Specialist Testing · Deeper Investigation
Metabolomix+
Comprehensive Nutritional Profile
When a standard organic acids test gives you the metabolic pathway picture but the clinical story asks for more — Metabolomix+ adds amino acid status and oxidative stress markers from the same first-morning urine collection, with an optional blood-spot add-on for fatty acid balance.
What Metabolomix+ Is
Metabolomix+ is Genova Diagnostics' comprehensive nutritional and metabolic urine test. It is not simply an organic acids test with a different name — it combines three analytical layers that no standard OAT provides in one collection: organic acid metabolites, amino acid precursors and breakdown products, and oxidative stress indicators. A fourth layer, fatty acid balance, is an optional add-on measured from a finger-prick blood spot rather than urine.
Where a standard OAT answers the question what are my metabolic pathways doing, Metabolomix+ answers the deeper question: why are they doing that, and what nutritional substrate is missing or depleted that's causing it. The amino acid layer, and the fatty acid add-on where it is ordered, are the difference — they give you the raw material picture alongside the pathway dysfunction picture.
My default is Metabolomix+, for the amino acids and the oxidative-stress markers. I use the OAT when gut-microbial markers are the main question: it reports more of them. Metabolomix+ is the organic acids test in the TDG Five-Test Programme.
Clinical positioning
Metabolomix+ is the standard organic acids test in the TDG Five-Test Programme, and my default outside it too. I use the Mosaic OAT instead when gut-microbial markers are the main question.
What It Measures — Three Layers Plus a Fatty Acid Add-On
Each analytical layer of Metabolomix+ answers a different clinical question. Understanding what each layer adds is the key to knowing when to order it.
- Krebs cycle / energy production markers
- Neurotransmitter metabolites (HVA, VMA, 5-HIAA, kynurenate, quinolinate)
- Yeast and fungal metabolites (citramalic, tartaric, D-arabinitol)
- B-vitamin functional status (methylmalonate, xanthurenate, pyridoxate)
- Detoxification and oxidative stress markers
- Mitochondrial dysfunction indicators
Similar ground to the Mosaic OAT, which reports more gut-microbial markers (including HPHPA, 4-cresol and arabinose, which Metabolomix+ doesn’t list).
- Essential amino acids (tryptophan, phenylalanine, methionine, lysine, leucine/isoleucine/valine)
- Neurotransmitter precursors (tryptophan → serotonin; tyrosine → dopamine/noradrenaline)
- Glutamic acid, glutamine and GABA (urine levels)
- Sulphur amino acids (cysteine, taurine, homocysteine pathway)
- Protein digestion markers (hydroxyproline, 3-methylhistidine)
- Urea cycle function (arginine, citrulline, ornithine)
Critical for ADHD, anxiety, depression, autism spectrum, eating disorder recovery — any presentation where neurotransmitter precursor status is clinically relevant.
- Omega-3 status (EPA, DHA, DPA)
- Omega-6 status and arachidonic acid load
- Omega-3:6 ratio (inflammatory balance)
- Trans-fatty acid markers
- Saturated and monounsaturated fatty acid balance
- Elongation and desaturation enzyme function (delta-6 desaturase activity)
Fatty acid imbalance is mechanistically relevant to ADHD (DHA and neuronal membrane function), cardiovascular risk, chronic inflammation, and mood disorders. Not measurable on any urine OAT, including the base Metabolomix+; it needs the Fatty Acids add-on.
- 8-OHdG (8-hydroxy-2'-deoxyguanosine) — DNA oxidative damage
- Lipid peroxidation markers
- Antioxidant capacity indicators
- Glutathione pathway status
8-OHdG is a marker of oxidative damage to DNA; results depend on how the lab measures it. Not on the Mosaic OAT.
The ADHD and Anxiety Case for Metabolomix+
For neurodevelopmental presentations — ADHD, anxiety, autism spectrum, developmental delays — Metabolomix+ provides a level of mechanistic detail that no other single urine test matches. The reason is the combination of organic acid and amino acid layers that bear directly on neurotransmitter function, with fatty acids (including DHA) available through the blood-spot add-on:
Key markers for neurodevelopmental presentations
HVA : VMA Ratio
Homovanillic acid and vanillylmandelic acid are breakdown products of dopamine and noradrenaline, mostly made outside the brain. Urine metabolites reflect the whole body, not brain chemistry, so I don’t use them to diagnose or explain ADHD. Both tests measure them.
Tryptophan pathway
Tryptophan is used both for serotonin and for the kynurenine pathway, which inflammation can push up. Urine 5-HIAA, kynurenic and quinolinic acid show that balance in the whole body; they don’t measure serotonin or inflammation in the brain.
DHA status
Docosahexaenoic acid is the structural fatty acid of neuronal membranes and synaptic vesicles. Low DHA impairs neurotransmitter release kinetics. ADHD research consistently shows lower DHA in affected individuals. On Metabolomix+ it needs the Fatty Acids add-on (finger-prick blood spot); no urine organic acids test measures it.
