January 31, 2012

American Psychiatric Association Task Force on supplements for major depression

Posted in depression, fish oil, folic acid, SAMe, St. Johns Wort tagged , , , , , at 6:09 pm by jarebe

The American Psychiatric Association recently commissioned a task force to study the state of “alternative and complementary” therapies for major depression. This follows widespread interest from the scientific community and a considerable accumulation of research to date. The Task Force reported in a 2010 article that focused special attention on these supplements: omega-3 fatty acids (commonly taken as fish oil supplements), St John’s Wort (the botanical Hypericum), Folic acid (a synthetic form of folate, a B vitamin found in leafy green vegetables, citrus fruits, beans, and fortified breads and cereals), and S-adenosyl-L-methionine (SAMe).

We welcome this acknowledgment by the mainstream US medical establishment that supplements have a role to play in treating a disabling condition that affects millions of people per year, and is not always easily treatable. (Only one-third of adult patients newly diagnosed with major depression achieve complete symptom relief when taking one antidepressant, so there is often an extended search for the right combination of drug and other treatment needed for remission.)

Below is a brief recap of some of the latest thinking on these key supplements for depression. Of course NYBC recommends that you use these supplements in consultation with your healthcare provider. More information on these supplements can be found by following the links to the NYBC website.

Omega-3 Fatty Acids (fish oil) recommended as a stand-alone treatment for people concerned about side effects, such as those with multiple medical conditions. It has also been combined with other antidepressants as an adjunct therapy. Fish oil’s blood-thinning property makes it problematic for doses above 3g/day. Added benefit: fish oil supports cardiovascular health.

St. John’s Wort is an herb widely studied and used, especially in Europe, for mild to moderate depression, though it hasn’t proved effective for major depression. Those taking protease inhibitors or certain other drugs should avoid St. John’s Wort because it interferes with their action.

SAMe (S-adenosyl-l-methionine). Supplementing with SAMe increases concentrations of neurotransmitters that influence mood, and multiple studies have confirmed its antidepressant effect. A dose of 400-800mg/day has been studied for mild-to-moderate depression, and 800-1600mg/day for moderate-to-severe. Studied as a stand-alone treatment, or as an adjunct treatment. Added benefit: SAMe supports joint health and liver function.

When combined with an antidepressant, folic acid supplements can improve symptoms, particularly in women. However, folic acid supplements are not a stand-alone treatment for depression. The safe upper limit is 1,000 mcg per day.

March 31, 2011

Supplements for the Brain (and Nerves)

Posted in Acetylcarnitine, alpha lipoic acid, Alzheimer's Disease, Antioxidants, anxiety, B vitamins, cardiovascular health, cognitive impairment, Curcumin, depression, evening primrose oil, fish oil, gingko biloba, HIV, mental health, Multivitamins, NAC (N-acetylcysteine), neuropathy, Omega-3, resveratrol, Vitamin B12 tagged , , , , , , , , , , at 10:24 am by jarebe

“For Your Peace of Mind…”

Recent research on supplements for memory, cognition and other neurological functions
You may remember (we hope you remember!) the Scarecrow’s petition to the Wizard of Oz for a brain. Be advised–we at NYBC do not stock new brains, so don’t come to us with that request.

However, we do follow the sometimes startling new research on supplements, brain function and related neurological issues. In this department, there’s special cause for concern for people with HIV. According to a Canadian study released in 2010, in a group of 1615 people receiving treatment for HIV during the decade 1998-2008, one fourth had neurological problems, including memory loss, cognitive impairment and peripheral neuropathy. Of course being worried about brain function–and neurological function in general–is not unique to people with HIV. As people age, they are more likely to experience memory loss or forms of dementia such as Alzheimer’s. And the nerve condition called peripheral neuropathy (pain, tingling in the feet and hands) is found not just in people with HIV, but also among the growing population with Type 2 diabetes.

Now, on to what we see as some of the most valuable recent findings about supplements and brain or neurological function:

B vitamins can be considered a foundation because they are needed in so many processes essential to the brain’s operation, from energy supply and healthy blood flow, to the formation of neurotransmitters (=chemical messengers of neurologic information from one cell to another). Furthermore, there is evidence that several groups of people, including those over 60 and those with HIV, have a greater risk for Vitamin B deficiencies. So supplementing with a B complex vitamin is a sensible start to cognitive health. More specifically, there is good research linking deficiency of vitamins B12 and B6 to mood disorders like depression—and depression earlier in life is associated with higher risk of dementia in later life. Last, there is also some evidence that B vitamins may reduce stroke risk in older people.

