Innovative Neurotransmitter TestingMay 2017
By Scott Fogle, MD
LE: Life Extension® has always been at the forefront of presenting innovative lab tests that aren’t always available from mainstream doctors. Are there any new tests on the horizon?
Dr. Fogle: Yes. We are pleased to introduce neurotransmitter testing, an innovative test that looks at the balance of chemical messengers in your brain. The results from this urinary test can offer important insight into numerous health issues that may be difficult to assess by standard blood testing.
LE: What are neurotransmitters, and why are they important?
Dr. Fogle: Neurotransmitters are powerful chemical messengers, just like hormones. When neurotransmitters are out of balance, it affects mood, cognition, attitude, coping skills, energy, sleep, overall health, and more. At Life Extension, we have always encouraged people to balance their sex hormones, such as testosterone, estrogen, progesterone, DHEA, and pregnenolone. We receive positive feedback from customers around the world that balancing sex hormones has helped change their lives. These customers report improvements in mood and well-being as well as healthy changes on blood testing markers. Now people can do the same thing with neurotransmitters! This scientific approach to wellness is something that very few doctors offer to their patients. Yet clinical experience has shown that balancing both sex hormones and neurotransmitters is a strategy for feeling great, functioning optimally, managing stress better, promoting longevity, and just feeling more vibrant and healthy.
LE: Who should have this type of neurotransmitter test done?
Dr. Fogle: It is especially important to get your neurotransmitters tested if you are experiencing issues such as mood disorders, depression, anxiety, adrenal issues, fatigue, insomnia, loss of mental focus, ADD, ADHD, brain fog, addiction, poor impulse control, hormonal imbalances, cravings, irritable bowel syndrome (IBS), headaches, cognitive dysfunction, chronic pain, and insulin resistance, to name a few.
But in general, this test is also beneficial for anyone who is not feeling optimal. If you wake up feeling fantastic and go to sleep easily, then your neurotransmitters are probably well-balanced and you don’t need to bother testing them. If you do not feel that way, then it is a good idea to test and see how balancing your neurotransmitters can help bring those positive attributes back into your life.
LE: Why don’t more doctors check neurotransmitters?
Dr. Fogle: From my experience, doctors are overwhelmed with information these days and too often reach for the prescription pad rather than think outside the box. If I could change the healthcare industry, I would make it so everyone gets both sex hormones and neurotransmitters tested every year. By balancing both of these important and vital chemical communicators in the body, many diseases could be prevented, saving pain, heartache, and billions of healthcare dollars, and ultimately enhancing lifespan.
LE: What neurotransmitters are included in the test?
Dr. Fogle: This test measures serotonin, dopamine, epinephrine plus glutamate, norepinephrine, and GABA. These are the most important neurotransmitters, and they represent both the excitatory and inhibitory aspects of neurotransmitters. Think of neurotransmitters like the gas pedal and brake pedal on your car. Your nervous system needs a balance of both excitatory (the gas pedal) and inhibitory (the brake pedal) neurotransmitters to function optimally. One of the biggest problems in today’s society is that too many people are pressing down too heavily on the gas pedal, yet barely touching the brakes. This leads to elevated epinephrine, norepinephrine, and glutamate (the excitatory neurotransmitters) and low GABA (the primary inhibitory one) and low serotonin. This imbalance makes you feel depressed, irritated, negative, and tired, but at the same time, you cannot sleep or rest well because the excitatory neurotransmitters are too high. That person will continue to struggle with these symptoms until neurotransmitters are brought back into balance. Making matters worse, out-of-balance neurotransmitters can often push hormones out of balance as well.
LE: Have you seen neurotransmitter testing work in clinical practice?
