Dear Pharmacist Suzy,
Last week, you gave a ‘Dumb’ Award to “anti-depressant drugs and the doctors who prescribe them for every woman who is tired or tearful.” I struggle with depression, and my medications don’t help. Can you elaborate? –D.D. Tacoma, Washington
You and millions of other people will get shuffled from one psychiatrist to another, and one drug to another, and you will remain on the ‘medication merry-go-round’ until you feed your brain what it’s hungry for.
For those of you who did not read my column last week, I will re-post my exact comments here:
Dumber Award: We have a tie between anti-depressant drugs and the doctors who prescribe them for every woman who is tired or tearful. Of the various ‘happy’ chemicals naturally produced in our body, serotonin is the one most likely to be raised by anti-depressant drugs. But research shows that depression may be caused by elevated stress hormones, low vitamin D levels, diabetes or insulin-resistance (diagnosed or not), low progesterone hormone, niacin or folate deficiency or exposure to plastics. So what’s up with all the drugs? Their side effects are depressing if you think about it -problems achieving orgasm, low sex drive, insomnia, suicidal thoughts and heart palpitations. Anti-depressant drugs don’t fix the underlying cause for neurotransmitter deficiencies and doctors should be conducting lab tests to determine the cause for emotional instability before prescribing pills and dismissing you.
These comments left many readers curious about what they could be doing to improve their emotional health and ability to cope with stress.
Anti-depressants such as Zoloft, Prozac, Cymbalta, Celexa, Lexapro, Paxil, Wellbutrin, Effexor and so forth, DO help some people, and I am not going to knock these very effective drugs. That said, as a class, these medications are incapable of correcting underlying nutritional deficiencies, hormonal imbalances or neurotransmitter imbalances.
Medications artificially -and temporarily- lift brain chemicals, and they have numerous uncomfortable side effects that some people experience during treatment. The most common side effects associated with prescribed drug therapy may include nausea, insomnia, constipation or diarrhea, low appetite, headache, weakness, restlessness, trembling, shaking, abnormal dreams and changes in taste perception. Sexual dysfunction is another real problem associated with prescribed anti-depressants, although some drugs are less disruptive than others. Problems such as decreased sex drive, inability to climax are two common issues that cause people to go off their medications.
It gets a little more disturbing when you think about pediatric patients who are taking prescribed anti-depressants. Only after many years of prescribing, the Food & Drug Administration (FDA) conducted a review (2004), and they studied 2,200 children treated with SSRI anti-depressants. They found that children taking the SSRI medications experienced suicidal thinking and thoughts of self-harm, suicidal attempts at TWICE the rate of those taking placebos (sugar pills). In response, they decided to strengthen safety warnings and forced drug makers to place a “black box” warning on these drugs alerting prescribing physicians that these medications may increase the risk of suicidal thinking.
There is a press-release entitled “FDA Launches a Multi-Pronged Strategy to Strengthen Safeguards for Children Treated With Antidepressant Medications” which can be read by CLICKING HERE.
The intention of this column is not to frighten you, or shock you, it is to help raise awareness for dietary supplements and vitamins and herbal extracts which could be effective and safer than medications. Everything you read here, needs to be fully discussed with your doctor. One more thing, as you are reading this, you may be tempted to just stop your anti-depressant medication but DON’T. Never suddenly stop prescribed medications based on anything I say, especially with anti-depressants because you could suffer dangerous withdrawal side effects. Ask your doctor to help you wean off if you are determined to get off prescribed drugs, don’t just suddenly stop them. Some integrative medical doctors help their patients get through the withdrawal effects by advising them to begin natural anti-depressant nutrients/herbs (which I’ll get to in a minute) while weaning off the prescription drugs, but again, getting off prescribed anti-depressants and on to natural ones is between you and your physician(s). I am only providing education for you.
