Neurotransmitters play a role in shaping who we are and how we perceive ourselves and the world around us. They influence our moods, memory and learning, self-esteem, anxiety levels, motivation, and more. I think this explains why some people who have been suffering for years with unresolved thyroid symptoms can become grouchy, angry, and pessimistic. That may reflect not who they really are, but instead their worsening brain health due to thyroid hormone deficiency.

There is no scientifically validated way to test neurotransmitter levels through lab testing. The best way is to assess your symptoms. Also, if you see symptoms in one area this does not necessarily mean your levels are low. It could be other areas of the neurotransmitter pathway are affected, such as neurotransmitter release, binding, or clearance. Also, various factors can affect neurotransmitter levels, including blood sugar imbalances or hormonal imbalances. Rarely, if ever, does poor neurotransmitter activity indicate an antidepressant deficiency.

I talk more extensively about neurotransmitters in my new book Why Isn’t My Brain Working? However, for quick reference you can review the symptoms below.


Acetylcholine is the learning and memory neurotransmitter. Symptoms of poor acetylcholine activity include:

  • Loss of visual and photographic memory
  • Loss of verbal memory
  • Memory lapses
  • Impaired creativity
  • Diminished comprehension
  • Difficulty calculating numbers
  • Difficulty recognizing objects and faces
  • Slowness of mental responsiveness
  • Difficulty with directions and spatial orientation


Serotonin is the joy and well-being neurotransmitter. Symptoms of poor serotonin activity include:

  • Loss of pleasure in hobbies and interests
  • Feelings of inner rage and anger
  • Feelings of depression
  • Difficulty finding joy from life pleasures
  • Depression when it is cloudy or when there is lack of sunlight
  • Loss of enthusiasm for favorite activities
  • Not enjoying favorite foods
  • Not enjoying friendships and relationships
  • Unable to fall into deep restful sleep


GABA is the “calm and relaxed” neurotransmitter. Symptoms of poor GABA activity include:

  • Feelings of anxiousness or panic for no reason
  • Feelings of dread
  • Feelings of inner tension and inner excitability
  • Feelings of being overwhelmed for no reason
  • Restless mind
  • Hard to turn your mind off when you want to relax
  • Disorganized attention
  • Worry about things you never had thought of before


Dopamine is the “pleasure and reward” neurotransmitter. Symptoms of poor dopamine activity include:

  • Inability to self-motivate
  • Inability to start or finish tasks
  • Feelings of worthlessness
  • Feelings of hopelessness
  • Lose temper for minor reasons
  • Inability to handle stress
  • Anger and aggression while under stress
  • Desire to isolate oneself from others
  • Unexplained lack of concern for family and friends


Select your interests below:

  1. Dorothy Baker

    thank you for this info. I have your previous bk on the thyroid. Unfortunately, I don’t tolerate any of the suggested supplements. From the above info, I deduce that I prob. have the cerebellum issue & most likely the dopamine & other transmitter issues. Now what? I have such severe gut & gluten & other issues, I can’t take most supplements. I am on a very limited version of the GAPS diet, but it is so limited, it’s impossible to adhere to strictly, but it does help with neuro & emotional issues to an extent. I suspect it’s more abt what I DON’T eat than what I do at this point. So while I wish your new book could help me, it seems futile to buy another one when I can’t implement the rxed treatment. Any suggestions appreciated. Best, Dorothy B.

    • Marina

      May sound odd, but have you tried synthroid, etc alone with the diet with no supplementation at all? Perhaps, just probiotic, if you could tolerate. If not, teaspoons of any fermented food added?

      I could not tolerate supplementation and especially this trial and error approach that simpply does not work for me.
      Did you try to find an endoclinologist, just a good clinician?

  2. Heather

    I have read your new book; Why isn’t my brain working. And wonder if it is possible to fit all of these neurotransmitter issues? Although GABA and Acetylcholine take the cake. I tried to do some supplements with ALA and NAC and had some really unpleasant side effect even at doses were less then a pinch. Side effects include: sore neck, brain fog, anxiety/panic, involuntary muscle contractions. Thank you.

    • val


      If you tried ALA “Alpha Lipoic Acid”, maybe you should check out the website “Amalgam Illness”. ALA and NAC are sulfur compounds that move mercury around and can cause the symptoms you mentioned.

  3. Sharon

    Any suggestions or help for people with Schziophrenia?

    • Dr. Kharrazian, DHSc, DC, MS, MNeuroSci

      Google the gluten – schizophrenia connection. Not that it’s the answer for everyone but it should certainly be explored.

  4. Sharon

    Correct email

  5. martha sue

    wow….thank you so much…..this more valuable than gold to me right now….peanut butter main protein plus dairy….for years plus grain an tomato, potato……lots of sugar last few days too… wonder I feel so seriously low…..low thyroid, positive for lupus markers but will bet this is central…..brain fog, pain in joints….not even rheumatologist suggested dietary changes….this finally speaks reason to my weary soul and anxious mind….may God bless you abundantly forever thanks mega

  6. Hi, I am Jessica (41) and I have a question, is having dopamine problem the same as having dopamine receptor problem? I have a pituitary adenoma (prolactinoma) and I’ve been taking L-Tyrosine for about 1 year without any result. Conventional medicine ask me to take Dostinex, ut it makes me feel awful. I’m following a keto-Gaps diet for about a year too. I feel much much better, but I cannot get my menstruation back. Have a great day!!!

