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Vitamin D & The Brain

Vitamin D DeficiencyVitamin D deficiency has hit an epidemic level. Not only are intakes devastatingly low, but also exposure to the sun has become increasingly limited for fear of contracting skin cancer. In his June 23, 1011, newsletter at Newsmax Health, Dr.Russell Blaylock educates his readers when he states that vitamin D3 is actually a hormone rather than a vitamin, and that a deficit of this compound may result in undesirable consequences in the brain, including depression.

Dr.Blaylock is a renowned neurosurgeon with a keen desire for people to take some control over their own health.  He implies that supplemental vitamin D3, “…lowers risk of infections, which would reduce the incidence of brain inflammation.”   He adds that research can place behavioral disorders in the lap of vitamin D deficiency, and  suggests that all of us get a vitamin D blood-level test to find out where we stand, noting that current accepted values are too low to be any benefit.   About the conditions, Dr. Blaylock says, “…depression, anxiety, panic attacks, obsessive-compulsive disorder, suicide risk, and even criminal behavior…can be traced to chronic brain inflammation.”  The good doctor would like to see blood vitamin D levels between 70 and 100 nanograms per milliliter.  That means that most of us need to take at least 2000 IU of vitamin D3 a day, with as much as 10,000 IU for severe deficiency.

The body needs cholesterol to make vitamin D from the sun’s ultra-violet radiation.  When the resulting chemical mix gets to the liver it becomes vitamin D3, the active form of the hormone, which the body uses to help maintain bone integrity, to increase neuromuscular function, and to modulate the immune system.  There has been considerable support over the past decade for the role of vitamin D in brain development and function.  It was noted by Kesby and colleagues at Australia’s Queensland Brain Institute that, “…this vitamin is actually a neuroactive steroid that acts on brain development, leading to alterations in brain neurochemistry and adult brain function.”  (Kesby. 2011)  Deficiencies have been related to depression, as well as to Parkinson’s disease and cognitive decline.

Of particular interest to American researchers at the U. of South Carolina is the relationship of vitamin D deficit to postpartum depression as one of the several mood disorders studied in 2010.  Using a moderate sample size at the outset, scientists found that low levels of vitamin D are associated with increased postpartum depression, as measured by evaluation on the Edinburgh Postpartum Depression Scale. (Murphy. 2010)  Even though larger studies are encouraged, the outcomes are likely to be the similar.

When the immune system abandons its competence because of nutritional deficit, inflammation ensues, often with a mighty wrath.  Such is the case with deficit of vitamin D in various maladies that include diabetes and multiple sclerosis, as well as depression.  Depression is a family affair characterized by feelings of hopelessness, despair, anxiety, irritability and restlessness.  Depression understandably accompanies degenerative disease, in part by the hopelessness is may engender.  If vitamin D is able to address depression, might it also be able to help get a handle on these conditions?   Whatever the cause of vitamin D deficiency, levels lower than 30 nanograms per milliliter have been associated with heart disease, type 2 diabetes, infectious diseases, autoimmune disorders, and neurological conditions. (Nimitphong. 2011)

References

MAIN ABSTRACT
Dr. Blaylock
Up Vitamin D3 for Your Brain
Thursday, June 23, 2011 10:11 AM

SUPPORTING ABSTRACTS
Mol Cell Endocrinol. 2011 Jun 1. [Epub ahead of print]
The effects of vitamin D on brain development and adult brain function.
Kesby JP, Eyles DW, Burne TH, McGrath JJ.

Source Queensland Brain Institute, University of Queensland, St. Lucia, Qld 4076, Australia.

J Am Psychiatr Nurses Assoc. 2010 May;16(3):170-7.
An exploratory study of postpartum depression and vitamin d.
Murphy PK, Mueller M, Hulsey TC, Ebeling MD, Wagner CL.

SourceMedical University of South Carolina, Charleston, SC, USA, [email protected]

Curr Opin Clin Nutr Metab Care. 2011 Jan;14(1):7-14.
Vitamin D, neurocognitive functioning and immunocompetence.
Nimitphong H, Holick MF.

SourceSection of Endocrinology, Diabetes, Nutrition, Department of Medicine, Boston University Medical Center, Boston, Massachusetts, USA.

Acta Psychiatr Scand. 2011 Apr 12. doi: 10.1111/j.1600-0447.2011.01705.x. [Epub ahead of print]
D’ for depression: any role for vitamin D?: ‘Food for Thought’ II.
Parker G, Brotchie H.

SourceSchool of Psychiatry, University of New South Wales, and Black Dog Institute, Randwick, Sydney, NSW, Australia.

Psychopharmacology (Berl). 2011 Jun;215(4):733-7. Epub 2011 Jan 29.
Exploring the relationship between vitamin D and basic personality traits.
Ubbenhorst A, Striebich S, Lang F, Lang UE.

SourceDepartment of Physiology, University of Tuebingen, Gmelinstr. 5, 72076, Tuebingen, Germany.

FASEB J. 2008 Apr;22(4):982-1001. Epub 2007 Dec 4.
Is there convincing biological or behavioral evidence linking vitamin D deficiency to brain dysfunction?
McCann JC, Ames BN.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Yoga

yogawomanIf there exists such a philosophical regime that can bring a person closer to Elysium in every aspect of life—balance, health, aging—its enthusiasts argue that it is yoga.  Investigations into the complexities of this physical / mental / spiritual discipline have focused on the almost inexplicable efficacy of its practice.  That it is conjectured to effect a return to normal following a physical or mental derangement deserves at least a little attention.

The cognitive behaviors of yoga entail calorie restriction, meditation, breathing techniques and additional practices that separate it from other holistic modalities, and have a distinct affect on the function of the human body.  Research at the Albert Einstein College of Medicine, in New York, has classified yoga’s influence on human physiology into four categories that encompass humoral factors (affecting immunity), CNS activity, cell trafficking, and bioelectromagnetism (the study of membrane and action potential).  The investigators allowed that, “…yogic practices might optimize health, delay aging, and ameliorate chronic illness and stress from disability.”  (Kuntsevich. 2010)  A reductionist approach tries to explain complex matters by using the simplest of its facets and nomenclature, but this cannot address the intricacy of yoga and its long-term benefits to the whole person.

From lower back pain, arthritis and carpal tunnel syndrome, all the way to functional development in children, yoga has been an oft-visited body of knowledge.  Practicing yoga increases flexibility, strength and stamina, and can do that in the gentlest of manners using Hatha techniques, or by employing the more explosive Ashtanga form, which relies on quick movements from one pose to another.

