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Amino acid testing for depression, anxiety and other mental symptoms
As a naturopathic doctor I believe in treating the person, not the disease. For mental symptoms such as depression and anxiety, amino acids may be a consideration. However, there multiple possible causes for these symptoms. The information covered in this page is just one them.
Amino acids introduction
Amino acids are the building blocks of proteins. Our muscles and organs are mostly made out of protein. We need amino acids to perform numerous metabolic functions. In addition they are needed to make neurotransmitters such as serotonin and dopamine.
There are 9 essential amino acids. Our bodies can’t make these on their own so we have to get them through our diet.
The nine essential amino acids:
- Valine
- Methionine
- Histidine
- Phenylalanine
- Isoleucine
- Threonine
- Leucine
- Tryptophan
- Lysine
Other amino acids which our bodies can manufacture are called “non essential.” However, if we are deficient in protein, nutrients, dealing with excess toxicity or under stress, we can become deficient in non-essential amino acids as well.
Non-essential amino acids:
- Arginine
- Aspartic acid
- Glutamine
- Cysteine
- Glycine
- Glutamic acid
- Taurine
- Proline
- Alanine
- Tyrosine
- Asparagine
- Serine
Factors which can lead to sub optimal levels of amino acids:
- Lack of protein in diet, either eating too little, or a poor vegetarian diet.
- Poor digestion
- Genetic factors
- Toxicity
- Iatrogenic (side effect of medical treatment) [1]
In case of a deficiency ,amino acid supplements can help, but it’s also important to find out what caused the deficiency and fix that problem as well. Certain vitamin deficiencies may lead to high levels of amino acids on tests. The body may have the amino acids, but lack the vitamins necessary to use them.
Amino acid testing
Amino acid status can be tested in blood or urine. Generally blood is the preferred method to monitor status and guide supplementation. Urine is mostly used to detect genetic problems, nutrient deficiencies or toxicity related to amino acid status.
The above test shows low amounts of histidine, lysine and marginally low phenylalanine. Elevated tryptophan can be related to poor usage, or in this case supplementing with 5-htp.
The following section will overview the amino acids generally most relevant with respect to mental symptoms.
Arginine
We are always producing some ammonia as part of normal metabolism. Arginine is needed to remove ammonia from the body and insufficiency can lead to excess ammonia (hyperammonemia). [2]
Signs of excess ammonia:
- Anorexia (loss of appetite)
- Heavy or rapid breathing
- Combativeness
- Irritability
- Disorientation
- Obtundation
- Lethargy
- Somnolence (sleepy)
- Cerebral edema
- Vomiting
- Disorientation
- Coma
Histidine
Histidine is the precursor to histamine. Many people are familiar with the role histamine plays in triggering allergies. However, in the brain histamine functions as a neurotransmitter, especially in an area called the hypothalamus which regulates hormone production.
The diagram shows just a few of the many jobs histamine has:
If one process (such as an allergy) uses up a lot of histidine, this may leave less available for the brain and present as mental symptoms. Therefore, not only may supplementing with histidine make sense, but it’s important to investigate why the body is using up all it’s histidine. [3]
Phenylalanine and Tyrosine
Phenylalanine and tyrosine are precursors to both thyroid hormone, and three neurotransmitters.
Dopamine, norepinephrine and epinephrine (commonly known as adrenaline) make up a family of neurotransmitters called catecholamines. Catecholamines are needed for movement, memory, attention, problem solving, desire, motivation, the stress or “fight or flight” response, regulation of the cardiovascular system and energy production.
Deficiency of tyrosine (or nutrients needed to convert tyrosine to the catecholamines) may lead to: hypothyroidism, chronic fatigue, nervous system dysfunction, depression, impaired learning, memory and behavioral disorders including anxiety. [4]
The newer class of antidepressants, the SNRIs (serotonin norepinephrine reuptake inhibitors) in theory increase the levels of norepinephrine available to brain cells.
But doesn’t it make more sense to give the body the amino acids and vitamins it needs, then to manipulate the brain with toxic medications?
In addition to testing amino acid levels, the production of dopamine, norepinephrine and epinephrine can be looked at on an organic acid test.
Tryptophan and 5-HTP
Tryptophan, and 5-HTP (5-hydroxy-tryptophan) are the precursors to serotonin.
Serotonin has been promoted as a feel good neurotransmitter related to depression. However, it has numerous functions:
- Most of it is (over 90%) is in the gastrointestinal system regulating digestion.
- Regulation of pain perception. Low levels of serotonin increase pain perception. This can contribute to chronic pain such as in classic fibromyalgia.
- Regulates sleep through conversion to melatonin. Melatonin is our sleep hormone. It is low during the day, then goes up at night so we can fall asleep.
Vitamin B6 and magnesium are also needed to convert tryptophan to serotonin. Signs of low magnesium include constipation, muscle cramps (especially calves and bottom of feet), and chocolate cravings (chocolate is relatively high in magnesium). Lack of dream recall sugests a need for vitamin B6.
GABA
GABA is a inhibitory neurotransmitter low in some people with mental symptoms such as depression or anxiety. GABA is available as a supplement. Vitamin B6 can also help the body make more on its own. [33]
Serine
Serine is the amino acid precursor for the neurotransmitter acetylcholine. Acetylcholine is important for memory, and the nervous system. Studies have also found a link between low serine levels and depression. [34]
Other tests for neurotransmitter status?
There are no tests which measure brain levels of neurotransmitters. Various blood or urine tests for neurotranmitters do not show what is going on in the brain.. Rather the results are used to infer brain biochemistry.
Hypothetically, even if a test was available to measure brain neurotransmitters was available the results could still be of limited value. For example, if someone felt depressed and a neurotransmitter test showed low serotonin, that still doesn’t say why serotonin is low. Is serotonin low due to a specific nutritional deficiency? Toxcity? Emotional abuse? Something else?
A test that may be good to run with an amino acid panel is the organic acid test. This measures breakdown products of cellular function and gives insight into B vitamin status, serotonin and dopamine production, mitochondrial function, nutrition and dysbiosis markers.
References
[1] Lord, Richard S., J. Alexander. Bralley, and J. Alexander. Bralley. Laboratory Evaluations for Integrative and Functional Medicine. Duluth, GA: Metametrix Institute, 2008. 185. Print.
[2] Lord, Richard S., J. Alexander. Bralley, and J. Alexander. Bralley. Laboratory Evaluations for Integrative and Functional Medicine. Duluth, GA: Metametrix Institute, 2008. 198. Print.
[3] Lord, Richard S., J. Alexander. Bralley, and J. Alexander. Bralley. Laboratory Evaluations for Integrative and Functional Medicine. Duluth, GA: Metametrix Institute, 2008. 252. Print.
[4] Lord, Richard S., J. Alexander. Bralley, and J. Alexander. Bralley. Laboratory Evaluations for Integrative and Functional Medicine. Duluth, GA: Metametrix Institute, 2008. 219. Print.
[5] Lord, Richard S., J. Alexander. Bralley, and J. Alexander. Bralley. Laboratory Evaluations for Integrative and Functional Medicine. Duluth, GA: Metametrix Institute, 2008. 222. Print.
[6] Ibid.