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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by jms600 on December 16, 2008, at 16:28:39
Hi everyone,
I've read about this a little but can't seem to find much information on it. Can tests be carried out to ascertain the levels of serotonin, norepinephrine and/or dopamine in the brain? If so, how accurate are they?
Has anyone tried these tests? I'm no expert in such areas, but if the tests show that your lacking in serotonin or producing excess dopamine, then surely appropriate drugs can be prescribed to address the imbalance??
Are there any other chemicals within the body that can cause excess anxiety/depression which can also be tested for??
Thanks!
Posted by JadeKelly on December 16, 2008, at 17:08:09
In reply to Chemical testing for anxiety and depression...., posted by jms600 on December 16, 2008, at 16:28:39
> Hi everyone,
>
> I've read about this a little but can't seem to find much information on it. Can tests be carried out to ascertain the levels of serotonin, norepinephrine and/or dopamine in the brain? If so, how accurate are they?
>
> Has anyone tried these tests? I'm no expert in such areas, but if the tests show that your lacking in serotonin or producing excess dopamine, then surely appropriate drugs can be prescribed to address the imbalance??
>
> Are there any other chemicals within the body that can cause excess anxiety/depression which can also be tested for??
>
> Thanks!Gosh I wish. But maybe one of the geniuses on the board knows of such tests? There are a lot of physical problems to rule out. But when they can do a test to tell us exactly what and where we are lacking neurotransmitters, or have too many, and we can take those results to obtain accurate treatment, I'll be the first in line!
~Jade-I'll be watching your thread! Thnx
Posted by desolationrower on December 16, 2008, at 17:50:20
In reply to Re: Chemical testing for anxiety and depression.... » jms600, posted by JadeKelly on December 16, 2008, at 17:08:09
You might test cortisol, and then use that to decide melancholia->tca or atypical->MAOI. Not aware of any other useful tests.
-d/r
Posted by linkadge on December 16, 2008, at 18:17:02
In reply to Re: Chemical testing for anxiety and depression...., posted by desolationrower on December 16, 2008, at 17:50:20
There are no formal tests for neurotransmitters. You can measure blood serotonin but this is not an indicator of CNS neurotransmitter function.
In addition, there is no relyable link between blood neurotransmitters and depression (in fact, there is no relyable link between CNS levels of monoamines and depression).
Alternative healers may use neurotransmitter tests but these are kind of bunk.
Linkadge
Posted by azalea on December 16, 2008, at 18:23:57
In reply to Chemical testing for anxiety and depression...., posted by jms600 on December 16, 2008, at 16:28:39
There's almost certainly someone willing to sell you a test to measure levels of neurotransmitters. But whether or not the results are clinically useful is another question.
> Hi everyone,
>
> I've read about this a little but can't seem to find much information on it. Can tests be carried out to ascertain the levels of serotonin, norepinephrine and/or dopamine in the brain? If so, how accurate are they?
>
> Has anyone tried these tests? I'm no expert in such areas, but if the tests show that your lacking in serotonin or producing excess dopamine, then surely appropriate drugs can be prescribed to address the imbalance??
>
> Are there any other chemicals within the body that can cause excess anxiety/depression which can also be tested for??
>
> Thanks!
Posted by llurpsienoodle on December 16, 2008, at 19:38:26
In reply to Re: Chemical testing for anxiety and depression... » jms600, posted by azalea on December 16, 2008, at 18:23:57
There have been dexamethasone suppression tests available to psychiatrists for several decades. This test measures the cortisol response. Sure, it indicates some imbalance, but isn't really strongly correlated with severity of depression, and certainly not with selection of effective treatment.
I second linkadge- there's not strong evidence for the "neurotransmitter" theory of depression/anxiety/ etc.
Our brains are so much more than a handful of neurotransmitters. There's many many NT's and other interesting little communication molecules. There's bloodflow, there's activation of genes, long term changes resulting from metabolic stress... so many things happen to minds that are somewhat "disorganized".
Are the signs a *cause* of mental illness, or a *result* of mental illness?
If the *cause* of an illness is known, -sometimes- it helps us determine appropriate treatments. other times, not so much. AIDS is a challenge, on the vaccination front. Down Syndrome has a well-known cause, but one that cannot be remedied. However, what some might not know is that early speech therapy and occupational therapy and other interventions can help a child with Down's syndrome have a real chance to grow up surrounded by typically-developing peers.
Maybe it's not about fixing us, but rather about helping our suffering. I dunno.
********I think psychiatry would LOVE to get a reliable test to help them figure out which molecule to tweak in order to alleviate our suffering.
My former pdoc: "When all you've got is a hammer, the whole world looks like a nail"
-Ll
Posted by llurpsienoodle on December 16, 2008, at 19:42:47
In reply to Re: Chemical testing for anxiety and depression..., posted by llurpsienoodle on December 16, 2008, at 19:38:26
I sounded really discouraging in my above post.
