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Commentary on Nutritional Treatment
of Mental Disorders
from Willam Walsh, Ph.D., Senior Scientist, Pfeiffer Treatment Center
www.hriptc.org
(The following information is taken from Dr. William Walsh's discussion on Safe Harbor's "Integrative Psychiatry" email list for professionals. To preserve Dr. Walsh's wealth of information, we have posted his comments here, with the notation of added commentary [with the date] as discussion goes on.)
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Index
ADD/ADHD
Alzheimer's Disease
Amino Acids
Anorexia
Antidepressants
and Cancer
Autism
B6
Bipolar Disorder
Candida
Celiac Disease
Choline
Copper
Coral Calcium
Crime &
Violence
Depression
Downs
Essential
Fatty Acids
Fetal Alcohol
Syndrome
Hair Analysis
Head Injury
Histamine
Hives
Learning
Disabilities
Metabolic Types
Mercury
Metallothionein
Methylation
Neurotransmitters
Obsessive Compulsive Disorder
(OCD)
Oxidative
Stress
Paranoia
Placebo effect
Post Partum Depression
Pregnancy
Psychiatric Medications
Pyrrole Disorder
SAMe
Schizophrenia
Taurine
Womb Trauma
Zinc
ARTICLES A-E
ADD/ADHD
We've treated more than 6,000 children & adults diagnosed with ADHD, ADD, or LD. There is a great variety of biochemical phenotypes within these broad classifications & completely different treatment approaches are needed. About 60% of these patients are high dopamine, low choline persons and thrive on choline-enhancing supplements. (10 Jan, 2003)
After testing & treating more than 6,000 ADHD patients, I've learned that most of these patients exhibit chemical imbalances which impact neurotransmitter concentrations and brain function. In this sense, ADHD actually is a brain disorder. In countless cases, we have seen the ADHD disappear after treatment for the imbalances. Also, there clearly is a strong genetic component to ADHD. To me, this is good news, since genetic differences are usually expressed as chemical differences.... and chemistry can be adjusted. Just because ADHD is a brain disorder does not mean that drug therapy is indicated. In my experience, more than 80% of ADHD patients respond beautifully to nutrient therapy aimed at normalizing brain chemistry & body chemistry. ADHD usually involves disturbed brain chemistry & imperfect brain function. However, drugs are not the answer in most cases.
We have seen more than 5,700 children diagnosed with ADD/ADHD and most of them were mis-diagnosed & didn't have it at all. Hundreds of these kids were extremely bright with terrific concentration for things they cared about. The major problems they experienced were boredom (number 1) and authority issues. Quite a few had OCD and oppositional/defiant tendencies which have nothing to do with ADD/ADHD. (6 Jan, 2003)
Is there a simple combination that's generally effective for ADHD?
Not really, since there are several phenotypes comprising ADHD and the treatments may be completely different and in some cases opposite. (13 Jan, 2003)
A classic component of ADHD is impulsivity. Impulsivity leads to accidents &
injuries. It would be very surprising if an ADHD population didn't have a
higher incidence of injuries. To complicate things, bumps on the head
resulting in brain trauma can worsen ADHD. (Feb 10, 2003)
We've known for
more than 20 years that the metallothionein protein system
does not perform well in most ADHD patients. About 68% of them
exhibit very poor control of Cu & Zn, based on lab data
from more than 6,000 patients diagnosed with ADD/ADHD. Autism
is different in that about 90% of patients exhibit Cu/Zn
imbalances that are generally much more severe than in ADHD.
For several months, we have extended our metallothionein-promotion
protocol to ADHD, behavior, depression, and schizophrenic
patients who exhibit Cu/Zn imbalance. The informal results so
far are very encouraging. However, we've not yet done a formal
outcome study for these populations, and thus have no
statistics yet.
We are considering applying MT-Promotion to Alzheimers &
Parkinsons patients in the near future. Both disorders involve
serious oxidative stress and abnormal trace metal levels. In
addition, recent research has revealed a striking
metallothionein deficiency in the brains of Alzheimers
patients. (Feb 25, 2003)
The two primary
ingredients for paranoid schizophrenia are (a) elevated copper
levels and (b) over-methylation. In our database of more than
6,000 ADHD kids, 68% have elevated copper in blood serum.
Since most ADHD individuals have one of the two SZ
prerequisites, it would be a surprise if the SZ incidence were not relatively high in the
ADHD population. Fortunately, very few ADHD kids become
schizophrenic. (March 10, 2003)
ADHD is a real condition, but grossly overdiagnosed in the
USA. NIMH estimates that the incidence is about 4.75%.
However, there are states like Utah and Virginia in which more
than 20% of all children are receiving Ritalin or other
stimulant medication. Many parents prefer a diagnosis of ADHD to having to focus on family dynamics that
might be a contributing factor...... the prospect of a
"magic bullet" drug is very seductive. I agree that
most children labelled ADHD don't really have it! (March 25,
2003)
Overdiagnosis of ADHD. The incidence of ADHD has been determined by NIMH
to be approximately 4.75%. However, there are many areas of the country
(including entire states) where more than 20% of school
children are taking Ritalin or other stimulant medication for ADHD. Many children who simply
have behavior problems are misdiagnosed with ADHD.
Alzheimer's Disease
It is becoming increasingly clear that Alzheimer's Disease is a condition of
oxidative stress. Niacin has good antioxidant properties, thus it protects
against AD. Many other antioxidant nutrients also protect against AD.
Amino
Acids
If a person is low
across the board in amino acids, supplementation with mixed
AA's could be beneficial. However, if an individual is known
to be deficient in one or two AA's, it might be better to
supplement these apart from each other and from food.
There is a large volume of published literature that indicates
competition between amino acids in passage through the
intestinal mucosa..... the highest levels of absorption are
achieved in the absence of other AA's.
Genetic differences in persons can result in great variations
in nutrient requirements. If a genetic tendency for low AA
levels is present, it might be impossible to eat enough food
to supply what's needed. (Aug 18, 2003)
Anorexia
We've treated many anorexics and
find most of them to be undermethylated and zinc deficient.
Our standard treatment regimes for these two imbalances are
usually very successful, especially in concert with quality counseling.
(July 22, 2003)
Antidepressants
and Cancer
The FDA requires
that all psychiatric medications be tested in animal studies
for possible enhanced cancer risk. These are usually done with
rodents. However, medications are often approved even if the
medication causes cancer in rats. The box score on three drugs
is as follows:
Paxil: Male rats exhibited increased incidence of
lymphoreticular tumors & cell sarcomas.
Prozac: No evidence of carcinogenesis.
Zyprexa: Mammary gland adenomas and adenocarcinomas found in
rats, suggesting possible increased risk of breast cancer.
Increased prolactin levels which has been associated with
increased risk of hormonal cancers....breast, ovarian, etc.
Also one of two studies indicated increased incidence of liver
cancer. (Feb 24, 2003)
Asperger's
Syndrome
Asperger's Syndrome. True Aspergers is a striking and disabling disorderwhich often involves "Rainman-Type" abilities and terrible social
skills. We're now seeing that many bright kids with poor social skills (often called
"nerds") are inappropriately labeled with this autism-spectrum disorder.
