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Doctors' Answers to "Frequently Asked Questions" - Serotonin

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Serotonin [posted 1/13/99]
Question: I received a pamphlet in the mail about a new diet pill called serotril. It states that it will help you feel better and lose weight. Its main ingredient is serotonin. It does not contain ephedrine or caffeine. It says it helps you sleep better, reduces stress, and will control carbohydrate cravings. It also states that it is better than Fen-Phen. Can serotonin really do all this and is it dangerous?

Answer: Probably not.

Serotonin Syndrome  [posted 1/4/99]
Question: I have Hypertension, Angina, and Depression. When a Psychiatrist tried to give me a serotonin based drug I had the following severe side effects: a heavily coated white tongue, lots of mucous in my throat and mouth, high blood pressure, pulse, and my heart rate increased to very high levels. I went to the Emergency Room and the doctor there took me off of drug. I eventually lost most of the side effects. Then my General Practitioner also gave me a serotonin based drug and I developed the same side effects and was immediately taken off of drug. Because I kept having problems with hypertension I was referred to a Cardiovascular Specialist and he put me on Procardia XL, Atenolol, and Paxil. I knew from my pharmacist that the drug was serotonin based, but I thought (because it was stated in the information I received) that it was a reuptake inhibitor. I thought that meant it was inhibiting the flow of the chemical to the brain that in some way it controlled the balance of the serotonin chemical in the brain. Through my lack of understanding I took the drug for 3 months when I noticed the previous symptoms coming back along with the following additional symptoms: toxicity throughout my entire body, blurred vision, my throat inside felt like it was closing or swollen, my gums were swollen and inflamed, my teeth extremely sensitive, my tongue did develop some lesions, swallowed globs of mucous, constipation to no bowel movement, a cold feeling in the extremities, tremors of the hands and arms, extreme pain in the upper back and abdomen, and my body would automatically go into a panicky feeling. From the rise of blood pressure, heart and pulse rates I did have to be taken to the Emergency Room on several occasions. The first time I have already mentioned. The second time I was kept in the hospital for one day until I passed all blood tests and treadmill, and x-rays for potential heart attack. The third time I was released with the doctor giving me potassium tablets. I have been bedridden from June of this year until September. I have recently been able to get back to trying to take up my sporting activity that I enjoy. I am a Professional Bowler and tour nationally. This has caused me to put my professional career on halt and I do not currently know when I will be able to go back out again. This is why I need someone who is in the neurological field to try and help me solve my problem since it does have to deal with the neurotransmitters in my brain. I believe that the psychiatric drugs did set off an imbalance of serotonin levels in the brain and now, I think I'm in trouble. My husband and I came up with a way of fasting to rinse out the drug (Paxil) that I had been taking for 3 months from my system, but found out after months the symptoms kept coming back accompanied by this heavy fatigue (which should have been included in the previous symptoms). I began to feel like a hypochondriac when trying to explain to my doctor the things that were going wrong with me. He had blood and urine lab tests run, of which he gave me a copy. He seemed to feel that I did not have a serotonin problem, but from what I could read of the lab tests, they looked inconclusive to me. I need to know what is your opinion? Should I go see a Neurologist and have him/her run tests on me to be sure? Would any Neurologist understand serotonin neurotransmitters and how the chemical drug serotonin would affect a person? Of the symptoms remaining is the pain in the back and abdomen. I take Darvocet for that and Klonopin (which! I had stopped taking) I started taking it again and between the fasting and that, it seems to be the only thing that has gotten me back on my feet. Not totally, but enough to start practicing my bowling again.

Answer: Have you checked serotonin levels in the blood? Also, I strongly doubt that the SRI drugs would have residual effects for months. I suspect there is something else going on which is undiagnosed.

