The proper name for the tests we use are called Organic Cation Transporter (OCT) Assays (more on that in a second), but they are often referred to as ‘neurotransmitter tests’ although that term does not properly describe the extent of what is being measured.  What we are really measuring and trying to optimize are a set of ‘gates’ that are called organic cation transporters (OCTs) that act the same in the brain as they do in the kidney. This simple urine test allows us to measure your unique response to amino acid therapy so that we can customize your amino acids therapy specifically to you. The beauty of these tests is that they allow us to pinpoint your exact amino acid needs so you can be assured you are getting everything you need and nothing you don’t.

The problem – imbalanced neurotransmitter levels

As we’ve discussed at length in this blog neurotransmitters are chemical messengers; when neurotransmitter levels are too low or imbalanced, the messages get garbled and symptoms of disease or disorders develop, like the urge to pull. We correct this by restoring proper neurotransmitter balance by providing the body with the nutrients it needs to restore proper neurotransmitter function. However, it isn’t quite as simple as giving the body the nutrients and having it ‘make’ the necessary neurotransmitters.

The primary determinant of neurotransmitter levels in the body is the functional status of molecules called transporters. Transporters, which are molecules in the cell walls, facilitate the movement of neurotransmitters in and out of the cells, including the neurons. Neurotransmitters cannot cross the walls of the neurons on their own as they are water-soluble and the cell walls are made of fat. Water and oil (fat) do not mix. The transporters remedy this by escorting the neurotransmitters in and out of the neurons.

When there is damage to the neurons, a signal is sent throughout the body to all the transporters that tells them to alter the flow or neurotransmitters in a way to try and compensate for the problem. When the damage is minor, the transporters can compensate for neurotransmitter imbalances by utilizing nutrients from a healthy diet. However, when significant damage occurs, properly balanced amino acid therapy needs to be used to correct the problem.

The solution – Organic Cation Transporter Optimization

A special transporter called the ‘organic cation transporter (OCT)’ is primarily responsible for the transport of serotonin and the catecholamines (dopamine, norepinephrine, and epinephrine) as well as their amino acid precursors across the cell wall. These transporters are found throughout the body in many tissues, including the kidneys, gut, liver as well as the brain and function similarly in all tissues throughout the body. This means that if we affect change to the OCTs with amino acid therapy it affects all the OCTs throughout the entire body.  This is very important.

When we run a ‘neurotransmitter test’ what we are really doing is determining the functional status of these OCTs in the kidneys in relation to a given amount of amino acids. By giving the body properly balanced amino acid therapy we can define the exact amounts of neurotransmitters and amino acids needed to restore proper functioning of the OCTs in the kidneys.

However, because this also affects the OCTs in all the other tissues, including the brain in exactly the same way, testing the urinary excretion of neurotransmitters while taking a known amount of balanced amino acids allows us to restore proper functioning within the brain as well. This restores the flow of electricity in the neurons and leads to the relief of symptoms – in this case eliminating the urge to pull.

So what we are really doing is using amino acid therapy to help optimize the function of the OCTs in the neurons to facilitate proper signaling. This is akin to unscrambling the messages so that the brain gets the proper signals. When the signals are no longer crossed, you get your life back.

If this explanation is too much science for you, don’t worry. Amino acid therapy works whether or not you understand why it works. It’s wonderful that way.

“This is the longest time I’ve went without pulling in 16 years!”

I have had trichotillomania since I was 8 years old (I’m 24 now) and I really wanted to try and find a way to decrease my urges to pull out my hair. I also have some anxiety and migraine headaches and wanted to see if I could get rid of them as well.

I read Dr. Oler’s free online report on trichotillomania and thought it made sense for me to attempt this. After reading other people’s thoughts and hearing about their results, I knew that it was something I needed to try.

Since I was 8 years old I’ve always had the urge to pull out my hair. The urge varies day to day, but it is always there. Sometimes it is something I can control; most the time I can’t. I started just pulling my eyelashes. As I got older I started pulling my eyebrows as well. When I was about 16 years old is started pulling on the top and sides of my head to the point where I had bald spots, but I could usually cover them up.

In addition to trich, I also have anxiety that varies from day to day but that is always there. I also have migraine headaches about twice a month.

I started seeing results within the first week of using the amino acids as Dr. Oler had recommended. The urge to pull was substantially less, so I was optimistic (I have had periods in the past when the urge was not as strong, but it this time it seemed to coincide with taking the amino acids – I guess time will tell). In addition, I didn’t have any migraines and my anxiety was much lower.

