Your First Neurotransmitter

ReportsRuth Hobson, ND

Staff PhysicianLabrix

Sample NT Test Report

Adult Reference Ranges

Male 17+Analyte Range Lower

rangeUpper range

Serotonin 42-105 54.6 92.4

GABA 1.4-5.0 2.12 4.28

Dopamine 90-220 116 194

Norepinephrine

12-50 19.6 42.4

Epinephrine

0.9-9.2 2.56 7.54

Glutamate 8-45 15.4 37.6

N/E ratio <10.0 ----- 8.0-10

Female 17+

Analyte Range Lower range

Upper range

Serotonin 52-155 72.6 134.4

GABA 1.6-8.0 2.88 6.72

Dopamine 95-275 131 239

Norepinephrine

15-78 27.6 65.4

Epinephrine 1.0-11.1 3.02 9.08

Glutamate 10-52 18.4 43.6

N/E ratio <11 ----- 8.8-11

Pediatric Reference RangesAnalyte Ages 0-3 Low range Upper range

Serotonin 130-415 187 358

GABA 2-15 4.6 12.4

Dopamine 200-800 320 680

Norepinephrine 25-126 45.2 105.8

Epinephrine 4.3-36 10.64 29.66

Glutamate 25-150 50 125

Analyte Ages 4-12 Low range Upper range

Serotonin 70-280 112 238

GABA 1.6-12 3.68 9.92

Dopamine 150-600 240 510

Norepinephrine 20-104 36.8 87.2

Epinephrine 1.6-24 6.08 19.52

Glutamate 10-80 24 66

Pediatric Reference RangesAnalyte Ages 13-16 Low range Upper range

Serotonin 58-200 86.4 171.6

GABA 1.6-10 3.28 8.32

Dopamine 125-450 190 385

Norepinephrine 17-90 31.6 75.4

Epinephrine 1.5-20 5.2 16.3

Glutamate 10-40 16 34

N/E ratio Reference range Upper range

0-12 <12 9.6-12

13-99 F <11 8.8-11

13-99 M <10 8-10

Creatinine

• Non-diagnostic• Used to normalize concentration of NTs in urine.

Concentration of creatinine directly reflects concentration of NTs; therefore, the NT levels are stated as a function of creatinine (industry standard)

• When doing any urine test that utilizes a creatinine correction, there will be differences between adult males and females, as well as children.

• Since males generally have a higher body mass, their creatinine is higher than females.

• Therefore, when you divide your measured value by creatinine, males will have lower reported levels than females and children, who have lower creatinine levels.

CASES

Wendy56 year old postmenopausal femaleCC: • Pronounced fatigue; energy (3/10)• Inability to concentrate (6-8/10)

NeuroAdrenal Panel (Cortisol x 4, DHEA, Serotonin, GABA, Dopamine, Epinephrine, Norepinephrine, Glutamate)

WendyAdrenal function resultsPhase 3 HPA axis/adrenal dysfunction

WendyNeurotransmitter results• Serotonin low range. • Acute increase in epi/norepi noted. Contributing to wired and tired

feeling and inability to maintain focus and concentration. • Dopamine levels are low, resulting from increased epi/norepi

production. • Low GABA not sufficient to counterbalance excitability.

WendyTreatment considerations• Tx for adrenal

cortex• Hydrocortisone• Adaptogenic herbs

and nutrients• DHEA

• Neurotransmitter support• 5 HTP • L-tyrosine and Macuna pruriens• B complex, SAMe• Promote GABA levels

• Glutamine (When giving glutamine for GABA, always give P5P).• L-theanine• Herbal blend containing anxiolytics like valerian, lemon balm, passion flower

• Vitamin D

Jeffrey28 year old maleCC: • Impulsive • Gaming and food addictions

NeuroBasic panel (Serotonin, GABA, Dopamine, Epinephrine, Norepinephrine, Glutamate)

JeffreyNeurotransmitter results

• Elevated glutamate is commonly associated with increased impulsivity• Low dopamine is associated with addictive tendency and sense of

discontentment• Inadequate GABA is insufficient to dampen the heightened glutamate

JeffreyTreatment considerations

• Decrease dietary sources of glutamate (MSG, yeast extract and other hidden sources of free glutamic acid)

• Dampen glutamate activity: • L-theanine• Taurine • NAC

• Increase dopamine levels:• N-acetyl-L-tyrosine• Mucuna pruriens• Vitamin D

• Boost GABA/promote inhibition: • P5P

Irina49 yo postmenopausal femaleCC: • Very high anxiety QD

• awakens her at night (7/10)

• IBS• Bowel movements coincide with anxiety… 6-10 loose

stools some days…however, then adds that some days, even though anxious, no BM at all

NeuroBasic panel (Serotonin, GABA, Dopamine, Epinephrine, Norepinephrine, Glutamate)

IrinaNeurotransmitter results

Serotonin is below the reference range • Contributory to anxiety. Alternating diarrhea and constipation is

consistent with the effects of serotonin within the proximal and distal intestinal tract (consider SIBO if further investigation is needed).

IrinaTreatment considerations• Support serotonin levels

• 5 HTP • B complex• Vitamin D

• Stress reduction techniques • Probiotics and omega 3s

Neurotransmitter pathways

Summary Points

• Consider overall balance between excitatory and inhibitory neurotransmitters

• Support low NT levels with precursor amino acids and elevated levels with applicable co-factors for enzyme function and metabolism

• Methylation support is a consideration with upper range or high N/E ratio and/or low monoamines.

• General support in the form of probiotics, omega 3 fatty acids, L-theanine and vitamin D will likely be important for every patient and a great place to start if you’re unsure of treatment