Dr. Fogle: Since I saw such good results with hormone testing, I was one of the first doctors to start doing specialty neurotransmitter testing many years ago. I tried it out on my staff first. A young female staff member was gaining weight, feeling irritable and anxious, had low libido, no energy, no desire to exercise, and craved carbs nearly every evening. Her results showed major imbalances in her neurotransmitters, especially with low serotonin. We targeted those imbalances with the appropriate nutrients to support serotonin and GABA, and within a week her mood picked up dramatically, she felt more positive, slept better, experienced increased libido, was less irritable, and had more willpower to resist the carbs in the evening. In another week, she was feeling so much better that she was motivated to start working out and losing weight. I have since used this test with many patients and have been impressed with the results. I’m amazed these tests are not utilized more widely to help restore people back to good health.
LE: Should people do neurotransmitter testing in place of sex hormones?
Dr. Fogle: Ideally, people should test both since they are different types of chemical messengers that communicate with the body. If someone already has done hormone testing and treatment but still thinks they could feel even better, then neurotransmitter testing is the next step to discovering more about how to balance their individual biochemistry for optimal health. Testing both neurotransmitters and sex hormones provides a much more comprehensive view of the body’s functional neuroendocrine status, and it brings to light additional factors that may be contributing to symptoms. For example, low estrogen can lead to low dopamine in a woman and can cause serotonin receptors to be less responsive. Low progesterone can contribute to low GABA receptor activity. Serotonin is involved in the release of ACTH and proper cortisol response. The connections between hormones and neurotransmitters could fill a book. Only by testing both can you get a more complete picture of your individual biochemistry.
LE: How are sex hormones different from neurotransmitters?
Dr. Fogle: Both are powerful chemical messengers. They differ in their molecular structure in that sex hormones have a steroid base and neurotransmitters are more amino acid based. Hormones act more globally on tissues, and especially on DNA in the nucleus of our cells. This makes sex hormones very powerful and important because they interact with our DNA to turn on and off important genes. On the other hand, neurotransmitters act in the synapses of the nerves, such as in the central nervous system (CNS). Since the CNS/brain drive communication to the rest of the body through hormones, it makes physiological sense to balance both. Neurotransmitter and hormones work together, and if they aren’t working together you will feel the negative effects.
LE: So, like sex hormones, the neurotransmitter testing helps provide a targeted approach customized to your unique biochemistry?
Dr. Fogle: Exactly. Some people need more support for the excitatory neurotransmitters while others need more inhibitory support. People need different natural ingredients to support balance in their individual neurotransmitter pattern. The same natural support that can make one person feel fantastic can make another person feel worse. Hence, the importance of testing them just like testing hormones.
LE: Some drugs work via neurotransmitters right?
Dr. Fogle: Correct. Antidepressant drugs like Prozac inhibit the reuptake of serotonin in the synapses to help prolong its effect. Barbiturates and benzodiazepines both bind to GABA receptors to augment GABA-mediated responses. Wellbutrin acts as a relatively weak inhibitor of the neuronal uptake of norepinephrine, serotonin, and dopamine, thus keeping more of those specific neurotransmitters in the neural synapse longer. I have seen all these drugs work effectively for some people, but I have also seen them cause unpleasant side effects in other people. Also, due to genetics, people metabolize these drugs differently, which helps explain why some medications might be life-changing for one person, but can cause a negative reaction in another person.
LE: That leads me to my next question. Are there natural ingredients that can help support neurotransmitters?
Dr. Fogle: Amino acids, plant extracts, vitamins, hormones, and other natural ingredients can support healthy neurotransmitter levels. For example, tryptophan or 5-HTP helps with serotonin formation. Tyrosine supports the formation of the catecholamines such as dopamine and epinephrine. Plant extracts such as saffron, the Chinese orchid Gastrodia elata, curcumin, adaptogenic herbs like rhodiola, and more can benefit neurotransmitter balance. In addition, cofactors such as vitamins are important for the transformation of precursors into neurotransmitters. For example, if someone has low dopamine, insufficient activated vitamin B6 (P5P) could be to blame since it is a necessary cofactor needed for dopamine formation. Testing allows you to see which neurotransmitters need support, and then identify specific amino acids, cofactors, and other natural ingredients to help restore balance. A targeted approach based on testing dramatically increases success.
LE: Do you recommend combining conventional treatment with natural alternatives?
