![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 52 to 76 of 112. Go back in thread:
Posted by barbaracat on March 29, 2005, at 23:40:36
In reply to Re: Vitamin D and depression » mystery road, posted by Larry Hoover on March 29, 2005, at 23:09:33
I need a reality check. Is the Vit D test expensive? My doctor did an about face on the Vit D issue. She'd been to a seminar about it, was all excited about high dosing for my mood disorder and just wanted to get more info before prescribing it. Next time I saw her, she said high dosing was only indicated for active osteoporosis and I should just take the standard 400IU. I said, 'well, is it worthwhile to at least get a blood level?' and she said 'oh, the test is too expensive, and doesn't tell you anything useful. Just get more sunlight'. Yeah, right, I live in the rainy NorthWest!
It left me with a weird feeling and I don't know what to think. I can't imagine the test is that expensive, and even if it is, it's my money. She's probably doing a CYA for legal reasons, but what a strange thing. So, I ordered the Biotics 2,000IU brand and am back to being my own doctor, but jeez, I'd prefer to do this with a bit more caution. Sigh. Are there ANY decent docs out there? Or is 'decent doc' an oxymoron under managed care? - BCat
> Any doctor can order the test. For the results to be meaningful, discontinue all vitamin D supps at least 7 days before having blood drawn.
>
> Lar
>
Posted by mystery road on March 30, 2005, at 5:36:01
In reply to Vit D and weird doc, posted by barbaracat on March 29, 2005, at 23:40:36
> I need a reality check. Is the Vit D test expensive? My doctor did an about face on the Vit D issue. She'd been to a seminar about it, was all excited about high dosing for my mood disorder and just wanted to get more info before prescribing it. Next time I saw her, she said high dosing was only indicated for active osteoporosis and I should just take the standard 400IU. I said, 'well, is it worthwhile to at least get a blood level?' and she said 'oh, the test is too expensive, and doesn't tell you anything useful. Just get more sunlight'. Yeah, right, I live in the rainy NorthWest!
>
> It left me with a weird feeling and I don't know what to think. I can't imagine the test is that expensive, and even if it is, it's my money. She's probably doing a CYA for legal reasons, but what a strange thing. So, I ordered the Biotics 2,000IU brand and am back to being my own doctor, but jeez, I'd prefer to do this with a bit more caution. Sigh. Are there ANY decent docs out there? Or is 'decent doc' an oxymoron under managed care? - BCatBCat..
I say, why wait?..If your going through depression and need some relief, just try this on your own..Give it a few weeks and see if it helps you..If it helps and then you go to a doc and tell them what you've been doing, they'll likely prescribe the test..The risk to reward is in your favor..
MR
Posted by raybakes on March 30, 2005, at 9:07:13
In reply to Re: Vitamin D and depression » raybakes, posted by Larry Hoover on March 28, 2005, at 10:30:33
> I have no idea what might be in a liver glandular. I used to work at a health food warehouse (long before I realized what was the point of having this stuff available), and we used to sell dessicated liver powders. All I remember is the yuck that got all over us when we were packaging that stuff.
>
> So, re: geneology. Are you going to tell us what famous ancestors turned up in this search, or what?
>
> Lar
>
>No one famous, sadly! just carpenters, blacksmiths, porters and shipbuilders from London mainly, but also Germany, France and Scotland.
Ray
Posted by barbaracat on March 30, 2005, at 17:34:37
In reply to Re: Vit D and weird doc, posted by mystery road on March 30, 2005, at 5:36:01
Oh, I'm not waiting. I've started taking 4,000IU daily, may bump it up depending on how I feel but. I generally take these matter into my own hands anyway. I'm feeling frustrated at the sorry condition of medical care and how much I have to pay in insurance premiums for the priviledge.
> I say, why wait?..If your going through depression and need some relief, just try this on your own..Give it a few weeks and see if it helps you..If it helps and then you go to a doc and tell them what you've been doing, they'll likely prescribe the test..The risk to reward is in your favor..
>
> MR
>
>
>
Posted by Elainep on April 3, 2005, at 16:46:37
In reply to Re: Vit D and weird doc » mystery road, posted by barbaracat on March 30, 2005, at 17:34:37
Hi Barbaracat and MR
Sorry to hear your trials and tribulations with your doctor Barbaracat. I can't believe the medical profession: they seem to have an inbuilt resistance to the idea of vit D. I was at a party the other night and chatting to a GP who didn't believe me when I told her my daughter had been vit D deficient. She was so disbelieving it wasn't funny. In New Zealand? Hah.
