Nutritional Biochemistry and Mental Health pt 2 - 047

SPEAKER A The following program presents principles designed to promote good health and is not intended to take the place of personalized, professional care. The opinions and ideas expressed are those of the speakers. Viewers are encouraged to draw their own conclusions about the information presented. Welcome to healthy living. I'm your host, Margot Marshall. In our last program, we asked the question can food change our mood? In part two of this topic, we will look about biochemical individuality, and targeted nutrient strategies for mental. SPEAKER B Healthy Living is a production of 3ABN Australia television focusing on the health of the whole person body, mind, and spirit. You'll learn natural lifestyle principles with practical health solutions for overall good health. SPEAKER A Today we will continue our discussion on nutritional biochemistry and mental health. My guest is Dr. Andrew Pennington who is an integrative general practitioner. Welcome, Andrew, and tell us what an integrative general practitioner is. SPEAKER B Sure. Thanks for having me. It's lovely to be with you. An integrative general practitioner, or integrative doctor is someone who takes from both orthodox strategies traditional things that we learn in medical school and postgraduate training but also looks at evidence based complementary medicine strategies and tries to merge both of them together for the best outcome for the patient. So it often involves using a lot of lifestyle approaches, nutritional approaches, environmental approaches. Some doctors also do skills in counseling or acupuncture or other traditional Chinese medicine. There's a lot of different ways that people look at integrative medicine. But my interest predominantly is in nutrition and lifestyle and how that has a role in health. SPEAKER A Excellent. And it does play a big role as we've been noticing in past programs. SPEAKER B Certainly does. And if I just recap because this is part two of the discussion that we're having about brain health and nutritional chemistry but really what we probably should have said is gut and brain health because there's quite a strong connection between the two. And if we have a look at just one of the slides from the last presentation that we had and I particularly just want to focus on this for our viewers to recap again because I think this is one of the landmark studies looking at depression and can we treat depression using food? And the answer is, absolutely we can. And this was a randomised control trial that was done in Australia under Felice Jacker and her team in Deakin University. And as you can see in this trial if I just briefly explain it again they took a group of individuals who had depression and then they looked at their diets and they found the group of people within those depressed individuals who they felt had a poor diet. And they randomized that group of people into a dietary intervention. And it may have included social support. I just can't remember. I'd have to look at the paper again. But at least a diet intervention versus the other arm of the randomization was social support. Only. And as you can see in this graph here, the people who were randomized to social support. This is on the left hand side, or the Y axis is the depression scores and down the bottom is the two groups. You can see here that after three months of the intervention, the social support group did improve too. So just giving social support improves. But you can see in the diet intervention that there's a much bigger improvement. So you certainly can treat depression with diet. And this was essentially a good Mediterranean style diet with lots of fruits, vegetables, whole grains, good oils. So that was possibly the first decent quality trial to really prove that it is possible to treat depression with diet. And I guess I'd like to perhaps go a little bit deeper. And so today for the viewers, it will be a little bit of chemistry. There's going to be a little bit of I'll try and break it down with you and make it not too difficult to understand. But I want to focus a little bit on the question, well, how would this work? Like, why would diet have an impact on mood and how does it work? Well, I think the first thing that may be obvious just to many of you is that, well, if you get the right nutrients, then your brain is going to be using the right nutrients and actually be healthy. SPEAKER A That makes sense. SPEAKER B That's right. That makes intuitive sense. And I think our whole body needs good quality nutrients. All organs and tissues require that. So that, I guess, is not too unusual to say. But the other point is that if you have a poor diet, you may not have the nutrients in the right ratios that your brain's producing its neurotransmitters. And for those of you who don't know what a neurotransmitter is, but a neurotransmitter is essentially a middleman in the communication between your nerves. You've got a couple of nerves that will come together and then they release a neurotransmitter to take the electrical impulse from one nerve to the other nerve. So if you get the neurotransmitter mission right, you tend to help people's mental health. And obviously people with good neurotransmission don't tend to have mental health problems. The other way that this works, and they're all into play, is that it improves the gut microbiota, or the microbiome, which is the composition of bacteria and other microbes in the gut and they repay us. And we talked earlier in the last program about one example of E. Coli and its ability to produce neurotransmitter precursors and vitamins that are helpful for both the colonic health and for brain health and other health. And I should have added also into that discussion, which I didn't mention last time, is the role of inflammation. So when you feed your gut microbiota