Tag Archives: mental health

The Gut-Brain Connection

Screen Shot 2013-07-16 at 2.42.44 PMA large body of evidence is accumulating to support a role between healthy gut function, brain development and function of the central nervous system. The organisms contained in the gut should be considered an inner organ with functions similar in importance to any other organ present in the body. Disruptions in this “organ” may alter many things including brain function and cause symptoms like depression, anxiety, ‘brain fog’ and more.

At birth the human gastrointestinal tract is sterile, however, it is quickly colonized and by the age of one year, the bacterial profile looks similar to that of an adult.1 The connection between the gut and the brain is known to be bidirectional. This means messages from the gut affect brain function just as much as messages from the brain affect gut function.2

 The mechanism by which alterations in bacterial profiles of the gut affect how we feel, think and move is fascinating. It all begins with lipopolysaccharides (LPS). LPS are structures located on the surfaces of bacteria present in our gut. These LPS may actually get out of the gut and into the blood stream producing a very strong immune response. Normally, the gut does a very good job keeping these LPS from getting into the blood stream.3 However, when the barrier in the gut weakens (‘leaky gut’) LPS is more easily absorbed and enters circulation.  When this occurs, inflammation ensues. If the process continues, high levels of inflammation are generated and this begins to alter neurotransmitter levels in the brain. With enough change in neurotransmitter levels, mood, behavior and cognitive function suffer.

What causes leaky gut? There are a lot of factors, however, evidence points to a high fructose diet (sugary beverages), the Western diet (high in processed foods) and nutrient deficiencies like vitamin D, A, zinc and magnesium.These factors are also known to increase the ability of LPS to get into the blood stream.4

 Symptoms of depression, anxiety, ‘brain fog,’ or poor memory may not always be coming from your brain. The genesis of the problem might actually be in your gut! By maintaining a healthy diet and addressing potential nutrient deficiencies you may see many of your symptoms disappear without the need for expensive, mind-altering medications!

1Palmer C, Bik EM, DiGiulio DB, Relman DA, Brown PO. Development of the human infant intestinal microbiota. PLoS Biol. 2007 Jul;5(7):e177.

2O’Mahony SM, Hyland NP, Dinan TG, Cryan JF. Maternal separation as a model of brain-gut axis dysfunction. Psychopharmacology (Berl). 2011 Mar;214(1):71-88.

3Bested AC, Logan AC, Selhub EM. Intestinal microbiota, probiotics and mental health: from Metchnikoff to modern advances: Part II – contemporary contextual research. Gut Pathog. 2013 Mar 14;5(1):3.

4Teixeira TF, Collado MC, Ferreira CL, Bressan J, Peluzio Mdo C. Potential mechanisms for the emerging link between obesity and increased intestinal permeability. Nutr Res. 2012 Sep;32(9):637-47.

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Depression – An Inflammatory Condition

More and more research is pointing to inflammation as the culprit behind human disease and suffering.  And depression, yes depression, is no different! Watch this short video about how levels of depression in your body may be affecting your mood. By reducing inflammation you have the opportunity to improve serotonin production and elevate mood!!

 

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Coffee Wards Off Dementia!

In a new study published in the Journal of Alzheimer’s Disease participants with mild cognitive impairment who had a certain level of caffeine in their blood did not go on to develop dementia.  This is the first study to attempt to isolate whether it’s just coffee that’s protective in dementia or if it is indeed the caffeine that imparts the benefit. In this case, the caffeine seems to be the protective variable.  See the video below for more.

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How Your Diet Affects Your Mood

Depression and Bipolar

Food is fuel.  The fuel we put into our body determines how efficiently it runs.  It’s a pretty simple concept yet when it comes to brain function there is a disconnect for many physicians.

When people come to me for help with various conditions, dietary changes are almost always part of the program.  They are especially important if someone if suffering from a mood disorder.

If a poor diet can lead to poor function of the heart, gall bladder, immune system, pancreas, intestines, etc., then why couldn’t it lead to poor brain function? It can, but it’s always overlooked by traditional medicine.  Let me explain.

The Basics

Remember, food is fuel.  The neurons in your brain consume up to 40% of your circulating blood sugar at a resting state.  That figure can jump up to 80% when your brain is working hard like studying for a test or doing your taxes. Your blood sugar is the fuel your brain needs to keep going.

