The neurotransmitters that we are most concerned about are serotonin and the catecholamines (which include dopamine, norepinephrine and epinephrine). Serotonin is made from L-tryptophan and/or 5-hydroxytryptophan (5-HTP). The catecholamines are made from L-tyrosine and/or L-dopa.

Picture from Marty Hinz, MD: www.neuroassist.com

The important thing to note is that neurotransmitters cannot cross the blood-brain-barrier (this is depicted as the solid line in the above illustration. However, the individual amino acids (and the cofactors) can cross the blood-brain-barrier. Therefore, in order to raise the levels of neurotransmitters in the brain it is necessary to take the appropriate amino acids and cofactors AND facilitate their delivery across the blood-brain-barrier so they can be transformed into their respective neurotransmitters.

In theory, this is a fairly easy thing to do. It is a little bit more complicated in practice. How this can be best accomplished will be discussed in a future post.

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!!

Most people have heard of several common neurotransmitters, including serotonin, dopamine, norepinephrine and epinephrine (also known as adrenaline) and are familiar with at least some of their functions in regards to mood (especially depression) and sleep (serotonin is the immediate precursor to melatonin, which helps you fall asleep and stay asleep). What most people do not know is that neurotransmitter imbalances can dramatically affect many other aspects of your health and can cause or exacerbate any of the following conditions:

A full list of the disorders and diseases related to neurotransmitters imbalance can be accessed here. The key point is that when imbalances in neurotransmitters occur, information is not relayed optimally in the brain which causes symptoms. Most people exhibit more than one of these conditions but don’t make the connection between them because most health care professionals don’t know that much about brain chemistry or how to use amino acid therapy to correct the underlying neurotransmitter imbalances.

We have a novel approach to help those with these disorders substantially reduce and/or eliminate their symptoms.  It is based on underlying biochemical imbalances in brain chemistry, and it works. Contact us to learn how you can achieve optimal neurotransmitter function.

Source for full list of disorders and diseases related to neurotransmitters imbalance

The main excitatory neurotransmitters in the body are dopamine, norepinephrine, epinephrine and glutamate.

Dopamine plays a number of important functions in the brain. It is very important in the reward system whereby we feel pleasure, achieve heightened arousal and do much of our learning. Every type of reward that has been studied increases the level of dopamine transmission in the brain. A wide variety of highly addictive drugs, including cocaine and amphetamines (i.e., methamphetamine, “speed”, Adderall, Vyvanse, Dexedrine) act directly on the dopamine system.  Dopamine also helps with focus, concentration and memory as well as motivation. Several important diseases are associated with dysfunctions in the dopamine system, including Parkinson’s disease, schizophrenia and ADD/ADHD.

Norepinephrine is made from dopamine and plays many roles it the body. It along with epinephrine are responsible for the “fight-or-flight” response to stress, which increases your heart-rate, increases blood sugar and increases blood flow to the muscles to allow you to act or react to stressors. Norepinephrine also affects blood pressure and heart rate, although it’s most widely known impact is on alertness, arousal, decision making, attention and focus. Several ADHD medications, such as methylphenidate (Ritalin/Concerta), amphetamines (Adderall, Dexedrine) and atomoxetine (Strattera) are used to increase norepinephrine levels in the brain in an attempt to help improve focus and concentration. Other classes of drugs seek to modulate norepinephrine in the brain to improve depression, including venlafaxine (Effexor), duloxetine (Cymbalta) and bupropion (Wellbutrin).

Epinephrine (also known as adrenaline) is released in reaction to stress and is partially responsible for the “fight-or-flight” response. It affects a number of important functions, including heart rate, breathing and blood pressure. Imbalances in epinephrine can lead to “adrenaline junkies”, a term that is often used to describe people that seem to enjoy stress and stressful activities. Unfortunately, they also usually suffer from constant need for urgency, have trouble relaxing or sleeping and keep ‘the pedal to the medal’ as they race through life.

Glutamate is the most abundant excitatory neurotransmitter in the human brain. It plays key roles in cognitive functions like learning and memory. Imbalances in glutamate levels are associated with Alzheimer’s disease, seizures and forms of autism. Interestingly, glutamate is also used as a flavor enhancer in the form of monosodium glutamate (MSG).

If the balance between the inhibitory and the excitatory neurotransmitters is disrupted for some reason, many symptoms can develop. We will cover the many symptoms of neurotransmitter imbalance next.

There are several inhibitory neurotransmitters in the body, but the two that are thought to have the greatest and widest reaching effects are serotonin and GABA (gamma amino butyric acid).

