Neurotransmitter Testing—Tools for Optimal Mental Health and Wellness

Posted by Medical Board on May 5, 2021 in Uncategorized Last updated on May 20, 2021 Neurotransmitter Testing—Tools for Optimal Mental Health and Wellness

Roughly 86 billion neurons make up the brain and its complex communication center where molecules known as neurotransmitters carry chemical messages through the small gap in cells, known as the synapse.  These neurotransmitters are produced within neurons and are necessary for the many functions and processes involving the brain and body.

Neurons have three parts including the cell body that manages neuron activity, the axon that transmits messages from the cell body, and the dendrites that receive messages from neurons.  The myelin sheath protects the axon so messages can travel faster.[8] 

Neurotransmitters can either act locally on a small region of the brain or more diffusely, spread over a wide area.  Some neurotransmitters act as neurotransmitters in the brain in one region, while acting as a hormone in others.[7]

Types of Neurotransmitters and Their Function

Within the brain a multitude of neurotransmitters exist.  In fact, research suggests that more than 100 molecules meet at least some of the criteria used to define a neurotransmitter.  Seven main neurotransmitters are responsible for major function, however.  These are considered either excitatory, because they allow the brain to give commands, or inhibitory since they stop a particular action within the body.  Both are necessary for optimal function and communication between the brain and the body.[6]

The majority of excitatory and inhibitory neurotransmissions involve amino acids.[2]

Each of the following neurotransmitters plays an important role in neurotransmission.   

Glutamate—This is the main excitatory neurotransmitter that is present in 90% of the brain’s synapses.  Glutamate works to excite brain cells in order to respond to commands.  The brains neuroplasticity depends on glutamate as well.

GABA(γ-aminobutyric acid)-GABA acts as a main inhibitory neurotransmitter that reduces central nervous system activity.  This promotes a calming effect that lowers the heart rate and allows the body to fall asleep.

Dopamine—Dopamine activates the pleasure and reward centers of the brain.  It gets released whenever an activity, accomplishment or substance brings pleasure.  A dopamine feedback loop is created when we remember the reward and wish to re-create it.  One of the functions of the neurotransmitter dopamine includes its ability to support smooth motor function in the body as well.[3]

Adrenaline—Adrenaline (epinephrine) prepares the body for fight or flight.  By sending more oxygen to the muscles and increasing the heart rate the body can respond quickly to a threat.  Epinephrine and norepinephrine help control the body’s reaction to perceived or real stressors.[3]

Serotonin— The neurotransmitter serotonin helps modulate mood, sleep, appetite and emotion.[3]

This neurotransmitter works in the gut as well as in the brain.  It is one of the chemicals that helps individuals feel satisfied after eating and promotes feelings of well being and sleepiness when tired.  

Oxytocin—This neurotransmitter helps foster bonding between humans and facilitates contractions during childbirth.  Men need oxytocin to help create feelings of loyalty and trust in friendships. 

Acetylcholine—Acetylcholine makes muscles contract and affects learning and memory as well.

Neurotransmitters and Pain

One specific type of neurotransmitter known as an endorphin helps to relieve pain and create an overall sense of well-being. Endorphins are peptides that bind to opioid receptors in the body’s central nervous system.  Certain behaviors such as physical exercise, or eating can help release endorphins in the brain.[5]

What conditions are associated with neurotransmitter dysfunction?

Anxiety and Depression

Conditions such as anxiety, depression, and panic attacks are often associated with neurotransmitter imbalance.  While glutamate affects panic attack activity chronic stress is related to epinephrine and norepinephrine levels.  Phenethylamine, histamine and serotonin are also involved in neurotransmitter function associated with stress and mood. 

According to recent statistics more than 40 million Americans suffer with some type of anxiety disorder that affects their daily living and the ability to function happily and effectively.[1]

Chronic Fatigue

Long-term, persistent fatigue can be directly related to a neurotransmitter imbalance between excitatory and inhibitory neurotransmitters.

Impulsivity

Impulsivity, a feature in conditions such as ADHD and OCD often involves the chemical messengers dopamine, serotonin, and GABA.    

Insomnia

Insomnia involves a number of neurotransmitters including glutamate, histamine, dopamine, GABA and Serotonin.  When these levels are out of balance sleeplessness can occur.

PMS or PMDD

Premenstrual syndrome and the more serious premenstrual dysorphic disorder involve hormone imbalances that affect neurotransmitters including serotonin, dopamine, norepinephrine and GABA.

Schizophrenia

Schizophrenia involves thoughts and experiences that are not based in reality, disorganized thinking and speech, and concentration and memory difficulties.

What influences neurotransmitter production and balance?

There are a number of factors that contribute to neurotransmitter production and the way in which neurotransmitters function.  These include exposure to environmental elements such as heavy metals or other toxins, genetic predisposition, medications or psychological stressors.