One of the "treatments of choice" for autism is Risperdal, and it is given
freely to tens of thousands of children under the age of 5 years. I'm
especially concerned about its frequent use for autistics under the age of
3, when their little brains are still developing and maturing. There are legitimate concerns about Risperdal for teens, but the situation
in autism is even more alarming.
Autism
Autism involves a powerful genetic component, so the real question is whether these genetically autism-prone children are hypersensitive to mercury. Recent research has shown that autistics are severely depleted in metallothionein, a protein needed for the body & brain to cope with mercury & other toxic metals. There is a definite possibility that a mercury preservative in a vaccine could harm such a child.
The concordance of autism in identical twins is 60%. The recipe for autism appears to be (1) a genetic predisposition plus (2) an environmental insult. We've had a set of identical twins at our clinic in which one was a productive, high-functioning adult and the sibling was a mute autistic with wild mood swings who was institutionalized. (9 Jan, 2003)
We have seen more than 2,000 autism-spectrum children.... and agree
completely about the value of sensory imputs. I've become convinced that the
primary problem in autism is not so much a damaged brain, but rather a brain
that has not completely matured. PT, OT, etc shower the brain with stimuli
which enhance development of new neuronal connections which are especially
needed in the hippocampus & amygdala of autistics. Biochemical therapies
which normalize the pruning, development, and growth inhibition processes in
the brain are also vital. (Feb 3, 2003)
My clinic has seen
more than 2,500 autism-spectrum children and I'm convinced
that most of these kids have above average intelligence. We've
seen many who were labeled "retarded" with IQ scores
below 50..... who later had IQ scores above 120 following
therapies such as CF/GF diets, metallothionein-promotion, normalization of the
G.I. tract, behavioral therapies, etc. The problem is with the
test methods, not the innate intelligence of the children.
Unfortunately, DSM-IV itself is perpetuating this myth! Page
67 of DSM-IV, Fourth Edition, Section 299.00 Autistic Disorder
......states the following: "In most cases there is an
associated diagnosis of mental retardation, commonly in the
moderate range (IQ 35-50). Approximately 75% of children with
Autistic Disorder function at a retarded level."
DSM-IV should not give currency to the high incidence of
inappropriate diagnoses of retardation nor to incorrect IQ
scores for these difficult-to-test children.
Most traditional autism experts believe that autism is
"incurable" and that the associated "mental
retardation" cannot be reversed. This is so wrong!!!
There are tens of thousands of families that despair upon
hearing this pronouncement..... and just give up! Please
continue your efforts to get the truth out --- It could make a
big difference in the life of many of these children. (Feb 20, 2003)
For years, autism was the most difficult population for our
clinic to work with, compared to persons diagnosed with
behavior disorders, ADHD, depression, anxiety disorders,
bipolar, or schizophrenia. However, this has changed following
our discovery of the central importance of the metallothionein
protein in ASD and development of metallothionein-promotion therapy
At Dr. Rimland's request, we carried out a small outcome study
about 6 months ago which measured the impact of MT-Promotion
for 46 patients. I presented the results at a D.A.N.
"Think Tank" at which Dr. Amy Holmes' outcome
results for MT-Promotion were presented by Stephanie Cave.
There is no doubt that autism outcomes are far better at the
Pfeiffer Center since MT-Promotion. Our group of 46 patients ranged from ages
3 to 18. A few of the families were unable to achieve
compliance & a couple others gave up after a couple of
days. More than 85% of the 41 families that achieved
compliance reported impressive gains in cognition, speech, and
socialization. More than 20% reported irritability and sleep
problems, usually coincident with improved cognition or
speech. Only 10% of the compliant families reported zero
progress.
We found the greatest improvements were obtained with younger
children, including a significant number whose autism was
rapidly disappearing. However, our data showed definite (but
slower) improvement in the autistic teenagers. A few examples:
A mother from New Hampshire reported that her mute 17 year old
daughter began speaking after 6 weeks of MT Promotion. A 13
year old girl from Virginia began talking after the first
month. A 4 year old in Illinois who could only say a few words.... began
speaking in complex sentences after 5 days of MT-Promotion. A
socially isolated 7 yr old son of a doctor became very
friendly & communicative during the first month. We now
have many dozens of such outcomes.
Dr. Holmes' population was much younger than ours, and her
results indicated even higher efficacy than we had achieved.
It was nice to have efficacy confirmed by an independent third
party. Early intervention is essential, but benefits are
possible for the older children also.
We are organizing a much larger and more scientific outcome
study which should begin in a couple weeks.
Children between 2-4 years of age generally respond within a
week or two. Since their little brains are still
actively engaged in the brain-cell pruning, development, and
growth inhibition processes..... the impact can be much
greater. Families of ASD persons over the age of 20 have
reported nice partial improvement after our treatment, but
we've yet to experience a case in which a 20+ year old became
completely free of autism symptoms.
My guess is that once MT normalization is attained, a
simplified maintenance therapy can be implemented. Also there
is a very good chance that CF/GF diets, yeast therapies,
digestive enzymes, etc, will become unnecessary at that time.
However, at present we recommend these therapies be
continued..... just in case the genetically-weak MT system
cannot be fully normalized. We should know a lot more within a year or so.
(Feb 22, 2003)
I believe this can all be
explained by the fact that estrogen and progesterone enhance
metallothionein, whereas testosterone suppresses it.
Therefore, given the same genetic tendency for weak
metallothionein function, females would be more protected
against environmental stresses which can trigger autism as
they would have more MT to combat stresses.
Also, if the environmental triggers of autism have increased
in recent years, you would expect the disparity in male/female
incidence to drop. In essence each autism-prone child has a
threshold with respect to environmental insults. In boys the
threshold in lower. As the environment worsens, we get higher
up on the statistical bell curve in both males and females
& the disparity should moderate.
In my opinion, a wide variety of environmental triggers can
trigger autism, including oxidative stress (e.g., mercury),
immune crises (e.g. multiple vaccines or serious illness),
severe emotional or physical stress, etc. It is very possible
that the stress of circumcision could cripple metallothionein
& impair brain development, at least temporarily. I'm not
aware of peer-reviewed evidence of differences in autism
incidence between circumcised and non-circumcised children.
Stresses of all kinds deplete metallothionein..... In persons
without metal-metabolism disorders, the stress automatically
induces production of more metallothionein. In autism, the
metallothionein system has gone AWOL. (May 17, 2003)
There is no longer any doubt that autism results from a
combination of genetic predisposition and environmental
factors. Identical twins reared apart have an autism
concordance of 60%...... This shows a powerful genetic
influence, but the fact that the concordance isn't 100%
clearly shows that environment factors are also involved. I
once tested a pair of identical twins (age 38) in which one
was a successful professional writer & the other was an
institutionalized severely-autistic mute young man who needed
to be physically restrained. They were quite different from
the day they were born.
In our database of 2,500 autistics, about 30% of the families
reported autism symptoms from birth with the remaining 70% of
autistics exhibiting "regressive autism" with
typical onset between the ages of 16 to 22 months.
Yes, the ratio of boys/girls has declined in the past 6
decades & the causes for the lessened maleness are
certainly environmental. Also, there is mounting evidence that
the overall incidence of autism has increased rapidly since
1990..... Again, environmental factors must be responsible.
