Did you know it can take modern medical research 17 to 20 years before it reaches mainstream medical practice?
Sometimes it takes us time to be sure and this means repeating study results over and over again with various populations. Sometimes, however it can take time to instill new consciousness into our habits and routines. We humans are creatures of habit and prone to bias. It can he hard to change our minds and change our ways, which can lead to even the most well-meaning and intelligent doctors making outdated recommendations or relying on old science.
For instance, have you ever been told (or know someone who’s been told) to avoid eggs for your cholesterol (facepalm). What about low-fat diets? Ridiculous as it may seem, this is still being said to my patients.
You get my point, right?
This brings me to the topic of supplementation for two nutrients that we North Americans are prone to deficiency in: Vitamin D and Iron.
Let’s start with iron.
Iron: Is needed to make hemoglobin in red blood cells. It shuttles oxygen around the body. We use that oxygen for cellular respiration (to make energy) in our mitochondria.
Low iron can lead to anemia (lack of red blood cells, hemoglobin and hematocrit).
Low iron can cause symptoms such as: low energy, low mood (dopamine), low thyroid function, feelings of cold, racing heart, anxiety, dizziness, weakness, hair loss, dry and pale skin, low stamina and exercise tolerance as the body is not able to move oxygen around the body to make energy.
So, what do you do when your iron is low? Supplement, right? Normally, I would have said yes.
That’s where things have changed for me.
So, I noticed that even if I recommended gentle iron supplements (iron bisglycinate or heme iron), patients wouldn’t take them. Even if they didn’t cause constipation (which the conventionally prescribed ferrous fumarate is infamous for) or other gastrointestinal symptoms, patients had a certain aversion to iron supplements that was hard to explain.
Further, sometimes they would raise blood iron levels and sometimes they wouldn’t. Sometimes they would raise levels and then levels would fall back down again.
It’s interesting to note that iron is the most abundant element on the planet, making up 35% of the Earth. It is fortified in commonly eating foods like bread and cereals. The problem is not iron intake, it is iron metabolism, or the way that iron is moved throughout the body.
We can have 10 times the amount of iron lodged in our tissues than is present and measured in our blood. And this isn’t good. Iron interacts with oxygen and causes oxidation (or “rusting”). This can cause inflammation of our tissues, like gut tissue. It can negatively impact our livers. We want iron safely stored in hemoglobin.
In order to get iron out of our tissues we need an enzyme call ceruloplasmin, which depends on the element copper. Copper is needed to get iron out of the tissues and into the blood in the form of hemoglobin so that it can be used to move oxygen to our mitochondria to give us energy.
Now, we also need preformed vitamin A (retinol, only found in animal foods) to load copper into ceruloplasmin.. (to get iron into hemoglobin so that oxygen can get to our cells, it’s like that song “The Farmer takes a wife”, haha). You get the picture.
Put simply:
Energy– > oxygen in mitochondria –> hemoglobin (with iron) –> requires ceruloplasmin (vitamin A and copper).
So, the key to supporting iron levels and energy production is not more iron! It’s the nutrients that help iron work properly in the body. Copper and Vitamin a, which are found (along with highly absorbable heme iron) in Beef Liver!
Interestingly enough Whipple, Minot and Murphy were awarded the Nobel prize in physiology and medicine in 1934 when they discovered that beef liver cured anemia and pernicious anemia (B12 deficiency).
Beef liver is rich in choline (supports the liver, especially fatty liver, cell membranes, brain health, digestion, gallbladder function, mood and memory), zinc, B vitamins and hyaluronic acid.
Very often we find that we are implementing too many interventions and the key is to go back to our roots: to nature and ancestral practices to solve our problems. Sometimes we don’t need more technology, but more nature. An ancestral food that few of us consume anymore (at least not regularly). Good old beef liver. I will tell patients to consume lightly cooked grass-fed liver or take it in a supplement form (which is what I do).
Vitamin D is actually a hormone. It regulates 900 genes in the body that are involved in bone health, immune function (supporting low immune function and autoimmunity) and mood.
We humans get vitamin D from the sun. Sun hits cholesterol in our skin and our skin makes vitamin D. This is the best way to get vitamin D. Therefore in sunny climates, get sun! Clothing and sunscreen blocks vitamin D, fyi. About 20 minutes a day of direct sun on 20% of your skin (t-shirt and shorts), can generally give you your daily vitamin D.
However, in the winter, our skin does not have access to sun exposure and we don’t make vitamin D. So what do we do? Well, up until recently I would have told you to take a vitamin D supplement, in the form of drops (as D is fat-soluble) to make sure that your blood levels of 25-hydroxyvitamin D (25-OH D) is >125 nmol/L.
However: vitamin D requires magnesium to be activated in the body (and most modern humans are notoriously deficient in magnesium). Sometimes low blood levels of D are actually an indication of low magnesium.
Further, high levels of supplemental vitamin D also deplete levels of vitamin A (or retinol). Vitamin A and vitamin D must be taken together as they are biological partners. In fact, one of the things that sunlight does is activate preformed vitamin A in the skin as well as activate vitamin D synthesis. Vitamin A helps activate Vitamin D receptors (and remember that vitamin A is responsible for iron metabolism as well).
The good news is that both vitamin D and vitamin A are found together in nature in Cod Liver oil (along with the antiinflammatory omega 3 fish oils EPA and DHA). So, I am more frequently recommending Cod liver oil as a vitamin D source along with magnesium to help support vitamin D metabolism in the body. We need to get vitamin D from a supplemental source in the winter if we’re not getting enough sun, however the precautionary principle will tell us that historic supplementation (what our Northern ancestors might have practiced) contains lots of wisdom.
Nutrients don’t work in isolation. They work in networks (just like our hormones and immune cells). We need copper and Vitamin A to regulate iron. We need magnesium and vitamin A to regulate vitamin D.
Isolating and supplementing with single vitamins and minerals may be indicated for some patients (going deep and narrow, particularly for people with pronounced and specific deficiencies), however in general I’m moving to a more holistic and ancestral prescribing practice with most patients when appropriate–this is where I see the current evidence pointing: to a more holistic vs. reductionist approach.
That being said, everyone is different and so all prescriptions are highly individualized. There are some people who these supplements are not indicated for or appropriate for and so alternatives are prescribed.
The reason my practice is built around 1:1 visits is because this is where the magic lies. In individualist prescribing. You are not the same as your neighbour. You have specific needs and considerations for your health.
I hope that makes sense. The world of nuritition is a fascinating subject. In order to stay on top of the current best practices it is my responsible to be on top of the research (sifting through the vast arrays of information) and flexible enough to pivot my approach when necessary.
I don’t practice the same way I did when I graduated. Or even the exact same way I did last year. It is important to keep things fresh and current and not let ego stand in the way of changing things for the better.
What do you think? Do you take beef liver and cod liver oil? How’s that been going for you?
When it comes to improving mood, most of us will do anything, including taking boatloads of pills.
One of the challenges I face as a naturopathic doctor is choosing which supplements to prescribe my patients; in the realm of natural medicine we have what seems like an infinite amount of options.
I can prescribe herbs for regulating the stress response, calming inflammation, or Zen-ing out the brain. I can prescribe amino acids, like 5HTP, which help regulate chemicals in the brain. I can recommend the hottest new products, like collagen, or a greens powder, or the newest Superfood. There are also a host of nutrients that the brain and body need for optimal functioning.
