Neurotransmitter Testing: A Dubious Tool (+ what to do instead)

Edited and medically reviewed by Patrick Alban, DC | Written by Deane Alban

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There are good reasons to be skeptical of lab neurotransmitter testing. Instead, learn to assess signs and symptoms to gauge your neurochemical levels.

Neurotransmitters are chemicals that brain cells use to communicate with each other.

These brain chemicals have a major impact on all aspects of life.

They regulate your mood, motivation, cravings, energy, libido, and sleep.

Neurotransmitters control your ability to focus, concentrate, learn, remember, and handle stress.

They send messages to your autonomic nervous system which controls involuntary actions like breathing, heart rate, and digestion.

Abnormal neurotransmitter activity is responsible for many nervous system diseases and psychiatric disorders.

Laboratory neurotransmitter testing is sometimes used to uncover chemical imbalances that could be an underlying cause of a mood or mental health disorder.

But the effectiveness of these tests is in doubt.

5 Reasons to Be Skeptical of Laboratory Neurotransmitter Testing

Scientists have found over a hundred neurotransmitters and more will certainly be discovered. (1)

It’s estimated that the majority of Americans have suboptimal neurotransmitter levels, with our unhealthy modern lifestyle largely to blame. (2)

Chronic stress, poor diet, environmental toxins, drugs (prescription and recreational), alcohol, nicotine, and caffeine can cause neurotransmitter depletion.

Every laboratory offers a different menu of tests, but typically a neurotransmitter testing panel will encompass some or all of these major neurotransmitters:

  • serotonin
  • dopamine
  • acetylcholine
  • glutamate
  • norepinephrine
  • epinephrine
  • GABA

It’s claimed that this information can be used to more effectively treat a whole gamut of brain-related disorders such as:

  • Alzheimer’s
  • anxiety
  • attention disorders
  • autism 
  • brain fog
  • depression
  • memory loss
  • mood swings

As you might expect, the biggest proponents of neurotransmitter testing are the laboratories that sell these tests and the doctors who use them (and sometimes get a cut of the test fee).

These companies often recommend and sell supplements as well.

There is plenty of potential for conflict of interest.

" There is no scientifically validated way to test neurotransmitter levels through lab testing. The best way is to assess your symptoms.

One neurotransmitter testing company, NeuroScience, Inc., was fined over $6 million for violating laboratory testing requirements. (3)

The company founder admitted his company intentionally manipulated neurotransmitter test results and then recommended and provided supplements based on these bogus test results.

In a separate lawsuit, NeuroScience was also found guilty of Medicare fraud. (4)

One neurotransmitter lab website has the catchy slogan “test, don’t guess.”

But are these tests any better than guessing?

Here are 5 compelling reasons to be skeptical of neurotransmitters testing. 

1. Lab Tests Can’t Measure Neurotransmitter Levels in the Brain

Neurotransmitter tests are performed on samples of your saliva, urine, or sometimes blood.

But no correlation has ever been established between neurotransmitter levels in the brain and the rest of the body.

Neurotransmitters that are created in the brain are used to activate brain receptors.

By and large, neurotransmitters that are created elsewhere in the body stay outside the brain since they can’t cross the brain’s filter, the blood-brain barrier.

A surprising number of neurotransmitters are produced in areas of the body besides the brain.

For example, a whopping 95% of your serotonin is produced in your intestines. (5)

Some neurotransmitters are not even produced by your own cells.

The bacteria that reside in your gut have been found to synthesize over 30 neurotransmitters! (6)

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2. Neurotransmitter Levels Are Constantly Changing

The amount of any given neurotransmitter present is constantly and rapidly changing.

The half-life of a neurotransmitter can be as long as a few minutes or as short as a fraction of a second.

A molecule of serotonin, for example, has a half-life of one second. (7)

Everything you do — even the thoughts you think — impacts your neurotransmitter status on a moment-to-moment basis.

Any neurotransmitter test, at best, could give you only a snapshot of one moment in time. 

3. Lab Tests Ignore Neurotransmitter Receptors

Even if we could accurately measure neurotransmitter levels in the brain, there are other factors to consider.

