This test is a good screening tool because of the diversity of the information it gives. From a urine sample, the laboratory measures several dozen different biochemicals which, when present at abnormal levels, are associated with metabolic dysfunction and a variety of symptoms. The causes include: disturbance of acid-base balance, suboptimal carbohydrate metabolism, inflammation, toxin exposure, impaired detoxication, oxidative stress, imbalances of neurotransmitters, and deficiencies of B vitamins, minerals, lipoic acid, carnitine, amino acids, glutathione, and coenzyme Q10. Most of the organic acids are compounds produced from normal metabolism. However, some are produced by bacteria, yeast, and parasites residing in the small intestine. When these chemicals are found in high concentration in the urine, it means that there is an overgrowth of these organisms in the intestines, their metabolic waste products are being absorbed into the bloodstream, stressing the liver, activating the immune system, circulating throughout the body, poisoning it, and then being eliminated in the urine. Some of these microbial organic acids are structurally similar to the organic acids used by the body in cellular energy production. It is theorized that the close resemblance of these microbial compounds results in a "jamming" of the body's cellular energy machinery, resulting in fatigue. In fact, patients with Chronic Fatigue Syndrome have a unique organic acid elevation in their urine. This organic acid has been found to be of bacterial origin.