nutritional neurochemistry

NutritionalNeurochemistry

EsalenSeptember 2012

Jan Hanson, M.S., L.Ac.

www.JanHealth.comjanhealth@comcast.net

Perspectives on Natural Methods

Potential benefits: Often highly effective Minimal side effects (pure molecules that the body knows how to

metabolize) Readily available

But use wisely: Gather information. Don’t do on your own with psychotropic meds. Start with low doses. If something does not feel good, stop. Make sure other co-factors are adequate, (e.g., B-6, iron). Consider further testing (e.g., amino acids).

#1: Provide a Complete Array of Nutrients

Nutrients:

Build tissue

Act as substrate for metabolic processes

Act as co-factors for enzymes that facilitatemetabolic steps

Act as anti-oxidants

Nutrients from Food

Protein: 3 Times per day, the size of the palm of your hand Animal protein -- well absorbed, hypoallergenic Nuts and seeds Protein powder Vegetarians consider an amino acid supplement

Vegetables and fruits: Vegetables: More is better, at least several cups per day Primary source of carbohydrate Fruit: eat whole fruit (not juice or dried), be mindful of

sugar content

Nutrients from Food

Grains: Not so much Whole grain, not made into flour Gluten free (gluten= wheat, oats, rye, barley,

spelt, kamut)

Oils: Primary oil is olive No trans-fats Mindful of saturated fats

Nutrients from Food

Dairy:

Try to eliminate cow dairy -- major allergen Goat and sheep are best Substitute with almond milk, coconut milk, etc.

Go paleolithic!

Eat like the hunter gathers did -- that is your evolutionaryheritage.

Animal protein, vegetables, fruit, eggs, nuts, healthy oils.

Nutrition From Food

Eat No Sugar and little refined flour…

If you must, as little as possible. The average American eats 158 lbs per year. Sugar raises and dysregulates blood sugar. Sugar raises insulin and puts you on the road to diabetes. High insulin is inflammatory. Increased risk of Alzheimer’s disease and depression with

diabetes Decreases cognitive performance

Nutrition Basics: Supplements

Multi-vitamin with minerals High B-vitamins (10x d.v.; 800 mcg folic acid)

Folate, B-12, and B-6 cut brain shrinkage in half in oldermildly cognitively impaired adults with high homocysteine.(Smith, D, et al., 2010)

Folic acid + SSRI almost doubles success rate over SSRIalone.

Low folate predisposes people to depression.

Nutrition Basics: Supplements

Minerals The multi-vitamin should have the daily value (or more) of most

minerals: zinc, selenium, manganese, molybdenum, chromium,iodine.

Usually, you will need to add calcium and magnesium to yourmulti. You want at least 400 mg. magnesium. Women want atleast 1000 mg. calcium.

Iron is a critical brain nutrient, but is toxic if you get too much. Carnivorous men usually don’t want added iron. Menstruating women usually do need iron. It’s best to test for iron with an iron panel or serum ferritin. A

blood count helps, but can miss low iron. If you have fatigue and/or depression, test.

Nutrition Basics: Supplements

Fish oil: Take about 500 mg. each of EPA (ecosipentanoic acid andDHA(decosahexaenoic acid).

There is a high concentration of DHA in the brain (25% of all brain fat).

DHA & EPA are important regulators of inflammation.

Levels of EPA & DHA negatively correlate with level of depression(DHA has more data).

EPA more anti-inflammatory; DHA more brain structure

May be helpful prevention for Parkinson’s and Alzheimer’s

Nutrition Basics: Supplements

Vitamin D Made in the skin from unprotected sunlight Get 10 - 15 minutes sun mid-day; do not burn. Your goal is 50 - 60 ng./ml.. Your doctor can order a test.

