Histapenia (overmethylation low folate)

For info on vitamin approaches  for histapenia (brain overmethylation, low folic acid), a biotype affecting up to 25% of bipolars, especially when more prone to mania or paranoia, see my Natural Healing for Schizophrenia blog at http://naturalhealingforschizophrenia.blogspot.com/
Check posts June 25, 2013 to Sept 19. (More to follow shortly.)
You can find the complete rundown in either of my books, Natural Healing for Bipolar Disorder or Natural Healing for Schizophrenia, available at http://boragebooks.com
Questions? You get a free educational consult when you buy my book at http://boragebooks.com

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.

Manic psychosis: Vitamin B3 and Vitamin C

Megavitamin Therapy (which evolved into, Orthomolecular Psychiatry) began with the Hoffer/Osmond research into niacin (a form of vitamin B3) and vitamin C. See my post at: http://naturalhealingforschizophrenia.blogspot.com/2010/02/how-did-orthomolecular-psychiatry-begin.html

Over the next half century, although other supportive nutrients have been discovered, orthomolecular physicians and researchers have continued to find megadose vitamin B3 and megadose vitamin C to be major therapeutic agents for most adult psychoses,* including manic and depressive psychoses. This applies to all biotypes, even histadelia (more on biotypes later). 

That is, niacin and C, within the context of a complex of indicated nutrients, health therapies, and other treatments, as per individual biochemical requirements, including contraindications.

For references, consult the literature, and see my books, Natural Healing for Schizophrenia and Natural Healing for Bipolar Disorder.

Caution: My blog entries are solely educational. If you need treatment, consult a knowledgeable physician.

* Some exceptions: for pyrolurics and for young people, B6 or B6 plus B3, may often be more effective than B3 alone.

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.