I'd listen to MR on this one, start supplementing and tell your doctor eventually that you're doing it so she'll be forced to test you out of worry. I don't think the blood test is anything out of the ordinary, and especially if you're willing to pay for it! What's wrong with your doc?
Congratulations MR: sounds like Vit D may well be at the root of all your biochemistry problems, just like it was for my daughter. I'm sure you're not imagining the changes!!!! I've been directly emailing one of your other members about vit D and he's been tested and came back really low so is about to megadose.
By the way, turns out the megadose was a form of vit D2 for my daughters called calcifediol. And it was 3 mcg? or about 120,000 iu. They don't have therapuetic doses of D3. Just to set the record straight on that one.
Barbaracat, too many of your symptoms sound vit D related to me: that whole fibromyaglia thing as well as your depression, plus your mom having ricketts, plus the good ole rainy pacific northwest. So good for you for dosing up anyway, follow MR's advice and threaten and cajole once you're taking it to get your doctor worried enough to get you tested.
Anyway it's great to know that vit D has proved so helpful to you MR: I hope others of you out there are paying attention and thinking of giving it a try. Let me reiterate that your symptoms don't have to be classic SAD in the winter type stuff to have a vit D deficiency: it can be unipolar or bipolar, it can happen in the summer, whatever. Your vit D levels go down over time and if you're just not getting enough sun for whatever reason, it can show up at any time. Remember Vit D impacts the adrenal glands and stops them working properly, so your moods are not being regulated the way they should, and who knows how that looks in terms of an individual's symptoms.
Good luck MR! And Barbaracat I hope you show some signs of improvement once you start dosing: I'm sure you sound like a good case for vit D doing a lot of good.
Bye now
Elainep
Posted by barbaracat on April 3, 2005, at 20:58:19
In reply to Re: Vit D and weird doc, posted by Elainep on April 3, 2005, at 16:46:37
HI Elaine,
My husband and I have started on Biotics Forte, which is an emulsified Vit D at 2,000UI a drop. I've started on 4 drops, or 8,000IU and will see how it goes. A question for you - did your daughter take only 1 megadose and then supplemented on a daily basis with a higher than normal dose?Also, can you provide more info on adrenals and D? The adrenal connection is a particular interest of mine. They go through alot of wear and tear through stress and anrenal fatigue impacts the entire hormonal system. The story is that if the adrenals are compromised, the thyroid will continue to suffer even if TSH values are supposedly normal. Being hypothyroid, another little Vitamin D bell just rang.
Posted by mystery road on April 4, 2005, at 9:36:19
In reply to Re: Vit D and weird doc, posted by Elainep on April 3, 2005, at 16:46:37
So far, so good Elaine..Thanks.
I'll keep posting as things progress..Especially as we start to see some sunlight on the east coast..Its been very sunless here for a long time..MR
Posted by Elainep on April 4, 2005, at 15:56:11
In reply to Re: Vit D and weird doc » Elainep, posted by barbaracat on April 3, 2005, at 20:58:19
Hi Barbaracat
Here's a link with a short something about Vit D and adrenals, but I never really found anything on the internet about it, it was what one doctor told me when she was explaining how Vit D affected moods (she said it was through the proper regulation of the adrenal glands, which in turn handled the mood chemicals).
http://www.mercola.com/2002/feb/23/vitamin_d.htm
Yes, my daughter only had the one megadose. My other daughter was low as well and also had a megadose. Here are the actual numbers:June 2004: Jo tested at 16 nmol/l (normal range is 50-150 nmol/l) Jo weighs about 50 kg. Had a megadose of 3 mcg? of calcifediol.
July 2004: Jo tested at 86 nmol/l. Took supplements of 400iu a day.
Jan 2005: Jo tested at 68 nmol/l. Have now upped her supplements to 1000iu a day. Will get her retested this July.
June 2004: Pat tested at 22 nmol/l. Pat weighs about 72 kg. After the one megadose of 3 mcg? of calcifediol:
July 2004: Pat tested at 72 nmol/l. Took no supplements for the next 6 months, but 'basked' most mornings in the sun for 10-15 minutes.
Jan 2005: Tested at 67 nmol/l. Not as great a loss as Jo (who continued to see no sun but supplemented at 400iu a day for the same period). Pat now on 1000iu a day, will get retested in July.Me. I got myself tested in January with the girls. Test results: 48 nmol/l. I am also taking 1000iu a day for six months, will get retested in July.
Hope this helps Barbaracat.