Omega-3 fatty acids (fish oil) support cognitive health in a variety of ways. In 2008, UCLA researchers reported on a lab study showing that the omega-3 fatty acid DHA, together with exercise, improved cognitive function. This caught our attention, because there is wide agreement that regular exercise strongly supports brain function as we age, and here the suggestion is that omega-3 fatty acids multiply that known benefit. A diet rich in omega-3 fatty acids/fish oil has also been linked to lower risk of depression—another plus. And still more: recent research found that omega-3 fatty acids block the development of retinopathy, a chief cause of blindness as we age. (The retina of the eye is actually part of the brain–it is full of nerve cells essential for vision.) All in all, the neurological benefits of omega-3 fatty acids seem both wide-ranging and quite convincing, so it’s high on our recommended list.

The amino acid acetylcarnitine has shown benefit for brain function in a number of studies with humans. In the last decade, acetylcarnitine has also been investigated for peripheral neuropathy in people with HIV. (Some recommend using it with evening primrose oil and Vitamin C.) A 2008 study found that acetylcarnitine influences a chemical process in the brain that triggers Alzheimer’s, so researchers are continuing to puzzle out how this supplement produces its neurological benefits.

Antioxidants. There’s much suggestive research about how antioxidants counter destructive oxidative processes in the brain, thus blocking memory loss and cognitive decline. For example, a 2003 report found that the antioxidant combination alpha lipoic acid and NAC reversed memory loss in aged laboratory mice. And there’s also been a lot of attention to the combination acetylcarnitine and alpha lipoic acid for memory impairment. Furthermore, other antioxidants such as curcumin are under study for their potential to fight the processes that lead to declining brain function.

Acetylcholine. The first neurotransmitter to be identified, acetylcholine is closely associated with memory, with lower levels linked to memory loss. NYBC currently stocks two combination supplements that support acetylcholine levels in the brain, while also providing other nutrients for neurological function: Neuro Optimizer (Jarrow), which includes acetylcholine enhancers, acetylcarnitine, and alpha lipoic acid; and Think Clearly (SuperNutrition), which includes B vitamins, as well as acetylcholine enhancers and a botanical traditionally used for cognitive support, ginkgo biloba.

Resveratrol. In the past decade, there has been intense scientific interest in this compound, most famously found in red wine. While some research ventures have hoped to find in resveratrol a life-extending supplement (a capacity demonstrated in animal studies), others have focused on its therapeutic value for conditions like diabetes or cognitive decline. For example, Cornell researchers reported in 2009 that resveratrol reduced the kind of plaque formation in animal brains that causes Alzheimer’s. And a year later another lab investigation, this one at Johns Hopkins, found that a moderate dose of the compound protected animal brains from stroke damage.

Ginkgo biloba, a botanical derived from Earth’s most ancient tree species, has been widely used for cognitive function. In the late 1990s, two reviews of dozens of ginkgo studies concluded that it could improve symptoms of dementia. However, a long-term trial of ginkgo published in the Journal of the American Medical Association in 2008 found that the supplement did not prevent development of dementia in a group of more than 3000 older people who had normal cognitive function at the start of the research. One possible conclusion: ginkgo may help symptoms of cognitive decline, but doesn’t address underlying causes.

NYBC’s RECOMMENDATIONS: A B complex supplement (like Jarrow’s B-right) and fish oil (like Jarrow’s Max DHA) are foundations for maintaining cognitive health, especially important for people with HIV or people over 60. There is some evidence for acetylcarnitine, alpha lipoic and acetylcholine supplementation for memory impairment and possibly for cognitive decline. Acetylcarnitine and other supplements can be used to address peripheral neuropathy. And stay tuned for emerging research on preserving brain function with compounds like resveratrol, NAC and curcumin.

February 25, 2011

Supplements for Depression

Posted in depression, DHEA, fish oil, mental health, Omega-3, SAMe, Tryptophan tagged , , , , , at 2:13 pm by jarebe

We’ve updated our info sheet on supplements and depression–see below. See the NYBC entries for further information on DHEA; 5-HTP; SAMe; St. John’s Wort;
Fish oil (Max DHA); Tryptophan.

In recent years there’s been a lot of well-designed scientific research about the effectiveness of dietary supplements for depression. The supplements studied have ranged from the herb St. John’s Wort, which has a long tradition of use, to molecules like SAMe, L-Tryptophan, and 5-HTP, which play a role in the body’s production of neurotransmitters (such as serotonin) connected with mood and cognitive function. Other developments in depression research involve the steroid DHEA and fish oil.

DHEA (Dehydroepiandrosterone). In a study sponsored by the National Institute of Mental Health, DHEA was found to be an effective therapy for mild to moderate or severe midlife depression, on a par with some prescription drug treatments. Moreover, the NIMH research showed that taking DHEA promoted both a significant lifting of depressive symptoms and an improvement in sexual functioning. (On the other hand, inhibition of sexual function remains one of the chief troublesome side effects of prescription anti-depressants). Note that dosing recommendations vary for men versus women, and DHEA is not recommended for those diagnosed with prostate problems or cancer.