There are several reasons that neurotransmitters, even when present in sufficient amounts, may not be well utilized and may be unable to do their job: (8)

  • Your brain has too few neurotransmitter receptors.
  • These receptors exist, but aren’t working very well.
  • Other substances have bound to these receptors instead. (Many drugs and recreational substances work by binding to neurotransmitter receptors.)
  • Neurotransmitters are not being appropriately recycled.

4. Neurotransmitter Testing Has No Scientific Validity

A comprehensive analysis of neurotransmitter testing concluded that there is no connection between neurotransmitters found in the urine and those in the brain.

Another study on the viability of commercial neurotransmitter testing found that these tests have no scientific foundation, and that there was an abundance of evidence refuting their validity. (9)

5. At Best, Neurotransmitter Tests Can Be an Adjunct Diagnostic Tool

The best health care is part art and part science.

Even clinicians who use lab neurotransmitter testing don’t use it as a stand-alone diagnostic tool, they use it as an adjunct to the body of knowledge they’ve acquired working with patients.

Neurotransmitter testing, at best, can provide you with additional insights, but it should not be used for diagnosis since there are no scientifically established norms for ideal levels of neurotransmitters. (10)

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Should You Use Online Neurotransmitter Tests?

You can order do-it-yourself neurotransmitter tests online that measure neurotransmitters from a sample of your saliva or urine.

But online tests may be your worst option.

Even health care professionals who use neurotransmitter testing admit that they do not rely on test results alone and that tests results are very hard to interpret.

Some commercial labs will help you interpret test results, often for an additional fee.

Here’s a screenshot of one such test showing neurotransmitter levels and commonly associated symptoms.

Keep in mind when you look at this chart that there are no established normal ranges for neurotransmitters

chart showing neurotransmitter level test results
Test results showing neurotransmitter levels and commonly associated symptoms.

Since these test results include typical symptoms, it begs the question “If you’re experiencing these symptoms, couldn’t you match them to the corresponding neurotransmitter without the lab test?

The answer is yes.

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Symptom Assessment: The Best Way to Gauge Neurotransmitter Levels

Symptom-based questionnaires have effectively been used for years to determine neurotransmitter deficiencies.

Datis Kharrazian, PhD, DHSc, is the author of the book I consider my “brain health bible,” Why Isn’t My Brain Working?.

He is a Harvard Medical School-trained clinical research scientist with an impressive list of credentials.

In his research, Dr. Kharrazian has found that:

“There is no scientifically validated way to test neurotransmitter levels through lab testing. The best way is to assess your symptoms. “ (11)

How to Assess Signs and Symptoms of Neurotransmitter Dysfunction

Below are lists of signs and symptoms that are linked to subpar levels of each of the four major neurotransmitters.

Read through each list and note the set of indicators that sound most like what you’re experiencing.

Then review our related articles on each of the various neurotransmitters (“Read more”).

There, you’ll find information on proven supplements, diet, and lifestyle habits that can help bring that neurotransmitter back into balance.

Acetylcholine Dysfunction Signs and Symptoms

Acetylcholine is the neurotransmitter associated with learning and memory.

Here are typical signs and symptoms experienced when there is an insufficient level of acetylcholine:

  • You aren’t as mentally sharp as you used to be.
  • You regularly misplace everyday items like phone, keys, and glasses.
  • You lose your train of thought during conversations.
  • You often have trouble finding the right word.
  • You find learning new things stressful.
  • You frequently forget what you just read.
  • Your sense of direction is poor and you often get lost.
  • Your reaction time is slow and you sometimes drive under the speed limit.
  • You crave fatty foods.

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Dopamine Dysfunction Signs and Symptoms

Dopamine is the “motivation molecule.”

It’s also in charge of the human pleasure-reward system.

Common low dopamine signs and symptoms include:

  • You lack motivation, you procrastinate and leave projects unfinished.
  • You need caffeine, sugar, nicotine, or other stimulants to get through the day.
  • You’re mentally scattered; your focus and concentration are poor.
  • You’re tired, apathetic, and have little zest for life.
  • You are inexplicably disinterested in the lives of those around you.
  • You’ve lost your ability to feel pleasure of all kinds and have little interest in sex.
  • Life seems hopeless, you feel worthless.
  • You lose your temper, especially when under stress.