Bye now
Elainep
Posted by barbaracat on April 4, 2005, at 19:04:26
In reply to Re: Vit D and weird doc, posted by Elainep on April 4, 2005, at 15:56:11
Posted by Larry Hoover on April 9, 2005, at 13:59:07
In reply to Re: Vit D and weird doc, posted by Elainep on April 4, 2005, at 15:56:11
> Hi Barbaracat
>
> Here's a link with a short something about Vit D and adrenals, but I never really found anything on the internet about it, it was what one doctor told me when she was explaining how Vit D affected moods (she said it was through the proper regulation of the adrenal glands, which in turn handled the mood chemicals).
>
> http://www.mercola.com/2002/feb/23/vitamin_d.htmI appreciate the link, but the reference he gives as a source page does not once mention the adrenals.
In fact, he snipped paragraphs from this unreferenced work:
http://www.westonaprice.org/basicnutrition/vitamindmiracle.html
However, I tracked down the adrenal reference, and it's at:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9011759Not a problem, really. I'm glad they're coming up with reasons to supplement D....if it makes people take some, that's a good thing. I know I seldom get sunlight. That's all I need to know. Cod liver oil and supplement tablets, for life. Who knows how long I've been deficient, but I have to believe I must be. I have all the risk factors.....easily sunburn (sun avoidance).... work, live and play generally indoors....health problems that keep me in the house....how could I not have a vitamin D deficiency?
BTW, the idea that milk is properly fortified with vitamin D (and vitamin A) is false. Just because it says it on the label....Testing has proven otherwise:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3391970
The only way to be sure is to take a supplement, IMHO. God knows what my health would be like if I'd had it all along.
Lar
Posted by barbaracat on April 9, 2005, at 16:44:52
In reply to Re: Vit D and weird doc » Elainep, posted by Larry Hoover on April 9, 2005, at 13:59:07
Larry,
This article you linked to and others I've been reading mention the tyrosine hydrolxylase gene re adrenals in Vit D therapy. Do you know whether this tyrosine gene relates to the amino acid L-tyrosine, which is the precursor to thyroxine hormone? I'm hypothyroid, as so many of us are, and if Vit D is relevant then one more bingo.BTW, I've been dosing with 8,000mg of Vit D emulsion drops (Biotics Research) for about 2 weeks now. Maybe it's my imagination, maybe it's getting alot of other things balanced, but I do feel more energy, less bone pain and I guess one would say 'sunnier' of disposition. - Barbara
Posted by Larry Hoover on April 9, 2005, at 17:11:44
In reply to Vit D, adrenal and tyrosine » Larry Hoover, posted by barbaracat on April 9, 2005, at 16:44:52
> Larry,
> This article you linked to and others I've been reading mention the tyrosine hydrolxylase gene re adrenals in Vit D therapy. Do you know whether this tyrosine gene relates to the amino acid L-tyrosine, which is the precursor to thyroxine hormone? I'm hypothyroid, as so many of us are, and if Vit D is relevant then one more bingo.Sorry, the bingo announcer called out the wrong number.
The hydroxylation of tyrosine turns it into L-DOPA, the intermediate for dopamine synthesis.
Tyrosine that is to become thyroid hormone is first incomporated into a massive protein glob called thyroglobulin. It's kind of like a porcupine, studded with tyrosines. The tyrosine molecules are iodinated, then combined to form T4 and T3. They are totally distinct processes.
> BTW, I've been dosing with 8,000mg of Vit D emulsion drops (Biotics Research) for about 2 weeks now. Maybe it's my imagination, maybe it's getting alot of other things balanced, but I do feel more energy, less bone pain and I guess one would say 'sunnier' of disposition. - Barbara
I am so glad to hear that.
One wonders if the adjective sunny, with respect to disposition, bears with it a history of observation.....those who take the sun have it, more than others?
Lar
Posted by barbaracat on April 9, 2005, at 21:36:18
In reply to Re: Vit D, adrenal and tyrosine » barbaracat, posted by Larry Hoover on April 9, 2005, at 17:11:44
> One wonders if the adjective sunny, with respect to disposition, bears with it a history of observation.....those who take the sun have it, more than others?
>
**And those who don't take the sun have the moon and are therefore more 'loony' or 'luna-y'?Larry, talking about tyrosine got me thinking about a test my former naturopath wanted me to take, a urine test to measure serotonin, NE, dopamine, histamine and GABA. I declined because I don't believe the science has been perfected to measure these with any accuracy and didn't want to waste $200. Or maybe I'm wrong, although it would seem that if such testing were available we'd be using it to save alot of time and heartache with our med trials. But maybe docs aren't aware of it?
