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Serotonin

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Serotonin is a neurotransmitter associated with happiness and contributes to our overall sense of well-being. If we experience anxiety, it could indicate an imbalance in serotonin levels. Such imbalances may manifest in various ways, such as sleep disturbances, digestive problems, and intense cravings, to name a few. Due to its role in regulating several bodily processes, testing for serotonin levels can help identify imbalances. Correcting low or high levels of serotonin can be achieved through dietary and lifestyle changes.

Serotonin's functions:

Serotonin is produced mainly in the gastrointestinal tract and central nervous system and is considered an inhibitory neurotransmitter, similar to GABA. Its inhibitory properties help to balance the excitatory effects of other neurotransmitters in the body. This balancing act is crucial for mood and sleep regulation, memory, pain management, and various other biological functions. Maintaining adequate levels of serotonin is essential for regulating mood, which can result in reduced anxiety, increased happiness, better focus, and a sense of calm. Moreover, serotonin also plays a vital role in regulating several other physiological processes, such as:

  • Aggression 5
  • Appetite and cravings 6
  • Calm and relaxation 7
  • Gastrointestinal motility 8
  • Learning 5
  • Menstrual health 10
  • Mental and emotional health (including mood and anxiousness) 5
  • Pain perception 11
  • Sleep 12
  • Stress response 13
  • Thermoregulation

How is Serotonin made in the body?

Serotonin, like all neurotransmitters, is derived from an amino acid. It is the only neurotransmitter produced from tryptophan and is the end product of the metabolism of tryptophan to 5-hydroxytryptophan (5-HTP). Serotonin is produced in both the central nervous system and the GI tract. Nearly 90% of serotonin originates in the enterochromaffin cells of the small intestine. Platelet serotonin also originates in the small intestine. The remaining serotonin is produced in the brain. 1-3

What happens when you have a Serotonin imbalance?

Imbalanced serotonin levels are associated with a number of health concerns that impact quality of life. For example:

  • Mental and Emotional Health
    • Low serotonin levels are often seen with low mood, anxiousness, and stress 5
    • High serotonin can cause euphoria, but can also lead to feelings of fear, restlessness, and blood pressure imbalances. 14
    • High serotonin is often seen in cases of low libido. 9
  • Gastrointestinal Function 15
  • High serotonin can lead to appetite suppression, whereas increased food cravings might be experienced in the presence of low serotonin.
  • Constipation and irritable bowel syndrome have been linked to serotonin imbalances. 16
  • Sleep-Wake Cycle Regulation
  • Fatigue 17 and irregular sleep patterns18 are linked to imbalanced serotonin.
  • High serotonin may cause sleeplessness at night, followed by fatigue during the day.

How does Serotonin interact with other hormones and Neurotransmitters?

Serotonin works in concert with other hormones and neurotransmitters. Estrogen, testosterone, dehydroepiandrosterone (DHEA), and thyroid hormone enhance serotonin activity. On the other hand, imbalances of cortisol as well as high insulin inhibit serotonin action. Imbalanced serotonin could also be a red flag for imbalanced melatonin levels. Optimized serotonin levels are known to promote healthy thyroid function and activity of the hypothalamus.

Serotonin works together with dopamine to maintain chemical balance in the CNS. They often produce opposite effects in the body to help maintain balance. For example:

  • Low dopamine may stimulate hunger, whereas elevated serotonin suppresses hunger. 19,20
  • Impulsive behavior 21 may be linked to elevated dopamine and deficient serotonin levels.
  • Dopamine is associated with reward and motivation; serotonin is associated with happiness and mood. 22
  • Cognition, memory, and attention 23 decline when both serotonin and dopamine levels are low.
  • Raising serotonin can be suppressive to dopamine, interfering with libido.

How does Serotonin become imbalanced?

A number of factors can disrupt serotonin levels or associated hormones or neurotransmitters. These factors include:

  • Digestive issues. Problems digesting food can lead to impaired absorption and breakdown of the precursors and cofactors necessary for building neurotransmitters. 24
  • Poor diet. A diet lacking in the nutrients needed to make serotonin can affect levels of this neurotransmitter. 25
  • Stress. Modern levels of stress can cause a cascade of symptoms, including decreased levels of serotonin, oxidative stress, and cortisol imbalances. 26

How can we naturally support Serotonin?

It is possible to encourage healthy levels of serotonin through lifestyle measures, including:

  • Eating foods rich in the amino acid building block and cofactors needed to make serotonin. 
  • Dietary supplements that contain the necessary precursors and cofactors to promote the synthesis, release, and/or function of serotonin can also support healthy levels of serotonin. These include:
    • L-tryptophan
    • 5-hydroxytryptophan
    • Vitamin B6 (as pyridoxal-5-phosphate)
    • Iron
  • Exercise, even at moderate levels a few times a week, can increase serotonin levels while also improving stress, mood, and cognition. 33
  • Meditation has been shown to increase serotonin levels, while also reducing stress and anxiousness. 34 Additionally, meditation may also aid in improving other indicators of serotonin imbalance such as cognition and memory.

