720 North Tustin Avenue
Suite 104
Santa Ana, CA 92705-3606
Phone: (714) 565-1032
Fax: (714) 565-1035

Jeremy E. Kaslow, MD, FACP, FACAAI Physician and Surgeon
Board Certified Internal Medicine

NOTICE TO CONSUMERS
Medical Doctors are licensed and regulated by the Medical Board of California
(800) 633-2322
www.mbc.ca.gov

Neurotransmitter Repletion

Neurotransmitters are the naturally occurring chemicals inside your body that transmit messages between nerve cells.  In the brain alone there are 183 different neurotransmitters.  Two major neurotransmitters are serotonin and catecholamines, which includes norepinephrine, epinephrine, and dopamine.  Although this is the focus of this webpage, sometimes additional neurotransmitters such as acetylcholine, histamine and GABA must be considered in a comprehensive successful program.

For years it has been known in medicine that low levels of Serotonin and/or Norepinephrine can cause many diseases and illness.  Some of the diseases and/or illnesses caused by or associated with low levels of Serotonin and/or Norepinephrine include:

  • Depression/Moody
  • Anxiety
  • Panic Attacks
  • Insomnia/Sleep disorders
  • Premenstrual Tension
  • Fibromyalgia
  • Obesity
  • Anorexia
  • Bulimia
  • "Hypoglycemia"
  • Chronic pain states
  • Migraines
  • ADD/ADHD
  • Restless Leg Syndrome

In addition, over 60 diseases and illnesses may be caused by or associated with neurotransmitter deficiency.  Low neurotransmitter levels is not only very common, it is epidemic.

 "How do the levels of serotonin and catecholamine neurotransmitters get to such critically low levels?"  There are several explanations. 

  • The first is that neurotransmitter depletion is nutritionally based.  Neurotransmitters are made from amino acids that must be obtained from protein in the diet.  In addition, amino acids, vitamins and minerals eaten in food are required for the creation of the neurotransmitters. If the diet is deficient, neurotransmitter deficiency develops. 
  • There are multiple medications that have shown to cause depletion of serotonin and/or catecholamine in the urine.  These are the medications prescribed to increase the activity of serotonin in the brain such as fluoxetine (Prozac, Sarafem), paroxetine (Paxil), sertaline (Zoloft), Luvox, Citalopram (Celexa), Lexapro, etc.  Apparently as a result of increasing the brain level of serotonin, the body increases the metabolism of serotonin and thus the levels slowly decline because these medications do nothing to increase the level, they just re-circulate the already low level.  The same holds true for medications that block the re-uptake of serotonin and catecholamines such as Effexor, Cymbalta, and Pristiq.
  • It has been suggested that several SSRI medications deplete 40-60% of the serotonin receptors in the brain.  It is also reported that receptors in the liver, kidneys, and colon are also damaged by SSRIs.
  • Caffeine, ephedrine, ephedra, guarana, and other stimulants including Ritalin, chocolate, etc. also seem to reduce the effectiveness of neurotransmitters thereby creating a resistance to neurotransmitters.  Phentermine (of the Phen-Fen diet) actually cause long-term damage to the receptor so that in order to get the effect of serotonin, you have to have an even higher level.  This is why so many people gain even more weight after stopping Phen-Fen.
  • Sensory overload.  The brain is bombarded by sounds, rapid visual effects from television, movies, electronic monitors flickering faster than the eye can detect, radio waves, fluorescent artificial light, etc.  All of this requires the brain to modulate this sensory bombardment so that you can stay focused on the task in front of you.  Brain overload means that you have to literally calm yourself down.
  • Rapid lifestyle, stress, over work, chronic pain, etc. may also contribute.
  • Since the largest source of neurotransmitters is the gastrointestinal tract, dysfunction as discussed above could be a major contributory component.  This would include congestive bowel toxicity, Candida/yeast overgrowth conditions, increased intestinal permeability (leaky gut syndrome), IBS, & inflammatory bowel.
  • John A. Allocca, M.D. lists a variety of additional mechanisms by which neurotransmitters are lost: ingestion of various food allergens or sensitivities, inhalation or ingestion of various chemicals, chemical sensitivities, rapid changes in hormone levels, rapid changes in barometric pressure, head cold or sinus congestion, rapid changes in blood sugars, dehydration, inadequate exposure to sunlight (hence the excessive conversion of serotonin to melatonin), and hepatobiliary dysfunction.  These remarks may be based on the precipitation of migraines, which Dr. Allocca assumes to always be related to serotonin imbalance.