The company is Neuroscience and the website is www.neuroscienceinc.com if you have a hankering to check them out. How great if it were true, but I don't think so. A little flag started waving in that they conveniently sell their own remedy line of amino acid products. - Barbara
Posted by Larry Hoover on April 10, 2005, at 11:18:56
In reply to Re: Vit D, adrenal and tyrosine » Larry Hoover, posted by barbaracat on April 9, 2005, at 21:36:18
> Larry, talking about tyrosine got me thinking about a test my former naturopath wanted me to take, a urine test to measure serotonin, NE, dopamine, histamine and GABA. I declined because I don't believe the science has been perfected to measure these with any accuracy and didn't want to waste $200. Or maybe I'm wrong, although it would seem that if such testing were available we'd be using it to save alot of time and heartache with our med trials. But maybe docs aren't aware of it?
Waste of time and money, and potentially distracting from more appropriate therapies.....
http://www.dr-bob.org/babble/alter/20050323/msgs/482309.html
Nothing wrong with maybe buying their aminos (if they're cost effective), but the rationale for choosing from among them is seriously flawed.
Lar
Posted by joebob on April 12, 2005, at 18:18:02
In reply to Re: Vit D, adrenal and tyrosine » Larry Hoover, posted by barbaracat on April 9, 2005, at 21:36:18
and i could replicate the formulas myself more cheaply except for a few peculuiarities....
one being 'zinc nicotinate' and the other being the sublingual 'lipolyzed' theanine and 5-htp...
i can say this at this point....a large part of the neuroscienceinc protocols rests on theanine and 5htp, at least in in the early stages.....
i do have the next level, stage 2 of supps for my wife, and there is a lot more stuff in it....unfortunately they are being a little more tricky about telling you how much of what is in each capsule.....
ask me more and i'll tell you what i can as time allows
we deserve to be treated well and fairly, just as much as dr. kellerman deserves to make a living and be heard...i hope some of us on this board can follow this thread for a while and compare notes
best,
joebob
Posted by barbaracat on April 12, 2005, at 18:34:55
In reply to i did the test and now have the supps recommended » barbaracat, posted by joebob on April 12, 2005, at 18:18:02
Dear JoeBob,
Thanks so much for replying. I'm really interested in hearing from people who have taken these tests to measure neurotransmitters.I don't doubt that amino acid therapy would help although I have doubts about taking single aminos without balancing them out. My question lies more with, are these tests really measuring something useful? Since the whole body runs on neurotransmitters, how can these tests be specific? It seems there are a number of these urine tests popping up over the internet. Most docs I've talked to about them just roll their eyes - which doesn't mean anything, but I can't find much on the methods they're using to isolate anything definitive.
> and i could replicate the formulas myself more cheaply except for a few peculuiarities....
>
> one being 'zinc nicotinate' and the other being the sublingual 'lipolyzed' theanine and 5-htp...
>
> i can say this at this point....a large part of the neuroscienceinc protocols rests on theanine and 5htp, at least in in the early stages.....
>
> i do have the next level, stage 2 of supps for my wife, and there is a lot more stuff in it....unfortunately they are being a little more tricky about telling you how much of what is in each capsule.....
>
> ask me more and i'll tell you what i can as time allows
>
> we deserve to be treated well and fairly, just as much as dr. kellerman deserves to make a living and be heard...i hope some of us on this board can follow this thread for a while and compare notes
>
> best,
> joebob
Posted by joebob on April 13, 2005, at 10:27:59
In reply to Neuroscience tests » joebob, posted by barbaracat on April 12, 2005, at 18:34:55
below.......he is also dubious about the tests
i had it and paid for it, now i have the first round of supps....they are listed in the thread:
http://www.dr-bob.org/babble/alter/20050323/msgs/482309.html
or in my reply
i'll let you know how it goes, my wife is trying it too
best,
joebob
Posted by Larry Hoover on April 13, 2005, at 11:04:13
In reply to Neuroscience tests » joebob, posted by barbaracat on April 12, 2005, at 18:34:55
> My question lies more with, are these tests really measuring something useful?
Simply put, no the tests do not measure anything useful.
They use the tests to sell a philosophy, a belief structure. They use the tests to increase cash flow for themselves, while simultaneously convincing you that they are doing something to help you. The test itself does not contribute to changing how you feel (other than by suggestion).
But, once convinced of the validity of their philosophy ("Look! The tests prove you are low serotonin, high histamine (or whatever)."), and already having you invested financially and emotionally, they can now sell you expensive supplements to "treat your low serotonin, high histamine" etc.