I try to keep my list of supplement recommendations to a maximum of 5, letting diet and lifestyle do the rest of the heavy-lifting. This means that I work in layers. When I see a new patient, I start by prescribing nutrients that fill in nutritional gaps. Perhaps my patients are showing signs of deficiency, based on their health histories, diet diaries or blood results; Or perhaps they just need a bit more nutrient support in the face of physical, mental, emotional and environmental stressors. After they start to notice improvement, we might move on to clearing more layers using herbs or therapies, like acupuncture or Mindfulness-Based Cognitive Therapy.
Naturopathic medicine does not believe in one-size-fits all treatment plans. If I see two patients with depression on the same day, both may receive entirely different plans. I base my recommendations on the person and her unique biography and biology, not the condition. However, because I try to keep my supplement suggestions to a minimum, when I work with patients with depression, I find these 5 nutrients continue to appear on my list.
1. Fish Oil
While most anti-depressant therapies target the brain, we know that depression isn’t simply a brain disorder. Depression is a complex condition impacted by our genes, physical health, social and physical environments, early childhood traumas, current stressors, nutrients status, and many other factors. Our minds and bodies are connected and therefore depression is as much a product of the health of our bodies and our environments, as it is of our brains.
Mounting evidence shows that inflammation in the body plays a major role in depression. Since the 90’s, scientist have found inflammatory cytokines (immune system molecules that cause inflammation), like IL-6 and TNF-a, elevated in depressed individuals.
When pro-inflammatory substances, like lipopolysaccharide (LPS) or interferon-a, traditionally used to treat hepatitis C, are injected into healthy individuals they cause symptoms of depression like lack of motivation and pleasure, and feelings of sadness.
Anti-inflammatory substances are effective anti-depressants. The omega-3 fatty acid eicosapentaenoic acid, or EPA, found in fatty fish like salmon and sardines, is a well-known anti-inflammatory nutrient. One study found that supplementing with EPA prevented depressive symptoms in individuals who were injected with interferon-a.
Fish oil contains the omega-3 fatty acids EPA and docosahexaenoic acid, or DHA. Both of these marine omegas are found in certain fatty fish, which can be remembered by the acronym SMASH: sardines, mackerel, anchovy, salmon and herring (also trout). Fish oil supplements combine EPA and DHA. DHA is a component of our brain mass. It is needed for developing the brain and nervous system of growing babies, and is indicated in pregnant and breastfeeding women. EPA confers the anti-inflammatory benefits.
A meta-analysis composed of 15 randomized control trials involving almost 1000 participants, found that fish oil was an effective therapy for treating depression as long as the fish oil contained over 60% EPA relative to DHA.
Another review of three studies, showed that omega-3 fish oil supplementation reduced depressive symptoms in children and adults by 50%.
When it comes to supplementing with fish oil for depression, it’s the EPA that counts, not the DHA. Also, more fish oil seems to be better than less. Studies that showed the best anti-depressant actions dosed participants with at least 1 gram of EPA per day. Some studies gave patients 2 grams of EPA or more per day. Supplements that showed the most benefit contained higher amounts of EPA relative to DHA.
A 100-gram serving of wild Atlantic salmon contains about 400 mg of EPA, while farmed Atlantic salmon, surprisingly contains more: 700 mg of EPA per 100 grams. While consuming fatty fish, like sardines, and pasture-raised, rather than grain-fed, animals can increase our dietary ratio of omega 3 to omega 6, which has general health benefits, supplementation with a high-EPA fish oil is probably necessary to supply the 1 to 2 grams of EPA per day that have been shown to reduce depression.
2. An Active B Complex
B vitamins are cofactors for thousands of reactions in the body. Cofactors are “helpers”. They help enzymes and cellular process work—without these helpers, important jobs just don’t get done. This can have major implications for our mental health.
For example, the vitamins B6 and folate are needed to convert the amino acids tryptophan and 5HTP to serotonin, the “happy hormone”. Serotonin is a neurotransmitter responsible for managing mood: soothing depression and anxiety; and regulating appetite, memory, and sexual desire. Serotonin is the main target of conventional anti-depressant therapies, SSRI (selective serotonin reuptake inhibitor) medications, which raise brain levels of this chemical.
Both B12, which is important for energy production and neuronal health, and folate, which is important for DNA repair, detoxification and reducing inflammation, have been found to be low in patients with depression. A B12 deficiency, resulting in fatigue, memory loss and low mood, can also mimic the symptoms of depression.
It’s important to supplement with an active form of the B vitamins. This means buying and consuming a B complex or multivitamin that contains B12 and folate in their active forms: methylcobalamin and methyl-folate (or 5-methyltetrahydrafolate, or 5-MTHF), respectively.
Individuals who have a genetic mutation that prevents them from efficiently converting folic acid (a synthetic vitamin found in cheap supplements and fortified grains, like wheat and rice) to active folate, are highly represented in the major depressive disorder population. This gene is called MTHFR C677T and is associated with lower blood levels of folate and an increased risk of depression. To learn more about folic acid and MTHFR mutations, read my article here.
B vitamins are also needed by the mitochondria, the “powerhouses” of our cells. By helping our mitochondria work properly, they help reduce inflammation, boost energy production and promote antioxidant synthesis.
We can find B vitamins in egg yolks and liver. The only dietary sources of B12 are found in animal foods, making it difficult for vegans and vegetarians to get without supplementing. Folate is abundant in leafy greens.
Physical, mental, emotional and environmental stressors create a higher demand for the B vitamins. The B vitamins are water soluble, excreted in the urine and not stored. Therefore, to support neurotransmitter synthesis and energy levels in my depressed patients, I often prescribe a good-quality B complex supplement to complement their diets.
3. Magnesium
Because my clinical focuses are mental health, hormones and digestion, I prescribe magnesium to virtually every patient I see—magnesium is an important nutrient for all of these conditions.
Like the B vitamins, magnesium is a cofactor. It’s involved in helping with over 800 chemical process in the body that simply won’t get done without it. We need magnesium to make cellular energy in the mitochondria, to produce neurotransmitters, like serotonin, and to repair DNA, among many other jobs.
Due to soil deficiency, low intake, stress and decreased absorption, it’s estimated that about 40 to 60% of North Americans are magnesium deficient. Only 1% of the magnesium in our bodies is present in blood. Blood levels don’t reflect the body’s magnesium stores, and so testing for deficiency is unreliable.
Magnesium is a potent muscle relaxer. Deficiencies show up wherever muscles are contracted, rather than relaxed: this can include constipation because of poor intestinal motility, muscle aches and pains, frequent urination due to contracted bladder muscles, menstrual cramps, and headaches and high blood pressure from constricted blood vessels. Insomnia, anxiety and sensitivity to loud noises can also all be signs of a magnesium deficiency. PMS, insulin resistance and sugar cravings are all further indications for magnesium supplementation.
Magnesium can be obtained from leafy greens like spinach and chard. However, most individuals need to supplement to stock up their magnesium levels, particularly if experiencing stress, fatigue, anxiety or depression. Like the B vitamins, magnesium is water soluble, excreted in the urine in response to stress.
A 2017 randomized control trial published in PloS One, found that 248 mg of magnesium chloride decreased the PHQ-9 score of those with mild-moderate depression by almost 5 points. This result compares to standard anti-depressant medications. Despite the relatively low dose and inferior form of magnesium, the effects were well-tolerated and benefits were seen in 2 weeks.
I prescribe magnesium glycinate, a much better-absorbed form, before bed to help patients sleep better. This means starting with 100 to 200 mg per night and increasing by that amount every 3 to 4 days or until patients are having a bowel movement on waking—this is called “prescribing to bowel tolerance”.
