Low dopamine (e.g. dopamine deficiency): causes, symptoms, diagnosis and treatment options

Low dopamine (or dopamine deficiency as called by physicians) might be a cause of serious medical issues. This posts features information on its causes, symptoms, diagnosis and treatment options.

What is dopamine and a little something about dopaminergic pathways

Dopamine contracted from 3, 4-Dihydroxyphenethylamine is a type of hormone and also is a neurotransmitter that plays many important functions in human body and brain. It belongs to two families of organic compounds, which are as following:

• Catecholamine
• Phenethylamine

Being an amine, it is formed by the removal of Carboxyl group from L-Dopa (3, 4-Dihydroxyphenethylamine). The systematic name given to Dopamine by IUPAC (International Union of Pure and Applied Chemistry nomenclature) is 4-(2-Aminoethyle) benzene-1, 2-diol. In the brain, Dopamine acts as a neurotransmitter. Nerve cells release it in the form of a chemical to transmit signals to other nerve cells. Brain has many distinguished Dopamine systems. Its major role is in Reward Motivated Behavior. Dopamine level is increased due to some of reward motivated behaviors. Use of addictive drugs results in increased dopamine neuronal activity. Dopaminergic pathways or systems of the body are categorized in two parts:

Inside the brain

Inside the brain dopamine acts as a neurotransmitter. It is a type of chemical released by nerve cells to communicate with other nerve cells. The role of dopamine is categorized into two following groups according to their importance.

• High level functions; these include motor controls, motivation, arousal, cognition and reward motivated behavior.
• Low level functions; these include lactation (milk production), sexual gratification (orgasm) and nausea.

Neurons that release dopamine are called Dopaminergic Neurons. There are 400,000 dopaminergic neurons in human brain. These cells although confined to specific small brain parts can exert powerful effects on their target. Annica Dalhstrom and Kjell Fuxe mapped these dopaminergic cell groups in 1964. They represented them with letter A- areas A1 to A7 contains neurotransmitter Norepinephrine and the areas A8 to A14 contains Dopamine.

The dopaminergic pathways are as follows:

• Substantia Nigra; It is a little midbrain area forming parts of Basal Ganglia. Substantia Nigra is of Latin origin, which means Dark Substance. Dopamine Neuron cells are found in Cell group A8 and A9 in a part known as Pars Compacta. Their role is mostly motor control. Their damage can lead to Parkinson’s syndrome.
• Ventral Tegmental Area (VTA); It is also a midbrain area and has cell group A10, which is the largest of dopaminergic cells. Their play a critical role in reward motivated behavior.
• Posterior Hypothalamus; It is of group A11 of dopaminergic cells. They project themselves onto spinal cord. Although their function is not that well established, there is evidence of them playing important role in Restless Leg Syndrome. This syndrome causes a condition in which person experiences difficulty in sleeping due to constant movement of body parts especially those of legs.
• Arcuate and Periventricular Nucleus; They form cell groups A12 and A14 of hypothalamus. These dopaminergic cells project onto pituitary gland that influences hormonal secretion of Prolactin. Dopamine is main neuroendocrine inhibitors for Prolactin secretions. Due to Dopamine’s role as inhibitor for Prolactin secretions it is also known as Prolactin-Inhibiting factor (PIF).
• Zona Incerta; These belong to cell group of A13. They are projected to different regions of hypothalamus. Their function is to control Gonadotropin releasing hormone. This hormone is important as it activates reproductive systems in both males and females during puberty.