  7. Alisha

    I desperately need a salad referral to a doctor here in Atlanta Georgia for my hypothyroidism. I have Hashimoto’s and suffer severe depression to the point of thoughts of suicide. I need help from someone who will listen and thoughtfully manage my care.

  8. Alisha


  9. marcia pen

    In “Why Isn’t My Brain Working?”, you suggest to take neurotransmitters, compounds for neuroinflammation and Brain oxidation until you see a difference. However, in each category, how much is too much? My teenage daughter has been chronically ill for 5 years – undiagnosed. We have been able to rid her body of many symptoms. However, she is left (basically) with extreme fatigue and brain fog, along with symptoms of low neurotransmitters (all). We know she is low in iron and Vitamin D. She is supplementing for it. She is probably low in estrogen and progesterone (waiting for labs to return). We have taken up to a couple thousand 2x daily for neuroinflammation, acetelcholine, and brain oxidation with minor improvement. She has been taking 100 mg 5HTP 3x daily, with very minor improvement in seratonin symptoms and dopa support with minor improvement. When does it become too much? I’m sure there has to be some limit to supplement doses. Please help. I don’t know how much longer she can hold out. She has been so fatigued and foggy headed, we’ve had to drop her out of school, and finally out of her online schooling, and it’s her senior year! She can’t follow through with simple directions and walks away in the middle of conversations, thinking it’s finished. THX

  10. Elaine

    He doesn’t really give an upper limit when he teaches. However at a certain point if it’s not working then you’re probably not addressing the right mechanism. Fatigue and brain fog can stem from so many other things that a supplement may not be able to address. Check out to see if there’s a functional neurologist in your area who also is educated by Dr. Kharrazian. Perhaps it’s a neurological issue more than a metabolic one, it’s impossible to say without proper assessment.

    • marcia

      Thank you, Elaine, for the reply. Over the last 5 years, my daughter has been seen by some of the best neurologists. Barrows Clinic decided her brain fog and fatigue are not caused by a neurological issue. She has been cleared of Fibromyalgia. She has been seen by any medical specialist that could even possibly help her. Her hormones are fine, according to her gynecologist. She has been with a functional medicine doctor who understands neurotransmitters and has been helping her with them. And the list of medical labs, exams, scans, medical doctors and natureopaths goes on and on. But, the brain for and fatigue persist in a very debilitating way. She is currently under the care of a functional medicine chiropractric neurologist, who has had some training/guidance from Kharazian, but there has been no improvement in 6 weeks and she has been on the strict diet for 10 weeks now. However, after reading the Brain book, it is obvious that this current neurologist does not follow the supplements to the extent that Kharazian suggests – not even close.
      So the question is – to anyone who may know – at this point, when there are no other options, as all other possible diagnosis (at this point) have been eliminated —-
      how many milligrams of supplements for brain oxidation can you give, before it becomes too much?
      How many milligrams of dopamine support, before it becomes too much? Etc. Etc.

  11. Lisa

    Have you had her MTHFR tested? If not, do it through 23andme then upload her genome to livewello for a methylation report. In the meantime, check out the MTHFR Facebook groups and see if anyone there has any ideas of what’s going on.

  12. Alice

    Would Dr. K’s acetylcholine be appropriate if one fears early Alzeimers given the acetylcholine deficiency present in the disease?

  13. Lizzi

    Hello There,

    I have had 11 surgical procedures in the last 6 years, the last one was a total knee replacement. I walk a couple miles a day, but can not walk in a straight line, I walk like I am drunk, my legs are very stiff all the time. I get leg, feet and ankle cramps all night with a need to stretch all night long as well as when I set for too long during the day. I also can sound drunk at times, but do not drink. I have a raspy voice that no one can help me with. Yes, I have a bit of brain fog, too. Energy levels at rock bottom as well and I now have developed small lesions on my legs, like plaque psoriasis. My TSH is .59 and my family doctor says she will recheck in a year, down from 1.3 the year before, will not allow any further testing at all. I have gone off gluten, soy, most dairy, & eggs.

    The worst is the walking with stiff legs, and not able to loose weight. And I have to clear my throat all the time.

    I have been to several doctors, none can help, they all think I am a hypochondriac and there are no Functional doctors in my area or on my insurance plan. Not sure where to start. I have both books, and find that taking the protocol for low dopamine seems to help the most, along with taking minerals, calcium, magnesium and potassium. I tend to run low in Potassium and Magnesium.

    Any other ideas..??

    Thanks, Lizzi

  14. heather

    Is there a connection between meningitis as a baby and chronic depression from teen years all the way to age 50 and counting? I have read a lot about meningitis’ symptoms but they seem to occur during or briefly after the illness and don’t usually last. Thanks.

  15. Elizabeth

    After reading “Why Isn’t My Brain Working?” I am afraid that my early stage Parkinson’s cannot be helped? I am only receiving minimum dose meds and wish to delay Parkinson’s progress! I am in the Northeast can you help or refer? Is it too late for me?

  16. Lu

    There is a “contact” link way up at the top of the page.
    Don’t rely on comment threads to put you in touch with a doctor!
    Good luck.

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