Because lower back pain cannot satisfactorily be treated with surgery and injections, other interventions have been pursued, yoga paramount among them.  Chronic back pain has a significant impact on a person’s ability to work and perform daily tasks.  The fact that pain is non-specific makes some therapies uncertain, but the physical motions of yoga meet the need for non-invasive remediation.  (Carter. 2011)  Perhaps it is such that synovial lubrication is enhanced, or that directed movements create healing substances at the cellular level.  Whatever the reason, it works.

If yoga intensifies a person’s awareness of his body and helps him to understand his relationship to a body in pain, with the expectation of attenuating discomfort, then the discipline has been effective, particularly in changing cognitions and behaviors towards nociception.  (Tul. 2011)  Modified forms of Hatha yoga have been tested on such patients with outcomes that were not surprising.  Not only were flexibility and reach improved, but also the emotional insults that accompany refractory pain, such as anxiety and mild depression, were reduced, as reported in a study performed at the Richard Stockton College of New Jersey, providing renewed interest in additional study on the salubrious nature of yoga.  (Galantino.  2004)

Recent work at Johns Hopkins examined prior studies on yoga’s application to arthritis, and found that evidence was strong for reduced disease symptoms and disability, especially the tender and swollen joints that characterize the condition.  (Haaz.  2011)  Noting that it can be tailored to the specific needs of the geriatric population, investigators at the University of Pittsburgh concluded that yoga is among the mind-body interventions associated with reduced pain perception.  (Morone.  2007)

Executive function in a human being is that capacity to make decisions in novel situations, outside the domain of normal automatic processes.  This is tantamount to thinking outside the box, and appears to be a desirable developmental milestone in children.  Yoga is just one of the activities that can help to develop such a trait, one that telegraphs creativity, flexibility, self-control, and self-discipline.  The physical benefits are the cherry on top.  (Diamond. 2011)

It is accepted that what enters a pregnant woman’s digestive system has an effect on the neonate, as well as on the mother.  Could mind-body processes do the same?  There is evidence that improvement in perceived stress, mood, and perinatal outcomes may be realized from practicing yoga.  Not only that, but also it was found that such practices resulted in higher birth weight, less time in labor, and fewer instrument-assisted births, accompanied by lower stress and anxiety levels in both mother and child.  (Beddoe. 2008)  Good news, eh?

Other health issues that benefit from yogic practices include metabolic syndrome (Anderson.  2011), chronic obstructive pulmonary disease (Fulambarker.  2010), and essential hypertension (Anand.  1999).  Each deserves additional attention.

References

Kuntsevich V, Bushell WC, Theise ND.
Mechanisms of yogic practices in health, aging, and disease.
Mt Sinai J Med. 2010 Sep-Oct;77(5):559-69.

Carter C, Stratton C, Mallory D.
Yoga to treat nonspecific low back pain.
AAOHN J. 2011 Aug;59(8):355-61; quiz 362.

Tul Y, Unruh A, Dick BD.
Yoga for chronic pain management: a qualitative exploration.
Scand J Caring Sci. 2011 Sep;25(3):435-43. doi: 10.1111/j.1471-6712.2010.00842.x.

Galantino ML, Bzdewka TM, Eissler-Russo JL, Holbrook ML, Mogck EP, Geigle P, Farrar JT.
The impact of modified Hatha yoga on chronic low back pain: a pilot study.
Altern Ther Health Med. 2004 Mar-Apr;10(2):56-9.

Haaz S, Bartlett SJ.
Yoga for arthritis: a scoping review.
Rheum Dis Clin North Am. 2011 Feb;37(1):33-46.

Morone NE, Greco CM.
Mind-body interventions for chronic pain in older adults: a structured review.
Pain Med. 2007 May-Jun;8(4):359-75.

Diamond A, Lee K.
Interventions shown to aid executive function development in children 4 to 12 years old.
Science. 2011 Aug 19;333(6045):959-64.

Beddoe AE, Lee KA.
Mind-body interventions during pregnancy.
J Obstet Gynecol Neonatal Nurs. 2008 Mar-Apr;37(2):165-75.

Anderson JG, Taylor AG.
The metabolic syndrome and mind-body therapies: a systematic review.
J Nutr Metab. 2011;2011:276419.

Fulambarker A, Farooki B, Kheir F, Copur AS, Srinivasan L, Schultz S.
Effect of Yoga in Chronic Obstructive Pulmonary Disease
Am J Ther. 2010 Oct 22.

Anand MP.
Non-pharmacological management of essential hypertension.
J Indian Med Assoc. 1999 Jun;97(6):220-5.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

B Vitamins And Energy

happygirlA considerable fraction of the general population reports using one or more vitamin supplements. Reasons include fighting stress and tiredness, and improving mental function. Until recent decades, there was only modest support from the allopathic community that supplements could render any benefit.

Using questionnaires that tracked mood states, levels of perceived stress, and general health, researchers at the Brain Performance and Nutrition Center of Northumbria University, in the UK, discovered a relationship between vitamin supplement intake and overall performance as related to fatigue, mood, and feelings of well-being.  High-dose B-vitamin supplementation “…led to significant improvements in ratings…” in the vigor subscale of the subjective assessments.  (Kennedy. 2010)  Cognitive and executive function improved in parallel fashion as a result of physical reinvigoration.  The authors concluded that, “Healthy members of the general population may benefit from augmented levels of vitamins/minerals via direct dietary supplementation.”

When questioned about the rationale behind supplementation, the answer should list poor dietary choices, processed food, depleted soil, chemical fertilizers and biocides, synthetic additives, malabsorption, careless food preparation, haphazard storage and shipping, and the use of medications and alcohol.  Feel free to add a few.

Because the vitamin B complex is water-soluble and relatively delicate, it responds to whatever insults include boiling or steaming, heat, and prolonged exposure to light.  Not only that, but the complex is vulnerable to the aerosol pesticides used by the produce brokers who store foods prior to over-the-road shipping.

The B vitamins comprise a group that plays a vital role in cell metabolism.  They were once thought to be a single vitamin, but later were found to have distinct functions in the body, although they coexist in the same foods.  They received their numbers based on the order in which they were isolated.  In conjunction, the B complex is helpful to combat most symptoms and causes of conditions such as depression, stress, coronary heart disease and other cardiovascular concerns.  Working together, the B’s are able to support metabolic homeostasis, the immune system, and the nervous system, while simultaneously maintaining healthy skin, muscle tone, and promoting cell growth and division.  Neat, eh?