MIXED NEUROTRANSMITTER DYSFUNCTION/DEPLETION

Providing the body with ingredients to make just one neurotransmitter (either serotonin or catecholamines) does not produce uniform results in all patients.  It has been the experience of NeuroResearch in treating a group of 100 patients for a given disease with just 5-HTP, only about 10% to 15% will get "good relief". Overall 30% to 40% of patients will get "some relief" and the majority (60% to 70%) will get "no relief."

This observation led Dr. Hinz to formulate "Mixed Neurotransmitter Dysfunction Theory."  Five percent of patients with a given neurotransmitter dysfunction disease are purely a serotonin dysfunction, 5% of patients are a purely catecholamine dysfunction, and the remaining 90% of patients are a mixture of both serotonin/catecholamine dysfunction and lie along a spectrum between the two extremes.

This implies for the vast majority of patients with a neurotransmitter related condition, the serotonin system and the catecholamine system (dopamine, norepinephrine, and epinephrine) must both function properly for the entire system to be healthy and free of neurotransmitter disease.  This appears to be reflected in urine neurotransmitter testing by the fact that patients with dysfunction of the catecholamine system tend to need higher serotonin levels to compensate and obtain a clinical response.

NEUROTRANSMITTER DEFICIENCY

The treatment methods of Marty Hinz, M.D. for neurotransmitter dysfunction have not only been helpful for patients in whom other methods of treatment haven't worked, but also for patients with almost any one of the symptoms due to neurotransmitter deficiency. 

Afternoon urine specimens have been shown to be a useful indicator of catecholamine and serotonin levels but require proper timing and collection to be of value.  According the Dr. Hinz, the urine levels seem to reflect brain levels.  Some interpretation is required since high urine levels may indicate excessive loss of the neurotransmitters due to medications, etc. Testing is not done before treatment since it can be confusing and mis-leading.  Urine testing during therapy may be necessary for monitoring the proper dosage of neurotransmitter repletion.

PHARMACEUTICAL DRUGS:  NOT THE ANSWER

If you have neurotransmitter deficiency, most likely you have been given a medicine that will reduce the symptoms but are not curative.  Although effective to some degree in reducing symptoms, in the long run the medications can actually make the underlying neurotransmitter deficiency worse.  For example, if you have depressive symptoms caused by low levels of serotonin, taking a "SSRI" medication such as Prozac, Zoloft, Celexa, or Paxil is merely tricking the brain into thinking that it has more serotonin. These medications merely interfere with the body's normal metabolism of serotonin and do nothing to correct the real cause, which is not a neurotransmitter metabolism problem but rather a deficiency of the neurotransmitter itself.  These medications do not stimulate the production of more neurotransmitters.  In fact there is solid scientific evidence that they accelerate the depletion of the neurotransmitters over time.  This is why many of these medications only work for a short time and then stop being effective.  The Neurotransmitter Repletion program pioneered by Dr. Hinz actually enables the body to make more serotonin and other neurotransmitters that naturally corrects the cause of the problem.

The SSRI medications are designed to work just on a very specific part of the brain.  While this may temporarily correct the deficiency in that one location, what about the rest of the body's need for serotonin and catecholamines?  There are receptors for these important chemicals throughout the entire body.  Medications don't address the deficiency in these areas, but the neurotransmitter repletion will give the entire body what it needs.

