The Truth about Low Mood and Urinary Serotonin Levels

Last week’s post about serotonin and the immune connection got me thinking about the clinical utility of evaluating urinary serotonin levels. I have recently been fielding calls from practitioners questioning the value of urinary serotonin measures for patients with depression. 

I find urinary serotonin measures to be very valuable for patients suffering from depression and other mood disorders.  Just over a year ago a study was published in the respected journal Analytical and Bioanalytical Chemistry by Nichkova, et al. at Pharmasan Labs entitled, “Evaluation of a novel ELISA for serotonin:  Urinary serotonin as a potential biomarker for depression.”  This original research demonstrated a significant link between depression and low urinary serotonin levels.

In fact, Psychology Progress (a forum to alert the scientific community of breaking journal articles considered to the best in psychology research) recently featured this Pharmasan Labs publication as a significant contributor in the study of depression.  A full text copy of the article is available here.

The Pharmasan Labs study reviewed serotonin concentrations in urine for 60 depressed individuals and 60 healthy controls.  The depressed population was found to have significantly lower levels of urinary serotonin as compared to the control population.

Furthermore, the study evaluated the clinical utility of using urinary serotonin measures to monitor the efficacy of serotonin-focused treatments.  46 depressed patients were evaluated based upon three treatment classes:  5-hydroxytryptophan (5-HTP) supplementation, selective serotonin reuptake inhibitor (SSRI) usage, or a combination therapy (both 5-HTP and SSRI).  Urinary serotonin measures were significantly higher in treatment groups when compared to the control group. The authors concluded that urinary serotonin measures can be effectively used to evaluate and guide treatment for depressed patients.

Peer-reviewed literature supports the clinical utility of urinary serotonin levels for evaluating and guiding treatment for depressed patients as well as monitoring the efficacy of these treatments.  The research and development team at Pharmasan Labs works tirelessly to offer high-quality research-supported laboratory testing.  Future publications will reveal additional Pharmasan Labs’ efforts in the R & D arena.  Their comprehensive test menu and wide-ranging services are tailored to support the needs of research institutions and healthcare businesses.  Pharmasan Labs, Inc. is certified by the Clinical Laboratory Improvement Amendments program (CLIA) and the New York State Department of Health.

More information about urinary neurotransmitter measures can be found below.

Neurotransmitters excreted in the urine as biomarkers of nervous system activity: Validity and clinical applicability

Studies on the immune response and preparation of antibodies against a large panel of conjugated neurotransmitters and biogenic amines: specific polyclonal antibody response and tolerance

Novel ELISAs for Screening of the Biogenic Amines GABA, Glycine, B-Phenylethylamine, Agmatine, and Taurine Using One Derivatization Procedure of Whole Urine Samples


About Bradley Bush, N.D.

Dr. Bradley Bush received a N.D. degree from National College of Naturopathic Medicine in 2000 and is currently the Director of Clinician Affairs for NeuroScience, Inc. and oversees their NEI Nutrition division. Dr. Bush specializes in neuro-endo-immune health, nutrition and infusion therapies. His focus is on addressing gastrointestinal and HPA axis disturbances in addition to nutritional deficiencies as a cornerstone of patient care. He is co-author of the ND: Notes Science Board Review and ND Notes: Clinical Board Review books. Dr. Bush has worked for years for manufacturers of nutritional supplements, is a founder and past-organizer of the annual Pharmaceutical Perspectives conference, and currently sits on the board of the Naturopathic Education and Research Consortium (NERC).
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2 Responses to The Truth about Low Mood and Urinary Serotonin Levels

  1. I am curious as to why you are not considering a whole blood serotonin level instead of a urinary serotonin (I assume that would be the 5-HIAA)? Intuitively, it would seem that the blood levels of serotonin would be more accurate than what is excreted. Is my thinking incorrect? Thanks!
    Dr. Diana

    • Sarah Mo says:

      Neurotransmitters can be accurately measured in both blood and urine. NeuroScience prefers urinary assessment for a number of reasons, the most important of which include:

      A non-invasive collection. This is important from a practical perspective. Patients can collect in the comfort of their home, in an environment that minimizes stress, which ultimately affects neurotransmitter release and excretion.

      A non-invasive collection also negates the stress of venipuncture and “white coat syndrome”, both of which activate the sympathetic nervous system, thereby potentially skewing results.

      While blood may seem a “more accurate” means to assess nervous system biomarkers, possibly by virtue of being one step closer to the brain, ultimately the value of a biomarker is in its ability to predict, diagnose, or guide/monitor treatment for various symptoms and/or disease states.

      The article by Nichova, et al and a number of additional peer-reviewed publications increasingly suggest urinary neurotransmitter testing can be an effective tool to enhance a clinician’s ability to manage various mental health concerns.

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