Omega-3 fatty acids. Omega-3 fatty acids are
long-chain polyunsaturated fatty acids found in fish and various oils,
such as flaxseed or canola oil (Logan AC 2003). The brain has a high
concentration of polyunsaturated fatty acids (Yehuda S et al 1999;
Bourre JM et al 1991), and depressed people have lower levels of
omega-3 fatty acids compared with the pro-inflammatory omega-6 fatty
acids (Tiemeier H 2003). Adding the omega-3 fatty acid eicosapentaenoic
acid (EPA) to conventional antidepressant treatment relieves depressive
symptoms (Puri BK et al 2001). Among children with depression,
supplementation with omega-3 fatty acids has shown “highly significant”
effects on symptom scores (Nemets H et al 2006). In 2006, researchers
analyzed results from six published studies on depression and omega-3
fatty acids. They found that omega-3 fatty acids can reduce symptoms of
depression among adults (Williams AL et al 2006).
Omega-3 fatty acids are also beneficial because they reduce the risk
of cardiovascular disease, which is highly associated with depression
(Burr ML et al 1989; Singh RB et al 1997).
Zinc. Zinc is a trace element known to have a
regulatory function in the human nervous system (Nowak G et al 2002).
It not only promotes creation of new brain cells but acts as an
antioxidant, decreasing oxidative stress. Decreased blood levels of
zinc are associated with depression (Maes M et al 1994, 1997;
McLoughlin IJ et al 1990), and maintaining a healthy zinc level in the
brain is essential to normal brain function (Takeda A 2000).
Animal studies show that antidepressants and electroconvulsive shock
treatments change zinc concentrations in areas of the brain associated
with depression (Nowak G et al 1999). In an animal study, zinc was also
shown to enhance antidepressant effects of imipramine (Kroczka B et al
2001).
Vitamin C and vitamin E. Vitamin C is a well-known
antioxidant. Studies indicate that levels of vitamin C are lower in
people with depression than in those without depression (McKee T et al
1999a; Khanzode SD et al 2003). Ascorbic acid indirectly inhibits
oxidative stress by enhancing the activity of other antioxidants, such
as vitamin E (McKee T et al 1999b). Low serum levels of vitamin E are
linked to major depression (Maes M et al 2000).
St. John’s wort. St. John’s wort (Hypericum
perforatum) is a medicinal herb used for the treatment of neurological
and psychiatric disorders, including depression (Nangia M et al 2000).
Compared to placebo, H. perforatum extract can effectively treat mild
to moderate depression, reducing symptoms and recurrence rate
(Lecrubier Y et al 2002).
The mechanism of action of St. John’s wort in depression is not
entirely clear. One idea is that St. John’s wort affects presynaptic
serotonin uptake and inhibits norepinephrine reuptake (Nangia M et al
2000). By affecting or inhibiting reuptake mechanisms of presynaptic
neurons, St. John’s wort may increase availability of serotonin and
norephinephrine. Clinical trials show positive response rates to
treatment with St. John’s wort (Kim HL et al 1999; Linde K et al 1996).
Please see the important safety information on St. John’s wort at the
end of this chapter.
Ginkgo biloba. The herb Ginkgo biloba
has been shown to produce an antioxidant. Ginkgo has been studied in
animal models of depression with good results. In one study, rats were
subjected to chronic stress—the same kind of stress that may lead to
depression in humans. When the rodents were treated with the
antidepressant venlafaxine, Ginkgo biloba was able to protect
the brain while mitigating the side effects of the synthetic
antidepressant (Qin XS et al 2005). Another study examined the ability
of ginkgo to reduce the sexual dysfunction that sometimes accompanies
conventional antidepressant drugs. Ginkgo was administered at 240 mg
daily for 12 weeks. Interestingly, although the researchers didn’t find
any statistically significant change across the whole group, they noted
“spectacular individual responses” (Wheatley D 2004).