And while I’m educating you about depression, I found an interesting quote from my friend Dr. Bruce Lipton’s book “The Biology of Belief” (Hay House 2008). Here’s what he said:
“In a 2002 article in the American Psychological Association’s Prevention & Treatment, “The Emperor’s New Drugs,” University of Connecticut psychology professor Irving Kirsch found that eighty percent of the effect of antidepressants, as measured in clinical trials, could be attributed to the placebo effect. (Kirsch, et al 2002)
Kirsch had to invoke the Freedom of Information Act in 2001 to get information on the clinical trials of the top anti-depressants: these data were not forthcoming from the Food and Drug Administration. The data show that in more than half of the clinical trials for the six leading anti-depressants , the drugs did not outperform placebo, sugar pills. And Kirsch noted in a Discovery Health Channel interview that “the difference between the response of the drugs and the response of placebo was less than two points on average on this clinical scale that goes from fifty to sixty points. That’s a very small difference. That difference clinically is meaningless.”
I feel like having some fresh perspective on this really makes you question the value of medications and if they honestly can help enhance mood, improve emotional wellness or mental stability. Can they? Perhaps for some, but not all of you. If this is true, and you are suffering day to day, and questioning your life on Earth, then do read on.
I’m going to give you a brief characterization of each brain neurotransmitter/hormone so you will see how important these compounds are. Let’s meet the primary players in emotional wellness:
Serotonin is famous as the neurotransmitter/hormone that is most often ‘lifted’ by pharmacological drugs known as Selective Serotonin Reuptake Inhibitors (SSRI’s). It is synthesized from tryptophan via chemical reactions. Serotonin is thought of as a brain hormone, but surprise… 80% of this so-called “happy” brain chemical lives in your gut, and when you eat food, gut cells known as the enterochromaffin cells release the serotonin so your digestive tract contracts. Serotonin happens to help us regulate GI function, but it also improves mood, learning, memory, cognitive function, self esteem and feelings of joy. Lifting serotonin could relieve pain too. Numerous prescribed antidepressants work along this pathway.
Serotonin is a “monoamine” (MAO) neurotransmitter that is also targeted by many anti-psychotic, anxiolytic and anti-migraine medications. You are supposed to be able to make serotonin naturally in your body, but you can’t if you become deficient in certain nutrients, vitamins or amino acids. Our serotonin levels are affected by diet, no surprise here. An increase in the ratio of ‘tryptophan to phenylalanine and leucine’ will increase serotonin levels. Fruits with a good ratio include dates, papaya and banana. And this is interesting. Foods with a lower ratio of these amino acids inhibit the production of serotonin and therefore leave you at greater risk for depression. These foods include whole wheat and rye bread. One more reason to eat gluten-free (but haven’t I asked you to do this a hundred times over the years?)
Norepinephrine is primarily responsible for communication between your nerve cells, and also for your ability to experience the famous “fight or flight” response. Norepinephrine is sometimes shortened to norepi (pronounce “nor- epee”) and it is synthesized from dopamine, another neurotransmitter that affects mood. Norepinephrine is associated with arousal levels, and so too much of a good thing can cause worry, anxiety, phobias, restlessness, fears of crowds, insomnia and so forth. Too much norepi can also increase heart rate and blood pressure -this can be dangerous.
Finally, too much norepi has been tied to panic attacks and it’s easy to see why. Balance between all your brain hormones are crucial to emotional wellness. With depression, you have to think imbalance of norepi to other brain hormones, or perhaps too little norepi production. When you fail to produce enough norepinephrine, you may find it harder to focus and pay attention (think attention-deficit… and in fact, many ADHD drugs lift this chemical). Low levels of norepi are also associated with poor memory, depression and low levels of arousal.
A brain neurotransmitter that helps us relax. This substance has to be in balance with glutamate or mood suffers. GABA is involved in sleep too. GABA is a quieting hormone, and for this reason it is useful in helping to prevent seizures (an excitatory state). Deficiencies of GABA could lead to trouble coping, feeling anxious, stressed out or depressed. You can buy dietary supplements of GABA at any health food store nationwide and many people take this with good effect.
The big debate is whether GABA supplements really work because the molecule is very bulky and cannot easily penetrate the blood brain barrier. GABA may or may not get past the blood brain barrier very well, but anectdotal reports suggest that it does.
