Edelman podcast interview on Wellness for Life

My recent interview on webmd with Dr Susanne Bennett can be found on her website at
http://radiomd.com/show/wellness-for-life-radio/item/38075-natural-treatments-for-bipolar-disorder
or go to  iTunes at
https://apple.co/2NVJ8bw 
and click on Natural Treatments for Bipolar Disorder

Influence of Copper and Metals on Mania, Voices and Paranoia

The influence of copper and metal metabolism on stimulation, mania, voices and paranoia: http://naturalhealingforschizophrenia.blogspot.com/2014/01/iiib-metal-metabolism-copper-paranoia.html
Also see previous posts on histapenia.
To learn more about copper, toxic metals, mania, and bipolar vitamins, get my book, Natural Healing for Bipolar Disorder, from Borage Books, here, and you also get a FREE educational phone consult.

Help Us Spread the Word

Help people find out about natural approaches for bipolar and schizophrenia by providing a link on your website to http://boragebooks.com
and/or to http://naturalhealingforbipolardisorder.blogspot.com
Thank you for your support.
Eva Edelman

Histadelia and Methylation. Part III: Forming SAM.

In the next step, methionine is transformed into SAM, the most important methylator in the human body:

  Methionine  --via ATP + magnesium + MAT*--  yields SAM

Problems forming SAM in the brain** (assuming methionine is sufficient):
1 A genetic enzyme disorder. 
2 Scarcity of magnesium.
3 Conceivably, insufficient brain ATP.*** 

Therapeutic Considerations (Walsh)
Give SAMe, perhaps magnesium.
 Methionine and TMG are of little benefit.

Caution: Some psychiatrists warn against giving SAMe to bipolars, even for bipolar depression.

Walsh, on the other hand, states that when you are dealing with histadelics with subnormal production  of SAMe, supplementation is helpful, rather than a problem, as long as introduced gradually, to the level appropriate for the individual. Then, once improvement is established (within a month or so), most patients are tapered off while introducing methionine (which is cheaper).

* The enzyme, methionine adenosyltransferase
** These occur in a small number of histadelics.
***ATP provides energy to our cells. It is formed via glycolysis (carbohydrate to pyruvate metabolism), acetyl-CoA creation, and the mitochondrial Krebbs cycle and electron transport chain. Some of the nutrients involved in this process: vitamins B3 (NADH), B2 (R5P), B5, B6 (P5P), B12, B1, C; biotin, CoQ10, carnitine, alpha lipoic acid, malic acid, magnesium, chromium, sufficient oxygen and antioxidants, and thyroid-support nutrients, as relevant.

To review where we are in the methylation cycle click here.

Reminder: This information is presented for educational purposes only, and is not intended as diagnosis or treatment recommendations for the individual. Even within the histadelic subgroup, each person's biochemical requirements tend to be unique. So if you need treatment for depression, mania, bipolar, or any other medical condition, please consult a knowledgeable physician. 


For info on the role of histadelia in bipolar disorder, see my book, Natural Healing for Bipolar Disorder
In the next post we will talk about what SAM does.

Histadelia and Methylation. Part IIB. Oxidative stress, Glutathione and B12.

Even if methyl folate is available, that methyl cannot always be used to form methyl B12, as either glutathione or B12 may be unavailable.

Glutathione (GSH) acts to:

1 Increase B12 availability. Glutathione normally protects B12, which is highly reactive, from being diverted* by reacting with free radicals, toxins, immune or stress molecules, etc.
GSH also, as a critical antioxidant and detox agent, and metal metabolism activator, reduces the levels of such toxins.
* Suggested by elevated methylmalonic acid. 

2 Turn hydroxy B12 into glutathionyl-B12, an intermediate step toward methyl-B12 formation.
Thus, low glutathione decreases the transfers of methyl from methyl-folate (5MHTF) to B12, and so fosters methyl folate accumulation.

3 Stimulate methionine synthase to create methionine.
When glutathione levels are too low, the methylation cycle slows. Thus:
Homocysteine  --via methyl folate +  B12 +  low GSH--  will not yield much methionine
Instead, homocysteine will be be diverted down the transulfuration pathway, to create more glutathione. More on this in a future post.

4 Protect all cells from oxidative stress, including the mitochondria, which supply cellular energy (by creating ATP). 

Glutathione can be low* due to

1 Genetic problems in creating or recycling glutathione.
2 High demand, e.g., ongoing oxidative stress. Also, chemical or heavy metal toxicity, infections, vaccinations, chronic stress, injury or surgery.
* Suggested by decreased SAM and accumulation of SAH and oxidized glutathione, as well as other measures of oxidative stress.