That is finally the point where treatment becomes possible.....the taking of supplements.
You don't have to buy *their* supplements to have the effect. You don't have to believe *their* philosophy to have the effect. No, all you have to do is swallow some supplements, which could come from any source.
They sell you two things. One is an overarching belief system (which may or may not be valid, and is unproveable, in any case). And the other thing they sell you is (expensive) supplements.
That's how I see it, anyway.
Lar
Posted by barbaracat on April 13, 2005, at 11:36:15
In reply to Re: Neuroscience tests » barbaracat, posted by Larry Hoover on April 13, 2005, at 11:04:13
**I'm inclined to believe you, Larry, since I'm not aware of any 'breakthroughs' in neurotransmitter testing - which indeed it would be for the psychicatric community. However, I have a friend who is being encouraged by the same (ex)naturopath as I to take this test. The naturopath does not have any financial interest in the two companies she's recommending and I think she'd like to believe that these tests would help. So here's my questions, just so I can display more knowledge to my friend before saying 'don't waste your money', also because my own health care providers make noises in these directions every now and then without understanding the science involved, and finally just so I can understand - mainly because there SHOULD be such a test, dammit.
1. What exactly are these tests measuring or trying to measure? amino acids? metabolites of catecholamines? valines?
2. You mentioned that these measurments didn't necessarily show only brain neurotransmitter levels, but muscle also. Could there be a base level, no matter where those values come from, that show optimum vs. unhealthy neurotransmitter values? In other words, a specific range is the goal and let the body figure out where to put the stuff.
For my own curiosity, what would make this test so impossible? Neurotransmitters produce metabolites. I understand the liver passes, etc., but maybe urine is not the way to go. If indeed spinal fluid is the only valid way so far, why aren't more doctors using these tests? Barring any cost, forget the snake oil supplements, it would be a relief to do away with the medical dart board approach.
I KNOW amino acid level tests do exist. Too bad it's not all about amino acids, as these guys seem to be implying. But even so, maybe amino acid levels could tell us more than we're curently getting.
I'm going to to pursue this, Larry, and would appreciate any help - just point in a general direction of what would be involved in getting some useful data of neurotransmitter status. Thanks as always for your most edifying help. - Barbara
>
> They use the tests to sell a philosophy, a belief structure. They use the tests to increase cash flow for themselves, while simultaneously convincing you that they are doing something to help you. The test itself does not contribute to changing how you feel (other than by suggestion).
>
> But, once convinced of the validity of their philosophy ("Look! The tests prove you are low serotonin, high histamine (or whatever)."), and already having you invested financially and emotionally, they can now sell you expensive supplements to "treat your low serotonin, high histamine" etc.
>
> That is finally the point where treatment becomes possible.....the taking of supplements.
>
> You don't have to buy *their* supplements to have the effect. You don't have to believe *their* philosophy to have the effect. No, all you have to do is swallow some supplements, which could come from any source.
>
> They sell you two things. One is an overarching belief system (which may or may not be valid, and is unproveable, in any case). And the other thing they sell you is (expensive) supplements.
>
> That's how I see it, anyway.
>
> Lar
Posted by tealady on April 14, 2005, at 3:50:40
In reply to Re: Neuroscience tests » Larry Hoover, posted by barbaracat on April 13, 2005, at 11:36:15
Hi Barbara,
This is a post by Larrian written about 5 years ago. I think I've posted on it b4 here..but the search don't bring up my posts much any more (:-
http://forums.about.com/ab-thyroid/messages?msg=6675.139
She used to use it in her practise as a gyno-urologist..both blood and urine testing of amino acids and compare for metabolic pathways.
She did know what she was doing as she was a researcher in hormones )(MSH ? I think from memory) http://forums.about.com/ab-thyroid/messages?msg=6675.127Mind you this is dated 2000, and she is referring to pre 1995 before she retired.
testing both urine and bloods would have to give you some idea of what goes on in the body..which is (as far as I know) usually reflected in the brain (yeah I have heard of the blood brain barrier). I've never heard of spinal fluid being tested for neurotransmitter levels, even the more common ones.anyway..just thought I should mention that some others seem to believe it urine amino acid testing gives some indication , although she used to compare with blood levels.
