Before the introduction of psychiatric medications in the 1950s, researchers studied the relationship between nutrients and mental health. They noted, for example, that people known to be deficient in B vitamins had more of a tendency to be moody and irritable. However, interest in nutrition took a nosedive with the ever-growing number of prescription medications that doctors used to treat their patients’ symptoms.

Why do we need to take supplements? 

Until recently, doctors frequently reassured patients that there was no need to take supplements and that eating fruits and vegetables would provide all the nutrients they needed. In fact, I often heard my colleagues say that supplements do nothing but “make expensive urine.”

Due to the degradation of our soils from the overuse of chemicals in agriculture, and due to commercial processing, the nutritional content of our food is only a fraction of the nutrients found in food grown before the 1950s.

Donald Davis, PhD, a former crop scientist at the University of Texas, published an article in 2004 in the Journal of the American College of Nutrition about the results of his research on the nutrient content of 43 different fruits and vegetables. He documented the drop in their nutritional content from 1950 to 1999. The calcium content in broccoli, for example, dropped from 130 mg per serving in 1950 to 48 mg per serving in 1999.

From 1999 until the present, the level of nutrients in our food has continued to drop, especially the trace minerals.

In these times, not only are we getting fewer nutrients from our food, we are also eating more processed foods, and we are eating foods contaminated with herbicides. On top of that, we are exposed to an unprecedented amount of emotional and physical stressors, including toxins in our homes and workplaces that create inflammation and damage to the cells in our bodies. Such stressors result in an increased need for vitamins, minerals and antioxidants to help repair the damage.

While supplements can be very important for mental health and the health of our whole body, they are no substitute for a healthy diet.

 

Case history 

Robert, a 33 year-old medical student, consulted with me in hopes of getting help with an anxiety disorder that interfered with his studies and with his married life. He said that he could not identify any reason for being chronically anxious, except that anxiety ran in his family.

Robert said that he tried his best to eat a good diet when he was at home. Although he and his wife ate conventionally grown food, he said that he tried to eat plenty of vegetables and made an effort to avoid caffeine and alcohol and sugar. He said that the food served in the hospital where he trained was not very healthy.

Robert took all the measures he could to quell the ever-present anxiety. He diligently went for counseling twice a month—even though the anxiety did not diminish with the talk therapy. He meditated for a half hour daily, did deep slow breathing when especially anxious, and took tinctures of calming herbs.

I discouraged Robert from taking anti-anxiety medications and said that I would like to see if there was a biochemical component to his anxiety. I suggested that he get both nutritional testing and genetic testing. From those tests, we learned that he had multiple nutrient deficiencies, including B-12, magnesium, methylfolate, omega 3 fatty acids, and vitamin D.

Two months after Robert treated his nutritional deficiencies with a set of carefully selected supplements, I ran into his wife at the health food store. She had recently switched to buying organically grown food. While standing in front of the fresh produce section, we talked about her husband. She said that, since taking the supplements, Robert was calmer and that the frequent agitation and mood swings had diminished noticeably.

She also reported that Robert’s leg cramps had disappeared along with his constipation, eczema, and headaches—a side benefit of the supplements.

Before we parted ways, she said with a smile, “I feel like I’m meeting the real Robert for the first time.” 

Which supplements play a strong role in maintaining mental health?

Although the subject of supplements for maintaining mental health is vast, I will touch on only a few of the most essential ones and then give you some references for much more in depth and comprehensive coverage of this important subject.

The supplements that I will mention apply to most people who want to maintain brain health and are not specific to those with mental illness or mood disorders.

Omega 3 fatty acids are important sources of brain food. Omega 3 oils have a powerful anti-inflammatory effect and have been proven to reduce symptoms of depression, anxiety, and mental illness, including schizophrenia, bipolar disorder, OCD, and psychosis.

In 2001 Harvard psychiatrist, Dr. Andrew Stoll, wrote a book called, “The Omega-3 Connection.” The book discusses the importance of using omega 3 oils for depression and mental illness.