SAMe (S-adenosyl-l-methionine). First studied by Italian researchers in the 1950s, SAMe is produced naturally in the body from the amino acid methionine. Supplementing with SAMe increases concentrations of the neurotransmitters serotonin and L-dopamine, which are related to mood. Several studies show SAMe having an anti-depressant effect comparable to that of some prescription drugs. A dose of 400-800mg/day has been studied for mild to moderate depression, and 800-1600mg/day for the moderate to severe condition. As of 2007, SAMe was being compared with the prescription drug Lexapro® in a 5-year NIH-funded study. SAMe generally has fewer side effects than prescription anti-depressants. However, it should be avoided in people with bipolar disorder, and should be used cautiously with other anti-depressants, because the combination may push serotonin levels too high. Taking a B-complex vitamin while using SAMe can counter build up of homocysteine, which is associated with heart disease. (It’s best to take them separately.) SAMe also supports joint health and liver function, so may have positive effects for overall health if taken over the long term.

St. John’s Wort is a widely used herb with clinically demonstrated (multiple, well-controlled studies, mostly in Europe) anti-depressant effects for mild to moderate depression – generally without the side effects of prescription antidepressants. High doses of the herb may cause a sensitivity to light (phototoxicity), so avoid direct sunlight or sunbathing while using. Do not take St. John’s Wort with 5-HTP, serotonin re-uptake inhibitors (like Prozac), or with protease inhibitors, as it my affect beneficial liver enzymes. St. John’s Wort may also have activity against Epstein-Barr and herpes infections.

L-Tryptophan and 5-HTP (5-hydroxy L-tryptophan): These closely-related supplements are converted in the body to serotonin and to melatonin. (Specifically, L-Tryptophan converts to 5-HTP, which then converts to serotonin or melatonin.) Their use as antidepressants has been studied, and they have also been found to aid sleep and suppress appetite. (To minimize appetite suppression, try taking the supplement an hour before bedtime.) Mild gastrointestinal side effects have been reported with both. For best absorption, take with water or juice, and separately from protein-containing foods and dietary supplements. Although L-Tryptophan and 5-HTP are close relatives, people may respond somewhat differently to them. Thus, if encountering unwanted side effects or lack of effect from one, it may still be worthwhile to try the other.

The suggested dosage for 5-HTP is wide, ranging from 50 and 500 mg daily. It can be used together with other anti-depressants, in which case an effective dose could be quite low. The best approach is to start at the low end of the range and increase as needed. Like 5-HTP, L-Tryptophan has been used in combination with other anti-depressants, and has also been employed with lithium for bipolar disorder. An added benefit: 5-HTP may also decrease symptoms of fibromyalgia and migraine headaches.

Fish Oil. Epidemiological studies have suggested that populations that eat fish regularly have low rates of depression. More recently, research has found fish oil supplements (omega-3 fatty acids being the significant component) of benefit in treating depression and bipolar disorder. It’s also worth noting that fish oil can be taken with other anti-depressants as an adjunct therapy. Doses found effective in treating depression are quite high, 3 to 9 grams per day, so be aware of potential problems related to the supplement’s blood-thinning properties. Added benefit: as has been widely reported, fish oil can have a beneficial impact on cholesterol regulation and in supporting cardiovascular health.
_____________________________________________________________________________References:
REFERENCES: Christian R. Dolder, “Depression,” in Natural Products: A Case-Based Approach for Health Care Professionals, ed. Karen Shapiro, published by the American Pharmacists Association, Washington, DC (2006), pp. 97-114.
Shaheen E Lakhan and Karen F Vieira. “Nutritional therapies for mental disorders” in Nutrition Journal (2008), 7:2doi:10.1186/1475-2891-7-2. Accessed 10/7/2009 at http://www.nutritionj.com/content/7/1/2
Schmidt PJ, et al. “Dehydroepiandrosterone Monotherapy in Midlife-Onset Major and Minor Depression,” Archives of General Psychiatry (February 2005): Vol. 62, No. 2, pp. 154–62.
Hyla Cass, “Prescriptions for Depression,” in Supplement Your Prescription: What Your Doctor Doesn’t Know About Nutrition. Basic Health Publications (2007), pp. 113-128.

November 11, 2010

Be here now!

Posted in anxiety, cognitive impairment, depression at 7:57 pm by jarebe

Does your mind wander a lot? This CAN be a good thing as it can be a way of roaming around the world and generating new ideas.