Therapeutic Considerations (Walsh)

Glutathione to support B12 availability, to attach methyl to B12, and to stimulate methionine formation.
Plus, in some cases, methyl-B12 may need to be supplied directly.

Glutathione and other needed antioxidants. Elimination of factors worsening oxidative stress.

Attention to any metal metabolism dysfunction, toxicity, relevant health issues, other mental and physical stressors.

More on glutathione:
Dr. Mark Hyman's video.
Also, this youtube.  (A good presentation, but ignore the marketing.)

Reminder: This information is presented for educational purposes only, and is not intended as diagnosis or treatment recommendations for the individual. Even within the histadelic subgroup, each person's biochemical requirements tend to be unique. So if you need treatment for depression, mania, bipolar, or any other medical condition, please consult a knowledgeable physician. 

For more info on histadelia and bipolar disorder, see my book, Natural Healing for Bipolar Disorder

Histapenia in bipolars: Vitamins

The focus in histapenia treatment  is reducing brain overmethylation, increasing folate and histamine, and addressing high copper and metal metabolism problems, if present.

Treatment must reflect individual biochemical requirements.

Doctors Pfeiffer, Hoffer, Walsh and other orthomolecular physicians have, over tens of thousands of histapenic patients, have found these vitamins almost always beneficial, roughly grouped around the following symptoms:

Voices and other psychotic symptoms.

Vitamin B3 — Critical to brain circulation and metabolism, histamine production, metal metabolism, copper elimination. Antioxidant. May create a flush.
Vitamin C — Counters overstimulation, voices, and paranoia. Promotes copper excretion, protects brain tissue from oxidation.
Vitamin B6 — May be even more important than B3 for psychosis in children. Helps form GABA, glutathione, CoQ10. Antioxidant. Supports B12 absorption, zinc metabolism. May decrease available methyl.
Zinc — Inhibits absorption and promotes copper excretion. Facilitates histamine storage. Antioxidant. Helps maintain GABA levels.

Paranoia:

Vitamin C, Zinc (above)

Stress, overstimulation, hypomania, mania:

Vitamins B3, C, B6, Zinc, Magnesium. Plus:
B complex — Supports neural function; helps prevent deficits due to high doses of specific B vitamins.
Pantothenic acid (B5) — Supports adrenals. Helps keep copper low.
Manganese — Lowers dopamine. Supports metal metabolism and copper elimination. Makes choline available to form acetylcholine.
Choline or DMAE — Counters dopamine  and norepinephrine.
GABA — Counterbalances norepinephrine. But may interact with meds.
Valerian — Only if needed. Check for drug interactions.

Depression: 
Vitamins B3, C, B6, B5, omega 3,  L-carnitine.
Folic acid and B12 — Counterbalance and trap methyl.   Helps produce histamine (via BH4).

High copper and poor metabolism of divalent metals:

Zinc, C, B6, B3. manganese.
Molybdenum — Important to copper metabolism. Especially suggested by pronounced allergies and high urinary sulfite.
NAC — Critical in decreasing copper. Introduced slowly, and only after at least three months of zinc, etc. Can cause severe symptoms if given too early. For a discussion on decreasing copper see: Copper Tox Doc.

Neural support
B complex, zinc, magnesium. 

Vitamin C and E, selenium, other antioxidants — Helps protect against peroxidation due to overstimulation and to elevated copper.
Omega 3 — Supports neural receptor function.  

Chronic lack of physical energy,  but not indicated if voices or overstimulation worsen:
 L-carnitine — Brings fuel (fats) to the mitochondria (cellular energy factories) and protects mitochondria from oxidative stress.
Iron — only if deficient.

Other

Isoleucine — Helps retain B3. While usually not needed, Hoffer finds it rapidly effective in some acute low-B3, high-leucine patients.

Diet — Fresh whole foods (organic, if possible), omega 3 fish, abundant folic acid-rich vegetables. Avoid allergens, fried or hydrogenated fat, sugar, alcohol, refined carbs.
Intake of meat depends on individual reactions and chemistry.*

* Meat is rich in B3, B6, B12, zinc and carnitine, and benefits hypoglycemia. However, as Walsh points out, meat can markedly increase methionine and methylation.

Cautions

Methionine and SAMe increase methylation.
Copper worsens voices, paranoia, overstimulation and hypomania.
SSRI’s, and St Johnswort may produce adverse reactions.


