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What Doctors Don't Tell You

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July 2019 (Vol. 4 Issue 5)

Mental illness may not all be in the mind

About the author: 
Dr Pam Shervanick

Mental illness may not all be in the mind image

American psychiatrist Dr Pam Shervanick argues that the key to solving mental illness lies with your body's other systems.

I am a psychiatrist, and I'm supposed to prescribe drugs to treat a range of 'mental' issues, from depression and anxiety to bipolar, ADHD and the like. But having studied these problems for many years, I've come to a view that many consider controversial: there's no such thing as mental illness.

Pinpointing where mental issues originate requires looking upstream—far upstream. Several elements are common to many health problems, both physical and mental: inflammation, nutritional imbalances or deficits, environmental toxicity, problems with cellular communication, and lifestyles that do not promote health. Although Western medicine likes to compartmentalize aspects of health, especially distinctions between the mind and body, ultimately, everything is actually part of the same overall system.

A so-called domino effect occurs in the body no matter where the problem starts. For example, severe anxiety, agitation and other potential symptoms of mental health issues may be the result of a problem in the formation of hemoglobin (which occurs in the spleen). Without remembering that the person is one holistic structure, it's difficult to find the root of any illness.

When molecules that our bodies do not recognize as 'self' get into the bloodstream, our immune system will typically attack the substance, seeing it as foreign. This initiates the cascade of the inflammatory process. If those molecules can cross the blood-brain barrier (a selective and protective filter of the blood as it travels from the body into the brain), they will also inflame the brain.1

All 'mental illnesses' are due, at least in part, to inflammation. A perfect example of this is autoimmune encephalitis. Autoantibodies causing psychiatric symptoms were first reported in the 1930s in a case of schizophrenia.2 And as it turns out, the body can sometimes target the NMDA-glutamate receptor in the brain as if it is a foreign substance, which drastically alters neurological transmission.

The symptoms look similar to schizophrenia. Affected people may experience a range of problems including irritability, depression, hallucinations, short-term memory loss, sleep and personality disturbances and even seizures. But a growing number of studies have shown that immunotherapy to suppress the faulty antibody signaling can often reverse and resolve the psychiatric symptoms in these cases.3

Your brain is an incredibly sensitive organ, which is why it needs the blood-brain barrier to act as a separate filter for blood and ensure that only select substances can reach the central nervous system from your body. But more and more, damaging molecules from pollution and other toxins are either crossing that barrier or changing it for the worse.

The brain-body connection
Heavy metals and chemical toxins, electromagnetic fields, poor nutrition, the fast pace of our daily lives, multitasking, lack of face-to-face community, isolation and poor self-care—all can interfere with brain signaling and cause a lack of synchrony between cells.

One of the major organs in the body that becomes dysfunctional when your thyroid malfunctions is the brain. There are many causes of this problem, but environmental toxins like heavy metals play a major role.

Fluoride and bromide are two known noxious substances that alter the function of this indispensable gland. Fluoride is present in many water supplies, in toothpaste and mouthwash, and is used by dentists for cleaning teeth. Bromide is found in packaged baked goods as a preservative, as well as in plastics, pesticides, medications and fire retardants. Both are known in chemistry as halide salts, with very similar binding properties.

Studies have found that children living in communities with high levels of fluoride in their water have significantly lower levels of thyroid-stimulating hormone.4 This may be because iodine (the non-salt form of iodide) is absolutely essential for the proper functioning of the thyroid, but fluoride and bromide bind to the receptors on the cells of the gland instead of iodide and disrupt their function.

