Urinary Indican Test


The Urinary Indican Test is a simple-to-use point-of-care screening tool that allows for assessment ofdysbiosis, SIBO and malabsorption states as evidenced by the presence of indican. Also known as indoxyl sulfate, indican is produced when there is putrefaction of tryptophan from dietary protein by dysbiotic bacteria in the gastrointestinal tract.

A positive test result suggests dysbiosis and/or SIBO and/or malabsorption states, with darker shades indicating more severe dysfunctions.

Clinical Applications

Key Applications:

Also consider for:

Important Considerations


Dysbiosis is an overgrowth of unfavourable bacteria, yeasts and/or parasites in the lower digestive system (i.e. bowel). Indican (indoxyl sulfate) is a by-product of bacterial metabolism of tryptophan.6 Putrefactiveprocesses in the large intestine typically give rise to a variety of potentially toxic metabolites including phenolic and indolic compounds .7 Indole-positive bacteria that test positive for cleaving indoles from tryptophan include: Aeromonas hydrophilia, Aeromonas punctate, Bacillus alvei, most Citrobacter spp., Edwardsiella spp., Escherichia coli, Flavobacterium spp., Haemophilus influenza, Klebsiella oxytoca, Proteus spp. (excluding P. mirabilis), Plesiomonas shigelloides, Pasteurella multocida, Pasteurella pneumotropica, Streptococcus faecalis and Vibrio spp.8 Yeasts do not cause indole conversion and therefore will not show if a patient has a yeast overgrowth. Tryptophan is metabolised by intestinal bacteria to indole which in turn is oxidised to indoxyl by the liver, conjugated with sulphate, and excreted.


Dysbiosis of the small intestine may be caused by altered intestinal transit, which can facilitate theovergrowth of bacteria and contribute to malnutrition. Urinary concentrations of indole and indican, which are degradation products of tryptophan, are increased in patients with small intestinal bacterial overgrowth (SIBO). These changes, associated with bacterial overgrowth can contribute to the dysfunction of mucosal cells, impairing protein and carbohydrate absorption.


Constipation alone may permit excessive indole production and absorption from the colon.10 Constipation can cause an overgrowth of bacteria and allows for existing dysbiotic organisms to act on tryptophan forlonger.


Diet, efficiency of absorption, the qualitative and quantitative nature of intestinal flora, the rate of movement of intestinal contents and the frequency of evacuation may all affect the amount of indoxyl sulphate in the urine by influencing bowel health and bowel flora balance.


Indican excretion can also be increased in malabsorption when excessive tryptophan reaches the colon, arising from either endogenous or dietary protein. Even patients with normal intestinal bacterial populations can show increased postprandial indican excretion when they fail to digest dietary protein. The relationship between increased indican levels and incomplete digestion might be utilised as a measure of protein digestive adequacy. Therefore it is not uncommon to see a level 1 indican level in patients with normal intestinal bacteria.


  • On first meeting Shenaz, I was immediately put at ease by her comforting manner and calm and thorough composure. Her attention to detail regarding ‘finding’ the cause of my issues was obvious yet unobtrusive and very caring.

    Shenaz Morkas Read More
  • My Dear Lida, Your teachings have brought me so much on the spiritual plane and on a personal level that you have remained for me a guide to whom I make constant reference.The philosophy of Ayurveda was a revelation

    Lida Zannier Read More
  • Colleen is a gift in my life. Her connection to my personal and health issues never cease to amaze. Her care, tact and accuracy is beyond belief. Not only has she assisted in becoming a better healthier me, she has supported my husband

    Colleen Allman Read More
  • We have been seeing Madhavi kathiria for a period of more than one month. In this time my son's allergic symptoms have been resolved due to the program, help and advice we received during this time. I would recommend this as an option to

    Madhavi Katharia Read More
Make an Appointment click here.