Low blood sugar occurs when people do not eat frequently enough or in an amount that satisfies the demands for energy of the entire body, including the brain.  Low blood sugar, or hypoglycemia, causes mood to change.  Most notably, people experience irritability. This irritability is relieved by simply eating food and allowing your blood sugar to rise back to a normal level.  Next time you’re feeling irritable and you haven’t eaten in a few hours, try eating a healthy snack.  It might just be the fix you’re looking for.

If something as simple as low blood sugar can alter your mood, what else can?

Alcohol

Alcohol is consumed the world over mainly for one reason and one reason only – it has mind altering properties. Let’s face it; alcohol does not taste good in the way that ice cream does.  People are not consuming it solely for the taste. The per capita consumption of ethanol in the United States is 2.31 gallons per year.  That means, on average, every American over the age of 15 consumes 2.31 gallons of pure alcohol per year.  This is equivalent to 702 beers, 410 glasses of wine or 197 shots per year, per person.

Alcohol works on the brain by affecting the neurotransmitter GABA.  GABA is an inhibitory neurotransmitter in the brain.  Initially, consuming alcohol elevates mood and reduces anxiety and stress.  As a matter of fact, most current pharmaceuticals aimed at reducing anxiety work by acting on GABA.

However, continuing to consume alcohol has a downside.  When consumed to excess, moods begin to go down and depression is often the consequence.  It also causes sleepiness which illustrates alcohol’s powerful depressive effects.  Always remember, alcohol is a depressant and it’s this way because it acts on the inhibitory neurotransmitter in the brain called GABA.

How Foods Affect Our Neurotransmitter Levels

A few weeks ago I wrote a post about neurotransmission and how getting your neurotransmitters measured is a good way to assess your mood status and possibly change it for the better.  I went into the details of some neurotransmitters and it would be good to read before continuing to read this post.  Click here to view it.

The neurotransmitters in our brain allow one nerve to talk to the next.  It is the level of these neurotransmitters, to a large extent, that govern how we feel.  Low levels of some neurotransmitters lead to anxiety while others may lead to depression.  The interplay between all of them is complex and a problem with mood is often due to more than low levels of a single neurotransmitter but there are primary players to blame in each mood disorder.

Carbohydrate Heaven

Many people have noticed that when they eat a meal that is high in refined carbohydrates they notice an elevation in mood.  So much so that people can often become addicted to this type of food just to feel good.  This is for one very real physiological fact – eating refined carbohydrates increases serotonin production in the brain.

Serotonin is the neurotransmitter that most of the anti-depressant drugs like Prozac and Paxil work on.  They work by tricking the brain into thinking it has more serotonin than it actually does.  Consuming refined carbohydrates works by actually increasing serotonin levels.  Here’s how.

There is a barrier between our brain and our blood.  It prevents things from getting into the brain that should not.  It is very effective.  However, it also prevents necessary nutrients from getting in as well.  They need a special pass to  get in.  This includes the amino acid tryptophan. Tryptophan is what the body uses to make serotonin.  If one consumes a diet very low in tryptophan, serotonin levels are likely to be low.  Tryptophan is found in foods that contain protein.

In order for tryptophan (an other amino acids) to get into the brain a transporter system exists.  It is called the large neutral amino acid transporter or the LNAA.  Competition for the LNAA is fierce.  Tryptophan is a weak competitor.  It is often left out of brain except when refined carbohydrates are consumed. When refined carbohydrates are consumed high amounts of insulin are secreted.  Insulin sends free amino acids out of our blood into our muscles when it is circulating.  Because tryptophan is a bound to albumin it is left unaffected by this process.  It is now free to circulate up to the brain where competition for the LNAA is now low and it gets into the brain more easily.  It also allows more serotonin to be produced.

Now, I hear what you’re saying.  I am not suggesting you go eat tons of refined carbohydrates to feel good!  As a matter of fact you should avoid them because they just lead to a blood sugar crash later in the day resulting in irritability.  Now you’re irritable and depressed – not a good combination!