I just wanted to share that I am enjoying a symptom free week, and have generally been doing well for the last 6 months. I'm Dx'd with bipolarII and PTSD.
So, there are meds out there that CAN and DO help many people. Don't give up hope
-Ll
Posted by Phillipa on December 17, 2008, at 0:51:02
In reply to I'm sorry, posted by llurpsienoodle on December 16, 2008, at 19:42:47
And you have seriously done so well I'm amazed and hung in there when I would have thrown in the towel. I congratulate you I really do. Love Phillipa
Posted by bleauberry on December 17, 2008, at 17:37:22
In reply to Chemical testing for anxiety and depression...., posted by jms600 on December 16, 2008, at 16:28:39
The problem is that there are many biological causes of depression.
Measuring neurotransmitters in urine or blood is probably not useful for psychiatry because it doesn't tell you what is going on at a cellular level in the nervous system. And it doesn't show anything about the condition or behavior of the receptors that receive those neurotransmitters.
Some of the primary causes of depression can be measured, in my opinion. They include:
-Lyme disease...lab tests often negative, but an LLMD can make or rule out a clinical diagnosis.
Primary symptoms are neuropsychiatric. If not Lyme, there are several co-infections that mimic it and are diagnosed or discovered at the same time Lyme investigation is going on.-Heavy Metal Accumulation...a one-time challenge test of high dose DMSA can measure mercury and lead and other metals in urine (DMSA is a chelation drug that pulls metals out of tissues). All of us have a certain amount of heavy metals, but the test shows whether they are out of a normal range. That being said, no amount of mercury is safe. Even tiny bits can cause severe symptoms, mostly neuropsychiatric. The biggest risks are with amalgam fillings.
-Thyroid freeT3,T4, and antibodies.
-24 hour saliva cortisol, four samples taken over a day to see the daily pattern compared to how it should look.
-Candida. Too much of this yeast floods the brain with endotoxins and neurotoxins. While measuring candida directly by antibodies or stool can be faulty or misleading, there is a test called Organix Dysbiosis Urine that measures the waste products unique to candida in your urine.
If cortisol or thyroid or candida look suspicious, it is likely due to an ongoing undiagnosed infection or metals. So in reality, the first two causes listed above cover the majority of things, as I see it. Genetics obviously play a huge role, determining how susceptible we are to the various environmental insults, and how radically our bodies respond to them.
There are many causes, but the above cover most of the biological ones that I personally consider big players, usually overlooked or unsuspected, but with tests that are easily accessible and affordable. These are my own opinions. Not fact, but strongly supported by a lot of science and research.
Posted by yxibow on December 19, 2008, at 1:57:54
In reply to Re: Chemical testing for anxiety and depression...., posted by bleauberry on December 17, 2008, at 17:37:22
> The problem is that there are many biological causes of depression.
There are some -- but there are also many forms of depression, dysthymia, endogenous depression, major depression, depression with polarity, etc.
> Measuring neurotransmitters in urine or blood is probably not useful for psychiatry because it doesn't tell you what is going on at a cellular level in the nervous system. And it doesn't show anything about the condition or behavior of the receptors that receive those neurotransmitters.
Completely true -- there is no way of correlating blood levels of serotonin with depression or measuring any form of it. Also, serotonin and its receptors are present outside the blood-brain barrier -- in fact mostly in the gut.
> Some of the primary causes of depression can be measured, in my opinion. They include:
>
> -Lyme disease...lab tests often negative, but an LLMD can make or rule out a clinical diagnosis.
> Primary symptoms are neuropsychiatric. If not Lyme, there are several co-infections that mimic it and are diagnosed or discovered at the same time Lyme investigation is going on.Lyme disease is a very real organic disease, but there are many real organic diseases and probably more mosquitoes and deer ticks than people on this earth just in one city of this country. It doesn't follow that you are going to get Lyme.
It is largely confined to the Northeast, there are clear signs in at least 2/3 of the cases of distinctive rashes; yes I know, these don't always show up, but other medical pointers are known.
> -Heavy Metal Accumulation...a one-time challenge test of high dose DMSA can measure mercury and lead and other metals in urine (DMSA is a chelation drug that pulls metals out of tissues)
And chelation therapy is medically unproven and can be dangerous, why do we keep coming back to this ?
There are only certain situations where chelation therapy (with EDTA formulations) has some genuine medical use and this is usually in the ER -- such as the hideous and bizarre use of thallium to poison people who speak against the former KGB.
