•   Anger
•   Sleep
•   Fatigue
•   Memory

                           Cortisol levels

                               DHEA level

                         Melatonin level 

The lab results showed some clear-cut issues.  The neurotransmitter levels overall were low with Serotonin,  Epinephrine and GABA being the primary issues.  GABA the most powerful calming neurotransmitter was nearly now existent which would explain the patients anxiety, anger and poor sleep.

The cortisol graph was high all around.  There may have been an issue with the early morning test, since it was 3x higher then expected.  I chose to concern my self with the fact that the cortisol level was high throughout the day and rose when the patient was trying to sleep.

Clinical Note:  The adrenals are high but Epinephrine and Norepinephrine are low. This indicates to me that the adrenals are struggling to meet the stress needs of the patients and is allowing other products of the adrenals lag.   

When reviewing NeuroScience labs it is important to decide on a starting point and not try and correct everything all at once.  I always start by strengthening the adrenals.  The adrenals are involved in pain, fatigue, GI function, mental stability, muscle and nerve function, just about everything in the body is reliant on proper adrenal function. The adrenals will make the biggest and quickest change in how your patient feels both physically and emotionally, this will insure program compliance. Fine tuning of their labs can be done on follow up visits. 

Recommended Nutritional Supplements and why:

Dr. Zodkoy's Resiliency - 1 in am - see below 

Sevelance: 1 - 3x a day - Dysregulation of the sympathetic branch of the autonomic nervous system (ANS) can lead to a wide variety of symptoms commonly associated with persistent stress, including fatigue, poor concentration, and low mood. Selevance helps restore balance to the sympathetic nervous system.* The primary ingredient, tyrosine ethyl ester, is an easily absorbed form of tyrosine and a precursor for norepinephrine.* The locus ceruleus, a key brain area, utilizes norepinephrine to regulate sympathetic nervous system activity. Selevance also contains glutamic acid to stimulate vagal signals to the brain to further enhance central norepinephrine output.* In addition, Selevance contains 5-HTP to support serotonin, L-arginine to boost the parasympathetic nervous system, and L-DOPA as an additional modulator of central ANS control.*  

Recommended Nutritional Supplements and why:

Great progress was made in the first 90 days. His physical and emotional complaints are way down. His big complaints are anger and sleep.  I believe his anger comes from the frustration of not being able to handle both physical and emotional stress and lack of sleep.  

The retest showed that his neurotransmitter levels have gone from deficient to above average. These swing should level out as time goes on, but the surge in neurotransmitters is sure to improve how he feels.  His cortisol levels are good overall, but a reduction after 6 pm would greatly improve his sleep. 

New Nutritional Program: 

Dr. Z's Resiliency Formula - 1 upon awaking - This formula is designed to strengthen the adrenals to respond better to all types of stress and improve energy, but not overstimulate the body or cause anxiety.  It contains adrenals and adaptogens, see above for more details.
Avipanix - 1  30 minutes before Breakfast and 1 30 minutes before lunch - This product with Huperzine is excellent for cognitive function. It works by improving acetycholine levels. It also contains L-carnitine which improved mitochondria and fatty acid transportation which improves energy and focus.
Calm CP - 2 at 4 pm - This product contains Banaba to reduce cortisol production and Phosophatidyleserine which helps the Hippocampus-Hypothalamus-Pituitary-Adrenals communicate better.  This communication is often damaged by long periods of stress and anxiety.
Kavinace Ultra PM - 1 after dinner - This formula contains Phenibut and Melatonin which makes it excellent for promoting sleep.
Kavinace (not Kavinace PM) if you feel anxiety during the day, as needed. max 3 a day.  This product contains Phenibut and Taurine which are  GABA agonist. This is a strong anti-anxiety product.