February 12, 2018 at 3:02 pm #982
This is my son’s OAT test. He has Asperger’s, OCD and anxiety. He is, to me, a total dopamine seeker, always looking for rewards and ways to make himself feel better and I think that he may be a low dopamine, low catecholamine kid, but was always unsure whether he had circulating dopamine but was not able to utilise it properly. He is also very stressed a lot and morning salivary cortisol levels last tested were were 50nmol/L. He is on a range of supplements but I would love your opinion, especially in the neurotransmitter area and anything else that may be impacting on that as his anxiety, self worth, concentration and executive function really need a helping hand. He also gets alopecia constantly in patches and has quite bad keratosis pilaris.
Hair test shows lead at 1.9mcg/g (ref 1mcg/g) and mercury at 4mcg/g (ref 4mcg/g) with low lithium and slightly high copper/zinc ratio.
Urinary neurotransmitter testing (not sure of the value of this) showed off the scale high serotonin excretion, with lower end of the normal range for GABA, NE and Epinephrine. Glyphosate test was 0.915. He is a massive sushi eater as I think he gets the dopamine rush from it, but he has low sodium,organic, non GMO tamari with it most of the time.
I would love to hear your opinion to check I am on the right track with analysing the OATS test.
Thanks so much,
Attachments:You must be logged in to view attached files.February 12, 2018 at 8:28 pm #984
I would agree. Both his HVA and VMA are low normal. This would explain low Dopamine and Norepinephrine. His B6 and Vitamin C are low too. No issues of significance with bacteria toxins or mitochondrial deficits though which is good. The low serotonin (5-HIAA) sometimes goes along with the low dopamine.
Have you checked his Total Cholesterol and Vitamin D levels?
Any particular supplements he does not do well with?
Done any SNP testing?
Dr. WoellerFebruary 12, 2018 at 9:14 pm #985
well interestingly (and annoyingly) vitamin B6 has always been a problem. When he was younger, any dose, any form (P5P or pyridoxine) meant total lack of behavioral control by him. I have recently restarted him with a compounded formula containing only 1 mg of P5P in the hope to slowly build it up. He has also recently started high school and is being bullied so its hard to tell the effects but he seems okay on it.
I can’t get blood out of him unfortunately but managed to do a vitamin D blood spot 2 yeas ago (which he will never do again) and it was 75nmol/L.
He has been on 5-HTP in the past but I have also read that it can cause issues if elevated cortisol.
SNPs- yes: homozygous for mnSOD, DAO, GAD, COMT (v158M), FUT2, MAO A, NOS1, eNOS, HTR1A, SLC6A4, TPH2 and a few CYPs. No problem with metylation.
MelissaFebruary 13, 2018 at 11:14 am #986
One to help with some of the reactions to B6 is with magnesium. What I commonly do is give B6 with Magnesium Chelate from New Beginnings. So, one tablet of 50mg B6 is given with one capsule of Magnesium Chelate. If two tablets are use of B6, then I will give two capsules of Magnesium Chelate.
Sorry to hear about the bullying at school. That is always a tough thing to deal with.
Vitamin D – okay. A good rule of thumb on Vitamin D dosing is 1000IU – 2000IU per 25lbs body weight daily. You can split the difference with 1500IU per 25lbs body weight and usually keep the Vitamin D in a normal range.
Cortisol – what you can do too is some adaptogenic botanicals for adrenal support. New Beginnings Nutritionals carries – Adrenal Stability – https://www.nbnus.net/shopexd.asp?id=481.
Look at their Dopa-Plus product too – https://www.nbnus.net/shopexd.asp?id=468. It does have some B6 in it though.
If the Hair Lithium is low I would suggest using Liquid Lithium as well – https://www.nbnus.net/shopexd.asp?id=78. A good dose to start is 2 drops daily, then work up to 5 drops by increasing a drop daily every 48 to 72 hours. Children usually take 5 drops daily and Adults, 10 drops daily.
The MAO-A SNP’s are often associated with increased MAO-A activity which depletes serotonin. The GAD can lead to increase glutamate sensitivity and less GABA production which could explain the GABA from the neurotransmitter test.
Is the TPH2 the Tryptophan Hydroxylase 2?
Dr. WoellerFebruary 13, 2018 at 5:13 pm #987
Thanks Dr Woeller,
All great advice. Yes it is tryptophan hydroxylase 2. So that may be interfering with serotonin production? I’m inclined to think about supporting dopamine and catecholamines first with trying to increase B6 (and concinmittant magnesium), adaptogens, tyrosine, vitaminC, zinc and vitamin D etc. I’ll check out all the above supps.
Thanks so much!!!!!
MelissaFebruary 14, 2018 at 8:45 am #988
Yes, it is possible that the TH2 mutation could effect central nervous system serotonin. This enzyme is controlled by a vitamin D receptor element gene sensitive to Vitamin D status. Therefore, low vitamin D can lead to under performance of the TH2 and low serotonin levels.
Dr. WoellerFebruary 14, 2018 at 5:29 pm #989
Thank you!February 14, 2018 at 5:55 pm #990
With the SOD SNP and low NAC has anything been done for liver (detox) support? Also with SNPs on DAO and FUT2, how is the response to foods high in histamine?February 14, 2018 at 8:02 pm #991
Interestingly, in his last OATS he had normal NAC levels but he was not taking NAC. Prior to this one, he has been taking NAC regularly. There are no obvious signs of problems with high histamine foods, but it could contribute to his anxiety and they use antihistamines for Alopecia, so may play a part in that. I haven’t figured that one out yet. He’s also taking pycogenol to increase GSH and SOD, as well as sulfurophane.
MelissaFebruary 15, 2018 at 7:22 am #992
Milk thistle is also known to increase glutathione too, in addition to its liver effects.
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