I also think some idea of which path to take would help. I try to look for other symptoms ..not in the brain or emotional as a guide too, as the brain is connected to the body..even if there is a blood brain barrier.
e.g. Whenever I took SSRI's I'd get major gut symptoms. I think this should have been a sign they were not a solution. (over a no of months)
Besides most of the things we take don't go only to the brain..like our bodies have to tolerate them and need them as well. If our bodies are just going to excrete/object to whatever we take..well what's the use(except maybe over the very short term as an emrgency med).Interested in how you guys ago, although I do believe that Larrian 's approach would be more telling than just urine testing. (but frightfully exxy). She herself didn't recommend it a lot due to cost.
tea
Posted by Larry Hoover on April 14, 2005, at 8:29:10
In reply to Re: Neuroscience tests » Larry Hoover, posted by barbaracat on April 13, 2005, at 11:36:15
> **I'm inclined to believe you, Larry, since I'm not aware of any 'breakthroughs' in neurotransmitter testing - which indeed it would be for the psychicatric community.
Indeed. If it was as simple as peeing into a cup....
> However, I have a friend who is being encouraged by the same (ex)naturopath as I to take this test. The naturopath does not have any financial interest in the two companies she's recommending and I think she'd like to believe that these tests would help.
The test itself, in my opionion, offers confirmation of the philosophy. "Believe in me, and I shall show you a sign."
> So here's my questions, just so I can display more knowledge to my friend before saying 'don't waste your money', also because my own health care providers make noises in these directions every now and then without understanding the science involved, and finally just so I can understand - mainly because there SHOULD be such a test, dammit.
>
> 1. What exactly are these tests measuring or trying to measure? amino acids? metabolites of catecholamines? valines?That's not totally clear to me, but I haven't looked *everywhere* on the site. Take the first example on this page:
http://www.neurorelief.com/index.php?major=302The first panel is a urine collection and saliva sample, said to provide analysis of: Estradiol, Estrone, Progesterone, Testosterone, Dihydrotestosterone, DHEA, Cortisol x4, Epinephrine, Norepinephrine, Serotonin, Dopamine,
GABA, PEA, Histamine, Glutamate.I needed to have my testosterone and DHEA tested, and my poor doctor was under the illusion that he needed a blood draw, under fasting conditions, at 8 a.m. And, poor man, he was under the impression that he needed to measure total testosterone, dihydrotestosterone, and free testosterone, and both DHEA and DHEA-S, all from that specially-collected blood sample.
I don't exactly know what Neuroscience is measuring, and I have no idea how they have validated their methodology. Cortisol can be measured from saliva, but it is nowhere near clear that other hormones can be, or if there is any relationship at all between saliva and/or urine concentrations and free/bound plasma levels, i.e. they can be measured non-invasively.
In the realm of neurotransmitters, again it's not clear if they measure break-down products, the metabolites, of the neurotransmitters involved, along with traces of the parent, or what. For serotonin (5-hydroxytryptamine) as an example, that would be 5-HIAA (5-hydroxyindole-acetic acid). It would be useful to determine parent and metabolite concentrations, and the ratio between them, I would think.
When I read this article, they make certain claims. When I check the references (bottom of page), the claims are not supported.
http://www.neurorelief.com/showarticle.php?NewsletterView&ArticleID=456They provide many, many references to biochemical disturbances associated with mental health disturbances, but only 3? (perhaps more) deal with urine concentrations. Not only are those references sparse, they are old (twenty years). All those older references did was confirm something we already knew, and could measure by other means. The norepinephrine metabolite normetanephrine *is* elevated in the urine of *one class of depressives*, and it turns out that class is the dexamethasone non-suppressors. I fail to see how that adds to our knowledge.
Moreover, norepinephrine has multiple metabolites (as do the other catecholamine neurotransmitters), and it would require analyses of ratios between them all, and their respective parents, to develop a true metabolic profile. That work has not been done, or at least, has never been published.
Finally, 80% of the references upon which Neuroscience itself seems to rely for its scientific rationale involve cerebrospinal fluid assessments, or blood platelet/serum analyses.
In the case of CFS, only a lumbar puncture (spinal tap) can get you behind the blood/brain barrier for a biopsy sample (that's what a spinal tap represents). It is so horribly invasive a procedure (in the sense of breaching the natural barriers of the central nervous system) that it is only done in life-threatening situations. It is done precisely because CNS biochemical profiles cannot be assessed in any other way. There is no useful correlation with the biochemical profile of CFS with any other fluids in the body.
With respect to the biochemistry of blood cells, they are employed because they float around in the blood/serum, but they are metabolically separate tissues, with their own membranes isolating them from their environment, and they are easily collected. At best, they are markers for relative rates of uptake/metabolism of some biochemicals.....but making an extrapolation to brain cell biochemistry from that of a blood cell with no nucleus, whose job it is to carry oxygen, is rather tenuous. Moreover, a *blood draw* is a rather essential requirement for this test.....as it is for serum analysis. How do they (Neurosciences) get *this* info from urine, anyway?
