Skin basic profile (acne) – gut, histamine & micronutrients test

Zinc is a trace element needed for wound healing, immune defence and skin renewal. Marked zinc deficiency can show on the skin, hair and nails (PubMed 31144371). In a systematic review, people with acne had on average lower blood zinc levels than people without acne (PubMed 32860489).

A low value does not mean that zinc deficiency is the cause of skin problems. The blood level varies, for example, with inflammation and shortly after taking supplements; that is why supplements should be paused before blood collection.

Selenium is part of enzymes that protect cells against oxidative stress. In a meta-analysis, selenium levels in people with acne, psoriasis and atopic dermatitis were on average lower than in healthy people; for other skin conditions there was no difference (PubMed 32497930).

Copper and iron are among the minerals whose deficiency can show on the skin, hair and nails (PubMed 31144371). The report shows whether each value lies within the laboratory's reference range. For iron, menstruation shortly before collection affects the result.

The electrolytes sodium, potassium, calcium and magnesium are part of the mineral analysis from capillary blood. The body keeps their blood levels within narrow limits. On their own they say little about the skin; they complete the picture of mineral supply.

If an electrolyte value lies clearly outside the reference range, this should be seen by a doctor promptly, regardless of the skin question.

Histamine is formed in the gut partly by bacteria and occurs in matured foods. It is broken down mainly by the enzyme diamine oxidase (DAO) in the intestinal lining (PubMed 33921522). The report shows how much histamine is present in stool and how active DAO is.

A high histamine value or low DAO activity is linked to histamine intolerance, in which skin flushing, itching and hives are also described (PubMed 17490952). However, the condition is disputed and there is no established laboratory test for it (PubMed 38068827).

Zonulin is a protein that can loosen the connections between cells of the intestinal lining; it is therefore measured as a marker of gut permeability ("leaky gut") (PubMed 21248165). The profile measures zonulin in both stool and blood. In a study of 75 people with acne, blood zonulin levels were higher than in the comparison group (PubMed 40013532) – a single finding that needs confirmation.

Important context: according to one study, a widely used zonulin assay does not detect zonulin itself but related proteins (PubMed 29459849). The value is therefore an indication, not proof of a leaky gut wall.

The microbiome analysis describes the composition of the gut flora: diversity, enterotype, butyrate producers such as Faecalibacterium and Roseburia, Akkermansia muciniphila, yeasts such as Candida and methanogens. In a study of 43 people with acne, gut flora diversity was lower than in healthy people, and certain bacterial groups considered beneficial were less common (PubMed 29756631).

Whether these differences are cause or consequence is open. A microbiome report is a snapshot, and results from different test methods can differ considerably (PubMed 41748906).

Research uses the term "gut-skin axis" for the link between gut and skin: gut bacteria and their metabolites influence the immune system, and disturbances at one barrier can change signalling pathways at the other (PubMed 40050613). This is studied mainly in atopic dermatitis, psoriasis and acne.

For acne, reviews assume that besides skin bacteria, hormones and metabolism, the gut flora may also be involved; clinical studies on this are still few (PubMed 35889022).

Acne is an inflammatory disease of the sebaceous follicles. Increased sebum production, clogging of the pores, the skin bacterium Cutibacterium acnes and inflammation are involved; hormones, especially androgens, are an important driver (PubMed 41473651). Genetic predisposition and metabolism also play a role (PubMed 35889022).

On diet, a systematic review shows a small but measurable association between foods with a high glycaemic load and acne; for dairy the results are inconsistent (PubMed 35373155). Certain medicines and supplements, such as high-dose vitamin B6/B12, whey protein or anabolic steroids, can also trigger or worsen acne (PubMed 32941710).

No. The profile measures values linked to the gut-skin axis: gut flora, histamine, zonulin and minerals. Studies show average differences in some of these values in people with acne (PubMed 29756631, PubMed 32860489). But this does not reveal why an individual person has acne.

The diagnosis and treatment of acne are described in a European guideline and belong in a dermatology practice (PubMed 41847993). The profile can complement this treatment but not replace it.

These links between skin, gut and nutrients have been described, with varying strength of evidence:

• Acne and gut flora: lower gut flora diversity in people with acne – observed in studies, cause unclear (PubMed 29756631).
• Acne and diet: small association with a high glycaemic load – observed in studies (PubMed 35373155).
• Acne in hormonal disorders such as polycystic ovary syndrome (PCOS), often together with cycle disorders and increased hair growth – well established (PubMed 41473651).
• Rosacea: small intestinal bacterial overgrowth (SIBO) more common than in healthy people in one study – observed in studies (PubMed 18456568).
• Atopic dermatitis and psoriasis: links via the gut-skin axis – being researched (PubMed 40050613).
• Skin changes, brittle nails, hair loss with deficiency of zinc, iron, copper or selenium – well described in true deficiency (PubMed 31144371).
• Flushing, itching, hives after histamine-rich meals – described in histamine intolerance; the condition is disputed (PubMed 17490952).

These are associations from studies, not causes in an individual. The test cannot explain skin problems and does not provide a diagnosis. Persistent complaints belong in a medical assessment first, and for the skin in a dermatological one.

See a dermatologist or doctor directly if acne suddenly becomes very severe, with painful, open nodules and fever, weight loss or joint pain – this can be a rare, severe form (PubMed 21029206). The same applies to acne that leaves scars, acne with irregular periods, increased body hair or a deeper voice, and acne that appears after starting a new medicine or supplement (PubMed 32941710).

Acne can be a heavy emotional burden (PubMed 41134527). If your skin weighs heavily on you or you find yourself withdrawing, talk to your doctor. In a crisis, the German TelefonSeelsorge is available free of charge around the clock: 0800 111 0 111. Blood in the stool, unintended weight loss, fever or nocturnal diarrhoea also call for the doctor's practice first, not a self-test.

This page does not give treatment advice. Whether changes in the gut flora affect the skin is being researched; there are so far only a few studies with probiotics in acne (PubMed 35889022). There is a European guideline for the treatment of acne (PubMed 41847993).

Whether a finding means anything at all and which steps make sense depends on your whole situation – skin findings, previous results, medicines and diet. That belongs in a conversation with the ORY expert team or with your doctor or naturopath, for example from the ORY expert network. The results consultation is included in the price.

No antibiotics for at least 4 weeks and no probiotics for 2 weeks beforehand, so that the sample shows your usual gut flora. Pause supplements, especially minerals such as zinc, selenium and magnesium, for 48 hours before blood collection; take prescribed medicines as usual. If possible, do not collect blood during menstruation but 3–5 days afterwards, because blood loss affects iron values.

The stool sample must not come into contact with toilet water; a collection aid is included. Gently swirl the yellow OmicSnap tube, do not shake it; shake the dosing rod firmly, on the other hand. For capillary blood, warm your hand and discard the first drop. Send all samples together on the same day, Monday to Thursday only.

The analysis usually takes 7–21 days from the samples' arrival at the laboratory. As soon as the report is ready, you will be notified. The results consultation with the ORY expert team is included in the price.

The skin basic profile costs €518 including VAT, shipping, return shipping and results consultation.

Statutory health insurance in Germany usually does not cover analyses you order yourself. With private insurance, reimbursement is possible; how this works is described under "Reimbursement by private insurance".

The skin basic profile (€518) combines gut flora, histamine, zonulin, DAO and minerals. Individual areas are also available separately: the gut profile microbiome & gut barrier (€315), the basic gut profile (€285), Mikrobiom Maxi Plus (€285), the histamine and DAO analysis (€93) and the basic vitamin check (€98.50).

Which scope makes sense for you can be clarified in the free initial consultation.