Dr. Oler made some adjustments and within another week I had almost no urge to pull, although there was a slight urge sometimes. However, I could easily resist it and had not pulled at all. My anxiety was pretty good, but I did get a headache when I got my period, although I took some Advil and it was gone. I was doing quite well, but wanted to see if I could feel better.

Dr. Oler made a couple more adjustments to my amino acid therapy. I’ve now been on the amino acid therapy Dr. Oler recommended for 4 months and I have not pulled since I started. I do occasionally have a little urge to pull, but I can easy ignore it. I haven’t had any headaches over the past 2 months and my anxiety is gone!

This is the longest time I have gone without pulling in 16 years! I am so grateful to Dr. Oler for helping me. My hair, eyelashes and eyebrows are all growing back in nicely and the bald spots are gone! I missed a few doses of my supplements when I had the flu, but the urge to pull did not come back (Dr. Oler told me that it might). This was amazing to me and I am so happy to be almost completely free of the urge to pull! Thank you Dr. Oler!!

Recall, neurotransmitters (such as serotonin and dopamine) are chemical messengers that control most of the body’s functions – everything from mood and the urge to pull to cravings and sleep. Stress can create both short and long-term imbalances in neurotransmitter levels, which can cause you to want to pull more.

Stress is a ‘loaded’ reaction

Stress affects everyone differently and can affect each individual differently on any given day. This is because the overall effect of stress is what is often called a ‘load reaction’. This simply means it is the combined effects of all the stressors in your life at any given moment that will determine the overall ‘load’ or impact that stress has on you at that time. This is the reason, for instance, that sometimes a certain stressor, like arguing with someone, affects you very little one day, but throws you into a state of utter turmoil on another day.

Many things can cause us stress, including:

It can be a fragile balance that keeps us functional when stresses mount. If the stressors overwhelm us, even for a period of time, many hormone and neurotransmitter imbalances can occur, which can increase the urge to pull. Under ideal circumstances (stress gets under control and neurotransmitter levels can rebalance), this increased urge will typically last 3-5 days. If the stress continues or your neurotransmitter levels do not rebalance, the increased urge can last a much longer time.

Addressing the causes

We know of two sure-fire ways to help restore proper neurotransmitter levels which will reduce or eliminate the urge to pull: (1) reduce the cause of imbalance and (2) replenish neurotransmitter function with amino acid therapy. The first has to do with reducing the effects of stress in your life. This may include exercise, establishing a regular sleep cycle, meditation, counseling or any number of other longer-term therapies to help mitigate the ongoing effects of stress.

The second acts more quickly, as providing the body the nutrients it needs to rebalance neurotransmitter function can lead to a dramatic decrease or elimination of the urge to pull, often within days or weeks. This allows you to incorporate the longer term stress reduction strategies into your life so you can have a life that is free of the urge to pull, no matter what stresses life throws at you.

In that post, we covered some simple ways to improve sleep; since that post, many people have contacted us asking for other suggestions to improve sleep. This is the first of a two part series to outline several more lifestyle ideas that our clients have found useful for getting and staying asleep. The next post will focus on dietary changes to help you saw some more logs (and keep your hands off your hair).

Start with one or two of these ideas and try them out for a couple weeks before passing judgment on whether or not they work for you. Keep trying them until you find the right combination for you:

• Make your bedroom your sanctuary – use your bedroom only for sleep and lovemaking. Avoid bill paying, eating, or reading in bed. Remove your telephone and/or TV from your bedroom.
• Practice deep breathing or alternate nostril breathing at least twice daily – 12 minutes morning and night is great, although even a few minutes will help.

• Engage in moderate exercise that you enjoy and that clears your mind – listen to your body and go with it!
• Exercise regularly in the morning, late afternoon or early evening – but not right before bedtime. Physical exertion is an excellent way to wake up or make your body tired so that sleep comes about more easily.
• Eat dinner at least two hours before bedtime. This will allow digestion to run its course before you settle into bed
• Go to bed when you are initially tired and feel sleepy. If you listen to your body, this is probably around the time your melatonin levels are on the rise (usually between 8-10 PM) – now is the time to get to bed and get restored.
• Take a bath with one or two cups Epsom salts, which is hydrated magnesium sulfate – available in any drugstore. This will allow your body to calm as the magnesium is absorbed through your skin. Warming your core body temperature will make you drowsy. You could also put in a little lavender oil to help promote a sense of calm.
• Read an entertaining book or magazine before bed (but not in bed). This will often calm you down and get your brain out of ‘do’ mode. Don’t read a business book or anything else that gets your brain stimulated to start thinking about work.
• Start a ‘gratitude journal’: get a journal (a notebook will due, but you may enjoy having a special diary-type book or journal – nobody else is going to see it anyway!) and every night before you go to bed, write down five (5) things in your day that you are grateful for. This is especially helpful if you’ve had a rough day and need something fun to think about.
• Do not nap during the day if this isn’t a normal thing for you to do. A short nap can help if you’re exhausted or stressed out, but a nap that’s too long will interfere with your body’s sleep rhythm.
• Don’t sleep late on weekends. Even if you are out late, try to get up within two hours of your usual time of waking.

