I am often asked why we need to complete testing to help optimize neurotransmitter levels and if we need to do testing, how many tests will be necessary to achieve success. The answer to this question isn’t as straight forward as most people would like. Here’s why. (more…)
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Organic Cation Transporter Assay Interpretation: www.labdbs.com
Lymphocyte Response Assay (food hypersensitivity testing); www.elisaact.com
With all of these ways to throw your neurotransmitter levels out of balance, you may think it would be impossible to address them all. Luckily this isn’t so.
There are really only two major effects that all of the causes of neurotransmitter imbalance listed above have on the body. They either (1) cause a decrease in the amount of neurotransmitter available or (2) they cause damage to the post-synaptic neuron. In the first case, restoring proper neurotransmitter levels using amino acid therapy can quickly and effectively eliminate the relative deficiency and alleviate symptoms. In the second, more directed therapy, often requiring specific testing can make up for the damage and restore proper function.
Neurons are intended to function for life. Loss of a neuron to cell death is permanent. As damage to the receptors and neurons progress the neuron’s function slowly fades until neurotransmitter production decreases and eventually stops over time.
A nerve is made up of many neurons, often called a nerve bundle. As individual neurons fade and/or die, the amount of neurotransmitter sent through a nerve bundle decreases, as depicted here:
As this process continues, a person will experience more and more symptoms of imbalance; these can include mood swings, headaches/migraines, OCD tendencies, decreased focus/concentration, decreased memory, anxiety, sleep imbalances, hormone imbalances, food cravings and increased pain amongst other symptoms.
As we discussed earlier, the only way to increase neurotransmitter levels in the brain is to take amino acids (along with the necessary cofactors) which can cross the blood brain barrier where they can then be made into neurotransmitters. Increasing neurotransmitter levels through the neurons is analogous to increasing the voltage in an electrical wire, where by turning up the voltage you get more electricity out the other end of the wire.
It may help to think of it like this: when neurotransmitter disorders are present, some of the neurons within the nerve bundles are damaged to the point that the electricity flowing out of them is diminished to the point where symptoms develop. Increasing neurotransmitter levels through the administration of properly balanced amino acid therapy will effectively increase the voltage in the remaining viable neurons in the bundle. This causes the electrical flow out of the damaged nerve bundles to increase to the point that normal regulation and/or control is once again observed. In this state, from a clinical standpoint, the symptoms of disorder are under control.
If this all sounds like Charlie Brown’s teacher (i.e., “Wah, wa, Wah…”) try this: There isn’t a feedback loop in the brain for neurotransmitter production. Therefore, even if 50% of the neurons in a nerve bundle are damaged or destroyed, if we give the remaining neurons more amino acids (in the right dosages), the remaining healthy neurons will manufacture more neurotransmitters, effectively alleviating symptoms and restoring normal function.
In essence, we give the healthy neurons what they need to make up for the damaged ones; when we get the balance right, it’s as though the damaged neurons don’t exist and you function normally.
Everything seems pretty easy and straight-forward up until this point – it would seem that if you give the body amino acid precursors, it should make the respective neurotransmitters in a relatively straightforward fashion:
Illustration taken from Marty Hinz, MD.
However, achieving proper neurotransmitter balance can be very difficult to do. This is because there are several steps during the conversion of amino acids into their respective neurotransmitters and in the degradation (or breakdown) of neurotransmitters where there is a competition of sorts for precious resources.
Figure 1 shows how tyrosine is converted into dopamine, norepinephrine and epinephrine and how tryptophan is converted to serotonin. The important thing to see is that the enzyme needed for these conversions is the same (i.e., aromatic amino acid decarboxylase). This means that tyrosine competes with tryptophan (or 5-HTP) to be converted into dopamine or serotonin, respectively. This may not seem like that big of a deal in theory, but in practice it often makes the difference between not seeing any results or the complete resolution of symptoms.
Figure 1: The synthesis of serotonin, dopamine, norepinephrine (noradrenaline), and epinephrine (adrenaline) from amino acid precursors.
Here’s why: because tyrosine and 5-HTP compete with each other for this enzyme taking the improper balance of either amino acid can cause a substantial imbalance in their respective neurotransmitters. Said differently, if you take only 5-HTP or L-tyrosine they will compete with and inhibit the synthesis of the opposite precursor because they compete for this enzyme. This means that if you take only 5-HTP (to increase serotonin) or only L-dopa or L-tyrosine (to increase dopamine levels) you will decrease the synthesis of the other neurotransmitter (dopamine or serotonin respectively).(1) Over time, this will lead to or increase the neurotransmitter imbalances present.
In addition, there are many interactions noted in the literature between amino-acids and neurotransmitters:
Illustration taken from Marty Hinz, MD.