There is great public debate over the possible role of
vaccinations or mercury preservatives in the vaccines. My
personal opinion is that a wide variety of environmental
stresses and toxins can contribute to the onset of autism.
Your suggestion that circumcision and infant separation may be
among them..... appears quite plausible. (June 9, 2003)
At the request of an autism parent group about 6 months ago, I checked out iron levels in our population of 3,000 autism patients. We found that autistic children exhibited higher serum iron levels than controls (non-autistic, healthy
children). However, all of the differences occurred in about 1/3 of the autism population with the other 2/3 resembling the controls. The high iron kids were extremely high, the rest of the autistics were quite normal, and there was little or no "middle ground". It appears that a segment of the autism population has very abnormal iron metabolism (and abnormal ceruloplasmin).
My data essentially confirms the findings of the M.H. article. Iron free radicals (ions) represent the primary oxidative stress in the brain of most humans. Autism involves oxidative stress during early brain development. In theory, elevated iron in the brain could result in autism. A genetic inability to regulate iron might be causative in 1/3 of autism cases.
(Sep 15, 2003)
We are engaged in a foundation-funded study measuring estrogen, progesterone, testosterone, and other hormones in autistic subjects and age/gender matched controls. We expect to have the first data in a few weeks.
This is an area of interest since (a) there have been several reliable reports of efficacy using progesterone cream for autistics, and (b) progesterone and estrogen promote synthesis of metallothionein & testosterone inhibits MT. If autistics exhibit consistently abnormal levels, we plan to develop a hormone-normalizing therapy. (Oct 29, 2003)
After studying 3,200 autism-spectrum children & adults at our clinic, I am
convinced that autism is caused by a genetic inability to cope with
oxidative stress, involving weak functioning of the neuroprotective
metallothionein/glutathione system. This condition results in inability to
regulate Cu and Zn, hypersensitivity to metal toxics, extremely poor immune
function & hypersensitivity to vaccines, yeast overgrowth, inability to
break down casein & gluten, and worst of all..... incomplete maturation of
brain cells and synaptic connections.... especially in
hippocampus, amygdala, Purkinje cells, inferior olives, and pineal gland.
There are many environmental insults which can trigger autism in a
genetically predisposed child. Mercury is just one of the many
possibilities. Mercury (Thimerosal) is an unnecessary health risk and
should be banned forever. However, I expect that elimination of mercury from
infant vaccines will not stop the epidemic in autism cases, because of the
other environmental triggers which remain.
I once met a health-conscious mother who had been hypervigilant prior to her
pregnancy. She had avoided all amalgams & had her husband's amalgams removed
2 years before conception. Her diet was exemplary before and during the
pregnancy, and she & her husband carefully avoided potential environmental
insults including vaccines. She was crushed to discover that her baby
exhibited severe autism soon after birth. She stated that she was amazed and
horrified that this had happened. A little digging revealed that she had a
severe infection during the 7th and 8th months of gestation. This apparently
was sufficient to cripple the MT/GSH system during a critical phase of brain
development. A very sad case.
Our Center's autism outcomes have greatly improved since beginning
metallothionein-promotion therapy. It's no longer a surprise when a young
autistic child becomes free of all traces of autism. We are a public charity
and have made this protocol available to more than 100 doctors, many of whom
report treatment successes. MT-Promotion must be done very carefully to
avoid zinc depletion which can result in temporary worsening of behavior,
stimming, enuresis, etc.
We are beginning a funded study which we expect will provide strong evidence
of severe oxidative stress/damage in 100% of autism subjects. We'll be
measuring isoprostanes, levuglandins, and pyrrole adducts, etc., in
autistics and age/gender controls. (Nov 3, 2003)
ASD usually involves multple chemical imbalances, including....
1. Metallothionein Deficiency
2. Extreme Oxidative Stress
3. Undermethylation (more than 50% of ASD)
4. Overmethylation (about 10-15 % of ASD)
5. Maldigestion and/or malabsorption
6. Elevated GSSH/GSH ratio
7. Elevated Cu/Zn ratio..... etc.
Most ASD individuals exhibit a genetic tendency for undermethylation. A relative few exhibit a genetic tendency for overmethylation. However, it's important to consider the impact of (1) inadequate diet and (2) inefficient digestion/absorption which is present in most of these individuals. Regardless of innate tendency for methylation, many ASD individuals are starved for all components of the SAM cycle and MTHF. In other words, they are deficient (across the board) in most nutrients. Two of the greatest deficiencies in ASD appear to be B-12 and methionine. B-12 is one of the most difficult vitamins to assimilate in healthy persons, and the situation is much worse if significant G.I. tract problems exist. The principal source of methyl groups is methionine from dietary protein. However, most ASD children receive inadequate amounts of dietary protein AND are very inefficient in cleaving the complex proteins into the amino acid units to enable absorption. Folic acid is also in a deficiency state in many ASD children...... including children with a genetic tendency for overmethylation and folic acid overload.
Supplementation of any nutrients which are in a deficiency state leads to better health and overall functioning. However, care must be taken to limit the supplementation of nutrients which tend toward overload (for genetic reasons).
Therefore supplementation of folic acid and B-12 can help an undermethylated ASD child who is deficient in these nutrients. However, these same children TEND to develop excessive levels of folates.... and vigilance is needed to avoid going beyond correctioon of the folate deficiency.
The same is true with respect to supplementing methionine to malabsorbing persons with a genetic tendency for overmethylation. A patient can benefit from overcoming the deficiency, but you have to be careful not to overshoot the methyl levels.
Managing methyl/folate levels is complicated enough, without adding the factor of severe
maldigestion/malabsorption. Autism is the most complex disorder in our clinical population. We find it very helpful to address a person's biochemical individuality in determining the best therapeutic protocol.
We have seen more than 3,500 patients in the autism spectrum. It's clear
that most of them suffer from some degree of gluten intolerance and most
families report significant improvements following gluten-free diets. In
this case, severe zinc deficiency and intestinal oxidative stress cripple
the synthesis of the enzymes needed to break down gluten.
B6
The dangers of B-6 have been greatly overexaggerated. The original
concerns began with a university study 25 years ago in which volunteer
students were paid to take B-6 (pyridoxine hydrochloride) doses ranging
from zero to 10,000 mg daily. After a few weeks, a number of the
students taking doses higher than 5,000 mg/day reported a loss of
sensation in areas of the skin. The study was stopped and in every case
the symptom completely disappeared. This result became widely known &
the side effect was identified as neuropathy.
Within a few years, similar neuropathy was observed in a small fraction
of persons taking megadoses of 2,000 mg/day and for a while B-6 dosages
were limited to 1,000 mg/day. Later, there were rare cases of persons
who experienced temporary neuropathy with doses of a few hundred mgs. In
the hundreds of neuropathy cases, the neuropathy completely disappeared
after stopping the B-6. The effect a temporary one, and I'm unaware of
anyone ever being permanently "hurt" by B-6.
