ABOUT ME: I am board certified in internal medicine, have been diagnosed with CFS and POTS in the past, and have spent the last few years diving deep in my own study of neurobiology and the art of “neurohacking”. I usually keep my theories to myself but when I stumbled on this one, I felt that it was too intriguing not to share with others.

Trace amines are biologically related to major amines such as norepinephrine and dopamine but they are present in much smaller concentrations. Trace amines molecules include phenythylamine (PEA), tyramine, octopamine, tryptamine, 3-iodothyronamine (T1AM) and a number of others.

Trace amine-associated receptor 1 (TAAR1) is a G-coupled protein receptor that was discovered in 2001, and since then at least eight more species of this receptor type have been identified in various tissues (stomach, small intestine, liver, kidneys, lymphocytes, astrocytes, monoaminergic neurons). In the past few years, there has been a rapidly emerging understanding about the important the role trace amines in the regulation of nervous system, metabolism and olfaction (sense of smell).

Before TAAR1 was identified, trace amines were thought to have little biological function but in recent years, their role as very powerful neuromodulators has emerged. Via their action on TAAR receptors trace amines act as “master ” that essentially influence all other aminergic neurotransmitters (NE, DA, SE) in the central nervous system. TAAR receptors also appear to be involved in the neuromodulation of glutamate, histamine, and GABA.

Their most profound influence appears to be on the release of catecholamines (norepinephrine and dopamine). TAAR1 is widely expressed in the primary monoaminergic areas of the brain and well positioned to modulate locomotor, emotional, and motivated behaviors that are traditionally associated with monoaminergic activity.

Trace amines are also believed to inhibit transporters of these molecules (NET transporter deficiency has been observed in some POTS patients). They can also affect a marked effect on the release histamine, which is another common problem in many patients. TAAR receptors are also involved in the neuromodulation of glutamate, GABA and serotonin.

So here are the top ten reasons that led me to believe that trace amines and TAAR receptors deserve a full investigation regarding their possible role in etiology of CFS and POTS. (My guess is that there is likely either a primary hypersensitivity or down regulation of the receptors depending on clinical picture, although abnormalities in the synthesis or breakdown of trace amines are also a possibility).

TAAR receptors have been found in leukocytes and B lymphocytes, and are thought to be directly involved in regulation of immunity. This would explain the underlying immune system abnormalities found in CFS/POTS patients.

3. TAAR1 and TAAR 2 receptors are present in large numbers in play a crucial role in olfaction (smell), in particular detection of volatile amines, which would explain the hallmark sensitivity to chemical smells.

4. Trace amines molecules act as indirect sympathomimetic agents involved in regulation of sympathetic system. They also have been shown to have a direct effect on alpha1 and alpha2 receptors. It is possible, that the over-activation of sympathetic nervous system combined with the catecholamine depletion due to the persistent release (a phenomenon known as “tachyphylaxis” is what causes the infamous “tired but wired” state, when it feels like nerve cells are pushing on the gas pedal while running on an empty gasoline tank.

5. Trace amines synthesis (in particular conversion of T4 to 3-iodothyronamine (T1AM)) appears to be closely related to the metabolism of thyroid hormones, and due to its synthesis within intestinal lumen, also possibly to gut flora. (Hartmut et al, 2017).

6. High levels of 3-iodothyronamine (T1AM) have been shown to induce a state of “torpor/immobility” in rodents. This would correlated with a physiological signature of “dauer’ described by R. Naviaux (Naviaux et al, 2016) et al in their recent CFS metabolomics study. It appears that T1AM plays a pivotal role in orchestrating neuronal energy balance in conjunction with thyroid hormone. (I don’t know about you but I like the word “torpor”, to me it sounds like a very apt description of what I’ve experienced on my worst days).

7. Overstimulation of TAAR receptors has been linked to the oxidative damage to neurons and a decrease in glutamate clearance (Cisneros IE, Ghorpade A, 2014).

8. There is some evidence that TAAR receptors may play a role in regulation of ACTH, and as we all know hypothalamic dysregulation of cortisol levels is common in patients with CFS, POTS and fibromyalgia. (Zucci et al, 2006)

9. TAAR receptors regulate cellular cAMP accumulation via their effect on adenylyl cyclase. The rank order of potency for cAMP production is

p-tyramine> β-phenylethylamine>tryptamine>octopamine>m-tyramine>>dopamine (Zucci et al, 2006).

Thus, the energetic abnormalities observed in at least some CFS patients (I do believe it is a heterogeneous diagnosis right now) may be due to mitochondrial impairment of energy production but rather to disordered intracellular cAMP regulation (which would explain why the Stanford study did not find any mitochondrial impairment in CFS patients).

