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Transcript of Natural Treatment
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Natural Treatment
of Depression
With depression and mood disorders rising to epidemic levels, we need to move
beyond the initial treatment options of psychiatry, namely medication, and embrace amore natural and complete treatment approach. Whether someone is clinically depressed
or has a bad case of the blues, the keys are two neurotransmitters, namely
norepinephrine and serotonin.
Mainstream medicine has lost sight of the fact that nutrients in our diet are the
precursors of neurotransmitters, just as nutrients make up 100% of the body. Amino
acids are the precursors to every neurotransmitter, with the exception of acetylcholine.
There are several ways to test for neurotransmitters to find out which ones are
deficient, and which ones are causing a persons feeling of depression. Well get to lab
testing later. Medicine and psychiatry have assumed that serotonin is the main problemin depression, and so their first treatment approach is with an SSRI antidepressant (like
Prozac, Paxil and Zoloft) to raise serotonin levels. After testing people for
neurotransmitters since 1982, Ive found that at least 65% of depressed people are
deficient in norepinephrine and not serotonin. Some depressed people are deficient in
serotonin and some are deficient in both norepinephrine and serotonin.
How can you tell if your feeling of depression or the blues is a serotonin or
norepinephrine problem? When norepinephrine is deficient, the person will feel
depressed, and generally has an array of cognitive problems, such as decreased memory
and concentration, brain fog, indecision, irritability, increased worry, anger, and
insomnia.
Serotonin deficiency is associated with depressed mood and insomnia. There can be
some cognitive problems, but they are much less frequent and intense than in
norepinephrine-related depression.
Which Natural Way To Turn?
Lets say youre feeling depressed due to a serotonin deficiency, and you want a
natural approach (or you want a natural approach to help you get off medications). Doyou supplement with St. Johns Wort, SAMe (S-adenosyl methionine), L-tryptophan, 5-
HTP (5-hydroxy-tryptophan), omega-3 fatty acids, or magnesium?
Before exploring which approach to take, lets look at the biochemistry. The amino
acid L-tyrosine enters the brain and is converted into the neurotransmitter dopamine,
which then converts into norepinephrine. For an adult, 1000 mg of L-tyrosine twice a day
will bring results. Tyrosine must be taken 45 to 60 minutes before or after breakfast and
lunch. Protein is made up entirely of amino acids, and several amino acids will compete
with tyrosine to cross the blood-brain barrier to get into the brain.
L-tyrosine requires pyridoxal-5-phosphate, P-5-P, to get converted intonorepinephrine. P-5-P is the active form of vitamin B6, pyridoxine, and must be taken as
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an enteric-coated capsule. If you purchase P-5-P in a capsule, it will do little good, for it
will be broken down by stomach acids and rendered useless.
The biochemistry that increases serotonin is similar to that of norepinephrine. The
amino acid L-tryptophan, on an empty stomach, enters the brain, and in the presence of
P-5-P, gets converted into 5-HTP and then serotonin. There is no controversy aboutwhether L-tryptophan turns into serotonin, but there is debate about the efficacy of 5-
HTP, which is unpredictable in getting into the brain.
The simple equation is this: L-tyrosine, in the presence of P-5-P, increases
norepinephrine brain levels. L-tryptophan, in the presence of P-5-P, increases brain
serotonin levels. The total biochemistry is a long chain of events in which a weakness in
any part of that chain will interfere with the goal of increasing a deficient
neurotransmitter.
In addition to L-tyrosine and L-tryptophan, other amino acids are implicated in mood.
A study of 500 depressed people revealed a deficiency in the amino acid L-glutamine in50% of the subjects.
Lab Testing
The most important lab test for depression is amino acid analysis. Amino acids, like L-
tyrosine and L-tryptophan, are the input side to brain chemistry. Because almost all
neurotransmitters are made from amino acids, treatment with amino acids is the first
step in a natural approach.
The second important lab test is for urine organic acids. These are the breakdown
products of 40+ important biochemical processes. This is the output side of brain
chemistry. The organic acid test includes testing for the breakdown products of
catecholamines (norepinephrine and dopamine) and serotonin. If your VMA (from
organic acid testing) is quite low, I know that you are deficient in norepinephrine. On the
other hand, if your 5-HIAA (5-hydroxy-indolacetic acid) is low, youre deficient in
serotonin.
Lets look at how to understand the lab work. On amino acid testing, if L-tyrosine is
low, chances are extremely high that you are deficient in norepinephrine, but Ill want to
look at the results of organic acid testing for confirmation. If L-tyrosine is low, VMA, thebreakdown product of norepinephrine, is usually deficient.