Our brains are 60% fat. DHA, an animal-based omega 3 fat, along with EPA, are protective of neurons in the brain and are crucial for normal brain function and mental health. DHA can be obtained from breast milk, fish oil, or algae oil.

Over thirty years ago, in my early years of practicing medicine, I remember reading an article in the newspaper about a tribe in the Pacific Northwest that had lost their rights to catch salmon as they had done for centuries. The tribal elder who was interviewed in the article said that ever since the tribe stopped eating the salmon, they were seeing their first cases of overt mental illness ever recorded by their people—including schizophrenia.

Most people do not get enough omega 3 fat from the diet alone and need to supplement their diets. Vegans sometimes consume flax seeds or walnuts in order to get their omega 3s. While flax seeds and walnuts offer many health benefits, they often are not converted into DHA and EPA by the body. That’s because many people have insufficient levels of an enzyme called delta-6 desaturase (D6D) that converts the alpha-linoleic acid (ALA) in flax seeds and walnuts into DHA and EPA—the components of omega 3 oils that are most beneficial to the brain.

When purchasing omega 3 oils, it’s important to research the company that you select to make sure that the pollutants are distilled out of the product.

If the taste of the fish oils bothers you, try putting the bottle in the freezer. The cold cuts down the fishy taste.

Adult dose is about 2000 mg of total fish oils a day with a meal.

B-complex includes B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid). B6 (pyridoxine), B7 (biotin), and B9 (folate), and B12 (cobalamin) The B vitamins are essential for brain health and can alleviate the symptoms of stress and mental illness and mood disorders.

B-12 (cobalamin), is commonly deficient in people over 50 because of an inability to absorb it from the gastrointestinal tract due to diminished gastric acid and the absence of a protein called intrinsic factor. Intrinsic factor facilitates the absorption of the B-12 into the cells.

The best way for older adults to get adequate B-12 is through an injection or by taking the B-12 daily under the tongue where it can diffuse directly into the blood stream by the capillaries on the underside of the tongue.

The dose can range from 1000 mcg to 5000 mcg, depending on the test results. I like to see my patients’ blood levels in the very high end of normal, greater than 1000 pg/mL.

Since B-12 is mostly found in animal foods, vegans and vegetarians are often deficient in B-12. Signs and symptoms of B-12 deficiency can include, fatigue, short-term memory problems, confusion, “brain fog,” neurological diseases, anemia, anxiety and depression.

Methylfolate is the “activated” version of folic acid, a synthetic vitamin. Many people have a genetic mutation of an enzyme called MTHFR that is involved in methylation. They are not able to convert the folic acid into methylfolate. Low folate levels are related to severe depression and anxiety, rage attacks, schizophrenia, bipolar disorder, and an inability to respond to antidepressant medication.

The dose that I recommend of methylfolate is 1-2 mg a day for an adult.

When you search for B-complex vitamins, look for ones whose B vitamins are in their “bioactive” forms. For example, the cobalamin (B-12) needs to be methylcobalamin, adenosylcobalmin, or hydroxycobalamin—not cyanocobalamin. The folic acid needs to be in the form of methylfolate. And the pyridoxine (B6) needs to be in the form of pyridoxal-5-phosphate. 

Magnesium is a common deficiency. Inadequate magnesium can cause or exacerbate seizures, leg cramps, asthma, migraine headaches, abnormal heart rate and rhythms, high blood pressure, menstrual cramps, anxiety, OCD, depression, and fatigue.

Magnesium glycinate and magnesium asporotate are well absorbed. Magnesium citrate is often used to treat constipation because it is not totally absorbed. The part that is not well absorbed can cause loose stools. The dose I recommend is 400-600 mg a day for an adult. I suggest taking the magnesium at bedtime because it relaxes the smooth muscles found inside the body.

Another form of the mineral is Magnesium L-Threonate, the only form of magnesium that is able to cross the blood-brain barrier. This barrier is formed by the tight juncture of cells that line the inner wall of the capillaries that flow inside the brain. Because the cells are packed so tightly together, they can regulate what passes into the brain and what is kept out, in order to protect the brain from harm. Magnesium is extremely beneficial for the brain.

