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Droxidopa in neurogenic orthostatic hypotension. Expert Rev Cardiovasc Ther. 2015;13(8):875-891. doi:10.1586/14779072.2015.1057504":1,"#Shaw W. Increased urinary excretion of a 3-(3-hydroxyphenyl)-3-hydroxypropionic acid (HPHPA), an abnormal phenylalanine metabolite of Clostridia spp. in the gastrointestinal tract, in urine samples from patients with autism and schizophrenia. Nutr Neurosci. 2010;13(3):135-143. doi:10.1179/147683010X12611460763968":1,"#Hamner MB, Gold PB. Plasma dopamine beta-hydroxylase activity in psychotic and non-psychotic post-traumatic stress disorder. Psychiatry Res. 1998;77(3):175-181. doi:10.1016/s0165-1781(98)00001-1":1,"#Cubells JF, Sun X, Li W, et al. A polymorphism in the dopamine beta-hydroxylase gene is associated with “paranoid ideation” in patients with major depression. Biol Psychiatry. 2002;51(5):358-363. doi:10.1016/s0006-3223(01)01162-x":1,"#Li W, Zhao D, He J, et al. Reduced plasma dopamine-β-hydroxylase activity is associated with the severity of bipolar disorder: a pilot study. Front Psychiatry. 2021;12:566091. doi:10.3389/fpsyt.2021.566091":1,"#Li Y, Zhao X, Tang H, et al. Association between dopamine beta-hydroxylase 19-bp insertion/deletion polymorphism and major depressive disorder. J Mol Neurosci. 2014;54(2):259-264. doi:10.1007/s12031-014-0339-y":1,"#Meltzer HY, Cho HW, Carroll BJ, Russo P. Serum dopamine-beta-hydroxylase activity in the affective psychoses and schizophrenia. Arch Gen Psychiatry. 1976;33(5):585-591. doi:10.1001/archpsyc.1976.01770050011001":1,"#. Cross AJ, Crow TJ, Perry EK, et al. Reduced dopamine-beta-hydroxylase activity in Alzheimer’s disease. BMJ. 1981;282(6258):93-94. doi:10.1136/bmj.282.6258.93":1,"#Beuger M, van Kammen DP, Kelley ME, Yao J. Dopamine turnover in schizophrenia before and after haloperidol withdrawal. CSF, plasma, and urine studies. Neuropsychopharmacology. 1996;15(1):75-86. doi:10.1016/0893-133X(95)00180-O":1,"#Kurian MA, Gissen P, Smith M, Heales S, Clayton PT. The monoamine neurotransmitter disorders: an expanding range of neurological syndromes. Lancet Neurol. 2011;10(8):721-733. doi:10.1016/S1474-4422(11)70141-7; see also: Weinshenker D. Dopamine beta-hydroxylase and its genetic variants in human health and disease. J Neurochem. 2019;152(5):600-617. doi:10.1111/jnc.14893":1,"#Rahman MK, Rahman F, Rahman T, Kato T. Dopamine-β-Hydroxylase (DBH), its cofactors and other biochemical parameters in the serum of neurological patients in Bangladesh. J Clin Biochem Nutr. 2009;45(3):292-297. doi:10.3164/jcbn.09-18":1,"#DBH sits at a critical biochemical junction, managing the balance between dopamine and norepinephrine throughout the nervous system. Its impairment, whether from clostridia toxin inhibition, cofactor deficiency, or genetic polymorphism, can have significant consequences for autonomic function, neurological health, and mood. Reduced DBH activity has been associated with major depressive disorder, psychotic depression, and bipolar disorder severity, while elevated activity has been observed in certain psychotic states including PTSD with psychotic features. Comprehensive functional assessment of DBH, including the OAT, and metals testing provides clinicians with the tools needed to understand and address the root causes of DBH-related dysfunction.":1,"#<strong ljsid-0=\"\">Pharmacological intervention: </strong>For individuals with confirmed decreased DBH functionality, droxidopa (Northera), a synthetic amino acid precursor to norepinephrine, is an FDA-approved prescription