The water-solubility of B vitamins helps them disperse throughout the body, but also means that they need replacement every day.  Excess is excreted in urine, which explains the dark yellow-orange color that occurs after taking the supplement.  (That would be riboflavin, B2.)  One of the B group’s claims to fame is its role in the burning of carbohydrates for energy.  If this metabolic purpose is impaired, fatigue strikes, often with a vengeance.  Thiamine in particular, or one of its derivatives, is known to improve energy metabolism during physical fatigue (Nozaki.  2009), and is a reputed activator of carbohydrate processing (Masuda. 2010).

If taken as an isolated supplement, a singular B vitamin may act as a drug, even though there are few adverse reactions, with the possible exception of very high-dose pyridoxine (B6) being associated with sensory neuropathy.  (Scott. 2008)  Alcohol of any type, even the comparatively innocuous beer, will result in a net deficit of the B vitamins.

The stress that characterizes the Western lifestyle takes a physical, as well as psychological, toll.  The mood changes and testiness that follow physical exhaustion are shared with family and friends.  B-vitamin supplementation has shown itself to attenuate the causes and effects, either one at a time or together.  (Stough. 2011)  People with the lowest levels of the B vitamins in their diets usually have the poorest memories and cognitive abilities.  Those with gastric dysfunction, such as that characterized by low stomach acid or deficit of intrinsic factor, will absorb the least vitamin B12 from their foods, so are well-advised to supplement.

The interaction of the body’s chemistry is complex.  We need vitamin B2 to metabolize B6.  We need B6, B12, and folate to clear homocysteine, a marker for cardiac involvement.  But taking an isolated B vitamin without the rest of the family upsets the apple cart.  The RDA is a poor guide because it recommends only that dose of a nutrient that will prevent deficiency disease, such as beriberi or pellagra.  Meeting with a health care professional can help you to figure what’s what.

References

Kennedy DO, Veasey R, Watson A, Dodd F, Jones E, Maggini S, Haskell CF.
Effects of high-dose B vitamin complex with vitamin C and minerals on subjective mood and performance in healthy males.
Psychopharmacology (Berl). 2010 Jul;211(1):55-68.

SUPPORTING ABSTRACTS
Nozaki S, Mizuma H, Tanaka M, Jin G, Tahara T, Mizuno K, Yamato M, Okuyama K, Eguchi A, et al
Thiamine tetrahydrofurfuryl disulfide improves energy metabolism and physical performance during physical-fatigue loading in rats.
Nutr Res. 2009 Dec;29(12):867-72.

Masuda H, Matsumae H, Masuda T, Hatta H.
A thiamin derivative inhibits oxidation of exogenous glucose at rest, but not during exercise.
J Nutr Sci Vitaminol (Tokyo). 2010;56(1):9-12.

Scott K, Zeris S, Kothari MJ.
Elevated B6 levels and peripheral neuropathies.
Electromyogr Clin Neurophysiol. 2008 Jun-Jul;48(5):219-23.

Stough C, Scholey A, Lloyd J, Spong J, Myers S, Downey LA.
The effect of 90 day administration of a high dose vitamin B-complex on work stress.
Hum Psychopharmacol. 2011 Sep 8.

Bassett JK, Hodge AM, English DR, Baglietto L, Hopper JL, Giles GG, Severi G.
Dietary intake of B vitamins and methionine and risk of lung cancer.
Eur J Clin Nutr. 2011 Aug 31.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Menopause and Memory

Coping with the menopauseFor eras women’s physical and mental suffering has been trivialized when it is associated with the condition of menopause.  But the reality of hot flashes, fatigue, sleep disturbance, moodiness, and discomfiting cerebral performance during menopause is virtually tangible.   Various traditional and alternative therapies are used to address these symptoms, from hormone replacement therapy at the allopathic end to black cohosh and essential fatty acids at the complementary end. The brain fog, on the other hand, has been viewed with less fervor until recently.

The Department of Neurology at the University of Rochester, In New York, reported that the memory problems described by women as menopause approaches are real (Weber, Mapstone, et al, 2012). Of course, this is nothing new to the millions of women who have had periods of forgetfulness or fogginess in their 40s and 50s.  Their experiences have been validated by a rigorous battery of cognitive tests administered by researchers at Rochester and the U. of Illinois at Chicago.  The goal of the study was to find a relationship between subjective reports of memory complaints and objective tests of cognitive function, described as the intellectual process by which a person perceives and comprehends ideas.   Included here are all aspects of thought, reason, and recollection.   Antipodal is the brain misstep that affects all ages and is characterized by confusion, decreased clarity of thought, and forgetfulness.  In some folks this can lead to minor depression on the one hand and delinquency on the other.  For as often as this happens to women all over the globe, it still is barely seen as a “real” condition.

The subjects who participated in the study completed a comprehensive neuropsychological battery of tests that measured attention, working memory, verbal memory and fluency, visual-spatial skills, and fine motor dexterity.  Self-report inventories of perceived memory symptoms were included.  The findings indicated a link between the subjective memory faults and actual memory deficits in some, but not all, realms.  Working memory and complex attention tasks were most affected.  Working memory is the ability to hold information in the mind long enough to perform a complex task regardless of interfering processes and distractions.  If this operation is hindered, the person is frustrated.  If this recurs, the presentation of depressive symptoms should not be a complete surprise.  The physical changes of menopause are identifiable, but the mental changes are not to be identified with the mental aberrations of dementia.  Menopausal women can rate their own memory skills; demented ones cannot.

Brain fog can be triggered by physical, psychological, biochemical and even spiritual factors.  Some of these are adrenal exhaustion, food and chemical reactions, stress, and nutritional deficiencies.  There are, however, age-related cognitive changes that, though of non-dementia origin, can interfere with a person’s daily functioning, which makes this a relevant clinical issue.  Overcoming this situation may be as simple as getting enough sleep, exercising, or eating the right foods.  Meditation and prayer have been used as first-line treatment in some venues.  While the complex relationship of mood, memory and hormones is not identical in every case, it is inferred that the amount of attention paid to a novel situation or perception influences the persistence of memory (Weber & Mapstone, 2009).  Overall, if a woman says she experiences disconcerting bouts of forgetfulness, she deserves confirmation that these cognitive signs are part of the array of menopause symptoms (Schaafsma, 2010).