A side effect of taking too much magnesium is loose stools, or soft stools that fall apart in the toilet on flushing, which can be corrected by lowering the dose. I personally take about 900 mg of magnesium at night to manage my stress, mood, energy levels and muscle tension.
4. Vitamin D
About 70 to 90% of North Americans are deficient in vitamin D, which acts like a steroid hormone rather than an actual vitamin, and regulates over one thousand genes in the body. Our skin makes vitamin D when it comes into contact with UVB radiation from the sun. Those of us who live in northern climates with limited sun exposure don’t make enough vitamin D and need to supplement, especially during the Winter months.
Vitamin D is needed to regulate the gene Tryptophan Hydroxylase 2, which converts the amino acid tryptophan (a component of protein that can only be obtained from diet and is found in foods like turkey and pumpkin seeds) to serotonin in the brain.
Low vitamin D concentration has been associated with depression, however researchers aren’t sure if the relationship is causal: does low vitamin D status put someone at risk for developing depression? Or do depressed individuals have low vitamin levels in their bodies because of some other factor?
Studies have failed to show that taking vitamin D supplements impacts depression. I also haven’t found vitamin D to impact my patients’ moods as a solo therapy. It’s likely that nutrients like vitamin D acts as part of a network, in conjunction with other vitamins, like magnesium, which is responsible for converting supplemental vitamin D into the active form. Vitamin D is a fat-soluble vitamin, and taking it in chalky tablet form may not raise levels. I prescribe vitamin D3, the active form of the vitamin, in drop form. Vitamin D drops are suspended in fats like coconut or flax oil, which makes them easier for the body to absorb.
Whether a case of the chicken or the egg, when it comes to vitamin D and mood, we know that supporting vitamin D status is essential for achieving optimal health, managing immune function, reducing inflammation, reducing the risk of osteoporosis, and regulating mood, given vitamin D’s role in serotonin synthesis.
The Framingham study found that patients who had low levels of vitamin D had poorer mental functioning and reduced volume of a brain region called the hippocampus, which is responsible for memory formation and mood regulation. Reduced hippocampal volume is a risk factor for and consequence of major depression.
There is a “sweet spot” to optimal vitamin D levels; because it’s a fat-soluble vitamin and can be stored, too much vitamin D may be as bad as too little. Therefore, I like to measure my patients’ blood levels in the Fall to determine the right dose for supplementation. 4000 IU a day is a good, safe dose for most people during the Winter months.
5. Zinc
Zinc is the catalyst for hundreds of enzymes in the brain, including making serotonin, norepinephrine and dopamine, all of which are brain chemical targets of anti-depressant therapies.
There is a major concentration of zinc in the hippocampus, a brain region affected by depression. Studies show that zinc plays a role in supporting neurogenesis (the creation of new brain cells) by stimulating Brain Derived Neurotrophic Factor (BDNF). BDNF creates new brain cells and boosts mood. Anti-depressants may work by increasing brain levels of BNDF, protecting the brain against stress.
Plasma zinc concentrations are lower in major depressive disorder. Animal studies also show that depleting zinc can lead to major depression.
Zinc supplementation has been shown to boost mood. A study of 50 overweight or obese patients were assigned to receive either 30 mg of zinc or placebo. After 12 weeks, the group who received zinc experienced a greater reduction in the severity of their depression and an increase in the levels of BDNF in their brains.
Zinc is also an important nutrient for supporting the immune system and managing inflammation.
Besides depression, other signs of zinc deficiency include skin issues, like dry skin and acne, infertility, issues with gut membrane integrity (leaky gut), hair loss, low testosterone, poor immune function and fatigue.
Dietary sources of zinc are harder to come by for vegans and vegetarians, who are at a higher risk for developing a zinc deficiency. Zinc can be found in red meat, shellfish, lentils and pumpkin seeds.
I typically prescribe zinc the way I prescribe iron, in pulse doses: I recommend that patients work their way through a bottle of zinc (taking 30 to 100 mg per day), while we assess whether symptoms improve. Unlike iron (which we can measure more accurately by looking at its storage molecule ferritin), zinc can’t be accurately measured in blood. Like magnesium, zinc deficiency in the body’s tissues may be present long before low zinc levels show up in blood.
While this list can be a great tool for anyone interested in supporting their mood through boosting nutrient status, keep in mind that this information is not a substitute for medical advice.
I believe it’s essential to work with a naturopathic doctor, or a functional medical doctor, who can make the appropriate recommendations for your individual health needs. A personalized consultation that assesses your diet, blood work, health history and specific symptoms, can help you hone your list to come up with a dynamite nutrient plan that’s specifically tailored to you.
I will never get annoyed at a patient’s “lack of compliance” again.
Health care is scary, even when you know what you’re doing. When it’s your own health, putting yourself in the hands of a professional is not easy.
Yesterday I had an initial consult for myself with a nutrition specialist. She’s well-known in her field, super-academic, in her 70s, and has published books and papers.
She knows her stuff. She’s also really helped a friend of mine and the referral came from him. I had every reason to trust her and feel good about putting myself in her hands.
However, I was nervous getting ready to see her. I filled out a diet diary… what would she think? What would she say about my blood work? Would she be nice? Would she be understanding? Would we get along?
Survival instincts kick in.
We talked about a few things in the first visit (which cost an arm and a leg, but will be worth it if I’m left feeling great) and she prescribed some supplements for me to take.
I left, kind of satisfied. Ready to get on with our journey, with a list of things to pick up, dosages to tweak, things to consider and instructions to book again in 3 to 4 weeks.
Ok.
I woke up this morning, in the early hours tossing and turning, thinking to myself, “I don’t want to take vitamin E!” And “Did she truly understand my concerns?” And “what are all these supplements treating?” and “did she really hear me out?” And, “is all this going to actually help?”
The impulse to not trust, to run and hide, to override her assessment and recommendations with my own were overwhelming. (And, of course, as someone who does what she does for a living, the struggle to overcome this is real, we’re “experts” on the body, but it’s nice to let someone else give direction for a change, especially someone with 30+ more years’ experience).
Still, trusting is hard.
Being aware of the impulse to run and avoid, while also resisting the impulse, is hard.
I have people who neglect booking a follow-up even when they know that we still have lots of work to do.
I have people who don’t fill out diet diaries for fear of actually taking a hard look at their food intake.
I have people who email me that “nothing is working” when in fact they haven’t started taking their nutrients and supplements yet.
And, guess what, as frustrating as that may be (because ultimately, I want people to have success! I want people to heal), I’m doing the same thing.
Jeez, being in the patient chair is mighty humbling.
I highly recommend it to all my health practitioner colleagues out there.
And, yes, now I’m taking vitamin E. I’ve decided to just trust. (But I’m still taking my own multi-vitamin… hey, doctors make the worst patients… amiright?)
I talk about the supplements I take on a daily basis and their indications.