The thyroid is necessary for proper metabolism and energy maintenance by all of the cells and organs in the body. In the brain, if these systems are not functioning properly, symptoms of depression, anxiety, ADHD and bipolar disorder can result. In fact, the most common anomaly found in bipolar disorder across the board is thyroid dysfunction.5

Another common toxin affecting the thyroid gland is mercury. The 2007-2008 US National Health and Nutrition Survey found that women with high mercury exposure were more than twice as likely to have thyroid autoantibodies, a sign of thyroid autoimmune disease.6

Alternative behavioral and emotional expressions are also often the result of a simple lack of nutrients. In some extreme cases, with multiple missing nutrients at many levels, a nutrient-deficient brain with abnormal cellular communication may present as a severe mental illness like schizophrenia.

Among people with depression, prescription and over-the-counter drugs often play a major role in causing the condition or making it worse. It's long been known that psychiatric drugs, as well as common over-the-counter medications such as ibuprofen and acetaminophen (paracetamol), change people's perceptions and blunt their ability to express or feel emotion. This perceptual shift may be a catalyst for unwanted behavior. In fact, five of the top 10 prescription drugs linked to violence are antidepressants.7

Statin drugs, which doctors prescribe to lower cholesterol, have the potential to cause irritability, aggression, anxiety, depressed mood, violent ideation, sleep problems including nightmares and possibly suicide.8 Isotretinoin (Accutane), a drug commonly prescribed—especially to adolescents—to treat acne, has been shown to cause depression, suicidality, anxiety, worsening of bipolar disorder and schizophrenia.9 The list goes on and on.

Breaking the cycle

The good news is that when doctors treat the whole person, 'mental' illness often disappears. A patient of mine named Martha, age 47, came to see me with debilitating depression and was out of work on medical leave. Although the depression had been present for over a decade, it had been gradually worsening over time, and she could no longer get out of bed on most days, shower, or even care for her son.

Martha was a single mother of a high school student who had a history of being bullied and struggling socially and academically. She had endured a very unpleasant divorce, had been working hard at a full-time job she did not enjoy, and had been taking antidepressant medication for many years prior to our meeting. On the first day we met, she was on the maximum dose of her meds, and many trials of other antidepressant medications had failed.

After first measuring potential deficiencies in her blood and urine, I discovered that she had disturbances in her methylation cycle (a process for activating and deactivating certain genes and biological mechanisms in the brain and body). Over several months, we slowly instituted changes based on her history and the information we learned through her testing.

The results revealed that she would best thrive on a vegan or vegetarian diet. In addition, the 'brain fog' she was experiencing suggested that eliminating gluten would be beneficial. She began to eat
organic and mostly unprocessed food, stopped eating refined sugar and followed a personalized supplementation regimen.

Regular, enjoyable exercise (she hired a trainer) became a part of her daily routine, as did meditation. Things that had piqued her interest in the past were finally pursued. She took a class on reiki, learned to knit and joined a weekly knitting group, and took up the challenge of learning how to bake in a new and healthy way. She also increased her social contacts.

Over two months, Martha was weaned off her medication and has remained fully functioning with no negative effects for well over a year. She is no longer depressed, is an avid meditator and healthy eater. Now in a new job, working part time and starting her own business, her life is full, and she has a good relationship with her son, who is doing well in school and in life overall. She feels empowered to educate herself to remain healthy and live a satisfying life.

Trish, another of my patients, came to see me complaining that she felt constantly anxious and unable to focus. Her worries spanned from her work to her kids, her failing marriage and her feelings of being unfulfilled in life.

A few years prior, Trish had overcome a long-term problem with alcohol. Although initially proud of her sobriety, worries slowly crept back in until they began taking over virtually every waking hour in her life. Consumed by these intrusive and disturbing thoughts, she found herself tempted to return to drinking, but knew she never could.

During her rehabilitation program for alcohol, she had been put on Prozac, the bestselling drug for depression and anxiety, and was still taking it. Trish also told me she had been longing to be an artist again, but this great passion of hers had to be put aside after she began her family.

I gave her a batch of tests, which revealed that she had underlying biochemical issues, including an overload of copper, which is toxic in excess. Symptoms of too much of this heavy metal can vary, but in Trish's case it was causing her excessive anxiety and most likely had contributed to bouts of depression in her past. Tests also showed that Trish was extremely low on vitamin D, which can affect mood.