Or a child who has broken a mercury thermometer (not really an issue these days since glass thermometers are rarely used any more with the advent of cheap and effective electronic thermometers and they have a thin amount of alcohol)
Possibly a child who lives in a house that has not been repainted and has consistently chewed paint that is known to have lead in it.
All of us have a certain amount of heavy metals, but the test shows whether they are out of a normal range. That being said, no amount of mercury is safe. Even tiny bits can cause severe symptoms, mostly neuropsychiatric. The biggest risks are with amalgam fillings.Again, the ADA has shown amalgams to be safe and effective in proper use. Yes, the jury is out on that one to a very limited extent, but between not being able to eat because your teeth have decayed and you're down to bridges, and having the choice of preventative medicine, I would gladly choose the latter.
That being said, if a filling is done in the front, it can usually be done with epoxy fairly well, but rear fillings with plastic generally don't stand up and may fall out.
> -Thyroid freeT3,T4, and antibodies.
Thyroid tests are important in diagnosing root organic causes, I'll give you that.
> -24 hour saliva cortisol, four samples taken over a day to see the daily pattern compared to how it should look.
Actually, the only completely effective method is a 24 hour urine catch, urinating in a large jar that you basically take around with you, hence a weekend or day off is better. If you exceed the jar, you just use a clean empty distilled water bottle. I've had this done before. Cortisol varies not just 4 times a day but many many times a day.
> -Candida. Too much of this yeast floods the brain with endotoxins and neurotoxins. While measuring candida directly by antibodies or stool can be faulty or misleading, there is a test called Organix Dysbiosis Urine that measures the waste products unique to candida in your urine.
This one I can't say much about. And candida is endemic in the human system.
> There are many causes, but the above cover most of the biological ones that I personally consider big players, usually overlooked or unsuspected, but with tests that are easily accessible and affordable. These are my own opinions. Not fact, but strongly supported by a lot of science and research.
As I've said before you're entitled to your own opinion -- thyroid and cortisol are supported by known medical factors for depression, chelation therapy, Candida issues, heavy metals are generally considered out of the realm of evidence based psychiatry and medicine.
Posted by linkadge on December 19, 2008, at 11:29:19
In reply to Re: Chemical testing for anxiety and depression.... » bleauberry, posted by yxibow on December 19, 2008, at 1:57:54
I gree with yxibow. I don't think there is any solid proof at all that heavy metal toxicity is a 'common' cause of clinical depression.
Linkadge
Posted by jms600 on December 19, 2008, at 17:40:09
In reply to Re: Chemical testing for anxiety and depression...., posted by linkadge on December 19, 2008, at 11:29:19
Thanks for the input everyone. My main diagnosis is chronic anxiety (and related anxiety disorders) - so I'm not sure how thyroid/cortisol or the other things mentioned would affect or lead to anxiety.
I'm currently on lithium so my thyroid levels are being tested anyway - my doctor hasn't said anything so I guess the levels are OK.
Any advice?
Thanks again.
Posted by linkadge on December 22, 2008, at 17:06:38
In reply to Re: Chemical testing for anxiety and depression...., posted by jms600 on December 19, 2008, at 17:40:09
It sounds like the routine tests are being done. There is, unfortunately, not more than can be done. Psychiatry isn't really a science, there is little or nothing objective to guide which meds or doses to choose.
Basically, they just go one which drugs make you feel better.
Linkadge
Posted by Phillipa on December 22, 2008, at 20:30:51
In reply to Re: Chemical testing for anxiety and depression...., posted by linkadge on December 22, 2008, at 17:06:38
What if they make you feel worse and not better ????Phillipa
Posted by yxibow on December 23, 2008, at 1:10:10
In reply to Re: Chemical testing for anxiety and depression.... » linkadge, posted by Phillipa on December 22, 2008, at 20:30:51
> What if they make you feel worse and not better ????Phillipa
Try, try again. Yes, psychiatry is both a science and an art. Its not perfect and we're not at that point, we have just begun. It doesn't mean there isn't hope.
Combinations of medications can be better for refractory depression, the caveat is that the more medications, of course, the more side effect interactions.
And what if they make you feel worse -- well with any medical condition, you ultimately choose to accept certain side effects and come to grips with whatever limitations you may have at a certain point and you move on, one day at a time.What can't be covered by medication can also be explored by therapy, but you have to be open to it and unfortunately a lot of insurance doesn't pay for most of it, which is terrible in my opinion.
Hope comes from within, I'm not trying to end on a downer.
Happy holidays and good feelings for what is a trying season for a lot of people.
-- Jay
Posted by Phillipa on December 23, 2008, at 19:43:31
In reply to Re: Chemical testing for anxiety and depression.... » Phillipa, posted by yxibow on December 23, 2008, at 1:10:10
Jay no kidding Happy Holidays to you too!!!! Been friends for a long time. Love you Jan
This is the end of the thread.
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