option. It converts dopamine to norepinephrine by aromatic L-amino acid decarboxylase, bypassing the need for DBH and providing an alternative source of norepinephrine. ¹²":1,"#<strong ljsid-0=\"\">Cofactor repletion: </strong>Supplementation with vitamin C and copper can support DBH enzyme activity in individuals with deficiencies.":1,"#<strong ljsid-0=\"\">Clostridia overgrowth: </strong>If elevated clostridia toxins (4-cresol or HPHPA) are identified on the OAT, treatment aimed at balancing the gut microbiome is considered, followed by re-evaluation of DBH function and symptomatology. Resolution of clostridia overgrowth may restore DBH activity and alleviate associated mood and neurological symptoms.":1,"#Addressing DBH dysfunction is often aimed at addressing underlying factors.":1,"#How to Approach DBH Dysfunction":1,"#<a ljsid-0=\"\"><strong ljsid-0-0=\"\">Heavy Metals Testing</strong></a><strong ljsid-1=\"\">: </strong>To rule out arsenic toxicity and other metals that may deplete vitamin C and copper, impairing DBH function.":1,"#<a ljsid-0=\"\"><strong ljsid-0-0=\"\">Organic Acids Test (OAT)</strong></a><strong ljsid-1=\"\">: </strong>The first-line screen for DBH dysfunction. The neurotransmitter section assesses HVA (homovanillic acid), VMA (vanillylmandelic acid), and the HVA/VMA ratio. <strong ljsid-3=\"\">In DBH dysfunction, it is common for HVA to be elevated, VMA proportionally decreased, and the HVA/VMA ratio elevated This indicates impaired dopamine-to-norepinephrine conversion. Clostridia markers (4-cresol and HPHPA) are also assessed.</strong>":1,"#A multimodal testing approach is often considered for patients presenting with symptoms consistent with DBH dysfunction:":1,"#Assessment of DBH Function":1,"#If clostridia toxins are not elevated and cofactors are at normal levels, there is the possibility of a genetic predisposition to decreased enzyme function. There are several single nucleotide polymorphisms (SNPs) in the DBH gene have been identified that affect the enzyme’s expression and activity. The two best-characterized functional polymorphisms are a 19-bp insertion/deletion in the promoter region and a -1021C/T SNP, both of which significantly influence plasma DBH activity levels and have been linked to psychiatric risk.¹¹":1,"#Genetic Polymorphisms (SNPs)":1,"#DBH requires vitamin C and copper as essential cofactors. Without adequate levels of these nutrients, the enzyme cannot perform efficiently. Vitamin C and copper levels have been shown to be decreased in patients with various neurological disorders, and populations at risk include those with eating disorders, inadequate micronutrient nutrition, or arsenic toxicity — the latter of which has been correlated with decreased vitamin C and copper.2 The Copper + Zinc Profile can guide appropriate supplementation, as zinc competes with copper for absorption. Clinicians should also be mindful that high-dose vitamin C supplementation can potentiate oxalate production in those with elevated oxalates.":1,"#When Clostridia metabolites are elevated, dysfunction of DBH can ensue. The most common of these toxins (4-cresol and HPHPA) are tyrosine derivatives produced by Clostridium species in the gastrointestinal tract. Because these compounds are structurally similar to dopamine, they competitively and irreversibly bind to the DBH enzyme, blocking its ability to convert dopamine to norepinephrine.