Dopamine is your pleasure hormone, it is associated with feelings of happiness, even more so than serotonin in my opinion. Dopamine is the chemical most associated with rewards and enjoyment, it gives us that ‘high’ so-to-speak, which then causes us to want to keep doing a particular activity. Think compulsive gambling, sex and so forth. Cocaine happens to stimulate levels of dopamine too. As it pertains to depression, it is the imbalance of this hormone to the others, or a decreased ability to utilize it, or produce it. So low levels of dopamine are associated with depression and when you give the body precursors (such as tyrosine or levodopa) the effects works very fast, much faster than prescribed anti-depressants which usually take 4 to 8 weeks to exhibit optimal effects.
Dopamine is the substance that is associated with Parkinson’s disease (low levels) and schizophrenia (higher than normal levels). Drugs that are ‘dopaminergic’ meaning they behave like dopamine act outside the brain, not inside. In other words, if you want to increase brain levels of dopamine, you can’t give it as a drug, you have to give precursor nutrients and amino acids so they can slip inside the ‘blood brain barrier’ get into the brain and then the brain can ‘bake the dopamine’ out of the recipe ingredients that you provide. Got it?
Now, how about some solutions?
With your physician’s approval, you can try one or two of the dietary supplements below, or you can buy a combination formula for enhanced effects. A combination ‘multi-tasking’ formula may be more cost-effective too, and there are several high-quality brands to think about. One of them is Deproloft which I will talk about shortly. xxx
For some people, even one or two of the substances below can have a positive impact on mood. The reason is that some of the compounds below (such as Vitamin C or 5-MTHF) are needed to drive a chemical reaction in the body that forms our mood-boosting hormones. Without these simple, inexpensive nutrients, the chemical reaction comes to a screeching halt so the mood-boosting hormones don’t form. See, it’s very simple chemistry but unfortunately, the vast majority of physicians are educated at conventions that are pharma-funded so it’s all about the next best drug, rather than simple biochemical reactions. I’ll give you some new perspective and natural choices. All of these are available over-the-counter, at many health food stores, some pharmacies, online or through your physician’s office.
You need vitamin C to make dopamine, norepinephrine and serotonin. Without C, you will run low on these crucial happy brain chemicals. Did you hear that? Inexpensive, over-the-counter vitamin C can be tremendously useful in helping you make more happy brain chemicals. I need to be clear however, supplementation with vitamin C is just one option, you need many other nutrients to make these chemicals, so it’s not just about C levels.
Vitamin C is sold everywhere nationwide. Buffered forms seem to be less irritating to the gut. Dosages vary (500 – 2,000 mg ascorbic acid per day should be okay, ask your doctor). Also, an herb called “Camu Camu” is a fantastic way to get natural vitamin C. It is a dietary supplement that is extracted from the Camu Camu berry and it is probably THE richest source of vitamin C, botanically-speaking. You can find vitamin C and camu camu at any health food store and pharmacy.
It has an important effect on the release of serotonin and norepi. The body uses this vitamin to help convert glucose, into fuel and if there isn’t enough, you can develop fatigue, depression, irritability, anxiety, and even thoughts of suicide. Deficiencies can also cause memory problems, low of appetite, nervousness, psychosis, insomnia, and gastrointestinal disorders. People who drink alcohol (even one glass a night) are usually deficient in this B vitamin. (There is a lot more information about vitamins like thiamine (and symptoms of deficiency in my Drug Mugger book sold at Amazon.
A typical thiamine dosage is 100mg daily, but sometimes it is best to take B1, along with other B vitamins so you have all the Bs on board. This is fully explained in Drug Muggers. The idea is to not tilt the other Bs out of balance when you take full dosages of one particular B.
It’s another B vitamin and B vitamins play a crucial role in helping ease and prevent depression. B vitamins cannot be stored in the body, they have to be taken in, through food or supplementation. This B vitamin is the biologically active form of folic acid and 5-MTHF is worth hunting down. It helps make happy brain chemicals. Why not just take folic acid? Because many people have a genetic problem turning folic acid into 5-MTHF and so they become deficient. That’s why I put 5-MTHF into Mito B Complex, my custom formula.