Similarly, on amino acid testing, if L-tryptophan is deficient, chances are very high
that you are deficient in serotonin, but Ill want to confirm that with the organic acid
test. If 5-HIAA, the breakdown product of serotonin, is deficient, you have a serotonin
deficiency.
Theres a mathematical equation that tells us the likelihood of L-tyrosine or L-
tryptophan working. To find out if L-tyrosine will work, taking the numerical values from
the test, divide L-tyrosine by the denominator, which is leucine plus isoleucine plus
valine plus phenylalanine plus tryptophan. If that number is .15 or less, chances are80% that you will have a good response to treatment with L-tyrosine. A similar equation
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exists to predict the response to treatment with L-tryptophan. The science of treating
depression by normalizing the brains nutritional deficiencies has been established for
more than 40 years.
The lab I use for amino acid and organic acid testing is Genova Labs. On occasion Ill
use Vitamin Diagnostics Lab, in New Jersey, to test for more than 10 differentneurotransmitters. Their testing is based on research that has shown that the levels of
neurotransmitters in blood platelets correlates strongly with brain levels of those
neurotransmitters. Ill go this route if I think someone might be deficient in
acetylcholine, the lack of which causes severe memory problems and a feeling as if
someone pulled the plug on mental energy.
Links in the Chain
The response to amino acid therapy depends on the weakest link in a chain of events.
First, its important to identify and treat any problems with digestion and absorption
from the gut. If the digestive tract is not running at 100%, absorption of nutrients
declines.
B vitamins are essential for this biochemistry. Nearly every B vitamin plays a role in
brain chemistry, the most important ones being biotin, folic acid, P-5-P, and B12. So
supplement with a multi-B vitamin. Vitamin C is also important, and is critical for the
production of serotonin, norepinephrine, and for adrenal function.
Minerals also play a role, the most important ones for neurotransmitters being
magnesium, zinc, copper, and iron. Magnesium is the most important mineral for amino
acid chemistry. If youre depressed and feeling agitated, or fatigued, apathetic and
slowed down, you are likely to have a magnesium deficiency.
Essential fatty acids (EFAs) are another link. Omega-3 fatty acids have been shown to
alleviate depression. The balance of omega-3 and omega-6 fatty acids is important in
maintaining healthy cell membranes. Given that the brain is 40% fat, we cant ignore the
role of EFAs.
SAMe has become a popular natural treatment for serotonin-related depression.
SAMe, a variant of the amino acid methionine, is a cofactor in the biochemical chain that
produces serotonin.
St. Johns Wort, an herb, has been found to be helpful in treating depression. There
are a number of theories about how it works, and that research goes on.
Many people ask why L-tyrosine is recommended to raise norepinephrine levels,
instead of using the amino acid L-phenylalanine. Phenylalanine turns into L-tyrosine and
will raise norepinephrine levels, but one should first go the L-tyrosine route, along with
the needed cofactors, for a couple of months. If you are still depressed, or improving but
still have a way to go, then add L-phenylalanine. Phenylalanine can raise blood pressure,
so its not a first line treatment.
Lets summarize the initial supplements for treating depression:
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1) L-tyrosine, L-tryptophan or both - depending on what the lab data indicates. 2) P-
5-P, 3) B complex, 4) multivitamin, 5) multi-mineral, 6) magnesium, which needs to be
taken with calcium to keep the two in balance, 7) Vitamin C, and 8) sublingual B12.
The Anxiety-Depression Connection
Many depressed people also feel anxious. For many people, correcting norepinephrine
and serotonin will alleviate depression and anxiety. However, if anxiety persists,
supplementing with GABA, up to 4 grams a day, is recommended. If GABA is helping
you, do not think that more is better. At high doses GABA produces anxiety, rather than
alleviating it.
In treating depression with or without anxiety, there are a number of issues, beyond
the normal biochemistry, to look at: 1) Sugar depletes B vitamins; 2) Nicotine depletes
vitamins A, C, E, and B. It decreases vitamin C by 50%; 3) Caffeine stimulates the
release of norepinephrine, but in the process depletes the brain of L-tyrosine, the
precursor to norepinephrine; 4) Long-term excessive alcohol use can deplete almost all
neurotransmitters, including norepinephrine, serotonin, GABA, and acetylcholine. Alcohol
abuse will lead to depression. Alcohol treatment involves repairing all neurotransmitters,
but GABA depletion is the lynch pin.