Besides a simple supplement and dietary regimen to correct these imbalances, we discussed the power of meditation and explored various methods of self-empowerment. Realizing the importance of prioritizing herself, Trish cut back her hours at work and began painting again on a regular basis. As she began feeling better, I helped her to come off Prozac over three months.

After just a year, Trish had improved concentration, was sleeping well and had planned an upcoming show at a local gallery. She joined a meditation group with her mother and replaced her constant worrying with hope for her future. The last time we spoke, she reported being free of anxiety and feeling healthy and fulfilled.

These are just two of the hundreds of so-called 'mental patients' I see who have found healing and quality of life without resorting to psychiatric drugs. They've caused me to conclude that no brain is permanently broken.

With the correct information and helpful guidance about the connection between mind and body, the natural power to heal—even from mental health issues like depression—is within us all.

Of all the diseases afflicting people across the globe, there is one that stands out for its grimness. Depression can lock people in a world of gloom, drain their energy and ambition, damage their relationships and families and, for some 800,000 people every year, tragically lead down a dark path to suicide.

More than 300 million people worldwide suffer from depression. Some 16 million are diagnosed each year in the US,1 and a recent UK survey found that nearly 1 in 5 Britons had experienced depression or anxiety in the past year.2

Soaring drug use

Most of these people, if they pursue conventional medical treatment, will at some point find themselves sitting in front of a general practitioner or psychiatrist, who will question them about their symptoms. They might inquire about family history, and a few will ask about sleep patterns and exercise habits. Since there is no blood or urine test for depression and no results to wait for, usually, out comes the prescription pad on the first visit.

Researchers at Johns Hopkins Bloomberg School of Public Health found that 60 percent of visitors to office-based psychiatrists left with two or more prescriptions for psychiatric medications in 2005-2006, up from 43 percent in 1996-1997. The number of people given three or more prescriptions roughly doubled—from 17 percent to 34 pereent—in the same period.3

The US Centers for Disease Control and Prevention found that antidepressant use rose 65 percent in just 15 years from 1999 to 2014, with one in eight Americans over age 12 reporting antidepressant use in the past month.4

But if people are consuming so many drugs, why are so many still depressed and anxious?

"Too many psychiatrists prescribe medications without understanding the root causes of the disorders they seek to treat. So they are, in essence, guessing," says psychiatrist James Greenblatt, MD, Chief Medical Officer at Walden Behavioral Care in Massachusetts and a professor of psychiatry at Tufts University and the Geisel School of Medicine at Dartmouth College.

A pioneer of what he calls "integrative psychiatry," Greenblatt uses tools ranging from nutrition and herbs to lifestyle changes once relegated to the fringe of traditional psychiatry, which, he says, are finally starting to get some attention.He overviews that research in his forthcoming book, Integrative Medicine for Depression (Sunrise River Press, 2019).

Shots in the dark

"There are at least 15 different causes of depression," Greenblatt tells WDDTY, ranging from thyroid hormone imbalance and vitamin deficiencies to celiac disease, medication side-effects and trauma.

In traditional psychiatry, all these different types of depression are corralled into the same pen based on similarity of symptoms, so a 42-year-old mother of three working as a corporate lawyer and experiencing fatigue, insomnia and food binges is diagnosed with the same 'major depressive disorder' as a 78-year-old retired plumber who is feeling intense guilt and contemplating suicide.

Usually, the doctor adopts a 'shot-in-the dark' approach, starting at the top of the list of recommended drugs for the diagnosis, prescribing them one after another to see if they work, tinkering with doses and adding new medications to deal with side-effects and secondary symptoms like sleeplessness or anxiety.