Other than brain

Dopamine doesn’t cross the Blood Brain Barrier (BBB). Dopamine circulates in small amount within bloodstream. In humans 95 percent dopamine is found in plasma is in the form of Dopamine Sulphate. This is mostly produced in Mesentric Organs surrounding some parts of digestive system. This Dopamine Sulphate production is thought to detoxify the dopamine ingested by food or either by digestive process. Dopamine Sulphate is excreted from the body through urine. Substantial amount of dopamine found in body is produced by Sympathetic Nervous System, Digestive System or other organs. Dopamine receptors are also present in walls of arteries. Their dopamine receptors perform Vasodilator and as Norepinephrine inhibitor functions. Other than modulating blood flow, dopamine circulates in a limited area of Peripheral Systems, where it performs Exocrine and Paracrine function. Some of the important functions of dopamine in body are as follows:

Immune System

Dopamine is involved in immune systems of human body. It affects immune cells receptors mainly that of Lymphocytes. Other immune cells affected by dopamine include those of Spleen, Bone marrow, and Circulatory system. Immune cells can synthesize and release dopamine on their own. Dopamine decreases the activation level of lymphocytes. This system is considered to be the best way of interactions between Nervous System and Immune System. It might also be involved in certain autoimmune disorders.

Kidneys

Cells of kidneys also contain various types of dopamine receptors. Tubule cells inside kidneys synthesize dopamine and discharge it in Tubular Fluid. The dopamine functions inside kidney involve the following.

• Increase blood supply
• Increase filtration process via Glomeruli
• Increase excretion of sodium through urine

Problems in Renal Dopamine function are normally caused by high blood pressure or genetic problem. It leads to reduce excretion of sodium and hypertension.

Pancreas

Pancreas consists of two parts:

• Exocrine; synthesis and secretion of enzymes and other substances occur in this part. One of the substances synthesized by exocrine pancreas is Dopamine. This secreted dopamine after entering small intestine prevents Intestinal Mucosa from damage and also lowers the level of Gastrointestinal Motility (movement rate of food through intestines).
• Endocrine; this part synthesizes and secretes hormones like Insulin in blood stream. The Beta Cells within this part producing insulin also contain traces of dopamine receptors. These dopamine receptors regulate the secretion rate of insulin. The dopamine input is not clear.

Human body may suffer from a disorder due to the defect of dopamine system. This disorder is characterized by low levels of dopamine in body. The condition is either called Low Dopamine or more commonly as Dopamine Deficiency. Low levels of dopamine result in low energy, demotivated state and suicidal tendencies. Dopamine is also called Happy Neurotransmitter because it triggers following sensations:

• Sensation of pleasure
• Feelings of attachments and love
• Unselfish care and wellbeing of others or more commonly Sense of Altruism
• Integrating thoughts and feelings.

Low dopamine levels result in the following conditions

• Pleasure lackness (Anhedonia)
• Lacking the feeling of attachments or love
• Lacking remorse for one’s actions
• Distraction

Causes of low dopamine

Low dopamine is caused by several conditions and stimuli. Most common of the causes related to Low Dopamine levels are as follows:

Stress

One of the causes for Dopamine Deficiency is stress. Studies have been conducted on the effects of acute stress on dopamine nerve activities. Dopamine synthesis and its secretion by brain is decreased by acute stress. Stress also results in depleting adrenals.

Alcohol Withdrawal Syndrome

One of the causes for dopamine deficiency includes alcohol withdrawal. Continuous use of alcohol in daily life results in impairment of dopamine levels in brain. When a person becomes addicted to alcohol, the brain areas producing dopamine are depleted. Person in such cases have to continue use of alcohol to feel pleasures of everyday life. Otherwise they develop Alcohol Withdrawal Syndrome.

Obesity

Obesity itself is a critical health condition on its own but may also lead to dopamine deficiency. Brookhaven National Laboratory conducted experiments on obese people and found that they have low dopamine levels. This was because of fewer number of dopamine receptors.

Unhealthy nutrition

Unhealthy nutrition also results in dopamine deficiency. This cause was investigated by researchers at Franklin Institute. They published a report that intake of unhealthy nutritional products like caffeine, alcohol, and sugar causes dopamine deficiency in brain. The treatment for it is to include fresh fruits and vegetables in your daily diet as they are antioxidants. They prevent dopamine using brain cells from damage.

Parkinson’s Disease

Parkinson’s disease is a condition in which patients suffers with symptoms like tremors, muscular paralysis, reduced movement and difficulty in initiating any movement. Researchers have found that Parkinson’s disease and dementia are the result of dopamine deficiency in the body. These disorders usually lead to the destruction of dopamine secreting neurons.