A final consideration involves antidepressant medications. SSRIs (Paxil, etc) increase
serotonin levels but, in the process, deplete the brain of L-tryptophan, which is stored in
nerve endings. Bupropion (Wellbutrin), an antidepressant that increases norepinephrine
levels, depletes the brain of its stores of L-tyrosine. As a result, these medications often
start to lose their efficacy after many months. The usual psychiatric recommendation isto increase the dosage of that medication, rather than to supplement with the depleted
amino acids.
Optimal Mind
In this series weve looked at conventional treatments for mood, such as medications,
as well as natural ways of bringing the brain to an optimal level. A total approach also
includes looking at our relationships, stressors, unresolved conflict, spiritual connection,and sense of purpose. If life is a horse and carriage, our sense of purpose is the horse,
and its power will just pull our life forward automatically. Without a sense of purpose,
our life is only the carriage. In that situation it takes a great deal of effort to get going,
to feel happy, and motivated. While we dont all have a clear sense of purpose, Wayne
Dyer has explained that, for some, beginning to inquire about ones purpose is ones
purpose. So, dont wait to get that horse in place. My goal is to empower people by
helping them develop a healthy brain, a peaceful and powerful mind, a spiritual
connection, and a sense of purpose. With that holistic approach to life, people can go
way beyond limiting thoughts about their potential for healing, success, and happiness.
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David Gersten, M.D. practices Nutritional Medicine and Integrative Psychiatry out of his
Encinitas office and can be reached at 760-633-3063. Please feel free to access 1,000
online pages about holistic health, amino acids, and nutritional therapy
atwww.aminoacidpower.comandwww.imagerynet.com.
TyrosineOverview:
Tyrosine is a nonessential amino acid the body makes from another amino acid
called phenylalanine. It is a building block for several important brain chemicals
called neurotransmitters, including epinephrine, norepinephrine, and dopamine.
Neurotransmitters help nerve cells communicate and influence mood. Tyrosine also
helps produce melanin, the pigment responsible for hair and skin color. It helps in
the function of organs responsible for making and regulating hormones, including
the adrenal, thyroid, and pituitary glands. It is involved in the structure of almostevery protein in the body.
It's rare to be deficient in tyrosine. Low levels have been associated with low blood
pressure, low body temperature, and an underactive thyroid. This does not mean,
however, that taking tyrosine supplements will help any of these conditions.
Phenylketonuria (PKU)
This serious condition occurs in people whose bodies can't use the amino acidphenylalanine. It can lead to brain damage, including mental retardation. People with
PKU must avoid any phenylalanine in their diets. Because tyrosine is made from
phenylalanine, people with PKU can be deficient in tyrosine. Tyrosine is used in
protein supplements for people with PKU, but most doctors don't recommend more
tyrosine supplements. If you have PKU, your doctor will determine if you need more
tyrosine and how much.
Stress
Tyrosine is involved in the production of the stress hormones epinephrine and
norepinephrine. Some researchers believe that, under stress, the body isn't able to
make enough tyrosine from phenylalanine. Some animal and human studies suggest
that tyrosine supplements may help improve memory and performance under
psychological stress, but more research is needed.
Sleep deprivation
One study suggests that taking tyrosine may help you be more alert after sleep
deprivation, but more research is needed.
http://www.aminoacidpower.com/http://www.aminoacidpower.com/http://www.aminoacidpower.com/http://www.imagerynet.com/http://www.imagerynet.com/http://www.imagerynet.com/http://www.imagerynet.com/http://www.aminoacidpower.com/ -
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Other
Some athletes claim that tyrosine helps their performance. However, there is no
proof that this claim is true or safe.
Because tyrosine helps the body produce the mood-influencing chemical dopamine,
and because people who are depressed often have low levels of tyrosine, researchers
thought that tyrosine might help treat depression. However, studies have found that
it has no effect.
Dietary Sources:
Tyrosine is found in soy products, chicken, turkey, fish, peanuts, almonds, avocados,
bananas, milk, cheese, yogurt, cottage cheese, lima beans, pumpkin seeds, and
sesame seeds.
Available Forms:
Tyrosine is also available as a dietary supplement, in capsule or tablet form.
How to Take It:
Take tyrosine supplements at least 30 minutes before meals, divided into 3 daily
doses. Taking vitamins B6, B9 (folate), and copper along with tyrosine helps the body
convert tyrosine into important brain chemicals.
Pediatric
Don't give tyrosine supplements to a child without first asking your doctor.
Adult
Doses vary. Talk to your nutritionist or doctor about what dose is right for you. To
treat symptoms of sleep deprivation, one study used 150 mg per kilogram of body
weight per day.
