Neurotransmitter Testing

Your thalamus is like the manager of your brain.  All the signals from your body route through your thalamus to your cerebral cortex, where you actually do your thinking, and all of your thoughts route through your thalamus before affecting other parts of your body.

Your hypothalamus sits right below the thalamus (hypo means below or beneath, just like hypothyroid means your thyroid is underactive).  The hypothalamus is responsible for the body’s homeostasis, or balance with the outside world.  It regulates a number of functions, including body temperature, thirst (and thus, fluid balance and blood pressure), hunger, sleep, sex drive, bonding, “fight or flight” responses to threats, and mood.

The hypothalamus is one of several structures included in what is considered the brain’s limbic system, considered to be the seat of emotions in the brain.  Depression, whether organic or caused by an outside event, is associated with an overactive hypothalamus.

Dr Daniel Amen (“Change Your Brain, Change Your Life”) calls this an overactive “deep limbic system”, which is shown on SPECT studies to correlate well with clinical depression.  You can pretty well guess what will be affected when the hypothalamus is overactive, based on its actions listed above:

• moodiness and irritability
• negative thinking, hopelessness, and negative interpretation of events
• low motivation (usually due to apathy – “What does it matter what I do anyway?  Nothing ever works out.”)
• appetite and sleep dysregulation
• abnormally high or low sexual interest
• tendency to isolate socially, and a hindered ability to form relational bonds

If you think of depression as an overactive hypothalamus, then it makes sense that it is most frequently associated with decreased amounts of the neurotransmitters serotonin and epinephrine – the more active the structure, the more of the messengers it’s likely to burn through.

I wrote about lifestyle techniques to help cool an overactive hypothalamus a few weeks ago, and I definitely recommend you try these before taking any meds, or in addition to medication, if you are already on them.

Very often, people have an overactive hypothalamus due to repetitive negative thoughts.  It’s important to remember that you are in control of your thoughts.  You are capable of taking a step back, listening to what you are thinking, deciding whether or not those thoughts are helpful or harmful to you, and rejecting those thoughts that are harmful.  It will definitely be a battle at first, but will get easier over time.  I often share a biblical approach to this process with my patients, and I’ve shared it with you here.  

There are also some natural, over-the-counter approaches to minimize depressive symptoms as well, based on the principle that depression is correlated with low serotonin (due to an overactive hypothalamus).  These are generally precursors for serotonin.

• L-Tryptophan: This is an amino acid, most famously present in high concentration in turkey meat.  This becomes 5HTP, which becomes serotonin, which becomes melatonin (the sleep hormone) – and that’s why the joke is that everybody goes to sleep after Thanksgiving dinner! I like to suggest this as the first supplement to try, because your body gets to decide what it wants to make with it (as long as you’ve got enough of the basic nutrients to facilitate the process).  Recommended Dose: 1000 mg before bedtime.
• 5HTP: I’d recommend caution with this one simply because it’s a “committed pathway” to serotonin. Your body no longer gets to decide whether it needs more serotonin or not, and it is possible to overdose of serotonin. Use this under guidance of a health care practitioner.
• St John’s Wort: Careful with this one too. It increases the concentration of many pharmaceuticals in the bloodstream, so I would avoid it if you are already taking prescription or over the counter medications. It also directly raises serotonin in the body, so again, there’s a possibility of overdose. Finally, it can cause sun sensitivity.

Since some depression is associated with low epinephrine as well or instead of low serotonin, some people might do better with those biochemical precursors instead.  These patients might have issues with energy and focus in addition to the symptoms of a hyperactive hypothalamus.

• DL-Phenylalanine: Also an amino acid found in most animal meats. This converts to tyrosine, next on the list, which then goes on to become dopamine, epinephrine, and norepinephrine in the body. You want to make sure you take this one on an empty stomach, and the dose is around 1500 mg dosed several times daily.
• Tyrosine: The next step down the pathway, this one can be rather stimulating so make sure you don’t take it after 4 pm. Recommended dose is around 1000 mg daily.

For resistant cases, I test for neurotransmitters through a company called NeuroScience. This tells me which neurotransmitters are high, which are low, and which precursors and cofactors an individual needs in order to help restore balance. Unfortunately this test is not covered by insurance, but I have found it to be very helpful for many of my more challenging patients.