Serotonin vs. Dopamine

[WideBody]

How is serotonin involved in RLS? Or is it? Manerva wrote a very interesting post on dopamine. I was wondering if serotonin plays a part?

[DicCarlson]

Interesting question. They are both neurotransmitters. 90% of serotonin is in the gut - but with strong connections to the brain. "In some cases, serotonin appears to inhibit dopamine production, which means that low levels of serotonin can lead to an overproduction of dopamine. This may lead to impulsive behavior, due to the role that dopamine plays in reward seeking behavior. " from Medical News Today. Dopamine is clearly implicated in the onset of RLS with a similar connection to the iron status in the brain. So, the implication is that serotonin COULD influence the status of dopamine in the brain and RLS, and gut dysbiosis (microbial imbalance) could be an underlying cause. My severe RLS was directly tied to low Ferritin levels, but why was it low? I had enough SIBO symptoms (GERD, bloating, constipation, etc.) that I just treated myself for it and those symptoms are waning and hopefully the imbalance that created the low iron and RLS. Med News Today link... medicalnewstoday.com/articl...

[FluteE in reply to DicCarlson]

So if the gut is an issue wouldn’t a probiotic help with that? If we would only do what we’re supposed to... variety of fruits and vegetables and water... it would take care of the majority of our problems.

[DicCarlson in reply to FluteE]

Perhaps, but many probiotics actually can make that microbial imbalance worse. It's all in the strain of probiotics used. Now I eat Kimchi (fermented cabbbage and vegetables) daily as a source of probiotics. I also take Saccharomyces Boulardii as a supplement and a probiotic called GutPro (not histamine producing) on occasion. Every meal I take digestive enzymes and an HCL w/Pepsin supplement - to Increase stomach acid.

[Hidden in reply to DicCarlson]

I've recently read a suggestion from another member that it's a good idea to increase stomach acid levels.

I'm not so sure that it is such a good idea in general, because there may be circumstances in which it may be harmful.

As an example, it appears that medications that inhibit acid secretion can be useful in treating GERD. The reverse then appears to be logical, increasing acid may make GERD worse.

A complication is that these medications, despite being efficacious for GERD might make RLS worse, or even cause it, as they cause malabsorption of relevant nutrients from the gut. e.g. specifically iron and B12.

This might suggest then, that it's good to increase stomach acid, which isn't always the case. The REAL problem may not actually be the acid level, it may the consequences of the substance decreasing it.

[DicCarlson in reply to Hidden]

This is one of the biggest disconnects between traditional (Allopathic) medicine and natropathic practitioners. Traditional treatment for GERD, heartburn and acid reflux is treated with acid blockers, proton pump inhibitors, etc. Going into any drug store in the US, you would think there is an epidemic of people with faulty digestion - with a wall of drugs for these conditions.

But ALL the alternative medicine doctors (Dr. Mercola, Dr Axe, etc) prescribe INCREASING Stomach acid to combat symptoms. I had GERD so bad my teeth hurt from acid coming up and hitting my bottom teeth and constant coughing. Up half the night with the cough.

I take HCL w/Pepsin (250 mg, which is a small dose. It also comes in 650mg, too much for me). I also take digestive enzymes. You could also start with Apple Cider Vinegar, maybe a teaspoon in a 16oz glass of water, before eating. The biggest improvement in GERD I found was self-treating for SIBO (I wasn't officially diagnosed with it). 4 weeks on, 2 weeks off: 4 drops 100% oil of Oregano (mixed in Olive Oil), raw garlic, garlic supplement and Berbine.

[Hidden in reply to DicCarlson]

Thanks

A well expressed and interesting response.

Whether I accept this or not, my main message, which I think we agree on, is that acid blockers are NOT a good idea!

I agree that allopathic medicine doesn't have all the answers and often leads to an "iatrogenic" condition (e.g. augmentation).

Hence there are allopathic medicines that I don't think are a good idea, if there is a choice and where the iatrogenesis is worse than the condition they're intended to treat.

Sometimes the choice between taking an allopathic medicine and a (non-allopathic) "alternative medicine", or not taking any treatment at all is not so easy to make.

The extreme examples of these include cancer cases and I was recently horrified to hear a woman dying because she was convinced turmeric would cure her cancer, so cancelled her chemotherapy.