Precautions:
Because of the potential for side effects and interactions with medications, you
should take dietary supplements only under the supervision of a knowledgeable
health care provider.
People who have migraine headaches should avoid tyrosine, as it can trigger
migraine headaches and stomach upset.
People with hyperthyroidism or Graves disease should avoid tyrosine supplementsbecause tyrosine may increase levels of thyroid hormone.
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Possible Interactions:
If you are being treated with any of the following medications, you should not use
tyrosine supplements without first talking to your health care provider.
Monoamine Oxidase Inhibitors (MAOIs)-- Tyrosine may cause a severe increase inblood pressure in people taking antidepressant medications known as MAOIs. This
rapid increase in blood pressure, also called "hypertensive crisis, can lead to a
heart attack or stroke. People taking MAOIs should avoid foods and supplements
containing tyrosine. MAOIs include:
Isocarboxazid (Marplan)
Phenelzine (Nardil)
Tranylcypromine (Parnate)
Selegiline
Thyroid hormone-- Tyrosine is a precursor to thyroid hormone, so it might raise
levels too high when taken with synthetic thyroid hormones.
Levodopa (L-dopa)-- Tyrosine should not be taken at the same time as levodopa, a
medication used to treat Parkinson's disease. Levodopa may interfere with the
absorption of tyrosine.
Alternative Names:
L-tyrosine
Reviewed last on: 7/17/2011
Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in
complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed
Healthcare Network.
Read more:http://www.umm.edu/altmed/articles/tyrosine-000329.htm#ixzz28FitjoJl
Tyrosine is one of the amino acids, which are the building blocks of protein. The body makes tyrosine fromanother amino acid called phenylalanine. Tyrosine can also be found in dairy products, meats, fish, eggs, nuts,
beans, oats, and wheat.
Tyrosine is used in proteinsupplementsto treat an inherited disorder called phenylketonuria (PKU). People who
have this problem cant process phenylalanine properly, so as a result they cant make tyrosine. To meet t heir
bodies needs, supplemental tyrosine is given.
People take tyrosine fordepression,attention deficit disorder(ADD), attention deficit-hyperactivity disorder
(ADHD), the inability to stay awake (narcolepsy), and improving alertness followingsleepdeprivation. It is also
used for stress,premenstrual syndrome(PMS),Parkinson's disease,Alzheimer'sdisease,chronic
fatiguesyndrome (CFS), alcohol andcocainewithdrawal,heart diseaseandstroke,ED (erectile dysfunction), loss
of interest insex,schizophrenia,and as a suntan agent andappetite suppressant.
Some people also apply tyrosine to theskinto reduce age-relatedwrinkles.
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How does it work?
The body uses tyrosine to make chemical messengers that are involved in conditions involving thebrainsuch as
mental alertness.
Tyrosine is LIKELY SAFEin food amounts and POSSIBLY SAFEwhen taken by adults short-term in medicinal
amounts or applied to the skin. Tyrosine seems to be safe when used in doses up to 150 mg/kg per day for up to
3 months. Some people experience side effects such asnausea,headache,fatigue,heartburn,andjoint pain.
There isn't enough information available to know if tyrosine is safe for children to use in medicinal amounts.
Dont give it to children without the advice of yourhealthcare provider until more is known.
Special Precautions & Warnings:
Pregnancyand breast-feeding: Not enough is known about the safety of using tyrosine during
pregnancy and breast-feeding. Stay on the safe side and avoid use.
Overactivethyroid(hyperthyroidism)orGraves disease:The body uses tyrosine to makethyroxine,
a thyroid hormone. Taking extra tyrosine might increase thyroxine levels too much, making
hyperthyroidism and Graves disease worse. If you have one of these conditions, dont take tyrosine
supplements.
Levodopa interacts with TYROSINE
Tyrosine might decrease how much levodopa the body absorbs. By decreasing how much levodopa the
body absorbs, tyrosine might decrease the effectiveness of levodopa. Do not take tyrosine and levodopa at
the same time.
Thyroid hormone interacts with TYROSINE
The body naturally produces thyroid hormones. Tyrosine might increase how much thyroid hormone the
body produces. Taking tyrosine with thyroid hormone pills might cause there to be too much thyroid
hormone. This could increase the effects and side effects of thyroid hormones.
Tyrosine plays a large part in the making of the body's hormones. Adrenal hormones, thyroid
hormones and melanin (skin hormone) are all made with tyrosine. These chemicals are theessential building blocks for the central nervous system, and maintain our overall body-
metabolism function.