The side-effects of common psychiatric drugs are a major reason some patients decide to stop taking them. Antidepressants like Zoloft (sertraline) Prozac (fluoxetine) and Celexa (citalopram) have side-effects ranging from fatigue, blurred vision and loss of libido to, ironically, anxiety and suicidal tendencies.5 Greenblatt claims that only about one-third of patients experience full or nearly full recovery with medical treatment for depression.

Every depression is different

Greenblatt is now convinced that every patient's depression is as unique as they are, dependent on their biochemistry, genetics, hormones, life experiences, nutrition, relationships and more.

Unlike most psychiatrists, he begins treatment by ordering a battery of tests looking at amino acid levels, essential fatty acids, vitamins, minerals and immune system markers to give insight into the cellular picture inside a person's body.

Whereas traditional psychiatrists consider the brain and body as separate entities, this integrative approach sees the brain, mind and body as intimately connected. Based on the test results, Dr Greenblatt gives recommendations for supplements, diet and lifestyle changes.

There are many evidence-based steps that depressed people can take safely before resorting to antidepressants

1) Exercise

A 2011 review of 11 studies on the impact of exercise found it to be a "powerful intervention for clinical depression."6

High-intensity exercise triggers the body to release endorphins, the feel-good hormones responsible for the euphoric feeling some athletes describe as 'runner's high.' Consistent, low-intensity exercise also promotes the release of proteins called growth factors that stimulate nerve growth and new neuron connections and create an overall good feeling.7 Before you dive onto antidepressants, or even if you are already taking one, simply walking every day can be beneficial.

2) Take it outside

Taking your walk in the woods may have added benefits, according to a new body of research into what Japanese researchers call shinrin yoku, or 'forest bathing.' One 2018 study by researchers at Okayama University of Science found that urinary markers of oxidative stress in the body were lowered in people after they walked in woods, but not after an urban stroll.8

A 2017 review of 127 studies on the subject described physiological benefits including lower concentrations of the stress hormone cortisol, lower pulse rate, lower blood pressure, greater parasympathetic nervous system activity and lower sympathetic nervous system activity compared to walkers in city environments.9 A study of 498 Japanese residents suffering from acute and chronic stress reporting lowered feelings of hostility, depression and anxiety as a direct result of time spent in the forest.10

3) Hydrate to feel great

Researchers at the Human Performance Laboratory at the University of Connecticut found that even mild dehydration—as little as 1.5 percent water loss—altered people's energy levels, mood and clarity of thought, especially in women. Hydrating has the effect of alleviating depression and crankiness as well as headaches and sleepiness. The researchers recommended that adults drink at least eight, 8-oz glasses (about 2 liters) of water each day. A red-flag for dehydration is darker urine.11

4) Get the right fats . . . for you

Feeling thirsty is not only a sign of dehydration. Dr Greenblatt describes one young woman he treated who had been depressed for 10 years. As she described her history, she also mentioned having been very thirsty, fatigued and plagued by dry skin. Her tests revealed very low levels of omega-3 fats—a type of fatty acid found abundantly in fish, fish oil, flaxseed oil and walnuts.

Another type of fatty acid, omega-6, is found primarily in vegetable oils like sunflower and corn oil as well as in eggs and meat. Both are critical to brain function, but omega-6 fats, which are supposed to outnumber omega-3s by a ratio of 4:1, are far overrepresented, at a ratio of 25:1, in the standard American diet. Cattle raised in feedlots and farmed fish contain about one-fifth the omega-3 levels as wild fish and traditional grass-fed beef, which contributes to the imbalance.

When Dr Greenblatt corrected his patient's fatty acid ratio with omega-3 supplements, all of her symptoms faded away.

However, the story is not always so simple ,which is perhaps why there is conflicting evidence on the use of omega-3 supplements for depression. One large study by researchers at the University of Montreal, for example, found that omega-3 fats helped those with major depression, but not those with depression and anxiety.12

Curiously, Dr Greenblatt says that he sees a surprising number of patients whose testing reveals that they have too much omega-3 and not enough omega-6. This may be from over-supplementing omega-3 fats for longer than three months at high doses, so he does not recommend taking an omega-3 supplement higher than 2 g/day for more than three months, then testing your levels again.