One look at this figure and you can easily see that even though 5-HTP and L-tyrosine are made into serotonin and dopamine, respectively, they also have a number of other effects. Because of this, the odds of a person guessing the correct blend of amino acids necessary to address their specific issues are virtually zero.
This is why it is so important to work with a health care professional that is trained in the proper use of amino acid therapy: you have to take properly balanced amino acids when you are attempting to improve neurotransmitter function. If you take only one amino acid precursor, the administered amino acid will dominate the enzyme and compromise proper production of the other system’s neurotransmitters, creating further imbalance, which can lead to more and greater symptoms. The same is true if you take an improperly balanced amino acid formula. This is where conducting proper urinary testing can become very important.
Each neurotransmitter is made from a specific amino acid through a series of steps that require specific nutrients (called cofactors). Taking these amino acids and cofactors is the only way to improve neurotransmitter levels and function in the brain because the neurotransmitters themselves cannot cross the blood-brain barrier.
Picture from Marty Hinz, MD: www.neuroassist.com
Neurotransmitter systems
Neurotransmitters are either inhibitory or excitatory in their effect on the nervous system. Because of this, they work in opposing pairs to make sure the body’s systems stay in balance. There are several of these systems set up in the body; the two most studied are the serotonin-catecholamine system and the GABA-glutamate system.
Serotonin is a key inhibitory neurotransmitter in the body; dopamine, norepinephrine and epinephrine, collective known as the ‘catecholamines’ are key excitatory neurotransmitters. The serotonin-catecholamine system has a role, either directly or indirectly, in controlling most of the other systems and functions in the body. For example, cortisol synthesis, hormone synthesis and the sympathetic nervous system are all controlled by norepinephrine; mood, body temperature and sleep are regulated by serotonin and norepinephrine; and focus, concentration, memory and fine-motor skills are controlled by dopamine.
Anxiety control – using neurotransmitter system priority to find a lasting solution
In addition, other neurotransmitter systems are partially controlled by the serotonin-catecholamine systems. For example, the GABA-glutamate neurotransmitter system is associated with control of anxiety and panic attacks. Because of this, most of the medications prescribed to treat anxiety and/or panic attacks work on GABA receptors; these drugs include lorazepam (Ativan), clonazepam (Klonopin), diazepam (Valium) and alprazolam (Xanax). These drugs may help reduce the feeling of anxiety in the short-term, but do not provide lasting relief and can lead to dependence and withdrawal reactions.
Interestingly, a longer-term approach may be found if we look at the priority of neurotransmitter systems. It appears that the GABA-glutamate system is at least partially controlled by the serotonin-catecholamine system. This was discovered through clinical evaluation; when the serotonin and catecholamine neurotransmitter levels are brought to proper levels (as confirmed through laboratory testing), anxiety and panic attacks usually resolve. This indicates control of the GABA-glutamate system by the serotonin-catecholamine system even though at this time we have been unable to identify a chemical pathway for such in the literature.
Based on our clinical observation (and the observations of others, including Marty Hinz, MD), it is our assertion, that it is possible to restore proper balance to GABA-glutamate system by first addressing imbalances in the serotonin-catecholamine system. This means that the best amino acids to control symptoms of anxiety are not GABA or glutamate as they work with the secondary system. The best amino acids to use would be 5-HTP (or L-tryptophan) and L-tyrosine so that we influence the primary serotonin-catecholamine system. Doing so restores proper functioning by getting to the root cause and provides a long-term solution. In the rare case that optimal functioning of the serotonin-catecholamine system is achieved and symptoms are still present, then one can address any remaining imbalances in the GABA-glutamate system much more easily and directly.
Hormone imbalances – Addressing the cause to find the proper solution
Interestingly we have found the same to hold true with many hormone imbalances. We have noted previously that neurotransmitters are chemical messengers in the body that control bodily functions. Hormones represent another class of chemical messengers. In regards to hormone imbalances, we have found that if we balance the serotonin-catecholamine system as a first course of action (i.e., serotonin and dopamine), many symptoms associated with hormone imbalance (e.g., hot flashes, mood swings, irregular menses, etc.) often resolve or are reduced. Therefore, it is our assertion that in most cases, the serotonin-catecholamine system needs to be balanced first (or at the very least in concert with hormones) in order to properly manage symptoms of hormone imbalance. Once optimal neurotransmitter function is achieved, any remaining hormone imbalances can then be clearly defined and addressed.
In either case, the important thing is to keep looking upstream to find the root imbalance so we can achieve a lasting solution. Only by determining and addressing the root cause can we eliminate symptoms for the long term. In many cases, this means getting the serotonin-catecholamine system to function properly first; the best amino acids to do this are 5-HTP (or L-tryptophan) and L-tyrosine. Once the serotonin-catecholamine system is in balance any remaining imbalances can then be easily identified and addressed.