Use whatever combination of the above techniques you like; experiment with several and find the ones that work for you. And don’t be afraid to try some new ones now and then! Establishing a good sleep pattern will help you maintain optimal neurotransmitter levels and dramatically decrease your urge to pull over time.

If you ever need additional support or would like more information, feel free to contact us. In addition, if you use some tried-and-true technique to help you sleep that you don’t see here, please share it below – you never know who it may help.

This is a typical scenario and when it comes down to it, we have to start at the beginning – with the urge to pull. If we can eliminate the urge to pull, we can eliminate everything that comes after it.

The urge to pull begins in the brain. It is controlled by chemical messengers called neurotransmitters. When these chemical messengers are out of balance, you feel out of control. Your brain is literally sending out signals you don’t want, and you are powerless to control them over time.

What if you could get those chemical messengers sending the right signals – the signals that you want? You would regain control.

What if you could eliminate the urge to pull? You would be free of all the emotional baggage that comes along with years, and sometimes a lifetime, of pulling.

You can do this. We can show you how.

By giving your body the nutrients it needs to properly balance your neurotransmitter levels, you can regain control and eliminate the urge to pull – completely, once and for all.

You don’t need to understand why this works (if you do, just look through this site); you just need to understand that it works. It’s about getting back to the basics and starting at the beginning – the source. The source of your urge to pull is an imbalance in neurotransmitter levels. We can help you get them back into balance. But you have to let us; all you have to do is call.

The journey of a thousand miles begins with a single step. Please take that step.

We have shared many times throughout this blog that we us a combination of nutrients, including 5-HTP, tyrosine, L-dopa, cysteine, vitamin C, calcium, vitamin B6 and folate, individually tailored to each person’s specific needs in order to achieve a successful resolution of symptoms. However, proper use of these simple ingredients is not simple.

As I explained this to Mary, she began to see that what she had done was take a few pills in a haphazard way with no real clinical direction in the hopes of hitting a home run. While this is certainly understandable – she was desperate for results and was grasping at anything that even remotely promised some resolution – it had very little chance of success.

Mary then asked, “Why should I take the products you recommend when I can just go to the health food store and buy all the needed ingredients and take them myself?” I said she could certainly try this approach, but it had an incredibly low chance of success. I explained, “Going into a health food store and purchasing the ingredients would be like going into an art store and buying a bunch of paints then going home and expecting to paint like a master artist even though you have no previous painting experience. While it is possible for this to happen, it is incredibly improbable. These nutrients have tremendous potential when used in the right combination by someone trained in their proper use. However, just like with an artist, experience and practice is required to realize their full value.”

There was a pause and I could almost see the light go on in Mary’s mind – she got it. Her next question was a bit easier, “When can I get started?!” to which I replied, “Right now.”

Many people, in there desperate search for a solution to their (often) insatiable urges to pull try a whole host of different remedies and treatments to eliminate trich. This will many times involve the use of one or more supplements, including various amino acids. However, the utility of these compounds is only realized when administered under the care of a health care professional trained in their proper usage. When used properly, these nutrients can produce astounding results that are nothing short of miraculous in many cases.

“I started following my program and I’m pulling MORE – what’s going on?!”

The urge to pull that is so prevalent in trichotillomania is caused (in most people) by an imbalance in neurotransmitter function. To correct this imbalance, we have found a combination of amino acid supplements that provide the body the exact nutrients it needs to be remarkably effective. In fact, we have been able to help over 86% of the people that come to us with trich completely eliminate the urge to pull.

For most people, the positive changes happen relatively quickly. They go from having the urge to pull their hair out to having absolutely no urge to pull at all in a relatively short time frame.  However, this doesn’t mean that it is always a smooth road to becoming trich-free. In a very small number of people, symptoms actually increase when we start or adjust daily amino acid dosing. (We see this most often in dealing with people with depression or increased appetite, but we have seen it in a handful of cases of people with trich as well.)