As brain neurotransmitters, these hormones work to regulate our moods and emotions. Mood-regulating transmitters like dopamine, epinephrine and norepinephrine all depend on adequateamounts of tyrosine to function. During times of stress, the body converts the thyroid hormone intoadrenalin. As such, healthy levels of tyrosine are needed for healthy brain function.
Read more:What Does Tyrosine Do? | eHow.comhttp://www.ehow.com/about_4614938_what-does-tyrosine-do.html#ixzz28Fjq2tM4
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Tyrosine-Derived NeurotransmittersThe majority of tyrosine that does not get incorporated into proteins is
catabolized for energy production. One other significant fate of tyrosine isconversion to the catecholamines. The catecholamine neurotransmitters
aredopamine, norepinephrine, and epinephrine(see alsoBiochemistryof Nerve Transmission).
Norepinephrine is the principal neurotransmitter of sympathetic postganglionic endings. Both
norepinephrine and the methylated derivative, epinephrine are stored in synaptic knobs of neurons
that secrete it, however, epinephrine is not a mediator at postganglionic sympathetic endings.
Tyrosine is transported into catecholamine-secreting neurons and adrenal medullary cells where
catechaolamine synthesis takes place. The first step in the process requires tyrosine hydroxylase, which
like phenylalanine hydroxylase requires tetrahydrobiopterin (H4B, or written as BH4) as cofactor. The
dependence of tyrosine hydroxylase on H4B necessitates the coupling to the action ofdihydropteridine reductase (DHPR) as is the situation for phenylalanine hydroxylase and tryptophan
hydroxylase (see below).
The hydroxylation reaction generates DOPA (3,4-dihydrophenylalanine). DOPA decarboxylase
converts DOPA to dopamine, dopamine -hydroxylase converts dopamine to norepinephrine and
phenylethanolamine N-methyltransferase converts norepinephrine to epinephrine. This latter reaction
is one of several in the body that uses SAM as a methyl donor generating S-adenosylhomocysteine.
Within the substantia nigra and some other regions of the brain, synthesis proceeds only to
dopamine. Within the adrenal medulla dopamine is converted to norepinephrine and epinephrine.
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Synthesis of the Catecholamines from Tyrosine.
Once synthesized, dopamine, norepinephrine and epinephrine are packaged in granulated
vesicles. Within these vesicles, norepinephrine and epinephrine are bound to ATP and a protein called
chromogranin A.
The actions of norepinephrine and epinephrine are exerted via receptor-mediated signal
transduction events. There are three distinct types of adrenergic receptors: 1, 2, . Within each classof adrenergic receptor there are several sub-classes. The 1class contains the 1A, 1B, and
1Dreceptors. The 1receptor class are coupled to Gq-type G-proteins that activate PLC resulting in
increases in IP3and DAG release from membrane PIP2. The 2class contains the 2A, 2B, and
2Creceptors. The 2class of adrenergic receptors are coupled to Gi-type G-proteins that inhibit the
activation of adenylate cyclase and therefore, activation results in reductions in cAMP levels. The
class of receptors is composed of three subtypes: 1, 2, and 3each of which couple to Gs-type G-
proteins resulting in activation of adenylate cyclase and increases in cAMP with concomitant activation
of PKA.
Dopamine binds to dopamineric receptors identified as D-type receptors and there are four
subclasses identified as D1, D2, D4, and D5. Activation of the dopaminergic receptors results inactivation of adenylate cyclase (D1and D5) or inhibition of adenylate cyclase (D2and D4).
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Epinephrine and norepinephrine are catabolized to inactive compounds through the sequential
actions of catecholamine-O-methyltransferase (COMT) and monoamine oxidase (MAO). Compounds
that inhibit the action of MAO have been shown to have beneficial effects in the treatment of clinical
depression, even when tricyclic antidepressants are ineffective. The utility of MAO inhibitors was
discovered serendipitously when patients treated for tuberculosis with isoniazid showed signs of an
improvement in mood; isoniazid was subsequently found to work by inhibiting MAO.
Metabolism of the catecholamine neurotransmitters. Only clinically important enzymes are
included in this diagram. The catabolic byproducts of the catecholamines, whose levels in the
cerebrospinal fluid are indicative of defects in catabolism, are in blue underlined text. Abbreviations:
TH = tyrosine hydroxylase, DHPR = dihydropteridine reductase, H2B = dihydrobiopterin, H4B =
tetrahydrobiopterin, MAO = monoamine oxidase, COMT = catecholamine-O-methyltransferase,
MHPG = 3-methoxy-4-hydroxyphenylglycol, DOPAC = dihydroxyphenylacetic acid.