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Re: Urine Test to Measure Neurotransmitter Levels? Larry Hoover

Posted by Elroy on May 9, 2005, at 20:34:00

In reply to Re: Urine Test to Measure Neurotransmitter Levels? Elroy, posted by Larry Hoover on May 9, 2005, at 11:27:34

Lar,

Thanks for the info.

I am getting more and more stumped.

Anything that increases my NE levels (or that should be increasing them) causes an extremely noticeable increase in my anxiety and also my various physical symptoms (but especially the "prostatitis type sensations" - actually it is primarily a "burning urethra" type of pain).

It first occurred when my psyc doc put me on Effexor. Even at the starting low dose, the effect was almost immediate (the same evening). That was last July. Then a couple of months ago we had the same thing happen with Cymbalta. It just took a couple of days instead of right away.

Putting together that it was the NE angle (as I had been on SSRIs before and while they didn't help my anxiety problem any, they didn't worsen it nor cause the physical symptoms to increase), I decided on an "experiment".

I obtained some Tyrosine and tried ONE 500mg tablet. Yow! Anxiety increased as did the physical symptoms (especially the prostatitis type pains - I refer to it in that sense as it has been tested numerous times with no bacterial evidence found... but then the urologists go ahead and prescribe another cycle of antibiotics). Anyway, I cut the tablets in half (250mg) and still the same reaction. I cut the tablets in half again (125mg) and again the same reaction (just slightly muted a touch).

Well, I have been taking the Selegiline for about three weeks now and it too gives that same reaction, even at quite small doses (like 2.5 mg twice a day).

My primary mental/emotional problem is high anxiety, with only mild to moderate depression (and almost all of that centered around my anxiety and various physical symptoms).

As these total symptoms all came on within about 2 - 3 weeks of the severe anxiety onset, it just seems to me that there HAS to be some inter-relations there. I had chronic, high-level stress from 1996 to around 2002 and then moderate anxiety (so mild that ir was treated only with "talk therapy" and Ambien for a sleep aid) from July 2002 on. Anyway, it appears that all during that time my cortisol levels were steadily rising and that I hit some type of threshhold in June of 2004 when the severe anxiety and the various physical symptoms hit. The primary physical (main) symptoms include hypogonadism, burning / stinging pains of the hands and feet (to include at times lower arms and lower legs), yet icy cold sensations of insides of feet, the prosatitis type pain, tinnitus, and severe insomnia.

What is difficult for the MDs to fully understand is that these symptoms literally came on that quickly (almost overnight). What each want to do is look at each symptom as existing by itself. So the prostatitis is strictly a urology problem (with the urologist now being completely stumped) and the tinnitus being strictly an ENT problem (with the ENT doc being completely stumped), and the abnormally low testosterone being strictly an endo problem (and the endo doc being completely stumped), and the highly elevated cortisol being strictly an endo problem (and THAT endo doc being completely stumped)!

In fact, I am now in the proverbial "Catch-22" situation. The main endo says that the severe anxiety is "likely" causing elevated cortisol levels while the psych doc says that the elevated cortisol is "likely" causing the severe anxiety - with each saying that there's not much more that they can do!

As my Xanax XR is getting less and less effective, am I stuck in a Twilight Zone where I just keep increasing the doses of Xanax to (barely) keep a lid of the ongoing anxiety?

Anyway, I have also stopped the Selegiline. It's obvious that either my levels of NE are much higher than what the one blood test revealed or I have some super sensitivity to NE or something.

SSRIs (specifically Lexapro) caused their own terrible reactions, a deadening of emotions without really affecting the anxiety, sexual dysfunctions and severe nausea which wouldn't get better.

I wonder if possibly utilization of Tryptophan might be an option to try and raise serotonin levels if that might be a necessary addition? SAMe? Taurine?

I hate to stay on the Xanax XR, but we first tried Ativan and it did nothing for the anxiety after about an hour or so.

Personally, I believe that the cortisol is THE key element with what is going on here and am currently starting an aggressive protocol of taking various anti-cortisol supplements (seeing as how my main endo said that since it isn't Cushings that there's not much he can do for it).