But on a day-to-day basis, recent research suggests that nearly half our waking hours can be spent with a mind that wanders into areas that result in unhappiness. It is intriguing research and underscores the potential value of mindfulness meditation. Click on this sentence to read a fascinating review of the research.

Meditation is very simple–and very difficult. You just sit and breathe. And the more you practice it, the easier it gets. Like exercise, you just have to make time for it. There are many techniques but they revolve mostly around sitting quietly, in a relaxed way, focusing on the breath. Breathe in, breathe out. Focus on the breath and simply allow the thoughts of the mind to arise (the agitation, the distractions, the concerns, the joys) and simply return to thinking about the breath.

Walking and exercising can also be opportunities to meditate. Concentrate on simply being here now…the more you do it, the more the practice becomes a part of your life. And gradually, one’s outlook can shift, relax, and create a greater sense of happiness.

It would be great if this was something we taught from early childhood. Like gym class or art or social studies–a time just to relax and create a happy habit. (Other research shows you have to give it a few months to create a new good habit!)

August 20, 2010

SAMe helps depression

Posted in depression, SAMe at 11:44 am by jarebe

While this is not a study involving people living with HIV, there is good reason to believe that SAMe may be helpful in the depression that may arise with HIV disease.

S-Adenosyl Methionine (SAMe) Augmentation of Serotonin Reuptake Inhibitors for Antidepressant Nonresponders With Major Depressive Disorder: A Double-Blind, Randomized Clinical Trial
George I. Papakostas, M.D., David Mischoulon, M.D., Ph.D., Irene Shyu, B.A., Jonathan E. Alpert, M.D., Ph.D., and Maurizio Fava, M.D.

Objective: Despite the progressive increase in the number of antidepressants, many patients with major depressive disorder continue to be symptomatic. Clearly, there is an urgent need to develop better tolerated and more effective treatments for this disorder. The use of S-adenosyl methionine (SAMe), a naturally occurring molecule that serves as a methyl donor in human cellular metabolism, as adjunctive treatment for antidepressant nonresponders with major depressive disorder represents one such effort toward novel pharmacotherapy development.

Method: Participants were 73 serotonin reuptake inhibitor (SRI) nonresponders with major depressive disorder enrolled in a 6-week, double-blind, randomized trial of adjunctive oral SAMe (target dose: 800 mg/twice daily). Patients continued to receive their SRI treatment at a stable dose throughout the 6-week trial. The primary outcome measure for the study was the response rates according to the 17-item Hamilton Depression Rating Scale (HAM–D).

Results: The HAM–D response and remission rates were higher for patients treated with adjunctive SAMe (36.1% and 25.8%, respectively) than adjunctive placebo (17.6% versus 11.7%, respectively). The number needed to treat for response and remission was approximately one in six and one in seven, respectively. There was no statistically significant difference in the proportion of SAMe- versus placebo-treated patients who discontinued the trial for any reason (20.6% versus 29.5%, respectively), due to adverse events (5.1% versus 8.8%, respectively), or due to inefficacy (5.1% versus 11.7%, respectively).

Conclusions: These preliminary results suggest that SAMe can be an effective, well-tolerated, and safe adjunctive treatment strategy for SRI nonresponders with major depressive disorder and warrant replication.

Am J Psychiatrya 2010; 167:942-948
(published online July 1, 2010; doi: 10.1176/appi.ajp.2009.09081198)
© 2010 American Psychiatric Association

June 25, 2010

Symptoms common, often ignored by docs

Posted in Acetylcarnitine, alpha lipoic acid, cognitive impairment, depression, diarrhea, fatigue, gastrointestinal health, Glutamine, immune support, mental health, neuropathy, Vitamin B12 at 1:18 pm by jarebe

A recent report underscored the myriad symptoms and problems facing significant numbers of people living with HIV. The study involved 751 patients enrolled in the Veterans Aging Cohort Study, undertaken between 1999 and 2000. Commonly reported symptoms included fatigue (71%), difficulty sleeping, depression, muscle aches and diarrhea (each reported by 60% of the respondents). Over 50% of patients reported headache, difficulty remembering, tingling hands or feet (neuropathy), weight loss and body shape changes.

The worry is that some may be associated with meds and this may reduce adherence to drug schedules. This can lead to resistance, etc. Which is why we at NYBC take very seriously the methods and means that may be available to manage some of these side effects. Diarrhea has been managed in studies that investigated agents like calcium and glutamine. Acetylcarnitine has some benefit for nuke-related neuropathy. You can review our literature on what we know (and need to learn more) about such interventions along with the different symptoms and side effects people experience and how they can be managed.

The study included about 54% African American. The study noted that healthcare providers often don’t recognize these as important symptoms. Perhaps this is why there is a strong racist element within American health care, one that arises out of blindness and ignorance as much as any overt hostility.

