New Age Psychiatry: Nutrients for a Calmer State of Mind
Note From the Editor
As always, if you are facing a medical or psychiatric emergency, please dial 911. If you need immediate support, you can call the specific support services listed below. The Trans Life Line Crisis & Suicide Hotline is 1-877-565-8860. If you’re thinking about suicide, please care for yourself and reach out for help. Here are some resources that can help support you below. If you’re uncomfortable using the phone, the National Suicide Prevention Helpline and the Trevor Lifeline also have a chat feature on their websites.
National Suicide Prevention Helpline: 1-800-273-8255 (or chat on their website)
The Trevor Lifeline for LGBTQIA+ Youth: 1-866-488-7386
Trans Lifeline: 1-877-565-8860
We also have the following resources: Complementary Healthcare Providers, “How to Help a Loved One with Depression,” “Resources for Recovery & Mental Health,” “It’s Not Just Sadness: How to Tell if You Might Have Depression,” and more.
Painting courtesy of Pierre Boncompain
A lot of people who have anxiety, depression, and other emotional and mental conditions either do not want to start pharmaceutical therapy because of the side effects they've heard of or are on pharmaceutical therapy and are tired of the side effects that they are experiencing. More and more evidence is starting to reveal that nutrients may play a big role in alleviating mood and mental symptoms. When someone wants to start a nutrient protocol, genetic testing needs to be completed to find out which nutrients should be used and which are not needed. Basically, testing helps curate a nutrient protocol specifically for the individual's symptoms and their test results. Testing involves finding variations in genes through salivary samples that research has shown to play a role in developing psychological symptoms. Additionally, incorporating this genetic data with a health care team composed of medical doctors, naturopathic doctors, and therapists will provide an all-encompassing treatment plan at illuminating and targeting the root causes of emotional and mental symptoms. So, I've lined up some of the common genetic variations (also known as single nucleotide polymorphisms) that may be valuable information in supporting a wellness journey.
MTHFR
Nope, it's not pronounced like what I know you're thinking. It's an abbreviation for methylene tetrahydrofolate reductase, and it's a protein that is involved in turning folic acid into it's bioactive form, methyltetrahydrofolate. Why care about this? Genetic mutations for this protein are strongly associated with incidence and severity of mood disorders and may reduce the production of neurotransmitters. Also, proper function of this protein is involved in mitochondrial performance with B12 (to make cellular energy); DNA maturation via B12; cardiovascular health through homocysteine; neurotransmitter production (such as serotonin); and histamine metabolism (histamine is associated with asthma, food sensitivities, eczema, and other allergy responses). So, it's pretty important to know your MTHFR status along with other proteins that interact with it for those functions listed above.
Solution? Supplement with bioactive folic acid and riboflavin. Riboflavin acts as a cofactor to make sure that MTHFR functions properly.
COMT
Catechol-O-methyl transferase (COMT) is involved in breaking down catechols (dopamine and estrogen). Variations in the COMT gene can lead to low-functioning COMT or high-functioning COMT. With low-functioning COMT, this leads to high amounts of dopamine in the brain. This can mean better concentration and cognitive function, but it can also mean great sensitivity to stimulants. With high-functioning COMT, it leads to lower amounts of dopamine in the brain, and may mean lower cognitive function and greater response to stimulants.
Solutions? With low-functioning COMT, SAMe, magnesium, and adenosyl-B12 may provide relief if there are symptoms associated with anxiety. For high-functioning COMT with cognitive symptoms, dietary approaches to reduce COMT function may be helpful. Foods that research has shown to be effective at that are caffeine, green tea, and quercitin. Nutrients and herbs that could help support dopamine production are tyrosine, Mucuna pruriens, and Rhodiola rosea (all underlined links lead to our recommended supplements).
Okay, you've got COMT in check, but what if dopamine isn't attaching onto receptors to cause cognitive effects? Another gene, DRD2 (Dopamine D2 receptor) may provide answers. Genetic variations for this receptor can reduce the effects of dopamine, leading to symptoms similar to high-functioning COMT. So, if there is a DRD2 genetic variation in the picture alongside COMT mutations, adding in higher amounts of herbs, nutrients, and dietary approaches may be helpful to alleviate symptoms.
CBS
Remember when I mentioned homocysteine with MTHFR? Homocysteine is an inflammatory metabolite that has been associated with increased risk for cardiovascular disease, miscarriages, and, more importantly, mood disorders. CBS (aka Cystathionine beta-synthase) is one protein that can reduce homocysteine in the body if it is working properly. Mutations in the CBS protein can lead to low-functioning or high-functioning CBS activity. With low-functioning, there is the potential for build-up of neurotoxic homocysteine. With high-functioning, there is a potential for build-up of homocysteine metabolites, such as sulfites.
Solution? For low-functioning CBS activity, activated vitamin B6 becomes a major player in helping CBS do its function properly. With high-functioning CBS, making sure pathways lower down the ladder are supported so that sulfites are metabolized to safer forms. So, that's when another protein comes into play - enter, SUOX. SUOX (aka Sulfite oxidase) is an enzyme that metabolizes sulfites into sulfates. This protein needs molybdenum to function properly. So, supplementation with that trace mineral will be vital if there are any genetic variations found in SUOX.
MTR
MTR is the gene that codes for Methionine synthase, which is involved in B12 regeneration and is also involved in metabolizing homocysteine. Methionine synthase basically takes homocysteine and turns it into the amino acid methionine, which is used in a bunch of different proteins and reactions vital to the proper working of the body. When there are mutations in this gene, it means that B12 is regenerated at a slower rate.