Reminder: This information is presented for educational purposes only, and is not intended as diagnosis or treatment recommendations for the individual. Even within the histapenic subgroup, everyone's biochemical requirements are unique. So if you need treatment for mania, bipolar, or any other medical condition, please consult a knowledgeable physician.

Mania Vitamins: Attention to Potency of Therapy

Thoughts on mania

Our brains feed on stimulation. New experiences, and ideas, and learning in general, are exciting.
But with mania, excitement comes without the counterbalance. So one cannot distinguish whether one idea is more relevant than another. And information can come so fast, that it cannot be integrated with past knowledge. Eventually, neurotransmitter pathways can be so overloaded that neurons do not have time to recover between messages.
Essentially, excitatory messaging and/or second-messaging predominate, excluding inhibitory activity needed to maintain useful function.

A severe enough mania can elude an arsenal of potent meds (even the more powerful herbs).
And even when you are able to suppress the mania, research is beginning to suggest that by attacking aggressively (perhaps, especially with substances not intrinsic to brain biochemistry) you may have set the stage for bipolar deterioration longterm.

Acute manias and vitamins
On the other hand, orthomolecular physicians are finding that nutrient therapies which nourish inhibitory mechanisms and normalize excitatory systems tend to work increasingly well with time, while usually proceeding gradually enough* to sidestep the above mania escalation and chronic repercussions.

See my posts here on inhibitory aminos, from June 21 to Aug 24, 2010, and also the outline of Mania and Stabilization info at the top of the Borage Books Nutrient Summary page.

* Nonetheless, in some cases, e.g., with violence or heart problems, a more rapid improvement may be necessary. See previous post on IV therapies.

Addressing root causes
Aside from resolving acute episodes,  ferreting out and addressing root causes (e.g., methylation imbalances, hormonal issues, pyroluria, problems with metal metabolism, etc.) is particularly important to long-term mood stability. See Ongoing Mood Stability, Biotypes, Toxicity, and Health at the bottom of the Borage Books Nutrient Summary page.

For further details, including contraindications, see my book, Natural Healing for Bipolar Disorder.

Reminder: This information is presented for educational purposes only, and should not be construed as treatment recommendations. Treatments should be fine-tuned to individual biochemical requirements. Also note: sudden changes in medications can be disastrous. See:
http://naturalhealingforbipolardisorder.blogspot.com/2010/04/nutrient-approaches-for-bipolar-and.html
If you have concerns about meds, or if you need treatment for mania, bipolar, or any other medical condition, please consult a knowledgeable physician.

Bipolar Vitamins and Mood Stability

In general vitamins work gradually. The right nutrients, tailored to unique individual needs, will steadily promote and build brain health (and support body health as well), because, along with oxygen, nutrients are the main constituents of brain biochemistry.

 

Most of the time, for bipolars, the gradual improvement that vitamins provide is ideal, as the alternative, rapid change, tends to increase cycling and ultimately destabilize mood. After all, in the abstract sense, we probably all intuit that the cure for bipolar disorder is moderation.  

Even so, rapid change is sometimes needed during life-threatening mood states. This is the point at which people are usually taken to the hospital. Wouldn't it be great if the hospital had IV orthomolecular treatment available (i.e., intravenous nutrients as per unique need)? So a person could stabilize while supporting brain function and vitality?

For some of the work now being done with IV vitamins, see:
Dr. Joan Larson's site

For a general overview of  the nutrients now being studied for bipolar, see:
http://boragebooks.com/bipolar_treatments.html

or, to learn more, check out my book, Natural Healing for Bipolar Disorder

Bipolar Vitamins: Histadelia and Folic Acid

Folic acid is a critical vitamin for both mood and neurological health in general.

So why should histadelics restrict it?

1 They are already overloaded in folic acid.
2 Histadelics do not readily turn folic acid into methyl folate, which is needed to support  neurotransmitter methylation. Instead folic acid accumulates, worsening histadelic depression.


So the focus of therapy becomes: restrict folate, and support brain methylation (see previous posts).

Note: We are talking here only of histadelics, that is, people with undermethylation of brain neurotransmitters, and already elevated folate. For almost everyone else with mood problems, folic acid tends to be essential.

For more information, see my book, Natural Healing for Bipolar Disorder.

Reminder: This information is presented for educational purposes only, and should not be construed as treatment recommendations. If you need treatment for histadelia, bipolar, or any other medical condition, please consult a knowledgeable physician.

