Neurotransmitters and alcoholism (levels similar to our kids)

The HPA Axis The “Home” of Alcoholism in the Body and Mind Research has concluded that the “home” of alcoholism resides in the HPA (hypothalamus, pituitary, adrenal) axis of the neuroendocrine system. Now that we have the well-defined markers of addictive chemistry and we know where they live, scientists have developed extremely sophisticated tests which monitor the performance of this axis under various conditions by measuring dopamine, serotonin, GABA, glutamate, epinephrine (adrenaline), norepinephrine (noradrenalin), cortisol and DHEA which are the six big neurotransmitters and two key hormones which define either the health of the neuroendocrine system or its state and depth of illness. In Alcoholism: The Cause & The Cure you learn that addictive or addicted biochemistry is essentially the body's inability to adequately self-medicate with the natural, feel-good transmitters such as serotonin, GABA, dopamine and endorphins (as well as enkephalins) which predisposes an individual to “seek” relief in external ways such as alcohol. Addictive biochemistry is intricately associated with an upregulated (in excess) sympathetic nervous system where, due to low GABA, serotonin, and endorphins; excitatory neurotransmitters such as glutamate, norepinephrine and epinephrine are overexpressed which cause the many symptoms problem drinkers are known to self-medicate. It is also the bedrock of the progression of alcoholism in active drinkers because the longer one drinks, the more damage is done to the neuroendocrine system rendering it progressively unable to medicate the body naturally which intensifies symptoms which then causes one to drink more. To help you understand the root of this phenomenon I will go into a little more detail regarding genetic addictive biochemistry and active addiction and how they affect the HPA axis. The endocrine system is the network of glands in the body comprised of the hypothalamus, pituitary, pineal, adrenals, thyroid, parathyroid and the sex glands; ovaries and testes. These glands secrete hormones throughout the body to each and every organ via the blood which are received by their complimentary receptors. Hormones are “messengers” which carry messages coded by our DNA with the intention of keeping an organ regulated and healthy, essentially functioning as it should. A hormone's message will stimulate, suppress or maintain functional cell or tissue activity of the organ it is received by. The hypothalamus is the center piece of the endocrine system and is located in the middle of the base of the brain. The hypothalamus' ultimate purpose is to establish and maintain homeostasis; balance within the body. It regulates all the functions of the autonomic system of breathing, heart rate, etc… but also hunger, thirst, sexual drive, sleep urination and metabolism which includes blood sugar control. Although technically the hypothalamus is part of the endocrine system it is really central to both the endocrine and nervous system; in fact, it is in the hypothalamus that these two extremely complex systems of the body intersect. As the Master Accountant, the hypothalamus performs checks and balances and responds to chemical messages of deficient or excess by sending various hormones and neurotransmitters to “adjust” to the requirements of your internal and / or external environments to maintain status quo. The hypothalamus is able to do this because it houses receptor sites for both hormones from the endocrine system and neurotransmitters from the nervous system and it utilizes the information it receives from those sites to do its job of not only controlling the entire endocrine system, including having a profound influence on the liver, heart and kidneys, but establishing healthy brain chemistry and nervous system performance by correcting neurotransmitter imbalances by either slowing production of what is in excess, ingesting or degrading them faster, or in cases of deficiency, producing and releasing them as required. The door to addictive biochemistry opens when either the hypothalamus or one of the organs which serve the hypothalamus in accomplishing this job is injured, or if the nutrients required are not available. In any one of these conditions the entire system will fall off the “point zero” (homeostasis) that the HPA system tries to maintain, and the door for addictive biochemistry is opened. It is a well known fact that addictive biochemistry and full out alcoholism are associated with over expression of the sympathetic nervous system; low serotonin, GABA, dopamine, endorphins and enkephalins and it is in the hypothalamus where the delicate job of balancing this network of hormones and neurotransmitters to achieve physical and mental health is supposed to be done - whether it be directly from the hypothalamus or via the pituitary and adrenals under the control of the hypothalamus. The