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Neurotransmitter Frequently Asked Questions

Neurotransmitters are powerful chemicals that regulate numerous physical and emotional processes such as mental performance, emotional state, physical energy, and pain response. Imbalances in certain neurotransmitters are associated with most of the prevalent symptoms and conditions seen in practitioners offices today.

  • Depressed mood
  • Anxiety
  • Adrenal dysfunction
  • Fatigue
  • Poor sleep
  • Loss of mental focus, or cognitive fog
  • ADD, ADHD
  • Addiction or dependency
  • Loss of appetite control
  • Compulsive behavior
  • Cravings
  • Low libido
  • Sexual dysfunction

Adrenal hormones, sex hormones, and neurotransmitters are functionally interrelated. Changes in sex hormones and adrenal hormones can lead to neurotransmitter imbalances. In turn, neurotransmitter imbalances can affect hormone function. Including neurotransmitters with hormone panels provides a more comprehensive view of the body’s functional neuroendocrine status, this interrelationship, and the associated factors that may be contributing to symptoms.

When attempting to balance neurotransmitter levels by supplementing with amino acids and nutrient cofactors there are many factors that can affect how long this can take. The imbalances were likely created over an extended time of influence from stress, poor diet, lifestyle, and other factors. A natural supplementation therapy can be very effective, but can also take time.

Retesting at 2 to 3 months is recommended to monitor progress and make adjustments to therapy. Some patients may require monitoring and adjustments to therapy again at 6 months. Depending on a patient’s health and adherence to therapy, the balancing process can often be achieved within 12 months, yet balancing neurotransmitter levels is an individualized process.

Initial follow up testing is recommended at 2 to 3 months after treatment is initiated. Exact times for retesting to monitor treatment progress will vary depending on the individual patient and their health status. Read more under “How long does it take to balance neurotransmitters?”

Depending on dosage and other patient specific factors, you may see increased neurotransmitter levels higher in patients taking an SSRI or SNRI. However, if a person has been on the medication for an extended period of time, levels can begin to present lower than expected. Since the neurotransmitter levels are being influenced by the SSRI/SNRI, it can take up to two months of nutrient supplementation to establish natural production of neurotransmitters. You will want to see serotonin test results at the high end of the reference range before considering titrating the SSRI.

The norepi/epi ratio reported on Labrix test results provides insight on how well the norepinephrine to epinephrine conversion process may be working. An elevated ratio indicates there may be factors limiting the synthesis. The elevated ratio can be a result of high norepinephrine or low epinephrine.

Factors contributing to poor norepi/epi conversion can be adrenal dysfunction and poor methylation. It is recommended to test cortisol levels when the norepi/epi ratio is elevated.

Together, the effects of cortisol, epinephrine, and norepinephrine engage system-wide defense mechanisms, fostering mobilization through processes such as secretion and distribution of glucose and stored energy, in part through inhibition of insulin secretion and promotion of insulin resistance. While the epinephrine and norepinephrine responses are rapid and fairly short lived, the cortisol effect lasts for hours and helps the body repair damage and reduce inflammation.

Serotonin is a key component for hypothalamic stimulus of ACTH, which in turn, is necessary for the release of cortisol and DHEA. Insufficient supply of serotonin will lead to an insufficient release of cortisol.

Cortisol, epinephrine, and norepinephrine work together to engage system-wide defense mechanisms, fostering mobilization through processes such as secretion and distribution of glucose and stored energy. As adrenal dysfunction develops, the catecholamines will elevate as a compensatory action to manage fatigue and stress.

Addressing neurotransmitter imbalances is an essential component of the successful treatment of adrenal dysfunction. For more information refer to the “Neurotransmitter Disruption & Adrenal Dysfunction” document in the Materials and Resources section.

Cortisol has numerous important roles, including epinephrine synthesis in the adrenal medulla. Produced in the cortex, cortisol reaches the adrenal medulla and at high levels, the hormone can promote the up regulation of phenylethanolamine N-methyltransferase (PNMT), thereby increasing epinephrine synthesis and secretion.

Together, the effects of cortisol, epinephrine, and norepinephrine engage system-wide defense mechanisms, fostering mobilization through processes such as secretion and distribution of glucose and stored energy, in part through inhibition of insulin secretion and promotion of insulin resistance. While the epinephrine and norepinephrine responses are rapid and fairly short lived, the cortisol effect lasts for hours and helps the body repair damage and reduce inflammation.

Eating foods, drinking fluids with alcohol, sugar, or any kind of flavoring can all increase neurotransmitter activity in a variety of ways. Exercise can have effect on the production of serotonin, dopamine, and norepinephrine. The objective for sample collection is to collect when there has been little to no influence that could increase neurotransmitter activity.

For 48 hours before and during the collection, avoid eating avocados, eggplant, tomatoes, bananas, melons, pineapple, grapefruit, plums, nuts, nut butters, wine, cheese, and chocolate.

For 24 hours before and during the collection, avoid strenuous exercise, alcohol, coffee, tea, and tobacco. It is preferable to be off medications, including those that regulate allergy, mood, sleep, pain, and inflammation NEVER discontinue prescription medications without first consulting your physician.

Do not take any supplements on the day of testing until after sample collection.

The night before collection, don’t eat anything after you’ve eaten your dinner. Collect your urine sample before you eat again in the morning.