The second aspect of such care is that many people, of every ethnicity, are economically impoverished. So how can many people access sometimes costly, nearly always out-of-pocket agents like acetylcarnitine? NYBC is working on ways to make this possible, though we will need additional help to assure such access. State-run programs like ADAP and Medicaid can help in some states–but many of these programs are facing cuts due to tight budgets. Tight budgets induced by banks getting a socialized bailout for their malfeasance while Americans suffer?

So political activism will remain a key component in any comprehensive effort to provide care and treatment that includes the types of agents NYBC investigates and makes available. Ongoing research into dietary supplements and the ways in which they may improve health outcomes, enhance adherence to medications, reduce side effects and lower the burden of public costs by reducing morbidity and mortality are keenly needed.

March 31, 2010

Top search terms bringing visitors to this blog

Posted in Acetylcarnitine, alpha lipoic acid, B vitamins, cardiovascular health, cholesterol, depression, diarrhea, evening primrose oil, Florastor, gastrointestinal health, Glutamine, HIV, NAC (N-acetylcysteine), neuropathy, Saccharomyces boulardii, sterols, Vitamin D tagged , , , , , , , , , , at 1:08 pm by jarebe

Dear NYBC Blog Reader,

Thought you might be interested to see some of the most popular search terms that brought people to the New York Buyers’ Club Blog in the past year:

1. “Saccharomyces boulardii C difficile”
2. “glutamine ulcerative colitis”
3. “cholesterol lowering supplements”
4. “B vitamins depression”
5. “HIV Vitamin D”
6. “vitamins for neuropathy”
7. “Tylenol antidote”

And here, in very brief form, is the information these searchers found on the NYBC Blog:

Saccharomyces boulardii, which NYBC stocks in the form of Florastor, appears in a recent study to be the best probiotic for the stubborn gastrointestinal infection C. difficile.

Glutamine has shown effectiveness in reducing symptoms of ulcerative colitis and other gastrointestinal conditions in a number of research studies.

Plant sterols, fish oil, niacin, pantethine have been studied for cholesterol control.

B vitamins strongly affect mood and memory, and addressing a B vitamin deficiency can improve depressive symptoms.

Vitamin D deficiency is widely prevalent among people with HIV, and supplementing with 1000IU/day of D3 plus 1000mg/day of calcium may be a good way to support bone health for people taking HIV meds. Other research has noted the link between Vitamin D deficiency and cardiovascular disease, certain cancers, and susceptibility to cold and flus.

Acetylcarnitine, alpha lipoic acid and evening primrose oil are among the supplements studied for diabetic or HIV-related neuropathy (pain, tingling in feet, hands).

NAC (N-acetylcysteine) is used as the antidote to acetaminophen overdose. Acetaminophen is the active ingredient in Tylenol and is added to many other over-the-counter drugs, so overdose leading to liver damage or liver failure has become common in the US.

December 1, 2009

NEW! Managing and Preventing HIV Med Side-Effects

Posted in Acetylcarnitine, acidophilus, alpha lipoic acid, anxiety, B vitamins, bone health, calcium, cardiovascular health, Carnitine, cholesterol, Chromium, Coenzyme Q10, depression, DHEA, diabetes, diarrhea, digestive enzymes, fatigue, fish oil, Florastor, GABA, gastrointestinal health, Glutamine, hepatitis, HIV, immune support, insulin resistance, K-Pax alternative, lecithin, lipodystrophy, liver disease, mental health, milk thistle, Multivitamins, NAC (N-acetylcysteine), nausea, neuropathy, Niacin, Omega-3, pantethine, PharmaNAC, Probiotics, Saccharomyces boulardii, SAMe, sexual function, silymarin, sleep aids, sterols, THE SUPPLEMENT - Newsletter of NYBC, theanine, ThiolNAC, Traditional Chinese Medicine, triglycerides, Tryptophan, Vitamin B12, Vitamin C, Vitamin D tagged , , , , , , , , , at 12:18 pm by jarebe

To mark its fifth anniversary, the New York Buyers’ Club has prepared a special edition of SUPPLEMENT. In it you will find a concise Guide to managing and preventing HIV medication side effects with supplements and other complementary and alternative therapies.

This is an invaluable introduction to how nutritional supplements can be used to counter those side effects that can make life miserable–or even disrupt treatment adherence–in people taking antiretroviral medications for HIV.

Read about approaches to dealing with diarrhea, nausea, heart health issues, diabetes, insomnia, fatigue, liver stress, lipodystrophy, anxiety and depression.