are good food sources, it causes a decreased level of inflammatory reactions in our body. And the opposite is true. If we feed junk food and rubbish to our microbiota, you basically produce more inflammatory reactions in your bowel and that can go into other parts of your body as well. But the other role here is actually it is linked sorry, with this comment, the inflammatory comment, but the other process which happens when we have inflammation is we get oxidative stress. And for those of you who don't know what oxidative stress is, essentially the easiest way to look at it is it's rust. It's aspects in our body rusting, which is an oxidative reaction in metal, but this can happen in our body. We release too many free radical oxygen species and normally we mop those up in our body using antioxidants. And of course, a lot of those antioxidants come from a good quality diet, fruits and vegetables, et cetera. So I think that probably gives you a bit of a summary as to why food can have some impact on mood and neurotransmission. So I wanted to just that's good. SPEAKER A I'm pleased you explained all that because even if we didn't get it all, or if we got it but don't remember it, at least you've satisfied us that it does play a role. SPEAKER B For sure. SPEAKER A It's been established how it works. Thank you. SPEAKER B Now, what I'm going to introduce to your audience now is something that many may not have heard of. And although I wouldn't be surprised if intuitively, a lot of people felt that this may be valid. And this data comes out of unfortunately, a lot of the data is actually unpublished, so it's hard to show this in the literature and so there needs to be some level of caution in interpretating it. But this comes from Dr. Bill Walsh in the United States and he has learnt some techniques through a nutritional psychiatrist, a couple of people who are interested in nutritional psychiatry. SPEAKER A Nutritional psychiatrists? So that's a new term to me. SPEAKER B Well, it's been around for many years, the founders have, because you have to understand that before we ever had antipsychotic and antidepressant and other psychoactive drugs, how did we treat mental illness, how did we work with these people? Well, often we didn't know much what to do with them, but there were a couple of people in the US who felt that there were some nutritional issues involved here and in particular they started using different concoctions of vitamins and minerals to try and treat mental illness. Now, some of that stuff's quite old fashioned in the way it was done, but what they did find quite interestingly was that certain subsets of people with schizophrenia responded very, very well to vitamin B three, which is niacin. SPEAKER A Was that just a disease you just don't want to have? SPEAKER B Well, not at all. SPEAKER A So to think there's some help there absolutely. From nutrition is incredible. SPEAKER B Absolutely. And I won't focus too much on schizophrenia today, but basically the profoundness that came out of that was about 40% of people had schizophrenia would actually recover with high doses of vitamin B. SPEAKER A Three recover. SPEAKER B I'm talking back to being not delusional, not having paranoid voices, et cetera, not psychotic behaviors. And this was anecdotal experience of course. So it's not greatly published work. And that's one of the I do still struggle, I guess with it not having the published data that it should for it to gain the credibility amongst many of my colleagues. But I hope that will eventually come. But I will say this laid the platform for some people, some psychiatrists in the US. To think about nutrition. And as I say, this was before antipsychotic therapy was developed, which sort of happened in the 1950s when some of the first antipsychotic medications came out. And of course what happened then was you had a whole lot of doctors who basically jumped on board with that as being the way to treat and then it became very mainstream. That was what happened. But there are alternate ways of looking at it. So I want to focus a little bit today on depression, though not so much on schizophrenia, although that is a condition that we can treat with nutrient therapy too. And I want to just put a slide up for you from Dr. Walsh's work looking at individual biochemistry and variation in depression. So Dr. Walsh has around about 3000 OD people who have clinical depression diagnosed on his database and he has tested them for many different chemical and vitamin and mineral analyses and this is what he finds. Not all people with depression have the same chemistry in their brain. This is very interesting and I will explain some of these things through this presentation. But you can see here that undermethylation is about two in five people and Folate deficiency, which is really over methylation, the opposite of that. And I'll explain these terms, as I say later, makes up about so that's. SPEAKER A The big blue one there, the big. SPEAKER B Blue one and the green pie, they are what we call methylation problems. And we'll talk a little bit. This is a genetic issue. It comes inherited and we'll talk about what that means. But they have completely different treatment strategies and if you treat them the same way, one will get better, one will get worse. So then you've got about in the yellow part of the chart there shows copper overload. Now this is something that I wish my colleagues understood a bit more about because it really is associated with people with anxiety and ADHD in a number of conditions having too high copper. And if I can talk just briefly to the traditional medical models, there is a disease genetically of copper overload we call Wilson's disease and it's well recognized within Wilson's disease and they'll get liver damage from excessive amount of copper that those people get psychiatric symptoms too. So what