L-phenylalanine and tyrosine. Just as tryptophan
and 5-hydroxytryptophan are precursors to serotonin, L-phenylalanine
and tyrosine are precursors to dopamine and norepinephrine. Although
not many clinical studies have examined the effects of these two amino
acids, one review study found that people experiencing mild to moderate
depression may find it helpful to “preload” with precursors of valuable
neurotransmitters (Meyers S 2000).
Tryptophan and 5-hydroxytryptophan. Available as
dietary supplements, these two substances are immediate precursors to
serotonin. In some countries, tryptophan is licensed as an
antidepressant (Murphy SE et al 2006). In one study, healthy women
given tryptophan for 14 days experienced increased recognition of happy
faces and words and decreased recognition of negative words. The
research team concluded that tryptophan had improved the study
participants’ supply of serotonin, much like a conventional SSRI
(Murphy SE et al 2006). More study is needed on the use of these
supplements in depression.
Vitamin Depot Online.com Foundation Recommendations
Treatment of depression often takes place on several fronts.
Depressed patients may benefit from exercise and other strategies, such
as acupuncture, yoga, or meditation. In addition, psychiatric
counseling can help people deal with the feelings of sadness and
hopelessness that accompany depression.
If there are any underlying conditions, these should also be
treated. Heart and vascular disease are associated with depression, and
hypothyroidism can also cause depression. For more ideas on how to
treat these conditions, please see the chapters on thyroid disorders
and heart disease.
The following dietary supplements have been shown to help restore neurotransmitter levels and alleviate depression:
B vitamins—A
full complement of B vitamins (including at least 1000 micrograms (mcg)
vitamin B12, 250 milligrams (mg) vitamin B6, and 800 mcg of folic acid
daily
Tryptophan—500 to 1000 mg once or twice daily on an empty stomach
DHEA—15 to 75 mg daily, followed by blood testing in three to six weeks to make sure optimal levels are maintained
In addition, hormone therapy may be necessary to balance levels of
important hormones, including pregnenolone, estrogen, progesterone, and
testosterone. Hormone testing is recommended, followed by hormone
supplements if necessary. Progesterone creams are available for
application directly to the skin, while testosterone is available in a
number of delivery systems. Special compounding pharmacies can help
produce estrogen supplements that reflect the natural balance of
estrogens rather than the strong animal estrogens used in conventional
hormone replacement therapy. For more information, see the chapters
Female Hormone Modulation and Male Hormone Modulation.
Product Availability
All the nutrients and supplements discussed in this section are
available through the
Vitamin Depot Online.com Foundation Buyers Club, Inc. For
ordering information, call anytime toll-free 1-800-544-4440, or visit
us online at www.LifeExtension.com.
The blood tests discussed in this section are available through
Vitamin Depot Online.com National Diagnostics, Inc. For ordering information, call
anytime toll-free 1-800-208-3444, or visit us online at
www.LifeExtension.com.
Depression Safety Caveats
An aggressive program of dietary supplementation should not be
launched without the supervision of a qualified physician. Several of
the nutrients suggested in this protocol may have adverse effects.
These include:
Choline
Do not take choline if you have primary genetic trimethylaminuria.
Choline can cause fishy body odor, excessive perspiration,
hypotension (low blood pressure), depression, and gastrointestinal
symptoms such as nausea and diarrhea.
Creatine
Do not take creatine if you have diabetes, kidney failure, a kidney
disorder such as nephrotic syndrome, or are otherwise at risk of having
a kidney disorder.
If you take creatine, have your serum creatinine level monitored frequently.
Creatine can cause muscle cramping, muscle strains, and gastrointestinal symptoms such as nausea and diarrhea.
DHEA
Do not take DHEA if you could be pregnant, are breastfeeding, or could have prostate, breast, uterine, or ovarian cancer.
DHEA can cause androgenic effects in woman such as acne, deepening of the voice, facial hair growth and hair loss.