Glutamate : GABA
The amino acids include the building blocks for some brain chemicals. A urine or blood level doesn’t measure what’s happening in the brain.
Phenylalanine status
Phenylalanine → tyrosine → DOPA → dopamine. If phenylalanine is low or conversion to tyrosine is impaired (tetrahydrobiopterin cofactor issue), the entire catecholamine synthesis pathway is rate-limited upstream. This shows in the amino acid panel as low phenylalanine or high phenylalanine with low tyrosine.
Who This Test Is For
Outside the TDG programme, Metabolomix+ is not the default OAT choice for every presentation. It is the right test when the clinical picture specifically benefits from the amino acid, fatty acid, or oxidative stress layers — which means the following presentations:
🧠
ADHD and Neurodevelopmental
Adults or children with diagnosed or suspected ADHD, autism spectrum, or developmental delays where amino acid status and fatty acid balance (with the add-on) are worth checking. It doesn’t diagnose or explain these conditions; it looks for nutritional leads.
😰
Anxiety, Depression, Mood Disorders
Where nutrition is part of the question: the amino acids (including tryptophan) and the kynurenine-pathway markers can show leads worth following. They don’t measure brain chemistry.
🍽️
Eating Disorder Recovery
Restriction and compensatory behaviours create profound amino acid depletion — particularly the essential amino acids and the sulphur amino acids. Refeeding without understanding the specific depletion pattern risks under-correcting the most critical deficits. Metabolomix+ maps the full amino acid status alongside the organic acid markers of mitochondrial and neurotransmitter function.
⚡
Complex Chronic Fatigue
When the standard OAT shows mitochondrial pathway dysfunction and the clinical picture suggests profound nutritional depletion — the Metabolomix+ amino acid layer (and the fatty acid add-on, if ordered) help show whether CoQ10 precursor availability, carnitine status, and omega-3 balance are contributing to the energy production failure. 8-OHdG adds a marker of oxidative damage.
🔥
Chronic Inflammation Investigation
The 8-OHdG oxidative DNA damage marker and lipid peroxidation indicators place the Metabolomix+ alongside the standard OAT organic acid findings to give an oxidative stress picture. For clients with chronic inflammatory conditions, autoimmune presentations, or post-viral syndrome where oxidative load is mechanistically central.
🌿
Post-COVID / Post-Viral Recovery
Urine kynurenine-pathway markers can be raised with inflammation, including after an infection. They don't measure IDO activity in the tissues or the brain. Metabolomix+ adds the amino acid precursor picture (is tryptophan actually available?) and the oxidative stress markers (is ongoing oxidative damage measurable?) — together these give a more complete post-viral metabolic picture than the OAT alone.
Metabolomix+ vs Standard OAT — What's Different
| Marker category |
Mosaic OAT |
DSL OAP |
Metabolomix+ |
| Organic acid metabolites (full panel) |
✓ Full |
✓ |
✓ Full |
| Neurotransmitter metabolites (HVA, VMA, 5-HIAA) |
✓ |
? |
✓ |
| HPHPA / Clostridia markers |
✓ |
? |
✗ |
| Yeast / fungal metabolites |
✓ |
✓ |
✓ |
| B-vitamin functional markers |
✓ |
? |
✓ |
| Amino acid profile (full direct measurement) |
✗ |
✗ |
✓ Metabolomix+ only |
| Neurotransmitter precursors (direct) |
✗ |
✗ |
✓ Metabolomix+ only |
| Fatty acid balance (omega-3/6, DHA, EPA) |
✗ |
✗ |
✓ Add-on (blood spot) |
| 8-OHdG (oxidative DNA damage) |
✗ |
? |
✓ Metabolomix+ only |
| Glutamate / GABA (urine levels) |
✗ |
✗ |
✓ Metabolomix+ only |
| Collection method |
First-morning urine |
First-morning urine |
First-morning urine (+ blood spot for fatty acid add-on) |
| Client fee (Nordic) |
£318 |
£224 |
£419 |
? = not confirmed against the lab’s current list (Diagnostic Solutions Laboratory, Organic Acids Profile page, checked 15 October 2026).
When to choose Mosaic OAT instead
The Mosaic OAT costs less (£318 vs £419) and reports more gut-microbial markers, so it’s the better choice when gut dysbiosis is the main question. My default is Metabolomix+, for the amino acids and the oxidative-stress markers. I use the OAT when gut-microbial markers are the main question: it reports more of them.
Available Add-Ons
Two optional add-ons are listed below. Urine Elements uses the same first-morning urine collection; the Fatty Acids panel needs a finger-prick blood spot. Each adds a specific analytical layer for presentations where that data is clinically relevant.