Most of the time, this happens in the first week or two of using amino acids. This is often described as a “gets worse before it gets better” type of reaction. What’s happening here is that as a person approaches the dose needed for them to experience a relief of symptoms their neurotransmitter levels go through a phase that makes them more aware of the urge to pull, thus increasing the overall “need” to pull. In order to get this person urge-free as quickly as possible, we need to increase the daily amino acid dose, which is completely counter-intuitive, especially for someone that wants to pull more. When amino acid dosing is properly increased however, the increase in symptoms will often resolve completely within 1-2 days.

Obviously, it can be very difficult from a client’s perspective to increase the dose of something they think is making them worse. However, from a clinical perspective, having this type of reaction is a sure-sign that the person will become completely symptom free if they can hold on and make the recommended changes. Luckily, it only takes 1-2 days to prove that this is the proper approach once the amino acid dosing is increased.

If you begin taking amino acids as directed and you experience any increase in symptoms, contact us immediately so we can get you through this phase as quickly as possible. Take heart that every single client that we have had that experienced this type of reaction had a complete elimination of the urge to pull within a week of increasing their amino acid dosing as directed – every single one.

Most people would never suspect food as a culprit with trich, but there is some good evidence pointing to the possibility that what you eat can dramatically alter your neurotransmitter balance, particularly serotonin levels. Serotonin is an important neurotransmitter that affects sleep, mood, cravings (especially for carbohydrates), migraines and a host of other functions, including the urge to pull. It has been estimated that about 95% percent of the serotonin in your body is stored in your gastrointestinal tract. Therefore, gastrointestinal function is very important in maintaining proper neurotransmitter balance.

A great many studies support the fact that intestinal permeability and enzyme deficiencies  are often found in folks suffering from depression (which is caused by imbalances of serotonin with dopamine); this is underscored by reports that depression is a very common symptom of celiac disease (which is  a condition of severe gluten intolerance). (1-8)

Here at the clinic, it is almost universal that long standing gastrointestinal imbalances, including food allergies almost always lead to or exacerbate depression as well as other conditions related to neurotransmitter imbalances, including the urge to pull, migraines, anxiety, obsessive compulsive tendencies and sleep disturbances.

Therefore, as we are working to help people correct their underlying neurotransmitter imbalances, we will often begin to investigate the many possible reasons why these imbalances are there in the first place. Looking at what someone is eating can provide major insights into eliminating the urge to pull.

We have found the most accurate food hypersensitivity test to be the Lymphocyte Response Assay from Elisa/Act Technologies. Using this test, one can run any number of foods, additives, colors, drugs, supplements, and environmental contaminants to determine which, if any, of them are causing an immune reaction with subsequent neurotransmitter disruption. Once the offending agents are determined, we then work with clients to help eliminate them so their bodies can heal while reestablishing optimal neurotransmitter levels. In doing so, many people can reduce or eliminate the need for ongoing supplementation and remain symptom free for the rest of their lives.

NOTE: If you cannot find a practitioner in your area that can run the LRA test, contact us to arrange for an in-home blood draw.

References

1. Corvaglia L, et al. Depression in adult untreated celiac subjects: diagnosis by the pediatrician. Am J Gastroenterol. 1999 Mar;94(3):839-43.
2. Ciacci C, et al. Depressive symptoms in adult coeliac disease. Scand J Gastroenterol. 1998 Mar;33(3):247-50.
3. Addolorato G, et al. Anxiety and depression in adult untreated celiac subjects and in patients affected by inflammatory bowel disease: a personality “trait” or a reactive illness? Hepatogastroenterology. 1996 Nov-Dec;43(12):1513-7.
4. Pellegrino M, et al. Untreated coeliac disease and attempted suicide. Lancet. 1995 Sep 30;346(8979):915.
5. Cheliout W. [A misleading depression]. Encephale. 1994 Sep-Oct;20(5):531-4. French.
6. Hernanz A, et al. Plasma precursor amino acids of central nervous system monoamines in children with coeliac disease. Gut. 1991 Dec;32(12):1478-81.
7. van Praag HM. Affective disorders and aggression disorders: evidence for a common biological mechanism. Suicide Life Threat Behav. 1986 Summer;16(2):103-32. Review.
8. Hallert C, et al. Psychic disturbances in adult coeliac disease. I. Clinical observations. Scand J Gastroenterol. 1982 Jan;17(1):17-9.

A quick look at the literature shows exactly that; an example:  there is a strong association between sleep disturbances and mood disorders, including depression. (1, 2) In fact, insomnia is reported by more than 90% of depressed patients. (3) This is all well and good, but how do we know that this correlation is due to neurotransmitter levels?

Research shows that in people suffering from insomnia, balancing the brain’s neurotransmitter levels can improve sleep. (4) This has led many researchers to believe that complete relief of insomnia may improve the symptoms of depression. (3) But what does this have to do with trich and the urge to pull?