I was also impressed by a recent post where a member, in order to avoid the consequences of taking a dopamine agonist decided to take a herbal dopamine booster, ended up with augmentation, struggled to wean off the herb, got no cooperation at all from his allopathic doctor and ended up in a right mess.

I hear other examples, so you can appreciate my reservations.

My own view of allopathic medicine is not so much that treatments may be iatrogenic, but that allopathic medicine fails to take a holistic approach to health issues. Any "specific" health issue should be considered in the context of the whole person, not as if it's somehow not part of them.

Furthermore, my personal view, for myself, is that I am willing to consider "complementary" therapies where there is some indication that they may be helpful, but especially where it's clear THEY will do no harm.

Furthermore, just because a treatment is non-allopathic, "alternative", "complementary" or "natural" doesn't necessarily mean it does no harm or hasn't any iatrogenic consequences. Nor does it mean it's holistic.

Where it seems to me logical that a non-allopathic treatment might do harm and there is no apparent credible evidence of it doing any good, then I am reluctant to take it myself and may inform others of my reservations and my reasons for them.

In the case of GERD, there are, I believe, many reasons for it happening. In your case there may be one specific reason. For other people there may be other reasons for their GERD. It is not holistic to consider all people suffering from GERD as being the same and therefore the same treatment for all may not be appropriate.

In the case, for example, of a person suffering GERD because of a hiatus hernia, it doesn't seem at all logical to me to increase stomach acid. I understand that you do NOT have a hiatus hernia. What if a person nhad

If there were some credible evidence that increasing stomach acid is effective for ALL cases of GERD then I wouldn't feel the need to question it.

There are lots of people who are vulnerable and suggestible because of suffering such conditions as RLS and GERD who may be desperate to try anything. Then there are lots of people touting their own pet theories, adverts for products (which will make a profit for someone), misinformation, scammers and people claiming that something "works" for them, (as if this proves it does work or that it will work for everyone) which will persuade someone to try something without being aware of the possible adverse consequences.

I consider myself lucky that I believe I'm in a position to distinguish what is credible evidence and what is not. I don't think many people are that lucky or don't realise that they aren't.

I don't feel comfortable advocating increasing HCL, pepsin etc for someone with GERD due to Hiatus Hernia nor Gastroparesis however. I'm not aware of any evidence that it can help and can see in the absence of any explanation, it still seems logical to me that increased acid, at least in these cases, will do more harm that good.

In the light of credible evidence that acid blockers can worsen RLS, I am happy to advocate NOT using them.

[WideBody in reply to DicCarlson]

Thank you, it was a very interesting article.

[Hidden]

There are a lot of neurotransmitters and it's difficult to get your head round them all, if you'll excuse the pun.

The include dopamine, serotonin, noradrenaline, glutamate GABA, acetylcholine, nitric oxide. etc.

It might be an oversimplification to say they each perform a specific function, because the functions they serve vary to where they act. The effect of dopamine (or serotonin) in one part of the nervous system may be different to its effect in another.

They may interact, because sometimes, the effect of one contradicts the effect of another so something has to hold them in balance.

It's further complicated by interactions with hormones. Hormones can, to some extent, be considered as neurotransmitters " at a distance".

Whereas a neurotransmitter from one nerve cell travels across a microscopic gap to to another cell, where it triggers a receptor site, hormones travel through the blood and trigger receptor sites in target cells in other parts of the body. They can be chemically related.

Noradrenaline is BOTH a neurotransmitter AND a hormone.

A further factor is that the availability of all these substancs, like everything else depends on a constant supply of the right sorts of nutrients, (largely proteins) from which to produce them.

Some hormone are made from other substances e.g. "steroids", the names a clue, are derived from chole STERol.

Since in order to be absorbed, from the gut, all nutrients have to be broken down into simple molecules glucose, fatty acids, amino acids etc. they all have to be manufactured from these elements and any fault in the digestion - absorption systems, in the gut may affect availability.

All in all to say, myself I haven't a clue how neurotransmitters affect each other, it's a "miraculous mess" and I 'm not surprised it can go wrong, and, so many things can go wrong.

In answer to your question, serotonin may play a part in RLS, but it might not be easy to say what that part actually is although it's known that substances that increase serotonin levels can make RLS worse. This doesn't mean tt serotonin directly affects dopamine or vice versa, but they may have different effects on a third common factor.