WHAT NEUROTRANSMITTER REPLETION CAN DO

From the Hinz, MD experience in thousands of patients using the same products and program that we have available, he reports…

  • For most patients with migraines, we can get rid of them completely.
  • For people taking medications for migraines, we can get most patients off the medications completely.
  • For patients with depression where the medication quit working, we can get most feeling normal again.
  • For patients with depression where no medications have seemed to work, we can help most.
  • For patients with depression who want to get off their medications, we can help most.
  • Patients with fibromyalgia and chronic pain benefit greatly.  Most can stop some or all of their medications soon after treatment starts.
  • In patients with insomnia, most are sleeping 5 to 8 hours a night after the first 3 to 4 weeks of treatment.
  • Most patients with panic attacks find their symptoms are gone in the first month.
  • Most patients find PMS symptoms are much better or completely gone.
  • Chronic anxiety resolves for most patients.
  • For patients with "complex appetite", we have the only known effective cure.
  • A medical weight management program that is 75-90% successful in reaching the goal weight in participants who also follow the dietary program.

With the exception of treating weight problems, most patients should have their problems brought under control and be free of symptoms in less than 4-6 weeks.  Below are some notes from Dr. Hinz' experience on specific symptoms related to neurotransmitter insufficiency.

Migraine Headaches:  In patients with true migraine headaches who have suffered for years, treatment with the process outlined in our patents is remarkable to say the least.  Over 95% of patients have no more migraine headaches within 1 to 2 days of starting treatment!  Imitrex is a popular and effective medicine for short term relief of migraine symptoms but does not cure the disease nor can it be used to prevent the onset of a migraine.  Imitrex is also very expensive.  It is not uncommon to see patients taking $200 to $300 or more in Imitrex each month.  NeuroReplete programs completely resolves migraine headaches in the first few days of treatment for most people and is less than 1/3rd the cost.  It also solves many other conditions related to neurotransmitter insufficiency.

Depression: The evidence is very convincing that low levels of brain serotonin and/or norepinephrine cause depression.  Current medicines used by doctors to treat depression work by redistributing serotonin and/or norepinephrine effectively tricking the brain into thinking it has more neurotransmitters, but there is none.  They do nothing to increase the amount of the depleted neurotransmitters in the body and thus do nothing to actually correct the underlying cause of the problem.  In fact in the long run, they can actually make the underlying problem of low Serotonin and/or Norepinephrine levels lower and worse.  For example, there are many stories told by doctors of patients treated for depression with medicines where the medicine worked well initially, but then one day the patient literally woke up and found the medicines were no longer working but they had to stay on the medicine anyway to keep from feeling even worse.  Another type of patient is depressed and medicines simply do not work.  In both these circumstances, the patented treatment approach has been highly effective in getting them to feel normal once again without medications

Depression is generally divided into two categories. They are "Exogenous depression" and "Endogenous depression".

  • Exogenous Depression develops as a reaction to events that happen in the environment around the patient, a sort of situational condition.  Dr. Hinz describes the following as an example of exogenous depression, "if your house burns down, your car blows up, and your dog dies all in one day you may feel depressed for a time".
  • Endogenous depression can appear to start for no particular reason. In many cases, the patient literally wakes up one day to find that he/she is not functioning normally due to depression. Low levels of serotonin and/or norepinephrine in the body causes endogenous depression.

Diagnosis of depression is made using the DSM IV criteria. In diagnosing patients, proper laboratory work-up for thyroid and anemia should be preformed. If 5 of the following 8 items are present for 2 or more weeks, the diagnosis of depression can be made.

  • Change in appetite or weight
  • Sleep disturbance
  • Psychomotor retardation or agitation
  • Loss of energy
  • Decreased ability to concentrate
  • Loss of self worth
  • Decreased interest in daily activities
  • Depressed mood almost every day
  • Suicidal ideation

"Severe depression" is life-threatening depression where the patient is contemplating suicide and this necessitates the referral to a psychiatrist immediately. One study showed that virtually all suicides had been seen by a physician within the previous 7 days.  Refractory depression is defined as patients treated with prescription drugs where there is no clinical response.  The cause of this problem is simple - "Drugs that work with neurotransmitters do not work if there is not enough neurotransmitters to work with…"  In the abstract of a May 2000 Journal of Clinical Psychiatry article by Dr. Delgado (The Role of Norepinephrine in Depression), "Norepinephrine-selective antidepressant drugs appear to be primarily dependent on the availability of norepinephrine for their effects.  Likewise, serotonin-selective antidepressants appear to be primarily dependent".  In refractory depression where the drugs quit working, the problem is that the level of neurotransmitters has dropped below the critical level needed the patient to be healthy and disease free and below the level for the drugs to work.