There are factors in the aging process that interact with menopause itself, among them  homocysteine values, hypercholesterolemia, metabolic syndrome or type 2 diabetes, hypertension, and depression.   If drugs are used to address any of these concerns, and if a drug has anticholinergic properties, there likely will be cognitive impairment to some degree.  This compounds the matter, and may lead to improper diagnoses and unneeded treatment for a condition that does not really exist.  This class of drugs—the anticholinergics—is used to treat gastric disturbances, urinary problems, respiratory matters, and insomnia, among others disorders that may display themselves as menopause signs in the first place.

The use of hormones to improve mental function in menopause has been hit and miss.  Observational studies say one thing, while randomized clinical trials report something else.   In a Wake Forest University study it was concluded that using estrogen with progestin to mediate global cognitive function in women over age 65 was less effective than the placebo.  In fact, it increased cognitive decline (Rapp, 2003).  While no clinically relevant adverse effects were reported, the trial was stopped because of “certain increased health risks for women” (Ibid.).  Hedging its bets, another study, following a similar protocol, found a negative effect on verbal memory, but a “trend to” a positive impact on figural memory, with other domains unaffected by the combination of estrogen and progestin (Resnick, 2006).  For those who put all their eggs into one basket—the basket of allopathic medicine and Big Pharma—this is an eye-opener.

Walking down the primrose path, we stumble upon complementary medicine or functional medicine or integrative medicine, all of which are supported by evidence-based science, none of which is a sham.  Because it can’t be a money-maker for mega-corporations, since natural substances cannot be patented, complementary medicine raises a jaundiced eye.  And because your physician has little time to examine the research for himself, being directed by the verbal testimonies of the pharmaceutical representative, he knows little or nothing about the efficacy of alternative modalities.

It’s uncertain whether money, time, compassion, or philosophy drives the Euro-Asian medical community to study alternatives to allopathic treatment more earnestly than happens in the States.  Studies on ginkgo biloba that were performed in the last century in the UK have determined that this extract has profound impact on working memory and psychomotor performance at doses of 120 mg a day, with those between ages 50-59 reaping the most benefit (Rigney, 1999).  An earlier study, employing 600 mg of ginkgo extract, found significant improvement in memory one hour after administration (Subhan, 1984).  If there is concern that these studies are too old to carry any weight, work done in this century agrees (Scholey, 2002) (Kennedy, 2000) In order to “kick it up a notch,” scholars of neuroscience and cognition, also in the UK, decided to combine ginkgo with Panax ginseng—the adaptogen that purportedly increases the body’s resistance to stress, anxiety and fatigue—and to measure the combined efficacy on cognitive benefit in tests of serial arithmetic tasks with varying cognitive load and in tests of memory quality.  Two studies found this phytopharmaceutical blend to offer substantial cognitive profit (Wesnes, 2000) and (Scholey, 2002)

Why settle for cognitive improvement alone when the whole body can capitalize on a protocol?  Ever hear of phosphatidylcholine?  It’s the number one phospholipid from which you are made.  It’s a component of each of the trillions of cells that make you, you.  You’ve heard the expression, “When Mama’s happy, everybody’s happy?”  When the cells are healthy, everything is healthy.  That’s what phosphatidylcholine (PC) does:  it restores and elevates cellular function and stability.    And it enhances learning and memory, and improves cognitive disorders (Nagata, 2011) (Fioravanti, 2005)  As an unseen but additional benefit, PC is accompanied in its extraction by phosphatidylethanolamine, a phospholipid that helps to manufacture phosphatidylserine, an ingredient known to attenuate many neuronal effects of aging, and to restore normal memory on a variety of tasks (McDaniel, 2003)  It’s possible to lift that fog, after all.

References

Fioravanti M, Yanagi M.
Cytidinediphosphocholine (CDP-choline) for cognitive and behavioural disturbances associated with chronic cerebral disorders in the elderly.
Cochrane Database Syst Rev. 2005 Apr 18;(2):CD000269.

Kennedy DO, Scholey AB, Wesnes KA.
The dose-dependent cognitive effects of acute administration of Ginkgo biloba to healthy young volunteers.
Psychopharmacology (Berl). 2000 Sep;151(4):416-23.

McDaniel MA, Maier SF, Einstein GO.
“Brain-specific” nutrients: a memory cure?
Nutrition. 2003 Nov-Dec;19(11-12):957-75.

Nagata T, Yaguchi T, Nishizaki T.
DL- and PO-phosphatidylcholines as a promising learning and memory enhancer.
Lipids Health Dis. 2011 Jan 28;10:25.

Park DC, Smith AD, Lautenschlager G, Earles JL, Frieske D, Zwahr M, Gaines CL.
Mediators of long-term memory performance across the life span.
Psychol Aging. 1996 Dec;11(4):621-37.

Rapp SR, Espeland MA, Shumaker SA, Henderson VW, Brunner RL, Manson JE, Gass ML, Stefanick ML, Lane DS, Hays J, Johnson KC, Coker LH, Dailey M, Bowen D; WHIMS Investigators.
Effect of estrogen plus progestin on global cognitive function in postmenopausal women: the Women’s Health Initiative Memory Study: a randomized controlled trial.
JAMA. 2003 May 28;289(20):2663-72.

Resnick SM, Maki PM, Rapp SR, Espeland MA, Brunner R, Coker LH, Granek IA, Hogan P, Ockene JK, Shumaker SA; Women’s Health Initiative Study of Cognitive Aging Investigators.
Effects of combination estrogen plus progestin hormone treatment on cognition and affect.
J Clin Endocrinol Metab. 2006 May;91(5):1802-10. Epub 2006 Mar 7.

Rigney U, Kimber S, Hindmarch I.
The effects of acute doses of standardized Ginkgo biloba extract on memory and psychomotor performance in volunteers.
Phytother Res. 1999 Aug;13(5):408-15.

Schaafsma M, Homewood J, Taylor A.
Subjective cognitive complaints at menopause associated with declines in performance of verbal memory and attentional processes.
Climacteric. 2010 Feb;13(1):84-98.

Scholey AB, Kennedy DO.
Acute, dose-dependent cognitive effects of Ginkgo biloba, Panax ginseng and their combination in healthy young volunteers: differential interactions with cognitive demand.
Hum Psychopharmacol. 2002 Jan;17(1):35-44.

