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Adrienne Dellwo

Serotonin Series: Do You Have Low Serotonin Levels?

By May 28, 2011

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Serotonin Series

The most popular treatments for fibromyalgia and chronic fatigue syndrome include increasing the available levels of serotonin, which is best known as a neurotransmitter but also acts as a hormone. SSRI/SNRI drugs do it, supplements such as SAM-e and 5-HTP do it, and some frequently recommended foods do it.

And yet, serotonin levels (and neurotransmitter levels in general) aren't something doctors test for outside of a research environment. In prescribing these medications -- which are highly likely to cause side effects and can even be deadly -- doctors must rely on symptoms. Many of them don't even do that, but simply make the assumption that our diagnoses automatically equate to low serotonin. (If you read last week's Serotonin Series post, you'll see what that's not always a valid assumption.)

To protect ourselves and make informed treatment decisions, we need to know for ourselves what symptoms are associated with low serotonin. Many of the symptoms listed below can be caused by multiple things, so just one or two isn't conclusive. The more you have, the more likely it is that you have low serotonin.

Physical Symptoms of Low Serotonin

  • Fatigue in spite of adequate rest
  • Disturbed sleep
  • Changes in appetite
  • Hot flushes and temperature changes
  • Headaches

Psychological Symptoms of Low Serotonin

  • Changes in libido
  • Mood disturbances
  • Depression
  • Irritability

Additional Symptoms of Extremely Low Serotonin

  • Muscle cramps
  • Bowel & bladder problems
  • Rapid, uncontrolled thought processes
  • Emotional numbness
  • Emotional or behavioral outbursts
  • Escape fantasies
  • Memory torture (dwelling on or reliving your most traumatic experiences)
  • Thoughts of harming yourself or others

Does this sound like you? Have serotonin-targeted treatments eased your symptoms? Have they made you feel worse? Leave your comments below!

See the rest of the Serotonin Series.

Learn more or join the conversation!


Photo Medioimages/Photodisc/Getty Images

May 28, 2011 at 8:37 am
(1) Flick says:

Yes, low serotonin which fluctuates for no apparent reason so far. 40mg of citalopram a day and still some days like today I feel immobilsed by pain and depression. I can check almost all the syptoms list above. I do sometimes wonder if the drug IS adding to it… not sure. I certainly feel today, back to where I was before going on them.

May 28, 2011 at 11:38 am
(2) fogmom says:

Wow, got almost a 100%, citalopram has helped. The memory torture thing was an eye opener used to be so bad it was almost constant. Now when it starts I say “STOP IT” and I get control of my thoughts. Couldn’t do before the citalopram.

May 28, 2011 at 7:10 pm
(3) Kellie says:

My doc tested my serotonin level and it was quite low. I am now on Cymbalta, trazodone for sleep (an old antidepressant) and I take a bioidentical serotonin nutritional supplement. My doc said reuptake inhibitors only work when you have enough serotonin circulating, so the supplement is necessary in addition to reuptake inhibitors. My dreadful, embarrassing head sweats are almost entirely gone despite summer being here and temps hovering around 100.

May 29, 2011 at 1:13 pm
(4) Stwart Jenssen says:

Vicodin is a pain reliever used for relieving any kind of arthritis pain. It is made up of two different kinds of drugs. One of them is acetaminophen which is also known by the trade name of Tylenol and the other one is hydrocodone. Although arthritis does not requires drugs to cure its symptoms people have started to use this drug on a large scale. This has also led to the abuse of these drugs.

Stwart jenssen

May 29, 2011 at 9:36 pm
(5) Tami Stackelhouse says:

I’m so glad you’re doing these posts about serotonin!

About nine months ago my doctor had me take a neurotransmitter test to find out my actual level of serotonin. My test came back showing that my serotonin level was extremely low. The thing that is interesting about those results is that at the time I was taking Cymbalta, which is an SNRI, as well as tramadol, which also has some SSRI properties. I was already taking two things that should have increased my serotonin level.

I wasn’t surprised at all to learn that my serotonin was low because I was showing many of the symptoms of low serotonin, including IBS-C. (Many folks don’t realize that 80-90% of your serotonin receptors are in your gut and that serotonin is responsible for the speed at which food moves through your digestive system.)

This is exactly what Kellie was talking about above. My husband had the best analogy: If SSRIs are like stoplights, and serotonin is like cars, you still can’t create a traffic jam if there aren’t enough cars on the road! My body simply wasn’t producing enough “cars.” So no matter how much we blocked the re-uptake, it was still a ghost town. Not to mention the fact that the serotonin re-uptake meds just help with re-uptake in the brain, not in the digestive tract where the majority of the receptors are, and where my IBS-C symptoms are.

