What is a neurotransmitter?

What is a neurotransmitter?

It is a chemical messenger from the nervous to nerve tissue as well as to the organs and glands of the body. They regulate many emotional processes; cognition as well as response to movement, pain, energy and stress.  It occurs primarily in the central nervous system which communicates from the brain to the rest of the body. They are released from the neurons and travel across a small space called a gap junction that occurs between nerves and the cells on organs, glands and muscles. Inadequate amounts of neurotransmitters will create an altered pain response and other imbalances.

What are the symptoms of neurotransmitter imbalance?

  • Mood disorders: depression and anxiety, mood imbalance
  • Adrenal Dysfunction: fatigue and insomnia
  • Loss of Mental Focus:  ADD, ADHD, cognitive function and mental fog
  • Addiction and Dependency
  • Hormonal Imbalances: Estrogen Imbalance, Androgen dysfunction
  • Loss of Appetite Control: obesity and insulin resistance

* Symptoms often worsen with the addition of bioactive substances like: caffeine, alcohol, nicotine and prescription medications.

What are the different types of neurotransmitters?
The body is like a finely tuned machine that has a system of checks and balances which occur when functioning properly. The neurotransmitters  also balance each other out by using both inhibitory and excitatory neurotransmitters that regulate our system and are classified by their effect on the post-synaptic neuron or the neuron that is receiving the signal.

  • Excitatory neurotransmitters cause the depolarization of the cell and thus a signal is sent from the neuron.
  • Inhibitory neurotransmitters cause a hyper-polarization of the cell and thus prevents the neuron from sending any form of signal.

How do I know that my neurotransmitters are out of balance?

A urinary HLPC Mass Spec Technology test is done using one of two laboratories based on a patients specific need.  They usually test the following 6 main neurotransmitters as they are most significant in the symptomatic conditions:

  1. Serotonin
  2. GABA
  3. Dopamine
  4. Norepinephrine
  5. Epinephrine
  6. Glutamate

What are the functions of the different neurotransmitters?

  1. Serotonin – is an inhibitory neurotransmitter that is responsible for the regulation of sleep, appetite and aggression.  Common imbalances of serotonin will lead to mood disorders, anxiety and depression .  It is also commonly altered by pharmaceutical agents, stress,  stimulate medications  and caffeine.
    • Out of Balance = depression, anxiety, insomnia, carbohydrate cravings, PMS, difficulty with pain control and sleep disturbances.
  2. GABA (gama-aminobutyric acid) –  is an inhibitory neurotransmitter that resides mostly in the Central Nervous System (CNS) and is responsible for calming most of the excitatory neurotransmitters. Low levels may suggest adrenal dysregulation and high levels of stress where as high levels of GABA suggest an excitatory overload on the system in an individual and create sluggishness. Alcohol mimics the sedating GABA like effect on the body.
    • Out of Balance = GABA low – impulse control or a hyper-reactiveness in response to stimulus – even seizures.  GABA high – sluggish energy, feeling of sedation, and mental fogginess.
  3. Dopamine – is both an inhibitory and excitatory neurotransmitter and is associated with the pleasure/reward pathway, memory and motor response in the body.
    • Out of Balance =  Dopamine low – will often cause issues of decreased motor control (conditions such as Parkinson’s and others), addictive behavior, impulse control, (ADHD and ADD) loss of satisfaction and cravings.  These individuals will self medicate by overeating, drinking caffeine, taking ADD and ADHD medications, drugs, smoking in an attempt to raise their dopamine levels.  Continual stimulation of Dopamine by caffeine and medication will cause depletion over time.  Dopamine high – will result in hyper-activity, anxiety (conditions such as schizophrenia  and other disorders), mood swings, psychosis and attention disorders.
  4. Norepinephrine (noradrenaline) –  is an excitatory neurotransmitter  produced in the CNS and in the adrenal medulla as a stress hormone.It’s associated with actions including attention, focus, inflammation regulation and regulating heart rate.  Also it is associated with arousal and stimulating  the sympathetic nervous system which is the fight or flight reaction.
    • Out of Balance = Norepinephrine high –  will cause anxiety, stress, elevated blood pressure and hyperactivity.  Norepinephrine low – lack of energy, memory loss, lack of focus and decreased motivation.
  5. Epinephrine (adrenaline) – is an excitatory neurotransmitter produced from norepinephrine in the CNS and the adrenal medulla; its conversion is stimulated by cortisol.  Associated with muscle contraction, heart rate and glycogen break down, blood pressure and the stress response.
    • Out of Balance = Epinephrine high – hyperactivity, ADHD, sleep issues and low adrenal function.  Epinephrine low – fatigue, depression, low cortisol, chronic stress and low recovery from illness.
  6. Glutamate – is an excitatory neurotransmitter and the most abundant in the  neurotransmitter in the nervous system.  It is involved in the higher areas of the brain including learning, memory and most cognitive functions.
    • Out of Balance = Glutamate high – panic attacks, anxiety, difficulty concentrating, OCD and depression.  Glutamate low – agitation, memory loss, sleep issues and low levels of energy.

