urinary neurotransmitter testing Archives

Francoise posted this feedback and her surprise about her elevated GABA levels – as reported on a urinary neurotransmitter test. She was justifiably confused because she had looked at the low GABA symptoms and resonated with them i.e. physical anxiety/tension, stiff and tense muscles, stress eating, self-medicating with alcohol, insomnia and intrusive thoughts etc:

I previously bought Gaba Calm after reading your blog since my symptoms seemed to match your description [of low GABA].

However, I recently did an exhaustive neurotransmitter test to realize that it was the exact opposite, having a significantly high level of GABA.

Unfortunately, I’ve looked all over the internet after talking to my doctor, and it seems that no one knows how to downregulate GABA.

Not sure what to do from there, but thought I should let you know that the situation exists despite not being common.

I posted this feedback for her: I do not use urinary neurotransmitter testing as it’s not accurate. I use the low GABA symptoms questionnaire and we do a trial of GABA if low GABA symptoms are present.

She said it perfectly – “I previously bought Gaba Calm after reading your blog since my symptoms seemed to match your description” i.e. it’s very likely she does in fact have low GABA symptoms and if we were working together I’d have her do trial of GABA.

I did ask her what her doctor and the lab recommended and to share the name of the lab/test and have yet to hear back. I will share when I do.

Someone else also had the neurotransmitter report high GABA so she stopped taking her GABA supplements

When I shared Francoise’s comment and my feedback on Facebook, I had someone share a very similar outcome. Kristin had already figured out that she had low GABA levels (based on the symptoms questionnaire), was already taking GABA with good results and was then told to stop taking GABA because the urinary neurotransmitter test reported elevated GABA levels!

This is what Kristin shared on Facebook: “I just did the neurotransmitter test. It said I was high in GABA as well, so I stopped taking it.”

These were the questions I asked her: Why were you taking GABA at the time – was it because you had/have low GABA symptoms and was GABA helping to ease these symptoms? I also asked which lab did the test and what her practitioner recommended? She shared the following:

I was taking GABA for anxiety. It was helping. .

My doctor recommended that I stop the GABA and use supplements to support the areas I was low in, which were: Dopamine, Norepinephrine, Epinephrine, and Serotonin (was VERY low).

Doctor’s Data is the company. And it wasn’t a cheap test.

I was surprised that even though GABA was helping Kristin, the doctor said to stop using it. What does also concern me too is that supporting dopamine, norepinephrine and epinephrine without supporting GABA can actually increase anxiety. I’ve seen this backfire a number of times.

After seeing my post and our Facebook back and forth she decided to start back on the GABA products she had been taking: GABA Calm 1-3 tablets a day and if she is struggling terribly with morning anxiety, then 1/2 to 1 tablet as needed. In the evening she takes 2 capsules of Neurocalm which has 100 mg of GABA (and some other ingredients).

Kristin confirmed that, once again, GABA was helping to ease her intrusive thoughts, anxiety and physical tension, all low GABA symptoms.

I said to Kristin that I’d reach out to Doctor’s Data and have done so. I shared all this and I am hoping to hear back from them. I’ll keep you posted when I do.

Kristin has offered to share this blog with her integrative doctor who prescribed this test. I’m hoping she does and you do too.

I appreciate both these women sharing their experiences so I can share with you.

Urinary neurotransmitter testing falls short and other practitioners weigh in too

I find many functional tests extremely useful and Doctor’s Data is well regarded in functional medicine. However, I do find it very unfortunate that so many practitioners continue to use and recommend this test when it’s not useful, doesn’t correlate with symptoms and so often causes confusion, like in these instances (which are just two of many similar cases). By the way, they are not the only lab offering urinary neurotransmitter testing.

Be sure to read this older blog: Urinary neurotransmitter testing falls short where I share more about why I’m not in favor of this testing.