Bipolar Depression: Histadelia Vitamins II

Nutrients commonly used for histadelic bipolars include:
SAMe, methionine, vitamin B6, magnesium and TMG, as per individual requirements. See:  the sample histadelia page from Natural Healing for Bipolar Disorder (as per my previous post).

Further histadelia nutrients can include:

Calcium — often depleted. Calcium decreases histamine and supports release of antidepressant neurotransmitters.
Inositol — may reduce anxiety, promote sleep. Critical to signalling. Counterbalances choline and supports folate, vitamin B6, vitamin B12, betaine and methionine.  Too much may promote anxiety or panic in some bipolars, but not usually histadelics.
Methyl  B12 — Needed to turn homocysteine to methionine. Especially critical if oxidative stress is prevalent.
Omega 3 — supports methylation.
Niacinamide — modest amounts, introduced gradually, with attention to reactions. If voices occur,  B3 tends to be crucial. Anxiety may also signal greater need.
Zinc — Counters overstimulation. Supports homocysteine metabolism to cysteine or methionine.

Antioxidant support. With undermethylation, oxidative stress increases, and further compromises methylation pathways and depletes neurotransmitter precursors. Consider the following antioxidants:
Glutathione — of prime importantce. Needed to support formation of methyl B12.
Selenium and E — works with glutathione.
Vitamin C — decreases histamine; moderates stimulation; antidepressant.
Vitamin A — helps counter the seasonal allergies.
Vitamin D — supports calcium absorption and helps counter depression. 
Acetyl-L-carnitine — a great mitochondrial antioxidant; need may be suggested by low mental energy. However, may overstimulated.
Other antioxidants, as relevant.

Other nutrients, sometimes indicated 
Serotonin support (e.g, St Johnswort, tryptophan, 5HTP) — modest intake may help balance mood, especially if depleted.
Kava — calms limbic activation, but overstimulating for some.
Tyrosine — may  temporarily help counter the depression, especially if depleted, at least until methylation increases.
Copper — supports dopamine and norepinephrine formation, decreases histamine. In histadelics, metal metabolism disorders tends toward overactivity, decreasing copper. If so, small doses,  in some cases, may become useful (but not if it worsens oxidative stress).

Diet

Plentiful quality animal proteins (preferably fish from mercury-free waters; organic meats, free-range poultry) provide methionine. A good whole foods diet is recommended, with lots of complex carbohydrates and vegetables (though intake of greens, in some cases where folate is too high, needs to be moderated), healthy fats, and some fresh fruit. Minimize/avoid immunoreactive foods. Dairy provides calcium, which the histadelic needs, but is commonly an allergen (if so, consider goat milk products and a possible need for more zinc). Avoid sugar, white flour, fried and hydrogenated fat.

Restrictions 
Folic acid, is typically excessive relative to methylation status, so often must be significantly restricted.
Choline (which counterbalances norepinephrine) may worsen histadelic depression, so may need to be limited. DMAE, especially, tends to be detrimental,
GABA often is less than helpful during low-catecholamine histadelic depression.

This material reflects approaches developed by Doctors: Walsh, Hoffer, Pfeiffer, Jaffe, Kruesi, Bibus, and others.  See Natural Healing for Bipolar Disorder for further info, including contraindications and references

Reminder: These are general summaries presented to educate the public and are not treatment recommendations. Treatment depends on the individual's unique biochemistry and response pattern. Attention to contraindications is essential.  If you need treatment for histadelia, bipolar, or any other medical condition, please consult a knowledgeable physician.

Bipolar Disorder: Pfeiffer/Walsh Biotypes and Corresponding Nutrients

Here is a short description by Dr. William J. Walsh of major biochemistries (biotypes) and corresponding nutrient therapies -- found in a substantial portion of bipolars -- with some corresponding nutrient therapies.
http://alternativementalhealth.com/articles/commoncauses.htm

Actual treatment must be tailored to each patient's unique biochemical requirements. So, if you need treatment for bipolar disorder, consult a knowledgeable physician.

Bipolar Nutrient Article: Integrative Medicine Approach

Again, one of the problems with starting to discuss potential mania vitamins and minerals in this blog is that it's easy to miss the wider therapeutic context -- given this medium, I can only say so much at any one time. In Natural Healing for Bipolar Disorder,  on the other hand, you have it all together in one book, and can pick specifics as you are drawn to them.


So, you can either buy my book or, meanwhile, you can gain some perspective by looking at one of the better articles on bipolar:

Bipolar Disorder as Cell Membrane Dysfunction. Progress Toward Integrative Management

by Parris M Kidd, PhD, Alt Med Rev, 6/2004.