Subhan Z, Hindmarch I.
The psychopharmacological effects of Ginkgo biloba extract in normal healthy volunteers.
Int J Clin Pharmacol Res. 1984;4(2):89-93.

Weber M, Mapstone M.
Memory complaints and memory performance in the menopausal transition.
Menopause. 2009 Jul-Aug;16(4):694-700.

Weber MT, Mapstone M, Staskiewicz J, Maki PM.
Reconciling subjective memory complaints with objective memory performance in the menopausal transition.
Menopause. 2012 Mar 12. [Epub ahead of print]

Wesnes KA, Ward T, McGinty A, Petrini O.
The memory enhancing effects of a Ginkgo biloba/Panax ginseng combination in healthy middle-aged volunteers.
Psychopharmacology (Berl). 2000 Nov;152(4):353-61.

Wilson RS, Beckett LA, Barnes LL, Schneider JA, Bach J, Evans DA, Bennett DA.
Individual differences in rates of change in cognitive abilities of older persons.
Psychol Aging. 2002 Jun;17(2):179-93.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Low Cholesterol And Mental Health

sad-eggsIf mental health is defined as a state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life, then we need to take care of the garage in which this vehicle is kept.  Measures of depression and anxiety assess things such as self-disparagement, pessimism, lack of drive, apprehension, inability to relax, and irritability, to name a few.  Interestingly, these evaluations have demonstrated a relationship to low lipid and lipoprotein concentrations.

In work done at the end of the last century, an inverse association between mental challenges and total cholesterol and lipids was found.  That means when one goes up, the other goes down.  Testing young adult females, Duke University Medical Center discovered that women “…with low total cholesterol concentrations (<4.14 mmol/liter) relative to those with moderate to high cholesterol levels, were more likely to have higher scores on the NEO depression subscale…and anxiety subscale…” after adjustments were made for age, body mass index, oral contraceptive use and physical activity.  (Suarez.  1999)

Before we got too involved, it pays to know that 4.14 mmol/liter is equal to a cholesterol level of 160 mg/dL, or just plain 160.  Cholesterol is a steroid substance necessary to human life.  It forms the cell membranes in all organs and tissues of the body, is essential to the production of the hormones we need for growth, development, and reproduction, and it makes the bile acids necessary for absorption of nutrients.  Very little, if any, dietary cholesterol becomes serum cholesterol.

Back in the 1990’s it was noted that cholesterol levels below 160 were tied to excess mortality from all causes, primarily from a variety of cancers, respiratory and digestive diseases, and violent deaths from suicide and trauma.  Reasons behind low cholesterol have been ascribed to genetics, resistance to dietary sources, acute infections, and alcohol use/abuse.  (Meilahn.  1995)  If suicide is tied to depression, then it may be a legitimate effect.  Depression is twice as common among women as men, with about one in four suffering at some point in her lifetime.  The greatest vulnerability appears during the childbearing years, the time when its diagnosis is often overlooked.  The turbulence of hormones flooding a woman’s system at different times and in differing amounts can surely be a potent stressor.

Scientists in Barcelona, Spain, realized the connection of cholesterol to neuropsychiatric disease in a review of related literature that preceded their interest.  They found a link to early death, suicide and aggression, and personality disorders and dementia. (Martinez-Carpio.  2009). It appears that the good intentions of reducing what was thought to be the cause of cardiac mortality opened a different can of worms.  The Japanese explored the intrigue that was sparked when total mortality was not reduced despite reduction of mortality due to coronary heart disease, and found an increase in death rates due to suicide and accidents, many of which were tied to risky behaviors in persons with low cholesterol levels.  (Kunugi.  2001)  Does low cholesterol compromise judgment?  The U. of California conducted trials in the early 90’s to determine the cause behind the rise in suicides in men older than fifty years, and found that depression was three times more prevalent in those whose cholesterol was lower than 160.  Health status, number of chronic diseases, number of medications, and exercise seemed not to have had an adverse effect on depressive signs and symptoms. This led to the suggestion that the intentional lowering of cholesterol be more deliberate.  (Morgan. 1993)

Cedars-Sinai Medical Center, in Los Angeles, reported that serotonin, a neurotransmitter that controls impulsive behaviors, is tied to cholesterol levels at the synapses.  Low membrane cholesterol decreases the number of serotonin receptors, thereby reducing suppression of aggressive and destructive behaviors.  (Engelberg. 1992)  That magic number, 160, once again made headlines in the Netherlands, where epidemiologists discovered a higher prevalence of depression in males whose cholesterol was below that level.  (Steegmans. 2000)  Low cholesterol was cited as causative to rises in criminal violence in Sweden, following the association of reduced cholesterol values to low serotonin activity. (Golomb. 2000)  Reduced levels of total cholesterol, LDL, and HDL resulted in minimized serotonin values in personality disordered cocaine users, as reported by addiction researchers in their journal. (Buydens-Branchey. 2000)  In school-aged children, those with cholesterol values lower than 145 were three times more likely to have been suspended or expelled from school.  This is an absolute consideration, and has nothing to do with socio-economic status or ethnic background, nor with nutrition status or academic achievement.  (Zhang. 2005)

Life is supposed to be a balancing act.  Lots of us overdo something.  The balance between total cholesterol and HDL can allay fears of cardiovascular disease, despite cholesterol in the 200 range.  Cholesterol levels below 170 can make us irritable…and irritating.

References

Suarez EC.
Relations of trait depression and anxiety to low lipid and lipoprotein concentrations in healthy young adult women.
Psychosom Med. 1999 May-Jun;61(3):273-9.

Elaine N. Meilahn, MD
Low Serum Cholesterol  Hazardous to Health?
Circulation. 1995;92:2365-2366

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[Relation between cholesterol levels and neuropsychiatric disorders].  [Article in Spanish]
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Kunugi H.
[Low serum cholesterol and suicidal behavior].  [Article in Japanese]
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Morgan RE, Palinkas LA, Barrett-Connor EL, Wingard DL.
Plasma cholesterol and depressive symptoms in older men.
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Engelberg H.
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Paul H. A. Steegmans, MD, Arno W. Hoes, MD, PhD, Annette A. A. Bak, MD, PhD, Emiel van der Does, MD, PhD and Diederick E. Grobbee, MD, PhD
Higher Prevalence of Depressive Symptoms in Middle-Aged Men With Low Serum Cholesterol Levels
Psychosomatic Medicine 62:205-211 (2000)

Beatrice A Golomb, Håkan Stattin, Sarnoff Mednick
Low cholesterol and violent crime
Journal of Psychiatric Research. Volume 34, Issue 4 , Pages 301-309, July 2000

Laure Buydens-Branchey, Marc Branchey, Jeffrey Hudson, Paul Fergeson
Low HDL cholesterol, aggression and altered central serotonergic activity
Psychiatry Research. Volume 93, Issue 2 , Pages 93-102, 6 March 2000

Zhang J, Muldoon MF, McKeown RE, Cuffe SP
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Am J Epidemiol 2005; 161:691-9.

