About Neurotransmitters and How to Restore Balance

By: Michael Lam, MD, MPH; Dorine Lam, RDN, MS, MPH


Read Part 1 | Part 3 | Part 4 | Part 5 | Part 6

What are Neurotransmitters? Symptoms of NT Imbalance

About neurotransmitters, your mental health, and adrenal fatigueHave you ever wondered about neurotransmitters and how the are affecting your life? We don’t learn much about neurotransmitters growing up, however, they play a prominent role in nearly everything that we do? It important to know the facts about neurotransmitters and the manifestation of an imbalance. There may be over sixty different mental and physical illnesses associated with a deficiency in neurotransmitters, including:

  • Addiction in any form, including sex, sugar, gambling, drugs, alcohol, caffeine, smoking (nicotine), carbohydrate addiction and/or binge eating
  • Advanced stages of Adrenal Fatigue Syndrome
  • Fibromyalgia
  • General malaise
  • Irritable bowel syndrome
  • Memory impairment (forgetfulness)
  • Obsessive-compulsive disorder (OCD)
  • Parkinson’s disease
  • Tourette’s syndrome

In particular, neuroscience research has proven strong association between low levels of serotonin and/or norepinephrine with the following mental conditions:

  • ADD/ADHD
  • Anorexia
  • Anxiety
  • Bulimia
  • Chronic pain
  • Depression or mood disorders
  • Fibromyalgia
  • Insomnia or sleep disorders
  • Migraines
  • Obesity
  • Panic attacks
  • Premenstrual tension
  • Restless legs syndrome
  • Bipolar disorder
  • Cognitive disorders
  • Depression

Keep reading below to learn more about neurotransmitters and how they may impact your life negatively and positively as well as what you can do to better manage their effects.

Causes of NT Deficiency, Imbalance or Malfunction

When learning about neurotransmitters one must evaluate the components having an impact on them.  There are a number of different reasons why people have imbalanced levels of NTs in their system:

  1. Diet. NT depletion may be caused by poor dietary choices. Neurotransmitters are made from amino acids that in turn are derived from protein, vitamins, and minerals in the diet and any supplements. If there is a deficiency of these vital ingredients, there will be a deficiency in the level of neurotransmitters in the system. Practicing vegans or vegetarians on a low protein diet are more prone to neurotransmitter deficiencies.Unsuitable nutrients can also be problematic. Caffeine and sugar top the list of foods most harmful for neurotransmitters. They affect the brain in much the same way as hard drugs. Junk food and foods made from white flour also cause damage to neurotransmitters.
  2. Toxic Consumables. Alcohol, nicotine, mind-altering drugs, ephedra and ephedrine are some medications that can lower the effective action of NTs. Phentermine (used in the fen-phen diet years ago) actually causes long-term damage to the receptors for serotonin. This means that you need to have even higher levels of serotonin in your system to get the benefits of the neurotransmitter. This was why many people on the fen-phen diet gained their weight back and even more when they went off the diet.
  3. People with neurotransmitter deficiencies or imbalances experience symptoms and often use alcohol and/or drugs to deal with their discomfort as a form of self-medication. This might provide some initial relief, but the problem is exasperated because this only causes further damage and depletes their natural production of neurotransmitters even further, along with dependency behavior.
  4. Sensory Overload. The brain is constantly bombarded with sensory overload from noise, radio waves, rapid visual stimulation from computer monitors, TVs, movies, fluorescent lights, etc. When all this light flickers faster than the eye is able to detect the brain is required to work harder modulating all the incoming stimulation in order to remain focused on the task at hand. More NTs need to be produced which can lead to ultimate exhaustion and thus depletion.
  5. Understanding about neurotransmitters can help you avoid pitfallsEnvironmental Toxins. Most everyone is exposed to toxins in the environment and even inside our homes, every single day. We use cleaning products, laundry soap and fabric softeners, air fresheners, perfume and cologne, nail polish, and other personal care products. We are exposed to pesticides and herbicides in our garden and construction products if our home is undergoing a remodel. Our indoor and outdoor carpeting contains chemicals and so does our clothing. All of these things contain toxic chemicals that can seriously affect our neurotransmitters. These toxins can directly affect the receptors and even inhibit our natural production.
  6. Genes. There are certain individuals who are born without essential enzymes for synthesizing NTs. These people naturally have deficiencies or dysfunctional NTs serotonin transporter genetic defects, for example, which have been associated with child maltreatment.
  7. Bowel Dysfunction. Since the majority of neurotransmitters are in the gastrointestinal tract, any sort of GI dysfunction could be a major cause of NT depletion. They include:
    • Candida—yeast overgrowth
    • Congestive bowel toxicity
    • Inflammatory bowel syndrome (IBS)
    • Leaky gut syndrome—increased permeability in the intestines
  8. External and Internal Environmental Factors. NT balance can be altered by many external factors, such as a rapid change in barometric pressure. Many have reported onset of depression after a visit to a high attitude environment. Internal factors can include any of the following:
    • Head cold or sinus congestion
    • Hepatobiliary dysfunction (liver congestion)
    • Ingesting foods that one is sensitive or allergic to
    • Polluted extracellular matrix
    • Rapid changes in hormone levels
    • Rapid changes in blood sugar
  9. Chronic Stress. Stress has the effect of raising blood pressure, insulin levels and the activity of free radicals in the body. All of this damages the neurons. Chronic stress is especially damaging to our overall NT production, regulation, and control. Our body operates on a system of checks and balances, which keeps everything in alignment. When we are stressed, such as someone with Adrenal Fatigue Syndrome (AFS), excitatory NTs like catecholamine levels may increase. This is especially prevalent in advanced stages of AFS where the body is flooded in a sea of norepinephrine and adrenaline. As a compensatory response, the body will release more inhibitory NTs like GABA and serotonin to calm the body down. If we are under chronic stress and are releasing these neurotransmitters on a regular basis, the body becomes desensitized to them and production and release is down regulated and thus reduced. This leads to a state of relative catecholamines dominance that are excitatory, leading to anxiety, insomnia, and depression.

