[CreatingVibrantHealth] The Nutritional Approach to Depression

[Guest guest]

TAKEN FROM: " The Way Up from Down " by Priscilla Slagle, M.D.

(website: www.thewayup.com)

 

What does the nutritional approach to depression really mean? What is it

all about... lets look at the idea briefly..

 

Medical science now understands a great deal about the specific chemicals

that exist in our brains. In particular, certain chemicals known as the

brain amines seem to be directly connected with the way we feel about life.

We have discovered that people who suffer from depression often have an

insufficient amount of these amines in their brains.

 

The nutritional approach to depression proposes that if the brain's balance

of these chemicals can be restored, the depression itself is likely to lift.

If you are not enjoying life, a simple chemical imbalance may be largely

responsible for causing your suffering.

 

Fortunately, the brain chemicals in question can be created by increasing

the amount of certain nutrients - vitamins, minerals and amino acids - in

your diet. These nutrients really can lift depression.

 

Serotonin and Noreprinephrine

 

Serotonin and norepinephrine are the most significant neurotransmitters that

are depleted in the brains of those who are depressed. Norepinephrine is

present in excess in the brains of those experiencing mania, which is, in

many ways, the opposite or obverse of depression.

 

....Since norepinephrine and serotonin belong to a chemical group called the

amines, the theory of depression that emerged from all this very persuasive

research became known as the " brain amine (or monoamine) theory of

depression. 90% of these amines are located in the area deep in the brain

known as the limbic system. This system controls emotions, pain perception,

sleep, and involuntary functions such as digestion, elimination and so on.

 

Because the amines are so important, the normally functioning brain has a

mechanism for conserving them. This process is called 'reuptake'. After the

reaction takes place, the nerve cell takes back about 85% of the amines it

has released and conserves them for later use. The other 15% is broken down

by an enzyme called MAO (monoamine oxidase) and usually leaves the body in

the urine. Thus, in the normal brain only 15% of the amine concentration

regularly needs to be newly manufactured in order to keep the nerve cell

communication mechanism going.

 

What can happen to foul this astonishing chemical process?

 

1. There may not be enough amines in the first place because of inadequate

" raw materials " or precursors, chiefly amino acids, and their necessary

cofactors, enzymes, vitamins and minerals.

 

2. There may be a genetically determined excessive ned for the substances

required to form the brain amines.

 

3. The reuptake mechanism may not be functioning properly.

 

4. There may be too much MAO so there is excessive destruction of the

amines. This tendency toward excess MAO may be inherited. Also, as we age,

we have increased MAO, a factor leading to higher risk for depression in the

elderly.

 

5. The receptor cells may not be properly sensitive or receptive to a

normal level of the amines.

 

The common purpose of all biochemical treatments for depression is to

increase the amount of these neurotransmitters at the synapse. Some drugs,

such as the tricyclics, block the reuptake mechanism, allowing more amine to

accumulate in the synapse. Others, such as the MAO inhibitors, block the MAO

enzyme and slow the breakdown. Other drugs increase the sensitivity of the

receptor cells and still newer and newer medicines act by mechanisms we've

yet to understand.

 

The precursor nutrients (amino acids, enzymes, vitamins and minerals) appear

to b the safest, most effective way of increasing the brain amine levels.

They simultaneously increase both norepinephrine and serotonin, while the

more traditional antidepressant drugs generally increase only one or the

other of these brain amines and may not work if both amines are depleted.

 

To put things bluntly, the research and results indicate we are almost to

the point where ignoring such chemical factors in a person with major

depression might constitute negligence, if not malpractice.

 

This antidepressant therapy:

 

1. Has far greater overall safety than conventional drug therapies;

2. Is preferable for long-term use;

3. Can be effective with intermittent usage;

4. Offers associated health benefits such as improved overall energy,

improved mental and physical endurance and functioning, decreased infections

and a myriad of other health benefits that can accrue from a basic balanced

nutritional program;

5. Can prevent further depressive episodes;

6. Has flexibility, in that it can be adjusted to deal with a large variety

of symptoms;

7. Has no associated withdrawal symptoms;

8. Has almost no toxicity and is virtually immune to dangerous misuse (in

contrast, for example, to many standard antidepressant drugs);

9. Is composed of water soluble substances that don't accumulate in your

brain or other tissues;

10. Is metabolized by enzymes in your body;

11. And finally, relies on your brain's own remarkable ability to override

and to shut off the process if the neurotransmitter concentrations become

too high.

 

 

The Program Explained

 

Our basic supplements are the amino acids, L-tyrosine and L-tryptophan,

Vitamin B complex, Vitamin C and a multivitamin mineral. Generally, for

more predictable and more rapid absorption, I recommend all supplements be

taken in capsule or powder form rather than in hard tablets. (The " L " and

" D " in these names refer to the chemical rotation of the molecules).