Scanlon SM, Williams DC, Schloss P.
Membrane cholesterol modulates serotonin transporter activity
Biochemistry. 2001 Sep 4;40(35):10507-13.

Laure Buydens-Branchey,a Marc Branchey,a and Joseph R. Hibbelnb
ASSOCIATIONS BETWEEN INCREASES IN PLASMA N-3 POLYUNSATURATED FATTY ACIDS FOLLOWING SUPPLEMENTATION AND DECREASES IN ANGER AND ANXIETY IN SUBSTANCE ABUSERS
Prog Neuropsychopharmacol Biol Psychiatry. 2008 February 15; 32(2): 568–575.

BRIAN HALLAHAN, MRCPsych and MALCOLM R. GARLAND, MRCPsych
Essential fatty acids and mental health
The British Journal of Psychiatry (2005) 186: 275-277

Hillbrand M, Waite BM, Miller DS, Spitz RT, Lingswiler VM
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*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Longevity And Stress

hand-squeezing-stress-ballJust as oxidation causes iron to rust and brass to tarnish, it causes our cells to rust and tarnish, only figuratively and not literally…unless the Tin Man is part of the gene pool.  When you get stressed out—and there’s a litany of reasons for that—your body makes oxidative chemicals that hasten aging, increase cardiovascular risk, and set the stage for myriad chronic and acute illnesses, including relatively benign things like colds.

Vanderbilt University discovered that accurate and uncomplicated assessment of oxidative stress inside the body could be accomplished by the measurement of chemicals called isoprostanes.  These substances are derived from the action of free radicals on fatty acids, and can be found in plasma and urine.  Primarily associated with risk of atherosclerosis, isoprostanes levels are elevated by “cigarette smoking, hypercholesterolemia, diabetes mellitus, and obesity,” among other factors.  Additionally, “Enhanced oxidant stress occurring either locally in the vessel or systemically is implicated…in atherosclerosis in humans.”  (Morrow. 2005)   In circumstances not cardiac-related, isoprostanes are inflammatory mediators that augment the perception of pain.

As long as there is oxygen there will be oxidation, but most species have developed ways to deal with it.  What separates humans from other life forms is that we do things on purpose to increase the oxidative process.  We eat the wrong foods, we smoke, we are sedentary, and we worry about things that never happen, while fretting about things we cannot change.  We even worry about getting diseases that are not likely to attack us by virtue of genetic exclusion, but sometimes do get a start because we worried about them needlessly.  The body’s response to oxidative stress, which can be prompted by both mental and physical assaults, is tied to aging and life span.  (Finkel. 2000)

There is increasing evidence that psychosocial stress can cause system-wide derangement of cellular homeostasis, accompanied by heightened oxidative stress and pro-inflammatory activity.  (Marotta. 2011)  Persons under stress have elevated levels of malondialdehyde (MDA), a product that stems from the oxidation of fatty acids and that degrades the integrity of the cell.  This, in turn, can cause mutations of DNA.  That can initiate a plethora of unwelcome events.

Mental stress can incite physical responses, some of which may appear as gastrointestinal conditions, tension headaches, hypertension, irritable bowel syndrome, sexual dysfunction, alcoholism, fatigue, and skin conditions that include psoriasis, lichen planus, itching and hives.  Some or all of these may be related to increased cortisol production by the adrenal glands.  Stress can affect other hormones, as well, and is implicated in depression and impaired immune function.

Because the brain has high fatty acid content, it seems logical that fatty acids are involved in brain chemistry, physiology, and function.  Therefore, it follows that cognitive health and neuropsychiatric well-being are intertwined.  Omega-3 fatty acids, such as those from fatty fish and fish oil supplements, appear effective in the prevention of stress (and manufacture of cortisol) and in the regulation of mood.  (Perica. 2011)  In fact, the first consistent demonstration of the effect of dietary ingredients on the structure and function of the brain involved omega-3 fats.  (Bourre. 2005)

At the ends of our chromosomes are telomeres, pieces of DNA that are the equivalent of shoelace aglets (those plastic sheaths that help to thread the laces).  When telomeres start to fray because of continual cell replication, cells become senescent—they grow old.  Oxidative stress shortens telomeres, thus hastening aging and the onset of age-related diseases, none of which started yesterday.  (Epel. 2004)  If cortisol is one of the major hormones related to telomere shortening, then it is to our benefit to diminish it.  Stressors coming from outside the body are not so easy to handle.  But this does not mean that internalized stressors are more manageable.  Maintaining proper weight and controlling glucose are important stressors to consider.

The employment of functional foods and certain supplements can help to ease stress, to lighten the cortisol load, and to bolster immune defenses.  Telomeres may be preserved by a diet that reduces added sugars.  Essential fatty acids can ease the mental burdens of the daily grind.  Green tea polyphenols have shown to be effective in addressing a variety of oxidative, pro-inflammatory processes (Yang. 1998), while having a beneficial effect on nucleic acid and protein synthesis (Beltz. 2006).  The vitamin B complex is collectively known as the stress vitamins, and their utility as such has been reported often over past decades (Kennedy. 2011)  (Stough. 2011)  Intense Chinese research has discovered that telomeres may be rescued from senescence by epigallocatechin gallate (ECGC) in green tea, and by quercitin from apples, onions, citrus, and dark berries. (Sheng. 2011)

Stress-fighting, mood-lifting foods include such simple ingredients as oatmeal, pistachios, avocadoes, and wine.  Turkey, eggs, water, and almonds can affect your affect.  Chocolate can calm things by releasing endorphins, and walnuts can get rid of the blues by increasing uridine, which boosts communication among neurons.  Spinach helps maintain normal levels of serotonin, a mood enhancer that also deals with the sleep-wake cycle and pain perception.  If, on the other hand, you care little about stress and what it does to your body, go ahead and eat half a dozen bacon-fried doughnuts.