Persons who have normal metabolism of B-6 need only a couple of
milligrams daily, which is easily obtained from their diet. However,
there are many persons with metabolic disorders which result in innate
B-6 deficiency.....These persons may need 100 to 1,000 mg/day of B-6
to normalize B-6 levels in the body. An example is provided by the
genetic disorder pyroluria, in which B-6 is stripped from the bloodstream by kryptopyrrole/hemepyrrole molecules.
In a nutshell, most persons have no need for B-6 supplements, whereas
innately B-6 deficient persons may need hundreds of mg/day to normalize
B-6 activity. B-6 toxicity occurs only in persons who already have
sufficient or elevated B-6 levels.
Another indicator of B-6 overload is the onset of vivid, troubling
dreams. When that occurs in a patient, the B-6 dose can be lowered
before neuropathy begins.
There are many nutrients that have serious dangers associated with
overdose...... B-6 is not one of them. Examples of potentially-dangerous nutrients include the fat-soluble vitamins (A, D,
E), copper, and selenium. (Feb 19, 2003)
In the 1980's, I
was collaborating with the late (and great) Dr. Carl Pfeiffer
in developing nutrient programs for troubled individuals.
In1986 we discovered that certain malabsorbers didn't respond
well to B-6 in the form of pyridoxine hydrochloride, but were
helped greatly by the P-5-P form of B-6. For about a year we
used P-5-P exclusively in treating B-6 deficiencies.....
However, we later discovered that certain patients responded
better to pyridoxal hydrochloride than to P-5-P. Thereafter,
we provided both forms of B-6 in treating B-6 deficiency. A
typical B-6 deficient patient might receive 300 mg pyridoxine hydrochloride and 50 mg P-5-P daily.
This practice has continued at the Pfeiffer Treatment Center
over the past 13 years, with most patients receiving both
"regular" B-6 and P-5-P. We tend to emphasize P-5-P
for persons with malabsorption, maldigestion, or other gut
problems...... with other patients receiving a balanced mix of the two forms of B-6. (Feb 20, 2003)
I've worked with more than 3,000 patients who received at
least 500 mg/day of B-6. I know of only 2-3 dozen cases in
which neuropathy symptoms occurred..... In these cases we had
incorrectly believed there was severe B-6 deficiency. In every
case, the neuropathy disappeared after stopping the B-6.
Nobody was harmed.
The incidence of skin neuropathy after megadoses of B-6 is
rare, but real. The specter of permanent harm from B-6 appears
to be a myth. I am unaware of a single case. (Feb 22, 2003)
Bipolar Disorder
Bipolar disorder is not a single condition, but an umbrella term which includes a number of very different biochemical abnormalities. I'm bothered by any attempt to generalize over the bipolar phenotypes & to blindly recommend any formulation or therapy for all of them. The key is to determine a patient's biochemical individuality, and to provide focused appropriate treatment. In our database of 1,500 bipolar patients, about 25% are overmethylated, 35% are undermethylated, and the remaining 40% do not exhibit a methylation disorder.
The three primary biochemical classifications of bipolar disorder are the following:
A. Undermethylation: This condition is innate & is characterized by low levels of serotonin, dopamine, and norepinephrine, high whole blood histamine and elevated absolute basophils. This population has a high incidence of seasonal allergies, OCD tendencies, perfectionism, high libido, sparse body hair, and several other characteristics. They usually respond well to methionine, SAMe, calcium, magnesium, omega-3 essential oils (DHA & EPA), B-6, inositol, and vitamins A, C, and E. They should avoid supplements containing folic acid. In severe cases involving psychosis, the dominant symptom is usually delusional thinking rather than hallucinations. They tend to speak very little & may sit motionless for extended periods. They may appear outwardly calm, but suffer from extreme internal anxiety.
B. Overmethylation: This condition is the biochemical opposite of undermethylation. It is characterized by elevated levels of serotonin, dopamine, and norepinephrine, low whole blood histamine, and low absolute basophils. This population is characterized by the following typical symptoms: Absence of seasonal, inhalent allergies, but a multitude of chemical or food sensitivities, high anxiety which is evident to all, low libido, obsessions but not compulsions, tendency for paranoia and auditory hallucinations, underachievement as a child, heavy body hair, hyperactivity, "nervous" legs, and grandiosity. They usually respond well to folic acid, B-12, niacinamide, DMAE, choline, manganese, zinc, omega-3 essential oils (DHA and EPA) and vitamins C and E, but should avoid supplements of methionine, SAMe, inositol, TMG and DMG.
C. Pyrrole Disorder: This condition, also called pyroluria, is a genetic stress disorder associated with severe mood swings, high anxiety, and depression. The biochemical signature of this disorder includes elevated urine kryptopyrroles, a double deficiency of zinc and B-6, and low levels of arachidonic acid. Pyrolurics are devastated by stresses including physical injury emotional trauma, illness, sleep deprivation, etc. Symptoms include sensitivity to light and loud noises, tendency to skip breakfast, dry skin, abnormal fat distribution, rage episodes, little or no dream recall, reading disorders, underachievement, histrionic behaviors, and severe anxiety. They usually respond quickly to supplements of zinc, B-6, Primrose Oil, and augmenting nutrients.
To me, a bipolar patient who becomes "well" with greatly-reduced medication requirements may have achieved complete success. I don't believe that medication doses need to go to zero, as long as side effects are absent and long-term effects are minimal or absent.
Incidence of bipolar depression (diagnosis during lifetime):
TOTAL POPULATION OF ADOPTEES ... INCIDENCE = 4.5%
FRATERNAL TWINS SEPARATED AT BIRTH .... Concordance = 32%
IDENTICAL TWINS SEPARATED AT BIRTH .... Concordance = 80%
We have seen more
than 1,500 patients diagnosed with bipolar disorder, including
a few hundred who presented with a diagnosis of
"rapid-cycle" bipolar disorder. Many of the rapid
cycle patients exhibited a severe pyrrole disorder as their
primary imbalance. The key lab test is urine kryptopyrroles.
Most "pyrolurics" are prone to high anxiety, severe
mood swings, depression, and may be famous for their temper.
Classic symptoms include aversion to eating breakfast, poor
dream recall, sensitivity to bright lights & loud noises,
abnormal fat distribution, poor short-term memory (often
coincident with good long-term memory), and very poor stress
control. (Feb 27, 2003)
We have worked
with more than 1500 bipolar patients & found that most
have an atrocious diet. I remember one young man whose only
dietary intake for the past month consisted of Pepsi and
potato chips.
In our experience, best results are achieved with a two-step
procedure: (1) biochemical treatment followed by (2)
life-style changes including a better diet. We learned the
hard way that most bipolars are incapable of life-style
changes until after their chemical imbalances have been
corrected (or at least lessened). Once real biochemical
progress has been made, the patient is more functional and
real dietary improvements can be achieved. Trying to
everything at once tends to overwhelm the patient, and they
usually give up. (March 6, 2003)
About 20% of patients labeled as
bipolar have a pyrrole disorder (genetic) which is associated
with (a) fatty acid abnormalities, especially depressed
arachidonic acid, (b) strikingly weak immune function, and (c)
severe metal oxidative stress. The definitive test for the
pyrrole disorder is urinalysis for kryptopyrroles (Direct
Healthcare Access is the lab, 847/299-2440). These patients
might benefit greatly from therapy concentrating on zinc, B-6,
and primrose oil (or borage oil). Omega-3 oils can make things
worse because of the competition for Zn & B-6 between
delta-5 desaturase and delta-6 desaturase.