If you become deficient, you will not be able to form happy brain chemicals properly and so you may become depressed or develop a serious type of mental health disorder that would be improperly diagnoses. A prescription version of this is sold at pharmacies, called Deplin so you can see that folic acid, and more specifically 5-MTHF is crucial to mood, so much so that drug makers even recognize it’s value. I’ve got a smart bunch of readers so I’m going to give you just a tad more science (in case you want to discuss this with your doctors).
5-MTHF happens to help you ‘methylate’ which just means that it helps you to detoxify. Because it helps you to methylate (pronounced “meth-ill-ate”) it converts this toxic chemical called “homocysteine” into something useful called “methionine.” Taking it one step further, your body converts the methionine into S-adenosylmethionine or SAMe (pronounced “sam-ee”). Guess what, SAMe is known to relieve depression and is well-studied. The point is, if you have no 5-MTHF, you can’t make natural SAMe in the body. SAMe is sold at health food stores and pharmacies nationwide, or I would offer you an online link to help you. It’s easy to find/buy, although many practitioner’s feel that it’s action on the body may be short-lived and that it’s highly unstable. SAMe fine to take, and effective as far as I’m concerned but I think taking 5-MTHF is better overall. Further, 5-MTHF helps you to process estrogens more safely (it helps you form higher levels of 2-methoxyestradiol, which is thought to be an anti-cancer form of estrogen).
If you run out of this B vitamin (vitamin B3) it could produce serious mental health problems including psychosis and dementia. Niacin (B3) is involved with the dopamine transmitter pathway. Deficiencies of vitamin B3 can produce agitation and anxiety, as well as mental sluggishness, schizophrenia and depression. Holistic practitioners often recommend vitamin B3 (niacin) as part of a treatment plan for psychiatric problems, including schizophrenia.
One more thing, niacin deficiency can also cause high cholesterol so if you are depressed and have high cholesterol, you may have an undetected (subclinical) niacin deficiency. It’s usually safe to take niacin, although many people experience a hot-flushing sensation, but you should make sure you have your doctor’s approval.
Glutamine & Vitamin B6.
Some practitioners suggest taking L-glutamate capsules along with vitamin B6, because those two ‘ingredients’ make up the recipe for your body to make GABA. The glutamine and B6 slip easily into the cell, and that’s when the cooking starts. Both glutamine and B6 are widely available at health food store. It’s always wise to ask a holistic practitioner about this, as well as what dosage is right for you.
Magnesium. Replenishing magnesium could be one easy solution for depression* and/or migraines* without you having to do do anything else!
I agree that magnesium is powerful when it comes to mood enhancement, but I’m not convinced that it’s all you need. Magnesium has a role in minimizing migraine headaches too, Without enough magnesium to keep an eye on serotonin, serotonin starts to overact and constricts blood vessels and releases pain chemicals such as substance P and prostaglandins, contributing to migraines. Normal magnesium levels help to prevent the release of these pain chemicals and also blunts their effect.
Clearly magnesium plays an important role in the brain. It also helps the body manufacture brain neurotransmitters. The biggest issue I have with magnesium is how doctors measure it. They mistakenly take serum magnesium levels, but this needs to be measured intracellularly. You can find magnesium supplements at health food stores nationwide. If you want to take this orally, I prefer you get the chelated version, it will say “magnesium chelate” or “amino acid chelate” on the label.
You might be interested in Magnesium L-threonate which is available in powder form HERE. You can get magnesium to go right through your skin. It is topically absorbed. I just bought a spray bottle from “Ancient Minerals” and it works really good. You can apply it to your skin, and this is cool… it can be sprayed on you while you are getting a massage because magnesium has a muscle relaxing effect on the body. So it helps your mood, and your muscles, and also blood pressure.
Tyrosine and Iodine. These substances help you make thyroid hormone and low thyroid is a common overlooked cause for depression. Tyrosine also happens to be a precursor to the brain chemical, dopamine which is your ‘happiness’ hormone. Tyrosine is sold widely at health food stores, and so is iodine. I also sell a brand of iodine in 6.25mg capsules. It is HERE.