This FREE Guide is available online at:

http://newyorkbuyersclub.org/

On the NYBC website you can also SUBSCRIBE to the nonprofit co-op’s quarterly FREE newsletter, THE SUPPLEMENT, which continues to offer a unique perspective on current evidence-based use of supplements for chronic conditions including cardiovascular disease, diabetes/insulin resistance, hepatitis and other liver conditions, anxiety/depression, osteoarthritis, cognitive and neurorological issues, and gastrointestinal dysfunction.

October 9, 2009

Supplements for Depression: Updated Info Sheet from NYBC

Posted in depression, DHEA, fish oil, mental health, Omega-3, SAMe, sexual function, St. Johns Wort tagged , , , , , , , , , , at 10:57 am by jarebe

We’ve updated our info sheet on Supplements for Depression, reflecting some additional supporting evidence that has accumulated for these applications, plus new references. See www.newyorkbuyersclub.org for detailed product information.

In recent years there’s been a lot of well-designed scientific research about the effectiveness of dietary supplements for depression. The supplements studied have ranged from the herb St. John’s Wort, which has a long tradition of use, to molecules like SAMe, L-Tryptophan, and 5-HTP, which play a role in the body’s production of neurotransmitters (such as serotonin) connected with mood and cognitive function. Other developments in depression research involve the steroid DHEA and fish oil.

DHEA (Dehydroepiandrosterone). In a study sponsored by the National Institute of Mental Health, DHEA was found to be an effective therapy for mild to moderate or severe midlife depression, on a par with some prescription drug treatments. Moreover, the NIMH research showed that taking DHEA promoted both a significant lifting of depressive symptoms and an improvement in sexual functioning. (On the other hand, inhibition of sexual function remains one of the chief troublesome side effects of prescription anti-depressants). Note that dosing recommendations vary for men versus women, and DHEA is not recommended for those diagnosed with prostate problems or cancer.

SAMe (S-adenosyl-l-methionine). First studied by Italian researchers in the 1950s, SAMe is produced naturally in the body from the amino acid methionine. Supplementing with SAMe increases concentrations of the neurotransmitters serotonin and L-dopamine, which are related to mood. Several studies show SAMe having an anti-depressant effect comparable to that of some prescription drugs. A dose of 400-800mg/day has been studied for mild to moderate depression, and 800-1600mg/day for the moderate to severe condition. As of 2007, SAMe was being compared with the prescription drug Lexapro® in a 5-year NIH-funded study. SAMe generally has fewer side effects than prescription anti-depressants. However, it should be avoided in people with bipolar disorder, and should be used cautiously with other anti-depressants, because the combination may push serotonin levels too high. Taking a B-complex vitamin while using SAMe can counter build up of homocysteine, which is associated with heart disease. (It’s best to take them separately.) SAMe also supports joint health and liver function, so may have positive effects for overall health if taken over the long term.

St. John’s Wort is a widely used herb with clinically demonstrated (multiple, well-controlled studies, mostly in Europe) anti-depressant effects for mild to moderate depression – generally without the side effects of prescription antidepressants. High doses of the herb may cause a sensitivity to light (phototoxicity), so avoid direct sunlight or sunbathing while using. Do not take St. John’s Wort with 5-HTP, serotonin re-uptake inhibitors (like Prozac), or with protease inhibitors, as it my affect beneficial liver enzymes. St. John’s Wort may also have activity against Epstein-Barr and herpes infections.

L-Tryptophan and 5-HTP (5-hydroxy L-tryptophan): These closely-related supplements are converted in the body to serotonin and to melatonin. (Specifically, L-Tryptophan converts to 5-HTP, which then converts to serotonin or melatonin.) Their use as antidepressants has been studied, and they have also been found to aid sleep and suppress appetite. (To minimize appetite suppression, try taking the supplement an hour before bedtime.) Mild gastrointestinal side effects have been reported with both. For best absorption, take with water or juice, and separately from protein-containing foods and dietary supplements. Although L-Tryptophan and 5-HTP are close relatives, people may respond somewhat differently to them. Thus, if encountering unwanted side effects or lack of effect from one, it may still be worthwhile to try the other.
The suggested dosage for 5-HTP is wide, ranging from 50 and 500 mg daily. It can be used together with other anti-depressants, in which case an effective dose could be quite low. The best approach is to start at the low end of the range and increase as needed. Like 5-HTP, L-Tryptophan has been used in combination with other anti-depressants, and has also been employed with lithium for bipolar disorder. An added benefit: 5-HTP may also decrease symptoms of fibromyalgia and migraine headaches.

Fish Oil. Epidemiological studies have suggested that populations that eat fish regularly have low rates of depression. More recently, research has found fish oil supplements (omega-3 fatty acids being the significant component) of benefit in treating depression and bipolar disorder. It’s also worth noting that fish oil can be taken with other anti-depressants as an adjunct therapy. Doses found effective in treating depression are quite high, 3 to 9 grams per day, so be aware of potential problems related to the supplement’s blood-thinning properties. Added benefit: as has been widely reported, fish oil can have a beneficial impact on cholesterol regulation and in supporting cardiovascular health.