Hey, Everybody, my name is Dr. Talia Marcheggiani and I’m recording to you guys from my kitchen in Toronto. And this video is about the supplements that I take as a naturopathic doctor and health experimenter. When it comes to making treatment plans for my patients I prefer to focus on the Therapeutic Order, so starting with the foundations of health, which usually means making adjustments to diet and lifestyle and if possible using food prescriptions and functional foods to help heal the body as opposed to relying on supplements. And this is just from clinical experience and from a cost-benefit perspective. So, of course it’s better to get these nutrients from food sources, because, when you eat a pile of kale, like a big plate of leafy greens, you’re getting all of the vitamins that we know about: the magnesium, the fat-soluble vitamins, like A, D, E, and K, some iron, and all of the flavonoids, and anti-oxidants that are present in that big pile of greens, but you’re also getting a lot of nutrients that we haven’t been able to isolate and that we don’t know is present in those foods. Some of those nutrients may act synergistically. And so it’s always better to get things from their whole-food source, I think. That’s the philosophy that I come at when it comes to health and healing. And I’m always looking for the obstacles to cure. Ideally I’m prescribing something like magnesium to replenish a magnesium depletion or to compensate for a diet that may be inadequate for magnesium, or to replenish magnesium deficiency. So I’m not a big fan of prescribing a ton of supplements, and I think my patients appreciate that, because of the cost and the annoyance of taking a lot of things. That being said, there is definitely a benefit to supplementing with vitamins and minerals and other sort of functional supplements to improve optimal health. We’re trying, obviously, to eat a diet that meets the recommended daily nutrition intake for all the vitamins and minerals that the body needs to function optimally, but there’s some evidence that increasing these levels and taking higher doses of these vitamins and minerals may actually help our body perform properly. So, if you take something like vitamin C, if someone is completely deficient in vitamin C that will manifest as a disease called scurvy, where you’ve got loose gums, or you’re experiencing problems in creating collagen. You’re getting sore on the skin, there’s skin issues, there’s gum issues. And then there’s an adequate amount of vitamin C, where you’re not seeing those symptoms, and then there’s having optimal vitamin C, where your body is able to not just meet its daily requirements for all of the chemical reactions that it needs for us to feel our best, and look our best, but now it’s got an abundance of vitamin C and now it’s able to really divert a lot of the vitamin C that it’s getting to increase energy, to boost immunity, to target cancer cells, to exert an anti-oxidant effect, to accommodate all of the free radicals we might be exposed to, living in our modern times.
So, that being said, I do my own self-experimentation with vitamins and minerals, and there’s a few things that I’ll take on the regular, that I’ll take all the time, and then there’s other things that I might play around with, just to see what it’s like to take the medicine. Depending on what it is, I think doctors should taste their own medicine every now and then to know what the effect is on their patients and what their patients’ experience would be, experimenting with these vitamins and minerals.
So, the first thing I take, and this is something that I started taking in school, is a B complex. And a B complex contains all of the B vitamins. Some people get confused, they’ll refer to their B12 supplement as a B complex or they’ll refer to a B complex as B12, or they’ll get confused about all of the different B vitamins. In this product there are all of the B vitamins, from B1 all the way to folate. These B vitamins are cofactors in thousands of chemical reactions in the body. We need vitamin B6, for example, to make serotonin out of tryptophan and 5HTP, those are all the amino acids that are present in the pathway to synthesize serotonin and without B6 we’re not able to make serotonin, no matter how many of those building blocks, tryptophan building blocks, may be present in the body. So, if we’re deficient in these cofactors, our body is just not able to function properly. And we burn through B vitamins a lot more quickly when we’re under stress and some people have higher requirements for them. And some people have an issue metabolizing certain forms of B vitamins. So, for example, there’s some people that have an issue taking folic acid, which is often thrown into a lot of our grains and cereals, that are fortified and lots of multivitamins and taking that folic acid and making it into its active form, about 40%of people have a genetic polymorphism that reduces their ability to methylate and to make active folate and, therefore, they need to supplement with the activated from of folate otherwise the folic acid that’s in all of their foods starts to build up in their tissues and there’s some evidence that that can cause problems.
I showed you which B vitamin I use. I use the AOR brand and one thing to look for in a B vitamin is, what is the form of folate in it? So, you want to look for one that has L-5-MTHF or that’s the methyl-tetrahydrafolate, that’s the active form of folate. And you also want to look at the B12, what’s the form of B12? So there’s 3 different forms of B12: cyanocobalamin, hydroxycobalamin and methylcobalamin. Cyanocobalamin is the synthetic form and, for the same reason that people have a problem activating folate, they may have a problem activating B12 and using it. And it’s the methylated form, methylcobalamin, that crosses the blood brain barrier, and that would have effects on depression and anxiety, and help with cognitive decline, and energy and all of those things. So, it’s important to look for a B vitamin that’s got those activated forms of the B complex. And you also want one that has adequate forms and that will be better absorbed. And so, taking a B complex is not something that you can overdose on readily because it’s water-soluble, so you may notice, as you start to take it, that your body starts to up-regulate the receptors to absorb them, for the initial weeks of taking it, you might have really yellow pee. And that’s normal, that shouldn’t cause any issues, but it’s one side effect that sometimes surprises people when your first morning urination is highlighter neon yellow.
The other thing that’s a staple in my supplement regime is magnesium. So, magnesium is, again a cofactor in tons of chemical reactions, and one of the really important functions that magnesium has is in DNA repair and also in mitochondrial function. So, mitochondria are the furnaces in our cells. Without magnesium, our DNA won’t have that ability to repair itself, which can cause us to allow DNA mutations or issues with DNA replication to go unnoticed and that can cause problems such as cancer down the line. It’s not that you’re deficient in magnesium one day and that manifests as symptoms, it’s something that will manifest over time, over decades of having just insufficient magnesium to achieve optimal health. So, you might be meeting your general needs where you’re not outwardly deficient in magnesium but, you’re not getting those levels to really have your body functioning at its best. Magnesium deficiency can manifest as symptoms, as physical, clinical symptoms in people and a big one is tense and tight muscles. Magnesium is a skeletal muscle relaxant and a smooth muscle stimulant. So what that means is that, if you’re the kind of person that has got really tense shoulders, lots of muscle knots, lots of aches and pains, that are muscular in nature, magnesium can help relax that skeletal muscle. And if you’re the type of person that suffers from menstrual cramps, or constipation, then magnesium is helpful for getting things moving and stimulating motility of the digestive tract and relaxing the uterus as well. Magnesium, there’s been some studies showing that magnesium can be beneficial for headaches, and that is probably due to its muscle-relaxant properties. Magnesium is also a great remedy for fatigue and, like B vitamins we burn through magnesium a lot more quickly when we’re stressed. 40% of people have a diet that it is inadequate to obtain their optimal levels of magnesium. This may be because we’re not eating enough leafy greens, which is a really great source of magnesium. It’s about 2 cups of spinach or chard a day to get the 300 mg of the magnesium, and also from soil depletion. So, when crops are not rotated, and the soil’s not replenished, the next round of crops are grown in a soil that’s depleted and therefore those plants aren’t absorbing the nutrients that were then going to enter our bodies after we eat those plants. And from this soil depletion, it’s hypothesized that that’s why our magnesium levels are so low. Also, a diet that’s high in processed sugar increases our magnesium needs, and a lifestyle that’s high in stress also increases our magnesium needs, as we need it to make stress hormones.
So, B complex and magnesium.
I often recommend to my patients to take magnesium before bed because of the skeletal muscle-relaxant properties, it helps to calm the body and the mind. There’s different forms of magnesium and the forms are prescribed based on what your therapeutic goals are. So, something like a magnesium citrate will be prescribed for somebody who’s tending more to the constipation, because it can help draw water into the bowels and have a bit of an osmotic laxative effect. So, it doesn’t sort of stimulate the bowels, like a laxative would, like sennakot, but it will draw water into the bowels to kind of flush the system out. That can be problematic over the long-term so do that under the supervision of a doctor or naturopathic doctor. And then, for people that are really sensitive to those laxative effects of magnesium, they may want to go with a magnesium that’s conjugated to an amino acid such as glycine. And so I often recommend magnesium glycinate, because a lot of us are also deficient in glycine. Another good source of glycine is collagen, or gelatin, and glycine has this sort of relaxant and modulating effect on the nervous system, and so it can be great for depression and anxiety, more so for anxiety because of its calming effect on the brain.
