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Communication in the brain (and so many other places in the body) takes place through proteins called neurotransmitters. They conduct a message from one nerve cell to another, or from a nerve to a muscle.
Recently, I saw a 15-year old male in follow-up who had been struggling in school since kindergarten. He had been diagnosed with ADHD, along with a temper and sleep difficulties. He had tried multiple medications (which did help him focus), but he did not like the side effects and the meds didn’t solve the basic problems.
What Are Neurotransmitters, and How Do They Work?
Serotonin, dopamine, norepinephrine, and epinephrine are common neurotransmitters in the brain, a category called monoamine neurotransmitters. They work in the following way:
- When the nerve wants to transmit a message to the next nerve cell, it releases a neurotransmitter into a space called the synapse (the space between the two nerves).
- Some of the neurotransmitter connects to the receptor site on the next nerve, which initiates a small electrical charge.
- If enough of the neurotransmitter connects at the same time so that the electrical charge reaches a high enough level (or threshold), the next nerve is triggered and passes on the impulse (or message).
- If there is a deficiency of neurotransmitters, the electrical charge will never be reached and the message will not be transmitted.
- The receptor site releases the neurotransmitter. At that point, three things can happen:
- The neurotransmitter reconnects to the receptor site.
- The neurotransmitter is taken back into the original cell (called reuptake). It is now ready for release the next time a message needs to be transmitted.
- An enzyme in the synapse breaks down the neurotransmitter, thus further reducing the amount of the neurotransmitter.
When Messages Do Not Transmit Normally
When there is a deficiency of neurotransmitters, the message cannot take place and the brain does not function normally.
So, what diseases manifest when this communication network does not function? Because the topic of this article is communication in the brain, we will save the gastro-intestinal and other diagnostic categories of disease caused by disruption of this neurotransmitter network for later.
Here is a partial list of brain (neurological) dysfunctions caused or exacerbated, at least in part, by neurotransmitter deficiency:
- Addiction
- Alzheimer’s/Dementia/Cognitive decline
- Anorexia/Bulemia
- Anxiety/Depression/Panic attacks/Seasonal affective disorder
- ADHD/Asperger’s syndrome/Autism/Aggression
- Insomnia
- Migraines
- Obsessive-compulsive disorder/Trichotillomania
- Parkinson’s
- Phobias
- PTSD (Post Traumatic Stress Disorder)
- Psychosis/Schizophrenia
- Traumatic brain injury
There can be many causes of the above diagnoses, but if the diagnosis and treatment do not include addressing the brain communication issues, they may not solve the cause of the disorder.
So how do we get more serotonin, dopamine, norepinephrine and epinephrine into the brain? Unfortunately, we cannot use the neurotransmitter itself because it is too large to get past the blood-brain barrier into the brain. However, the precursors to neurotransmitters are small enough to enter the brain. Once inside, they can form the needed neurotransmitter and get communication going. For example,
L-tryptophan is an amino acid that does many things in the body.
- About 10% of it is broken down into 5-OH tryptophan, which is
- the immediate precursor of serotonin, which is
- further changed into melatonin,
- which induces normal sleep.
This is why it is so common to have sleep disturbances when there are other serotonin issues going on.
L-tyrosine is another amino acid that forms L-dopa, the immediate precursor of dopamine. Dopamine then becomes norepinephrine and epinephrine.
A Light at the End of the Tunnel
What about our 15-year-old I mentioned earlier?
Two months ago I put him on a supplement with 5-OH tryptophan and L-tyrosine in it to balance both sets of neurotransmitters. (If only the precursors to one are given, results will eventually lead to a deficiency of the other one.)
Patient and mother reported near 100% improvement in symptoms within 1 to 2 weeks, and mother could tell when he forgot to take the supplement for a few days, as the temper would be the first to appear. Of course, he was also taking other supportive measures to help the brain communication system, such as
- not eating sugar,
- taking B vitamins in a good multivitamin and
- omega-3 oils.
We’re All Different
Of course, not every patient is this responsive. Other things that have been shown to be important in treating anxiety or depression (or just about any of the above conditions) include:
- Addressing intestinal health, especially with probiotics. There are nine times more messages going from the intestines to the brain than there are from the brain to the intestines.
- Hormones (thyroid, adrenals, sex hormones)
- Exercise
- Bright light
- Methylation (a topic for another day) to turn on serotonin production
But it is successes like these, and seeing the joy in patients’ faces as they realize they CAN get better, that make being a medical doctor in integrative medicine a most rewarding profession.
If you would like more information about Dr. Gardner and his practice in Sandy, Utah, you may visit his website at keystohealing.net or call Keys to Healing Medical Center at (801) 302-5397 and leave a message.
ShaneMarch 29, 2016
My wife is going through a terrible depression episode right now and has been diagnosed with "baby" bipolar, at least that is how the Dr described it. She can't take some SSRI's or NSRI's. The Dr wants to try rTMS. Any experience with this?
Bob DeLangeMarch 29, 2016
Neurotransmitters are not proteins (as stated), but small molecules like epinephrine, etc. Receptors often involve proteins in the membranes of the cells, but they are not the neurotransmitters.