The correct test is 25-OH-vitamin D. If you cannot test, 2000 I.U. is my recommendation. Cofactor in synthesis of serotonin, dopamine, and

norepinephrine Implicated in depression Major immune vitamin Maybe helpful in preventing dementia and Parkinson’s

disease

#2: Get the Gut Right

The road to health is paved with good intestines. Our gastrointestinal (GI) tract has a huge effect on our brain. We can have a huge effect on our GI tract.

GI tract has huge effect on the brain via the immune system. 60 - 70% of immune system is in the GI tract. When the GI tract is inflamed, messengers, called cytokines,

are sent from the GI tract all over the body, including thebrain, causing inflammation and trouble.

By activating a particular enzyme, cytokines deplete thebrain of serotonin.

The cytokines also activate the brain in a way that up-regulates the stress pathway in the brain (HPA axis), andresults in higher stress hormones, including cortisol.

Get the Gut Right

When the intestines are inflamed, malabsorption of nutrientsoccurs.

Decreases amino acids, iron, folic acid, and fats. (probablyaffects all nutrients, but seemingly less effect on carbs)

We need these nutrients for brain health.

Improve the Microbes in the Gut

There are trillions of bacteria in the intestines. Beneficial bacteria protect against inflammation. Pathogenic bacteria cause inflammation.

Optimize beneficial bacteria. Supplement with probiotics:

Lactobacillus GG (Culturelle) Saccharomyces Boulardii (Florastor) Biffido-Biffidus (particularly for kids) Lactobacillus paracasei, casei, plantarum, rhamnosus, and

salivarius; Get a multi-strain 5 -25 billion CFU product VSL#3: extremely high potency probiotic, used for Crohn’s.

Eat a low sugar, low refined flour, high fiber diet. Bad guys like sugar; good guys like fiber.

Improve the Microbes in the Gut

Get rid of bad guys.

Parasites, yeast overgrowth, and bacterial overgrowth

You may need to test to identify pathogens. Acomprehensive stool test is offered by integrativepractitioners.

My favorite test is one that uses DNA to identify andquantify microbes -- it is very accurate.

Treat microbes as appropriate. If possible use naturalproducts. Parasites usually require prescription medication,and perhaps a long treatment.

Remove Food Allergens

Food allergens cause inflammation and reactivity all over thebody. No down side, except giving up your favorite foods Dramatic effects on mood and energy Particularly noticeable in children

The worst offenders are gluten and dairy, then soy. Gluten: wheat, oats, rye, barley, spelt, kamut Dairy: Cow is usually worse than goat and sheep.

Test Try a couple weeks off. Or you can do an IgG antibody test (through integrative

practitioners; testing is imperfect).

Optimizing Brain Chemistry

Two core functions of neurotransmitters: Calming down - “Inhibitory” Energizing up - “Excitatory”

Supplementing these neurotransmitters or their co-factors - In a context of overall health

Individual differences: More benefit from inhibitory neurotransmitters

Inhibitory and Excitatory Neurotransmitters

Inhibitory: Serotonin GABA

Excitatory: Norepinephrine Dopamine Acetylcholine Glutamic acid (glutamate)

A Neuron

#3 Make More Serotonin

Serotonin is the key neurotransmitter for“happy and relaxed.”

Serotonin is a neuro-modulator of GABAthat increases its effects, and also helpsdecrease overactive norepinephrine,dopamine, adrenaline, and cortisol.

Major effect on depression and anxiety

Serotonin

Tryptophan (with iron) -> 5-hydroxytryptophan (5-HTP) (with P-5-P) -> serotonin l----> melatonin

Options for increasing serotonin: 5-HTP, 50 – 200 mg./day; empty morning stomach Tryptophan: 500 - 1500 mg./day; before bed (great for

sleep)

Stop if it doesn’t feel good.

Serotonin and “Prozac Poop-Out”

Serotonin is eliminated from the synapse throughre-uptake, which SSRI’s prevent, or throughdegradation by monoamine oxidase (MAO).

