UnderstandingElevated Serotonin & Dopamine

Neurotransmitters like serotoninand dopamine are critical for mood, behavior, and physiological balance.While deficiencies get a lot of attention, excess levels can also causesignificant symptoms—and may point to underlying health issues that need to beaddressed.

WhenSerotonin Runs High

PossibleSymptoms

• Anxiety, agitation
• Diarrhea
• Altered mental status
• Hyperreflexia (overactive reflexes)
• Autonomic instability (e.g., abnormal heart rate, blood     pressure swings)

In severe cases—especially withsudden onset—consider serotonin syndrome, a potentially life-threateningcondition.

AssociatedConditions

• Schizophrenia
• Autism spectrum disorders

PotentialCauses

• Supplements:     melatonin, tryptophan, 5-HTP
• Medications     (especially in combination): antidepressants, trazodone, triptans,     dextromethorphan, opioids, antiemetics, lithium, linezolid, ritonavir
• Recent illicit drug use
• Diet & lifestyle:     low-protein/high-carb meals, high insulin levels, exercise, and bright     light exposure can all boost serotonin
• Enzyme deficiency:     decreased monoamine oxidase (MAO) activity
• Gut dysbiosis:     overgrowth of Clostridia, Staphylococcus, Bifidobacterium,     and Enterococcus can produce excess serotonin

WhenDopamine Is Elevated

PossibleSymptoms

• Worry, distrust, social withdrawal
• Hyperfocus or impulsivity (seen in ADHD, OCD)
• Heightened drive or agitation (acute stress, manic     states)
• Anticipation-related behaviors (gambling, addiction)

AssociatedConditions

• Schizophrenia
• Pregnancy-related mood changes
• Rare in children: neuroblastoma, Costello syndrome,     leukemia, pheochromocytoma, Menke’s disease, rhabdomyosarcoma of the     bladder
• Rare in adults: carcinoid tumor, pheochromocytoma

PotentialCauses

• Supplements:     phenylalanine, tyrosine, Mucuna pruriens
• Medications:     NDRIs, SNRIs, Parkinson’s drugs (dopamine agonists), MAOIs
• Recent illicit drug use
• Enzyme deficiency:     low catechol-O-methyltransferase (COMT) and/or MAO activity
• Gut dysbiosis:     overgrowth of Staphylococcus, Bacillus, Proteus, Serratia,     Escherichia, or Clostridia (which can slow     dopamine-to-norepinephrine conversion)

EnzymeFunction & Hormonal Influence

A Comprehensive NeurotransmitterProfile can help determine if slow breakdown of serotonin/dopamine is dueto reduced COMT or MAO activity.

• Lower testosterone     and/or estrogen dominance commonly reduce both enzyme activities.

FactorsThat Decrease MAO Function

• Tobacco
• Caffeine
• Nutrient deficiencies: iron, vitamin B2, vitamin B3
• Herbs: bilberry, curcumin, echinacea, evening primrose,     licorice, rhodiola, St. John’s wort

FactorsThat Reduce COMT Function

• Chronic stress, oxidative stress, environmental toxins     (metals, plastics)
• Multiple medications
• Poor diet (processed foods, high sugar, artificial     sweeteners)
• Leptin/insulin resistance
• Nutrient deficiencies: magnesium, methylfolate (MTHF),     methylcobalamin, methionine
• Genetic variants: COMT or MTHFR polymorphisms

SupportingCOMT & MAO Enzymes

COMT Support

• SAMe: 100–500 mg
• Magnesium: 150–500 mg
• MTHF: 400–5000 mcg
• Methylcobalamin: 1000–5000 mcg
• Foods/herbs: cruciferous vegetables, soy (genistein),     resveratrol, citrus, rooibos, dandelion, rosemary, curcumin

MAO Support

• Vitamin B2 (riboflavin-5-phosphate preferred): 50 mg
• Vitamin B3: 100 mg
• Iron (if deficient via serum testing): 25–50 mg

AdditionalTesting to Consider

• Hormone panel:     Salivary estradiol, progesterone, testosterone, diurnal cortisol
• Genetic testing:     SNPs (COMT, MTHFR) and methylation status
• GI360:     Especially with digestive symptoms, poor diet, or poor treatment response
• Specific tumor testing:
   
  • Pheochromocytoma:      episodic headache, sweating, tachycardia, hypertension → test via 24-hour      urinary fractionated catecholamines/metanephrines (low suspicion) or      plasma fractionated metanephrines (high suspicion)
   
  • Carcinoid tumor:      chronic flushing/diarrhea → test via 24-hour urine 5-HIAA

ClinicalPerspective

• Mild elevations     of serotonin or dopamine without alarming symptoms are usually not     cause for panic.
• First steps: review medications/supplements, assess     diet, digestion, stress.
• Next: order targeted testing (hormone profile,     microbiome mapping, genetic analysis) to uncover the root cause.

Bottom line: Rather than treating neurotransmitter levels in isolation,identify and address the upstream factors—hormonal imbalances, enzyme activity,gut health, and lifestyle—to restore natural balance.

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