10. Recent study identified TAAR1 gene SNPs as one of several abnormal genes in fibromyalgia patients cohort. Trace amines and TAAR receptors have been shown to be involved in regulation of nociceptive (pain) pathways and locomotion in spinal cord neuronal pathways (Smith SB et al 2012).


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Thank you for sharing!

Another interesting study about T1AM:

Transport of thyroid hormones is selectively inhibited by 3-iodothyronamine
Thyroid hormone transporters are responsible for the cellular uptake of thyroid hormones, which is a prerequisite for their subsequent metabolism and action at nuclear thyroid hormone receptors.

A recently discovered thyroid hormone derivative, 3-iodothyronamine (T1AM), has distinct biological effects that are opposite those of thyroid hormone.
Here we investigate the effects of T1AM on thyroid hormone transporters using COS-1 cells transfected with the multispecific organic anion transporting polypeptides (OATPs) 1A2, 1B3, and 1C1, as well as the specific thyroid hormone transporters MCT8 and MCT10, and show that T1AM displays differential inhibition of T3 and T4 cellular uptake by these transporters.

T1AM inhibits T3 and T4 transport by OATP1A2 with IC50 values of 0.27 and 2.1 µM, respectively.
T4 transport by OATP1C1, which is thought to play a key role in thyroid hormone transport across the blood-brain barrier, is inhibited by T1AM with an IC50 of 4.8 µM.
T1AM also inhibits both T3 and T4 uptake via MCT8, the most specific thyroid hormone transporter identified to date, with IC50 values of 95 and 31 µM, respectively. By contrast, T1AM has no effect on thyroid hormone transport by OATP1B3 and MCT10.
Given that OATP1A2, OATP1C1, and MCT8 are all present in the brain, T1AM may play an important role in modulating thyroid hormone delivery and activity in specific target regions in the central nervous system.
Thanks pattismith. I am currently reading a book titled "Trace Amines in Neurological Disorders". They show a link between MCT8 and TRPV chanells, the latter implicated in Calcium channels regulation.
I just reread this. How could you test any of this to determine if this is what's going on?

Number 9 is not the case for me. I have measurable mitochondrial impairment, due to the oxidative and nitrosative stress discussed my Maes, Mortis and Pall as well as mycotoxins. Also, the Lights at U Utah found mitichondrial SNPs negatively affecting mitochondrial function in each of the patients they tested who had adrenergic and muscarinic antibodies. There are many patients with ME/CFS with these same issues.

Many of us have low dopamine and low ACTH as well. I've found that supplementing tyrosine helps with the dopamine production.

I just went through Nathan Holladay's recent YouTube talk at the Bateman-Horne Center where he did a nice rundown of many aspects of ME/CFS. He was on the IOM committee that reviewed 9,000 papers. In it he specifically states, "It's not your thyroid causing this." He mentioned that some of the infectious agents can hijack our mitochondria for their own use.

I don't doubt that what you've shared is also happening, but its likely only one factor among many.

I suspect, though, as you state, and as he stated, we are heterogeneous, with different genes and environmental factors driving out illness, and each factor impacts us as individuals more or less significantly than in other people. One day, I hope that there's some graphic model that moves shoeing how these biochemical move through us individually, i.e. where you could plug in your own lab values and watch the model work.
There is no way to test for this right now, it's all cutting edge stuff and only done on experimental research basis. Someone from HHS CFS committee reached out to me regarding my blog articles on T1AM the other day, and she thought it was a very sound theory that needs to be explored further.

Given that none of the people who treat or study CFS have ever heard of T1AM or the T3 doses I use, I have to take their opinion with a grain of salt, at least for now.
Thanks pattismith. I am currently reading a book titled "Trace Amines in Neurological Disorders". They show a link between MCT8 and TRPV chanells, the latter implicated in Calcium channels regulation.
TRPV is interesting for its receptors' modulation by cayenne... I just stumbled on this a few days ago... I made a chicken recipe w cayenne, cinnamon and smoked paprika* and couldn't believe how reduced my pain was after eating it! I started reading about cayenne + TRPV and how TRPV is linked to pain... I've been drinking lemon water (which I often do...) with added cayenne 2x a day for the past couple of days... I still swear it's the cayenne, although I've been taking cod liver oil for cheap A + D vitamins in natural form and I think that's helped my vitality, too..

I also read that TRPV is modulated by vanilla, which is another fragrance that makes me feel better (although not as much as cayenne)... I've also noticed that edema has gone down; my face seems less puffy... I get ~7-8 good hours a day, feeling NORMAL.

If you can recommend more info re TRPV, I'd love to read it... I've been digging around, but mostly rat studies... Don't know anything about MCT8 or if it's an issue w me... What are calcium channels?

* https://www.epicurious.com/recipes/food/views/paprika-roast-chicken-with-sweet-onion-351430

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