An additional avenue through which nutrition can help mood disorders is via liver detoxification, which can influence mood via the modification of steroid hormone metabolism (e.g., DHEA, testosterone, estrogen, cortisol).Detoxification occurs in two phases: In phase one the CYP 450 enzymes are supported by a variety of nutrients (B2, B3, B6, folic acid, B12,Glutathione, branched-chain amino acids, flavinoids, phospholipids). Once these CYP450 enzymes have acted on the lipid soluble molecule, (drug, hormones, toxins), by adding an oxygen, these activated intermediates, (if not further detoxified via phase two, due to nutritional deficiency) can increase oxidative stress, and via mitochondrial damage, reduce neuronal function. Phase two conjugation pathways require glutathione, glycine, taurine, glutamine, ornithine, arginine, N-acetylcysteine, cysteine, methionine, selenium. If phase two conjugation is functioning well, the substances are rendered water soluble and can pass out of the body via the kidney, or bile (where in the presence of dysbioisis they may be re-absorbed if cleaved in the intestine [soluble fiber helps to counter this]).
Failure to detoxify steroid hormones, such as estradiol, can alter the synaptic availability of neurotransmitters, thereby affecting mood disorders. Failure to detoxify endocrine disrupting chemicals (e.g., PCB’s, BPA) will adversely affect mood disorders by altering normal endocrine function, which is necessary for normal brain function.
Nutritional Balance and Depression
Finally, we must look at the macronutrient aspect of the diet. Meals must be balanced in protein (1/3 of the meal volume) and complex carbohydrates (2/3 of the meal volume). This will keep blood sugar steady, eliminating the significant dysglycemic contribution to intra-day mood swings, irritability, and anxiety. Along these lines, it is important that the clinician manage insulin resistance and diabetes via diet, exercise, and supportive nutrients such as R-Lipoic Acid, chromium, vanadium. Van Praag (14) demonstrated that “50% of depressed patients had lower glucose utilization during a glucose tolerance test than did control subjects.” Furthermore, Cassidy (15) demonstrated that manic-depressive patients with diabetes mellitus (n=357) have a more severe course of illness, as indicated by a greater number of psychiatric hospitalizations (p=<0.05).
Based on this quick overview, it should be clear that adequate and individualized nutritional assessment and intervention is a cornerstone of appropriate treatment of mood disorders. Failure to utilize this basic information accounts for a significant component of treatment resistant depression, medication failure, and polypharmacy.
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