we're talking here is not Wilson's disease, we're talking about a spectrum of people who don't fulfill that criteria. But they still have elevated coppers. But it's not as high as what happens in Wilson's disease and it causes psychiatric problems. So some people have a toxic metal exposure. It's not that common. But clearly if you had a whole lot of lead exposure or arsenic or mercury, that ain't good for your brain and it can cause trouble. And then there's some other rarer things like celiac disease which is a gluten intolerance issue that can cause psychiatric problems. Hypoglycemia, thyroid disorders. They can all create mental health problems, but they're not as common. You can see they're in the sort of 5% bracket pyro disorder. I don't really like to refer to it as pyro disorder. I'll probably refer to it as a functional deficit of zinc and vitamin B six. And we'll talk about that a little bit later. So maybe if we go first into probably one of the things that I'd really like to focus on, and that is the balance between zinc and copper in our body. And these two nutrients are critical for our brain function. We need them for many different chemical reactions. Zinc is important in many health reactions gut health, immune function, skin, nails, hair, taste, digestion. But if we go back to that slide just on the copper zinc balance if you actually look on the periodic table of elements, the copper and zinc are right next to one another. They're really similar in size and they compete with each other for function. So what happens is when one's high, the other is often low and vice versa. So that actually tells you how you can treat the disorders. So very rarely do I see low copper. It's almost always high copper and low zinc and normally for brain function. And there's a couple of papers in the literature on this. It's not a lot, but we should have an optimal level of about one to one ratio between the two. Even a little bit more zinc than copper would be great. But invariably people who have mental health problems, if copper is associated, they'll have a high copper and it can sometimes be as much as three to one ratio of copper to zinc. And that can create problems. And what kind of problems? Anxiety and panic, postpartum anxiety, depression, fatigue, poor sleep. So this is a common one. I see people just can't get off to sleep. And I'll tell you why that happens in a SEC. SPEAKER A That postpartum that's following birth. SPEAKER B Yes, following birth. That's right. ADHD and poor concentration. Copper is a nasty player in people concentrating, anger outbursts and poor stress control. It's even associated with fibromyalgia and chronic pain syndromes. Now, I'm not saying this is the only factor involved. I'm certainly not. But I want you to understand this has a role. And just to explain the chemistry to people up the top there, you can see dopamine is converted to NA or what we call noradrenaline. And this is because the enzyme in our body that makes this conversion normally. So we will convert dopamine. It's a neurotransmitter that we generally use to concentrate with, and we will release it when we get reward from various things that our brain uses. A dopamine system, copper catalyzes, the enzyme that converts dopamine into noradrenaline. And the problem with this, of course, is if you had a concentrating system and you move that into an adrenaline based system, you're actually moving your body from concentration to fight or flight. And now that's great if you need to fight or flight. But if you're having this constantly happening because you've got a genetic reason for high copper, you're going to be on edge constantly and you're eventually going to get fatigued because your body's using up all its stress hormones. So it's a very important thing, I think, for us to understand that copper and zinc play a role in mental health. And as you can see, 17% can get depression. SPEAKER A Did I understand you to say that a lot of medical people don't actually understand that? SPEAKER B Look, I guess they just haven't sort of had the exposure to this level of training. And perhaps, to be fair, there isn't a bucket load of literature on this and I want to stick wherever I can to evidence based practice. But as I've adopted some of these as a bit of an experimental approach with my patients, time and time again I've seen the benefit of normalizing the copper zinc ratio in patients. So I hope we do get some good quality trials in the future. But this is certainly, in my opinion and my clinical experience, this is very relevant. SPEAKER A So, Andrew, are you saying that when you have normalized it, which you can do, then that takes care of their problem? SPEAKER B Often, but it may not be the. SPEAKER A Only issue going on for them. SPEAKER B So if we move on to the next one, I wanted to talk a little bit about ADHD and Add, and there'll be a number of parents who may be struggling with this issue. With children, whole diet plays a role. And we talked about this in an earlier program where whole food plant roles, good amount of food that definitely has a role in ADHD, but also that's the lower adherence to the Mediterranean diet, so higher rates of ADHD. We've discussed that in a previous program as well. But I also want to talk about the role of micronutrients in ADHD. And if we can go to the next slide, it looks like we don't have one for that. Well, let me just talk to that briefly. Copper, as you could see, converting dopamine to noradrenaline makes people poorly concentrate and they get agitated and on edge. Now, you imagine a poor child who's in the classroom, who's constantly having this progress, they're not going to concentrate, they're going to be the daydreamer, they're going to be fidgety. They're going to be potentially anxious and. SPEAKER A They'Re probably not going to be learning. SPEAKER B They're not learning. So