Mainstream medicine abandoned urinalysis for these purposes because, in my own words, "we can't really learn anything useful that way."
> 2. You mentioned that these measurments didn't necessarily show only brain neurotransmitter levels, but muscle also. Could there be a base level, no matter where those values come from, that show optimum vs. unhealthy neurotransmitter values? In other words, a specific range is the goal and let the body figure out where to put the stuff.
Urine eliminates wastes from all tissues, not just the brain. There is no way to trace a metabolite or waste product back to its source, unless you're using special radioactive substances as a probe, along with other specially controlled circumstances.
It may be that a gross measurement of urine content might indicate a systemic disturbance, but, once again, no evidence has been collected to demonstrate any relationship between urine content and mental state, but for the norepinephrine metabolite normetanephrine, and the adrenal steroid cortisol. Urine measurement of some other steroidal hormones (e.g. sex hormones) is sometimes useful, but you need to know the blood levels to complete the assessment.
> For my own curiosity, what would make this test so impossible?
It's not impossible. It's not validated. Whatever they are measuring, let us assume they are measuring it well. Modern analytical equipment can provide precise and accurate measures of chemical composition. The question is, what can we infer from those measurements?
Think about diabetic monitoring. They used to rely on urinalysis. You peed on a chemically treated swab or stick. That provided crude glucose/insulin monitoring. Then they developed home blood tests. Up until very recently, actual blood samples were analysed in portable devices.....blood tells you more than urine ever could. (I say, "up until recently", because I think they've developed portable devices that don't require a blood sample....I think I remember reading that. But still, it is a blood analyzer. A trans-cutaneous blood analyzer.)
> Neurotransmitters produce metabolites. I understand the liver passes, etc., but maybe urine is not the way to go.
Think of a full garbage truck at the dump. The garbage from each home is now blended and contaminated with all the rest. Urine is a garbage truck, except there are no "address labels" (the metaphor of the garbage truck is not perfect) as in household trash, that might let you backtrack to a particular home. Maybe you can make global statements, like "We need to control disposal of recyclables", or some such, but you can't determine who is breaking the rules.
Urine crudely records systemic metabolic processes, and only by inference, at that. E.g. serotonin that is captured by a reuptake pump is not converted to 5-HIAA. You don't know total serotinergic activity, only that which was captured by the enzyme MAO. You don't know if that chemical reaction occurred in the gut or not, or if the gut is normal (irritable bowel syndrome is serotinergic). And so on.
> If indeed spinal fluid is the only valid way so far, why aren't more doctors using these tests?
Two reasons. One, it's too invasive. It has a very high relative risk, and a life-threatening condition is pretty much the only reason for shifting the risk-benefit balance towards the benefit side. Secondly, even cerebro-spinal fluid doesn't tell us much. *It* doesn't tell us what parts of the brain might be off-balance. We can't track CFS components back to their sources, either. CFS is the garbage truck for the central nervous system.
> Barring any cost, forget the snake oil supplements, it would be a relief to do away with the medical dart board approach.
I am not saying there is *nothing* of value in these tests. It may well be that they can throw darts better after these tests than before. But, I think they exaggerate the benefit substantially, if not massively.
From a good clinical interview, you could get the same treatment objectives, IMHO, as these tests could possibly indicate.
What they offer differently from standard medical care is nutritional intervention. If you look at some of the treatment protocols, they also use SSRIs, as an example.
> I KNOW amino acid level tests do exist. Too bad it's not all about amino acids, as these guys seem to be implying. But even so, maybe amino acid levels could tell us more than we're curently getting.
Yes, amino acid levels might well be useful. That is exactly the realm I focus on.....interventions in supply management. The equipment exists. I try to make better use of it. You don't need expensive tests to begin managing supply intake.
> I'm going to to pursue this, Larry, and would appreciate any help - just point in a general direction of what would be involved in getting some useful data of neurotransmitter status.I still rely on symptoms, and symptom-specific indications. I still rely on the good old "let's do this experiment" process.