So, another supplement that I take is zinc. So, this is not the best form of zinc, I just picked this up because it was cheap and I could find it—I think I got this one at Bulk Barn, this is a zinc citrate. Even better absorbed form is zinc picolinate, so there’s a study that shows that that’s the best-absorbed form of zinc, which is appropriate for somebody that experiences nausea when they take zinc, which goes away in a few minutes, but it kind of sucks to have so, if that’s happening to you, then going with a more absorbable form of zinc, or taking zinc with food. A zinc deficiency manifests as dry skin, and depressed immune system, so you’re getting infections a lot more often than the average person. But inadequate levels of zinc can manifest as hair loss, leaky gut, depression and anxiety. Zinc helps us with neurogenesis, so it actually helps us make BDNF, brain-derived neurotropic factor, which is a chemical that our brain uses to make new neurons, and to promote resilience against stress. It sort of protects the brain against mental and emotional stress. And I also prescribe it for cystic acne and hormonal acne. And zinc is a really good remedy for PMS and heavy menstrual periods and vegetarians are often deficient in zinc.
4th is a fish oil. So a fish oil is combined with two kinds of omega 3 fatty acids: EPA and DHA.The one I use has got a 5:1 ratio for EPA. So, EPA is the anti-inflammatory omega 3, the anti-inflammatory fish oil. DHA is the fish oil that we use to build up our brain tissues. Most of our brain mass is made of fat and it’s mostly this kind of fat, DHA. So there’s some good studies that, because of its anti-inflammatory properties, EPA can help increase symptoms of depression. And this is probably because there’s some evidence that depression, like other mental health conditions, is an inflammatory condition in the brain. We don’t have pain receptors in our brain, so if our brain is experiencing even a small level of inflammation, it can kind of go undetected. It may just manifest as negative thoughts, mental chatter, low mood, lower or impaired neurogenesis. We’re not experiencing that acute, sharp memory that we’re used to, maybe we’ve got some brain fog, maybe we’re having trouble recollecting names and those kind of things. And there’s a little bit of evidence that it can be heart healthy as well. Our diet is really rich in omega 6 fatty acids. These are the more, inflammatory—this is sort of a general statement—they’re little bit more on the inflammatory side. I think our diet is about 10:1 omega 6:omega 3. And that’s mainly because we’re consuming animal products from animals that are not fed their natural diet, so for example cows should be eating grass, but we’re feeding them corn, which tends to make the fat in their meat more composed of the omega 6 fatty acids, and also because we’ve been told to avoid saturated fats and to eat a lot of industrial seed oils, like canola oil and corn oil, and vegetable oil, which is just corn oil, and soy oil. And so, these kind of oils are also rich in omega 6, those kind of pro-inflammatory fats. It’s been shown that our ancestors, our hunter-gatherer ancestors, had a diet that was more 1:1, for omega6:omega3. So, supplementing with omega 3 fish oils or eating fish a few times a week, those fatty fish I mentioned in other videos, decreases that ratio of omega 6 to omega 3. I also take NAC. And the reason I take NAC is I did a genetic test that showed that I have impaired phase II liver enzymes. So my body has a little bit of difficulty making glutathione, which helps detoxify all of the toxins and free radicals that pass through my body, all of the hormone metabolites. So, no matter how clean I live, if I’m using natural cleaning products, natural body care products, I’m still exposed to toxins, as we all are: there’s car exhaust outside, we’re consuming things that are wrapped in plastic, so no matter how perfect you try and be, you’re still going to be exposed to things. And so, to encourage my body to make more glutathione, I give it NAC, which is a precursor to making glutathione, the antioxidant. NAC helps with liver detoxification, so it also helps decrease symptoms of hormone metabolites, that estrogen dominance, that I also talk about in other videos, and it can also help with detoxifying the brain, so neurons. And that’s through its antioxidant effects and it kind of cleans out mitochondria. So you imagine if you’re running your car in your garage, the process of your car metabolizing, so spending its fuel, is creating some chemicals that are coming out of the exhaust pipe. And if your garage door is closed, all of those chemicals are filling the garage. And so, taking NAC is a little bit like opening a window, it’s just helping your body get rid of all of those toxic metabolites from performing its chemical duties. So I’ll take NAC and I’ll recommend NAC for mental health conditions, especially OCD and bipolar disorder. And sort of on that note, I also take something called estro-adapt. And it doesn’t have to be this product, there’s many other products that are similar to this, estroadapt has DIIM and calcium d-glucarate. Both of those are chemicals that help the body metabolize estrogen. So I’ve talked about estrogen dominance and other videos and the estrogen is not just one hormone, it’s a group of hormones and that there’s also these xenoestrogens, so these estrogens that are toxins in our environment that exert estrogenic effects. So, some of these include fragrances, and bisphosphenol A, BPA, that’s found in plastic, that has received a lot of media attention, what DIIM and calcium d-glucarate do is help us with normal estrogen processing. So, estrogen, when don’t need it any more, when it’s already done its thing, or those more toxic forms of estrogen, they’re conjugated in the liver, so the liver makes them inactive and then they’re dumped into the colon, where they’re removed from the body. And what happens if any of those steps are impaired, so if your liver is sort of overburdened processing other things, or you’re not able to process those hormones as well, is you’re going to have a higher level of metabolites in the body, or if you’re constipated, or if you’ve got a dysbiosis situation happening, and some pathogenic gut bacteria that aren’t able to keep estrogen conjugated, so they sort of put it back into it’s active form and the body reabsorbs it, which is not what you want. You want to get rid of those toxic estrogens.