How are neurotransmitters tested?

Neurotransmitters are done by a urine sample taken in the morning  after the first void of the bladder then waiting 1 hour without drinking anything to create a concentrated urine sample.  The sample must reach the lab within 7 days so the sample doesn’t degrade.  We have a lab that will not accept samples older than 7 days to assure the quality of the neurotransmitters in the sample.

How do we balance neurotransmitters?

This is a complex process that occurs when you add in things like enzymes and cofactors to allow either the stimulation of inhibition of the neurotransmitters or reduction of excitatory neurotransmitters so that all things in your body are brought into balance.  We balance the neurotransmitters through herbal and botanicals as well as lifestyle modifications.  These modifications include stress reduction, exercise and things like hormone balancing.

Adrenal Glands and Stress Disease and Fatigue

What are the Adrenal glands?

These are triangular shaped glands that sit superior to or on top of the kidneys like a hat around the 11th and 12th thoracic vertebrae.  These are known as the endocrine glands and are actually two different glands in one. The cortex and the medulla are encapsulated inside each other.  They secrete hormones such as mineralocorticoids, glucocorticoids, cortisol and androgens.

What is the major function of the Adrenal gland?

Medulla:

  • Release Adrenaline (epinephrine) – fight or flight response function, increase blood pressure and insulin resistance
  • Release Noradrenaline norepinephrine) – Vigilant concentration, increases contraction of the heart

Cortex:

  • Glucocorticoids, hydrocortisone (cortisol) – Weakness, fatigue, anorexia nausea, trouble sleeping
  • Testosterone, Androgens – Weakness, fatigue, lack of sex drive
  • Mineralcorticoids, aldosterone – Hypertension

What happens when this gland is dysfunctional?

One can experience hypo function of the adrenal gland itself and hyper function of specific hormones of the adrenal gland. Adrenal insufficiency is less serious but can cause major lifestyle dysfunction.

Hypo Function

  • Addison’s Disease – a failure of the adrenal cortex which can be caused by external triggers, infection, trauma, toxic chemical exposure and psychological stress (considered autoimmune)
    • Symptoms:  hyperpigmentation (mouth, areolae, perineum), weight loss, depression, postural hypotension causing vertigo and Azotemia (kidney failure and urea)
      • Test:  Serum cortisol, 24 hour free cortisol and ACTH stimulation test, standard electrolytes may be imbalanced potassium and depressed sodium
      • Adrenal Insufficiency Syndrome – caused in Western culture due to psychological stress and poor nutrition which depletes adrenal reserve
        • Symptoms:  Excessive fatigue, PMS, irritability, salt craving, confusion, poor memory, weakness, palpitations, insomnia, constipation or diarrhea
          • Tests:  Saliva or Urinary Cortisol usually done in 4 saliva tests or a 24-hour urine sample.  Also Test Testosterone, DHEA-S, Glucose, Serum Na, Serum K, BUN high normal or elevated

Hyper function

  • Cushing’s Disease – Excessive adrenocortical hormone production.  Adrenocortical production increases when a stressor occurs and then cortisol is released usually, cortisol is released until the stressor goes away, but in Cushings disease release of hormone is excessive and constant.  Some suffer from a low level of Cushing’s called hypercortisolism.  It is thus triggered by stress.
    • Symptoms in full blown cases:  Redistribution of the fat on the face and truncal (chest area) area (moon faces), hypertension, osteoporosis, weak connective tissue, insulin resistance, decreased immunity, mood disorders, poor wound healing, virilism (secondary male characteristics) in women.
      • Tests:  24-hour cortisol test, EKG, Elevated Na levels, K levels, Eosinophil levels low
      • Primary Aldosteronism (Conn’s Syndrome) – Excessive aldosterone is produced by the adrenal gland.  Most commonly caused by stress and seen in the majority of hypertensive patients.  Can occur secondarily to renal artery stenosis and thus a build up of a product called rennin or a begin tumor called an adenoma.
        • Symptoms:  Hypertension, women in 30-50 years old, heart palpations, weakness, muscle cramping, headaches, parasthesia, polydipsia and polyuria
          • Tests:  Potassium serum testing, blood pressure measurement, ECG, Serum aldosterone, urinary aldosterone, CT Abdominal, plasma renin levels
          • Pheochromocytoma – Tumor of the adrenal medulla that secretes high levels of norepinephrine, epinephrine and dopamine.  It is relatively rare.
            • Symptoms:  Headaches, diaphoresis, palpitation and hypertension
              • Tests:  Urinary measurement of Neuropinephrine and Epinephrine, CT scan Abdomen

How would I determine if I have Adrenal Insufficiency?

Adrenal insufficiency is a common diagnosis heavily related to everyday function and is especially prevalent in individuals with Thyroid conditions.  It is often under diagnosed since it is generally not recognized in conventional medicine.

Testing is done either through serum blood or saliva. Saliva testing is preferable because you can do it easily at home taking four separate samples throughout the day allowing you to see a daily rhythm. This is important as this gives us clinical knowledge to see if, and at what point in time, your cortisol level needs support or supplementation.