If a patient has a pyrrole disorder he/she likely would have
at least half of the following symptoms:
Poor stress control
Sensitivity to bright lights and/or loud noises
Preference for spicy or heavily flavored foods
Significant growth after age 16
Morning nausea
Tendency to skip breakfast
Poor dream recall
Emotional outbursts
Poor short-term memory, perhaps coincident with excellent L.T.
memory
Diagnosis of "rapid-cycle" bipolar
Much higher capability & alertness in the evening,
compared to mornings
Dry skin
Reading disorder. (March 27, 2003)
DMAE passes the
blood-brain barrier and converts to choline in the brain.
Therefore it has cholinergic action & enhances formation
of acetylcholine. As a result DMAE is generally very useful in
treatment of high dopamine (low histamine, overmethylated)
persons, but can seriously harm low dopamine, high histamine,
undermethylated persons. We've seen more than 1,500 bipolar
patients and confirmed that DMAE is generally effective for
the overmethylated phenotype (25% of bipolar cases), but
causes great worsening for those who are undermethylated (40%
of bipolar cases). DMAE definitely should not be used
indiscriminately for persons with serious mental illness.
(Aug 15, 2003)
Childhood Bipolar Disorder. There has been an explosion in this dubious
diagnosis in the past 5 years. It represents an attempt to predict which
children are headed for a bipolar-type mental breakdown -- The usual result
is early intervention with powerful atypical antipsychotic medication.
A very high percentage of our incoming bipolar patients exhibit elevated
liver enzymes, undoubtedly a result of the added stress on the liver due to
powerful psychiatric medications. There is plenty of published data showing
that many psychiatric meds can cause cirrhosis of the liver.
The benefits of psychiatric medications are often exaggerated and the risks
minimized. A very common side effect of psychiatric medications is death.
Candida
Another effective
way to combat candida is using zinc therapy. Candida is killed
by metallothionein (MT) proteins which are normally in high
concentration in intestinal mucosa. MT is induced by zinc.
Many persons with candida are low zinc and low MT persons.
They usually exhibit low zinc in plasma, serum, or packed
cells, but high zinc in hair. You can expect chronic candida
problems until zinc is normalized. In a sense, zinc can be an
effective weapon in your anti-candida arsenal. Typical
anti-candida therapies (including dietary restrictions) can manage the problem for a while.......
Maintenance supplementation with zinc (after these
interventions) can permanently fix the problem, in many cases,
without the need to continue dietary vigilance. (Feb 5, 2003)
Celiac Disease,
Wheat and Dairy Sensitivity
There are classic symptoms/markers of gluten intolerance which enable you to determine the small percentage that have symptoms consistent with this disorder. Examples are (1) compulsive, ritualistic behavior, (2) family history of
malabsorption, (3) frequent, explosive bowel movements, (4) lethargy, (5) abdominal pain, and (6) Dermatitis Herpetiformis (skin disorder). One could screen the population for the presence of some of these markers of celiac disease & then perform diagnostic tests to nail it down. (11 Jan, 2003)
Severe wheat gluten intolerance can cause classic symptoms of schizophrenia, and amounts to about 4% of all schizophrenia diagnoses in the U.S. These persons usually become quite normal when placed on a gluten-free diet. Psychiatry continues to ignore the small, but significant, population, estimated at 100,000 to 300,000 Americans. These people are usually treated with atypical anti-psychotic medications, but simply need a dietary change to become free of symptoms. (11 Jan, 2003)
Our Center has evaluated and treated nearly 20,000 persons. About 1,500 of them have reported terrible reactions to wheat and/or dairy. The wheat/dairy sensitive population is composed of two major groups:
Group A consists of those people who are truly allergic to these foods & must make the lifetime commitment to total avoidance of these foods. Failure to accomplish this could result in irritability, violent behavior, ADD, depression, anxiety, bipolar disorder, delusional disorder, schizophrenia, not to mention malabsorption & terrible physical health.
Group B consists of persons who have severe reactions to wheat and/or dairy solely because of a genetic or acquired oxidative stress condition. Fix the oxidative stress in the G.I. tract & the food sensitivities disappear. Moreover, merely avoiding wheat/dairy will provide only partial benefits to this group..... because the untreated oxidative stress could result in toxic metal overload, yeast overgrowth, copper dysregulation, weakened immune system, abnormal levels of dopamine and norepinephrine, impaired hippocampal and amygdala function, etc. The net result can be behavior disorders, depression, severe mental illness, frequent infections, and an increased tendency for cancer.
In summary, most Group A persons can be successfully treated with dietary restrictions alone. Persons in Group B must have therapy which focuses of normalizing the level of oxidative stress. (Sep 2, 2003)
Choline
Phosphatidyl
choline is also very effective in protecting DHA/EPA from free
radical oxidative stress..... another good reason to take it.
In my experience DMAE is especially effective for increasing
acetylcholine levels in the brain, since it passes the
blood/brain barrier & converts to choline. I like to
use this for overmethylated persons who have excessive
dopamine and norepinephrine levels. However, enhancing
acetylcholine activity must be avoided in persons who
genetically are overloaded in this NT. Choline, DMAE, and
phosphatidyl choline can cause nasty symptoms in these persons
(about 10% of the population).
Persons with innately high acetylcholine levels tend to be
very tense and sometimes nearly catatonic. They have
very high anxiety, but usually keep it inside. They also
usually have a history of seasonal allergies, perfectionism,
and OCD tendencies. Increasing acetylcholine activity can be a
disaster for them.
Those deficient in acetylcholine usually present with nervous
legs, are prone to pacing, and are quite voluble. Their misery
is plain to everyone. Therapies to increase acetylcholine
activity can be extraordinarily helpful for this population.
(March 6, 2003)
Copper
A complication is
that blood levels of copper can be very low in persons who
have severe copper overload. The classic example is Wilson's
Disease in which the liver accumulates huge amounts of copper.
These same Wilson's patients usually exhibit very LOW levels
of Cu in blood.....also the exhibit extraordinary low levels
of ceruloplasmin. Is essence their blood contains little
copper, but the blood Cu is predominantly in
"unbound" form.
Years ago, we mistakingly thought low blood serum or RBC
copper levels meant Cu deficiency..... and in a few cases we
cautiously gave Cu supplements in an attempt to correct the
situation. Most of these patients reacted badly to the Cu.
Proper evaluation of copper status requires both serum Cu and
serum ceruloplasmin tests.
Hair mineral copper is very valuable for behavior disorders
and ADHD patients, but is of far less clinical value for
autism, bipolar, and schizophrenia populations.
Giving supplemental Cu to patients is a risky business. It
should be considered only in those who exhibit sufficient
ceruloplasmin to accomadate between 80 and 95% of the Cu
present. (April 10, 2003)
Selenium deficiency itself could result in a nasty copper
elevation. Metallothionein at the intestinal mucosa and
in the liver is the primary agent which regulates copper in
the body. Selenium is needed for efficient metallothionein
functioning.