> Thanks as always for your most edifying help. - Barbara
You're welcome.Lar
Posted by joebob on April 14, 2005, at 11:25:04
In reply to Re: Neuroscience tests » Larry Hoover, posted by barbaracat on April 13, 2005, at 11:36:15
talk to dr. kellerman..from what i have been told he is very open to questions.....
if he won't talk to you, i could ask one of the folks who is using his system to make thc call...
he gives seminars and there are cd's of them, but i only have the last 4 of 6....
i will forward these posts to the folks who use the system and ask for their inputmaybe larry would be willing to call, he's the most kowledgable
we'll see what happens
Posted by barbaracat on April 14, 2005, at 23:28:57
In reply to Neuroscience tests...why don't you call them and » barbaracat, posted by joebob on April 14, 2005, at 11:25:04
Thanks for the suggestion, JoeBob. Actually, I did talk to someone about 6 months ago. He was one of the research guys and developer of the products and we exchanged a half dozen emails. I expressed my concern that they were using 5-HTP instead of tryptophan and got the usual rap about some people died from a contaminated batch and besides, 5-HTP is actually better and so on. I told him I disagreed that it was better, that for some people, like myself, 5-HTP actually makes me feel worse. I referred to the first conversion step that gets bypassed that is an important step in other cellular processes, as well as the fact that 5-HTP targets brain receptors sites only, whereas L-tryptophan targets serotonin receptor sites in the gut and peripheral muscles, important for someone like myself who has fibromyalgia.
In short, he thanked me for the info, said he wasn't aware of these mechanics or that some people did worse on 5-HTP and he would look into providing a tryptophan product. Needless, to say this discussion did not inspire me with confidence.
Neuroscience is not the only company offering these tests. In fact, they're springing up all over the web and it's either due to the fact that some new testing breakthrough has occurred or, disturbingly, a breakthrough has not occurred. I truly hope your friends are experiencing good things with the program. It would be great to get some actual reports.
Here's an interesting read by another company. I think if I were to have this test done, this protocol makes the most sense to me.
http://www.neuroreplete.com/Neurotransmitter_testing_and_amino_acid_therapy.pdf
> talk to dr. kellerman..from what i have been told he is very open to questions.....
> if he won't talk to you, i could ask one of the folks who is using his system to make thc call...
> he gives seminars and there are cd's of them, but i only have the last 4 of 6....
> i will forward these posts to the folks who use the system and ask for their input
>
> maybe larry would be willing to call, he's the most kowledgable
>
> we'll see what happens
Posted by barbaracat on April 15, 2005, at 21:01:05
In reply to Re: Neuroscience tests » barbaracat, posted by Larry Hoover on April 14, 2005, at 8:29:10
Thanks for the great reply, Larry. I've been digging around and the only lab and company that looks like it half knows what it's doing for neurotransmitter testing is this one: - if you can ignore the crappy website design (those revolving logos were driving me bonkers):
http://www.labdbs.com/home_page.htm
NeuroResearch is the company owned by same lab. There are a fews links that go somewhat into the testing methodology, namely using a urine creatinine ratio protocol. I'm going to do some more research and then give them a call. It'll take a lot of convincing but it'll still be interesting to talk with them. At any rate, he certainly has his opinions about some of the other operations out there, which I definitely share. Will keep you posted. - Barbara
Posted by Larry Hoover on April 15, 2005, at 22:17:59
In reply to Re: Neuroscience tests » Larry Hoover, posted by barbaracat on April 15, 2005, at 21:01:05
> Thanks for the great reply, Larry. I've been digging around and the only lab and company that looks like it half knows what it's doing for neurotransmitter testing is this one: - if you can ignore the crappy website design (those revolving logos were driving me bonkers):
>
> http://www.labdbs.com/home_page.htm
>
> NeuroResearch is the company owned by same lab. There are a fews links that go somewhat into the testing methodology, namely using a urine creatinine ratio protocol. I'm going to do some more research and then give them a call. It'll take a lot of convincing but it'll still be interesting to talk with them. At any rate, he certainly has his opinions about some of the other operations out there, which I definitely share. Will keep you posted. - BarbaraWhoa! That is one of the crappiest website layouts I've ever seen! And there should have been a little grammar/spell-checking, too.
I'll give them one thing....they're honest about what they offer.
http://www.labdbs.com/indication%20for%20high%20dose%20amino%20acid%20therapy.htm
"The bottom line is if you have a patient with neurotransmitter dysfunction simply start them on the amino acids as per the treatment protocols established by NeuroResearch and following neurotransmitter testing guidelines recommended by NeuroResearch once treatment us underway. Neurotransmitter testing is of no value or benefit at this time when preformed prior to starting treatment of the patient."
Also:
"Most important, use of neurotransmitter testing verifies that we are not over loading the patient with amino acids and/or neurotransmitters."Lar
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