The major anti-depressants are thought to work by affecting the balance and function of certain neurotransmitters. These include serotonin re-uptake inhibitors such as Prozac, Lustral, Seroxat which are designed to keep serotonin in circulation; adrenalin reuptake inhibitors such as Edronax, designed to keep adrenalin in circulation; monoamine oxidase inhibitors, which again help maintain adrenalin and dopamine levels and the tricyclic anti-depressants such as amitriptyline which also prevent adrenalin breakdown. Notice that most of these drugs block biochemical pathways. That is, they interfere with the body’s normal chemistry. The consequence is frequent side-effects and a need to get the dose just right to balance positive effects and the side effects. For example, Prozac, considered to be among the safest anti-depressants, has 45 known side-effects. The most common are nausea, nervousness, insomnia, headache, tremors, anxiety, drowsiness, dry mouth, excessive sweating and diarrhoea. According to a survey by US psychiatrist David Richman 10 to 25 per cent of people on Prozac experience all of these. An alternative approach to give the nutrients our bodies have evolved to use to make more of these neurotransmitters. Serotonin, for example, is made from the protein constituent tryptophan, in the presence of sufficient vitamin B3, B6 and zinc.
Objectively evaluate a person with abnormal biochemistry that would predispose them to depression and then change the body’s biochemistry by giving a personalised nutrition programme. “If there’s a drug that can alter the brain’s biochemistry, there’s usually a combination of nutrients that can achieve the same thing without side-effects” said Pfeiffer, who had spent most of his life researching biochemical aspects of mental health, funded by the US government. Now, after thirty years of positive research and good clinical results I believe the time has come for another option, nutrition counselling, to be made available to those with mental health problems.
The B-complex vitamins are essential to mental and emotional well-being. They cannot be stored in our bodies, so we depend entirely on our daily diet to supply them. Vitamin Bs are destroyed by alcohol, refined sugars, nicotine, and caffeine so it is no surprise that many people may be deficient in these.
Vitamin B1 (thiamine): The brain uses this vitamin to help convert glucose, or blood sugar, into fuel, and without it the brain rapidly runs out of energy. This can lead to fatigue, depression, irritability, anxiety, and even thoughts of suicide. Deficiencies can also cause memory problems, loss of appetite, insomnia, and gastrointestinal disorders. The consumption of refined carbohydrates, such as simple sugars, drains the body’s B1 supply.
Vitamin B3 (niacin): Pellagra-which produces psychosis and dementia, among other symptoms-was eventually found to be caused by niacin deficiency. Many commercial food products now contain niacin, and pellagra has virtually disappeared. However, subclinical deficiencies of vitamin B3 can produce agitation and anxiety, as well as mental and physical slowness.
Vitamin B5 (pantothenic acid): Symptoms of deficiency are fatigue, chronic stress, and depression. Vitamin B5 is needed for hormone formation and the uptake of amino acids and the brain chemical acetylcholine, which combine to prevent certain types of depression.
Vitamin B6 (pyridoxine): This vitamin aids in the processing of amino acids, which are the building blocks of all proteins and some hormones. It is needed in the manufacture of serotonin, melatonin and dopamine. Vitamin B6 deficiencies, although very rare, cause impaired immunity, skin lesions, and mental confusion. A marginal deficiency sometimes occurs in alcoholics, patients with kidney failure, and women using oral contraceptives. MAOIs, ironically, may also lead to a shortage of this vitamin. Many nutritionally oriented doctors believe that most diets do not provide optimal amounts of this vitamin.
Vitamin B12: Because vitamin B12 is important to red blood cell formation, deficiency leads to an oxygen-transport problem known as pernicious anaemia. This disorder can cause mood swings, paranoia, irritability, confusion, dementia, hallucinations, or mania, eventually followed by appetite loss, dizziness, weakness, shortage of breath, heart palpitations, diarrhoea, and tingling sensations in the extremities. Deficiencies take a long time to develop, since the body stores a three- to five-year supply in the liver. When shortages do occur, they are often due to a lack of intrinsic factor, an enzyme that allows vitamin B12 to be absorbed in the intestinal tract. Since intrinsic factor diminishes with age, older people are more prone to B12 deficiencies.
Folic acid: This B vitamin is needed for DNA synthesis. It is also necessary for the production of SAM (S-adenosyl methionine). Poor dietary habits contribute to folic acid deficiencies, as do illness, alcoholism, and various drugs, including aspirin, birth control pills, barbiturates, and anticonvulsants. It is usually administered along with vitamin B12, since a B12 deficiency can mask a folic acid deficiency. Pregnant women are often advised to take this vitamin to prevent neural tube defects in the developing foetus
The most promising nutrients to date are vitamins B3, B12 and folic acid, then vitamin B6, zinc and magnesium and essential fatty acids (EFAs). The first three are involved in the vital biochemical process known as methylation, which is critical for balancing the neurotransmitters dopamine and adrenalin.
Research on folic acid have shown improvement in both depression and schizophrenia. Giving those with borderline or low folate status 15mg a day alongside standard psychotropic treatment significantly improved clinical and social recovery in patients with depression and schizophrenia in a double-blind controlled trial at Kings College Hospital and the Department of Psychiatry(1).
Vitamin B6 and zinc work together. In fact vitamin B6 (pyridoxine) does nothing in the body until it is converted into pyridoxal phosphate, this conversion depending on adequate zinc levels. About one third of the psychiatric population show the excessive excretion of ‘kryptopyrroles’ in the urine, the formation of which robs the body of B6 and zinc. Giving more of these nutrients corrects this
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