only difference between addictive biochemistry and full out alcoholism is that addictive biochemistry becomes aggravated, meaning that the deficient condition within the hypothalamus, pituitary or adrenals is made more profound by the damaging effects of alcohol toxicity and the medicating effects which, while drinking, overexpress serotonin, endorphins and dopamine which magnifies the negative impact of an already upregulated brain chemistry. The symptoms the problem drinker experiences intensify in direct relationship to the diminishing health of the neuroendocrine system which further encourages the person to drink more thus causing even more damage. This cycle progressively intensifies until intervention which discontinues and heals the damage is required to stop it. The pituitary gland is located below the hypothalamus and is directly connected to it via nerve and circulatory pathways. The hypothalamus regulates the function of the pituitary gland which in turn controls hormonal secretions of all other glands; however, specific to alcoholism we are concerned with the function of the adrenals and the secretion of cortisol which is under control of ACTH (adrenocorticotrophin) secreted by the pituitary, and epinephrine and norepinephrine which is also released by the adrenals due to a rise in CRH and/or signals from the sympathetic nervous system. In the case of cortisol release, when the hypothalamus registers low blood sugar it will send CRH (corticotrophin releasing hormone) to the pituitary which then releases ACTH which will cause cortisol to be secreted from the adrenals. This chain of events will also cause the release of epinephrine and to a lesser degree norepinephrine. Prolonged increased levels of epinephrine will block insulin receptors which leads to insulin resistance and lowered serotonin, endorphin, enkephalin and GABA levels which impairs HPA functions and increases compulsive / addictive behavior. The adrenals sit on top of the kidneys and are directly controlled by the pituitary gland. The adrenals are comprised of two sections; one is the medulla which is the inner core and the second is the adrenal cortex which is the outer layer. The medulla relates to the sympathetic nervous system and produces the catecholamines epinephrine and norepinephrine. The adrenal cortex produces sex hormones, aldosterone, and what we're most concerned with cortisol. The adrenals receive chemical messengers (hormones) from the pituitary and signal from the sympathetic nervous system which determines how much of its hormones it will release. However, if they are injured, diseased or fatigued they will not be able to keep up with the demands from the hypothalamus to maintain homeostasis and mild to severe mental disorders will surface as symptoms of compromised adrenal health. Although it is hard to imagine because they are docked on our kidneys, adrenal health is fundamental to our mental health. Proper levels of cortisol, epinephrine and norepinephrine are crucial to our mental well-being so concentrated focus needs to be applied to their health when healing addictive biochemistry and alcoholism. How They All Work Together I will use stress as an example of how the organs of the HPA work together and then we will take a look at how excessive alcohol use causes alcoholism and how to correct the metabolism so the addictive biochemistry and conditions for alcoholism are no longer present. During periods of acute stress special serotonin receptors on the hypothalamus are stimulated which cause the hypothalamus to produce CRF (corticotrophin release factor). The CRF is sent directly to the pituitary which causes ACTH to be sent to the adrenals which triggers release of cortisol. Cortisol is sent throughout the body on a number of different missions with the primary one to reduce the stress by stimulating serotonin (inhibitory neurotransmitter) in the amygdala which has an inhibitory effect on amygdala glutamate (excitatory neurotransmitter) which helps to calm the person down. The amygdala is directly connected to the hypothalamus and is a component of the limbic area of the brain where processing of emotions, fear, panic and long term memories occur. Many forms of depression, anxiety and panic disorders originate in the amygdala due to low serotonin and its inhibitory effects on the glutamate pathways of the amygdala. The HPA and Addictive / Addicted Biochemistry The genetic markers in the brain chemistry which spell alcoholism are the same for those that earned the condition through alcohol abuse; they are low endorphin, enkephalin, GABA, serotonin and dopamine expression which results in the over expression of the sympathetic nervous system; glutimate, epinephrine and norepinephrine. It doesn't necessarily have to be all of these; it could be just one or two that can engage the practice of self-medicating once a person, regardless of age, is exposed to a substance that helps