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A 24 hour urine amino acid test is one of the best tests to evaluate nutritional factors contributing to depression. If this is not feasible, a first morning urine collection or a plasma amino acid done fasting in the AM would be alternatives. The urine amino acid will reflect digestive issues in the gut that are interfering with proper digestion of protein and the absorption and assimilation of amino acids. “Comprehensive stool analysis and parasitology” is a good companion test when digestive problems become apparent by an abnormal urine amino acid pattern. The finding of other abnormal amino acid patterns can be a guide to the identification and treatment of vitamin and mineral deficiencies, which can be causal to metabolic and cellular biochemistry impairments.
Looking for deficiencies in amino acid precursors of neurotransmitters can be of great value, such as L-Tryptophan, which makes 5-HTP, which in turn makes the important neurotransmitter Serotonin. Common signs of Serotonin deficiencies are restless or impaired sleep, depressed mood most of day, reduced pleasure in activities, fatigue, negative and obsessive thoughts, irritability, anxiety, difficulty concentrating and making decisions, feelings of worthlessness and guilt, suicidal thoughts, and carbohydrate craving. L-Tyrosine can also be measured. This forms the Catecholamines (Dopamine, Nor-Epinephrine and Epinephrine) and thyroid hormone. Common signs of Catecholamine deficiencies are feeling easily bored, apathetic, low energy most of time, difficulty focusing and poor concentration, tendency to put on weight easily, drawn to uppers as caffeine for energy, loss of enthusiasm, and depressed mood.
The amino acid analysis report comes with a suggested amino acid replacement formula that can be compounded for the patient by using easily absorbed crystalline amino acids. If levels of amino acids fall in the normal range, but the patient presents with evidence of Serotonin or Catecholamine deficiencies, one can add additional amounts of L-Tyrosine or 5-HTP to the formula. A larger percentage of 5-HTP gets to the brain and is converted to Serotonin; where as the larger percentage of L-Tryptophan is utilized outside of the brain. As there appears to be a reciprocal relationship between neurotransmitters in maintaining a balance and equilibrium, to help build up Serotonin you may need to also add Catecholamine precursors as they seem to be needed to help the body retain Serotonin. Adequate Serotonin levels are also needed to regulated Catecholamine levels. Much depends on the patient’s symptoms and presentation in making these decisions. If signs of catecholamine excess, as increased anxiety, sleep difficulties or excessive stimulation, GABA enhancers as Taurine and Glutamine, along with necessary vitamin and mineral co-factors can be added.
Other tests, currently in research and development, measure the amount of excreted neurotransmitter levels in the urine. This is felt to be an indirect indicator of systemic and brain levels, and also a possible guide to amino acid replacement. Organic acids testing will measure the metabolites of neurotransmitters in the urine, but it is hard to relate this to what the actual brain levels might be as most Serotonin for example is made in the gut. Correcting neurotransmitter imbalances with amino acids – alone, or in combination with the correction of other identified contributing factors or sometimes in conjunction with medication – has the potential for relief of other conditions in addition to anxiety and depression such as obesity, migraines, insomnia, obsessive-compulsive problems, PMS, attention deficit disorder (ADD), fatigue and fibromyalgia.