References:

  1. De Vadder F, Grasset E, et al. Proc Natl Acad Sci U S A. 2018;115(25):6458-6463.
  2. Chen Z, Luo J, et al. Immunity. 2021;54(1):151-163.e156.
  3. Shah PA, Park CJ, et al. Cellular and molecular gastroenterology and hepatology. 2021;12(3):1093-1104.
  4. Ranjbar-Slamloo Y, Fazlali Z. Front Mol Neurosci. 2019;12:334.
  5. Longone P, di Michele F, et al. Frontiers in endocrinology. 2011;2:55.
  6. Wurtman J, Wurtman R. Curr Obes Rep. 2018;7(1):1-5.
  7. Tauscher J, Bagby RM, et al. The American journal of psychiatry. 2001;158(8):1326-1328.
  8. Crowell MD. British journal of pharmacology. 2004;141(8):1285-1293.
  9. Goldstein I, Kim NN, Clayton AH, et al. Mayo Clin Proc. 2017 Jan;92(1):114-128.
  10. Yonkers KA, O’Brien PM, et al. Lancet. 2008;371(9619):1200-1210.
  11. Gupta A, Björnsson A, et al. British journal of anaesthesia. 2011;107(2):164-170.
  12. Bravo R, Matito S, et al. Age (Dordrecht, Netherlands). 2013;35(4):1277-1285.
  13. Møller SE. Pharmacology & toxicology. 1992;71 Suppl 1:61-71.
  14. Kloza M, Baranowska-Kuczko M, et al. Postepy higieny i medycyny doswiadczalnej (Online). 2014;68:738-748.
  15. Yabut JM, Crane JD, et al. Endocr Rev. 2019;40(4):1092-1107.
  16. Bonetto S, Fagoonee S, et al. Polish archives of internal medicine. 2021;131(7-8):709-715.
  17. Cordeiro LMS, Rabelo PCR, et al. Braz J Med Biol Res. 2017;50(12):e6432.
  18. Davies SK, Ang JE, et al. Proc Natl Acad Sci U S A. 2014;111(29):10761-10766.
  19. Freitas A, Albuquerque G, et al. Annals of nutrition & metabolism. 2018;73(1):19-29.
  20. Harrold JA, Dovey TM, et al. Neuropharmacology. 2012;63(1):3-17.
  21. da Cunha-Bang S, Knudsen GM. Biological psychiatry. 2021;90(7):447-457.
  22. Peters KZ, Cheer JF, et al. Trends Neurosci. 2021;44(6):464-477.
  23. Logue SF, Gould TJ. Pharmacology, biochemistry, and behavior. 2014;123:45-54.
  24. Kiela PR, Ghishan FK. Best practice & research Clinical gastroenterology. 2016;30(2):145-159.
  25. Gostner JM, Geisler S, et al. Neuropsychobiology. 2020;79(1):89-99.
  26. Belleau EL, Treadway MT, et al. Biological psychiatry. 2019;85(6):443-453.
  27. Francescangeli J, Karamchandani K, et al. International journal of molecular sciences. 2019;20(9).
  28. Barthelemy C, Bruneau N, et al. J Autism Dev Disord. 1988;18(4):583-591.
  29. Llorente AM, Voigt RG, et al. Clin Neuropsychol. 2006;20(1):133-144.
  30. Nichkova MI, Huisman H, et al. Anal Bioanal Chem. 2012;402(4):1593-1600.
  31. Grossman F, Potter WZ. Psychiatry Res. 1999;87(1):21-27.
  32. Linnoila M, Miller TL, et al. Archives of general psychiatry. 1984;41(7):688-692.
  33. Alghadir AH, Gabr SA, et al. International journal of environmental research and public health. 2020;17(11).
  34. Mosini AC, Saad M, et al. Revista da Associacao Medica Brasileira (1992). 2019;65(5):706-713.

What does it mean if your Serotonin result is too high?

Serotonin syndrome, or the condition of having too much serotonin, usually happens when taking one or more medications that increase serotonin levels. Serotonin syndrome can be life-threatening and should be addressed immediately.

Symptoms of too much Serotonin:

  • Confusion
  • Diarrhea
  • Poor blood pressure regulation
  • Goose bumps
  • Headache
  • Increased heart rate
  • Nervousness
  • Poor muscle control, muscle rigidity, or twitching
  • Severe sweating
  • Shivering
  • Sleep problems

A rare type of cancer called a carcinoid tumor can produce high levels of serotonin in the body and may cause skin flushing, diarrhea, difficulty breathing, rapid heartbeat, or skin lesions on the face.

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