Considering all of the above, you may be wondering what you can do about neurotransmitters inside of your body and how to not only determinine their imbalance but manage them in an effort to help create a healthier version of yourself.

Diagnosing NT Imbalance

It is fairly easy to determine the levels of most neurotransmitters in the body by testing a sample of urine. However, interpreting the results is not easy and often can be very confusing because the clinical correlations are not very accurate or definitive. For example, levels of neurotransmitters in urine vary rapidly in reaction to both stress chemistry and diet-related changes that affect the pH.

Other valid reasons why particular neurotransmitters may be outside their reference range would include:

  • When neurotransmitters are used they are destroyed and this process takes much longer than its production, which results in higher levels of the neurotransmitters when measured
  • Due to a fungal or yeast infection, a neurotransmitter can be transformed into a false form and be included in laboratory tests
  • Both viral and bacterial infections can destroy neurotransmitters, lowering the real value
  • Other neurotransmitters or certain neurochemicals can suppress a neurotransmitter, lowering the real value
  • If the supply of oxygen is decreased to some parts of the brain, the neurotransmitters will be affected

Clearly, sensitivity and specificity of NT testing by urine has much to improve and is a science very much in progress. It does give us a little glimpse of the NT world within. Clinical correlation is key to make the most sense with laboratory studies, as they can be misleading and confusing on their own.

About Neurotransmitters and How to Restore Balance

To understand the role of nutrients, you must know about neurotransmittersNT deficiencies can be replenished with amino acids, dietary, and lifestyle changes. NT excess can be helped by lifestyle modifications as well as compounds that calm NT release. It all comes down to balancing so that the excitatory NTs are in balance with the inhibitory NTs. Bias in any direction is not desirable. Most NT imbalances reflect underlying pathology. Comprehensive strategies of NT rebalance needs to also correct the underlying root cause.

To correct specific NT imbalances, what is needed is to first identify the defective pathway. Clinicians experienced in NT physiology find that a detailed history usually provides the best information to commence NT repletion when needed. Expansive testing may not be needed provided the patient is closely tracked and monitored by an experienced clinician. NT imbalance usually presents in a set of clinical behaviors with general recognizable patterns. Experienced clinicians will be able to ascertain this.

Clinical rebalancing trials can commence by stimulating one or more of the specific conversion pathways that may not be working properly or if sufficiently based on history and then observe the results. The key is to first be able to recognize the symptoms pattern when presented. For example:

  • Serotonin deficiency symptoms: depression, worry, anxiety, obsessive thoughts, PMS, heat intolerance, fibromyalgia, fatigue, and panic attacks
  • Melatonin deficiency symptoms: sleep onset insomnia, disturbed sleep, and night owl behavior.
  • Dopamine/norepinephrine/adrenaline deficiency symptoms: depression, fatigue, caffeine craving, lack of concentration, attention deficit
  • GABA deficiency symptoms: uptight, burned out, sore muscles, feeling overwhelmed

To replete what is deficient, nutritional supplements such as amino acids, vitamins and minerals are used to form a nutritional cocktail that can be taken orally. Adaptogenic herbs such as maca, rhodiola, and ashwagandha as well as glandulars can play a supporting role when indicated. Other supportive modalities or therapies include electromagnetic therapies that work on the body’s qi (energy) as well as brain wave entrainment technologies, bio-feedback, mitochondrial fortification, liver decongestion, extracellular matrix cleanse, and various detoxification techniques designed to enhance the body’s self-healing ability and rebalance power when these are deployed properly. Along with nutritional repletion, here are eight lifestyle changes that can help NT imbalance.

So, now that you have more information, what will you do about neurotransmitters and their effect on your health today?

Read Part 1 | Part 3 | Part 4 | Part 5 | Part 6

© Copyright 2016 Michael Lam, M.D. All Rights Reserved.

About neurotransmitters




2 Comments

  • Lesley Ann Foster says:

    Fascinating article. I would like to learn more. Who are the specialists in this field?

  • Elize Falk says:

    Thx this is how I fee; due to candida overgroth. So tired cam’t pick up my arms,