What you should do is make sure you eat foods that are high quality proteins.  This includes mostly animal products like meat and eggs.  Also, supplementing your diet with 5-HTP is helpful.  This is the direct precursor of serotonin and is in fact a type of tryptophan. It passes into the brain freely and does not compete for the LNAA.

Not Enough B6

Vitamin B6 is an essential vitamin in many ways.  In terms of brain health, it is essential to allow the conversion of the neurotransmitter glutamate into GABA.

Glutamate is the primary excitatory neurotransmitter in the brain.  When levels are too high seizures are known to occur.  At lower levels anxiety occurs.

GABA is the primary inhibitory neurotransmitter.  At very low levels seizures occur and when levels are slightly decreased anxiety is the result.

Glutamate ——–> GABA – GABA is converted from glutamate and B6 is required to do this.

A diet that is low in B6 will cause glutamate to build up in the brain and GABA levels will be low.  This may result in anxiety.  Foods that are highest in B6 are:

  • Spinach
  • Bell peppers
  • Turnip greens

Consuming these on a regular basis may help if your problem is the conversion of glutamate to GABA.  You may also have to supplement with B6.  This is easy to find over the counter.

No Fish? No Happy

Omega-3 fatty acids have been touted to help everything from heart disease to pain and inflammation.  Research also points to another aspect.  Brain health.  People who have the lowest level of a particular omega-3 called DHA report depression as a problem significantly more than people with the highest levels of DHA.

DHA is important for growing babies, but research is starting to show that it is important for overall brain health for adults as well.

Just how it wards off depression is not clear.  One theory suggests that because DHA is important for the insulation surrounding the nerves, low levels may prevent neurons from communicating effectively.  Whatever the reason, the research is pretty clear that low levels are not good for optimal brain function.

Consuming fish regularly is a good step.  However, more people will not be able to consume enough fish to get enough DHA.  Consider supplementing with a fish oil that is high in DHA.  Most nutrition companies now make fish oil that is high in DHA.  This may help ease your depression and prevent further episodes.

This list could go on and on.  The moral of the story is that what you eat can have a significant impact on how you feel.  If you want to feel good, inside and out, you must eat a healthy diet.  Hopefully some of these tips have helped.

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Anxiety or Depression? Test the levels of your neurotransmitters to guide therapy.

Depression

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Happy New Year!  A new era began at the Vreeland Clinic on January 1st this year.  Dr. Carrie and I would like to thank all of our friends and family for their well wishes.  We looked forward to continuing to serve the community for years to come!

Today I’d like to touch on something that has revolutionized the way I practice.

People come to me for many reasons.  Some people come to my clinic for weight loss or to get more energy.  Others for help with a chronic condition that hasn’t responded to traditional care.  Still others come to see me for a wide range of neurologic conditions.  These include things like Parkinson’s disease, multiple sclerosis, depression or anxiety.  It is the last two that I’d like to focus on today.

Anxiety and depression are extremely common in America.  Millions of Americans suffer from anxiety, depression or both.  These conditions may have many etiologies but one theory is a chemical imbalance in the brain.

Just what is this chemical imbalance?  When someone states that they have a chemical imbalance they are referring to an imbalance in the neurotransmitter system of the brain.  These neurotransmitters are really just proteins that each nerve in the brain uses to communicate with its neighbors.  Sometimes people can have too little of a certain neurotransmitter or too much of another.  This is problematic because it alters the way the brain functions.  It may cause anxiety and/or depression.

The pharmaceutical industry has figured that out and makes a large class of drugs that alters neurotransmitter function in the brain.  These are drugs like Prozac, Zoloft, Wellbutrin and Lorazepam to name a few.

Neurotransmitters are broken down into two categories – they are either excitatory or inhibitory.  That means they either tell the brain to go or tell the brain to stop.  The complexities of the neurotransmitter system are extensive and there is much more to it than “go” and “stop” but that basic principle holds true in most cases.

Examples of neurotransmitters include serotonin, GABA, epinephrine, norepinephrine, glutamate and dopamine.  Serotonin and GABA are inhibitory while epinephrine, norepinephrine, glutamate and dopamine are excitatory.

If you have anxiety and depression often times an imbalance exists in the levels of these neurotransmitters.

