Neurotransmitter Imbalance Quiz
Neurotransmitter Imbalance Questionnaire
The questionnaire below is designed to determine if you may have a depletion in your neurotransmitter levels. It is based on the work Julia Ross, MA. This is only a guide. For a more accurate way of determining an imbalance a neurotransmitter test is available.
The results from your questionnaire can help guide you in making treatment decisions. Supplement recommendations are provided at the end of each section. If you have scored positive for more than one imbalance you would need to take supplements from both sections and you could worsen the imbalance by correcting only one area. The inhibitory and excitatory systems must be in balance. Again, to obtain a more accurate picture of your brain chemistry Neurotransmitter lab testing should be considered.
This questionnaire is not intended to be a substitute for diagnosis by a qualified mental healthcare provider. If you do not have access to one in your area we offer telephone consultations with our licensed nurse practitioner or doctor. Please call 941 371-7997 to schedule an appointment.
Instructions: For all the questions you answered YES to, add up the points at the end of each section. If your score totals more than the amount listed at the end of each section consider trying the supplements listed for to correct that particular imbalance.
If you score shows a possible neurotransmitter inbalance consider taking a neurotransmitter lab test for more conclusive information.
Brain Balance: Brain Balance helps to increase levels of Serotonin, Dopamine, Epinephrine, Norepinephrine, and GABA. Take two capsules twice a day.
Part 1. Are You Under a Dark Cloud?
3 Do you have a tendency to be negative, to see the glass as half-empty rather than half-full? Do you have dark, pessimistic thoughts?
Total Score ____________ If your score is more than 12 then you are probably experiencing symptoms of low serotonin. Serotonin is an inhibitory neurotransmitter. Depletion of the inhibitory neurotransmitters are the most common cause of depression and anxiety.
Serocor supports the inhibitory neurotransmitter systems of serotonin and GABA that produce calming and balancing effects. A unique combination of precursor amino acids and nutraceutical cofactors activates their pathways of biosynthesis and prevent over-stimulation.- Take 1-3 at bedtime.
Part 2. Are You Suffering from the Blahs?
3 Do you often feel depressed - the flat, bored, apathetic kind?
3 Are you a thrill seeker or risk-taker?
Total Score ____________ If your score is more than 6 points then you are probably experiencing symptoms of low dopamine, epinephrine, and norepinephrine. These are excitatory neurotransmitters.
Dopamine Supplements (Choose One)
DOPA Maxx ES supports the excitatory neurotransmitter systems of dopamine, norepinephrine, PEA, and Epinephrine. A unique combination of precursor amino acids, nutriceuticals, and cofactors activates biosynthesis, release and signal strength, Higher levels can boost alertness, pleasure feelings, libido, and emotional wellbeing.
Mood Brightener supports the excitatory neurotransmitter system. Through a unique combination of amino acids, vitamins, and minerals, it supplies the necessary nutrients to support dopamine, norepinephrine, and epinephrine production.
Tyrosine Spray This sublingual preparation allows for rapid delivery when a stimulating or energizing effect is needed.
Part 3. Is Stress Your Problem?
3 Do you often feel overworked, pressured, or deadlined?
2 Do you tend to put on weight too easily?
3 Have a history of panic attacks or severe anxiety?
Total Score ____________ If your score is more than 8 then you are probably experiencing symptoms of GABA depletion and possibly adrenal fatigue.
GABA Boost contains Phenyl-GABA which is the only form of the neurotransmitter, amino acid GABA capable of passing the blood-brain barrier in significant amounts to improve neurological functions.
ExcitaCalm Cream topical cream works within minutes to reduce feelings of nervousness and anxiety.
Part 4. Are You Too Sensitive to Life's Pain? You could be suffering from depleted levels of endorphins.
3 Do you consider yourself or do others consider you to be very sensitive? Does emotional pain, or perhaps physical pain, really get to you?
3 Do you use drugs such as methodone, oxycontin, codeine, or other opiates?
Total Score ____________ If your score is more than 6 then you are probably experiencing symptoms of endorphin/PEA depletion.
Endorphin/PEA Support Supplements
NEURVANA PRO contains beta-phenylethylamine (PEA), a naturally occurring neurotransmitter in our brain that increases the activity of the major neurotransmitters (chemical signal messengers between nerves) to dramatically improve your mental and emotional functioning.
If you score revealed a combination of neurotransmitter depletions then take:
L-Tryptophan 500 mg 120 V Capsules
OptiCleanz GHI 31.61 oz Chocolate
DOPA Maxx ES Extra Strength Dopamine Supplement
Brain Balance IP formulas 120 Capsules
Diet Drops 2 oz
Adrenal Fatigue Formula 60 caps
NeuroScreen Neurotransmitter Test
NeuroScience TravaCor 120 caps