¹⁰ An Organic Acids Test (OAT) can assess whether a patient has elevated clostridia metabolites and can also provide insight into neurotransmitter status via HVA, VMA, and HVA/VMA ratios.":1,"#Cofactor Deficiencies: Vitamin C and Copper":1,"#Clostridia Toxins":1,"#Insufficient norepinephrine can contribute to low mood, anhedonia, and fatigue, which are symptoms often associated with depression. Many antidepressants including serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclics exert their effects in part by enhancing noradrenergic signaling, consistent with the hypothesis that low norepinephrine is pathogenic in depression. DBH impairment, by limiting norepinephrine biosynthesis, can therefore be clinically relevant as an upstream contributor to these downstream mood disturbances.":1,"#DBH and the Noradrenergic Basis of Mood":1,"#. Other conditions include postural orthostatic tachycardia syndrome (POTS), exercise intolerance, fainting, autism spectrum disorder, ADHD, seizures, bipolar disorder, psychosis, other neurologic conditions, and alcoholism.":1,"#Conditions associated with DBH dysfunction are wide-ranging. Mental health disorders such as depression, anxiety, bipolar disorder, and schizophrenia have been associated with dysfunction in the DBH enzyme":1,"#When DBH is not functioning optimally, regardless of cause, there will be a decreased conversion of dopamine to norepinephrine. This causes a subsequent rise in dopamine levels and decrease in norepinephrine. <strong ljsid-1=\"\">Symptoms commonly associated with this imbalance include: anxiety, depression, fatigue, low blood pressure, sluggish deep tendon reflexes, ptosis, hypotonic muscles, hyperflexible reflexes, weakened facial muscles, and increased stress response.</strong>":1,"#DBH catalyzes the β-hydroxylation of dopamine, incorporating a hydroxyl group to form norepinephrine. This reaction requires vitamin C and copper.<sup ljsid-1=\"\">1</sup> DBH is found in circulation as both a soluble form released from synaptic vesicles and a membrane-bound form. Plasma and serum DBH levels are stable within individuals but vary between individuals, a variation estimated to be over 50% genetically determined.<sup ljsid-3=\"\">2</sup> This variation is what makes circulating DBH a clinically relevant biomarker for assessment of noradrenergic tone as well as a potential indicator of vulnerability to psychiatric conditions.":1,"#The DBH Enzyme Function":1,"#Dopamine beta-hydroxylase (DBH) is an enzyme crucial to the conversion of dopamine into norepinephrine – a transformation that has far-reaching consequences not only for autonomic function, but also for mood, cognition, and psychiatric health. Dopamine acts as the substrate for DBH in a manner that is similar to a key fitting into a lock. When functioning adequately, DBH converts dopamine into norepinephrine, maintaining balanced levels of both neurotransmitters throughout the system. When DBH function is impaired, a cascade of neurochemical and physiological disruptions can occur – ranging from orthostatic hypotension to depression and psychosis.":1,"#Updated by Courtney Middleton, ND April 2026 | Reviewed by: Avni Dalal, ND | Published: May 2026":1,"#OAT 101: Новые тесты для органических игр - MosaikDX":1,"#OAT 101: Новые тесты органических пленок - MosaikDX":1,"#OAT 101: Основы тестирования органических кислот - MosaicDX":1,"#Закрыть":1,"#<a ljsid-0=\"\">الملف الشخصي MycoTOX</a> <sup ljsid-2=\"\">®</sup> في البول في تشخيص وعلاج مرض العفن الفطري":1,"#In today’s world, we are increasingly exposed to a variety of t…":1,"#Organic Acids (164 items)":1,"#Mental Health (19 items)":1,"#Hello. Welcome to the Mosaic Diagnostics Blog.":1,"#تقييمات الأدلة