Managing Trichotillomania Trichotillomania research: neurotransmitter neurotransmitter testing stop pulling hair out trichotillomania
by Stop Pulling Hair Out
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I am often asked what tests are available to help determine if a person’s neurotransmitter levels are imbalanced. There is a lot of misleading and inaccurate information out there, so I will try and summarize what testing procedures we use, what is being tested and how those test results are useful to help us determine how to optimize your amino acid dosing over the next two posts.
First, let’s clear up some misconceptions. Peer-reviewed research has shown that the following statements are FALSE:
- Doing a urine test prior to taking any amino acids is an accurate assessment of neurotransmitter levels in the body – this is completely false. Research shows absolutely no correlation between urinary test results and amino acid needs if a person is not already taking a known amount of amino acids (more on this below).
- Urinary neurotransmitter levels are indicative of brain (central nervous system) neurotransmitter levels – again false. The amount of measured neurotransmitters in the urine is indicative of the neurotransmitters formed and excreted by the kidneys, not what is present in the rest of the body. However, as you will soon find out, it does provide valuable information about how to properly dose amino acids to eliminate your symptoms.
- All neurotransmitter tests are the same – false. There is great variety in not only what is tested, but the accuracy and reproducibility of the tests and therefore, the utility of the results.
- Neurotransmitter test results are easy to interpret and use – unfortunately, this too is false. Because it is not a straightforward measurement, proper analysis of the results takes hours of training and extensive clinical experience.
Let’s expound upon these myths and talk about what is actually going on.
For urinary testing to be accurate, a person must be taking some known amount of amino acids; this puts the body into what is called a ‘competitive inhibition state’. This is similar to measuring a person’s glycemic response by giving them a set amount of glucose and then taking blood samples at timed intervals. If you don’t give them a known amount of glucose and take the measurement at set times, the results are misleading and worthless. Likewise, in order for neurotransmitter testing to be accurate, a person must be taking a set amount of amino acids and take the urine sample at a specified time.
Some of the confusion also comes from using the term ‘neurotransmitter test’. Many labs test the metabolites (break-down products) of neurotransmitters in the urine and say that these are indicative of levels throughout the body, including the brain. Research has shown this not to be the case, so what is actually going on?
This test should really be called Organic Cation Transporter (OCT) Functional Status Determination (or something like it), as this is more descriptive as to what is actually occurring. Simply said, there are mechanisms called transporters that direct (or transport) neurotransmitters formed in the kidneys either into the bloodstream or out into the urine. These transporters act differently in every person, but we can affect how these transporters work by giving a person amino acids in a balanced manner.
By giving the body the right amount and balance of amino acids, we can help these transporters work better and restore a person’s neurotransmitter levels to a level where they function properly, that is, don’t experience any symptoms. This works because the OCT transporters in the kidneys act exactly like the OCT transporters in the brain (and liver and intestines, etc.). Therefore, although the actual numbers given on the test are not direct measures of the body’s neurotransmitter levels, they do provide the clinician (properly trained in amino acid therapy) a means to determine the status of these OCT transporters so that they can help them function properly throughout the body. When this happens, any symptoms associated with neurotransmitter imbalance – like trichotillomania, depression, anxiety, OCD, attention deficit, Parkinson’s disease, insomnia, fibromyalgia, panic attacks, dementia and a host of other disorders – disappear.
We call the test a ‘Neurotransmitter Test’ or ‘Neuroregulatory profile’ because it is an easier concept for our clients to understand; however, as I point out above, it is technically incorrect.
The next post will reveal the difference between laboratory measurements, what labs we have found provide accurate, actionable results and how these results can help us determine your optimal amino acid dose.