathway activity, excreted in urine.
These markers are interpreted in functional assessment as indicators of antioxidant reserve and detoxification capacity, informing nutrient and lifestyle strategies. They are indirect and interpretation is functional-medicine-oriented. # REVIEWER FLAG: Confirm positioning.
Why is the Metabolomix+ test ordered?
- Comprehensive functional nutritional assessment in patients with non-specific symptoms such as fatigue, low energy, or mood concerns
- Evaluation of functional B-vitamin and cofactor status to complement direct serum micronutrient testing
- Assessment of suspected gut microbial imbalance or malabsorption patterns via urinary organic-acid markers
- Functional evaluation of mitochondrial and cellular energy metabolism in integrative practice
- Patients pursuing personalised nutritional optimisation under an integrative or functional medicine practitioner
- Assessment of oxidative stress and detoxification capacity as part of a broader functional workup
- Monitoring of response to targeted nutritional intervention over time within a functional-medicine programme
Sample collection and turnaround
Sample type
Urine (random)
Fasting required
First-morning urine; specific preparatory dietary restrictions usually apply # REVIEWER FLAG: Confirm fasting/preparatory-diet requirements with Genova.
Collection method
At-home collection kit
Turnaround
10–15 business days
Collection notes
A first-morning urine specimen is collected after a preparatory period that typically restricts certain foods and may pause specified supplements. Document supplements, antibiotics, antifungals, probiotics, and medications. Follow freezing and shipping instructions precisely, as organic-acid markers are sensitive to handling. If bloodspot add-ons are included, a separate bloodspot collection is required. # REVIEWER FLAG: Confirm full collection protocol, preparatory diet, supplement washout, and which components this SKU includes with Genova before publication.
Specimen requirements
First-morning urine per Genova collection kit; bloodspot card if add-ons included. # REVIEWER FLAG: Confirm volume, preservative, storage, and shipping conditions with Genova.
What can affect Metabolomix+ results?
Many organic acids derive from or are influenced by recent food intake, so diet in the day or two before collection can substantially affect results. Specific preparatory dietary restrictions are usually required. # REVIEWER FLAG: Confirm Genova preparatory-diet instructions.
Results are creatinine-corrected to adjust for hydration, but extremes of hydration or abnormal creatinine excretion can still distort the corrected values.
Antimicrobials and probiotics alter gut microbial metabolism, changing the dysbiosis-related organic-acid markers independent of baseline status.
Vitamin supplements, certain medications, and substances such as high-dose vitamin C can directly affect specific organic-acid and oxidative-stress markers. Supplement and medication use must be documented. # REVIEWER FLAG: Confirm Genova washout guidance for supplements.
Because markers are measured in urine and creatinine-corrected, impaired renal function alters excretion and creatinine handling, affecting interpretation.
Organic acids can be sensitive to storage and shipping conditions; first-morning collection and prompt freezing/shipping per protocol are needed to preserve marker integrity. # REVIEWER FLAG: Confirm Genova collection and shipping requirements.
What do Metabolomix+ results mean?
Elevated
Elevations in specific markers are interpreted within their functional category — for example, raised dysbiosis markers suggesting microbial imbalance, accumulated energy-cycle intermediates suggesting cofactor need, or elevated functional B-vitamin markers (such as methylmalonate for B12) suggesting cellular insufficiency. Validated markers carry more weight than exploratory ones, and elevations guide nutrient and lifestyle strategies rather than establishing diagnoses.
Normal
Results within reference intervals across the categories indicate no flagged functional imbalance by the criteria applied. A normal profile supports adequate functional status in the domains assessed but does not exclude conditions outside the scope of organic-acid testing.
Reduced
Low values in most organic-acid markers are generally unremarkable or favourable, though interpretation is marker-specific. Reduced markers are read within the functional framework rather than as defined deficiency states.
Note: Metabolomix+ mixes a small number of validated markers (notably urinary methylmalonate for B12) with many organic-acid markers whose clinical validity is not established in mainstream medicine; these must be weighted very differently. Results are strongly influenced by recent diet, supplements, and gut microbial activity, and urinary neurotransmitter metabolites do not reliably reflect central nervous system neurotransmitter status. The profile is a functional nutritional assessment to guide individualised intervention, not a diagnostic test, and exploratory markers should not be over-interpreted. # REVIEWER FLAG: Reviewer to confirm the platform's positioning on validated vs exploratory markers and overall framing of this profile.
Frequently asked questions
It is a functional nutritional profile built around a first-morning urine organic acids analysis, assessing markers of gut microbial balance, mitochondrial energy metabolism, functional B-vitamin status, neurotransmitter turnover, and oxidative stress, with optional bloodspot add-ons.
How to access the Metabolomix+ test
The Metabolomix+ reference page is free and open to all practitioners. Create a free practitioner account to see pricing, save tests to your list, and generate requisition forms. Verification takes 1–2 business days.
Create Free AccountAbout this page
Published: June 3, 2026
Last reviewed: June 3, 2026
- Kumps A, Duez P, Mardens Y. Metabolic, nutritional, iatrogenic, and artifactual sources of urinary organic acids. Clin Chem. (2002)
- Lord RS, Bralley JA. Clinical applications of urinary organic acids. Part 1: Detoxification markers. Altern Med Rev. (2008)
- Lord RS, Bralley JA. Clinical applications of urinary organic acids. Part 2. Dysbiosis markers. Altern Med Rev. (2008)
- Carmel R. Biomarkers of cobalamin (vitamin B-12) status in the epidemiologic setting. Am J Clin Nutr. (2011)
This content is for licensed healthcare practitioners only and does not constitute medical advice. Clinical decisions should be based on the full clinical picture and not on any single test result.
Related tests
vitamins minerals
B12
The Vitamin B12 test measures serum cobalamin, the front-line investigation for suspected deficiency presenting with macrocytic anaemia, neuropathy, or cognitive symptoms. Low results reflect dietary insufficiency, malabsorption (pernicious anaemia, ileal disease, post-surgical states), or drug interference (metformin, acid suppression).
gastrointestinal
GI Effects Comprehensive (3-Day)
The GI Effects Comprehensive Profile is a 3-day stool panel assessing digestion and absorption, gut inflammation and immunology, and the microbiome, alongside screening for pathogenic bacteria, parasites, and yeast. It combines validated markers such as faecal calprotectin and pancreatic elastase-1 with microbiome and metabolic markers whose interpretation is more functional-medicine-oriented.