Fatty Acids Panel (+£51)
Extends the lipid analysis to include a detailed breakdown of individual omega-3 and omega-6 fatty acid species, saturated and monounsaturated fatty acid balance, trans-fatty acid markers, and desaturation enzyme activity indicators. Most clinically relevant for ADHD presentations (DHA:EPA ratio and neuronal membrane function), cardiovascular risk profiling, and chronic inflammatory conditions where the specific fatty acid species driving inflammation need to be identified. The base Metabolomix+ does not include fatty acids. This add-on is how they are measured, from a finger-prick blood spot collected at home.
Urine Elements (+£100)
Measures a comprehensive panel of essential and toxic elements in urine — including heavy metals (lead, mercury, arsenic, cadmium, aluminium) and essential mineral excretion patterns (zinc, copper, magnesium, selenium, molybdenum). Urine elements reflect recent exposure and current renal excretion rather than long-term tissue burden — for that picture the Hair Tissue Mineral Analysis (HTMA) is the appropriate test. The Urine Elements add-on is most relevant when acute or recent toxic metal exposure is suspected, or when mineral excretion abnormalities may be contributing to enzyme dysfunction identified in the organic acid or amino acid layers.
Clinical note on add-ons
Urine Elements uses the same first-morning urine collection as the base test. The Fatty Acids add-on needs a finger-prick blood spot, a small extra step. The question is whether the additional data materially changes the clinical protocol. In most cases the base Metabolomix+ panel provides what is needed. Add-ons are best selected when a specific clinical presentation — heavy metal exposure history, or fatty acid status in ADHD — makes the additional markers directly relevant rather than generally interesting.
How It Works — The Process
1
Initial consultation and test selection
We discuss your health history, current presentation, and goals. If Metabolomix+ is the right test for your specific clinical picture, we confirm this in the consultation and arrange the test kit. If a standard OAT or a different test is more appropriate, we'll identify that too — the right test for your specific situation, not a default protocol.
2
Test kit collection and instructions
The Metabolomix+ kit is sent directly to your home address. Collection is a single first-morning urine sample — the instructions are clear and the collection takes under five minutes. The kit includes a prepaid return envelope to the Genova laboratory. No clinic visit required.
3
Laboratory analysis — 10 to 14 days
Genova processes the sample across each analytical layer ordered. The report is delivered to the practitioner portal as a detailed PDF with reference ranges, interpretive comments, and the results presented in integrated format. Turnaround is typically 10–14 days from sample receipt at the laboratory.
4
Results interpretation consultation
We review the full report together — not just which markers are out of range but what the pattern across the layers means clinically. The amino acid, oxidative stress and (if ordered) fatty acid findings are interpreted alongside the organic acid metabolites to build a coherent clinical picture. This integration across layers is where Metabolomix+ delivers its most distinct value.
5
Clinical protocol development
Based on the integrated findings we develop a targeted nutritional, dietary, and lifestyle protocol. For ADHD and neurodevelopmental presentations this will typically include neurotransmitter precursor support, fatty acid intervention, and gut-focused work if the Clostridia and yeast markers are significant. For fatigue presentations it will address the mitochondrial, oxidative, and nutritional depletion picture in sequence.
Pricing and Ordering
Metabolomix+ — Genova Diagnostics via Nordic Laboratories
Base test fee (client price)
£419
Add-on: Fatty Acids panel
+£51
Add-on: Urine Elements
+£100
Results interpretation consultation
£145
Base test plus interpretation
£564
Add-ons are selected at the time of ordering and added to the base test fee. Urine Elements measures toxic and essential elements in urine — useful when heavy metal or mineral excretion is clinically relevant. Urine Elements uses the same urine collection; the Fatty Acids add-on needs a finger-prick blood spot. Prices correct at July 2026 — confirm current pricing when ordering.
How Metabolomix+ Fits the Wider Investigation
Metabolomix+ is most powerful when interpreted alongside other test findings rather than in isolation. It is one layer of a clinical investigation, not a complete picture on its own.
Combined with the GI-MAP stool test: the urine dysbiosis and yeast markers are leads, and the stool test is where an organism is confirmed. No urine gut marker on either test has been validated against stool testing.
Combined with blood chemistry from a Regenerus blood panel, the fatty acid findings (when the add-on is ordered) add context to the cardiovascular risk picture — particularly when lipid markers are raised and the omega-6 load needs to be understood.
Combined with the DUTCH Plus hormone test, the OAT layer's cortisol-related organic acid markers and the oxidative stress findings from 8-OHdG together give a complete HPA-mitochondrial picture for chronic stress and fatigue presentations.
Is Metabolomix+ the right test for your presentation?
Book an initial consultation to discuss your health history and current picture. We'll identify whether Metabolomix+, the standard OAT, or a different investigation is the right starting point — and build a testing plan around your specific clinical needs.
Book a Consultation
Explore the Five-Test Programme
A note on test selection
Metabolomix+ is a powerful test in the right context. It is not a better version of the standard OAT for all clients — it is a more specific tool for specific presentations. Part of what we do in an initial consultation is identify the right tests for you rather than applying a standard protocol. The TDG approach is to test specifically, interpret clinically, and intervene on the basis of what the testing actually shows.