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The Clinical Utility of Urinary Neurotransmitter Analysis: An Overview

Joe Ailts,BS, Kelly Olson, Ph.D

Neurotransmitters are recognized as the primary biochemical messengers of the central and peripheral nervous systems. Studies have demonstrated that urinary neurotransmitter measures are reflective of circulating levels as evidenced by renal neurotransmitter clearance mechanisms. Laboratory methodology for the accurate assessment of urinary neurotransmitter levels has been established. Urinary measures are not recognized as a direct reflection of central activity, however definite associations exist. The ability to measure neurotransmitters has led to the generation of scientific literature that demonstrates urinary neurotransmitter measurements have clinical value as representative biomarkers of various neurological, immunological, and endocrinological conditions.

Urinary neurotransmitter assessment carries a long history as a means to assess nervous system activity. Early investigations date back to the 1950s when von Euler, et al, first described the measurement of urinary catecholamines as biomarkers for pheochromocytoma, a rare tumor of the adrenal gland. Since then, many studies have been published regarding neurotransmitter excretion and its relevance to neurological, endocrinological, and immunological function. While urinary neurotransmitter measures are not considered direct reflections of central nervous system activity, various disease states stemming from central nervous system imbalances have been associated with urinary neurotransmitter alterations. There is a definite association between urinary and central neurotransmitter concentrations and many studies have examined that association through various neuro-endo- immune communication mechanisms. Controlled studies have shown that after intervention with centrally-acting medications, symptoms resolve with changes in corresponding urinary biomarkers. Below are eight summaries chosen from the literature that discuss the validity and utility of urinary neurotransmitter measurement.

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