References:
Christian R. Dolder, “Depression,” in Natural Products: A Case-Based Approach for Health Care Professionals, ed. Karen Shapiro, published by the American Pharmacists Association, Washington, DC (2006), pp. 97-114.
Shaheen E Lakhan and Karen F Vieira. “Nutritional therapies for mental disorders” in Nutrition Journal (2008), 7:2doi:10.1186/1475-2891-7-2. Accessed 10/7/2009 at http://www.nutritionj.com/content/7/1/2
Schmidt PJ, et al. “Dehydroepiandrosterone Monotherapy in Midlife-Onset Major and Minor Depression,” Archives of General Psychiatry (February 2005): Vol. 62, No. 2, pp. 154–62.
Hyla Cass, “Prescriptions for Depression,” in Supplement Your Prescription: What Your Doctor Doesn’t Know About Nutrition. Basic Health Publications (2007), pp. 113-128.

Diet and depression — a follow-up note

Posted in cardiovascular health, depression tagged , , , , at 9:59 am by jarebe

In the Summer 2009 SUPPLEMENT, our feature story was entitled “Are You Ready to Join the Food Revolution?” The article referred to recent research highlighting a relationship between traditional diets, such as the Mediterranean or Chinese diet, and lower risk of certain cancers, heart disease, and even depression. So we were interested to read in our hometown newspaper The New York Times about a new report of findings about the health benefits of the Mediterranean diet. A large-scale epidemiological study in Spain again showed an association between the traditional Mediterranean diet and lower rates of mental health conditions like depression. Very interesting as well is this line of thinking from one of the researchers about why this diet should be linked to lower risk of both cardiovascular disease and depression:

Both cardiovascular disease and depression share “common mechanisms related to endothelium function and inflammation,” said Dr. Miguel Angel Martinez-Gonzalez, professor of preventive medicine at University of Navarra in Pamplona, Spain, and senior author of the paper, published in the October issue of Archives of General Psychiatry.

“The membranes of our neurons are composed of fat, so the quality of fat that you are eating definitely has an influence on the quality of the neuron membranes, and the body’s synthesis of neurotransmitters is dependent on the vitamins you’re eating,” Dr. Martinez-Gonzalez added. “We think those with lowest adherence to the Mediterranean dietary plan have a deficiency of essential nutrients.”

The elements of the diet most closely linked to a lower risk of depression were fruits and nuts, legumes and a high ratio of monounsaturated to saturated fats, the study found.

From:

http://www.nytimes.com/2009/10/13/health/research/13nutrition.html?scp=1&sq=Mediterranean%20diet&st=cse

February 3, 2009

Review article: “Nutritional therapies for mental disorders” (2008)

Posted in B vitamins, depression, fish oil, mental health, Omega-3 tagged , , , , , , at 5:16 pm by jarebe

Shaheen E Lakhan and Karen F Vieira. Nutritional therapies for mental disorders. Nutrition Journal 2008, 7:2doi:10.1186/1475-2891-7-2

This well-documented article provides a state-of-the-art review of nutritional therapies or nutritional supplementation for some of the most prevalent disabling mental disorders. Here’s an excerpt from the introduction of the article, which gives an idea of its scope and the significance of its topic:

Currently, approximately 1 in 4 adult Americans have been diagnosed with a mental disorder, which translates into about 58 million affected people. Though the incidence of mental disorders is higher in America than in other countries, a World Health Organization study of 14 countries reported a worldwide prevalence of mental disorders between 4.3 percent and 26.4 percent. In addition, mental disorders are among the leading causes for disability in the US as well as other countries. [...] [T]he four most common mental disorders that cause disabilities are major depression, bipolar disorder, schizophrenia, and obsessive compulsive disorder (OCD).

Typically, most of these disorders are treated with prescription drugs, but many of these prescribed drugs cause unwanted side effects. For example, lithium is usually prescribed for bipolar disorder, but the high doses of lithium that are normally prescribed cause side effects that include: a dulled personality, reduced emotions, memory loss, tremors, or weight gain. These side effects can be so severe and unpleasant that many patients become noncompliant and, in cases of severe drug toxicity, the situation can become life threatening.