Serotonin Level Testing  [posted 12/10/98]
Question: Just returned from Mayo Clinic, Jacksonville, and they do NOT do blood test for serotonin levels or Substance P. Is there a clinic or doctor located in the South who can do this testing? Diagnosed with FM in 1992, it has taken me 6 years, much time and money and an insistance for a referral to Mayo to rule FM out, as I strongly suspect I have serotonin deficiency.

Answer: Serotonin levels can be done by any lab. In fact, are sent to a reference lab like most uncommon tests. Any hospital or general lab can draw the test and send it off.

Can You Increase Serotonin Levels [posted 11/11/98]
Question: Why isn't there a drug out there that increases serotonin? This kind of medication would help people with Fibromyalgia and CFID's??

Answer: Amitriptyline increases the serum levels as do some of the other tri-cylic anti-depressants. Unfortunately hasn't helped a great deal with either problem.

Any Correlation Between Serotonin Levels & Cancer [posted 11/4/98]
Question: Does overproduction of seratonin in the brain create cancer in the intestinal tract or other parts of the body. Are high level seratonin levels and cancer related?

Answer: Interesting question;but, not as far as I know.

Elevating & Testing Serotonin Levels [posted 10/29/98]
Question: I have a five year old who has OCD and violent behavior. My questions are: 1. Given the blood/brain barrier, have serotonin blood tests been proven to reflect serotonin levels in the brain? 2. Prozac and other anti-depressant drugs increase levels of serotonin in the brain. Can serotonin be increased with natural substances that stimulate serotonin production, specifically dietary tryptophan and the nutritional supplement 5-htp? 3. Are any of the drugs, dietary changes, or supplements safe for a five year old?

Answer: Blood serotonin levels correlate poorly with brain levels. Also, one is talking about the levels at nerve endings-not the total body level. High levels of carbohydrates will usually elevate body serotonin levels. Elavil and that class of antidepressants is also effective. None of the dietary supplements will help that we are aware of.

Treating Serotonin Deficiency [posted 10/13/98]
Question: I am a patient that takes 75 mg of Effexor and up to 2 mg of Xanax a day due to my body not making Seratonin. I have severe panic attacks and this seems to keep them at bay most of the time. I am wondering if I took, in addition to the above, 50 mg of 5-HTP would that adversely affect me or would it add to the Effexor and actually lower the edge that I feel most of the time. Am I risking overdose of Seratonin or any other problem?

Answer: I wouldn't take the 5-HTP, maybe a small dose of a drug like amitriptyline -known to increase serotonin levels. Have you had your blood level checked? These are available. A serotonin deficiency is treated differently from serotonin acting antidepressants.

Serotonin [posted 8/11/98]
Question: The information available on this is difficult for me to piece together. My ex-wife is a 31 year old female, mother of two, and have occasional migraines. Flashes in peripheral vision, periods of extreme moodiness, denial, abdominal discomforts. As related by her from her doctor, serotonin was responsible for the abdominal problem. Through these web sites serotonin problems are related to various forms of depression. Could denial, selfishness, withdrawal and solitary solutions related to a +/- serotonin problem? Could it also be the root of a severe communication problem?

Answer: I think you are trying to group too many problems under one banner. While it is true that Serotonin is an important neurotransmitter, it is difficult to know if treatment would affect so many problems. One would have to try an antidepressant with Serotonin effects to see what effect it had in her.

Serotonin Levels [posted 8/4/98]
Question: What is a normal level for serotonin? I had mine checked and it is 50. Is this a normal level?

Answer: Depends on the normals for the particular level. The lab which performed the test would have the normal range on the test itself. This is probably normal depending on how it was done.

Increasing Seratonin [posted 7/29/98]
Question: Is there any type of foods, exercise, etc., other than drugs that will increase seratonin?

Answer: Not clear. There have been few studies studying serotonin levels with changes in foods and behavior. It is thought that exercise does this and carbohydrates, but sketchy data.