Sample of what a normal healthy cortisol level should look like.

cortisol_12032012

                         

 

 

 

 

 

 

What is the treatment for Adrenal Insufficiency?

The treatment is usually some lifestyle modifications coupled with a group of herbs called adaptogens.  A doctor will determine what types of adaptogens are needed based on your lab results and symptoms.  Lifestyle modifications include diet, sleep habits and stress reduction techniques.

What happens if I don’t treat Adrenal issues?

Since they are largely caused by autoimmune and stress response, people who are left untreated can face the following problems:

  • Hypertension
  • Thyroid issues start or become worse
  • Sleep issues
  • Hormone imbalances
  • Increased cancer risk

Our clinic prides ourselves on helping manage your health. It is our passion and it should be your goal.  You can fill out the hormone checklist on our website and email it to info@in-healthclinic.com for scoring to see what risk factors you may have.  We do cortisol and hormone testing in office and even offer 10-minute free phone consults to determine if we are a right fit for you.

Gastro Intestinal Health

What is GI the tract?

The GI tract consists of the stomach and lower intestinal area in addition to the transitional segments. The organs are the stomach, small intestine, large intestine (colon) and the rectum.  The upper digestive tract includes the mouth, duodenum and esophagus.

What does the GI tract do?

The GI system is responsible for the digestion of food and absorption of nutrients as well excretion.  Most digestion occurs in the small intestine, while the stomach is mainly responsible for the breakdown of food and particles in the system. The digestive tract is a series of tubes within tubes that are made up absorbent surfaces, each with a different job. The mucous layers absorb hormones, vitamins, minerals, water and other important nutrients essential to your health.  The GI tract is the immune system barrier, which is the main defense against outside infections and allergens.

What does it feel like when your digestive tract isn’t working properly?

–       Gas, bloating and pain

–       Stomach upset

–       Heartburn

–       Fatigue due to improper absorption

–       Constipation or diarrhea

–       Nausea and vomiting

What happens when your gut doesn’t work? 

The inability to properly process food can be a sign of other underlying health problems. For instance, “leaky gut” occurs when a particle of food or other foreign substance crosses the barrier from the intestines into the body. There they create a strong reaction that causes the immune system to attack the particle and sometimes areas of the body that may resemble the particle. This is a key theory in autoimmune disorders and diseases.  Another problem is that when your gut isn’t working well, your hormones don’t get processed properly resulting in a build-up of only one type of hormone.  Any hormone imbalance can lead to serious and unpleasant side effects.

What are the side effects of an unhealthy digestive system?

-Nutritional deficiencies since vitamins and minerals are not absorbed properly

-Fatigue, weakness and dizziness

– Yeast over growth and infection

-Anxiety from hormone imbalance

-Impaired immune function since the body is already fighting something

-Skin rashes due to decreased immune function

-Flatulence and bloating

-Diarrhea or constipation

-Headaches from hormone imbalance

 

What are a few steps to improving the health of your digestive tract?

-Test for food allergies that can make the leaky gut worse

-Decrease refined sugar in your diet

-Take healthy enzymes like glutamine which can heal the GI tract

-Use probiotics at a dose strong enough to replace your depleted flora

-Increase your intake of high fiber foods health

 

ADD and ADHD

Currently the diagnosis for ADD and ADHD is becoming more and more common for students and children with extra activity.  The most common form of treatment is to give stimulant type drugs that enable the children to focus and harness their energy.  However we find that stimulants are not only hard on children’s health but also not a good long term fix.  What most parents want to know is what are the healthier and more of the long term options.  The answer is holistic medicine and diets can actually be a really great option to manage an ADD child.

The first option is diet.  Numerous amounts of children with ADD or ADHD have food sensitivities of some kind.  There are two types of immunoglobulin’s IgE and IgG.  IgE antibodies are the ones that cause an immediate allergic reaction.  An example of this is a child that eats a peanut and then has an immediate allergic reaction which can put them in danger of not being able to breath.  IgG antibodies are a delayed sensitivity that can cause numerous symptoms. The symptoms include but are not limited to: fatigue, behavior modification, headaches, Sore-throat, loose stool, constipation, mood changes and decrease in immunity due to body inflammation.

The second option is homeopathy.  Homeopathic medicine is very effective in treating not only ADD but also other childhood behavioral disorders.  This is a type of treatment that is easy for kids to take and produces remarkable results.  An example of Homeopathy is taking a specific symptom or personality and diluting compounds that would enhance that symptom.  By diluting the compound only a mild remnant remains and this stimulates a negative feedback loop causing the body to stop the over active symptoms of ADD.  This reaction helps the body to teach itself to adapt to its lack of concentration by knowing when it’s time to focus and when there is an appropriate time to be energetic.  This can be a very empower solution for both parents and child.

The third option is daily activity modification.  For most of us this can be very challenging as a parent since it requires you to get your child on a schedule that can sometimes be very strict.  This schedule would include exercise, a set bedtime and scheduled study or homework time.

Our office can help with any and all of these elements. We would love to answer any questions you have.

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