This feedback from Nora Gedgaudas, author of Primal Body Primal Mind sums up what I often hear from other practitioners:

I have considered the urinary testing approach and was even enamored of the concept at first. Once I looked into the idea more closely, though, it just didn’t add up for me. I have been using amino acids now to address issues of mood, health and cognitive functioning for over 20 years. I have never used anything other than mood/symptomatic screening to guide amino acid supplementation. Results tend to be uniformly good to excellent. The sheer overwhelming complexity of amino acid/neurotransmitter activity in the human body/brain-and the compartmentalized nature of the biochemistry of each seems to best lend itself to a more functional and symptom-related evaluation. Lab testing simply falls short of the mark here.

A colleague and good friend of mine, Dr. Josh Friedman posted this in the comments section of the above blog post (back in 2014), further supporting what practitioners are reporting about this testing:

About a year ago I got excited about urinary neurotransmitter testing. I had been using Julia Ross’ pencil and paper neurotransmitter deficiency assessment for many years with good success. Over the past year I have done the neurotransmitter testing on about 10 people with very inconsistent results. With 2-3 we hit a home run, where the recommended supplements were just the right thing to diminish the presenting symptoms. More often than not the recommended supplements seemed to give little relief or even make the symptoms worse. Additionally the testing and supplements are quite expensive.

I have since given up on the testing and as I have found the pencil and paper NT deficiency sheet to be a more effective guide to treatment. When I am unable to make progress I will often turn to serum amino acid testing and the neurotransmitter markers on the Organic acid test offered by many functional medicine labs. In addition to information about neurotransmitter functioning, the Organic Acid Test provides information about other factors involved in mental health symptoms including levels of the yeast Candida, the bacterial infection Clostridia and others.

Of course, I wholeheartedly agree with both of them.

As you can see from these two cases (and the many others in my book and on this blog), using the low GABA symptoms and a trial of GABA is best. It’s the most effective way to determine if you need GABA initially and to monitor how it’s helping. It also doesn’t cost you anything more than your time and the GABA product/s.

Resources if you are new to using amino acids as supplements

If you are new to using any of the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low serotonin and low GABA).

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, self-medicating with alcohol and more.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs. You can find them all in my online store.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms). This is a paid online/virtual group program where you get my guidance and community support.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you done urinary neurotransmitter testing and did any of it correlate with the neurotransmitter deficiency symptoms?

Have you been told to stop GABA that was helping to ease your symptoms – based on labs showing high GABA?

If you’re a practitioner I’d love to hear your experiences using the urinary neurotransmitter testing.

If you have questions please share them here too.

lab

I am often asked about urinary neurotransmitter testing and often a new client will come in with results from a test she/he has had done. I would like to share my thoughts on this rather controversial subject and say that I am not a fan and do not ever use this test. Let’s take a deeper dive into this topic.

The question

Here is a question I received right after the Anxiety Summit:

I have had good results using urinary neurotransmitter testing and targeted amino acid therapy and bioidentical hormones. I am able to see if all levels are low, indicating low stomach acid. I am also able to see if histamine or glutamate are high, indicating food hypersensitivities. I also use the levels for balancing and replacing. I know that Julia Ross is opposed to testing. What is your opinion and what did your other speakers [on the Anxiety Summit] say about this topic?

This is my answer:
I am very pleased that this person sees good results using urinary neurotransmitter testing and targeted amino acid therapy.

Why I am not in favor of this testing

However, I am not in favor of this testing for a few reasons:

1) Julia Ross is not in favor of it and having worked with her in her clinic for 2 years I respect her professional opinion and the results she saw when urinary neurotransmitter results didn’t correlate with amino acid questionnaire and trials of amino acids. Julia wrote a great article on this topic for the Townsend Letter and you can access this via the anxiety summit blog for her interview

2) Since leaving the clinic and starting my own practice, I’ve worked with folks who come in with urinary neurotransmitter test results that don’t always with correlate with amino acid questionnaire and trials of the amino acids. But I will be the first to admit that I have not done a thorough analysis of where they haven’t correlated simply because it didn’t seem worth my time.