والتوصيات الإرشادية في داء لايم: الإدارة السريرية للدغات القراد المعروفة، والطفح الجلدي الحمامي المهاجر، والمرض المستمر":1,"#إرشادات الجمعية الأمريكية للأمراض المعدية/الجمعية الأمريكية لأبحاث السرطان/الجمعية الأمريكية للأمراض المعدية لعام ٢٠٢٠ للوقاية من مرض لايم وتشخيصه وعلاجه":1,"#داء لايم":1,"#أعراض متلازمة داء لايم بعد العلاج وتأثيرها على الحياة: هل ثمة ما يشير إلى ذلك؟":1,"#تطبيق تقنية نانوتراب لقياس عالي الحساسية لنطاق الطرف الكربوكسيلي لبروتين السطح الخارجي أ في البول في المرحلة المبكرة من داء لايم":1,"#. شدة داء لايم المزمن مقارنةً بالأمراض المزمنة الأخرى: دراسة استقصائية لجودة الحياة":1,"#مقارنة بين داء لايم في الولايات المتحدة وأوروبا":1,"#ما هو بارتونيلوزي":1,"#داء البارتونيلا البشري: مشكلة صحية عامة غير مُقدَّرة حق قدرها؟":1,"#). بكتيريا الدم من نوع بارتونيلا وأعراض الروماتيزم لدى مرضى من منطقة موبوءة بمرض لايم":1,"#بكتيريا بارتونيلا في الدم لدى مرضى يعانون من خلل عصبي وإدراكي":1,"#، العدد 17":1,"#مجلة ناقلات الطفيليات":1,"#داء البارتونيلوسيس العصبي: الظهور من غياهب النسيان!":1,"#وآخرون.":1,"#دليل جمعية الأمراض المعدية الأمريكية لعام ٢٠٢٠ لتشخيص وإدارة داء البابيزيا":1,"#التواجد المشترك لطفيليات بابيزيا ميكروتي، وبارتونيلا، وبوريليا بورغدورفيري، وأنابلازما فاجوسيتوفيلوم في القوارض من سيليزيا السفلى، بولندا":1,"#العدوى المشتركة بين طفيليات بابيزيا أودوكويلاي وبارتونيلا في الأمريكتين.":1,"#عند وجوده":1,"#ولاية مؤهلة":1,"#ملاحظة:":1,"#بارتونيلا":1,"#بابيزيا":1,"#[…] and discontinued 12–24 hours before the first saliva collection. Do not apply topical hormones on the day of saliva collection, as this will contaminate your sample. Sublingual <mark ljsid-1=\"\">hormone</mark> therapy Last dose should be taken and discontinued 24–36 hours before the first saliva collection. Drink two 8-oz glasses of water immediately after taking the last […]":1,"#<mark ljsid-1=\"\">Hormona</mark> Profile Sample Collection Instructions":1,"#Bioidentical <mark ljsid-1=\"\">Hormona</mark> Replacement Therapy (BHRT) can be an effective method for replacing diminished sex hormones such as estrogen and testosterone. This lecture by Dr. Tracy Tranchitella will discuss modes of delivery (e.g. oral, transdermal), best absorption, follow-up testing and more. The full webinar can be viewed here: During the course of the Webinar, individuals […]":1,"#Bioidentical <mark ljsid-1=\"\">Hormona</mark> Replacement Therapy (BHRT) Options – Revisited Q+A":1,"#[…] Stool 82272 82542 82656 8351 83631 83986 83993 85549 87045 87046 87102 87177*2 87209*2 87328 87329 89125 89160 Copper + Zinc Profile – Serum 82390 82525 84630 <mark ljsid-1=\"\">Hormonas</mark> Comprehensive Profile 82670 84144 84402 82626 82530*4 <mark ljsid-3=\"\">Hormonas</mark> Comprehensive Plus Profile 82679 82670 82677 84144 84402 82626 82530*4 IgE Allergy Advanced Combined Test (93/69) – Serum […]":1,"#[…] both local and sy… View Test Gut Health Detect Microbiology Test: The Microbiology stool profile includes comprehensive bacteriology an… View Test View All Tests Evaluate the Bodies’ <mark ljsid-1=\"\">Hormona</mark> Levels Learn More Hormones Hormones Comprehensive Panel: MDX comprehensive salivary <mark ljsid-3=\"\">hormone</mark> profiles measure both sex and stre… View Test View All Tests Clinical Expertise at Your […]":1,"#<mark ljsid-1=\"\">Hormonas</mark> Comprehensive Plus Panel":1,"#MDX comprehensive salivary <mark ljsid-1=\"\">hormone</mark> profiles measure both sex and stress hormones. Salivary measurement of hormones is a non-invasive convenient way to assess unbound biologically active <mark ljsid-3=\"\">hormone</mark> levels. Identifying hormonal imbalances is