Fibromyalgia:  Fibromyalgia is a descriptive term and not really a disease itself.  The hallmark of fibromyalgia is chronic pain in muscle and fibrous tissue points throughout the body.  There has been no real cure identified for fibromyalgia and treatment has centered on use of multiple medications for partial symptom management and counseling such as support groups.  Neurotransmitter Repletion has proven to be extremely effective and economical, and in most cases patients gradually quit taking all other medications for fibromyalgia.  One clinic in Kansas using the same methods treated employees of the state of Kansas who had fibromyalgia.  Results were so good that the program is covered by insurance for State of Kansas employees.

Insomnia:  Using the definition of severe insomnia as "sleeping less than 4 hours a night with frequent wake ups of 20 minutes or more" and including those people who simply do not sleep well at night encompasses a broad range of sleep disorders.  The issue of poor sleep is such a large problem that in larger cities many hospitals have sleep clinics.  Medications used for sleep obtain marginal results at best and sleeping pills on a chronic basis are not the answer.  Correction of sleep problems with Neurotransmitter Repletion usually takes two to four weeks but results are spectacular in most.  Patients sleeping only 2 to 3 hours a night with frequent wakeups find they are sleeping five to eight hours a night without waking up, and they report feeling better than they have in years.

Panic Attacks:  The hallmark of panic attacks is "an abrupt onset of an impending sense of doom"; the sudden feeling that something bad is going to happen even though there is nothing going on.  Many times people with panic attacks will also have agoraphobia, which is the fear of going into public or open places, or other fears.  In medicine, for years these have been very hard things to treat effectively.  Typically the patient is placed on multiple medicines, which do nothing more than mask the symptoms.  Neurotransmitter Repletion has proven to be very effective in actually getting rid of the disease and the symptoms, and in the process, getting patients off the medications.

Premenstrual Syndrome:  PMS are experienced by many women in the five to seven days prior to the onset of menses.  In some women these monthly symptoms can be severe enough to be disabling and include water weight gain and emotional changes.  In one of the more severe cases of PMS we have worked with, the patient would gain 17 pounds in fluid retention and went through extreme changes in personality and emotions.  Although some approach PMS with hormones primarily, even hormones (as well as other medications) are merely masking the problem and treating the symptoms without curing the underlying disease.  Using methods outlined under the patents has proven to be very effective.

Attention Deficit and Hyperactivity Disorder:  Over the last several years, Dr. Hinz has collected ample data that ADHD kids show a pattern of hyperexcretion of neurotransmitters (the kidneys are literally dumping neurotransmitters and depleting the system).  Approximately 86% of the kids dump serotonin and 40% dump norepinephrine.  Dr. Hinz however has not collected data about the clinical response in ADHD, i.e. "How many kids get better?" "What is the average group dosing to get better?" etc.  Following Dr. Hinz lead, our attitude is that "pharmaceutical grade amino acids are safe" under the guidance of a knowledgeable health professional."  If your give kids with ADHD, a trial of neurotransmitter repletion and they improve it suggests that neurotransmitters are involved in that particular child's case and you are not going to hurt anyone or interfere with other medications.  E-mail correspondences from other medical doctors and patients often talk about dramatic beneficial effects of neurotransmitter repletion in ADHD.  In fact, there are so many compelling reports that we feel it is worthy of trying even before a formal ADHD study is completed and reported.  For now, all we have to go on is anecdotal evidence that in the treatment of ADHD, neurotransmitters are safe and often very effective.