D,L-Phenylalanine
Do not take D,L-phenylalanine if you have phenylketonuria.
Do not take D,L-phenylalanine if you are taking nonselective monoamine oxidase inhibitors (MAOIs).
Do not take D,L-phenylalanine if you have schizophrenia.
D,L-phenylalanine can exacerbate tardive dyskinesia (involuntary facial
movements) in people who have schizophrenia.
Consult your doctor before taking D,L-phenylalanine if you
have high blood pressure. D,L-phenylalanine can exacerbate high blood
pressure. D,L-phenylalanine can also cause high blood pressure.
EPA/DHA
Consult your doctor before taking EPA/DHA if you take warfarin
(Coumadin). Taking EPA/DHA with warfarin may increase the risk of
bleeding.
Discontinue using EPA/DHA 2 weeks before any surgical procedure.
Folic acid
Consult your doctor before taking folic acid if you have a vitamin B12 deficiency.
Daily doses of more than 1 milligram of folic acid can
precipitate or exacerbate the neurological damage caused by a vitamin
B12 deficiency.
Ginkgo biloba
Individuals with a known risk factor for intracranial hemorrhage,
systematic arterial hypertension, diabetes, or seizures should avoid
ginkgo.
Do not use prior to or after surgery.
Avoid concomitant use of ginkgo with NSAIDS, blood thinners, diuretics, or SSRI’s.
Gastrointestinal symptoms (nausea and diarrhea) may occur.
Allergic skin reactions may occur.
Elevations in blood pressure may occur.
L-Tryptophan
Do not take L-tryptophan if you have carcinoid tumors.
Do not take L-tryptophan while taking monoamine oxidase inhibitors (MAOIs) (type A) or within 2 weeks of discontinuing MAOIs.
Do not take L-tryptophan with any antidepressant medications,
including selective serotonin reuptake inhibitors (SSRIs), tricyclic
antidepressants or MAOIs.
Do not take L-tryptophan with serotonin 5-HT receptor agonists, including naratriptan, sumatriptan and zolmitriptan.
Do not take L-tryptophan if you have ischemic heart disease
(e.g., a history of myocardial infarction, angina pectoris or
documented silent ischemia), coronary artery spasm (e.g., Prinzmetal
sangina), uncontrolled hypertension or any other significant
cardiovascular disease.
L-tryptophan can trigger excess serotonin formation in
tissues other than the target organ and cause significant adverse
reactions.
L-tryptophan can cause nausea, diarrhea, loss of appetite,
vomiting, difficulty breathing, pupil dilation, abnormally sensitive
reflexes, loss of muscle coordination, blurry vision and cardiac
dysrhythmia.
L-Tyrosine
Do not take L-tyrosine if you have inborn errors of metabolism alkaptonuria and tyrosinemia type I and type II.
Do not take L-tyrosine if you are taking non-selective monoamine oxidase (MAO) inhibitors.
Do not take L-tyrosine if you have hypertension.
Do not take L-tyrosine if you have melanoma
NAC
NAC clearance is reduced in people who have chronic liver disease.
Do not take NAC if you have a history of kidney stones (particularly cystine stones).
NAC can produce a false-positive result in the nitroprusside test for ketone bodies used to detect diabetes.
Consult your doctor before taking NAC if you have a history of
peptic ulcer disease. Mucolytic agents may disrupt the gastric mucosal
barrier.
NAC can cause headache (especially when used along with nitrates) and gastrointestinal symptoms such as nausea and diarrhea.
Niacin (nicotinic acid)
Do not take high doses of nicotinic acid (1.5 to 5 grams daily or
more) if you have liver dysfunction, an unexplained elevation in your
serum aminotransferase (transaminase) level, active peptic ulcer
disease, arterial bleeding, or if you consume large amounts of alcohol.
