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20

Functional Assessment of Urinary Neuro-biogenic Amines—A COMPREHENSIVE GUIDE

The correction of digestive disorders

and microbiome insufficiency may be

necessary to ensure the absorption and

assimilation of nutrient cofactors that

may be used to correct neurotransmitter

disorders. Digestive health may be eval-

uated through laboratory testing. Click

on the links below for more information

about the tests.

Comprehensive Stool Analysis w/Parasitology x3 Intestinal Permeability Microbiology Profile

Renal Function and

Neurotransmitters

The precursor amino acid phenylala-

nine is converted to tyrosine by the en-

zyme phenylalanine hydroxylase (PAH).

The kidney is the primary source of cir-

culating tyrosine; approximately 50%

of phenylalanine conversion (for the

whole body) occurs in the kidneys (see

Figure 7). Kidney disease may affect the

levels of neurotransmitters in urine. A

Creatinine Clearance test may be done

to evaluate kidney function prior to oth-

er urine tests. Click the link to access

further details on this test.

Creatinine Clearance

Endocrine and Metabolic Effects

on Neurotransmission

Endocrine hormones affect the func-

tion of neurons in the central nervous

system (CNS), and may influence neu-

rotransmission. Changes in the hypo-

thalamus-pituitary-adrenal axis may al-

ter neurotransmission, hormone levels

and physiology, as may thyroid and sex

hormones.

Parathyroid disorders disrupt calcium

metabolism. Mild hypercalcemia may

contribute to depression, apathy, irrita-

bility and lack of spontaneity. Severe hy-

percalcemia may result in symptoms of

psychosis, lethargy or catatonia, and may

progress to coma. Mild hypocalcemia

may contribute to symptoms of anxiety,

parasthesias, irritability and emotional

lability. Severe hypocalcemia may result

in symptoms of mania, psychosis, and

seizures.

Thyroid disorders may be associ-

ated with changes in mental status.

Depression is a common symptom in

hypothyroid (low) conditions, and anx-

iety may be seen in hyperthyroid (high)

conditions. Thyroid supplementation is

a common treatment for mood disor-

ders. Hypothyroid conditions have been

shown to decrease responses to sero-

tonin and decreased serotonin 5-HT2A

receptor density and sensitivity. Thyroid

hormone levels may be evaluated in the

laboratory:

Thyroid Profile

Phenylalanine

Tyrosine

L-DOPA

Dopamine

PAH

TH

AADC

FIGURE 7.

Phenylalanine is converted to tyrosine by the enzyme phenylalanine hydroxylase (PAH).