For example, high levels of glutamate may cause anxiety or seizures.  Low levels of GABA may cause anxiety.  Low levels of serotonin may cause depression.  Same goes for norepinephrine.

So how do you tell which neurotransmitters are low or which are too high?

Measuring Neurotransmitters

Measuring your neurotransmitters with a urine test is the best way to estimate your levels of neurotransmitters.  We do this routinely in our office for many patients.  It is incredibly insightful and directs our care for patients with anxiety, depression and many other conditions.

The measurement of neurotransmitters in the urine has been around for many years.  I’ve read studies dating to the 1960’s of scientists using similar methods to evaluate neurotransmitter levels.

Until relatively recently, perhaps the last 10-15 years, it has not been used frequently in clinical practice.  Now, through specialized laboratories, it is available to the general public and it is very affordable.

The knock on urinary neurotransmitter testing is that it does not correlate with brain levels of these hormones because the urine test is in fact testing whole body levels of neurotransmitters.

The very neurotransmitters that exist in our brain to make us happy exist outside the brain to serve the body in other ways.  So, yes, it is true that checking urinary neurotransmitter levels is technically a check of the entire body’s store of neurotransmitters.  But, through hundreds of thousands of tests these specialized labs have shown with high correlation that when neurotransmitter levels are abnormal certain psychiatric and neurological conditions are much more common.

Clinically, I have seen an almost one to one correlation in my patients with certain conditions an alteration in their neurotransmitter system.

The lab that I use will test all of the basic neurotransmitters plus a slew of metabolites of these neurotransmitters.  It provides a wonderful window into the neurological system.

If I find that serotonin is low, I supplement with something called 5-HTP.  If dopamine is low, I like to use L-tyrosine or an herb called mucuna pruriens.  The list can go on and on.

Once someone has been on a program for 6-8 weeks we recheck their neurotransmitter profile to gauge our therapy and adjust it if necessary.  We find that once a person’s profile returns to normal, their symptoms resolve.

If you have anxiety or depression, consider seeking out someone who does this kind of testing to improve your outcomes.  The brain is incredibly complex.  It never hurts to have a little extra information to guide your therapy.

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Fighting Depression Naturally

Depression

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Depression is a huge problem in the United States.  The numbers are quite amazing. Approximately 20.9 million American adults, or about 9.5 percent of the U.S. population age 18 and older in a given year, have a mood disorder. Depression is not just a disorder for adults, however. As many as one in 33 children and one in eight adolescents have clinical depression.

Depression is characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities. Unipolar depression, the most common mood disorder in the U.S., was first described by Hippocrates in the 5th century B.C. He believed that depression was caused by an imbalance in the four humors – blood, phlegm, yellow bile and black bile.  Excess black bile caused depression according to Hippocrates. In fact, the Greek term for depression, melancholia, means black bile.

This view may seem far fetched, but the fact that depression is a physical process is correct. Even Freud wrote of the various presentations of depression which range from mild and cognitive, to severe and somatic.
There are several ’causes’ of depression.  I put ’causes’ in quotes because no one really knows for sure what ’causes’ depression.  There are many theories.  In my opinion, an imbalance in the neurotransmitter system is a scientifically sound explanation as to how a person could develop a mood disorder.  I also like to consider that if a person is not in good general health, depression is more likely to take hold.  This is a view that is also supported by the research.
So if these are two ’causes’ of depression, how can we effectively treat it?  Good question.  See my answers below.

Get Healthy

First and foremost a person that is depressed must make every effort to get healthy.  This includes exercise and dietary changes.  Junk in equals junk out.  Period.  If all one eats is McDonald’s value meals they are very unlikely to be healthy and much more likely to develop depression in my opinion.  Did you ever see the movie SuperSize Me?  A documentarian decides to eat nothing but McDonald’s for 30 days to see what happens.  Not only did he fall apart physically but he developed depression! Now, this is just one case and is a bit anecdotal, but the result confirmed the  hypothesis I made before I even saw the movie.

You must eat a healthy diet in order for your body to work properly and be healthy.  For some reason modern medicine has separated the health of our body from the health of our minds.  It is widely understood that to have a healthy body we need to eat nutritious foods.  It is far less accepted that to have a healthy mind we need to have a healthy diet.  Why is this the case?  The food that we eat provides fuel to our bodies and to our brains. The same food nourishes our entire system, not simply our physical bodies.