Blood Test for Serotonin [posted 7/27/98]
Question: I have read on this web page that there is a blood test for testing the level of Serotonin. Could you please give me more information on this blood test and how I might get such a test taken?

Answer: For my patients, I just order the test and send them to the lab. I'm not sure the lab that the test is sent to, but I get the results in about 3 weeks. I'm sure your physician could do the same.

Question: My husband has had several blood tests in the last year and each has come back with a 352 level of Serotonin. We are told that this is high? What does this mean?

Answer: Low levels mean something and high levels do not with the exception of serotonin producing tumors(non cancerous growths). These are rare and serotonin levels are usually not checked to make the diagnosis.

Question: I would like to find all possible information regarding Serotonin and its effects on the brain when there's a chemical imbalance with testosterone. Can you point me in the right direction?

Answer: I'm not quite sure what aspect of serotonin /testerone you seek-can you be more specific.

Question: I was told I have something wrong with my Serotonin level, but I have no idea what it controls. Would you please tell me what it controls in the body and what happens if my level of Serotonin is low?

Answer: Serotonin is used by your body as a neurotransmitter. This means that nerves talk to each other and send signals to each other using serotonin as one of the mediums. Certain nerves use this chemical while other nerves use other chemicals. I have two patients with low levels of serotonin and I have never found a cause or many reports in the literature telling me what to do. Elavil or this class of anti-depressant seems to help. There are new anti-depressants called serotonin reuptake inhibitors. These people manifest their deficiency by depression and this seems to be genetic as far as we can tell.

Question: What is Serotonin?

Answer: Serotonin is a neurotransmitter used at the ends of nerves. It is manufactured in your body using the amino acid tryptophan. At the meeting of one nerve with another there is a space. Release of serotonin (or other drugs-depending on the type of nerve) causes the other nerve to fire and continue the message along the "cable". Its other name is 5- hydroxytryptamine and is also found in platelets. Release of serotonin by injured platelets is thought to cause blood vessels to contract.

Question: Could you tell me what the relationship is between the level of Serotonin in the brain and appetite? Also, what foods will increase the levels of Serotonin?

Answer: We really do not know the triggers for hunger or appetite. It seems that serotonin is involved, but where and how are currently unknown. Serotonin release is triggered by a carbohydrate load (sugar, etc.) and there are many who feel that eating Carbohydrates under stress is aimed at this serotonin release. Other potent drug stimulators are anti-depressants like Elavil (amitriptyline).

Serotonin & Suicide
Question: I have just read a research article by J John Mann (Colombia) regarding the possible use of Serotonin deficiencies as an indicator in suicide cases (other contributing factors understood). My question is how would one test for this (Blood test, etc?) And what is the acceptable validity for the use of medications as an aid in prevention? I have a friend (minor) who could possibly benefit from the proper medical (i.e.,pharmaceutical) treatment in conjuction with counciling, as opposed to (or perhaps in addition to) the normal depressent type medications.

Answer: There is a blood test for serotonin. Some Psychiatrists use it to indicate the appropriate type of drug to use. It is not clear exactly how this plays with"depression"-clearly the serotonin deficiency in the body effects many neurological processes.

Serotonin Syndrome
Question: I have been told I have Serotonin syndrome, but I am not sure what that implies. I realize I am unable to take the popular SSRI antidepressants without severe side effects. I notice there is a section on Serotonin syndrome of the FAQ page, but I am denied access. What can I do to either access this information, or find it somewhere else?

Answer: There are several syndromes that could be referred to as Serotonin Syndrome. First is overproduction by carcinoid cells of serotonin. This causes diarrhea, flushing and tachycardia. Second is serotonin deficiency which is characterized by a low level of serotonin in the blood. Third, a whole bunch of syndromes grouped under this when the physician can't make a diagnosis of the real problem. Carcinoid Syndrome can be localized in any general medicine textbook. Serotonin deficiency in a few articles-check Index Medicus for a complete listing.

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