Restless leg syndrome disorder

Patients with restless leg syndrome jerk their legs during sleep. This syndrome is considered to be the result of low dopamine levels in brain. This syndrome along with dopamine deficiency leads to disorders like social phobia and Attention Deficit Hyperactivity disorder. The jerks during restless leg syndrome are caused by sudden increase of heart rate and blood pressure. This also leads to cardiovascular diseases.

Creativeness

One of the most unfathomable causes of dopamine deficiency includes the high creativeness. People who are highly creative often suffer from low dopamine levels in their brains. Although they produce high dopamine levels yet they lack dopamine D2 receptors in their thalamus. Because of this particular reason their brains resembles to that of a Schizophrenic. Schizophrenic also suffer from low density of D2 receptors in thalamus. This low level of D2 receptors affects the patient’s ability to filter out information. The low density of D2 receptors causes more information to come from thalamus which enables creative people to see connections that normal people cannot. It may be a gift in problem solving conditions but can be dangerous as the patient can misinterpret intentions of other people.

Use of drugs

Drug also cause dopamine deficiency. Common street drugs which are easily available are one of the most common causes for it. Meperidine, a street drug containing a toxic chemical MPTP (1- methyl- 4- phenyl- 1236- tetrahydropyridine), causes the dopamine neurons breakdown and low dopamine levels. Cocaine, Amphetamine and other such drugs used for the treatment of narcolepsy increase dopamine levels. Cocaine prevents the breakdown of dopamine. Continued use of these drugs, however, result in the reduction of number of dopamine receptors. The continued use of these dugs causes desensitization i.e. the user develops tolerance and needs more dosage for same results.

Others

Other factors responsible for dopamine levels to decrease are as follows:

• Lack of sleep
• Hypothyroidism
• Exposure to lead, arsenic and cadmium
• Tyrosine deficiency
• Deficiency of magnesium, zinc, iron and vitamin B3, B6, C and D.
• Genetic problem of dopamine receptors
• Insufficient adrenals
• Influenza
• Estrogen
• Deficiency of Human growth hormone

Signs and symptoms of low dopamine

Symptoms of low dopamine can easily be diagnosed. When dopamine levels are low due to afore mentioned causes then the person experiences the following signs and symptoms.

Chronic Depression and Fatigue

The most important symptom of low dopamine level is Dopamine Deficient Depression (DDD). Conditions associated with DDD include the:

• Chronic boredom
• Lack of satisfactory feeling
• Fatigue
• Decrease in physical energy
• Undesirability for exercise

This causes the body to feel chills and also feet and hands become cold for no reason. Dopamine deficiency causes mood swings from positive to negative. In this depressed state due to dopamine deficiency, people tend to compensate depressed and low mood with cravings for stimulants. Common stimulants include alcohol, street drugs and caffeine to which patient become addicted. Severe case of dopamine deficient depressed person may develop suicidal tendencies.

Restless Leg Syndrome

Dopamine is responsible for the control of nerve signals involved in the control of movement of parts of human body. Decrease in levels of dopamine may be one of the causes of RLS (Restless Leg Syndrome), which is described as uncomfortable (itchy, pins and needles or creepy crawly) feeling in the legs. The sensations are usually worse at rest, especially when lying or sitting. Because of this very reason people suffering from low dopamine levels mostly show the symptoms of Restless Leg Syndrome.

Excess sleep and lessened libido

Oversleeping is one of the most important symptoms of low dopamine levels. This is caused due to the deficiency of nutrients like zinc, magnesium and iron, which in turn causes dopamine deficiency. Along with excess sleep, the person shows lack of motivation i.e. they do not take initiative for any activity. Such people are always heralded by negative thoughts and they believe that they will never be able to accomplish anything in life. Other symptoms include dullness of pleasure or being unable to feel any pleasure at all and also lessened libido i.e. one’s feeling for sexual drive.

