Epinephrine and norepinephrine are two neurotransmitters that also serve as hormones, and they belong to a class of compounds known as catecholamines. As hormones, they influence different parts of your body and stimulate your central nervous system. Having too much or too little of either of them can have noticeable effects on your health.
Chemically, epinephrine and norepinephrine are very similar. However, epinephrine works on both alpha and beta receptors, while norepinephrine only works on alpha receptors. Alpha receptors are only found in the arteries. Beta receptors are in the heart, lungs, and arteries of skeletal muscles. It’s this distinction that causes epinephrine and norepinephrine to have slightly different functions.
The Norepinephrine / Epinephrine ratio is an indicator of epinephrine (adrenaline) conversion (epinephrine is synthesized from norepinephrine). Anxiety, burnout, and poor blood sugar control are associated with a relative epinephrine depletion, and thus an elevated Norepi:Epi ratio.
Anxiety, burnout, and poor blood sugar control are associated with a relative epinephrine depletion, and thus an elevated Norepinephrine / Epinephrine ratio.
Elevated Ratio: Norepi/Epi may be consistent with poor conversion of norepinephrine to epinephrine. This conversion is driven by the phenylethanolamine N-methyltransferase (PNMT) enzyme that requires SAMe, magnesium and cortisol (adequate HPA axis function) as cofactors.
- Consider the actual levels of both neurotransmitters, and interpret in the ratio in context of cortisol levels/HPA axis function.
- Optimization of HPA axis function may be clinically warranted.
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