5) Eat the seed

Bradford Weeks, another holistic psychiatrist, is certain that people are getting too much omega-3 in supplements, and that the bad rap for omega-6 is because it is usually made rancid or oxidized from cooking and processing. "Our skin needs 1,000 times more omega-6 than omega-3," he says, and our brains require more omega-6 too.

The key, he says, is getting it fresh directly from seeds and nuts, rather than from adulterated oils. Good sources include sunflower seeds, pumpkin seeds, brazil nuts, walnuts, almonds, chia seeds, and even fruit seeds from apple and orange to kiwi, which can be ground into a fine powder with an old coffee grinder.

6) B vitamins

Folate and vitamin B12 are essential for normal brain function, and depressed patients are often deficient in both.13

One case report describes a 52-year-old woman, a lifelong vegetarian, who presented at the hospital in a catatonic state and who had been seen years earlier for "frequent crying" and anxiety. At a second hospital, her vitamin B12 levels were checked, and she was found to be severely deficient. Given high doses of vitamin B12, the woman recovered fully.14

Vitamin B6 (pyridoxine) deficiency has also been associated with depression,15 and it is recommended especially if your homocysteine levels are high (see page 39).

Suggested daily dosages: Vitamin B12, 1 mg total, as methylcobalamin and adenosylcobalamin.

Folate is best taken in its active form, menthyltetrahydrofolate, starting with 0.8 mg up to 5 mg per day.

Vitamin B6, as pyridoxyl-5 phosphate (P5P), 20-100 mg daily.

7) Magnesium

A 2018 review of magnesium's role in neurological disorders found a direct link between magnesium and depression; the lower the levels, the more severe the depression.16 This is no surprise, as magnesium is needed for hundreds of

bodily functions, and a deficiency can cause irritability, nervousness, anxiety, apathy, mood swings, insomnia, cardiac problems, difficulty concentrating and depression.

Since most of the body's magnesium is locked away within its cells, serum blood tests are not as helpful as a measurement of the level within cells, such as with a red blood cell trace mineral test (see page 40). Red blood cell magnesium should be between 5.2 and 6.5 mg/dL.

Suggested daily dosage: Some patients rapidly recover from major depression taking 125-300 mg of magnesium per meal and at bedtime (as magnesium glycinate or magnesium taurate but not magnesium glutamate or magnesium aspartate, which worsen symptoms), with no major side-effects besides loose stools.17

8) Zinc

Like magnesium, the essential mineral zinc has been linked to depression—the lower the level, the worse the depression. One 2013 review of 17 studies including a total of more than 2,400 participants found that those with depression had lower blood levels of zinc compared to healthy controls.18

Suggested daily dosage: Zinc picolinate, 25-50 mg.

9) Selenium

This essential trace element, vital for the brain and nervous system, is found in groundwater, meat, shellfish, nuts and grains. The content of zinc in foods depends on the selenium content of the soils in which they are grown. One in seven people is not getting enough selenium in their diet, and deficiency is strongly linked to major depressive disorder.19

Selenium helps generate glutathione, which is the body's main antioxidant and anti-inflammatory defense. It also plays a key role in synthesizing thyroid hormones. These two functions may explain why both abnormally high and low selenium levels have been linked to depression.

Suggested daily dosage: In adults, selenium levels should be in the range of 82-85 µg/L. In one study, eating just 5 g of Brazil nuts a day increased blood levels of selenium within six hours, and they remained high for 24 hours. The nuts also contain other key antidepressant nutrients including fatty acids, magnesium, zinc, niacin and vitamin B6.20

10) Saffron and other herbs

A 2016 review of the published literature concluded that the herb St. John's wort taken alone "is superior to placebo in improving depression symptoms and not significantly different from antidepressant medication," with fewer side-effects than the drugs.