Researchers have observed that the prevalence of mental health disorders has increased in developed countries in correlation with the deterioration of the Western diet. Previous research has shown nutritional deficiencies that correlate with some mental disorders. The most common nutritional deficiencies seen in mental disorder patients are of omega-3 fatty acids, B vitamins, minerals, and amino acids that are precursors to neurotransmitters. Compelling population studies link high fish consumption to a low incidence of mental disorders; this lower incidence rate has proven to be a direct result of omega-3 fatty acid intake. One to two grams of omega-3 fatty acids taken daily is the generally accepted dose for healthy individuals, but for patients with mental disorders, up to 9.6 g has been shown to be safe and efficacious. Western diets are usually also lacking in fruits and vegetables, which further contributes to vitamin and mineral deficiencies.

It’s refreshing to see a respected publisher of scientific journals such as Springer giving a place to this kind of review. By pulling together the best of recent research on nutritional therapies for mental health (there are 107 references for this article, almost all from the last two decades), the authors provide support to a very useful approach that has been unfortunately overshadowed by over-reliance on prescription medications. We hope this publication, together with others like it, will help educate both healthcare providers and healthcare consumers!

You can read the complete article at

http://www.nutritionj.com/content/7/1/2

January 13, 2009

Supplement recommendations in “The Ultramind Solution” by Dr. Mark Hyman

Posted in Alzheimer's Disease, Antioxidants, anxiety, B vitamins, calcium, depression, fish oil, flaxseed, magnesium, melatonin, Multivitamins, Omega-3, Probiotics, sleep aids, Vitamin B12, Vitamin D tagged , , , , , , , , , , , , , at 12:24 pm by jarebe

NOTE: NOW SEE NYBC’S LOW-COST ALTERNATIVE TO THE ULTRAMIND SOLUTION MULTIVITAMIN PACK–

http://nybc.wordpress.com/2011/04/02/nybcs-brainpower-multi-pak-low-cost-ultramind-solution/

One-third less than the over-priced “Ultramind Solution” supplements!

The UltraMind Solution: Fix Your Broken Brain by Healing Your Body First
Mark Hyman, M.D.

This is one of many books published in recent years that seek to translate the enormous body of research findings from the last few decades about nutrition and brain function into simple, useful guidelines for improving and maintaining good mental functioning and psychological well-being. While it’s a popularizing text (Dr. Hyman has even been on Martha Stewart–see link below!), this book does, we feel, accurately register many important trends in our knowledge of nutrition and nutritional supplements and how these factors relate to mental health.

Here’s the statistic that sets off Dr. Hyman’s project: one in three Americans suffer from some kind of “brain dysfunction” (one term in use: “brain fog”), including symptoms such as depression, anxiety, memory loss, attention deficit disorder, autism, and dementia.

“The Ultramind Solution” contends that revising your diet–changing your nutritional intake–can often make a huge difference in these symptoms. Dr. Hyman’s recommendations focus both on weeding out elements that adversely affect the system (too much sugar, poorly chosen carbs, alcohol, cigarettes), and sticking to a menu of what’s good, especially what’s good for brain function: 1) omega fatty acids (found in salmon, sardines, flaxseed); 2) amino acid sources (nuts, lean meats); 3) high-quality carbs (for example, beans, peas, and lentils); 4) phyto-nutrients (plant foods containing antioxidants and other helpful substances, like blueberries, cilantro, etc.).

Finally, Dr. Hyman observes that, since more than 90% of Americans don’t get adequate nutrients from food (a finding of an often-cited US government survey), people realistically will need to supplement at least periodically in several key categories: 1) a multivitamin; 2) fish oil (omega fatty acids); 3) Calcium/Magnesium; 3) Vitamin D; 4) B complex vitamins; 5) probiotics (for good digestion/absorption of nutrients); and 6) occasionally a sleep aid like melatonin to insure a good amount of rest.

Here are some NYBC suggestions for supplementing in the categories recommended by Dr. Hyman:

Multivitamins: Added protection with Iron (Douglas) ; Added Protection without Iron (Douglas) – recommended for those with liver conditions; Opti-Pack – iron-free (SuperNutrition); Super Immune Multivitamin – iron-free (SuperNutrition)

Fish oil: Max DHA (Jarrow); ProOmega (Nordic Naturals) 60 caps; ProOmega (Nordic Naturals) 180 caps;

For Calcium, Magnesium, Vitamin D, NYBC recommends Bone-Up (Jarrow), which provides all three nutrients in the most useful dosages.

B complex vitamins: B-right (Jarrow)

Probiotics: NYBC recommends Jarrodophilus EPS (Jarrow) because it doesn’t require refrigeration. But other probiotics may be useful as well–see the Probiotics entry on the NYBC website.

NYBC also stocks Melatonin in several formats.

See Dr. Hyman on Martha Stewart:
http://www.marthastewart.com/portal/site/mslo/menuitem.3a0656639de62ad593598e10d373a0a0/?vgnextoid=0f545e9ea969e110VgnVCM1000003d370a0aRCRD&vgnextfmt=default

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