Sudden weight gain

One of the most visible symptoms of low dopamine level include sudden weight gain. Dopamine deficiency causes cravings for the following types of foods.

• Sugar
• Sodas
• Alcohol
• Saturated fats

As low dopamine levels encourage inactivity of body movements and fatigue that is why the intake of these food groups results in sudden weight gain. These dietary products not only increase one’s weight but also decrease dopamine levels and their activity in brain - this is a two way process.

Mental distractibility

As dopamine is a neurotransmitter that helps in improving mental function and concentration that is why a slight change in dopamine levels result in one’s ability to concentrate and focus on daily life work. This neurotransmitter keeps the emotions in check and when dopamine levels reduce, a person gets intense feeling of sadness. This causes impairment in patient’s memory and thinking.

Parkinson’s disease

Research conducted at the University of Maryland Medical Center on Parkinson’s disease showed that it is in association with low dopamine levels. Parkinson’s disease is a neurological disorder affecting balance, movement and control of muscle movements. Furthermore, research has shown that deficiency of dopamine in Corpus Stratia of brain is responsible for disease and also the disease’s main feature. The disease can be treated in its early stages with the use of dopamine drug called Levadopa that helps in restoring dopamine levels. This treatment can become addictive and lose its effectiveness over long period of time.

Others

Some of the other common symptoms for low dopamine levels include:

• Lessened eye contact
• To become solution orientated and not looking the whole picture of situation
• Inability to present or focus
• Tend to become more cruel
• Aggression
• Zoning out in front of TV or computer
• Less interest in relationship
• Becoming socially withdrawn
• Becoming apathetic
• Low sexual interests

Diagnosis for low dopamine

Diagnosis for low dopamine levels is not very efficient. Only efficient way to diagnose the level of low dopamine in your body is to carefully monitor your symptoms. The most common diagnostic approach exercised by physicians is as follows.

• Firstly, the patient has to monitor his own behavior and symptoms. If he experiences any of the aforementioned symptoms then he should consult with their doctor.
• The doctor after making an appointment will firstly try to resolve the problem with early short term and easy treatments.
• If the symptoms prevail, the patient should share his concern with his doctor. In such case, there are two main lab tests for diagnosing dopamine levels that are.
  • Blood test
  • Urine test
• If the dopamine levels are abnormally low then patient has to make repeated visits to their doctor. Doctor then prescribes treatment including diet programs and medications based on patient’s history.

Treatment of low dopamine

There are several treatments to raise the amount of dopamine in body. These treatments include medical treatment through drugs and supplements, personal lifestyle changes and dietary changes. All of these treatments are discussed in detail below.

Dietary changes

There are certain foods that if you use in your daily diet help brain cells to produce sufficient amount of dopamine. These food products are as follows.

Almonds

Phenylalanine is an amino acid that is necessary for the production of dopamine. Almonds have this amino acid in abundance. Raw almonds are advised than smoked or salted ones as they are lower in sodium. If you feel mentally sluggish then almonds are a good snack for mental clarity.

Chocolate

Chocolate while being delicious also contains dopamine building amino acid Phenylalanine. However, it would be better if you eat dark chocolate instead of sugary chocolates. Dark chocolate contains 70 percent cocoa. Cocoa has highest concentration of phenylalanine.

Bananas

Bananas are also helpful in raising dopamine levels. The reason for bananas to be helpful in dopamine increase is that they contain Tyrosine, another amino acid needed for producing dopamine.

Eggs

Eggs along with natural vitamin D and proteins also contain dopamine producing amino acid Phenylalanine. When you sleep, the dopamine levels decrease. So in order to raise your dopamine levels early in the morning doctors advised to eat eggs in breakfast.

Fish

Fish have Omega 3 fatty acid, which is one of the building blocks for Dopamine. Common fishes that have omega 3 fatty acid in abundance are mackerel, tuna, salmon, trout, and sardines.

Apples

Apples are rich in two antioxidants.