Because this herb may mitigate the effects of some drugs such as anticoagulants and oral contraceptives, and theoretically cause your body to overproduce serotonin if taken with an antidepressant, it is best to take St John's wort alone, or check with a doctor or pharmacist for drug interactions before taking it.21

Similarly, turmeric, the bright orange cooking spice, has been used for centuries in traditional Ayurvedic and Chinese medicine to treat depression. Its active ingredient is curcumin, which has anti-inflammatory and antioxidant properties and protects brain cells. A 2017 review of six clinical trials involving 377 patients with depression found that the spice had a significant effect in reducing depressive symptoms.22

Saffron, the spice used in dishes like Spanish paella or French bouillabaisse, contains 40 to 50 different compounds that may contribute to its antidepressant effects, which are similar to SSRI drugs. One 2013 study found that saffron improved depression comparably to antidepressants.23 A 2018 review of 11 recent randomized controlled trials by Hungarian researchers at the University of Szeged also concluded that "saffron has a significant effect on the severity of depression."24

What's causing your depression?

To find out what may be causing your symptoms, Dr James Greenblatt suggests these biochemical tests to provide important clues.

Amino acids

These are the building blocks for all proteins as well as neurotransmitters, which send signals from neuron to neuron in your brain. Low levels of the amino acid tryptophan are linked to depression, for example, while tyrosine or phenylalanine deficiency can cause fatigue and difficulty concentrating.

Both blood and urine tests can be used to detect amino acid levels, which should be measured at least a few hours after eating for more accurate results—a test called a fasting amino acid profile. Supplements or diet can then be used to adjust them. Find an experienced practitioner to interpret the results.

Complete blood count (CBC) with differential

The CBC measures the number of white blood cells and breaks them down into types (the 'differential'). These may be elevated from infection, allergic reaction, leukemia or even low zinc levels. The red blood cell count (and characteristics, hemoglobin, hematocrit and platelets) can reveal anemia and pinpoint nutritional deficiencies in copper, folate, iron or vitamin B12.

Celiac screening

Depression and anxiety frequently tag along when people have hyperinflammatory reactions to the wheat protein gluten, so it is important to rule out celiac disease by a blood test for the anti-tissue transglutaminase and anti-giadin antibodies, which are hallmarks of the condition.

C-reactive protein

This protein, also called CRP, produced by the liver and considered a marker of inflammation in the body, is also linked to depression and can be measured with a simple blood test.

DHEA and pregnenolone

Dehydroepiandrosterone (DHEA) and pregnenolone are precursors needed to make the sex hormones testosterone and estrogen, along with as many as 150 other steroid hormones. Low levels of each, measured by a blood test, have been linked to depression.

Essential fatty acids

The omega-3 fats EPA and DHA, as well as omega-6 fats, are critical to brain function. Measured with a blood test, they need to be balanced in the right ratio (see main article).

Folate and vitamin B12

These vitamins are also strongly linked to depression (see main article) and measured with a blood test.

Homocysteine

High levels of the amino acid homocysteine in the blood are harmful and linked to depression, as well as being a common sign of deficiencies in folate, B6 or B12 vitamins, which can be supplemented to lower homocysteine levels.

Food allergies

People with food allergies are more likely to have depression, as in the case of celiac disease. It may be that a food is causing widespread underlying inflammation leading to depression. Testing involves exposing blood samples to allergens in a lab to see if they elicit a reaction.

Hormones (estrogen, progesterone and testosterone)

Sex hormones have been linked to mood and behavior in both men and women. Says Greenblatt: "The biochemical and metabolic relationships that link these hormones, however, are incredibly complex and absolutely specific to the individual." Review the numbers from a blood test with the ordering physician and an endocrinologist if necessary.