Well, as we have talked about in previous articles, the urge to pull is often due to or intensified by imbalances in neurotransmitters, including serotonin and dopamine. Decreased sleep can cause, as well as be caused by, imbalances in these same neurotransmitters. This means that if a person has insomnia or purposefully does not get enough sleep over time (i.e., goes to bed late, has odd sleep habits, etc.), neurotransmitter imbalances can result. These imbalances will then lead to increased urges to pull. Incidentally, they also usually lead to increased cravings for carbohydrate or sugar-laden foods, particularly in the afternoon or evening, along with the need for stimulants of one kind or another to keep focused and alert (think coffee, soda, ‘energy’ drinks and chocolate). Unfortunately, in addition to keeping you a little more alert in the short term, these stimulants can also cause further neurotransmitter imbalances that keep you awake – and pulling.

Here are some simple things that you can do to begin lessening the effect of too little sleep on your urge to pull:

1. Get as much sleep before midnight as possible; set a time and go to bed, say at 9-10 PM. Even if you can’t go to sleep right away, do some deep breathing and/or meditation and don’t worry about it. Your body is resting and eventually sleep will come.
2. Set an alarm and get up at the same time daily, even if you don’t fall asleep well the night before. You may be in for a few rough days, but eventually, most people will begin to get into a more normal sleep cycle.
3. Make your bedroom peaceful – turn off the lights, TV, radio and anything else that may distract you or keep you engaged. Sometimes, peaceful music or sounds can help, as can ‘white-noise’ such as a fan. Earplugs often help.
4. Stop drinking liquids 2-3 hours before bed to limit the number of times you need to get up to use the bathroom
5. Keep a notebook by your bed and write down everything that is churning through your mind and make a ‘to-do’ list for the next day. If new things come to you during the night, write them down and forget about them – they’ll be waiting for you in the morning.
6. In the morning, so some exercise or yoga to help you wake up and minimize the need for stimulants. If you still need something, try green tea (Earl Grey Green Tea is a bit heavier for those die-hard coffee drinkers.)

If you have insomnia or long-standing sleep issues, these simple steps are unlikely to be of much help. In this case, a more thorough workup is often necessary and additional therapies may be needed. Luckily, we have found (as have numerous other researchers) that re-establishing optimal neurotransmitter balance can safely and effectively improve sleep over time. This, combined with giving yourself the opportunity to get enough sleep will not only have you sleeping better, it will help you eliminate your urge to pull. Small things really can make a big difference over time and sleep is KING when it comes to maintaining neurotransmitter balance.

References

1. Ohayon MM, roth T. Place of chronic insomnia in the course of depressive and anxiety disorders. J Psychiatr Res. 2003 Jan-Feb;37:9-15.
2. Germain A, Kupfer DJ. Circadian rhythm disturbances in depression. Hum Psychopharmacol. 2008 Oc;23(7):571-85.

1. Thase ME. Antidepressant treatment of the depressed patient with insomnia. J Clin Psychiatry. 1999;60 (Suppl. 17):28-31.
2. Irwin MR, Wang M, Ribeiro D. et al. Sleep loss activates cellular inflammatory signaling. Biol Psychiatry. 2008 Sep15;64(6):538-40.

In particular, we have been seeing a lot of people suffering from trichotillomania that also have insatiable cravings for sweets and/or simple carbohydrates, including breads, cookies, candy, chips, pastries and similar foods. Most people that have this combination of sugar cravings and trichotillomania don’t realize they are connected, and they often feel helpless on both accounts. However, I am here to tell you that not only are they related, they can both be resolved using the same techniques.

Balanced Amino Acid Therapy

Both the urge to pull and cravings for sugar and sweets are regulated by your brain chemistry. The chemical messengers responsible for this regulation are called neurotransmitters, which include serotonin and dopamine. Imbalances in your neurotransmitter function will cause miscommunication, which often leads to symptoms including the urge to pull, cravings and any number of the conditions listed above. However, restoring proper neurotransmitter balance will improve communication and alleviate these conditions.

One of the keys to establishing proper neurotransmitter function is the employment of balanced amino acid therapy. This means that a health care professional trained in the proper use of amino acids will help you determine exactly the right mix of amino acids and cofactors you need in order to establish optimal neurotransmitter function. Once this occurs, not only will your urge to pull disappear, your cravings will also be substantially reduced or eliminated altogether. This occurs because you are addressing the root cause of your problems, and by digging down to the root, you can manage a whole host of symptoms due to neurotransmitter imbalance.