those people lowering their copper and getting their zinc higher will often help them. But let's move on to the next slide there which talks a little bit about methylation problems. And I hope I got time to go into this. It's quite complicated. Just before, actually, we look at these traits of people. Methylation, in simple terms is a chemical reaction in our body that can actually control DNA expression. And methyl groups are carbon with three hydrogens off them and a free electron spot, which makes them negatively charged. And we use them like BOOKMARKS in a sentence. We place methyl groups on the DNA and it'll change the electrostatic configuration of the DNA coiling on the chromatin molecule that stores the DNA in our nucleus of cells. Now, probably most of our listeners know that DNA is a code to produce proteins. And when you read DNA, that's what you'll spit out, that gene as in the proteins that come from that. But if you can control whether that reading of that DNA is possible or not using methylation and that's essentially one of the mechanisms that our body does. Now, this has a role in mental health because do you remember we talked earlier about the neurotransmission? SPEAKER A Yes. SPEAKER B Where electrical impulse comes down, the nerve crosses over using a neurotransmitter. Now, what actually happens in that little gap there is that the neurotransmitter is reuptaken back into the nerve terminal of that nerve that sent the impulse in the first place and repackaged. And it uses little protein pumps to do that. Now, the amount of protein pumps that are expressed on your nerve terminal are under the control of DNA methylation. And methylation is genetic. It's because the enzymes that control that chemical reaction are inherited. And depending on the combination of which ones you've got will depend whether you actually have a normal level of methylation, which about 70% of the population do or whether you have low methylation or under methylation or over methylation or high methylation. And it's interesting and we'll go into these traits that the methylation chemistry causes people to have certain personality traits, which is very fascinating. You'll never look at the world the same way again once you understand this because people who are low or Undermethylated tend to have these traits. Here, the classic individual is they're very strong willed, they're perfectionist. They're competitive. They have a very strong sense of what's right and wrong and they do well with rituals. They often have allergies hay fever and they tend to have an addictive personality and they often are lean individuals. That's a classic Undermethylated individual. And we know that these people can have depression. About one in five people with undermethylation develop depression. So it's certainly not a fate to complete or have undermethylation. In fact, this is quite good for many people. It helps them succeed having these traits. So this is not a problem. And I'm not saying people need treatment necessarily if they're Undermethylated, but if they're depressed and Undermethylated, they may well need some treatment. And interestingly, this individual often does well on an antidepressant medicine and that's because it'll elevate their serotonin levels, which these people will lack. But the opposite is true in overmethylation. And these people are very different. Very different. They're easy going people. They're not competitive at all. They are very artistic often and creative. They don't usually have any allergies or hay fever. They tend to be thicker set individuals, not usually lean individuals, and they're not at all perfectionists. So these guys make great neighbors. The next door neighbor is really easy going. However, again, some of these individuals can get mental health problems and they need a completely different approach. And if you put someone like this on an antidepressant drug, they get worse because they've got too much serotonin in their system. So it's very interesting. So I think that's an important thing to understand about individual biochemistry. We'll talk very briefly about Pyrols, which we can go on to the next slide. Pyrols, I don't actually want to focus on it too much because it is a very controversial area amongst most of my colleagues that don't believe that Pyrols are really a problem. But look, elevated Pyrols, it's not the Pyrol that's the problem, it's what Pyrols do. And they tend to have an effect on lowering one's zinc and vitamin B six levels. Now, we already saw the copper zinc connection, so that can be a problem. If your zinc gets low, your copper is going to start going high and often those two go together. But vitamin B six is a very important enzyme for converting our neurotransmitters from their precursor to their final step, serotonin, Dopamine, GABA. All of those require a B six dependent step to produce the final product. So you can see, if you lower your body's system of vitamin B six, you're going to find that you could get moody. And people with Pyrols, it's really their body gets under oxidative stress, they get stressed and inflamed and that creates mental health problems. The classic person with Pyrols is a really sensitive individual. They get sensitive to lights, noises, skin fabrics, and they're very moody. They get angry very quickly. They're very hard to control their temper. They're the person you got to walk around on eggshells behind them because they're going to blow up in a rage very quickly. They don't have very good stress control. And those things are because vitamin B six and zinc assist the neurotransmitters to be balanced and allow them to have good stress control. SPEAKER A And this is something you've gone into and studied absolutely that you use in your practice. SPEAKER B Absolutely. SPEAKER A People. SPEAKER B So I guess coming back then, in the time we've got