References

Morrow JD.
Quantification of isoprostanes as indices of oxidant stress and the risk of atherosclerosis in humans.
Arterioscler Thromb Vasc Biol. 2005 Feb;25(2):279-86.

Finkel T, Holbrook NJ.
Oxidants, oxidative stress and the biology of ageing.
Nature. 2000 Nov 9;408(6809):239-47.

Marotta F, Naito Y, Padrini F, Xuewei X, Jain S, Soresi V, Zhou L, Catanzaro R, Zhong K, Polimeni A, Chui DH.
Redox balance signalling in occupational stress: modification by nutraceutical intervention.
J Biol Regul Homeost Agents. 2011 Apr-Jun;25(2):221-9.

Perica MM, Delas I.
Essential fatty acids and psychiatric disorders.
Nutr Clin Pract. 2011 Aug;26(4):409-25.

Bourre JM.
Dietary omega-3 Fatty acids and psychiatry: mood, behaviour, stress, depression, dementia and aging
J Nutr Health Aging. 2005;9(1):31-8.

Epel ES, Blackburn EH, Lin J, Dhabhar FS, Adler NE, Morrow JD, Cawthon RM.
Accelerated telomere shortening in response to life stress.
Proc Natl Acad Sci U S A. 2004 Dec 7;101(49):17312-5.

Yang F, de Villiers WJ, McClain CJ, Varilek GW.
Green tea polyphenols block endotoxin-induced tumor necrosis factor-production and lethality in a murine model.
J Nutr. 1998 Dec;128(12):2334-40.

Beltz LA, Bayer DK, Moss AL, Simet IM
Mechanisms of cancer prevention by green and black tea polyphenols.
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Kennedy DO, Veasey RC, Watson AW, Dodd FL, Jones EK, Tiplady B, Haskell CF.
Vitamins and psychological functioning: a mobile phone assessment of the effects of a B vitamin complex, vitamin C and minerals on cognitive performance and subjective mood and energy.
Hum Psychopharmacol. 2011 Jul 12. doi: 10.1002/hup.1216.

Stough C, Scholey A, Lloyd J, Spong J, Myers S, Downey LA.
The effect of 90 day administration of a high dose vitamin B-complex on work stress.
Hum Psychopharmacol. 2011 Sep 8. doi: 10.1002/hup.1229.

Sheng R, Gu ZL, Xie ML
Epigallocatechin gallate, the major component of polyphenols in green tea, inhibits telomere attrition mediated cardiomyocyte apoptosis in cardiac hypertrophy.
Int J Cardiol. 2011 Oct 14.

Huk-Kolega H, Skibska B, Kleniewska P, Piechota A, Michalski Ł, Goraca A.
Role of lipoic acid in health and disease
Pol Merkur Lekarski. 2011 Sep;31(183):183-5.

Rios A, Delgado-Casado N, Cruz-Teno C, Yubero-Serrano EM, Tinahones F, Malagon MD, Perez-Jimenez F, Lopez-Miranda J.
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Marin C, Delgado-Lista J, Ramirez R, Carracedo J, Caballero J, Perez-Martinez P, Gutierrez-Mariscal FM, Garcia-
Age (Dordr). 2011 Sep 6.

Lin J, Epel E, Blackburn E.
Telomeres and lifestyle factors: Roles in cellular aging.
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Murillo-Ortiz B, Albarrán-Tamayo F, Arenas-Aranda D, Benítez-Bribiesca L, Malacara-Hernández J, Martínez-Garza S, Hernández-González M, Solorio S, Garay-Sevilla M, Mora-Villalpando C.
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*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Anxious About Anxiety?

mid-adult-male-portraitYou’re not anxious about going on vacation or performing a pleasant task. You’re enthusiastic (but not enthused). You could be anxious about going to the dentist or to defend your last income tax return. Here, you’re entertaining a feeling of dread or apprehension, probably lacking clear justification.  Anxiety results from a subjective way of looking at a situation in the absence of a clear and actual danger. Of course, the sweating, increased pulse, and tension coupled with self-doubt about being able to handle the matter tell a different story. Sometimes respirations increase, the mouth gets dry and the intestines gurgle. All this is part of a defense mechanism. Anxiety can be particular, such as a panic attack in a crowd of people, in which case the stimulus can be identified. Or it may be generalized, being a long-term experience with no explanation of its cause. Obsessive-compulsory disorder (OCD) is an anxious state characterized by quandaries of uncertainty and compulsions to act. If the act is frustrated, the uncertainty remains and anxiety is intensified. Anxiety is considered a normal, but transient, response to stress, encouraging a person to take action in order to deal with what is perceived to be a difficult situation.

What’s The Risk?

Women are twice as likely as men to become anxious, mostly because of hormones and the archaic expectations that women are supposed to take care of everybody else before themselves. Age plays a minor role, in that OCD, separation anxiety and social phobias that include panic disorder show up in childhood and the teenage years. Early identification and treatment can forestall later problems. Certain environmental factors, such as poverty, separation from family, overly strict parents, family conflicts, anxious family members and lack of support can induce anxiety disorders. That anxiety runs in families is accepted, but it’s not known if the onset is genetic or learned, or both.

Physiologically, anxiety may be prompted by faulty brain chemistry, where an imbalance of serotonin, for instance, may result in irregular moods and emotions. There may be a structural fault, too.  The amygdala is the part of the brain in charge of processing emotional reactions and memory consolidation, including the recollection of fear.  If it’s overactive, this structure will heighten the fear response and increase anxiety in social situations.   Non-structural physical concerns, such as health problems, can cause anxiety.  Diabetes, alcoholism, heart disease, odd sensations that have no apparent cause, and thyroid disease are a few.

How Do I Handle Anxiety?

Besides the traditional psychotherapy practices and anti-anxiety medications, there are a few things you can do to take charge. First, you need to know that withdrawal from a psychoactive drug can cause anxiety. So, weaning from benzodiazepines causes the thing for which you took the drug in the first place. But beta-blockers, typically used for blood pressure control, have no such effect. They’re used off label to control rapid heartbeat, nervousness, trembling voice and shaky hands that accompany anxiety attacks. Alcohol withdrawal causes anxiety in many people.

