Nutrients and Depression

By Chad Krier, N.D., D.C.

Depression is one of the most common emotional disturbances seen by doctors today. Around 25% of all Americans will suffer from some form of depression at some point in their lifetime. In fact, depression is the leading cause of hospitalization for mental illness. Warning signs for depression include poor appetite or increased appetite, poor sleep or too much sleep, fatigue, loss of interest in pleasurable activities, poor concentration, feelings of worthlessness, and suicidal ideations.

A few simple nutrients can have a profound effect on brain chemistry and mood.

Depression can be reactive (an external situation such as financial trouble), endogenous (no obvious trigger—perhaps biochemical, hormonal, or nutritional), or drug induced (oral contraceptives
lowering B vitamins which are needed for neurotransmitter synthesis). Causal factors are varied but can include any of the following: abuse of alcohol, caffeine use, anti-hypertensive medications, hormonal imbalances, nutrient deficiencies, eating too many simple sugars, or brain chemical imbalance (neurotransmitters).

In this article, we will focus on nutrients that have a balancing effect on brain chemistry. How our brain functions is largely dependent on the molecular environment we provide for it. We know
that our brain performs poorly when localized deficiency states exist in the nervous system. Our goal should be to prevent nutrient deficiency and promote balance too optimize normal brain metabolism.  When using nutritional therapy in the correction of mood disorders we often dose in amounts much greater than those required to simply prevent a deficiency. With the therapeutic loading of nutrients, it may be possible to overcome genetic road blocks that have been passed onto us.

One of the most important things we can do for brain health is balance our neurotransmitters. Neurotransmitters are chemicals used to relay, amplify, and modulate signals between nerve cells.
Amino acids (breakdown products of protein) serve as the building block for neurotransmitters. Both phenylalanine and tyrosine (amino acids) can be used to make the brain chemicals dopamine
(motivation, “wanting,” pleasure, associated with addiction and love) and norepinephrine (wakefulness or arousal). Tryptophan (amino acid) is needed to make the neurotransmitter serotonin
(memory, emotions, wakefulness, sleep, and temperature regulation).

How do we know which one to use? At The Center, we measure amino acids in the blood and neurotransmitters in the platelets in order to find an individual’s unique blood brain balance. For adults the recommended therapeutic dose for tyrosine is between 3000 and 7000 mg daily in divided doses. The therapeutic dose for tryptophan is between 1000 and 6000 mg daily in divided doses. Tryptophan tends to work best in depression populations that also suffer from insomnia (melatonin connection). Amino acids are best taken away from protein sources. I generally recommend taking amino acids away from meals with half a glass of juice (1/2 water and 1/2 juice). It is best to start with low doses and titrating up slowly to avoid adverse reactions. Side effects from too much tyrosine include anxiety, sweating, rapid heart rate, and an increase in blood pressure. Too much tryptophan can often lead to headaches. What’s the difference between drug therapy and amino acid therapy? Drug therapy for depression tends to work through inhibiting certain enzymes. By decreasing the functioning of brain enzymes the medicines can prevent the
breakdown of neurotransmitters. If you don’t break down the brain chemicals, you keep more of them around in the brain, which allows for more nerve communication. Supplementing with therapeutic levels of amino acids actually allows our nervous system to create more neurotransmitters from new material (amino acids) which allows for better nerve communication. The major difference between the two therapies is that the medicines make use of what is already there (recycled parts) and the amino acids build up a new supply (brand new/factory sealed) to replace
what has been used up and to improve on the total pool of neurotransmitters.

Vitamin B12 and folate are also important for neurotransmitter balance. Both are important for raising central nervous system (CNS) serotonin levels. Folate is important for making most of the neurotransmitters found in the brain through a process known as methylation.  Nearly 1/3 of all depressed patients may have low folate levels. Conventional lab values (reference ranges) for both
B12 and folate may be inadequate. We know that blood levels of nutrients do not equate with the CNS levels of nutrients. To achieve therapeutic benefit, we need therapeutic levels of B12 and folate much greater than normal lab parameters. Besides measuring absolute values of B12 and folate, we can measure a functional test known as homocysteine. High homocysteine means your brain could use more B12 and folate. The therapeutic dose for adults of folate is 2-15 mg daily in divided doses with food. Folate should not be used in high dosages if you are on anti-seizure medication. Methyl –B12 can be taken sublingually (under the tongue) at a of 5000 mcg daily. Injections of B12 and folate may work better initially to quickly reach therapeutic levels.

Beyond neurotransmitters it is important to support the structure and function of nerve cell membranes (where communication between cells takes place). Because the membranes are largely made of fat, it is important to optimize healthy fats in the diet and through supplementation. Omega-3fatty acids (giggle juice) from cold ocean fish supply the right type of fats to support our
brain health. Omega-3 fats play a major role in cell signaling (communication) and regulating inflammation in the central nervous system. Omega-3 fats also support the production of Brain Derived Neurotrophic Factor(a protein that supports the growth of nerve cells through adulthood). Low levels of brain derived neurotrophic factor have been correlated with depression. Supplementing 9-10 grams per day of cod liver oil can be effective for depression. It is best to take the cod liver oil with food in divided doses. After opening your cod liver oil it is best to keep it refrigerated.

Many who suffer from depression note that their mood often changes for the worse around wintertime. Researchers are beginning to pin this phenomenon on the sun and vitamin D. We know that  depression scores are worse at northern latitudes where there is less sun and, hence, less vitamin D production in the skin. Many Americans are showing up extremely low in vitamin D on lab studies. This is a problem because vitamin D works as a hormone in our body which can have positive effects on our mood. The brain has vitamin D receptors which need to be stimulated for our brain health. With the fear of the sun and lack of dietary vitamin D our brains are not receiving the stimulus they yearn for. Supplementing with 1000-4000 IUs of active vitamin D (D3) with food daily can build up vitamin D to adequate levels.

A few simple nutrients can have a profound effect on brain chemistry and mood. You may want to pick a few of the above nutrients and slowly build up over time to see how they benefit your mood. The overall goal should always be to take the hitch out of your “get along.”