Clinical applications of urinary organic acids. Part I: Detoxification markers

Altern Med Rev. 2008 Sep;13(3):205-15.


Modern instrumentation allows the measurement of organic acids in urine in their physiological concentration ranges. Eight of the compounds that are reported can serve as markers for specific toxicant exposure or detoxification challenges. Xylene exposure causes elevation of 2-methylhippurate, and orotic acid elevation reveals ammonia challenge that exceeds the capacity of the urea cycle. General hepatic detoxification stimulation by natural compounds, drugs, or xenobiotic compounds causes elevated levels of glucaric acid. Abnormalities of alpha-hydroxybutyrate, pyroglutamate, and sulfate can indicate up-regulated glutathione biosynthesis, impaired reformation of glutathione in the gamma-glutamyl cycle, and depleted total body glutathione status, respectively. Patterns of these compounds measured in a simple overnight urine specimen help to identify focal areas of clinical concern and monitor patient responses to detoxification interventions.

Publication types

  • Review

MeSH terms

  • Benzoates / urine
  • Biomarkers / urine*
  • Environmental Exposure
  • Environmental Pollutants / pharmacokinetics*
  • Glucaric Acid / urine
  • Hippurates / urine
  • Humans
  • Hydroxybutyrates / urine
  • Inactivation, Metabolic*
  • Orotic Acid / urine
  • Pyrrolidonecarboxylic Acid / urine
  • Sulfates / urine


  • Benzoates
  • Biomarkers
  • Environmental Pollutants
  • Hippurates
  • Hydroxybutyrates
  • Sulfates
  • 2-methylhippuric acid
  • Orotic Acid
  • 2-hydroxybutyric acid
  • Glucaric Acid
  • Pyrrolidonecarboxylic Acid