It’s also possible to have too much dopamine.

Too much dopamine is characterized by impulsiveness, thrill-seeking, and addictions. 

GABA Dysfunction Signs and Symptoms

GABA (gamma-aminobutyric acid) is the brain chemical associated with relaxation.

It’s been called “nature’s Valium.”

Here are some typical indicators of a low GABA level:

  • You’re filled with dread for no apparent reason.
  • You are easily overstimulated and overwhelmed, and find it hard to unwind.
  • You’re always busy but have little to show for your efforts.
  • You’re disorganized and usually run late.
  • You find it impossible to relax and always find something to worry about.
  • Racing thoughts keep you awake at night.
  • Your heart pounds or beats erratically.
  • You use food, alcohol, or drugs to relax.

Serotonin Dysfunction Signs and Symptoms

Serotonin is a neurotransmitter responsible for happiness and positive mood.

A low serotonin level is associated with these signs and symptoms:

  • You crave carbohydrates and sometimes binge on them.
  • You have been told you’re a pessimist or that you worry too much.
  • You don’t take pleasure in things you used to enjoy.
  • Your thoughts are predominantly negative or obsessive.
  • You have been diagnosed with depression, an eating disorder, obsessive-compulsive disorder, or seasonal affective disorder.
  • You are prone to anxiety and panic attacks.
  • You’re a night owl who has trouble getting to sleep and staying asleep.
  • You can be irritable, impatient, or angry.
  • Your muscles ache but feel better with exercise.
  • If you’re a woman, you have PMS (premenstrual syndrome).

Reputable Online Symptom-Based Neurotransmitter Tests

If you’ve gone through the above questions but are still unsure which neurotransmitters are at the root of your problems, here’s another option.

There are a few free neurotransmitter quizzes and questionnaires available online to help you determine what your symptoms mean.

Some are better than others.

Here are two neurotransmitter questionnaires created by experts in the field to further guide you:

The UltraMind Solution Companion Guide

Mark Hyman, MD, is the director of the Center for Functional Medicine at the Cleveland Clinic, which is consistently rated one of the top hospitals in the country. (12)

He offers The UltraMind Solution Companion Guide (PDF) as a free supplement to his bestseller The UltraMind Solution.

It contains a symptom-based set of quizzes not just for neurotransmitters, but also for fatty acids, vitamin D, magnesium, zinc, inflammation, thyroid and adrenal function, gut health, and more.

Mood Type Questionnaires

Psychotherapist Julia Ross, MA, is a pioneer in the field of biochemical rebalancing using nutritional therapy, and the author of The Mood Cure.

Her Mood Type Questionnaires will help you determine the status of your serotonin, GABA, endorphins, and norepinephrine levels.

You will find four separate questionnaires (one for each neurotransmitter) on her website JuliaRossCures.com.

NOTE: These tests and quizzes are for your general information only. They are not a substitute for professional medical advice.

Do not alter any medications based on a quiz outcome. If you exhibit signs of depression, an anxiety disorder, schizophrenia, bipolar disorder, or any other mood disorder, please see an appropriate doctor right away.

If you believe that neurotransmitters are at the core of any physical or mental health issues you are experiencing, your average general practitioner may not be of much help.

You can find lists of health care professionals in your area who practice alternative, complementary, or integrative medicine in our Mental Health Resources Guide (in-depth review).

Neurotransmitter Testing: Take the Next Step

The first neurotransmitter was discovered less than 100 years ago.

Our understanding of how they work, of the links between them and mental health disorders, and of reliable ways to test them are still in the early stages.

Someday, maybe a lab test will be able to accurately tell you what’s wrong with your brain chemistry and how to fix it.

But that day is not here yet.

Until then, the best option is to use your signs and symptoms as a guide.

Use our signs and symptoms lists or take one of the professionally developed quizzes we recommend to draw your own conclusions.

Then, use this information to optimize your neurotransmitter levels with appropriate lifestyle measures and by working with a health care professional, if necessary.