Anxiety:  Up until a few years ago, the intense and inappropriate anxiety that interfered with day-to-day activities was treated with tranquilizers.  In medicine today, most anxiety is treated with SSRI medications like Prozac, Zoloft, Paxil or Celexa.  As noted before, these drugs merely trick the brain into thinking it has more neurotransmitters and does nothing to actually correct the problem.  Anxiety, even if it has plagued you for a long time, methods used under the patents may help.

Complex Appetite:  Most people have never heard of this problem, but many people suffer from it.  Appetites can be categorized into one of two categories:

 1. Regular appetite, these are people who can go all day without eating and not experience symptoms.  A person with a normal appetite will only consume (on the average) enough calories to maintain their ideal body weight.  This is about 10 calories for every pound (Ex: a 150 pound adult should consume on the average 1500 calories/day).  Any ongoing intake above 10 calories/pound/day is excessive and suggests an imbalance in the brain centers that control appetite.

 2. Complex appetite, these are people who when they do not eat every few hours during the day experience many different symptoms.  In some, the label of hypoglycemia has been applied.  When diagnostic tests such as the oral glucose tolerance test is performed, there is in fact no hypoglycemia found.  The symptoms however are real and may be due to neurotransmitter deficiency.  The following is a list of some of the symptoms people with "complex appetite" experience.  In general, most patients that we have seen experience only 3 or 4 of the symptoms on the following list, but for many people these symptoms can cause the patient to not only feel bad but they can also interfere with daily activities:

Symptoms seen in complex appetite (misnamed "hypoglycemia")

Tremor

Dizziness

Nausea

Goose bump skin Headaches

Sweating

Anxiety

Feeling of uneasiness

Lightheadedness

Irritability

Disorientation

Abdominal pain

  Patients with a "complex appetite" are often mistakenly labeled by doctors as having hypoglycemia based primarily on the fact that the symptoms got better when the patients ate something.  This is NOT hypoglycemia, it is a neurotransmitter deficiency and while "complex appetite" can occur in patients of any weight, patients who are overweight and suffer from "complex appetite" are very much compromised.  Whenever they try and diet by eating less food, the complex appetite symptoms get worse.  Typical of complex appetite patients is if they do not eat something every 3 to 4 hours they experience symptoms such as headache and tremor.  This was can be a very real problem, especially during school, long business meetings, travel, etc.  Many patients keep candy with them in case they begin to experience symptoms.  The patented treatment method can be very effective in resolving "complex appetite" symptoms.

Obesity and Eating Disorders:  Of all the neurotransmitter deficiency diseases, obesity and eating disorders need the most intensive treatment.  Treatment of obesity and weight problems is something has not really been truly mastered, but the Hinz program does work with remarkable success.  At present, there are over a 100 clinics around the United States using this weight management program.  Results of his weight management program are impressive.  The average group weight loss the first month is 16.9 pounds and over 90% of patients starting the program make their goal weight and stay there with long-term maintenance. 

REPLENISHING NEUROTRANSMITTERS

Make no mistake serotonin and catecholamines come from only one source. The amino acids, vitamins, and mineral we eat are converted to neurotransmitters. Eat a diet deficient in these things and you will have a neurotransmitter deficiency. The following foods are serotonin-rich:  avocado, banana, red plum, tomatoes, pineapples, eggplants, walnuts, and possibly coffee.

However, it is not a simple as eating the right foods. From our database we know that prolonged dietary deficiency requires amino acid intake higher than normal food levels can give.  Dr. Hinz reports that neurotransmitter repletion excels in patients in whom medications do not work, "the refractory patient" and it is safe to use with prescription medications.  In most cases patients with refractory depression finds that their depression lifts in 3 to 4 weeks.  It is his recommendation that 4-6 weeks after the patient begins to experience relief; any medications the patient takes should gradually be tapered by every 2 to 4 weeks.

