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  4. You discussed organic acids testing as markers for microbial overgrowth and discussed a test from Genova and Great Plains. Number one, I’m unclear about the usefulness of these tests and the diagnosis of gut dysbiosis. Number two, are you going to present a more complete discussion of organic acid testing in the future? If not, which lab do you recommend for complete organic acid testing?

You discussed organic acids testing as markers for microbial overgrowth and discussed a test from Genova and Great Plains. Number one, I’m unclear about the usefulness of these tests and the diagnosis of gut dysbiosis. Number two, are you going to present a more complete discussion of organic acid testing in the future? If not, which lab do you recommend for complete organic acid testing?

Chris Kresser:  So as for number one, I think if you go back and you look at the organic acid section of the training, I think I did answer that there. There are some markers that are more evidence-based than others. For example, D-lactate is a really good marker and is even being investigated as a marker for SIBO. And so I tend to put more stock in D-lactate than some of the other dysbiosis markers. So I went through which markers I think are more important and which are less important in that presentation. So you may want to refer back to that.

D-arabinitol, for example, I think is more reliable as a marker for fungal overgrowth, and that’s on  the Genova panel. Whereas arabinose, which is on the GPL, Great Plains, lab panel is not as reliable in my opinion or not as evidence-based. And so there’s some important things to be aware of. But overall what I would say is that I do take the Great Plains, or excuse me, the organic acids dysbiosis results into consideration. But if you were to construct a hierarchy now when we look at like SIBO breath testing and stool testing and then organic acids urine testing, there’s far more research behind breath and stool testing than there is behind organic acids urine testing.

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