 

L-Tyrosine

 

Take 500 - 3500 mg when you get up in the a.m., and again in the

mid-afternoon.

 

This should not be taken with any protein food because you will absorb less

of this amino acid if other types of protein are being digested at the same

time. I recommend you take it with some water, and that you don't eat

anything else for at least 30 min.

 

Begin with 500-1000 mg 2x daily for one week. If you feel no improvement

after one week, gradually increase your dosage, staying at each increased

level for one week. In other words, if you started with one pill 2x daily

the first week, you would raise it to two pills 2x daily the second week as

needed, and so on. Do not exceed the maximum daily dosages listed here...

This warning is not because adverse effects have occurred at higher doses,

but becaus little is known about the long-term effects of higher amounts.

 

With all supplements, including the amino acids, stop and stay with the

amount that works for you and remain on this minimum effective dosage.

 

L-Tryptophan

 

Take 500 to 6000 mg at bedtime

Tryptophan, too should not be taken with any protein food, for the reason

given above. There won't be any problem if you take it with water or some

carbs. Actually, simultaneous ingestion of tryptophan with carbs can

increase the absorption of tryptophan. Note that if you have severe sleep

problems, you must try to avoid night-time sugar, fruits and fruit juices as

they will stimulate you when you want to be calming down. The exception is

grapefruit which has a sedative effect due to its high magnesium content.

 

Vitamin B complex

 

Take 50-100 mg with breakfast and again with the evening meal. (the 50-100

refers to the amounts of B1, B2 and B6 in the product. The other ingred's

will often be in amounts other than 50-100mg).

 

Deficiencies of almost any of the B vitamins can cause depression, so their

importance cannot be overemphasized. When low mood or depression is

complicate d by circumstances such as severe strss, illness and certain

dietary habits which have nutritionally depleted you, very large supplements

of B complex vitamins may be necessary. The recommended dosages in the

basic program are conservative and completely safe.

 

B complex vitamins are OFTEN YEAST BASED. To avoid the occasional probelm

with yeast, or other allergy reactions I prefer that the B complex be

yeast-free and hypoallergenic.

 

When you buy a multi-B vitamin, it contains the whole range of B vitamins.

Different manufacturers create products with slightly varying ratios of one

ingredient to another. Don't worry if what you find is not exactly what is

listed here as long as the amounts generally parallel these. When possible,

obtain a product with the Vit.B1, B2 and B6 in what are called the co-enzyme

forms. The approximate dose ranges that follow should be available in a

single supplement:

 

B1 - Thiamine hydrochloride 50-100 mg

B2 - Riboflavin 5 Phosphate 50-100 mg

B3 - Niacinamide or Niacin 30-100 mg

B5 - Calcium pantothenate 100-500 mg

B6 - Pyridoxal5-phosphate 10-120 mg

B6 - Pyridoxine hydrochloride 50-100mg

Choline 100-300mg

PABA 30-100mg

Biotin 100-400mg

Folic Acid 100-400mg

B12 100-500mg

 

IF your B complex vitamin does not contain vitamin B6 in the

pyridoxal-5-phosphate form, you will need to find this form of Vitamin B6,

and add it to your program separately, 20-120 mg twice daily. Try to buy

Vitamin B6 that is coated so that it will not be destroyed by stomach acid

(these products can be found at www.thewayup.com Dr. Slagle's site)

 

Vitamin C

 

Take 500-2,000 in the morning and again with dinner.

 

This can be taken with your first food in the a.m. and with your evening

meal. Use a corn-free vitamin C compound.

 

Multivitamin Mineral Capsule - Take half the daily dosage in the a.m. and

1/2 in the evening. (excellent quality multi's again at www.thewayup.com )

SHE DOES LIST IN HER BOOK EVERYTHING NEEDED IN THE MULTI - If you want me to

type it out ... let me know - wendy)

 

In the MULTI-vitamin/mineral formula - copper is excluded, even though it is

required for neurotransmitter formation. Copper deficiency is rare, more

often we find a copper excess - which can create depression asa one of its

symptoms. If your multi-vitamin does contain copper, it should be no more

than 500 micrograms (0.5mg).

 

Iron has also been omitted. If you are pregnant, menstruating, a

vegetarian, poorly nourished, are over 70 years of age, or have any evidence

of iron deficiency, use a multi-vitamin mineral which contains amino acid

chelated iron in the amount of 50-200mg. Unless you fall into one of these

categories, use iron-free supplements.

 

Please note that the amount listed on the side of the bottle is usually for

anywhere from 1-6 capsules daily to provide the specified dosage. In other

words, to get what you need you may have to take 1-3 capsules in the a.m.

with your first food, and the same amount with your evening food. YOu will

notice I have said " capsules " .... not tablets. You can also use powder or

liquid forms, if available. Tablets can sometimes pass right through you,

and not be digested at all. This was reported to me often enough for me to

realize the best laid plans can go awry. Now I suggest the use of capsules

whenever possible, unless you have a sensitive stomach and want very slow

release to avoid the p

possibility of irritation.

