Brief Answer:
Uncertain Clinical Significance

Detailed Answer:
Good evening. My name is Dr. Dariush Saghafi. I am a neurologist in the XXXXXXX OH region of the world. I'm wondering if you are also from XXXXXXX since I see that you've mentioned visiting the XXXXXXX Clinic on several occasions.

I'd like to ask you the name of the lab that tested your neurotransmitters and upon whose suggestion did you obtain such testing as well as the reason for the testing. The reason I ask is because from a purely medical point of view there is no disease entity for which neurotransmitter testing is considered a routine part of a standard neurological workup.

For example, in the condition of Parkinson's disease we know that dopamine is deficient in the brain, however, there is never any type of workup for this condition which suggests or requires that "neurotransmitter" levels be tested or measured for any reason. It's not a necessary thing for us to know as neurologists in order to successfully treat the disease. Furthermore, there is no predictive ability of any test commercially available which looks for dopamine levels in urine, blood, saliva, or other bodily fluid which is either predictive of disease or helpful in determining how well a person is responding to treatment.

Bottom line is that neurotransmitter measurements for Parkinson's is neither recommended nor are there any tests available commercially which we consider useful in the prediction or treatment of the disease.

The same holds true for every other neurotransmitter which you may list such as acetylcholine, GABA, glutamine, serotonin, or norepinephrine.

Therefore, a lower than normal DOPAC level as measured by a commercial laboratory advertising neurotransmitter testing has no value from a clinical perspective iand should not be advocated or promoted as being valuable for any medical purpose by physicians.

Please take a look at a similar perspective by Dr. XXXXXXX Weil who is a respected naturalist and holistic medical doctor known throughout the United States:

http://www.drweil.com/drw/u/QAA400661/Neurotransmitters-What-Tests-Work-Best.html



If the present information has been as helpful as before I would absolutely appreciate written feedback and seeing a STAR RATING by yourself on this question.

If you have no further questions or comments to place could you also do me the favor of CLOSING THE QUERY which will alert the network to process, archive, and credit this question appropriately for future reference?

I'm happy to answer questions personally through the following website:

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68474

This query required 27 minutes of physician specific review, research, and final draft documentation for envoy.

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Brief Answer:
Be cautious

Detailed Answer:
As I said in my original answer above.

There are no NEUROLOGISTS (M.D.'s) who I know, who are members of the XXXXXXX Academy of Neurology, or specialists in the movement disorders field of Parkinson's disease, ALS, or any other neurodegenerative illness where imbalances of brain neurotransmitters is suspected of occurring who promote or interpret these types of tests by private lab companies for the purpose of either diagnosing or treating their patients.

There are simply no credible clinical studies published in PEER REVIEWED JOURNALS that has ever shown a meaningful correlation between many neurotransmitter levels in different body fluids in order to either diagnose or treat a disease or illness. The exception to that statement may be something on the order of catecholamine levels in urine which are often looked for when talking about a person who may have certain types of adrenal tumors, etc.

I would be cautious and want to know if the acupuncturist has anything of an interest other than academic with the laboratories offering these tests. Often times these laboratories offer financial or other incentives to clinicians who send them business....the tests are very expensive...and the results, as I've said are of no clinical meaning to the vast majority of physicians simply based upon the lack of evidence that they have any value with the exception of a very small number of tests.

Actually, if the laboratory is reputable and gives good results for DHEA then, that particular blood test may give useful information. But again, one could literally submit themselves to doing hundreds of laboratory tests...all for nothing because clinically there is no reason to do them. I question whether an accupuncturist has the clinical knowledge to know why they are ordering many of their tests except to say that "the COMPLETE HEALTH PACKAGE" by the lab will include tests for x, y, and z. Not very good way to practice frugal medicine.

DHEA levels are looked at when people have conditions of abnormalities in their adrenal glands or women may be suspected of having Polycystic Ovary Disease. Are either of those 2 conditions descriptive of your situation? If not, then, I would question the validity of even getting the test in the first place. Being LOW normal is as good as being HIGH normal. You should not be moved to purchase or buy or whatever they suggest you do to "replace" or 'replenish" your levels because you're FINE!