Alternative approaches to anxiety treatment include things you can do and things you can swallow. Some modalities that require active participation include music therapy, art therapy, aromatherapy and meditation. With these you have to turn the music on, wield a paintbrush, light a candle, or think about pleasant things. But many people are unwilling or unable to be so engaged because of time constraints, family and job obligations, or simple faineance. Deglutition is the answer.

Options to psychological interventions for anxiety were sought in order to overcome limitations on time and resources. Because of adverse side-effects, alternatives to anxiolytic drugs also were explored. There is a shrub from the South Pacific islands that’s been used for centuries to calm the nerves, Piper methysticum, commonly known as kava kava. In a meta-analysis performed by the Cochrane Database at England’s Exeter University, researchers found that anxious subjects who took kava extract as a sole constituent in their treatment experienced a substantial reduction in symptoms compared to those taking a placebo (Pittler, 2000, 2003). One of the differences between a natural substance and a synthetic one is the time it takes to demonstrate effectiveness.  With a natural substance—in this example, herbal—you get the active ingredient and all the supportive components of the plant. Many enjoy an unexplainable synergy.  With a synthetic one—a drug—you get an isolated chemical that is not toned down by collaborative elements. Although earlier study found kava to be effective at taming anxious moments, it took eight weeks for kava’s superiority to placebo to be displayed (Volz, 1997).

Benzodiazepines are the drugs commonly used to treat anxiety. Their side effects, besides excessive drowsiness and decreased alertness, include paradoxical consequences, such as aggression, impulsivity, and irritability. Cognitive impairment and tolerance can result, as well. Tapering off these medications requires deliberation and a watchful eye. Using kava kava during such an ordeal, patients who were weaned from the drugs while being introduced to the herbal showed good tolerance and improved symptoms over a period of two weeks in a five-week trial in Germany (Malsch, 2001).

Generalized anxiety disorder has responded well to another folk remedy, passion flower. In a study comprising three dozen individuals, half received passion flower plus placebo and half received a benzodiazepine plus placebo in a one-month trial. The outcome showed both the herb and the drug to be effective in controlling anxiety symptoms. The drug, with rapid onset of action, impaired job performance (Akhondzadeh, 2001). The herb did not. Pharmacologically, extracts of the upper parts of the passion flower plant are most dynamic (Dhawan, 2001).

If you’ve taken fish oil for heart and brain health, that’s good. It’s been discovered that low levels of omega-3 fatty acids play a significant role in a number of mental irregularities (Buydens-Branchley, 2008) and that mood disorders respond especially well to omega-3 supplementation, with EPA getting better press than its companion, DHA (Ross, 2007). With a ratio of 3 to I, EPA to DHA, a fish oil product called Kirunal appears more than adequate to satisfy the mono- or adjunctive therapy approach in treating mood anomalies. For decades it’s been given that omega-3 fats are effective in the treatment of major depressive disorders, so it is reasonable to submit that they be likewise in anxiety disorders (Ross, 2009). If the presence of a substance yields a specific result, then the absence of that substance should yield the opposite. A deficit of n-3 fats has been identified in the red cell membranes of anxious persons (Greena, 2006), specifically those with social anxieties. Overall, it’s been proposed that human foods be supplemented with omega-3 fats as a strategy to improve behaviors and cognitive functions (Vinot, 2011). This makes one wonder if the education community needs to sit up and take notice. If that’s an inflammatory statement, n-3 supplementation can ameliorate that while reducing self-induced anxiety (Kiecolt-Glaser, 2011).

A relative newcomer on the anti-anxiety supplement stage is curcumin, the active ingredient of the turmeric spice common to Southern Asian and Middle Eastern cuisine.  Known predominantly as an anti-inflammatory agent, curcumin was found to have antidepressant like activity similar to tricyclic antidepressants, such as fluoxetine and imipramine (Sanmukhani, 2011). Because it is a natural substance, doses of curcumin used in an Indian trial were extraordinarily high, at 100 mg per kilogram of body weight, which equates to about 6,800 mg (6.8 grams) for a 150-pound person. Lesser dosages, from 10 to 80 mg/kg, demonstrated a positive effect on serotonin and dopamine activity, acting similarly to commonly prescribed drugs (Kulkami, 2008).

If you maintain a healthy diet, making sure to get the full array of macro and micro minerals, especially magnesium and zinc, as well as sufficient B vitamins, focusing on B 12, you’ll be able to avoid at least one cause of anxiety. Cutting back on alcohol and caffeine, and getting ample sleep are others. A caveat: before embarking on a supplement regimen to address anxiety, check with a healthcare professional to look for interactions with medicines and foods.

References

Andreatini R, Sartori VA, Seabra ML, Leite JR.
Effect of valepotriates (valerian extract) in generalized anxiety disorder: a randomized placebo-controlled pilot study.
Phytother Res. 2002 Nov;16(7):650-4.

Akhondzadeh S, Naghavi HR, Vazirian M, Shayeganpour A, Rashidi H, Khani M.
Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam.
J Clin Pharm Ther. 2001 Oct;26(5):363-7.

Buydens-Branchey L, Branchey M.
n-3 polyunsaturated fatty acids decrease anxiety feelings in a population of substance abusers.
J Clin Psychopharmacol. 2006 Dec;26(6):661-5.

Buydens-Branchey L, Branchey M, Hibbeln JR.
Associations between increases in plasma n-3 polyunsaturated fatty acids following supplementation and decreases in anger and anxiety in substance abusers.
Prog Neuropsychopharmacol Biol Psychiatry. 2008 Feb 15;32(2):568-75. Epub 2007 Nov 1.

Dhawan K, Kumar S, Sharma A.
Anti-anxiety studies on extracts of Passiflora incarnata Linneaus.
J Ethnopharmacol. 2001 Dec;78(2-3):165-70.

Dhawan K, Kumar S, Sharma A.
Anxiolytic activity of aerial and underground parts of Passiflora incarnata.
Fitoterapia. 2001 Dec;72(8):922-6.

Ernst E.
The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John’s Wort, Ginseng, Echinacea, Saw Palmetto, and Kava.
Ann Intern Med. 2002 Jan 1;136(1):42-53.

Ernst E.
Herbal remedies for anxiety – a systematic review of controlled clinical trials.
Phytomedicine. 2006 Feb;13(3):205-8. Epub 2005 Aug 15.

G. Fontani, F. Corradeschi, A. Felici, F. Alfatti, S. Migliorini, L. