Dear Dr Rosensweet:
I am not feeling as happy as I would like to, and it doesn't make sense. I am menopausal and have taken care to get into good hormonal balance. I have gone through a lot of stress in my life but have worked on this with therapists and in other ways, and am doing well. I care about my diet and exercise. Do you have any suggestions about improving mood? J.T. Naples

Dear J.T:
Happiness and mood are related to many factors: physical, emotional, mental and your life. I would need to have even more specific information about you to understand your individual situation, as there is always 'cause' for 'effect.' I would like to bring up a common possible factor related to less happiness: diminished neurotransmitters resulting from past stress.

Stress has a multitude of effects upon us. In general, it initiates an aggressive biological response to prepare us for "fight or flight." At the forefront of this response is the mobilization of hormones and neurotransmitters. The adrenal glands, for example, increase their production and secretion of adrenaline and cortisol. Also, in stress, your brain becomes far more active and energized so that you can think with greater clarity as well as feel more sensitively and strongly.

Our brain communicates internally, between neurons, via electricity and chemistry. An electrical impulse travels down a nerve fiber until it reaches the end of that fiber. There, the electrical signal is transmitted to the next nerve ending down-line by biochemistry, across a junction between the nerves called a "synapse." When the electrical impulse reaches the end of the first nerve fiber it triggers the release of bio-chemicals, called 'neurotransmitters.' These neurotransmitters traverse the synapse and trigger an electrical impulse to begin in the recipient nerve ending, then to travel electrically down that second nerve. Neurotransmitters are the biochemicals that bridge the signal and spatial gap between individual nerve endings.

There are many neurotransmitter bio-chemicals. Adrenaline, norepinephrine, dopamine, acetylcholine, GABA and serotonin are the most well known. Once a neurotransmitter is secreted into the synapse and triggers the electrical impulse in the next nerve, it is brought back up into the nerve ending from whence it came. This process is called "re-uptake" and forms the basis of a pharmacological approach to addressing neurotransmitter problems. All psychoactive pharmaceutical drugs effect these neurotransmitters.

Medications like Prozac, Paxil, Zyprexa and Zoloft (tell me, how do they dream up these names!), commonly known as "SSRI's" or "Selective Serotonin Re-uptake Inhibitors" elevate levels of serotonin in the synapse by interfering with the biochemical process of 're-uptake' that would take the serotonin back into the nerve ending. The result is an appearance of an increased amount of usable serotonin. This effect will not sustain over a long period of time however, as the fundamental issue of diminished serotonin is not being addressed by re-uptake inhibition. And, it is the stress that diminishes the serotonin. Ultimately, it is the reduction of stress that needs to be addressed.

In the short term, stress causes increased production and secretion of hormones and neurotransmitters. If stress continues, initially our body mobilizes and is able to produce more hormones and neurotransmitters to meet the increased demands. If significant stress continues, over the long run, our glands and neurons cannot keep up with the increased demands, and levels of these precious bio-chemicals diminish.

It would make sense that an approach to overall diminished serotonin might be to feed the body serotonin, or, to feed the body the raw materials to manufacture additional serotonin. Serotonin itself has too strong an effect on the intestinal tract so it does not work to give it in pill form. However, serotonin is manufactured in our bodies out of an amino acid called 'tryptophan' that happens to be a constituent of many proteins found in food. Tryptophan is most abundant in turkey. Feeding people increased amounts of tryptophan actually does increase serotonin and melatonin levels.

Tryptophan was one of the most popular sleep aids, probably because of the ability to also increase melatonin levels, until three weeks prior to the introduction of Prozac. At that time a poisoned batch of tryptophan arrived in North America from Japan, and resulted in severe illness and even death in many people. The FDA immediately halted the sale of tryptophan. They did not stop the production of tryptophan in the U.S.A. as it is mandatory that tryptophan be added to cow's-milk-based baby formula. The FDA knew the problem was not with the tryptophan, it was with the poisoned batch…yet did not allow tryptophan to be sold for decades. Many assert that this problem and its bizarre timing with the advent of Prozac, was not a coincidence.

The pharmaceutical companies are not interested in marketing tryptophan. Because it is a molecule that is found in the human body, it is, by law, not patentable, and thus, not profitable. So, a way around this was discovered to increase available serotonin by "inhibiting" (or shall we say "interfering with") the re-uptake system.

Prozac, Zoloft, Celexa, Wellbutrin and other SSRI's are so popular because they work to help improve sagging mood. Because they are foreign molecules to the body, they also have other effects known as "side effects." This list is long with these drugs and includes numbness to emotions and diminished libido among many other possibilities.

Holistic practitioners have long been aware of this problem with diminished neurotransmitters and are not new to treating it. Tryptophan or 5 hydroxytryptophan (5HTP) have been used extensively to raise serotonin and melatonin levels. Tyrosine has been used to raise the class of neurotransmitters called 'catecholamines' (these are epinephrine [adrenaline], norepinephrine and dopamine). GABA and other nutrients have been used to elevate other neurotransmitter levels. You have not heard of widespread excitement about these methods…but, before long, it is possible that you will. I feel the new difference is that to affect the neurotransmitters successfully, we have to address a bigger picture than just individual neurotransmitter levels.

New information has been arriving steadily, with a major contribution coming recently from a medical doctor originally involved in weight loss and a laboratory that has been assessing neurotransmitter levels. The weight loss doctor was cognizant of the problems involved in prescribing a caloric-restricted diet…excessive appetite often would eventually, sooner or later, sabotage any success. He, like many others were aware that the popular prescriptive drug combination, "Fen-Phen" definitely worked to suppress appetite…and definitely caused unacceptable side effects, including death, and was withdrawn from the market by the FDA. Fen-Phen had artificial amphetamines in it, and amphetamines, dangerous as they are, definitely suppress appetite. (By the way, there are popular herbal supplements that contain ephedra, which has similar, amphetamine-like effects, that over time, can lead to neurotransmitter dysregulation). The doctor surmised that the amphetamines were affecting neurotransmitters and set about, in conjunction with new information on neurotransmitter levels emerging from the laboratory, to develop a safe way to suppress appetite.

Testing neurotransmitters has not been easy. Neurotransmitter levels derived from blood tests have been very unreliable--the instant a lab technician brandishes a needle to draw the blood, the neurotransmitters are royally activated for the fight or flight response! A new laboratory is using a single morning urine to assess levels. To summarize what has been found in the laboratory: it is extremely common to see low serotonin levels in adults, as well as some combination of changes in the catecholamines. This is just as we would expect from our previous understanding of the effect of the stress response on the rest of the body, and, the widespread usage of SSRI's.

To get an effective response from treatment, the doctor developed formulas of amino acids to address specific profiles. Equally important is the combination of the amino acids with vitamin and mineral cofactors, so essential for safety and effectiveness in the biochemistry of enhancing neurotransmitter levels. The specificity to the patient and the comprehensiveness of the biochemistry of the supplements, as well as a fresh aggressiveness, are the new differences in working with a nutritional approach to neurotransmitter repletion. And in so many instances mood can be changed and even, appetite suppressed when desired.

Bottom line J.T: an answer to your mood issues may have a neurotransmitter component to it, biologically. I recommend that you get this testing done and go on a trial of the amino acid formulas, if indicated. The jury is not in on all of this however. If you choose this approach to treatment you are pioneering.

If you are interested, I have more information on other important aspects regarding weight loss in my newly published book: Menopause and Natural Hormones - available at www.MenopauseandNaturalHormones.com

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This article is from www.RosensweetMD.com and is Copyright 2003 Daved Rosensweet M.D.