Carl Pfeiffer of Princeton, NJ tested more than 25,000 persons
for copper & reported that Cu toxicity was common, but Cu
deficiency extremely rare. We have investigated the
metal-metabolism of about 20,000 persons & found the same
thing. I admit there are theoretical rationale for expecting
copper deficiency, but it rarely actually happens.
Hair analysis ALONE is a very poor way to assess copper
status. I say this after (a) evaluating more than 100,000 hair
analyses, (b) developing the first high-quality hair standards
(loaned to NIH and other researchers), and (c) performing
numerous double-blind, controlled experiments involving hair
chemistries. Findings of high Cu levels in hair are
compromised by the many external sources of Cu which cannot be
completely removed by washing. Low levels of Cu in hair and/or
blood often are coincident with dangerous overloads of Cu in
liver. Hair Cu values can provide information of clinical
significance, but by itself
is not clinically decisive.
Serum Cu indicates the total amount of Cu in serum. Serum
ceruloplasmin indicates the fraction of serum Cu that is bound
as ceruloplasmin. A simple calculation (paying attention to
the assay units) yields the numbers for comparison. Most
copper experts agree that the normal or "healthy"
situation is to have about 80 to 95% of the serum Cu present
as ceruloplasmin.
A high fraction of "unbound" Cu is a good indicator
of oxidative stress and low metallothionein activity...... and
also a warning to NOT to supplement with Cu, even if serum/RBC/hair
levels of copper are low. In addition, one should consider
possible environmental sources of Cu, especially drinking water and swimming pools/jacuzzis treated
with copper sulfate (to kill algae.) (April 11, 2003)
The ceruloplasmin analysis indicates the amount of Cu properly
bound to this protein (Should be 80-95% of total serum Cu). If
serum and hair Cu are low, a high proportion of
"unbound" Cu is a warning signal that there might be
a Wilson's Disease-like situation...... Low serum/hair copper,
but severe Cu overload in the liver. In some cases, testing
for possible Wilson's Disease is indicated.
Usually, the question is whether there is a Cu overload. The
incidence of true Cu deficiency/depletion is very low. (April
14, 2003)
High copper females respond very well to therapy with zinc,
B-6, P-5-P, C, E..... However the Zn should be introduced
slowly..... for example 25 mg....50 mg.... 75 mg..... and
given either at bedtime or after the evening meal. B-6
and P5P should be given before noon. Failure to phase in the
Zn slowly would be likely to result in temporary worsening of
symptoms over the first few weeks.
She should avoid estrogen therapy, drink bottled water, and
limit high-Cu foods like chocolate, carob, and shellfish.
If her primary imbalance is the Cu overload, very little
improvement is likely during the first 3 weeks..... followed
by striking improvement thereafter. If the patient is clearly
better during the first week, this is probably due to
overcoming the pyrrole disorder. In her case, you might get a nice initial improvement which is partial in nature.....
followed by a plateau of several weeks before more progress is
made. (April 14, 2003)
Crime &
Violence
We've spent the
past 25 years studying behavior disorders and have accumulated
the world's biggest & best chemistry database for
behavior. We have about 100 separate chemical assays of blood,
urine, and hair for more than 12,000 behavior-disordered
persons, including participation in 28 forensics studies of folks like Charles
Manson, Richard Speck, Henry Lee Lucas, and James Oliver
Huberty. This database clearly shows violent, delinquent
persons to have striking biochemical differences, compared to
the general population. The late & great Carl Pfeiffer
helped me over the last 12 years of his life to development
biochemical, non-drug treatments for these chemical
imbalances.
The Pfeiffer Treatment Center was named for Carl Pfeiffer, MD,
PhD of Princeton, NJ .... for his great contributions to our
work. He died 6 months before the Center opened in 1989.
The Pfeiffer Center has completed several outcome studies
measuring efficacy of this treatment system. The latest one
involves 207 consecutive patients in which we carefully
determined the frequency of physical assaults and destruction
of property before & after treatment. I've completed a
manuscript for this study which will be published in the
journal, Physiology and Behavior, hopefully within 4-6 months.
The results are quite spectacular
This study indicates excellent efficacy for young persons....
0-16 yrs of age.... with sharply declining efficacy at older
ages. The decline seems to coincide with the onset of drugs
& alcohol abuse. I am sorry to say that our experience
with adult ex-convicts is not very good & the information
you received about 95% success in overcoming recidivism in
violent criminals is not true. However, about 90% of compliant
YOUNGER violent/delinquent persons respond very nicely to the Pfeiffer therapy.... About 60% of
these report complete elimination of assaults and property
destruction, with the other 30% reporting excellent partial
improvements. Maybe some day we'll be smart enough to help the
older offenders too.
We believe that America's best hope for effective crime
prevention is early identification of at-risk youths and
effective treatment before their lives are ruined. I'm certain
that stimulant drugs and/or psychiatric medications are not
the answer. (Feb 6, 2003)
Many years ago I
did a study examining chemistry differences between male
siblings in which one was a violent delinquent and the other a
well-behaved child. We balanced age and birth order and accepted only those who lived in the same household
and attended the same school.
I clearly remember a family living in the squalor of Chicago's
south side black ghetto...... The father was in Stateville
Prison for murder.... the mother was a prostitute who
sometimes entertained her "guests" at home in the
presence of the children. The boys were age 10 and 11 and both had suffered physical and sexual abuse from the
customers. I've never seen a worse environment..... I remember
being very nervous just driving into the neighborhood.
The 10 yr old was oppositional, defiant, cruel, truant, and
was already in a violent gang. However, his 11 yr old brother
was quite amazing...... a well-behaved, polite young man who
was an excellent student and also class president. For years I
wondered how such a miracle could have happened.
We eventually found 24 families that included an
"all-American boy" and a "child from
hell". The ill-behaved children had clear chemistry
abnormalities whereas the well-behaved ones generally
exhibited expected trace-metal levels.
This experiment was a watershed experience for me. For the
first time I knew that environment wasn't the only causative
factor in behavior disorders and ADHD..... that disordered
biochemistry (probably genetic) also played a role.
In studying nearly 10,000 behavior-disordered children &
adults since that time, I've learned the following:
1. A child born with ideal body/brain chemistry is nearly
indestructible, and may thrive in a terrible environment.
2. A child with a MILD chemical predisposition to violence may
turn out fine, if the environment is good and there are
resources for counseling, etc. The same child might wind up in
prison if born into poverty or an otherwise terrible
environment.
3. A child born with a SEVERE chemical imbalance will exhibit
terrible behavior, even in an ideal environment. You can't
just "love away" a severe brain chemical imbalance.
My group once visited and tested Charles Manson at San Quentin
prison..... his chemistry was so extraordinarily aberrant that
I am convinced that if adopted into a different family, Manson
would have turned out the same. (July 28, 2003)
In the beginning, we had no way of knowing if the biochemical
differences were a causative factor or simply an association.