Most people know of serotonin in relation to mood and a class of drugs known as selective serotonin reuptake inhibitors (SSRIs) – including Paxil, Prozac, Zoloft, Celexa, Lexapro and Luvox. However, most people do not know that most of the serotonin in the body is produced and found in the intestine (approximately 90%) and the remainder is mostly found in the brain and central nervous system. Serotonin helps to regulate appetite, sleep, memory, learning, temperature, mood, behavior, muscle contraction, cardiovascular function and hormone balance.

GABA is an inhibitory neurotransmitter that helps with reducing anxiety, calming the mind and releasing tension. Some anti-anxiety medications like benzodiazepines (i.e., Xanax, Klonopin, Valium, Lorazepam) and barbiturates (i.e., phenobarbital, Fioricet), as well as many sleep medications (i.e., Ambien, Lunesta) work primarily by increasing the amount of GABA released in a neuron.

Both serotonin and GABA work in conjunction with a specific excitatory neurotransmitter (or group of excitatory neurotransmitters); in this way, they can balance one another to make sure only important signals are sent. Serotonin works in conjunction with a group of excitatory neurotransmitters called the catecholamines; these include dopamine, norepinephrine and epinephrine. GABA works in conjunction with glutamate. The balance between these respective sets of inhibitory and excitatory neurotransmitters is imperative for proper neurotransmitter function.

In its most basic form a neuron has two ends (although either can have multiple branches): an axon and a dendrite. A neuron communicates with other neurons by sending neurotransmitters from its axon to a dendrite of another neuron. The space between the axon and the dendrite is called a synapse; this is the space across which a neurotransmitter must cross.

Image Source

Neurotransmitters are stored in the axon (or pre-synaptic neuron) in little packages called synaptic vesicles. They are released if an appropriate charge is sent down the axon. Once released, they cross the synapse to dock with receptors on the dendrite of another neuron (often called the post-synaptic neuron). If enough neurotransmitters dock with the receptors, a signal is sent down that neuron and the message continues on. However, if not enough neurotransmitter docks with the receptor, then the message stops.

Either way, once the neurotransmitter is released from the receptor, it is either taken back up into the synaptic vesicle of the axon by a neurotransmitter reuptake pump/transporter or it is destroyed by enzymes that are present in the synapse.

Bundles of neurons run from your brain to every organ and system in your body.

Therefore, neurotransmitters help to control and regulate most of your body’s functions, including:

Most neurotransmitters are classified in one of two types – inhibitory and excitatory. Inhibitory neurotransmitters slow down the flow of information by calming and reducing the activity of neurons; they help to bring balance to the body. Excitatory neurotransmitters generally increase the flow of information. It is the balance between the inhibitory and excitatory neurotransmitters that has the greatest effect on your body functions.

We will discuss the different inhibitory and excitatory neurotransmitters in future posts.

CysReplete is a formula that is used in conjunction with any balanced amino acid therapy. CysReplete contains only L-cysteine, selenium and folate. CysReplete is necessary for two main reasons: (1) using tyrosine or L-dopa (i.e., Mucuna pruriens) without CysReplete can deplete the sulfur amino acid system and (2) to prevent neurotoxicity due to methylmercury.

The methionine-homocysteine cycle is the primary sulfur amino acid system in the body. Using tyrosine or L-dopa leads to a depletion of sulfur in this system, which can cause heart irregularities, pain, decreased immune function and insomnia. Luckily, there is a simple strategy to remedy this depletion: take sulfur.

S-adenosyl-methionine, also known as SAMe can be used for this purpose; however SAMe is quite expensive at the doses needed (about 4500 mg/day). We have found cysteine to work equally as well at a substantial cost savings.

The selenium is added to the formula to prevent cysteine (or any sulfur amino acids) from creating an environment that contributes to neurotoxicity from methylmercury. Methylmercury is formed in the body if body stores of mercury come into contact with a methyl donor, such as SAMe or cysteine. Methylmercury is a much more toxic and dangerous substances than elemental mercury, as it can cross the blood-brain-barrier and studies have shown that administration of sulfur-containing amino acids can increase the concentration of methylmercury in the brain. However, selenium irreversibly binds to methylmercury rendering the methylmercury biologically inactive and non-toxic. Therefore, by providing the body with sufficient selenium along with adequate sulfur amino acids, such as cysteine, the potential danger of methylmercury exposure is avoided.

Folic acid is required in order to provide optimal function of the folic acid cycle which keeps the methionine-homocysteine cycle functioning properly. Folic acid also plays a vital role in keeping homocysteine levels in check..

CysReplete is an important component of any balanced amino acid therapy program and needs to be included any time a person takes tyrosine or L-dopa (Mucuna pruriens) to insure optimal long-term care.

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.