So what I’ll recommend is doing a detox twice a year, Spring and Fall is a great time to do a detox and I’ll do another video on detoxification because our body can detoxify pretty effectively. It takes care of all of our detoxification needs, but sometimes it helps to give it a little bit of a boost, and so a product like this, with DIIM and I3C, or indole-3-carbinol, which is not in this product, or calcium d-glucarate, is really helpful for lowering those estrogen toxicity symptoms, which could be heavy menstrual periods, anxiety before your period, PMS, hormonal acne, irregular periods, weight gain, especially around the hips and a predisposition to female cancers, such as breast cancer. Another way you can get this from diet is from green leafy vegetables. So those are all the crucifates, broccoli, cauliflower, cabbage, brusselsprouts, chard, spinach, kale, all of those vegetables are really rich in I3C and DIIM and those help us clean estrogen from our body. Finally, I take an adaptogen. So, adaptogens, this is Withania complex, they’re herbs that literally just help the body adapt to stress. So my two favourites are withania, or ashwaghanda, and rhodiola. And I like taking them together, this complex doesn’t have rhodiola in it, but it does have ginseng, which is a little bit more stimulating. It’s got withania, it’s got ginseng, and it’s got licorice, and it has skullcap, which is a little bit more calming, nervous system calming. And, so what withania does, these just help us against the pro-aging and pro-inflammatory stress effects. So, they help sort of protect our tissues against stress, they protect our brain against stress, they can help calm the body down, they help the adrenal glands function more optimally, and rhodiola in particular, helps increase BDNF, just like zinc, so it increase brain-derived neurotropic factor, NAC also does this as well, and there’s a connection between low levels of BDNF and depression and anxiety and mental health conditions. The low levels of BDNF may be from nutrient deficiencies, or it could be from inflammation in the brain and that inflammation could be just a stress resistance. So, the stress hormone is coursing through our body 24/7 and our brain sort of stops responding to them as well, kind of like a diabetic, a type II diabetic, stops responding as effectively to insulin, an a resistance develops and, since those stress hormones have an anti-inflammatory effect, when you start becoming resistant to them, inflammation ensues. And so what withania and rhodiola do is just help calm down that inflammation. I’m a big fan of herbal medicine because in addition to sort of its active medicinal properties, herbs are also flavonoids, and have really important nutrients, like I talked about that big pile of leafy greens, we’re not exactly sure what is in these nutrients. We just know that, as a whole, they work really well. And so they’re flavonoids, they’re also anti-inflammatory, they’ve got anti-oxidants, as well as their medicinal properties that we can isolate and study. So I like herbs, it sort of brings us closer to nature, it puts a piece of nature into our body and some of that intelligence of nature, rather than just one supplement or one ingredient would do. And, because we’re so stressed out, and not all stress is bad. You think of a new mom, she just had a baby, she’s full of love and joy, but there’s sleep-deprivation, there’s all these kind of thoughts, and new responsibilities that are filling her life, so she’s stressed out, but she’s not full of negativity and negative thoughts. And so that’s still stress, the body still perceives that as stress. Some signs of stress are waking up in the middle of the night wide awake, inability to fall asleep, that tired and wired feeling, feeling like you’re getting an energy crash around 2-4pm, feeling a little bit more tired than usual, feeling a little bit more burnt out, feeling a little bit of ennui, and lack of motivation, so a lot of those signs of depression are actually present in someone who’s chronically stressed out: lots of mental chatter, lots of negative thinking and irritability can also be signs of stress. It manifests differently in every single person and so I’ll go through a full work-up to see how stressed out somebody is feeling and what their state of stress is. And there’s a difference between perceived stress and how stressed out you think you are, and actual, physiological stress and what the body’s under. And being in a state of inflammation, as well as riding the blood sugar roller coaster can also increase our physiological stress.
Finally, I take 5HTP. And I take this before my period, so I don’t take it all the time. I may take a couple hundred mg of it before bed, just to help with sleep. And, so 5HTP is a precursor to make serotonin. A lot of women will experience a dip in serotonin right before their period, sometimes up to a week before, so these women will experience irritability, those mental and emotional PMS symptoms, cravings for sugar, inability to sleep, worsening of depression and anxiety right before their period. And so sometimes they can benefit from 5HTP, which is an amino acid. 5HTP needs magnesium and B6 to work properly, though. So, we need to make sure the body has got adequate amounts of those nutrients, either through supplementation or diet, so that it can take that 5HTP and make it into serotonin. 5HTP crosses the blood brain barrier and so that sort of helps us get it into our brains where it can be made into serotonin. And the good thing about amino acids, like NAC and 5HTP and some of the other ones I mentioned in my amino acid video, is that they work pretty quickly, so sometimes they can exert their effects within hours and sometimes even within a matter of days, whereas something like fish oil can take months to be incorporated into the cell membranes and change the fatty acid profiles of our cells.
Even B vitamins work pretty quickly as well. So, these are what I take. You’re going to need something different, maybe less things, maybe more things. Some of these things are things that I experiment with, and sometimes I’ll do a wash. So, a lot of the time, if my patients are on a ton of things and they come in in that state, I’ll wash them, we’ll have them stop a few things, see if symptoms return, see what their baseline of health is. Because sometimes we just need a boost and to just take these things for a few years or months, and then our body gets back on track, sometimes we need some continual support throughout our lives. And so, everyone is different, everybody has different individual biochemical needs and everyone has different challenges with getting diet into their life and exercise and meeting those foundational health needs. And so someone who is a little bit more challenged in that department, who’s got a really busy and stressful lifestyle may need more nutritional support, someone who’s in a chronic disease state, recovering from more serious health issues may need more support and someone who’s having trouble maintaining their minimal nutritional requirements through diet may need some more support.
Again, I always tell people to pay for a consult with a functional medical doctor or a naturopathic doctor to figure out what your supplement regime would be. I see a lot of people in healthfood stores kind of going it alone and, not to say that you can’t get great information from the internet, but it may result in your taking a lot of things that you don’t really need, spending a lot of money that’s not targeting a specific health concern or meeting your higher levels of nutritional requirements. And also the form of the supplements and the dosing is something that’s individualized, that we need to talk about. So, there was a Marketplace study with CBC that showed that a lot of these vitamins and minerals that aren’t from professional brands and aren’t 3rd party tested don’t actually contain what they say they contain. This is specifically a problem with herbal remedies. So, if you have any questions leave me a comment below my video and you can check out my website at taliand.com .
Certain amino acids, when taken therapeutically, can affect our body’s ability to produce neurotransmitters that can greatly impact our mental and emotional health. These therapies can help treat depression, food addictions, alcoholism, psychosis and anxiety, among other things.
Transcript:
Hello, everybody, my name is Dr. Talia Marcheggiani. I am a naturopathic doctor and I work in Toronto and I focus on mental health and hormones, especially women’s hormones.
Today I want to talk to you guys about amino acid therapy and amino acid supplementation in preventing cravings, particularly for substance addictions or sugar addiction, but also for improving our mood and mental health and for treating specific psychiatric conditions.
Amino acids are the building blocks of protein. If you think of a string of beads, amino acids are the individual beads that get connected in a string and then folded up into the proteins that make up our body. Our body is basically just a hunk of protein and water. And these proteins set the stage for all of the chemical reactions, as well as the structure of our body.
When it comes to addictions and mental health conditions, there’s a lot of debate around what sets the stage for someone to experience addiction, or struggle with addictions throughout their life. And one of the things that gets a lot of blame, that also fits the pharmaceutical model, especially when it comes to depression and the prescription of serotonin re-uptake inhibitors, is this idea that mental health and addiction is something innate, that we’re born with and that needs to be corrected chemically with something like a drug like an SSRI. And we know that there’s obviously a genetic component to addictions and mental health and it’s certainly not the fault or moral failing in the person that’s suffering from these kind of things, but we also know that our genes don’t write the entire story of our experience and that, for many people, there’s lifestyle changes that can really influence genetic predispositions.
So a study that was done in rats who had a built-in genetic predisposition to addiction, to cocaine addiction, particularly, because they had a deficiency in a hormone called “dopamine”, or issues with their dopamine synthesis, and cocaine is a really potent stimulator of dopamine, which is kind of like a pleasure and reward hormone, or neurotransmitter, in our brains. These kinds of rats that were treated with amino acids, they didn’t display addictive behaviours, so they were essentially cured and their genetics were no longer relevant in terms of how they were acting out, or their behaviour, which is really promising because it was just amino acid therapy.
So neurotransmitters are hormones that work in our brain; they’re produced and act in the brain. Well, we know now with more research, I mean that’s the traditional definition of neurotransmitter, but from more research we’ve found that there’s evidence for the gut producing certain neurotransmitters like serotonin. So you can watch another video where I talk about the gut and how important it is to have a healthy gut when it comes to managing mental health, especially in depression and anxiety.