Solution? Supplement with B12. There are so many types of B12 (cyanocobalamin, hydroxycobalamin, adenosylcobalamin, and methylcobalamin). So, how would you know which to choose? Cyano-B12 is the most cost-effective form of B12 in the supplement aisle. I usually don't prescribe this since since the body needs to break it down to just B12 and turn it into bio-active forms of B12. Why waste the body's resources when you can purchase active B12 forms like hydroxy-B12, adenosyl-B12, and methyl-B12? Methyl-B12 is the most cost-effective bioactive form of B12. People with certain COMT variations might find this too stimulating, leading to anxiety, sweating, and palpitations. If this occurs, hydroxy-B12 and/or adenosyl-B12 might be a better option.
So, you're supplementing with the right form of B12, but your homocysteine levels are still high, then what? It makes me wonder two things: 1) if you're absorbing B12, and 2) if the absorbed B12 is going into the cells. There are genes associated with each that can be tested for. The FUT2 gene is responsible for determining the rate at which B12 is absorbed in the gut. It is also associated with gut bacteria populations. With mutations in FUT2, there is an association with high B12 status but low amounts of bacteria. The TCN2 gene codes for the protein transcobalamin, which helps transport B12 into cells. Variations in the TCN2 gene may lead to reduced amount of cellular B12. I've still yet to find research stating any natural solutions to help facilitate the action of low-functioning transcobalamin. In the meantime, it could be beneficial to give higher amounts of B12.
Summary & Takeaways
Common genetic variations that are associated with mood disorders are MTHFR, COMT, CBS, and MTR.
Genetic testing is easily done and can be collected through saliva.
Studies show that B-vitamins (B12 and folate) can support the impacts of common genetic variations. With that, careful selection of B-vitamins may be more beneficial for some genetic variations.
Minerals (molybdenum, magnesium, and lithium) can act as essential nutritional cofactors to help support aberrant biochemical function from genetic variations.
Foods and herbs (Mucuna pruriens and Rhodiola rosea) can improve common genetic variations of COMT.
If you're healthy and do get positive results for genetic variations, it does not necessarily mean you will get symptoms. It just means you have a greater predisposition to getting them. You should remember that genes are activated or inactivated depending upon environment and stress (external and internal). So, if you're healthy, take some self-care approaches. Simply add nutrients with the guidance of a healthcare professional that will pair well with your health goals, lab results, lifestyle, and happiness. If you are experiencing symptoms, it is vital to support yourself under the guidance of a health care team - with naturopathic doctors, medical doctors, and mental health professionals. Remember, not just 1 practitioner is able to fully support you through your mental health journey, and that mental health is best supported with psychiatric care and therapy.
If you want professional, naturopathic guidance on how to tame your symptoms due to genetic variations, prevent symptoms from taking place, find out about your genetic variations, and/or support your health and wellness, schedule an appointment with me at Jupiter Naturopathic Wellness. Remember that we're only open on weekends and that we also provide naturopathic medical services for a variety of conditions. We also accept HSA/FSA insurance plans. So, why not get your insurance company to sponsor your new 2018 self-care routine?
About the Author
Dr. Bryant Esquejo is a California-licensed naturopathic doctor practicing in the Silver Lake neighborhood in Los Angeles, California. You can book an appointment with him here and follow him on social media here.
He received his Bachelor’s Degree in Biology from San Diego State University in 2012 and his naturopathic medical degree from the National University of Natural Medicine in 2016. In his practice, he aims to help patients achieve optimal health and wellness by focusing on hormonal and thyroid health; adrenal dysfunction and stress-related chronic fatigue; gastrointestinal health; anxiety and depression; and nutrigenomics. He uses a variety of integrative modalities to assess and treat patients, such as bioenergetic muscle testing; advanced and basic functional laboratory assessment; therapeutic nutrition; lifestyle medicine; nutraceutical, vitamin, mineral, and herbal supplementation; intravenous micronutrient therapy; and energetic medicines, such as constitutional homeopathy and flower essences.
DISCLAIMER
These statements have not been evaluated by the Food and Drug Administration. There are no financial ties to any supplement companies, pharmaceutical companies, or to any of the products mentioned in this post. This post is not meant to treat, cure, prevent, or diagnose conditions or diseases and is meant for educational purposes. As always, please consult your doctor before trying any new treatments or supplements.
Sources
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Ikegame, Tempei, et al. “DNA Methylation of the BDNF Gene and Its Relevance to Psychiatric Disorders.” Journal of Human Genetics, vol. 58, no. 7, June 2013, pp. 434–438., doi:10.1038/jhg.2013.65.
Morris, Nathan. “Clinical Nutrigenomics Made Simple: How to Assess and Target Important Genetic Polymorphisms and Individualized Nutritional Support.” Pure Encapsulations Presents. Pure Encapsulations Presents, 26 Dec. 2017.
Morris, Nathan, and Kelly Heim. “Mind Over Genetic Matter: How to Address 6 Common Genetic Variations Affecting Mood and Memory.” Pure Encapsulations Presents. Pure Encapsulations Presents, 26 Dec. 2017.
Nielsen, Maria Gabriela, et al. “MTHFR: Genetic Variants, Expression Analysis and COMT Interaction in Major Depressive Disorder.” Journal of Affective Disorders, vol. 183, 2015, pp. 179–186., doi:10.1016/j.jad.2015.05.003.
Skovierova, Henrieta, et al. “The Molecular and Cellular Effect of Homocysteine Metabolism Imbalance on Human Health.” International Journal of Molecular Sciences, vol. 17, no. 10, 2016, p. 1733., doi:10.3390/ijms17101733.