So we added a 5-HTP spray to my regime, even though it is counter-intuitive at face value. Normally, you wouldn’t give someone too many things to increase serotonin at the risk of serotonin syndrome, which is deadly. That’s where the testing was so valuable!

I don’t know if anyone besides NeuroScience does testing for neurotransmitters, but the cost was fairly low and getting definitive results meant that I got the help I needed. Since then, I’ve been able to completely come off the tramadol – without experiencing the typical side effect of depression most folks have.

June 1, 2011 at 8:18 am
(6) Timber says:

It’s strange. I have nearly every symptom listed. Yet every time I’ve been put on SSRI’s, I feel better for a day or two, then feel agitated, and a little crazy. Like I’m not entirely home in my head — asleep at the wheel, or on auto-cruise. And I start to grind my teeth, clinch my jaw — and depending on the medication, if it’s really bad, I get so agitated, I start pacing, unable to sit still, and will even start to pull my hair. No doctor has ever explained it — just taken me off the med, and tried another — with the same results. And we’ve tried several different. The only psychotropic I’ve ever been able to tolerate is Depakote. I had some success on it.

But I can’t take it any longer because at this point, ANY drug in pill form causes me to have what they believe might be a gall-bladder attack. Maybe. I get nauseous, and it’s like my stomach backs up with bile, and I throw up non-stop for a few days unless I get my butt to the ER. My pain and heart rate go up. And lately, I get the ‘fist pain’. But they can’t tell me for sure that it’s my gallbladder.

I’m going to talk to my doctor tho about the neurotransmitter test.

Maybe someone could explain to me though: if FMS is a neurotransmitter issue, and we often are low not just in serotonin, but a host of others neurotransmitters, why the doctors NEVER seem to give us anything for those other neurotransmitters? They seem to hyper focus on the serotonin, and ignore the rest.

June 5, 2011 at 8:52 pm
(7) Stacey A says:

Hey Timber,i was just thinking that (hopefully not) it could be your pancreas not gall bladder.I only say this because my best friend has pancreatitis and her daughter and son,your symptoms go with it although there are more,maybe you could research it a bit unless you already have and usually with gallbladder your throw-up is kinda green.If you have to go to ER again have them check your levels(well crap my brain just stopped now i cant think of what levels are called)sorry:( anyway just say maybe its my pancreas.)Hope this may help,good luck.

March 31, 2012 at 10:08 pm
(8) staycalm says:

My daughter suffered from the stress/anxiety problems of low serotonin. She had and exhibited the symptoms listed. I did not know what to do for her but a neighbor recommended a nurse practitioner that might help. She tested her for levels of brain hormones and found that even with taking Zoloft she was 50% of where she should be with serotonin. She began a regime of prescription strength amino acids and so far she has been able to go from 100 mm of Zoloft to 75 mm and is much better with the symptoms. She has a way to go before she is where she wants to be but we are very encouraged with the progress. So thankful that we found some help.

June 28, 2012 at 5:32 am
(9) Got it says:

Hi…reading this just affirms what I have been going through. I got off of Celexa too fast and went on wellbutrin…I had all these side effects. My Dr. Kept testing my blood, sent me to an endocrinoligist, I went to the ER. No on has found this. I have been going through a month and a half of hell and did think about commiting suicide. How can Dr’s be so dumb! Ugh

October 11, 2012 at 5:52 am
(10) tink says:

i can totally relate to all of this.For months now i have been experiencing nausea, constant discomfort im my stomach and my bowel movements were all over the place.I put it down to having my children and the strain your body is under when you carry a child.However it really started to get me down i didnt want to go anywhere because i felt so rotten all the time and i was snapping at everyone around me.Then after a couple of visits to the doctors i had a break thru.My doctor mentioned the serotonin levels and how your stomach has its own and that he wanted to try me on citalopram.I thought he was kidding and trying to treat me for depression and anxiety as obviously i was starting to worry i was seriously ill and that they were missing something more serious!!! Its a vicious cycle.
Im not normally one to take tablets i do try and get on with things and hope they fix themselves but i really stuck to taking these tablets and im so glad i did.Im 3 months in and i feel so much better.Granted there are certain foods that i cant eat due to possible IBS but i know what triggers me and i can control it.I owe everything to my doctor for listening and taking the time to read my notes and piece together all my symptoms.
If anyone out there is experiencing any of the above symtoms i strongly reccommend contacting your doctor and having this chat. I wish you all well and i hope you feel better soon

December 9, 2012 at 10:47 am
(11) moneay says:

Hi im so happy to see this post all I know I got very depressed a few months ago and having anxiety didn’t want to anything I’m not familiar with serotonin and all that but been taking pill called cyproheptadine on and off for yrs for my appetite could that Med it low I’m I’m still taken it cause I’m depressed and have no appetite again and also taken fluoxetine and stool feel down what is the serotonin test called. Thanks