Dr. Fogle: If you’re already being treated for a condition, it’s important to work with your doctor, especially if you are on a prescription medication. However, more doctors are becoming open to working with educated patients, especially if they have lab results showing their neurotransmitter levels are out of balance.
One of the first patients I tested was a woman on an antidepressant medication. She complained of weight gain and low libido, both known side effects of her medication. When I tested her neurotransmitters, she had extremely low serotonin levels. We did a therapeutic trial of natural serotonin support, and I monitored her carefully. She responded great, and she worked with the doctor who prescribed the antidepressant to slowly wean her off it as she improved. Her mood and libido improved, and she felt more motivated to work out, which is another powerful way to improve mood and health. I love to see vicious negative cycles broken and replaced by positive changes that lead to more and more improvements in someone’s health, and I have seen hormone and neurotransmitter testing do just that.
LE: We have talked about how neurotransmitters and hormones influence each other. What other factors could cause an imbalance in neurotransmitters?
Dr. Fogle: Many seemingly unrelated conditions can have a profound impact on neurotransmitter balance. For example, chronic inflammation can cause depression through the neuromodulating effects of inflammatory molecules called cytokines. These same cytokines are the ones that make you feel lethargic and antisocial when you have the flu. In chronic inflammation, the brain has to contend with a continuous onslaught of mood-altering cytokines leading to melancholy and anxiety. For example, the inflammatory cytokines interferon regulatory factor (IRF), interferon-alpha (INF-a), and NF-kB can activate an enzyme that breaks down tryptophan, the precursor to serotonin, thus leading to depleted brain levels of this important mood-supporting neurotransmitter. This effect of lowering serotonin explains why being sick makes us feel terrible, depressed, and moody.
Gut inflammation resulting from imbalances between beneficial bacteria and harmful microbes, poor food choices, or food allergies can also impact neurotransmitters. To underline the importance of beneficial bacteria on mood, human studies on the combined administration of two unique probiotics, Lactobacillus helveticus R0052 and Bifidobacterium longum R0175, have demonstrated a 50% decrease in depression scores and a 55% improvement in anxiety scores.1,2
Traumatic brain injury (TBI), such as incurred in many contact sports, can also have long-lasting and detrimental impacts on brain health and neurotransmitter function. Victims of TBI may later suffer from memory and cognitive defects, depression, and anxiety. The chronic aftermath of TBI correlates with reduced acetylcholine, norepinephrine, and dopamine activity. Similarly, emotional trauma can lead to undesirable emotional states. Although grief, sadness, and fear can be normal, individuals often find themselves stuck in these types of responses. In cases of physical and emotional trauma, neurotransmitter testing can be an invaluable tool to feeling better again.
LE: How can people get this test?
Dr. Fogle: Some forward-thinking doctors already do these tests; unfortunately, most mainstream doctors are not even aware that they exist. In most cases, doctors order these tests through specialty labs. For our neurotransmitter testing, we collaborate with a lab in Portland, Oregon, that was founded by two doctors, one an MD and the other an ND, which is a great combination of knowledge and clinical experience. Their lab uses liquid chromatography combined with tandem mass spectrometry (LC-MS/MS), which is considered a gold standard in laboratory testing for its accuracy, and Life Extension is now pleased to offer this neurotransmitter test to customers.
LE: After someone gets tested, what do they do with that information?
Dr. Fogle: They can work directly with their doctor or call in to speak with one of our trained wellness specialists who can give them helpful information and customized suggestions. Our team of wellness specialists enjoys seeing people benefit from their suggestions. The information they provide helps people have more detailed conversations with their own doctor as well.
Dr. Scott Fogle is the Executive Director of Clinical Information and Laboratory Services at Life Extension®, where he oversees scientific and medical information as well as its laboratory division.
If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.
- Messaoudi M, Lalonde R, Violle N, et al. Assessment of psychotropic-like properties of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects. Br J Nutr. 2011;105(5):755-64.
- Messaoudi M, Violle N, Bisson JF, et al. Beneficial psychological effects of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in healthy human volunteers. Gut Microbes. 2011;2(4):256-61.