A theory: when the uptake of serotonin is inhibited,it leaves more serotonin available for thebreakdown by MAO -- thus, over time, depletingthe total serotonin available.

Treatment: add a little (50 mg.) 5-HTP. Be verycareful -- if it feels at all wrong, stop.

St. John’s Wort

Neurochemistry: Many pathways Uptake inhibitor of serotonin and probably dopamine and

norepinephrine; mild MAO inhibitor If the drug companies could make this, they would!

Dosing: 300 mg. 3 times per day

Concerns about decreasing the effectiveness of othermedications: Do not use with protease inhibitors for HIV. Unproven concern with birth control pills, but be mindful

#4: Increase the GABA/Glutamic AcidRatio

GABA and glutamic acid (GA) have a dance in thebrain. GABA is Yin and Glutamic Acid is Yang. GAis excitatory and GABA is inhibitory.

Too much GA feels like a monosodium glutamateoverdose.

Too much GA creates brain problems.

High Glutamic Acid/ Low GABA

Anxiety Depression Seizures Migraine Parkinson’s Bipolar Schizophrenia

Increase Magnesium

Many mechanisms for increasing GABA Studies on migraines, seizures, preeclampsia

found magnesium to be effective. Take 400 - 1000 mg. magnesium. Magnesium citrate will likely be a laxative. Magnesium glycinate is not usually a laxative.

Increase B-6

Glutamic acid -> GABA Vitamin B-6 as Pyridoxal-5-Phosphate

(P-5-P) is the key nutritional co-factor that shifts thebalance in the direction of GABA.

Take 50 mg./day of P-5-P on an empty stomach. Many people don’t make P-5-P from pyridoxine

effectively. Often deficient in women on birth control pills.

Increase Taurine

Taurine binds to GABA receptors, thus stimulatingGABA-like activity.

Stimulates the enzymes that make GABA, andinhibits enzymes that break it down.

It’s typically a benign amino acid, also depletedduring breastfeeding.

Consider 1000 mg./day (maybe more).

Optimize Melatonin

Melatonin blocks the main glutamate receptor.

Get good sleep. Take the time. Sleep is perhaps themost restorative activity for the brain.

For sleep, use 1 - 3 mg. before bed; or smalleramount for middle-of-night waking. Try sublingualpreparations. MelatoninZNSE has optimal activitythroughout the night.

Increasing Theanine

Theanine is an amino acid found in green teaand added to soft drinks in Japan (!).

It is “antagonistic” to glutamic acid.

Consider 100 – 200 mg./day.

Taking GABA

Theoretically, GABA does not cross theblood-brain barrier, but many people doreport a calming effect. Possibly there is a “leaky brain syndrome” allowing

GABA to get through. Small number of studies showing efficacy of

GABA with anxiety.

Consider 250 - 750 mg./day on an emptystomach.

Eliminate Food Allergens

The conversion of glutamic acid to gaba is mediatedby an enzyme, glutamic acid decarboxylase (GAD). The is evidence that, through a process of cross-reactivity,

people who are allergic or sensitive to gluten and/or dairyproducts, may make antibodies to GAD, which will inhibit theeffectiveness of this enzyme.

This will create an imbalance of too much glutamic acid andtoo little GABA.

Consider a trial of eliminating gluten and/or dairy products.

Taking Progesterone

For women only . . .

Progesterone stimulates GABA receptors,triggering a GABA-like effect.

Approaching menopause, progesteronedecreases before estrogen does, sosupplementing progesterone may be helpful.

Consider Pro-Gest cream, during the secondhalf of your cycle.

Summary of Possible Interventions forEnhancing GABA/Glutamic Acid Ratio P-5-P: 50 mg. on an empty stomach

Magnesium: 400 - 1000 mg. citrate (laxative) or glycinate (non-laxative)

Tryptophan or 5-HTP to enhance serotonin, which modulates GABA

Taurine: 1000 mg. (or more) on an empty stomach (in a.m.)