February 20, 2013 at 11:42 am
(12) Candice temple says:

I want to be able to quit my Effexor and not have to rely on like I have been since I was 12, will my natural level come back if I quit taking my meds because I notice that I actually get the side effects when I miss a day of not taking them as oppose to them causing it… Extreme fatigue, head ache , irritability, diss association ect… I have that they put me on this and that I had no choice in taking
it and now I feel like I am stuck and having to continue taking it the rest of my life… PLEASE someone help me

August 20, 2013 at 3:10 pm
(13) Michael says:

Hi, I didn’t realize but looking back over the last several + years, my mood was diminishing…I wasn’t enjoying life as much, wasn’t getting excited about things like I had used to, I was more irritable, etc…Then one day 2 years ago, I was hit with some strange lightheaded feeling that put me into a constant state of anxiety and panic for months…Which lead to severe insomnia, which led to worse depression. I tried SSRI’s but they made me worse, and I couldn’t tollerate the side-effects. I ended up going on a special amino acid/co-factor regiment which helped to a point, but never got me feeling 100%…So, now I’m trying St. John’s Wort with a little bit of 5-HTP or tryptophan to enhance the benefits of SJW. I think I’m just so far gone, with anxiety, panic, worry, that any Serotonin I do produce is just getting burned up…So, I need something like SJW to build up my levels, get me feeling better, so I can heal….

August 24, 2013 at 7:16 pm
(14) Kardigan says:


October 3, 2013 at 12:13 pm
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January 3, 2014 at 10:11 pm
(16) Tracey says:

Hi I have had Anxiety Panic attacks now for 4 years. They started 2 months after I gave birth to my 3 child. I’m on proxitine 50 mg…
I was on 30 mg but got upped due to having recent 3rd relapse and now i feel like im constant worrying I’m never going to get my life back and its destroying my family and marriage. I feel as if my doctor doesn’t care and he’s just dumping me on medication.. All I want is to be able to drive my car anywhere again with my family take my kids to school go shopping visit family but once again im restricted because of my anxiety which is caused by depression and stress please request for advice x

January 17, 2014 at 9:11 pm
(17) Joe says:

Tracy. don’t ever give up. I was diagnosed with panic and it lead to depression, back in 1995. I was given paxil to ease the panic and help with the depression. talking to a shrink really helped me, then I did a lot of reading on panic and how to get out of the nasty episodes. I still get those ugly panic attacks on occasions. what I’ve learned is that if you treat the panic as if it was a person bothering you, you can ease it to go away. stop laughing it works. this is what I did.
when I felt the attack coming on, I would talk to it as if it was a person bothering me. I would say to myself, ” look, hurry up and do what your gonna do, I got shit to take care of so hurry up”. to my surprise the attack would ease quickly. they would also come less frequently. this didn’t work for me over night, but over a couple of days to trying this I started working better and better. this is not a med replacement but just a technique I used to stop the attacks from blowing up.

April 19, 2014 at 5:18 pm
(18) Caroline says:

Hi Tracey! I just want to say that I know exactly how you are feeling!! I understand. I sat for months in my home and was Sooo scared to go out anywhere. I tense up and then get a pain in my left shoulder/arm which makes me feel like it’s heart related and I panic. My last episode was this past week when I had a severe panic attack while driving. I had uncontrollable crying that day quite frequently and it is within 2 weeks of starting my period. I have pretty much suffered with PMDD for 14 years but have not treated it until now. I started Paxil 10mg 5 days ago and I felt immediate relief. They also gave me 50mg of trazadone for nighttime to sleep but that dose was tooo much and I 1/2 the pills now. I’ve been seen by cardiologist and they monitored me in the ER last week right after the panic attack so for years cardiac has been ruled out. I never thought to have my serotonin checked until now. Now I’m able to go out and by myself! But instead of having anxiety about going places I’m still focused on now the possible side effects of these meds. So I trade one OCD thing for another!!! Ugh. I was on phentermine last year and lost a tremendous amount of weight but I think the phentermine screwed up my serotonin levels because I never had panic until now! I’ve gained weight from sitting around the last 4 months and went from 128 to 159.4 as of this morning with 10 lbs just in 3 weeks. However I’m moving now…I’m going out again!! So when my son comes home from college in 2 weeks I’ll get out there and exercise and hopefully loose this mess! But I still would rather be chubby than suffer like I was suffering. So please I know there are side effects but ask your MD about adding Abilify to your regime to enhance it. I want you to be able to go out there too and do normal things! But I truly understand. I hear ya….been there and it was soooo bad but Sooo sad too. I hope everyone reading has a very blessed and anxious free Easter!!

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