Pillar 01 of 07
A window on current chemistry
Daniel Tagge, MD
Last revised 2026-09-18
Metabolism & Metabolomics.
Urinary organic acids read the upstream patterns of energy production, neurotransmitter balance, detoxification, and recovery.
The small molecules your cells produce as they make energy, build, repair and clear waste. Because they change with diet, activity, medications, the microbiome and disease, they can offer a view of what is happening biologically now. In this framework metabolomics is a foundational way of looking; in practice it is used when it adds to standard laboratory medicine.
The system
What it is, and why it matters.
- What it is
- Metabolomics tracks the small molecules your cells produce as they convert food into energy, build neurotransmitters, process hormones, and clear toxins. Organic acids in urine, amino acids in blood, fatty acids in a bloodspot, and elemental status across both. Each marker is a footprint of a real cellular process.
- Why it matters
- A standard panel tells you what is wrong. A metabolomic panel tells you what is going right and where it is breaking down. It is the difference between waiting for disease and reading the biology that produces it. When your cells are not making energy efficiently, you feel it long before any conventional marker moves.
- What I read for
- Patterns across organic acids that point to a specific bottleneck. A B-vitamin gap. A mitochondrial inefficiency. Bacterial overgrowth metabolites bleeding into the urine. Neurotransmitter precursor problems. The point is to localize the dysfunction so the intervention is targeted, not generic.
What it can look like
When this system is under strain.
None of these is specific to this system, and none of them diagnoses anything. They are the presentations in which I find this system worth reading.
- Fatigue that does not match what you would expect from your lifestyle.
- Brain fog and mood instability that come and go without an obvious trigger.
- Recovery from training that takes longer than it used to.
- Persistent inflammation, low-grade and chronic.
- A general sense that your biology is operating at 70%, not 100%.
Evidence boundaries
What can and cannot be measured.
Stated plainly, so this page never reads as a promise. The standard for how evidence is weighed is on the framework.
Can show
- Which small molecules are present in a sample now, and in what relative amounts.
- Patterns that raise a question worth checking against the history and standard laboratory medicine.
- Change over time in the same person, when the same method is repeated.
Cannot show
- A diagnosis. A metabolomic pattern is a question to interpret in context, not an answer.
- That a symptom is caused by what a profile shows.
- A validated clinical target for most markers. Commercial metabolomic and organic-acid panels are not established clinical tools for fatigue, brain fog or weight.
What clarifies it
What information tends to clarify this system.
Two ways to read this system, depending on the depth you want.
Cellular nutrition read through iron studies, B12, RBC folate, homocysteine, magnesium, zinc and vitamin D, alongside the metabolic picture.
Testing is chosen for a patient inside care, when a result is likely to change a decision, and billed by the laboratory at its own price. Explore working with Dr. Tagge.
Everyday levers
What tends to help, in general.
General levers, not a protocol. Which of them applies to a given person, in what order and at what dose, is decided in care, against that person’s history and results.
Eat whole foods, broadly
Diversity of plants is the strongest signal for metabolic resilience. Aim for 30 different plants per week.
Target specific cofactors
B vitamins, magnesium, zinc, and carnitine all sit at metabolic chokepoints. Supplement what your data says you need.
Aerobic training
Zone-2 work builds mitochondrial density. Two to four hours per week is the threshold dose.
Sleep and stress
Both shape methylation, neurotransmitter synthesis, and detoxification in ways no supplement can replicate.
Reduce the exposomic load
Heavy metals, mycotoxins, and plasticizers all consume the same enzymes you need for normal metabolism.
Read next
Go one level deeper.
- Symptoms
- Presentations this system can contribute to: brain fog, perimenopause, low libido, hair loss, erectile dysfunction, high cholesterol concern, high blood pressure concern, food cravings.
- The Report
Recent issues that covered this pillar:
- Wednesday, October 14, 2026: Two meals with the same calories and nutrients produced different insulin and brain-reward responses, and the only difference was processing.
- Monday, October 5, 2026: A two-drug senolytic combination cleared fibrosis in a small randomized liver trial.
- Friday, September 25, 2026: A single night on the wrong schedule rewrites your blood chemistry within hours.
- Terms used here
- Homocysteine · Metabolomics · Mitochondria
- Connected systems
- No system stands alone. Mitochondria & Cellular Energy · Exposomics · Epigenetics
- The framework
- How this pillar sits with the other six, the method, and the order of intervention: how I think.
Questions
About metabolism & metabolomics
- How is this different from a standard blood panel?
- A standard panel reads concentrations. A metabolomic panel reads flow. It tells me how your cells are actually using the building blocks you are giving them, which is a fundamentally different question.
- Can I do this on its own?
- Metabolomics is the core tool of the practice, and inside a membership it runs on your testing rhythm. The interpretation is most of the value, and that requires the relationship.
This system, in your case
Reading it in general is not reading it in you.
Apply, and I follow up with you personally after I have read it. You tell me what is going on. I tell you how I would approach it. You decide if I am the right physician for you. Nothing is charged when you apply.
Written by
Daniel Tagge, MD
Board-certified family physician and founder of Tagge Health. Certified in Health Optimization Medicine.
About Dr. Tagge