 

A common Adjustment to the Basic Program

 

If after 4-6 weeks there insufficient results, one of the first things I do

is to add L-phenylalanine to the program. If a person initially has

physical pain as a part of her depression, I add D,L-phenylalanine right

from the beginning.

 

L-phenylalanine or D,L-phenylalanine

 

Use 1,000-3,000 mg in the midafternoon with food to replace the afternoon

tyrosine dosage. Continue taking the tyrosine in the a.m. More research has

been done on the use of phenylalanine than on the use of tyrosine for

treating depression, but since my patients have generally had better results

and better tolerance with tyrosine, i prefer to use it.

 

As Dr. Arnold Fox, described in " DLPA to End Chronic Pain and Depression " ,

the D form of phenylalanine helps relieve pain by slowing the breakdown of

pain-relieving endorphins in the brain.

 

L-phenylalanine can convert to tyrosine, but it also has other important

metabolic pathways, one of which is to form a substance called 2-PEA

(2-phenylethylamine). PEA is believed to be a neurotransmitter which is

closely related to norepinephrine. The amphetamnes, the stimulant Ritalin,

and the antidepressant Tofranil all cause an increase of 2-PEA in the brain,

and this is one mechanism through which they exert their excitant effects.

 

Some depressed people have insufficient 2-PEA and when this is so,

phenylalanine may be necessary. Since PEA is more of a direct stimulant

than norepinephrine, phenylalanine usage can give those people who don't

apparently need the extra PEA a " wired " feeling. This is one reason why it

is not usually my first choice, but only needs to be added in approximately

10% of cases.

 

WHERE can I get these supplements?

 

You may purchase the supplements at health food stores, at pharmacies or by

mail. I prescribe very specific products because I feel relatively certain

of their quality and potency. On a number of occasions, people who have

been doing very well using a certain product have then run out and replaced

it with an inferior product and relapsed. When we figure out what has

happened and use the original brand, they again improve.

 

When possible, buy encapsulated hypoallergenic supplements, which have no

corn, yeast, sugar, dyes, preservatives, or other additives.

 

**It really matters what quality of Amino Acids are used**

 

THE FORMS OF THE AMINO ACIDS

 

The chemical form of the amino acid is extremely important. For precursor

loading to work properly, the amino acids must be taken in fairly large

doses to make sure the digestive system manages to absorb enough of them.

Further, they must be taken in what is called the singular " free form " . This

means they do not have to go through complicated digestive processes that

may or may not occur, but are in the form that is ready for immediate

assimilation and use by the body. This clearly bypasses the problem of poor

digestion interfering with their usefulness. These free form amino acids are

so pure and effective they are the official food supplement for astronauts,

for U.S.S.R. parachute jumpers, for some professional athletes and for

others who must have optimal performance. Extra protein, protein powders or

protein supplements are NOT the same and will not give good results. If you

use them for other purposes, they must be taken at a different time than the

singular free form amino acids or they will interfere with the program.

 

There are many different kinds of amino acids on the market - basically 4

different grades are available:

 

THE FEED GRADE

The first is called the feed grade, because it is used in animal-feed

supplements. Ironically, these are the amino acid tablets that are often for

sale in health food stores. The problem here is that when the amino acids

are heated and compressed into tablets during manufacturing, they may lose

some of their potency. Hard tablets sometimes go right through your body

without breaking up or being digested, and its not clear how much of the

amino acids you are assimilating. Although they are the least expensive, I

don't recommend feed grade supplements.

 

THE COSMETIC GRADE

This second grade of amino acid is used in shampoos, hair conditioners, face

creams and so on.

 

THE PHARMACEUTICAL GRADE

The pharmaceutical grade is a pure, potent amino acid, used by drug

companies that manufacture amino acid-related products used in most high

quality supplements.

 

THE IV GRADE

This grade of amino acid is pure enough to be used intravenously. It is

more concentrated, and, not surprisingly, is the most expensive. It is not

readily available and is not used in oral supplements.

 

MY OWN RECOMMENDATION

My patients use the pharmaceutical grade with good, consistent results.

Take it in powder or capsule form. Again, remember to look for what are

called " free form amino acids " .

 

YEARS of practice have convinced me that EVERYONE who improves his diet and

takes appropriate supplements will benefit. Therefore, anyone who reads this

book and selects those elements which relate to him/her will be helped -

whether or not he is actually depressed.

 

But if you have low mood or depression, this treatment has a good chance of

working if you take the supplements regularly and as directed. It will work

even better and more lastingly if you are willing and able to change your

thought and life patterns.

 

PRISCILLA SLAGLE, M.D. - " The Way Up From Down " (www.thewayup.com)

 

 

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