I decided the quickest way to find out would be to correct the
aberrant chemistry of the violent children to see if the
behaviors changed. 10,000 behavior patients later, I can
report that the bad behavior in young children usually
disappears completely when the chemistry is balanced. Children
under the age of 10 usually correct beautifully without
counseling of any kind. However, older children (14+) benefit
greatly from counseling, behavior mod, conflict resolution,
etc after the chemistry is corrected. I'm not sure if this is
because of an ingrained negative self-image, poor social
skills, or problems in breaking the bad behavioral habits. All
I know is that counseling/therapy seems necessary with teens,
even after the chemistry has been normalized. We've also
learned that adult criminals generally fail to achieve
enduring benefits with our biochemical (non-drug) therapies.
Most are back in jail within 5 years. We are on a mission to
identify the at-risk children and intervene with effective
therapy before their lives are ruined. The window
of opportunity (for severe cases) begins to close in the early
teen years. Drug and alcohol abuse may be major factors in
this phenomenon.
Most children with a predisposition to bad behavior have
chemistry imbalances which are fairly mild, and for this large
group..... environment and life experiences rule. For them,
early traumae might be the deciding factor. (July 28,
2003)
Coral
Calcium
The calcium in
Coral Calcium is mostly calcium carbonate, which provides the
highest amount of calcium absorbed per unit volume. CaCO3 is
40 w/o calcium and is quite dense. Many manufacturers claim
higher calcium absorption on a percent basis for low density
products like calcium glycinate. A lot of this is deceptive
marketing. A capsule of calcium carbonate will result in more
calcium in your bloodstream than a same-size capsule of any
other form of
calcium.
That's the good news about CaCO3. The bad news is that CaCO3
can result in nasty stomach & intestinal problems in
sensitive persons. In some cases, all hell can break loose. In
my opinion, CaCO3 (not Coral Calcium) is the best option for
persons who don't experience side effects..... lowest volume
to swallow down and lowest cost. For sensitive persons, some
of the calcium blends are very absorbable with reasonable
volume, low cost, and minimal
side effects.
A significant advantage of Coral Calcium is the presence of a
multitude of micro-nutrients that are unavailable in most
supplements. Things like praesodymium, erbium, etc. Every year
we discover another micro-nutrient with a vital function in
the body. The "good" impurities in a natural product
like Coral Calcium could be significant. Of course the
"bad" impurities such as lead or mercury MUST be at
a negliglble level for the supplement to provide benefits.
(April 17, 2003)
Depression
After getting extensive biochemical data on more than 3,000 persons diagnosed with clinical depression, we found that 95% of them fit neatly into one of 5 separate biochemical classifications. Depression is not a single condition, but an umbrella term covering several completely different conditions. Anyway, we believe we have identified the 5 primary phenotypes..... each with their own classic symptoms and each with completely different treatment needs.
1) High Histamine (under-methylated)
40-70 is optimum histamine range for mental health considerations. Histamine is an important neurotransmitter which affects human behavior. This syndrome often involves seasonal variations in depression, obsessive-compulsive behavior, inhalant allergies, and frequent headaches. In severe cases involving psychosis, the dominant symptom is usually delusional thinking rather than hallucinations. They tend to speak very little and may sit motionless for extended periods. They may appear outwardly calm, but suffer from extreme internal anxiety. Most OCD patients with both obsessive thoughts and compulsive actions are in this category. Associated with under-methylation, which results in low levels of important neurotransmitters such as serotonin, dopamine and norepinephrine. Treatment focuses on the use of antifolates such as calcium, methionine, SAMe, magnesium, zinc, TMG, omega-3 essential oils, B6, inositol, and A, C and E. The dose of inositol is 500 to 1000mg. Choline is anti-dopaminergic and often makes undermethylated patients worse. Also bad are DMAE, copper and folic acid. Three to six months of nutrient therapy are necessary to correct this chemical imbalance. Symptoms will return if treatment is stopped. Two good labs for whole blood histamine are LabCorp and Quest. Also use a special absolute basophil count as a methlyation marker. The count must be direct and not differential. Alcian blue dye is the preferred staining agent. Best lab for this test is Direct Healthcare Access in Glenview IL 847 299 2440
2) Low Histamine (over-methylated)
Low-histamine depressives are usually nervous, anxious individuals who are prone to paranoia and despair. No seasonal allergies, but many food allergies and chemical sensitivity. Low libido. Obsessions but not compulsions. Heavy body hair. Nervous legs. Grandiosity. Many have a history of hyperactivity, learning disabilities and underachievement. They are over-methylated which results in elevated dopamine and norepinephrine levels. Treatment focuses on B3, C, B12 and , with about 2-4 months required for correction of the imbalance.. Also DMAE, choline, manganese, zinc, omega-3 essential oils, C and E. They should avoid methionine, SAMe, inositol, TMG and DMG.
3) Pyroluria
A stress disorder characterized by pronounced mood swings, temper outbursts, anxious depression. Inability to eat breakfast, absence of dream recall and frequent infections. The biochemical signature of this disorder includes elevated urine kryptopyrroles, a double deficiency of zinc and B-6, and low levels of arachidonic acid. Devastated by stresses including physical injury, emotional trauma, illness, sleep deprivation. Sensitivity to light and loud noises, dry skin, abnormal fat distribution, rage episodes, histrionic
behavior. They also have low levels of arachidonic acid. Treatment centers on correcting a double deficiency of B-6, zinc essential fatty acids and augmenting nutrients. It is believed to result from abnormal hemoglobin synthesis which depletes the body of these nutrients. A positive response often occurs within the first seven days of treatment, with 1-2 months usually required for correction of the imbalance.
4) High Copper (Hypercupremia)
If your level is above 140 mcg/dL, you would profit from getting rid of the excess copper. The most common depression phenotype for women. History of hyperactivity, tinnitus, and skin sensitivity to metals. Females with this condition usually have significant PMS and are prone to heightened depression during hormonal events such as puberty, gestation, childbirth and menopause. A woman's copper level more than doubles during the 9 months of pregnancy, apparently to enhance angiogenesis in the fetus. Women with an innate tendency for copper overload are prone to post-partum depression or post-partum psychosis. Estrogen increaases creuloplamin and copper levels and results in zinc depletion. Very elevated norepinephrine levels, elevated copper and low ceruloplasmin. Elevated norepinephrine/dopamine ratio. Most get worse after chocolate which is very high in copper. This condition is non-existant in males. Serum copper levels above 140 mcg/dl High NE and ADR levels can result from overmethlyation, probably genetic, elevated serum copper, and low folate/B12 levels. Hypertension is associated with high NE and ADR levels. Using folate/B12 will reduce hypertension and anxiety and depression. They often report a worsening of depression after estrogen or multiple vitamins. Most hypercupremics get worse if they overdose on chocolate. Treatment focuses on release of excess copper from tissues, promotion of copper excretion, and stimulation of metallothionein (a metal-binding protein). Many patients report a worsening for three weeks followed by steady improvement. Nutrient support is zinc, manganese, vitamin C and B6. Nutrients should be introduced gradually to avoid side effects. Use 25mg of zinc initially, then 50 then 75 as tolerated. A total of 60 to 90 days is usually required to correct this imbalance.