Exercise is unbelievably critical.  In fact, research has shown that the #1 cure for depression lasting less than 7 years is exercise.  Exercise does many things for the body. It improves blood flow, is a great stress reliever and changes the chemical balance in the brain to name just a few.  If you feel as if you suffer from depression and you do one thing for yourself this should be the one.  It has long lasting benefits in terms of depression and helps get the rest of your body healthy as well.

Supplements to take

There are several supplements that have been shown to reduce depression.  I would not suggest trying them all at once.  And I would suggest you consult a physician that is trained in functional medicine before you start a program.

5-HTP

If your problem is low serotonin this may help you.  5-HTP is short for 5-hydroxytryptophan.  5-HTP is the direct precursor in the body for serotonin.  Taking it may increase your serotonin levels and improve your mood.

St. John’s Wort

This is an herbal product that is used here in the U.S. to help with depression.  It acts by affecting the serotonin system.  I have found that it helps some, but not all depressed patients.  It’s a popular depression treatment in Europe.

SAMe

Short for the chemical name S-adenosylmethionine, it is pronounced “sammy.”  This has worked well in my practice for many people.  It is available over the counter in the U.S., but it’s used in Europe as a prescription drug to treat depression.

Omega-3 Fatty Acids

Diets higher in omega-3 fatty acids are known to protect people from depression.  It also appears that consuming more omega-3s reduces the symptoms of depression.  Consuming more in one’s diet is not likely to be enough.  Most people will have to supplement their diet with the oil or capsules to gain the most benefit.

This is just a small sample of the things that one can do to naturally ease depression.  People are most successful when combine exercise, diet and supplements together.  It will give you the best chance of improving your mood and feeling happier and more alive.

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6 Things For Your Journey To COMPLETE Health

Apples are an all-American success story-each ...

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Being healthy is a journey.  You never arrive at ‘completely healthy.’  There are always going to be things that can be improved and worked on.  This requires a whole body approach.  This approach includes being physically active, watching your diet and supplementing it with the necessary nutrients.  I discuss that side of being healthy a lot.  Today I want to talk about the other thing you must do to be healthy – nourish the soul.  There are many things that can be done to nourish the soul, but today I’ll list a few to get you started.

Laugh

Laughter truly is the best medicine.  Laughing is an activity that everyone likes to do, but not everyone takes the time to do it.  Laughing reduces stress, improves mood and reduces circulating stress hormones that can potentially have negative effects on our health.  Take the time everyday to laugh.  It might be watching your favorite TV show or reading your favorite cartoon in the newspaper.  Whatever it is, take time to do it every single day.

Go on a Hike

This is a great way to get outside and enjoy the beautiful fall weather.  Up here in the Northeast, the foliage is out and looking spectacular.  Something about being outside on the top of a mountain is a great stress reliever and allows us to connect with nature.  It’s also great exercise!

Go Pumpkin Picking

This is a great activity, especially if you have small children.  And it’s a great time of year for it.  The pumpkins are out and need to be picked!  It’s a great way to enjoy some quality time with your family away from the house (and the TV!).

Go Apple Picking

Similarly to the above, apple picking is a wonderful outdoor activity that gets us out of the house.  Apples are ripe this time of year and most apple orchards will let you go picking for a small fee.  The best part is you get to keep the apples and eat them later.  It’s great for the soul and an apple a day keeps the doctor away.

Treat Yourself

Take yourself out for dinner (a healthy one of course!).  Buy yourself that new gadget you’ve held off on purchasing or get your nails done.  There are a million things you could do for yourself and sometimes those things just feel good.  Often times we put ourselves last and it’s helpful to move you up to the front of the line from time to time.

Meditate

Meditating, doing yoga or your variation of a spiritual pastime is a great way to reduce stress and slow down to enjoy the moment.  It allows you to just be…and nothing else.  It also allows the busy Mom or Dad to take time for themselves.  It doesn’t have to be long – just 10 minutes is sometimes enough to re-center your focus and get you through the day.

There are many more things that you can do, but the list above should help you get started.  Remember to be truly healthy you must have a healthy mind, body and spirit.

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