There’s a few neurotransmitters that are really, that really influence our behaviour and our mental health status and so the first one I already mentioned is dopamine, which gives us that sense of reward and gives us a sense of pleasure. So, dopamine is active when you’re doing something that is really internally motivating. You’re engrossed in a task. In terms of addictions, it’s that seeking behaviour. So a lot of people will experience pleasure in seeking out their substance of choice or thinking about indulging in sugar when they get home from work. So, that’s dopamine, that’s sort of our—the pleasure that we get from acting in the world and it definitely runs part of the show when it comes to addictions.
To quote another study in rats, so dopamine is really prevalent in our hypothalamus and so, with rats, you can give them a lever where they can direct cocaine directly into that area, and so it gives them a giant hit of dopamine. And rats that are given that option, will choose that option over food and so they’ll just stimulate their brain until they die. They’ll drink some water here and there but most of the time all they do is stimulate their dopamine. So that’s how pleasurable it is. It’s pretty much the influence of how we behave in the world and what goals we set for ourselves in the world as well. It’s how we get our delayed gratification, it’s how we work towards pleasurable tasks and how we engage in things like study or work goals or things like that.
Another neurotransmitter, serotonin, which I’ve talked about before, and that’s what the SSRIs, so selective serotonin re-uptake inhibitors are working on. And those are the most widely prescribed psychiatric medications. And that’s the hypothesis that people with depression and anxiety have a deficiency in serotonin: just this kind of innate serotonin deficiency where they either don’t make enough or they’re metabolizing it more quickly than other people. So serotonin is kind of our happy hormone, that’s what gives us a sense of well-being and pleasure. And, there’s no evidence for this hypothesis, however know that through stimulating serotonin pathways, to an extent, we can get some favourable outcomes. We also know that SSRI medications deplete serotonin, and that there’s a connection between serotonin and sugar addictions, because eating sugar will increase serotonin. So a lot of women with sugar cravings during PMS. So a couple of weeks, sometimes up to two weeks before their periods, some women will get really intense cravings for sugar and carbs, and that’s indication of a fall in serotonin before their period, which is causing them to seek out these things to boost their serotonin levels. And that can be treated with amino acids.
And then a third is acetylcholine. So acetylcholine is involved in memory and cognition and sort of that feeling of being engrossed in a task. Not so much involved in pleasure, but in our ability to stay focussed and to concentrate.
A fourth neurotransmitter is called GABA. GABA suppresses our nervous system. So, this is relevant in people with anxiety and this is what the drug class benzodiazepines work on, is GABA receptors. So, in our limbic system, GABA kind of calms down that fight or flight, or that fear state in our body. And oftentimes people who have a heightened nervous system or stress response could use some GABA to calm them down.
So there’s a few amino acids that work on these neurotransmitters. So these neurotransmitters are built with an amino acid backbone. By giving these amino acids, we’re kind of like—if you think of all these neurotransmitters assembled on a factory line, the amino acid is the starting point. So if you’re giving a lot of the supplies, then you’re more likely to cause in increase in production of the thing that you’re increasing the supply for.
We also know that there can be deficiencies in amino acids and therefore, if there’s a shortage of supplies for the key ingredients for the things you’re producing in a factory, you’re not going to get the end result because there’s just not enough of the raw materials to make what you’re trying to make.
So, we can have things like serotonin deficiency not so much because there’s a genetic predisposition, or an issue with the brain’s ability to metabolize it or make it, but maybe that there’s a deficiency in the amino acids, or the vitamins and minerals that are needed to create serotonin.
When it comes to naturopathic medicine and functional medicine, we kind of look at this. We try and see how we can influence the body’s biochemical pathways to get more of what we’re noticing is lacking. And so one of the ways that we can find out which neurotransmitters are lacking is by running some functional tests. That’s not really a big part of my practice because of the cost involved in that, but we can tell a lot through symptoms. So we can tell a lot by asking, are people getting sugar cravings, what’s their drug of choice, are they heading towards cocaine or are they calming their nervous system down and stimulating their GABA pathways with alcohol. Are they trying to get that pleasure sensation with something like heroin? Are they going for stimulants or central nervous system depressants? So, based on what someone is addicted to, or looking at and really breaking down their addictive behaviours, we can find out more about which neurotransmitters might be off. And in a lot of cases there’s a deficiency in many of them.
One of the first things to recommend, just generally, is to increase more protein in the diet, because we know that these amino acids are contained in proteins. And, strangely enough, we don’t get a lot of high-quality protein in our diet in the Standard American Diet, so you think of a bacon and eggs breakfast and McDonald’s lunch and you’re like, ‘well, there’s protein in those foods…’ But, in something like eggs, we’re only getting about 6 grams of protein an egg, whereas I recommend more like 20 to 30 grams of protein in the morning for breakfast. And the reason for this is, of course, to just increase the amount of amino acids that your body can then use to make neurotransmitters, but also to keep blood sugar stable, because drops in blood sugar are going to cause stress hormones to be released and potentially for these neurotransmitters to be altered, worsening addictions, especially addictions to sugar and alcohol, which boost our blood sugar.
So the first thing, dopamine, that amino acid that creates dopamine is tyrosine. So, for some people, and tyrosine is a very stimulating amino acid, so people that kind of have that 2 pm slump, sometimes benefit with some tyrosine, or tyrosine in the morning when they’re feeling really low. And so these people kind of suffer from boredom, they really like stimulants, so they’ll do the caffeine, or they’ll use cocaine on the weekends, or they’re really involved in pleasure-seeking behaviour like, maybe they had a diagnosis of ADHD as a kid, or adult-onset ADHD, which is more involved in traumatic experiences and mental health and neurotransmitter imbalance than it is some genetic predisposition.
Sometimes with these people, supplementing with tyrosine can help, just give them that dopamine boost and keep their nervous system more stimulated so that they don’t need to stimulate it with substances.
For serotonin, the building block is l-tryptophan, which is then made into something called 5-HTP. So some naturopaths will prescribe l-tryptophan as a supplement, I tend to go more with 5-HTP because it passes a step so that your body has to do less work. 5-HTP is really great to help with sleep. It’s good to help with boosting mood, to a certain level, and it’s also really great for PMS sugar cravings, and alcohol cravings. I find myself, personally, so this Christmas I’m going sugar and alcohol free. I’ve been sugar and alcohol free for a few months, but I’m going to carry that on through the holidays, so I’ve had to turn to 5-HTP before my period because I realized how many sugar cravings I get before then. And, miraculously, just with a few hundred milligrams of 5-HTP, I’ve noticed a giant change in the foods that I was craving and in my ability to hold off on having sugar and alcohol. So, pretty powerful.
So, in order to make serotonin, 5-HTP also needs some B vitamins and magnesium. So, people that are deficient in things like B6 and B12 and folate, so I’m looking at vegetarians who often have B12 deficiencies, or vegans. And, actually I see a lot of B12 deficiency or suboptimal B12 in people that eat meat as well, so this isn’t necessarily something is only applicable to vegetarians.
But it’s important for a lot of people to supplement then with these other cofactors that help make serotonin, especially if they’re on an SSRI already. And I don’t advise just doing this on your own, it’s better to do this with a professional who can figure out what’s the underlying cause of a neurotransmitter imbalance and then help prescribe a comprehensive treatment plan that will get you to better neurotransmitter synthesis and treat your symptoms, or the underlying condition.
Something else that I find really helpful, and this is one of my favourite nutrients in psychiatry and in women’s health and something I take is something called N-acetyl cysteine, or NAC, “NAC”. And NAC is from the amino acid cysteine and it produces something called glutathione. So glutathione is the primary antioxidant in the body. This is what our body uses to neutralize all of the free radicals, that is kind of a buzzword—people will tell you to drink green tea, eat blueberries, to get antioxidants, well, the main antioxidant our body uses is something called glutathione, and NAC helps produce glutathione.