balance their deficiencies. Albeit for a short time with known ramifications but it seems to be worth it because they will continue the habit until they find a way to stop the mild to severe symptoms they suffer through another means. The symptoms those with inherited capacity for addictive biochemistry are not as pronounced as the active drinker, however they are indeed debilitating and extremely mentally and physically uncomfortable. These symptoms can vary depending on the exact deficiencies of these neurotransmitters combined but they can include everything from depression, mental / physical fatigue and cravings for simple carbs to low self-esteem / confidence and low grade anxiety or restlessness. Alcohol can fix all of these in one fell swoop because it immediately raises all of the deficient neurotransmitters. The price to pay is high though, because on the other end comes the bottoming out of the already inherently low levels of neurotransmitters. Long-term drinking causes exaggerated over expression of the sympathetic nervous system due to overexpression of excitatory neurotransmitters glutamate, epinephrine, and norepinephrine; and underexpression of the inhibitory neurotransmitters; serotonin, GABA and dopamine, and the opioids endorphins and enkephalins during periods of sobriety which cause the “excitatory” symptoms I mentioned earlier which the individual is encouraged to self medicate. They will suffer their own combination of these now magnified symptoms due to the similar, now magnified neurotransmitter deficiencies. Due to the continual extreme demands on the adrenals, problem drinking invariably fatigues the adrenals and brings the problem drinker to a serious stress syndrome due depletion of cortisol, epinephrine and DHEA in concert with the depressive effects of low serotonin. Due to low cortisol / epinephrine, they will suffer from overexpression of norepinephrine which is known to cause irritability, anxiety, aggression, hypertension, and bipolar disorder. What happens within the body of those that have been abusing alcohol for a while and have damaged their neuroendocrine system is this: while the person is drinking, GABA, endorphins, dopamine and serotonin are overexpressed and literally emptied out from the CNS and hypothalamus which gives them the relaxation and medication for their symptoms they desire (which causes one to drink even more to achieve relief they found with far less alcohol early in their habit). This extreme depletion of inhibitory neurotransmitters leaves stores “empty” the next morning when they wake up which causes the overexpression of glutamate and the catecholamines. The symptoms of this condition are any of those I've mentioned including anxiety, restlessness, worry, short attention span, inability to focus, can't sit in one place for long, jitters, insomnia; basically most any feeling that is associated with being too “amped” up internally - this doesn't necessarily mean you feel like running a marathon; you don't. It means you are internally overexcited. Your endorphins and enkephalins were also over produced and emptied out so you won't have much of your natural pain killers available to mediate the condition you're in; ergo, soon you will have another drink. The internal scene with most people who rarely drink excessively is quite different; they have ample healthy stores of serotonin, dopamine, GABA, endorphin and enkephalin and they will immediately rise to the job of balancing the overexpressed glutamate and catecholamines. In the long-term drinker this is impossible because their body's ability to manufacture and replenish healthy levels of these neurotransmitters has been diminished from the damage of alcohol toxicity and the resulting malnutrition. The possible genetic handicap of not being able to naturally balance the autonomic sympathetic and parasympathetic nervous system by producing ample amounts of inhibitory neurotransmitters may also be involved which means there was a precondition of low levels of the natural feel-goods which will serve to accelerate the progression of alcohol abuse. Once the damage is established in the HPA by long-term drinking the cycle becomes deeply embedded in the person's biochemistry because this condition renders them entirely dependent on alcohol to achieve peace, relaxation and the natural euphoria of life because they can't feel good inside their own skin naturally anymore within a reasonable amount of time, and not without a bout of severe withdrawal which they are not inclined to endure. Inherited and acquired imbalanced, upregulated sympathetic neuroendocrine hormones and neurotransmitters are predominately caused by weakened or injured organs of the HPA caused by extreme blood sugar fluctuations over a considerable period and / or malnutrition. Alcohol metabolites such as acetaldehyde will also injure all of these organs in variable degrees making a considerable contribution