While researchers don’t know exactly what causes some serious mental illnesses they believe that a chemical imbalance and predisposition toward the disorder may be at play.  The neurotransmitter dopamine is closely linked to schizophrenia for example, and complications during pregnancy or childbirth causing damage to the brain are also implicated in the condition.[9]

Testing for Neurotransmitters

Sometimes normal neurotransmission is interrupted because of a chemical imbalance in the brain.  Neurotransmitter testing can be done in person at a lab, or at home using a discreet prepackaged test kit.

Neurotransmitter testing measures both neurotransmitter and metabolite levels to pinpoint possible issues.

Neurotransmitter production can be measured by testing the byproducts involved in neurotransmitter metabolism.  Levels are measured in the urine and are found to correlate with both physical and mental symptoms.

Urine testing is accurate, convenient, and non invasive to patients.  Dried urine testing is efficient for testing neurotransmitter levels at various points throughout the day.

Neurotransmitter testing may measure levels of amino acids, metabolites, and neurotransmitters including:

  • Gamma aminobutyric acid 
  • Glutamic acid
  • Glycine
  • Dopamine
  • Epinephrine
  • Norepinephrine
  • Histamine
  • 5-hydroxytryptamine
  • Phenethylamine

These chemical compounds act on the limbic system to either stimulate or inhibit activity within the brain.

Depending on symptoms of a neurotransmitter imbalance, other elements may be tested as well, including hormone levels and heavy metals.  

Testing other elements related to neurotransmitter imbalances can help a physician get a clearer picture of overall health and types of treatment necessary for specific conditions.

Hormones

Hormone levels can directly affect neurotransmitters and the way in which they work to either excite or inhibit the central nervous system and its function.   

Heavy Metals

Heavy metals can damage brain health and affect the neuropathways involved with neurotransmitter function.  Oxidative stress can harm nerve cells and cause mood and memory disorders.   

Dried urine testing is convenient and easy with an at-home test kit.  Neurotransmitters or their metabolites can be evaluated through a certified partner laboratory and may include testing for:

GABA, Glu, Gly, DA, Epi, NE, HIST, 5-HT, PEA, DOPAC, HVA, 5-HIAA, NMN, VMA Trp, Kyn, 3-OHkyn, Tau, Gln, His, N-MeHist, Tyra, KynAc, Xanth, Tyr & Crtn 

Additional tests for hormone levels can be added as well including:

E2, Pg, T, DS & C Epi-T, DHT, DHEA, & 5α,3a

Cortisol and melatonin may also be tested, as well as essential elements, I, Se, Br, Li, As, Cd & Hg 

Medications to treat neurotransmitter imbalances include:

  • Selective serotonin reuptake inhibitors (SSRIs).  This type of medication works by interfering with the reabsorption of serotonin in the body.  Common SSRI’s include fluoxetine, paroxetine, and citalopram.
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs). These work by blocking the reabsorption of norepinephrine and serotonin.  These include duloxetine, venlafaxine.
  • Tricyclic antidepressants (TCAs). These antidepressants treat depression by blocking noradrenaline and serotonin in the brain.  These include imipramine and nortriptyline. 
  • Norepinephrine-dopamine reuptake inhibitors (NDRIs). These block the reabsorption of norepinephrine and dopamine and include the drug, bupropion.
  • Monoamine oxidase inhibitors (MAOIs).  This class of drugs interferes with the reabsorption of norepinephrine, serotonin, and dopamine.  These medications include isocarboxazid and phenelzine. 

Psychotherapy including cognitive behavioral therapy and psychodynamic therapy may also help support treatment for a neurotransmitter imbalance.

Natural Support for Neurotransmitter Dysfunction

In cases of anxiety and depression neurochemistry plays a major role in neurotransmitter imbalance and is complex.   Both conditions involve the neurotransmitters dopamine and serotonin and are interrelated. 

Issues such as aging, hormonal changes, illness, vitamin and mineral deficiencies, major life changes, and overconsumption or use of stimulants, or depressants can cause chemical structures within the brain to change. This can lead to neurotransmitter dysfunction and mood disorders.[1]

Certain disorders, substances and behaviors can alter the way in which the brain functions by stimulating or blocking the neurotransmission of cells between each other.  Normally there is a cycle of release, break up and re-entry of neurons.  Addictive drugs however, cause neurotransmission activity to highly increase or decrease beyond normal limits.[4]

Diet, lifestyle changes, specific therapies and nutrient support can play a significant role in treating both anxiety and depression in adults.  

Natural treatment for anxiety and depression may involve one or more of the following:

  • Massage therapy
  • Yoga
  • Cognitive behavioral therapy
  • Meditation and breathing
  • Botanicals and herbs
  • Vitamin and mineral supplementation
  • Dietary changes
  • Exercise

The following natural substances include amino acids, minerals, fatty acids and botanicals and may help relieve anxiety and depression:

5-hydroxytryptophan (5-HTP)—The precursor for tryptophan increases serotonin level while, nutritional D, L-phenylalanine and L-tyrosine further support the reduction of anxiety.

