by Michal Sladek
I am a nutritionist. My particular focus is on treatments in the mental health which is a relatively new area.
It is well accepted that good diet maintains good health, whereas poor diet leads to ill health sooner or later. This applies to mental health as well.
The general belief, however, among a majority of population and among many health professionals is that once you have a mental condition no matter how many vitamins or minerals you take, it won’t make any difference.
Why is it so? There is a solid research and a good clinical experience showing that nutritional therapy works.
Why is this method still on the fringe and not generally accepted?
One of the reasons it that much of the research has focused on single nutrients, which are but one aspect of overall effect. In reality, a combination of several nutrients is needed, together with changes in the diet and lifestyle, social support and counseling.
Another reason is the fact that it only works within a certain biochemical subtype. For example, people can suffer from depression for 5 different reasons, metabolically speaking: undermethylation, overmethylation (folate deficiency), excess copper, pyrolle disorder and toxicity. Undermethylators, for example, have low serotonin and respond well to SSRIs. Overmethylators have excess of serotonin and react adversely to SSRIs, but respond to benzodiazepines. From this example you can see why different treatments are necessary for different people and why scientific study that puts all people with depression into one category would arrive at inconclusive results.
The third reason for non acceptance of nutritional treatment is commercial. The pharmaceutical corporations are looking after their own business interests and in is not their intention to put money into researching something which could be not patented and sold with profit.
What are the origins of nutritional therapy?
In the 1950’s, Dr Abram Hoffer, a Canadian psychiatrist, was treating his schizophrenic patients with therapeutic doses of niacin (B3). He developed a successful treatment protocol using a combination of vitamins and diet. Dr Hoffer also discovered a condition known as pyroluria. It is a hereditary metabolic disorder which is characterised by a combination of B6 and Zn deficiency, excess of Cu and high oxidative stress. It can lead to depression, anxiety, postpartum depression, ADHD, autism, violent behaviour, paranoid schizophrenia or bipolar disorder.
Another pioneer of nutritional therapy was an American psychiatrist Dr Carl Pfeiffer. He collected a database of biochemical samples (blood, urine) of 20 000 schizophrenics and discovered that 90% of them fall into 3 main categories (undermethylation, overmethylation and pyroluria). Each category has its own unique cluster of symptoms, distinct biochemistry and require a specific nutritional treatment. Dr Pfeiffer analysed biochemical profiles from over 45 000 people with mental illness, he developed the first nutritional treatment strategies and trained several doctors in this mode of therapy, including Dr William Walsh. Dr Walsh’s book “Nutrient Power” is an eye opener to practitioner as well to people suffering from mental illness.
Today, nutritional therapy is accepted in a branch of psychiatry associated with the Society of Orthomolecular Medicine. It is also used in functional/integrative medicine and in holistic medicine such as naturopathy.
How does nutritional medicine work?
My qualifications are Advanced Diploma in Nutritional Medicine. I am a holistic medicine practitioner, which means I treat the symptoms within an overall assessment of the whole body and considering all facets of person’s life in their interconnectedness.
I can’t prescribe medications and I cant take people off medications. I can, however, provide a safe nutritional treatment which will result in improved mental and physical wellbeing, reduction of symptoms and improved efficiency of antipsychotic medications.
Any biochemical process in the body needs raw materials, regulatory enzymes to be present and catalysts /cofactors which enable the reaction but are not used in the process. If one of these is missing, the reaction can not happen. The reaction could be a synthesis of a neurotransmitter, neutralisation of a toxic substance or anything that needs to be built in the body.
For example, serotonin is made from amino acid tryptophan. Tryptophan is absorbed together with the other amino acids from a protein meal and goes into the liver and into the blood stream. To get into the brain, it has to pass the blood brain barrier and compete for entry with several other amino acids. If there is not enough tryptophan in the diet or if there are too many other competing amino acids, the amount of tryptophan in the brain will be limited. Also, in times of high stress or high cortisol, a larger part of tryptophan in the liver will be converted to kynourenine, which is needed for other processes in the body. Because this reaction is irreversible, this will lower the amount of tryptophan that can get into the brain.
The synthesis of serotonin happens in two steps. First, L-tryptophan is converted to 5-hydroxy tryptophan (5-HTP). This reaction is done by the enzyme tryptophan hydroxylase and requires Fe, Mg, Ca and active form of vitamins B6 and B9 to be present. The second step is performed by the 5-HTP decarboxylase enzyme and the indispensable cofactors for this reaction are vitamins C and B6, Zn and Mg. So we can see that in order to synthesise serotonin, we need Fe, Mg, Ca, Mg, Zn and vitamins B6, B9 and C. If one of them is missing, the reaction can’t happen.
To complicated things even further, there could be epigenetic mutations which result in faulty enzyme production or the symphony of hormonal regulation could be out of tune. Since hormones regulate the enzymes, this could be another reason for lower serotonin production.
From this, you can see how nutritional therapy works. I need to asses a nutritional status of a person and determine which nutrients are likely to be missing.
This is where nutritional supplements become very useful. Practitioner only supplements contain minerals in an easily absorbable form and some of them also offer vitamins in their active form for people who have poor metabolism.
I can also supplement amino acid tryptophan. It is taken between meals as to reduce the competition with other amino acids when it crosses the blood brain barrier.
There are even 5-HTP supplements, which are easily absorbed and go directly into the brain. Needless to say, these are expensive.
Some years ago I believed that eating a good diet is enough for good health. After studying nutrition, I realised several things:
It is a good idea to do your research first and stay within the recommended limits, because more is not necessarily better. It is safer to leave the therapeutic doses to the practitioners.
There are also some very common deficiencies commonly associated with poor mental health and often misunderstood as a part of natural ageing. These are deficiencies of Zn and vitamins B12 and D.
To have adequate intake of these prevents many problems in the body and mind. These three are big topics and each deserve a blog on their own.
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