First of all, we will conduct a personal health history to determine the possible cause and/or trigger that has led to the person's altered mental state.
An orthomolecular specialist not only focuses on the nutritional and biochemical aspects of a person, but also considers their emotional aspects.
We perform what is called a holistic assessment, taking into account both the physical and psychological aspects.
That's why it's important to spend enough time during the consultation to listen to the person, and thus come to understand what's happening both physically and emotionally.
In any case, it is necessary to assess both the psychological factors that may have led to this state of depression (unhappiness, stress, anxiety, frustration, repression, etc.) and the chemical processes that are altered and directly affect the patient's mood and motivation (low levels of tryptophan, tyrosine, phosphatidylserine, phosphatidylethanolamine, B6, B12, Zinc, Magnesium, etc.)
I guess you know the dilemma of “what came first, the chicken or the egg?”
The same thing happens in depression as in any psychiatric pathology.
Was it poor stress management and/or low emotional intelligence that led the person to develop a biochemical imbalance in the brain that altered their mood, or was it an inadequate diet lacking in vital nutrients necessary to support the biochemical functions of the nervous system that caused the disorder called depression?
Whatever the cause, brain biochemistry will need to be fine-tuned, and that's where orthomolecular science has a lot to offer.
I would like to criticize both the drugs called SSRIs (Selective Serotonin Reuptake Inhibitors) and MAOIs (Monoamine Oxidase Inhibitors).
What does an SSRI do biochemically?
Keeping the neurotransmitter serotonin in the synaptic space for longer, after preventing its reuptake into the presynaptic cell.
Have any psychiatrists ever stopped to think that if the problem is that the person has low levels of serotonin, that medication is of little use because the problem is that there is no serotonin, and if there isn't, what are you trying to recapture?
It's as if a river is practically empty, at 10% of its water capacity, and instead of looking for solutions to increase its levels, what we do is build a dam to keep that water from escaping. That way, the river will always remain at 10%!
What we need to do is restore normalcy and thus reach 100% capacity. The same thing happens with brain biochemistry.
If serotonin levels are low because a person has low levels of tryptophan, wouldn't it be logical to provide a supplement of that amino acid? Or perhaps the problem isn't the amount of tryptophan, but rather a problem in their metabolic pathway, since for that tryptophan to be converted into serotonin, there's a long path involving enzymes and cofactors.
Briefly summarizing that route:
Tryptophan is converted into 5HTP (5-hydroxytryptophan) through an enzyme, and that same 5HTP depends on an enzyme and its cofactors (magnesium and vitamin B6) to be converted into serotonin. Therefore, even if someone provides tryptophan in their diet (either through food or as a supplement), if they have low levels of magnesium and B6, they will continue to have low levels of serotonin. Or there is even a third possibility!!!
That tryptophan has another possible metabolic route (kynurenine pathway), and when there is an inflammatory process (which is usually quite common in depressives) instead of that tryptophan going towards the serotonin pathway, it goes towards the other one with the problem of developing depression since the person will always have low levels of serotonin!
So…
What is better: understanding the biochemistry and metabolism of tryptophan, which is responsible for our optimal mood, or giving SSRIs, which also have countless side effects and adverse reactions?
The same thing happens with MAOIs (monoamine oxidase inhibitors), which block the enzyme that breaks down dopamine, a neurotransmitter that increases our motivation, attention, learning, and mood.
If the problem is that we have low levels of dopamine, we are in the same situation as before with respect to serotonin!!
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Our dopamine levels are low because our tyrosine levels are low (if so, hypothyroidism can also be a small problem, since tyrosine is also necessary to increase thyroxine levels).
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The cofactors necessary for the enzymes involved in the conversion of tyrosine into dopamine are low, such as vitamin C, magnesium, manganese, iron, copper, and zinc. Today, the vast majority of people are deficient in all of these micronutrients! Except for copper, which the vast majority of people have high levels of.
The third reason is really interesting and few people appreciate it, and that is adrenal gland exhaustion.
When a person sustains stress for a prolonged period, their cortisol levels begin to get out of control.
Below I will explain the 4 phases of cortisol to help you understand how adrenal gland depletion leads to a decrease in dopamine.
Phase 1
Morning cortisol is high, as it is needed to face daily life with energy and motivation. It begins to decrease at midday, and even more so in the afternoon, to make way for melatonin at night when the levels of that same cortisol have decreased.
DHEA (Dehydroepiandrosterone) is within normal range
This is the phase in which we should all remain in order to have an optimal state of health (physical and mental).
Phase 2
Where the person is managing stress poorly and it is affecting their quality of life.
Cortisol levels are high in the morning, midday, afternoon, and evening, resulting in sleep disturbances, since if cortisol levels are high during the night, melatonin levels will be low.
DHEA levels remain within the normal range.
Phase 3
This long-term chronic stress is severely affecting adrenal gland function, increasing cortisol levels all day long, and this time, DHEA levels are decreased, with all the detrimental effects that entails.
A very large alteration in the circadian rhythm Cortisol/Melatonin.
Phase 4
This chronic stress has caused adrenal gland depletion, meaning that the person, apart from entering a state of depression, will have no capacity to increase their levels of catecholamines (adrenaline, noradrenaline, and dopamine).
Many people in this phase of adrenal exhaustion also have chronic fatigue or fibromyalgia in addition to depression.
What's more, many patients suffer from adrenal gland depletion and don't know it because their doctors or therapists haven't ordered a specific adrenal stress saliva test that assesses both cortisol and DHEA levels.