to the addiction. A family history of unmet need for brain sugars due to a number of reasons such as famine or dietary restrictions due to location or climate which caused an excess of grains to be consumed over protein has been identified as contributing factors for weakened adrenals and injury to the hypothalamus and pituitary which can result in inheriting the predisposition to seek alcohol, other simple sugars and stimulants to self medicate. Another contributor to a genetic predisposition to addictive biochemistry is an early adoption of the industrialized food craze which began in the 40s and 50s which has now manifested in nearly 95% of what is at your supermarket being adulterated with sugars, hydrogenated fats, or foods so processed that there really isn't any food in the product anymore. These so called “foods” cause malnutrition and also damage the delicate workings of the HPA axis. Excessive dietary sugars, OTC, prescription and street drugs, malnutrition, disease and environmental toxins (especially acetaldehyde) can create a deficiency of neurotransmitters and imbalance or even damage the neuroendocrine system, creating an immediate requirement to replete and balance them before illness and possibly disease sets in. Alcoholism is extremely responsive to neurotransmitter repletion since it is their deficiencies and imbalance that is at the very root of alcohol addiction. In the Brain - a drink in a long time problem drinker (simplified) ? serotonin, GABA, endorphins and dopamine > hypothalamus produces ? CRF > pituitary produces ? ACTH > adrenals produce ? Cortisol. Sympathetic nervous system produces ? norepinephrine and epinephrine. 20 to 30 min. later, sharp drop in blood sugar, serotonin, endorphins and dopamine. Individual begins to feel “excitatory” symptoms. Has another drink, cycle begins again. Next day: Individual experiences symptoms of low levels of the feel-good neurotransmitters: serotonin, GABA, dopamine, endorphins, enkephalins and GABA. Concurrently, he/she will suffer symptoms of high cortisol (due to low blood sugar this time), glutamate, norepinephrine and epinephrine. The “tank” for the parasympathetic, feel-good neurotransmitters is emptied out and mental and physical capacities are diminished while the person suffers resulting symptoms. The individual begins to cultivate his/her habits around repletion of these neurotransmitters through the use of alcohol which progressively damages the person's ability to produce them and an addiction is born. The biochemistry of alcohol related symptoms exposed: Symptoms of long-term alcohol abuse directly related to HPA function: Stress Disorder There are possibly a hundred pathways for the various symptoms caused by alcohol toxicity and damage. I am provided a simplified one to demonstrate the very real fundamental message of this section: that alcohol toxicity and the results of its metabolism in the brain cause the psychological symptoms they suffer which triggers the survival mechanism to reduce pain and since they can't do it naturally, will seek it relief in alcohol. Due to alcohol toxicity damage and malnutrition, adrenal fatigue causes low cortisol output which leads to high norepinephrine levels (overexpressed). I've mentioned the debilitating symptoms of this condition earlier. The cause is because cortisol is required (along with SAMe) to produce epinephrine from norepinephrine. When this doesn't occur, norepinephrine is overexpressed while epinephrine and cortisol are diminished. Note here that cortisol is required in some areas of the brain to activate serotonin so when it is low it can also inhibit serotonin expression. This condition delivers one to the “alarm” stage of stress disorder due to the profound states of mind that can result from elevated norepinephrine including extreme anxiety, panic attacks, exaggerated fear (paranoia), insomnia, aggression, irritability, hypertension and even bipolar disorder. All of these conditions center on the deregulation of the HPA axis. How The 101 Program Corrects Addictive Biochemistry (simplified) Through the use of HPA axis testing, measuring the key neurotransmitters known to facilitate addictive biochemistry: dopamine, serotonin, GABA, glutamate, epinephrine, and norepinephrine. Cortisol and DHEA levels are also tested to establish the degree to which the adrenals are damaged so that an appropriate treatment for the adrenals can be developed. Once the neurotransmitter deficiencies are exposed, the practitioner can develop a personalized, targeted nutritional therapy (TNT) and aggressive nutriceutical protocol to bring the neuroendocrine system back into balance, optimizing the HPA axis and relieving the individual of the symptoms they self-medicate. Other contributing factors such as liver and GI damage are considered and addressed as well to provide the system with the best possible environment to heal and correct the “broken” metabolism.