Either at:
http://findarticles.com/p/articles/mi_m0FDN/is_2_9/ai_n6112778/
If you choose this site, you have to click 34 times at the numbers or next button on the top.
Or you can get the pdf from Dr. Kidd's website:
http://www.dockidd.com/
Right side of page, under Brain Health Science,  third entry.

Nutrition and Mania: Zinc, Pyroluria, Root Causes

Because it is mania season for most, I have taken the occasion to very briefly introduce a few vitamins and minerals which tend to calm brain overstimulation. Soon we will proceed to inhibitory aminos.

Before going on with these symptomatic tidbits, I would like to emphasize the ultimate importance of getting to the deepest underlying influences.

For example, for a certain subset of manics with pyroluria, just taking zinc would be less effective than therapy completely addressing the pyrrole disorder. More later.

For a wider perspective on underlying influences, see my Table of Contents,
and my book, Natural Healing for Bipolar Disorder

Note: This blog necessarily presents only the most cursory notes on nutritional approaches. Its purpose is solely educational, with the hope of sparking your curiosity to learn more. 
If you need treatment, please seek the services of a knowledgeable physician.

Nutrients and Bipolar Mania: Reactions to high doses

Orthomolecular medicine used to be called Megavitamin therapy. As the name suggests, the approach, in general, is to bring dosage toward the level that has the optimum positive effect.

But how do you know if you have too much?

I am not going to cover all indications, contraindications, etc. For more complete discussions, see my book.  (And do consult a knowledgeable physician for treatment.)

Meanwhile, here are some easy-to-notice reactions to too much
of the nutrients we've already talked about:

Vitamin C - diarrhea.

Magnesium - (1) diarrhea; (2) some potential for oversedation; especially with a magnesium sulfate (epsom salt) bath (which is inadvisable if also taking sedative psych meds or herbs).

Vitamin D - (1) insomnia (especially if taken later in the day); (2) overstimulation (e.g., usually with many thousands of mg.)

Zinc -  (1) nausea, though this may just be due to not enough B6; (2) with very high doses, oversedation. See the next entry.

Nutrients and Bipolar Mania: Why Zinc?

Consider some of the means by which zinc might benefit mania:

— Helps moderate levels of the major stimulating neurotransmitters, dopamine and norepinephrine.
— Supports creation of GABA, a major inhibitory neurotransmitter, and is critical when taking taurine
— Crucial in handling stress. Depleted continuously in pyroluria (a common stress disorder in bipolars, see: http://boragebooks.com/bipolar_5_pyroluria.html )
— Critical in decreasing overloads of stimulating metals, such as copper and iron, and certain heavy metals.
— Supports balanced blood sugar (thereby, mood stability).
— Helps counter dairy and grain sensitivity (implicated in both mood and cognitive dysfunction).
— Some ability to neutralize excitotoxicity (which can trigger mania).

For more on zinc, mania, and bipolar disorder, including references, see my book, Natural Healing for Bipolar Disorder.

Nutrients and Bipolar Mania: Overview

Before proceeding further on nutrients and mania, here is a general overview of  investigational targets. 

Note: Only some of these would be relevant for any given individual. 

Minerals: magnesium glycinate, zinc, trace-mineral-dose lithium orotate, etc. May need to restrict copper and/or iron.
Inhibitory aminos: taurine (plus zinc), GABA (especially with histapenia or pyroluria), glycine (pyroluria). Perhaps, serotonin precursors.
B1, B3, B6, or other B vitamins.
Vitamin C. Other antioxidants.
Choline. Perhaps, omega 3 and/or GLA.
Kava (especially with histadelia), valerian (histapenia), theanine, skullcap, Bach Rescue Remedy, passion flower.
Moderate thyroid overactivity; support blood sugar and adrenal balance.
Treat histapenia, pyroluria, MT disorder, etc..
Attend to Candida, allergies, toxicity, malabsorption, immune, neurological, and other health issues.
Decrease stressors (e.g., quiet, darkened room; regular meals, sleep, etc).
Increase support with seasonal change and other stressors.

Important: These investigational targets should not to be construed as treatment directives. This material is presented for educational purposes only. 
 

Remember that therapy must be tailored to each individual's unique biochemical requirements, including contraindications. So if you need treatment for bipolar disorder, or any other medical condition, consult a knowledgeable physician. In some cases, this will be an orthomolecular or other nutritionally-oriented physician. 

For further info, see:"Natural Healing for Bipolar Disorder," available from boragebooks.com