left to just talk a little bit about oh, sorry, yeah, we've got the character traits there of elevated Pyrols causing the Zikin B six. And it's really the low zinc B six that causes these problems, not Pyrols per se. Okay, so then if we talk just coming back now to talk a little bit about treatment, and I think this is in the time I've got left, I want to just really focus in on that. Now, obviously, it's beyond the scope of this discussion to give a medical consultation about how to treat all of these things. What you need to do is to see someone who's trained using these techniques. SPEAKER A Which would be someone like yourself. SPEAKER B Certainly I've had that training, but there are other doctors there's about probably 150 to 200. SPEAKER A How would someone contact you if they wanted to talk to you about they. SPEAKER B Can go through my website, sanctuaryclinic.com. Dot au, or they can call up on there as all the details, or they can go to our Facebook page or my YouTube channel. And all of those, all of those you can go through and have a look. But sanctuary lifestyle clinic. If you Google, you're going to find it. But it's Sanctuaryclinic.com Au. But essentially, I guess what I want to focus on a little bit is the role of there is a role in these situations for diet. And sometimes we actually have to use a specialized diet. In general, I like to use plant based diet approaches, but we do have to tweak them for methylation problems. So people with undermethylation do well with a high protein content. So we need to sort of get a reasonable amount of protein with them. And people with over methylation do really well with a lot of Folate, so they do really well with high green leafy vegetable intakes. So there can be different slightly different. SPEAKER A Strategies that we this is definitely not a do it yourself approach. SPEAKER B In fact, you can harm yourself if you don't know what you're doing. SPEAKER A Definitely need to see someone. SPEAKER B You need to see someone who's trained. SPEAKER A In this to do the tests and know what they're dealing with. SPEAKER B And there are actually some naturopaths who have some understanding of these kind of things. But the naturopaths don't get the formalized medical training for the nutritional biochemistry. So they may not understand at all, even though they may have a good idea of how to start. But in general, most people in Australia can do well with a bit of zinc because we find our soils are low in minerals and zinc is often not as well uptaken. And I will say as much as I'm pro plant based diets, you don't get a heap of zinc in the plant based diet. So you often find for these people who have a problem, and obviously not all of them do, not everyone who has lower zinc has an issue. But if you do have an issue with mental health, you'll often need to supplement with zinc in order to get enough to shift copper or to treat pyros or to give you good mental. SPEAKER A Health that you should be tested to. SPEAKER B Know and not just absolutely, I think, because I must say zinc is very safe. It's very unlikely to get toxicity with zinc, but it could upset the copper. Exactly right. It absolutely could. Another nutrient that I find very positive is magnesium. And there is actually some good quality randomized control evidence now for magnesium. In the last two years, we've seen three randomized control trials for depression using magnesium versus placebo. And magnesium at a dose of around 250 to 300 milligrams elementally was better than a placebo at treating depressive symptoms. So just magnesium alone, and again, I find a lot of us are functionally low in magnesium. You won't often find you're lower on a blood test in magnesium, but you may find that you do better with more magnesium and that you're more relaxed, your mood is better, you get less leg cramps, things like that. And obviously vitamin B Six can be very important for some people, too. But beware do not supplement with B Six without consulting a health professional, because high doses of B Six in some cases can cause peripheral nerve damage that's usually reversible. But you just have to be very careful. And the take home message is to get a trained health professional who knows some of these nutritional and supplemental techniques to assess mental health. But I guess what I do want to get to your audience, and this certainly is published in the literature, that there are numerous helpful supplements that often need to be targeted. And so I'm not always a fan of a multivitamin, just popping that it's a targeted approach. And there are options to treat mental health without resorting to medications all the time. Occasionally, I've got to do both where I need a medication as well as the nutrient therapy to achieve the best outcome for the patient's mental health. And I'm certainly not opposed to the medications, but I certainly am opposed to using medications at the expense of thinking of other things. SPEAKER A Yes. SPEAKER B And I think that's very important. SPEAKER A And you're getting very good with this targeted approach. SPEAKER B Yes. As I mentioned, probably 75% to 80% of people improve. And as I say, some it's dramatic, some it's more modest, and others don't do so well. I will say probably less than 1% actually get worse on the nutrient therapy. So that is possible. But mostly people get better. They feel a lot better, and it's a really, really useful approach. SPEAKER A Very good. Thank you for that. That's been amazing. Not sure I could repeat everything that you said, but I did get the understanding of what you were saying, and it's great that you can help people so much. So our goal is to help support you on your journey through life, and we trust that today's program has been helpful to you or someone you love. God bless. SPEAKER B You’ve been listening to a production of 3ABN Australia Television.