I was recently asked to comment on what I thought of urinary testing for neurotransmitter deficiencies.
GOTCHA! -Just checking to see if you’re awake! :O
Within the last few years, this approach to attempting to quantify what might or might not be deficient neurotransmitter-wise has gained a great deal of popularity among numerous health care providers. This type of testing can be somewhat costly, as can the “customized cocktails” later prescribed once results have been summarily tabulated and quantified. It all seems very scientific, precise and appealing. After all, isn’t lab testing the way to go?
Welllll…there are several problems with this approach.
First, let me state that I am, in fact, a big fan of lab testing for all sorts of things. I regularly look at blood chemistries from a detailed functional perspective, salivary hormone panels to measure adrenal functioning (cortisol imbalances) and others, stool antigen tests for major food sensitivities (www.enterolab.com) and urinary loading tests for iodine deficiency. The numbers can be quite a credible wake up call for many and one can repeat the test at a later time to see what results are being gotten from whatever one happens to be doing for the associated issues. Very cool stuff. I much prefer lab testing to muscle testing and other approaches by virtue of its broader acceptance, clear tangibility and trackability with clear numbers.
I have considered the urinary testing approach and was even enamored of the concept at first. Once I looked into the idea more closely, though, it just didn’t add up for me.
As seductive as the urinary hormone testing approach is, I am sorry to say that it falls short of any real accuracy and genuine usefulness for several reasons…
Neurotransmitters are not unique to the brain and, in fact, act throughout the body and brain in varying capacities and concentrations. Many people aren’t aware, for instance that 95% of all serotonin production in the body occurs not in the brain, but in the gut! Within these very separate respective systems, concentrations of neurotransmitters can vary hugely.
For example, within the brain, the amounts of serotonin found in different regions of the brain acting on different things may be completely different. Also, an isolated measurement does not take into account other variables such as what are called uptake mechanisms, receptor site sensitivity, carrier protein ratios, the type of receptor sites (i.e., D1 or D2 for dopamine), degradation rates, and agonist and antagonistic influences from other messengers (Kharrazian). In other words, it’s a complicated story. It seems to me the analogy would be akin to trying to determine what was in some compartment of your refrigerator by looking in your garbage can. The correlations seem dubious, at best.
Also, even if you could determine how much of a given neurotransmitter you had based on some form of testing how can you know just how it was being used by the brain and/or body, and where? This also doesn’t take into account something called functional variables (i.e., brain timing mechanisms) at all either, which in my experience can make a monumental difference. I, personally, was entirely freed of what had been for me a near lifetime (35 years) of intractable depression as well as anxiety and panic attacks over 12 years ago doing neurofeedback that just hadn’t responded in a sustained way to anything else. For me the core issue was actually a functional timing dysregulation, and not biochemistry.
Medications manipulate physiology by artificially adjusting things like receptor site sensitivity, synaptic cleft activity and/or reuptake mechanisms. As such, these compounds can have a profound (albeit temporary) effect on the brain’s responses to neurotransmitters but never really change quantitative laboratory measurements. In other words, Prozac can’t produce one single molecule of serotonin. When taking oral neurotransmitter precursors one can and does impact brain levels of neurotransmitters, as well-but (for instance) taking 5-HTP or L-tryptophan increases serotonin in both the central and periperal nervous system. The central nervous system and the peripheral nervous system function biochemically very separately (it’s this whacky this called “the blood-brain barrier”). You’re influencing the brain levels of serotonin, but the majority of the conversion actually takes place in the GI tract and are produced for local responses which don’t translate to the brain at all. As such, a urinary serotonin test is more likely a measurement of the neurotransmitter produced in the gut than serotonin produced in the brain. Even if you were directly testing cerebro-spinal fluid (CSF) as a means of ascertaining how much neurotransmitter was actually present in the brain (the only way of really accurately determining what is going on on that side of the blood-brain barrier) you still wouldn’t necessarily know what serotonin in the central nervous system (CNS) was specifically doing where.
I have seen the best results evaluating functional aspects of neurotransmitters by symptomatic and a more “holistic assessment”, which seems of course less glamorous, is decidedly less lucrative and may seem less appealing from a left-brained “quantitative” perspective than a “lab test”. The symptoms I look at when it comes to identifying probable neurotransmitter issues are outlined in much greater detail in my book, Primal Body-Primal Mind (pages 279-284). This has consistently yielded good to excellent results for my clients when supplementation has been approached in a careful, systematic results-oriented manner.
Most people also tend to digest poorly and may have sub-optimal levels of hydrochloric acid, leading to poor protein digestion which can subsequently lead to sub-optimal levels of amino acids/neurotransmitter precursors. As such, I tend to additionally address digestive issues with people who seem to exhibit signs of amino acid deficiency.
I have been using amino acids now to adress issues of mood, health and cognitive functioning for over 20 years. I have never used anything other than mood/symptomatic screening to guide amino acid supplementation. Results tend to be uniformly good to excellent. The sheer overwhelming complexity of amino acid/neurotransmitter activity in the human body/brain-and the compartmentalized nature of the biochemistry of each seems to best lend itself to a more functional and symptom-related evaluation. Lab testing simply falls short of the mark here.
Save yourself some dough and aggravation. Next time you’re wondering what neurotransmitters you may be short of, just take an internal inventory of how you’re feeling instead (oh-and get my book!). Relief may be closer and much less expensive than you think!