Theanine: 100 – 200 mg.

GABA: 250 - 750 mg.

Progesterone cream (women only)

Melatonin 1-3 mg.

#5: Enhance Excitatory Neurotransmittersfor Energy, Focus and Learning

Increase dopamine and norepinephrine

Phenylalanine (with iron) -> tyrosine (with P-5-P) ->dopamine -> dopamine -> norepinephrine.

Tyrosine also builds thyroid hormone.

Supplement: 500-1000mg. L-Phenylalaine or L-Tyrosine (empty

stomach in the morning) 50 mg. of P-5-P (empty stomach in the morning) Supplement iron as shown by testing.

Increasing Dopamine andNorepinephrine These are stimulating neurotransmitters, and help

increase energy, happiness, and attention.

Phenylalanine (with iron) -> tyrosine (with P-5-P) ->dopamine -> dopamine -> norepinephrine.

Supplement: 500-1000mg. L-Phenylalaine or L-Tyrosine (empty

stomach in the morning) 50 mg. of P-5-P (empty stomach in the morning) Supplement iron as shown by testing.

Broad Neurotransmitter Increase

When fatigue is an issue, even chronic fatigue, a completeamino acid blend can be very useful. Taken on an empty stomach, it temporarily strongly boost

amino acids levels. The theory is, it primes the pump and gets the body and

brain going.

Use a free amino acid balanced blend. Take on an empty stomach, 30 minutes before food in the

morning. 3 - 10 grams Can modify with amino acid testing (from integrative

practitioners). Make sure vitamin and mineral co-factors are present.

Enhance Acetylcholine

Huperzine A. is extracted from Chinese club moss. Itprevents breakdown of acetylcholine.

Some studies have shown effectiveness withAlzheimer’s disease: One study showed improvedmemory in adolescents.

50 - 200 mg. Start slow. Although studies say no sideeffects, I have seen them.

Enhance Acetylcholine

Alpha GPC(glycerylphosphorylcholine) stimulatesmanufacture of new acetylcholine. Able to provide ahigh level of choline for the neurons of the brain.

Stimulates release of GABA

Benefit with memory, stroke, Alzheimer’s, and vasculardementia.

Try 300 - 600 mg. (Rx in Europe)

Enhance Acetylcholine

Phosphatidylserine A structural component of the neuron’s membrane Enhances acetylcholine release. Settles down the stress pathway of the brain, reducing

cortisol. Many studies on improving cognitive decline with aging. 100 - 300 mg. per day

Acetyl-L-Carnitine Enhances acetylcholine Study’s show slowing cognitive decline and help with

slowing the progression Alzheimer’s disease 500 - 1000 mg.

#6 Increase Glutathione

Increase glutathione, perhaps the most important anti-oxidant in thebrain Lipoic acid: 100 - 600 mg. per day.

Consider R-Lipoic form. Consider time-release lipoic acid

NAC (N-Acetyl-Cysteine) Most important building block of glutathione. May benefit the GABA/Glutamic Acid ratio. May be hard to tolerate on the digestive system. Try 500 - 2000 mg. per day on an empty stomach.

Oral glutathione is not well absorbed.

#7: Hormones

Check thyroid if fatigue is a factor TSH ideally under 2.00, but certainly under 3.00

Estrogen Estrogen does so many good things for the brain

Mood Memory Dementia prevention

Menopausal women test estrogen levels andconsider supplementation

Always bioidentical Always transdermal -- patch, cream, or spray

About Supplements

Most supplements are easily purchased at the health food storeof your choice.

Some products might be hard to find. If so, you can get them atmy website, Janhealth.com. Or, call me: (415) 472-3663.

If you want to check the formula’s of the vitamins and aminoacids products, you can check the products on my site. Thenyou can get them there, or get something comparable at thehealth food store.

As a point of comparison, look at the: Twice Daily Multi andeither BAM or All Basic Plus for Amino Acid Mixes.