With that information, many dysfunctional states could be reversed…
What else can we do about depression?
We have talked several times about the phospholipid phosphatidylserine, since it is necessary for the correct transmission of information from neurotransmitters to the postsynaptic receptor.
We may already have good levels of dopamine and serotonin, but if we have a deficiency in this phospholipid, there will be problems in transmission between neurons.
So, what do we do when we see in an aminoacidogram where phospholipids are also reflected that a person has a phosphatidylserine deficiency?
The easiest thing to say is… eat foods that have phosphatidylserine!
But do you know what's interesting about this topic?
Our body produces the vast majority of this phospholipid endogenously.
We have enzymes called kinases that have the function of modifying other molecules through phosphorylation.
In this case, what they do is transfer a phosphate group from ATP (adenosine triphosphate) to the amino acid Serine to produce that wonderful phospholipid called phosphatidylserine!
And you know what's even more interesting in this process?
These kinases depend on cofactors called magnesium and manganese to perform their function properly!
And it is a fact that today the vast majority of people have low levels.
The funny thing about this is that today, even those who call themselves specialists or experts in the study of aminoacidograms don't take it into account.
Let's see...
If you see normal phosphorus levels, normal serine levels, and low phosphatidylserine levels in the analysis, it doesn't take many brain cells to understand that the problem lies in the transfer of that phosphate group to the amino acid!
So let's see what happens to that enzyme.
Enzyme, enzyme, what's wrong with you?
Answer- I need the help of my little friends Magnesium and Manganese to be able to perform my function well, and I can't find them anywhere.
Calm down, enzyme, I will help you by providing Magnesium Carbonate and Manganese Diatonate so that you can do your job well.
Enzyme: Yuhu!!!!! Thanks!!
The following analysis showed high levels of phosphatidylserine!
The same happens with phosphatidylcholine, phosphocreatine, etc.
Omega-3 fatty acids are also necessary to improve the reception of neurotransmitters (providing a quality DHA product).
An important point regarding women is that low estrogen levels are synonymous with low serotonin levels, since estrogen blocks its breakdown.
The same thing happens with men regarding testosterone, so low levels equal low levels of serotonin.
So it would be important to do a hormonal study in both cases.
Hormonal changes can be observed in many athletes as a result of a low intake of fat and cholesterol.
Since cholesterol is crucial for synthesizing steroid hormones, we're increasingly seeing more athletes obsessed with avoiding fats and cholesterol, resulting in extremely low testosterone levels, even when they take prohormones to boost their levels.
The same could be observed in any type of person who follows a diet lacking in fat and cholesterol (such as vegans or strict vegetarians).
So, for this type of cause, readjust the amount of fat and cholesterol so that the person can synthesize the amount of hormones necessary for a correct balance in that neurotransmitter.
Exercise should be part of the daily routine of anyone with depression, as the changes that occur in the body regulate all biochemical functions of the brain. It is also well known that stress reduces serotonin levels, and exercise helps increase the amount of this neurotransmitter, thereby regulating the sympathetic and parasympathetic nervous systems.
We could dedicate an entire course to explaining all the possibilities we face when it comes to depression, as it's a very complex topic, and depending on the type of person we're dealing with and their individual needs, we'll approach natural therapy from one perspective or another.
In summary, what can we do about depression?
Conduct an amino acid and phospholipid profile study to see if you have deficiencies in Tyrosine, Tryptophan, GABA, Taurine, glutamic acid, phosphatidylserine, and phosphatidylethanolamine.
Find the cause of that deficiency and correct it
Conduct a fatty acid profile study on red blood cells to determine the levels of Omega 3 (alpha linolenic acid, DHA, and EPA).
Check if there is an excess of Omega 6, since if this happens the conversion of linolenic acid into EPA will be deficient since by sharing the same enzymes and cofactors, the enzymes can become saturated and as a result of an excess of Omega 6 we can trigger a deficiency in Omega 3 (EPA and DHA).
Evaluate the amount of saturated fatty acids (stearic, palmitic and myristic) in this same lipid study, since saturated fatty acids are also necessary for good neuronal function (the myelin sheath needs these fats to function properly!)
Nowadays people have the misconception that fats are bad.
Even doctors and therapists generally think the same, advising to reduce the intake of saturated fats!!
Then you look at the amount of saturated fatty acids in the red blood cell fatty acid profile and people have rock bottom levels.
Saturated fats are necessary.
So it's ignorant reductionism to say saturated fats and cholesterol are bad...
What's more, there are vegetarians who barely eat saturated fats (with the consequent deficiency of palmitic, myristic and stearic acids) and have low levels of DHA and EPA (since these fatty acids come from animal products) and are a disaster, with alterations in the nervous system everywhere).
Therefore, assess the lipid profile and address the individual's eating habits, providing a quality DHA and EPA product if necessary.
Adrenal stress test (depending on the patient)
Assess the 4 phases of cortisol and possible adrenal exhaustion
If so, provide adaptogens (Rhodiola or Ginseng) to improve its function.
Request a complete analysis where we can assess the levels of Vit D, B9 (folic acid), B12 (cyanocobalamin), Homocysteine (to complete the B12 assessment).
And if the cause of depression is determined by another type of illness that is limiting the person's life, thus causing sadness and pain, of course, we will go to that area to treat it in the most appropriate way and thus ensure the person improves and recovers 100%.
And most importantly.
Know yourself, and in this way you will be able to understand what you need in your life to feel fulfilled as a person and thus be happy.
There's nothing worse than spending your days wondering what to do with your mediocre life, putting off until tomorrow what could transform your life today.