Elroy

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> > I had the fancy blood test done. That was the one which showed the moderately low dopamine, very low normal range epinephrine, and the extremely low norepinephrine (way off the chart, BELOW the bottom of the normal range).
>
> Have you tried high dose vitamin C, for example? The conversion of dopamine to NE requires vitamin C and B6. You may have a defect in activating B6, too. You may need P5P instead of B6.
>
> I'm sorry if we've been over this before. I have trouble remembering who I talked to about what. I remember the what part, not the who.
>
> > The endocrinologist said that was a great result as it meant that my adrenal gland tumor was not only benign, but that it was NOT a "Pheo" tumor.
> >
> > The fact that I had circulating levels of very low adrenaline meant nothing to him.
>
> Did you dose with adrenal supports? Pantothenate, vitamin C (again), vitamin E, zinc, magnesium.
>
> What are you pituitary hormones like? Are your CRH and ACTH within normal range?
>
> > Now my psych doc was puzzled as I have had severe anxiety (kept at bay only by daily Xanax XR, and then just barely as it is always lurking in the background) for almost a year now and she would have (in her words) bet serious money that those levels would have been not only high, but very high.
> >
> > Well, what about the BEAM Scans (I think that's what they are called) as used by Dr. Eric Braverman and highlighted in his books and practice? Anyone have any experience with that testing protocol as relates to determining actual neurotransmitter levels?
>
> The only issue I have with BEAM is that nothing has been published. They claim to be developing a comparative database that provides treatment guidance, but I have not seen anything that validates the methodology. They claim it works, without evidence that it does.
>
> > Or possibly SPECT/PET (single photon/positron emission computed tomography) scans? Anyone have any experience with that testing protocol? Just seems that determining what NTs are actually deficient makes more sense than just throwing serotonin enhancement at every mental problem....
>
> Same problems with SPECT. The existence of abnormalities does not guide treatment modalities.
>
> > Anyway, I personally would still think that 24-hour urine tests of neurotransmitters would be beneficial just from the viewpoint of knowing what overall body levels were even aside from what was coursing through the brain. Low levels of dopamine, NE and epinephrine along with low levels of cortisol and DHEA would probably be a pretty strong signal that one might be approaching adrenal fatigue, for example (which is NOT a good medical condition to be in).
>
> Absolutely true, but did you ask your doctors if they even believe in the entity called adrenal fatigue/adrenal exhaustion? I would bet they do not.
>
> > BTW, I did talk my psych doc into starting me on a dose of 5mg Selegiline twice a day to hopefully start getting those levels up. I have apparently adapted at those low levels (and they've been ery low for a while) as our inclusion of DLPA and / or Tyrosine was immediately felt to be "too much" with an increase in agitation and increase in some of my phsycial symptoms that have been ongoing. In fact, had to start out at 2.5mg once a day (half tablet) and then work up to 5mg once a day and then gradually up to 5mg twice a day and then maybe look at adding in Tyrosine or DLPA....
>
> Low-dose selegiline most likely works via a mechanism that is tangential to catecholamine neurotransmission, in my opinion. Just what that is, I'm not clear on. Once you begin to saturate the MAO-B sites, the crossover to MAO-A does directly affect catecholamines.
>
> > Just to track the overall body's NT levels have recently asked by endo to include 24-hr urine test (General Assessment Neurotransmitter Test Panel - tracks levels of Serotonin, Dopamine, Epinephrine, Norepinephrine, GABA, PEA, Histamine and Glutamate) along with my monthly 24-hr UFC for cortisol.
> >
> > Elroy
>
> I hope you don't forget that all the testing in the world is for your cognitive experience.....the trying to understand part. It's the experiments you do, the interventions, that are actually of any use at all. They provide the only real data for further consideration. You do experiments, and see what happens. Hypothesis testing, with (hopefully) some drift towards the theoretically optimal intervention.
>
> Best, Lar


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poster:Elroy thread:493827
URL: http://www.dr-bob.org/babble/20050504/msgs/495757.html