Theanine—This amino acid found in green tea helps increase GABA and dopamine production, both of which promote a calmer mood and reduce anxiety.

Magnesium and Calcium—In controlled clinical studies magnesium taken together with calcium is shown to reduce anxiety in some individuals.

Selenium—Supplementing with the nutrient selenium has been shown to support the reduction of anxiety. 

Omega-3 fatty acids—Omega 3 fatty acids are known to promote elevated mood and reduce the risk for anxiety.

Vitamin C—Vitamin C helps reduce oxidative stress and limits cortisol in the bloodstream, which reduces anxiety.

St. John’s wort—This perennial plant found in many parts of the world including North and South America, Europe and Asia has been successful in reducing depression in some individuals. 

Ginkgo biloba—Extracts from Ginko biloba activate GABA pathways and reduce anxiety in humans.

Ashwagandha—This herb, which contains anti-inflammatory properties, may reduce anxiety in individuals.

Kava kava—This comes from the Piper methysticum plant that binds to GABA (Gamma-Aminobutyric Acid), dopamine, and opiate receptors.  These have shown the ability reduce anxiety in some individuals.

Valerian root—extracts form this plant have been shown to reduce anxiety in individuals when taken as a supplement.

GABA(Gamma-Aminobutyric Acid) —This neurotransmitter is naturally found in herbs and plants and works by reducing excitability in the neuro network involved with stress and anxiety.  It further increases delta brain waves associated with relaxation and calm.

What should I eat to help balance neurotransmitters naturally?

A number of foods contain natural neurotransmitters including acetylcholine, the modified amino acids glutamate and γ-aminobutyric acid, and biogenic amines dopamine, serotonin, and histamine.

These are powerful compounds that positively affect mental health and promote an overall sense of wellbeing.

  • Acetylcholine 
  • Squash
  • Spinach
  • Peas
  • Mung bean
  • Bitter orange
  • Wild strawberry
  • Radishes
  • Glutamate
  • Meats 
  • Seafood
  • Seaweeds 
  • Cheeses
  • Tomato
  • Salami
  • Mushrooms
  • Spinach
  • GABA
  • Oat
  • Barley
  • White, Red, brown, black rice
  • Buckwheat
  • Soya beans
  • Spinach
  • Potato
  • Kale
  • Broccoli
  • Chestnut
  • Dopamine
  • Bananas
  • Plantains
  • Avocado
  • Serotonin
  • Pepper
  • Paprika
  • Tomato
  • Cherry tomato
  • Hazelnut
  • Plum
  • Kiwi
  • Chinese cabbage
  • Pomegranate
  • Green onion
  • Strawberry
  • Chicory
  • Lettuce

If you suspect you may have a neurotransmitter imbalance talk with your doctor about neurotransmitter testing, or order an at-home test kit and share the results with a healthcare provider.  Healthy neurotransmitter function is important for both physical and emotional well-being as well as optimal neurocognitive function.

References

1Alramadhan, E., Hanna, M., Hanna, M., Goldstein, T., Avila, S., & Weeks, B. (2012, April). Dietary and botanical anxiolytics. Retrieved May 01, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3560823/

2Amino acid Neurotransmitters (SECTION 1, CHAPTER 13) Neuroscience online: An electronic textbook for The NEUROSCIENCES: Department of neurobiology and anatomy – the University of Texas medical school at Houston. (n.d.). Retrieved May 01, 2021, from https://nba.uth.tmc.edu/neuroscience/m/s1/chapter13.html

3MAOA gene: MedlinePlus Genetics. (2020, August 18). Retrieved May 01, 2021, from https://medlineplus.gov/genetics/gene/maoa/

4National Institute on Drug Abuse. (2021, April 05). Impacts of drugs on neurotransmission. Retrieved May 01, 2021, from https://www.drugabuse.gov/news-events/nida-notes/2017/03/impacts-drugs-neurotransmission

5NCI dictionary of Cancer TERMS. (n.d.). Retrieved May 01, 2021, from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/endorphin

6Purves, D. (1970, January 01). Two major categories of neurotransmitters. Retrieved May 01, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK10960/

7Purves, D. (1970, January 01). What defines a neurotransmitter? Retrieved May 01, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK10957/

8Therapy manuals for drug addiction. (n.d.). Retrieved May 1, 2021, from https://archives.drugabuse.gov/sites/default/files/manual4_1.pdf

9What causes schizophrenia? (n.d.). Retrieved May 01, 2021, from https://www1.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-w-whatschiz-toc~mental-pubs-w-whatschiz-cau

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