Non-Validity and Clinical Relevance of Neurotransmitter Testing

The testing of neurotransmitters by urinary testing has become popular to assess central nervous system imbalances, but the inferences from urinary testing to central nervous system imbalances are incorrect. The logic for testing urinary peripheral neurotransmitters to identify imbalances in central nervous system would be comparable to measuring hormones in the cerebrospinal fluid (CSF) for a menopausal patient. Hormones in the CSF are specific to hormones that influence the central nervous system and not the peripheral system. However, serum (not CSF) testing of hormones would be appropriate to assess the influence of hormones on peripheral tissues such as bones, arteries, organs, etc. The same logic applies to neurotransmitters. Laboratory analysis of neurotransmitters can be assessed either in the urine, serum, platelets, or CSF. Each method of analysis has different inferences and very little correlation with each other. CSF assessment appears to be the only appropriate method for testing levels of neurotransmitters that are produced and utilized in the central nervous system. This note attempts to explain the rationale and thinking behind testing assumptions and conclusions.