This is also called “Siberian Ginseng” adaptogenic herb which helps the body cope with stress, while improving concentration and feelings of well-being. It’s an herb that has been used in Chinese medicine for over 2,000 years. You won’t get an overnight effect with this one, you have to take it for several months, and you have to make sure you have a high-quality source (many brands are adulterated). This botanical can help reduce fatigue and increase stamina. Eleuthero is thought to relieve depression by nourishing the adrenal glands.
This is incredibly important and many traditional doctors don’t pay much attention to worn out adrenal glands. Women who are tired, stressed and juggling a job, kids, debt, caregiving, etc. etc. tend to burn out their adrenal glands and just need nourishment for them, in order to feel well again. Drugs won’t help. Eleuthero to the rescue.
It is beneficial when the HPA (hypothalamic-pituitary-adrenal axis) is depleted, and the symptoms of which include fatigue, stress, weakness, memory loss, and sore muscles associated with the low functioning of the endocrine system. Eleuthero can help balance dopamine, norepi, epinephrine and serotonin.
Progesterone is made in the body, it’s not the same as the drug Provera. Natural progesterone has a calming effect and balances estrogen which has more of a stimulating effect. A healthy woman will have the proper ratios of these each day of the month, and the ratios fluctuate depending on the time of the month, and the age of the woman. Progesterone is produced in women along with estrogen during the reproductive years and is often referred to as the ‘great balancer’ due to its important role in keeping estrogen and overall hormone levels in balance with one another. Around the age of 40, your hormone balance changes in preparation for menopause which usually occurs around the age of 50.
During these 10 years, estrogen levels fluctuate erratically and eventually decline to half of your youthful levels, but progesterone which is needed to keep estrogen in balance, can plummet to nearly zero. The condition of progesterone deficiency is sometimes referred to as “estrogen dominance.” You can tell if you have this problem by symptoms most of the time. Women are deficient in progesterone (estrogen dominance) may develop anxiety, depression, irritability, hot flashes, night sweats, weight gain, insomnia, osteoporosis & low sex drive.
Pre-menopausal women may have PMS, breast tenderness, migraines, mood swings, bloating, and heavy periods. Doctors may want to conduct hormone testing to detect the imbalance and this may include urine, blood or saliva analysis. My fear is that they will fail to tell you that natural progesterone is available over-the-counter, and instead, prescribe a medication which only mimics the effects, and causes dangerous side effects.
Natural progesterone is sold at health food stores, as a cream which you can apply to your skin. And it’s also available to doctors (and you) through compounding pharmacies, but bear in mind that bio-identical progesterone is not the same as synthetic medications like medoxyprogesterone, Provera or PremPro. Those are not bio-identical so if your doctor tells you that you need this hormone, buy it OTC and apply it to your skin on the neck, chest, inner arms, breasts or thighs. Dosages are on the bottle. Natural cream versions (sold OTC) may lift depression if it’s related to estrogen dominance (progesterone deficiency). If you apply progesterone and find that your hot flashes worsen, that usually means that you need to work on fixing your overworked adrenal glands for a few months, and calm the estrogen down, before trying the progesterone again. I really like Emerita’s brand “Pro-Gest” because it is paraben-free and contains vitamin E, sweet almond oil and other natural ingredients. You can buy it at most health food stores, and if you want to learn more click on their website: https://www.emerita.com/
People with depression or SAD (seasonal affective disorder) are usually deficient in vitamin D. I could write a book on this one. There are many many studies to prove that D deficiency is associated with depression and the vitamin/hormone is sold OTC. It has a profound effect on balancing the brain neurotransmitters mentioned above. There is a little debate over the what the healthy range is but you can have it measured. If it’s less than 50 ng/ml, I would start treatment.
Most traditional doctors would not agree with me, and would say that if it’s less than 35 ng/ml, begin treatment. The best form of vitamin D to take is D3, or cholecalciferol. It will say this on the label. A typical dosage that could help you if you have depression would be 2,000 to 10,000 IU per day, taken in the morning. To learn more about vitamin D and it’s relationship to depression, go to this website, The Vitamin D Council: https://www.vitamindcouncil.org/depression.shtml
Another good source for vitamin D is cod liver oil. There are good-tasting versions available at most health food stores, plus there are softgels so you don’t have to take a liquid if you don’t want to anymore.