Since all neurotransmitters are made up of proteins, the diet must contain adequate amounts of protein.  Because tryptophan is the amino acid from which serotonin is produced, patients who have mixed neurotransmitter dysfunction probably do not get enough of tryptophan in their diet.  Because tryptophan has other uses besides formation of neurotransmitters, using Dr. Hinz' Neurotransmitter Repletion program alone is not enough to regain mental and physical health.  Note in the diagram below that only 2-10% of the tryptophan is metabolized into serotonin, the majority is needed for other proteins and vitamin synthesis.  Also note that the vast majority of serotonin is produced in the gut.  Thus, a healthy gastrointestinal tract is also required for mental health.  Your success with any condition related to neurotransmitters requires more than just taking the NeuroReplete products; you must eat and digest enough high quality protein and have a healthy gastrointestinal tract!

Side Effects of Neurotransmitter Repletion

The undesirable effects of neurotransmitter substrate use include GI upset and on rare occasions drowsiness.  Other undesirable effects as reported by Dr. Hinz include:

  • Dry mouth  --- 2.1%
  • Insomnia  --- 0.9%
  • Headache  --- 0.7%
  • Nausea  --- 0.6%
  • Dizziness  --- 0.4%
  • Constipation  ---  0.4%
  • All other reported undesirable effects occurred at visits a rate less than 0.2%.

GI Upset:  By far the most come side effect is GI upset.  GI upset is divided into two groups "start up" and "carbohydrate intolerance".

  • Start-up GI upset occurs at the rate of about 1 in every 150 patients and occurs with the first dose and gets worse with every dose until about the third day.  At this point the patient can tolerate it no more and stops the program.  Apparently the patients who experience this problem in general are the most serotonin depleted.  All patients need to be warned about this problem at initiation of therapy to avoid drop out. The problem is best managed by restarting the patient on only one capsule at bed time and increasing the dosing after 3 to 4 days of no symptoms, with subsequent increases in until the normal dosing is achieved in 3-4 weeks.
  • Carbohydrate intolerance. GI upset that develops after the patient has been on neurotransmitter substrates was very difficult to pin down. Up to 70% of patients report periodic GI upset. Although they tended to blame this GI upset on the capsules, it was unrelated to the supplements.  What appears to occur is a carbohydrate intolerance that had is uncovered with treatment. Once this is understood and patients are properly educated, the incidence in the database went from 70% to 0.6%. If a patient, who is one or more weeks into treatment, begins to experience GI upset 2 to 3 hours after eating, they should be instructed to remember what they just ate. Usually it is easy to identify the carbohydrate causing the problem. In many cases, it is a favorite food that has been eaten for years.
  • Repletion Pass-throughs:  For some patients, a certain level of neurotransmitters provokes certain symptoms.  For example - let's say at a level of 10 you experience panic-like symptoms, at a level of 20 you have anxiety, at 30 perhaps depression, at 40 migraines for example, and normal function between 50-75.  If you start out at 15 with anxiety and near panic like symptoms as you take the NeuroReplete, etc. your level will increase to 30 and you may have depression or whatever your unique metabolism expresses at this level.  As you continue to the repletion program, the level of neurotransmitter will increase and the depression should resolve.  You may have no other symptoms or you may develop TEMPORARY symptoms at another sub-therapeutic level.  The important thing to remember is that with continued or increased doses the symptoms will resolve on your way to normal neurotransmitter levels and health.

Dosage:  The mainstays of therapy are three supplement groups

    • Neuro-T Supply or NeuroReplete (to balance catecholamines and increase serotonin)
    • GSH Boost or L-Cysteine (to increase catecholamine synthesis or when using Mucuna)
    • D5 and Mucuna (to balance neurotransmitters and increase dopamine)
  • Although it was originally recommended for these to be taken on an empty stomach, they can be taken with or without food.  Best results are seen when the products are taken throughout the day (breakfast, lunch, dinner, and bedtime if you go to sleep late).  Start off slowly and increase the dosage.  In general the maximum dosage of Neuro-T Supply or NeuroReplete and D5 is 16 capsules a day.

 

- Home - Office News - My Approach - Services Offered - Prospective Patients - Staff - Health Topics - Dietary Programs - Toxicity Topics - Supplements - Lab Findings - Contact Us

Copyright 2013 - Jeremy E. Kaslow, M.D. - all rights reserved
Website design by Laurence B. Abrams.  Site maintained by Jeremy E. Kaslow, M.D.