The list of things to avoid include the following:
1. Multiple vitamins/minerals containing Cu
2. Enriched foods with Cu added (learn to read the labels)
3. I recommend that she drink bottled water.
4. She needs to avoid swimming pools/jacuzzis treated with algicides containing copper sulfate.
5. The primary foods to avoid are chocolate, carob and shellfish.
5) Toxic Overload
This syndrome often involves a sudden, prolonged bout of depression without apparent reason and without a prior history of depression. Toxic substances which are capable of producing depression include lead, cadmium, mercury, and a wide variety of organic and inorganic chemicals. Treatment varies with the type of toxic material involved, and care must be exercised to avoid flooding the kidneys with toxins during the early stages of treatment. Heavy-metal overloads can be corrected quickly by in-hospital chelation, or more slowly using biochemical treatment. Organic chemical overloads require liberal use of antioxidants along with avoidance of the offending substances.
BTW, chocolate has 4 separate ingredients that can worsen malaise/depression in some people: (1) sugar, (2) caffeine, (3) copper, and (4) milk. The most significant
of these for females is usually copper. Unfortunately carob has even more copper than chocolate.
Many depression patients experience striking cycles in which their depression may wax for months or wane for months. It's really hard to evaluate treatment efficacy for such persons since the patient may deteriorate during effective treatment or improve while experiencing placebo or a harmful therapy. (30 Dec, 2002)
Histamine assays
for depression were introduced by Dr. Carl Pfeiffer of
Princeton, NJ in the 1970' and 1980's. My clinic has found
whole blood histamine to be very useful & has used this
assay more than 30,000 times.
First of all, the analysis must be done for whole blood (not
plasma, serum, etc), strictly adhering to the sampling
protocol. We presently use LabCorp but in the past Quest also
had proficiency for this assay.
The reference "normal" range for mental health is 40
to 70 ng/dL. Levels above 70 indicate undermethylation,
whereas levels below 40 suggest overmethylation.
Undermethylated depressives thrive on l-methionine, calcium,
magnesium, B-6, Zinc, and Vitamin C. In severe cases, up to
3,000 mg/day of methionine and 2,000 mg/day of Ca may be
needed. However, we also like to routinely run a homocysteine
test to assure the safety of the methylation protocol. This
population is believed to result in low serotonin activity.
This methylation therapy is quite slow in taking effect....
and often 6-8 weeks pass before
progress is obvious
Overmethylated (low-histamine) depressives thrive on folic
acid, B-12, niacin (or niacinamide), B-6, Zinc, Manganese,
DMAE, and Vitamins, C and E. In severe cases, up to 5,000
mcg/day of FA may be needed. Response is more rapid with this
phenotype, with clear progress usually by week 4. This
population is believed to have an innate tendency for elevated
serotonin, dopamine, and norepinephrine levels.
This test can also help guide psychiatrists in selection of
psychiatric medications. For example high histamine persons
may do quite well on SSRI's, but low-histamine persons usually
reactly very badly to SSRI's and are better candidates for
benzodiazapines.
We like to augment the histamine blood test with an
"absolute basophil" test offered by Direct
Healthcare, Inc. The histamine assay can be affected by
antihistamines and other medications with AH properties. The
reference range for ABC's is 30-50.
We have an enormous chemistry database for depression.....
more than 90 chemical assays for each of 3,200 persons with
clinical depression. We find that 90% of depressives may be
divided into five biochemical classifications, each requiring
a different treatment approach. Two of these depression
phenotypes are undermethylation and overmethylation. (June 2,
2003)
Estimated incidence of
hypercupremia in our depressive population:
Females: 45%
Males: 3%
Overall: 30% (We have more females than males in our
depression database)
As you can see from the numbers, hypercupremic depression is
generally a female event. We are about to publish a database
study which shows that hypercupremic feamles are especially
prone to post-partum depression and post-partum psychosis.
Many of these high-Cu females get worse on anti-depressants,
but respond beautifully to nutrient therapy which normalizes
Cu and Zn levels. (June 11, 2003)
Down's
We are not a
Down's clinic, but I have researched Down's biochemistry in
past years. One common factor is elevated levels of serum
copper and insufficient levels of serum ceruloplasmin. We did
an exploratory outcome study following treatment of 24 Down's
patients about 10 years ago and the results were the
following:
1. Better general health
2. Much better behavior control and moods
3. No detectable improvement in cognitive function.
If this person were in my family, I would have the following
tests run: serum copper, serum ceruloplasmin, and plasma zinc.
If the expected metal-metabolism imbalance were evident, a
simple and inexpensive formulation of vitamins and minerals
could normalize the metals. I would expect that the violence
would disappear and that he would have a better life.
(Aug 21, 2003)
Essential
Fatty Acids
Borage Oil is a good source of omega-6 oils. I think the widespread use of Primrose Oil results from widely publicized treatment successes with schizophrenia in England & the USA in the 1970's and 80's. I would
choose the one with the highest arachidonic acid level. (Sep 28, 2003)
I once collaborated with Dr. Doug Bibus, a Minnesota fatty-acid expert, on a study of 87 schizophrenics.
Bibus' lab provided reliable chemical analysis for about 60 fatty acids.
We reported the results at a national meeting of the Americal Oil Association (not petroleum) & plan to publish the results in a journal. We found that 75% of schizophrenics were somewhat elevated in omega-6 oils, and significantly depleted of omega-3 oils. However, the pyroluric schizophrenics comprised the other 25% and exhibited severe deficiency of arachidonic acid and other omega-6 oils.
We've had considerable success in using PUFA's (poly-unsaturated fatty acids) to treat persons with mental illness, but have found that omega-3 and
omega-6 oils can cause clear worsening if given inappropriately. Pyrolurics need omega-6..... whereas most other patients need omega-3. There is a competition between o3 and o6 for zinc, B-6, and the delta 5,6
desaturases. The ideal would be to identify a person's biochemical individuality, with respect to
PUFA's, then treat accordingly.
We've met several pyrolurics patients who reported a setback after omega-3 supplements. Most of them turned out to be
pyroluric.
Kennedy-Kreiger Institute in Bethesda has a lab that performs a reliable PUFA assay. Direct Healthcare Access in the Chicago area has an excellent kryptopyrrole assay for determining presence or absence of
pyroluria. (Oct 14, 2003)
If you look at the reaction cascades for omega-3 and omega-6 beginning with ALA and LA.... both cascades require B-6 and Zn, which may be in limited supply. If a person is overloaded in one of the omega's and depleted in the other.... supplementation with the omega already in excess will result in less B-6 and Zn availability and a worsening of the levels of the depleted omega.
About 60% of schizophrenics exhibit low omega-3 levels. About 20% of SZ patients (those with severe
pyroluria) exhibit extremely low AA and DGLA levels and thrive on Primrose Oil or other forms of omega-6. The remaining
20% do not exhibit PUFA anomalies.
The low omega-6 patients are very different from other schizophrenics and the general population. Classic symptoms include: Extremely dry skin (remember that the oils are the waterproofing of the skin), raised nodules
on the back of the upper arm, abnormal fat distribution, plus the symptoms of pyroluria itself.... These include severe mood swings, stress
dyscontrol, sensitivity to light and loud noises, poor immune function, little or no dream recall, reading disorder in childhood, craving for spicy/salty foods, poor appetite in the AM, etc.
My preference is the RBC membrane assay for the PUFA's. (Oct 20, 2003)
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