Iron and ferritin

A chronic deficiency of iron, necessary to blood cells, can cause fatigue, weakness and depression. It also influences enzymes that regulate the production of the neurotransmitters dopamine and serotonin. Two common blood tests that measure levels of iron and ferritin, a protein that stores it, are often ordered together. If ferritin is below normal, or even in the low-normal range (less than 100 ng/mL), Dr Greenblatt recommends taking iron supplements with vitamin C to help with absorption.

Kryptopyrrole

Pyrroles are organic compounds that are normally excreted in urine; if they accumulate, however, as is the case in the condition pyroluria, they can contribute to nutrient imbalances and exacerbate depressive symptoms.

Symptoms of pyroluria include nervousness and anxiety, mood swings, severe inner tension, poor short-term memory and depression, all of which are related to the depletion of B6 and zinc by excess pyrroles.

A simple urine test can detect high levels (>15 mcg/dL), which can be treated with 100 to 400 mg per day of vitamin B6 and 25 to 100 mg per day of zinc as zinc picolinate.

Lipids

Low total cholesterol in the blood has been linked to depression and suicidal thoughts. A 2018 study by researchers in Mexico found that total cholesterol levels were significantly lower in people with major depressive disorder than healthy controls, and lower still in depressed individuals who had attempted suicide.1

Lithium

An essential nutrient for the human body, low lithium levels are associated with increased rates of depression, volatile mood, aggressive behavior and suicide.

Lithium can be measured through a urine test or a hair analysis. Dr Greenblatt says depressed people can take between 2.5 and 20 mg/day of the nutritional lithium supplement lithium orotate, provided they are not taking any contraindicated prescription drugs.

Red blood cell trace minerals

This test evaluates the levels of a variety of nutrients, including magnesium, calcium, phosphorous, zinc, selenium, boron, chromium and vanadium, as well as potentially toxic elements, all of which have important effects on blood cells.

Thyroid panel and thyroid antibodies

Low thyroid hormone levels contribute to depression, anxiety and other psychological problems. A blood test to screen for thyroid problems should always be performed in cases of depression.

Urinary organic acids

Abnormally high levels of organic acids in urine indicate a blockage of one or more of the body's metabolic pathways. Dietary changes, nutrient supplementation, antifungal/antibiotic herbs or medications may be used to correct the underlying conditions.

Urinary peptides

When the naturally occurring proteins casein (found in milk) and gluten (found in wheat, rye, barley and certain other grains) are broken down incompletely, it can lead to high levels of proteins (including casomorphin and gliadorphin) that act like opioids and are linked to psychological symptoms including depression.

Vitamin D

There's little doubt that adequate vitamin D from sunshine or supplements is necessary for a good mood. Low levels are linked to depression, increased stress response, high blood pressure, high blood sugar, heart disease, cancer, multiple sclerosis and more. Test every three months until levels of 25-hydroxyvitamin D are at least 50 to 80 ng/mL. If supplementing, take along with 100 mcg of vitamin K2 in the form MK7.

Zinc and copper

Blood tests for zinc are not always reliable, but a zinc taste test can identify even a minor deficiency. Copper, measured by blood or urine test, is needed for the synthesis of neurotransmitters, so low copper levels can lead to symptoms of depression, while high levels are linked to aggression, paranoia and anxiety. Both can be balanced with supplements or diet.

To complicate matters, the ratio of zinc and copper should be balanced, too. Since they compete for access to receptors in the body, excess copper can deplete zinc, and zinc depletion can increase copper.

MTHFR genetic testing

Genetic analysis of a simple saliva swab can tell you a bit about how your body metabolizes or responds to various medications differently than others do.
People with genetic mutations called methylenetetrahydrofolate reductase (MTHFR) polymorphisms have impaired folate metabolism and, consequently, a higher incidence of depression and need for folate supplementation (see WDDTY July 2018).


The formula for creating best-selling drugs image

The formula for creating best-selling drugs

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