3) I have heard some rather unpleasant stories from people who have had the urinary neurotransmitter testing done and have been given supplement recommendations based on the results. I just received an email recently from someone who said this:

I was doing xyz’s program last year and the aminos recommended based on urine neurotransmitter testing nearly sent me over the edge with extreme anxiety, insomnia and panic attacks. He had me take 300mg 5-HTP and 3000mg tyrosine a day, based on test results.

We know that anyone can have a bad reaction to supplements. But let me comment on this example: 5-HTP can raise cortisol and be stimulating for some people so it’s not something I recommend for everyone with low serotonin symptoms; 3000mg tyrosine a day is not excessive (1-2 x 500mg , 3 times a day is often typical) BUT will be too much if you don’t need it and can cause anxiety and insomnia.

Low stomach acid and food hypersensitivities?

I’d like to also comment on two other parts of this question:

“I am able to see if all levels are low, indicating low stomach acid.” I have not heard this correlation and would use other labs markers for low stomach acid – like total protein, globulin etc – and the person’s response to a HCl trial.

“I am also able to see if histamine or glutamate are high, indicating food hypersensitivities.” I have also not heard of this correlation and would use an IgG test and food elimination and challenge to help figure out if someone has food sensitivities.

What do other speakers think?

It was also asked what other speakers on the Anxiety Summit said about this topic:

Other than Julia Ross, the only person who mentioned urinary neurotransmitter testing briefly was Dr. Anna Cabeca and we didn’t go deeper into the topic.

I did email Dr. Kelly Brogan and she said

I actually don’t use them. Occasionally I do serum amino acid testing (ION panel) but don’t feel that the science is there to support urinary neurotransmitter testing and feel that the reductionism around amino acids and behavioral translation is not consistent with my perspective and not needed for the outcomes I get.

If you listened to our interview on the Anxiety Summit, you’ll remember that Kelly doesn’t feel that low serotonin is a factor in anxiety and depression.

I will be following up with some of the other speakers like Josh Friedman, Hyla Cass, Amy Day and Corey Schuler.

What do Dr Weil and Nora Gedgaudas think?

I’d like to share some perspectives from a few others:

On Dr. Andrew Weil’s site

I checked with David Perlmutter, M.D., a neurologist colleague in Florida, about the accuracy of urine testing for neurotransmitters. He told me that neurotransmitters and their precursors are produced in abundance throughout the body and to assume that what is collected in the urine reflects what’s going on in the brain is a stretch.

Unfortunately Dr. Weil goes on to discredit salivary cortisol testing which has plenty of research supporting how effective it is!

Nora Gedgaudas, author of Primal Body Primal Mind states this on her site:

I have considered the urinary testing approach and was even enamored of the concept at first. Once I looked into the idea more closely, though, it just didn’t add up for me. I have been using amino acids now to address issues of mood, health and cognitive functioning for over 20 years. I have never used anything other than mood/symptomatic screening to guide amino acid supplementation. Results tend to be uniformly good to excellent. The sheer overwhelming complexity of amino acid/neurotransmitter activity in the human body/brain-and the compartmentalized nature of the biochemistry of each seems to best lend itself to a more functional and symptom-related evaluation. Lab testing simply falls short of the mark here.

I could not agree more with Nora’s comments. These are my exact thoughts. Here is the amino acids mood questionnaire I use with my clients. Based on symptoms we do amino acid trials and based on their response (which can happen as quickly as 5 minutes) we know if we’re on the right track.

I’ll be the first to say we don’t always have all the research to support what we do in the nutritional/integrative world and do agree that testing is extremely valuable but in this case I do not recommend urinary neurotransmitter testing as it does fall short in terms of accuracy and consistency.

I’d love to hear your thoughts and experiences. Have you been tested and had good results? Bad results? Are you a health practitioner and say ‘yes’ or ‘no’ to this testing?