• Quercetin
• Polyphenols

They help to maintain levels of dopamine by preventing dopamine cells from any damage. Most advised kinds of apples include Red Delicious and Northern Spy. They have highest level of antioxidants. It is advised to eat the skin of apple as it contains 5 percent more polyphenols than the flesh.

Strawberries

Strawberries are a packet of nutrition and fibers and also contain excess vitamin C, a general antioxidant. They also contain following phenol antioxidants.

• Anthocyanins
• Ellagitannins

They prevent dopamine cells from damage and also boost brain dopamine levels.

Lifestyle changes

Dopamine levels in body can be maintained by making some personal lifestyle changes. Some of these methods are as follows.

• Exercise is one of the most efficient ways to increase the production of dopamine. Cardiovascular exercises in general are more preferable. Running five days a week for 60 minutes increases dopamine production.
• Stress is one of the causes and symptoms for dopamine deficiency. Make some lifestyle alterations for treating stress through meditation and yoga. Take deep breaths and try to calm your mind from daily life stress even if it is for few minutes. Deep breathing technique involves taking a deep breath from nose and filling your chest cavity and then slowly releasing through mouth. Stress causes dopamine deficiency, which then leads to Dopamine Deficient Depression (DDD).
• Vitamin B6, C and E are some antioxidants. The intake of these antioxidants prevents dopamine oxidation, which in turn helps to fend off low dopamine levels.
• Personal lifestyle change demands a person to cut off the use of food products that are high in fat, cholesterol and sugar.
• Add dietary products like almonds, bananas and water melon in your diet that is enriched with amino acid like Tyrosine.
• After consulting with your doctor, start using dopamine precursors. Precursors are chemical compound that convert into other compounds. In case of dopamine deficiency, doctors recommend Phenylalanine that is precursor to dopamine. Common food products containing this precursor are meats, oats and milk.
• One of the most important tips to raise dopamine levels in body is engaging one’s self in sexual activity.

Medication and supplements

Dopamine deficiency can be coped with by the use of supplements and proper medications. This is perhaps the last resort that should be taken only after the recommendation of health care provider. Below we provide some dosage information. While doses of individual medical drugs and supplements are backed up with scientific research (see references) you must never take any supplements or medicine without prior consent of your physician, who may adjust recommended dosage based on your actual needs. 

Common supplements prescribed by physician include:

• L – Phenylalanine
• Vitamin B6 supplements

They increase dopamine production in brain. Another supplement that is beneficial and nutritious as well is chocolate. Chocolate contains Phenyl ethylamine (PHE) that helps raising dopamine levels. This is also therapeutically beneficial in weight loss.

Medications are prescribed by doctors to elevate dopamine production based on the secondary disease
 

• ADHD; if the patient suffering from low dopamine finds it difficult to focus and develops hypertension then doctor usually prescribes psychcostimulants. Commonly Ritalin is prescribed.
• Low dopamine causes depression. If the natural remedies don’t do work then after consulting with your doctor you can use antidepressants.
• Parkinson's disease is also associated to dopamine deficiency. Parkinson’s patients are prescribed Levadopa; a dopamine booster.

There are lots of other strategies for raising dopamine levels although they are very serious. These are recommended for those patients that are under psychological help. The most popular strategy nowadays for dopamine increase is Electro Convulsive Therapy (ECT). This strategy is only performed to those patients on whom medications do not work.

The medications taken to increase dopamine levels in brain are to be taken in the following manners (this is just for your information, remember to always consult your doctor before taking any medications or supplements)

• Tyrosine supplements are to be taken 500-2000 mg with empty stomach in normal conditions. In case of depression and drug addiction treatments, the dosage is over 5000 mg (1).
• L –Phenylalanine dosage to be taken with empty stomach in the morning is 1000 to 1500 mg (2).
• DL –Phenylalanine dosage on empty stomach is 1000 to 2000 mg (3).
• B –Complex dosage is in between 50 and 100 mg (4).
• B6 dosage is 50 to 100 mg if the patient is not suffering with Pyroluria (5, 6).
• Rhodiola is to be taken 1 to 3 times a day in normal dosage of 288-680 mg (7).