Low Homovanillate indicates low levels of dopamine. Symptoms associated with this condition are depression, sleep disturbances, inability to deal with stress, and fatigue.

- Low levels of HVA can be due to low levels of dopamine or poor conversion of dopamine to HVA. The latter may be due to insufficient levels of SAM, Magnesium, FAD and NAD which are needed to metabolize dopamine.

- Low circulating dopamine may be due to insufficient BH4, iron or tyrosine. It may also be seen when adrenal function is generally low.

- Low dopamine levels may be associated with addictions, cravings and pleasure seeking (to boost levels) in addition to sleepiness, impulsivity, tremors, less motivation, fatigue and low mood.

Other possible causes:

- Low precursors/neurotransmitters (phenylalanine, dopamine, noradrenalin)

- Low cofactors (B2, B3, B6, Mg or Fe)

- Impaired methylation

Additional investigations:

- Vitamins & Minerals Analysis

Treatment considerations:

Treatments to improve digestion, along with supplementation of tyrosine or phenylalanine, can help improve the ability to keep up with demand for these neurotransmitters.

- L-tyrosine & B6

- B2, B3 or Fe if low

- Support methylation (methionine/SAMe, B6, B12, folate, Mg)

- Elevated HVA may be caused by generally increased adrenal hormone output or because of a copper or vitamin C deficiency (which are needed for dopamine conversion to norepinephrine).

- Elevations may also be caused by a number of medications or supplements including: MAO inhibitors, quercetin, tyrosine, DL-phenylalanine (DLPA), L-dopa, macuna, dopamine medication (Levodopa, Sinemet, Methyldopa), SNRI medication (Wellbutrin), tricyclic antidepressants, amphetamines, appetite suppressants, and caffeine. Bananas also contain dopamine.

- Elevated dopamine may be associated with loss of memory, insomnia, agitation, hyperactivity, mania, hyper-focus, high stress and anxiety as well as addictions, cravings and pleasure seeking (to maintain high levels).

Elevations of Homovanillate and Vanilmandelate indicate an over-activation of nervous system function involving these neurotransmitters. This can be for various reasons, but is most commonly associated with stress, both internal (e.g., mental/emotional) and external (e.g., environmental toxins). Addressing the source of stress and improving the body’s ability to handle stress are useful in these cases.

Other possible causes:

- Increased catecholamine activity/stress pattern

 -Impaired production of noradrenalin from dopamine

Additional investigations:

- Adrenal Hormone Profile

Treatment considerations:

- Adrenal support

- Stress management