Consult your doctor before taking high doses of nicotinic
acid if you have a history of jaundice, peptic ulcer disease,
gastritis, disease of the liver or bile ducts, gout, kidney
dysfunction, or cardiovascular disease (especially acute myocardial
infarction or unstable angina).
Consult your doctor before taking high doses of nicotinic
acid if you have diabetes. High doses of nicotinic acid can negatively
affect glucose tolerance. Monitor your serum glucose level frequently
if you take nicotinic acid and have diabetes.
Have your doctor monitor your serum aminotransferase level if you take high-doses of nicotinic acid.
Nicotinic acid may cause flushing, principally of the face,
neck, and chest. This flushing is thought to be
prostaglandin-prostacyclin mediated. Histamine may also play a role in
the flushing.
Nicotinic acid can cause dizziness, palpitations, rapid
heartbeat, shortness of breath, sweating, chills, insomnia, nausea,
vomiting, abdominal pain, and muscle pain.
High doses of nicotinic acid can cause blurred vision, macular edema, toxic amblyopia, and cystic maculopathy.
PABA (Para-aminobenzoic Acid)
Do not take PABA if you are taking sulfonamides or have a kidney disease.
PABA can cause anorexia, nausea, vomiting, fever, and rash.
Saint John’s Wort
St. John's wort can increase sensitivity to sunlight. To avoid a
sunburn while taking St. John’s wort, minimize your exposure to the
sun.
St. John's wort can cause bloating and constipation.
SAMe
Consult your doctor before taking SAMe if you have bipolar
disorder. See your doctor frequently if you take SAMe and you have
bipolar disorder.
Consult your doctor before taking SAMe if you take
antidepressants. See your doctor frequently if you take SAMe in place
of or in addition to antidepressants.
Consult your doctor before taking SAMe if you have cancer.
Nucleic acid methylation patterns may change in people who have cancer
and take SAMe.
Do not take SAMe if you are undergoing gene therapy.
SAMe can cause anxiety, hyperactive muscle movement, insomnia,
hypomania, and gastrointestinal symptoms such as nausea and diarrhea.
Vitamin B1 (Thiamin)
Consult your doctor before taking vitamin B1 for a thiamin
deficiency, lactic acidosis secondary to thiamin deficiency,
Wernicke-Korsakoff syndrome, Wernicke's encephalopathy, or Korsakoff's
psychosis.
Vitamin B2 (riboflavin)
High doses of vitamin B2 (riboflavin) may interfere with the Abbott TDx drugs-of-abuse assay.
Riboflavin absorption is increased in hypothyroidism and decreased in hyperthyroidism.
If you are taking nucleoside reverse-transcriptase inhibitors,
even a mild riboflavin deficiency can increase your risk of lactic
acidosis.
Vitamin B6
Individuals who are being treated with levodopa without taking
carbidopa at the same time should avoid doses of 5 milligrams or
greater daily of vitamin B6.
Vitamin B12 (cyanocobalamin)
Do not take cyanocobalamin if you have Leber's optic atrophy.
Vitamin C
Do not take vitamin C if you have a history of kidney stones or of
kidney insufficiency (defined as having a serum creatine level greater
than 2 milligrams per deciliter and/or a creatinine clearance less than
30 milliliters per minute.
Consult your doctor before taking large amounts of vitamin C
if you have hemochromatosis, thalassemia, sideroblastic anemia, sickle
cell anemia, or erythrocyte glucose-6-phosphate dehydrogenase (G6PD)
deficiency. You can experience iron overload if you have one of these
conditions and use large amounts of vitamin C.
Vitamin E
Consult your doctor before taking vitamin E if you take warfarin (Coumadin).
Consult your doctor before taking high doses of vitamin E if you have a vitamin K deficiency or a history of liver failure.
Consult your doctor before taking vitamin E if you have a
history of any bleeding disorder such as peptic ulcers, hemorrhagic
stroke, or hemophilia.
Discontinue using vitamin E 1 month before any surgical procedure.
Print
PDF
Email
References
Suggested Products