It helps our liver detoxify and, in hospitals medical professionals will give people intravenous NAC to treat Tylenol overdose, which we know is liver toxic, so it’s widely recognized that NAC can treat toxicity of the liver. It’s also a powerful antioxidant for the lungs so I prescribe it to patients who are smokers or recovering from smoking or aren’t really ready to quit smoking yet but are experiencing some of the bronchitis, the emphysema, or the increased phlegm or lung issues that go along with a chronic habit of smoking. So, it’s a powerful antioxidant and it has an affinity for the lungs and for excess mucus production. It also helps balance estrogen because of the liver detoxification, so it helps us detoxify estrogen through the liver, and is really helpful for a condition called polycystic ovarian syndrome, which is when the ovaries are producing testosterone and not responding to other hormones properly, so this is really helpful. It also helps with blood sugar balance. NAC’s the best. And so, there’s lots of research for NAC in things like bipolar disorder and schizophrenia and psychosis and OCD. So these more serious psychiatric conditions, NAC can really help balance. And we’re not sure exactly why but one of the hypothesis is that, because it creates glutathione, it helps lower inflammation, and we know that inflammation is implicated in mental health conditions and so that’s why NAC might be so useful. It doesn’t interact with psychiatric medications and so it’s a really big part of my practice.
New research has shown that NAC can help with addictions and cravings for things like nicotine, cannabis, food, so binge eating, cocaine and gambling, interestingly enough. And then there’s a new study that NAC can help treat porn addiction. So, it’s involved in helping lower that desire for, not necessarily substances, or food, but behavioural addictions as well, which is useful. And there’s studies in trichotillomania, so that’s like, compulsive hair plucking—so people will pluck their eyelashes or pluck their hair—or skin picking, and NAC can work pretty rapidly in bringing down those desires and stopping those behaviours.
GABA is something you also might have heard of. So, GABA was a neurotransmitter that I cited before, that calms the nervous system down. GABA, there’s debate about whether it crosses the blood brain barrier. So, our brain has this really tight wall that it prevents certain substances from crossing. That’s to protect our brain tissue from toxins and foreign objects, or foreign substances. So we’re not sure, necessarily, if GABA’s acting on the brain unless there’s a leaky brain situation happening, so kind of like leaky gut, we can also have that with our blood brain barrier. But there’s herbal combinations that help stimulate GABA, that I implement in my practice sometimes to help people that are experiencing panic attacks or anxiety, to get them to a level where they can then make the changes that are going to sustain them. So, things like valerian and hops, and passionflower and something that I prescribe a lot, kava, another herb called lemon balm. So, sometimes combinations of these, or just one of these things can help, especially before bed. And so, one of the indications for GABA deficiency is a craving for wine, especially at the end of the day, and particularly white wine. I guess it has more GABA-stimulating properties. I have a lot of patients, many of them female patients, that just really crave a glass of wine at the end of the day. And a few other patients that will have an after-work beer. So, just doing some GABA, or some GABA herbs, on the way home from work might be enough to decrease that need to reward and balance that nervous system, because the alcohol does have a GABA-stimulating effect and calms people down. It’s us looking for a way to self-medicate and trying to balance our neurotransmitters through the actions that we’re familiar with that don’t necessarily set us up for powerful health because they perpetuate further addictions, like turning to alcohol to calm ourselves back down, or as a reward and stress relief.
And the last neurotransmitter I’m going to talk about is something called l-glutamine. So, glutamine is a fuel for brain cells and for gut cells, as well as kidney cells. It’s another amino acid, it’s involved in creating the neurotransmitter glutamate, which is excitatory. So, this is something that increases our nervous system tone.
So, glutamine we prescribe as naturopaths a lot for leaky gut because it helps feed our enterocytes, or our gut cells, it can help repair them. So, somebody with celiac disease who’s experienced a lot of intestinal damage and has now taken out gluten, might need some glutamine, some l-glutamine to repair the gut cells that were damaged or increase that cell turnover so that they’re no longer experiencing symptoms.
L-glutamine has kind of got a sugary taste, but it doesn’t stimulate us like sugar does, and so one thing that people do when they’re experiencing sugar and alcohol cravings is to take some glutamine powder or open up a capsule of l-glutamine and let it dissolve under their tongue. And they experience a remarkable decrease in their sugar and alcohol cravings, those physiological cravings—the emotional cravings are another piece, obviously—but the physical cravings where our body is really asking for these foods, the l-glutamine can really help calm that down powerfully. So this is something that I’m going to experiment with myself and with some patients that I know could really benefit from this.
So I wanted to give this talk, just to give you guys some easy things to try over the holidays, especially when you’re experiencing some of those sugar or alcohol cravings or getting into a situation where your vices are playing out in excess. I know that this is going to be helpful for me, because of my commitment to no sugar or alcohol this holiday season, which is actually easier than it sounds. And one thing to note too, is that with amino acids, because we’re pushing pathways, they don’t work necessarily like drugs that can take, like an SSRI can take 4 to 6 weeks before it’s effect comes on. These work within days. So, when I was experiencing sugar cravings before my period last month, and I started to take 5-HTP, which remember stimulates serotonin, or helps us produce serotonin, and can help with sugar cravings, and carb cravings. When I started to take 5-HTP, I noticed this sense of well-being and uplifted mood within a few days and it was a noticeable effect, as well as deepened sleep. My sugar cravings immediately dissipated when I started taking it. So it took a few doses to eliminate my sugar cravings and then a few days to increase my mood, which I didn’t even realize was kind of falling, based on that serotonin deficiency before my period. So, these are really powerful therapies that you can try. I don’t advise doing it on your own, but seeking the help of a professional, but these are things that can really help balance brain chemistry during the holiday season and set you up for better mental health.
So, next talk I’m going to talk about leaky gut and leaky brain and how avoiding gluten can help with mental health conditions. So, have a great holiday, everyone and I’ll see you next time. My name is Dr. Talia Marcheggiani, and I’m a naturopathic doctor who practices in Toronto. If you have any questions give me a shout on my email at connect@taliand.com. Happy Holidays.
It’s astounding when I reflect on the fact that three years of immersion in naturopathic medical philosophy haven’t remedied the need for a quick-fix pill. The pill itself has changed, to become more “natural” (with the assumption that natural is far superior to a synthetic derivative of the same drug with similar pharmaceutical effects), but our desire remains the same.
At a teacher training I recently attended, we were given the task of deciding what we would take with us if we were to go to a deserted island. While other people chose things like hatchets, food, water (and a boat), I automatically thought: castor oil! Sometimes I forget that the rest of the world isn’t living under the naturopathic bubble.
Meet Giacomo, my Italian neighbour. Giacomo enjoys gardening, making his own wine, cooking for himself and has recently undergone triple bypass heart surgery and is recovering fabulously. He has just celebrated his 92nd birthday.
Like all of the mothers of naturopathic medical students, my mother is reading the book The Supercharged Hormone Diet by Dr. Natasha Turner, N.D. I had the chance to flip through it and discovered a recipe for this easy “detox water” that Dr. Turner recommends to accompany the diet.
My Italian grandmother (“La Nonna”) remembers a time when, during World War II in rural Italy, she and her sister were given a daily supplement of cod liver oil, as part of a public health campaign under Mussolini’s government.