Did you read the article I provided the link to by Dr. Weil?

If the present information has been as helpful as before I would absolutely appreciate written feedback and seeing a STAR RATING by yourself on this question.

If you have no further questions or comments to place could you also do me the favor of CLOSING THE QUERY which will alert the network to process, archive, and credit this question appropriately for future reference?

I'm happy to answer questions personally through the following website:

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68474

This query required 45 minutes of physician specific review, research, and final draft documentation for envoy.

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Brief Answer:
Thanks for your update on the situation

Detailed Answer:
I guess I can understand when people are trying to find THE RIGHT answer and so they frantically search and search and spend money and then, they become impressionable to all sorts of things. And I can appreciate that. As a headache specialist I have patients for whom nothing we offer seems to work. So, who am I to stand in the way of any other physician, healer, motivational type of person giving them good Karma if there's a chance that good can be done?

But sometimes as my professor (a world renowned Neurologist himself) says, you just have to be GOOD ENOUGH of a doctor to recognize you CAN'T WIN EVERYTHING. He says that the BEST doctors are those who heal with consistency patients appropriate to THEIR expertise and recognize those patients who fall outside that realm of expertise who they should call outside help on and then, there are those who are within their realm of expertise BUT ARE SIMPLY NOT CURABLE no matter how good they are.

Do you agree with that philosophy. That's from the doctor's perspective. From the patient's side I think it needs to translate into something like.....at some point, after you've seen every specialist high and low, the good, the great, the extraordinary, after every therapist and medication have been within your realm.....well, sometimes....a patient who wants so desperately to be CURED....simply must stop all their travels and understand that what they seek is not on this planet. They need to change their focus, change their attitude, and their expectation levels.

No matter how badly an amputee wants his leg back.....at some point he MUST realize that he can't have it....and it's nobody fault that he can't have it....it's just the way things are. Doesn't mean a patient has to GIVE UP....that's not the point....but one needs to change the focus.....so I understand your case of saying, Western Medicine has done all they can....so, let's give a chance to someone or something different.....I get that, really I do. I send some of my patients to acupuncturists but not if the acupuncturist is going to send them up and down the street making them spend their money for things that have little to no chance of working. When I send a patient of mine to a consultant....it's not because that doctor or therapist can rack up more charges than anybody else and that's what makes them good. It's perhaps the opposite which is that at minimum cost to the patient the consultant has service, advice, and motivation or education to give to my patient. So then, I don't care if it's an acupuncturist, a therapist, a Tarot Card reader.....I know my patient is likely to get top service for a reasonable price.

But for someone to just send patients off for batteries of tests measuring all sorts of things using fancy terminology that sounds nifty and is just another way of disguising a "rock" for a "golden nugget" that we simply have no proof has any value...even though we can't do much better perhaps, I'm very much against that because to me that's simply taking full advantage of a desperate person and that's is without ethics or morality. However, people do this all the time.

Anyways, I'll get off my VERY TALL soapbox and come back down to earth for while just to sign off and tell you that as far as your other concerns go I see you've been soliciting a lot of other opinions so I don't think I can say anything more intelligent or revealing than you've already heard...especially given the fact that I'm just an Old Country Neurologist, as Dr. XXXXXXX XXXXXXX from Star Trek told XXXXXXX T. XXXXXXX on many an episode! HAHA!

I'll let you choose your winner suggestions from the other colleagues who know more gastroenterology than I do and remind you that I would be highly appreciative of your written feedback along with a STAR RATING.

I would be especially grateful if you would also CLOSE THE QUERY if there were no further comments or questions so that this transaction can be processed, archived, and credited properly to my work status and I also invite to write me questions or comments directly to my attention by using the following link:

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68474

All the best.

This query required 27 minutes of physician specific review, research, and final draft documentation for envoy.

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