essential in customizing <mark ljsid-5=\"\">hormone</mark> replacement therapies and other nutritional interventions aimed at relieving the signs and symptoms associated with hormonal imbalances. Our high-complexity […]":1,"#<mark ljsid-1=\"\">Hormonas</mark> Comprehensive Panel":1,"#[…] lead to serious health problems. Both men and women produce hormones like estrogen and testosterone, and balance is key for optimal health. The old “one-size-fits-all” approach to <mark ljsid-1=\"\">hormone</mark> replacement therapy is outdated, MosaicDX offers comprehensive salivary <mark ljsid-3=\"\">hormone</mark> profiles that measure both sex and stress hormones. Salivary measurement of hormones is non-invasive and convenient to […]":1,"#Saliva <mark ljsid-1=\"\">Hormonas</mark> Perfil":1,"#Found 44 results for Hormone":1,"#Search results for: Hormone":1,"#Cholesterol is a necessary component of animal cells and plays a vita…":1,"#Understanding <mark ljsid-1=\"\">Autism</mark> Spectrum Disorders Detailed Brochure":1,"#Learning Hub Tags":1,"#Found 74 results for autism":1,"#The critically important job of fighting off infections falls to our …":1,"#Toxins (112 items)":1,"#Stool Chemistry Test:":1,"#Encore Presentation: Untangling the Web: A Functional Medicine Approach to Lyme & Mold *Originally Presented on May 28th, 2025":1,"#Encore Presentation: Untangling the Web: A Functional Medicine Approach to Lyme & Mold - MosaicDX":1,"#This presentation will unpack the diagnostic challenges posed by their shared symptoms, such as chronic fatigue and cognitive fog, and provide practical tools and clinical markers to help differentiate between them in even the most challenging cases. We’ll also explore integrative, whole-person strategies for treating patients facing both conditions simultaneously. Don’t miss this opportunity to deepen your clinical insight and walk away with actionable steps to better support your patients on the path to lasting recovery.":1,"#Join us with Lead Clinical Educator, <strong ljsid-1=\"\">Karleen Sickinger, NMD</strong>, for an encore presentation of this engaging webinar, <strong ljsid-3=\"\">originally presented on May 28th, 2025, </strong>as we dive into the complex and often confusing world of Lyme disease and mold-related illness two conditions that frequently overlap but require distinct approaches.":1,"#July 28, 2026":1,"#Register for the August 13th Webinar":1,"#Organic acids testing is diagnostic tool that every healthcare practi…":1,"#La prochaine étape pour éviter de futures expositions consiste à changer les produits que vous utilisez quotidiennement – des contenants d’aliments et de boissons aux produits de beauté et de nettoyage. Au lieu d’utiliser des bouteilles d’eau et des récipients alimentaires en plastique, optez pour le verre ou le métal. Ne mettez jamais d'aliments au micro-ondes dans des récipients en plastique ou en polystyrène et ne buvez pas de boissons chaudes dans des gobelets en plastique ou en polystyrène. Assurez-vous que vos shampoings, savons, lotions et autres produits de beauté sont exempts de phtalates. Utilisez des produits de nettoyage à base d’ingrédients naturels ou fabriquez les vôtres à la maison.":1,"#*Originally Presented on May 28th, 2025":1,"#Enable THEBRIGADE FRANCE SAS Consent":1,"#Enable Axel Springer Tech GmbH Consent":1,"#Enable RAI PUBBLICITA' SPA Consent":1,"#Enable Fivecell Research Group Limited Consent":1,"#Enable The Channel Store, S.L. Consent":1,"#Enable TrustX Digital Advertising Services, Inc. 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