Essential Fatty Acids- These are good fats. A common sign of deficiency of essential fatty acids (EFAs) is depression. The EFAs offered by fish oils, krill oil, flaxseed, hempseed and cod liver oil all offer something special to help improve communication of the nerve cells, and help nourish the cell membrane which is extremely important in brain function and emotional wellness. If the cell membrane isn’t healthy, it can’t get rid of wastes, and it can’t properly send nerve signals. There are studies that hint that EFA therapy may be better than drug therapy. No surprise to me. If you want to take fish oils or cod liver oil, try about 1,000 mg once or twice daily with food. Nordic Naturals makes a very high quality brand (free of impurities) which is sold pretty much everywhere. In case you can’t find it, or you live remote, you can just go to their website: https://nordicnaturals.com/ To bring in flaxseed, go to your health food store and buy some ground flaxseed (or buy the seeds and grind them yourself in a coffee bean grinder).
Sprinkle about 1/2 a tablespoon every day. Additionally, buy hulled hemp seeds. I love this, and eat about a tablespoon every single day! These are also sold at health food stores, and they taste amazing. Larger health food stores carry hemp seed oil, and hemp seed butter.
Tryptophan is an essential amino acid. Your body can’t make it. When you get tryptophan from foods and supplements, your body converts it to 5-hydroxytryptophan, or 5-HTP. You can also buy supplements that contain 5-HTP, either as a stand-alone product of 5-HTP, or a combination formula that contains a little bit of it. Why does this matter so much? Because 5-HTP goes through the blood brain barrier and gets into the brain. It gets converted to serotonin there. If you recall, serotonin is one of your brain neurotransmitters.
If you want to make this conversion process easier, take 5-HTP with some vitamin B6 which pushes the reaction along faster. Vitamin Shoppe makes a good brand called “5-HTP with B6” and so does Doctor’s Best called “5-HTP Enhanced with B6 and C.” A typical dosage range is 50mg – 300mg, follow label directions for the product you buy.
Deproloft-HF This is a combo product made by Thorne Research which I formulated for them years ago. I like this company because they do not use magnesium stearate in their products, an inert ingredient used to make supplements that some people are sensitive to.
Deproloft-HF is sold online at Thorne Research, one of the world’s premier nutraceutical companies and they ship all over the world.
FYI, their phone number: 1-800 228 1966
The ingredients include many of those mentioned above, as well as St. John’s wort and Rhodiola, two fantastic botanicals when it comes to mood enhancement. What I like in particular about this product could work from so many different angles, it may ease depression if it is associated with any of any of the following issues:
—Low thyroid (it contains iodine and tyrosine)
—B vitamin deficiency (or genetic defects that don’t activate the B vitamins, all the Bs are active as in 5-MTHF and P5P rather than B6) —Adrenal fatigue (it has adaptogenic herbs like eleuthero, rhodiola)
—Low dopamine, norepi, serotonin or GABA (it offers the precursors to these hormones so you can make it intracellularly).
With any dietary supplement, ask your doctor if it is right for you. Remember, if you are feeling blue, there is always something you can try.
Please don’t give up. It doesn’t rain forever.
Know that you are loved and needed, and for every door that closes, a window opens.
The wheels of life keep turning.
Please -no matter how desperate you feel- know that there are options.
I’ve done the best I can to list the most effective, well-researched items, and there are more that are not even listed here. If you are feeling overwhelmed because I’ve mentioned so many choices for you, then try one of the multi-tasking combination formulas (such as Deproloft). If you are not feeling any better after about a month, add in some DHA fish oils.
If that doesn’t help you, get your hormones tested and see if you are deficient in DHEA, testosterone, progesterone or estrogen. If those are all normal, ask your doctor to check your thyroid hormone levels. You may be have hypothyroidism which is a common cause for depression. In fact, if you’d like to learn more about that, check out my book on the topic called Thyroid Healthy.