Vitamin D is deficient in many people in the US. Receptors for vitamin D can be found throughout the brain. A deficiency in vitamin D can lead to depression and frequent viral infections.

One of the many functions of vitamin D is to increase calcium uptake from food. For that reason, the vitamin D needs to be combined with vitamin K. Without the vitamin K, the calcium gets deposited wherever there is inflammation, such as the joints and arteries. With the vitamin K the calcium gets escorted to the bones.

The amount of vitamin D one needs to take is based on the results of the blood tests. Some people have genetic mutations of the vitamin D receptors and need to take very high doses. The “normal range” that is given on the blood test is not the range I agree with. My idea of an ideal range is 50-80 ng/mL in order to get maximum protection. 

Probiotics.

With frequent exposure to herbicides and antibiotics and processed foods, our micro biomes are under assault making probiotics essential to good health.

Researches have discovered that certain microbes can help with specific conditions, including mental illness. For example, some of the bacteria that look the most promising for conditions like OCD and bipolar disorders are Lactobaccillus fermentum, L. casei, L. reuteri, L. plantarum, L.rhamnos, and Bifidobacterium longum.

The list of possibilities for supplements to take that address specific conditions is long. I have listed above just a few basic supplements that can play a beneficial role in the treatment of psychiatric illnesses and mood disorders.

How do we know what supplements we need to take? 

One of the best ways to tell if you would benefit from a supplement is trial and error. When you add a new supplement to your regimen, try to make one change at a time so that you can observe over time how you feel.

Blood testing is another way to determine what you need to take, although the results are not always dependable because blood levels can fluctuate from one moment to the next.

Genetic testing has become popular for determining what one is predisposed to need, but it is incomplete.

Many of my patients prefer that I simply make an educated guess about what they need in their supplemental regimen, combined with the results of the genetic tests when they are available. 

What are the best supplement companies? 

Make sure the supplements are derived from food when possible. Find companies that are known for their pure ingredients. Avoid cheap petroleum-based supplements commonly found in drug stores. Some of the most reputable companies include the following:

• Biotics Research
• Pure Encapsulations
• Douglas Laboratories
• Metagenics
• Vital Nutrients
• Designs for Health
• ProThera
• Klaire Labs
• Thorne Research
• Transformation Enzymes
• Herb Pharm
• Gaia Herbs
• Energetix
• Ecological Formulas
• Mercola
• Life Extension
• Premier Research
• Nordic Naturals
• Carlson’s

Remember to read all the ingredients listed on the label before you make your purchase.

Nutrition-based psychiatry

There are growing numbers of psychiatrists who are delving into the world of diet and supplements as treatment for mental illness, either as an adjunct to prescription medication or in lieu of medication.

One of the psychiatrists with whom I have shared a few patients uses a company called True Hope to supply her patients with the supplements that they need. The people in customer service at True Hope are exceptionally helpful and kind. www.truehope.com

Reading Recommendations

“The Mood Cure” by Julia Ross is a useful guide to feeling better through specific supplements and dietary changes. The recommendations are customized to fit the particular characteristics of your mental condition.

“Nutrient Power: Heal Your Biochemistry and Heal Your Brain” by William Walsh, PhD. This book contains a wealth of valuable information for patients, psychiatrists and other healthcare practitioners. The information is heavily backed by research. 

Conclusion

Vitamins, minerals, amino acids, antioxidants, and herbal supplements not only have a significant amount of evidence supporting their use for the prevention and treatment of mental health problems, they also have an admirable safety record—unlike the risks involved in taking psyche medications.

A nutritionally oriented mental healthcare provider who is willing to use diet and supplements instead of potentially harmful prescription medications could be very helpful in your search for wellbeing.

While nutrient supplementation plays an important role in maintaining proper brain function and treating psychiatric disorders, nutrients do not replace the need for a healthy, whole foods diet.

My fervent hope is that in the not-too-distant future psychiatrists and mental health practitioners will be required to receive training in this area of healthcare, and that they will start their treatment plans with an in depth discussion of diet and nutrition.

In my next post, I’ll be addressing the connection between heavy metals and mental illness. Stay tuned!