Neurotransmitters Play a New Role in Health
Eileen Wright MD, Ashland Citizen-Times, 09/12/2003
During the past several decades, some people who suffer from depression, anxiety, obesity, migraines, insomnia, obsessive compulsive disorders, premenstrual syndrome and attention deficit disorder with or without hyperactivity, benefited from pharmacological treatments, including the well known drugs Prozac, Valium, Paxil, fenfluramine and dexfenfluramine (known as fen-phen), Imitrex, and Ritalin. On the other hand, other similarly afflicted people have not been helped or have experienced significant adverse side effects from drug therapies, finding that the promise of drug treatment falls short of relief. Research in neurotransmitter biochemistry during the last 30 years is bringing hope to many such sufferers.
Nerve cells, called neurons, don't physically connect with each other but have a gap called a synapse between them. Neurotransmitters, made by nerve cells from amino acids and vitamin and mineral co-factors, are chemicals that relay messages across this gap. By attaching to the receptor sites of neurons, neurotransmitters profoundly affect mood and metabolism. Serotonin, dopamine, norepinephrine, epinephrine (adrenalin), and gamma-aminobutyric acid (GABA) are neurotransmitters.
Because nerves affect the functioning of all cells in the body, neurotransmitter-related disorders are common. An estimated 84 percent of the population has some degree of neurotransmitter deficiency or imbalance. Prolonged stress, poor diet (especially protein deficiency or malabsorption), genetic predisposition and some prescription drugs can contribute to neurotransmitter imbalances. For example, antidepressants in the class of drugs called selective serotonin reuptake inhibitors (SSRIs) -Prozac, Paxil, and Celexa - often are effective in short-term treatment of depression. But extensive laboratory testing has shown they lower already depleted neurotransmitters serotonin and norepinephrine when used long term.
For years, the only way that a doctor could manipulate neurotransmitters was by the use of prescription drugs. Occasionally, a doctor would get lucky and hit a home run with a drug that happened to specifically address an individual's imbalances. However, recent scientific advances in the ability to measure neurotransmitters have taken much of the guesswork out of treating these imbalances, allowing doctors to address health problems more effectively. Research has also defined what to measure, when to measure, how to measure, and how to go about a nutritional program of conditioning, therapy, and maintenance. A urine sample is the preferred specimen, since obtaining a blood specimen is a stressful, invasive procedure that increases some neurotransmitters. The optimum time for specimen collection is between 9 a.m. and 11 p.m. Optimizing neurotransmitter function is best accomplished by supplementing the indicated amino acids and vitamin and mineral co-factors in specific ratios, at specific times of day, and in particular sequences.
Measuring and optimizing neurotransmitter levels provides a cutting-edge approach for patients with a variety of ailments. For example, serotonin has an ability to constrict blood vessels. During a migraine, serotonin levels drop significantly, causing blood vessels to dilate, resulting in intense pain. Once the migraine sufferer's neurotransmitters are measured, treatments that optimize serotonin production can provide a preventive approach that minimizes migraine occurrence and thus the need for repeated drugs to treat recurring acute episodes.
Many people who have not yet been diagnosed, but are the "walking wounded," find themselves less tolerant of stress than they once were, not sleeping as well as they once did, and having mood disorders including depression or anxiety. The physician who suspects and confirms an underlying neurotransmitter-related disorder can often greatly improve the quality of life for such people.
Dr. Eileen Wright practices at the Great Smokies Medical Center of Asheville.
For more information on diagnosis and treatment, see Neuroscience Lab
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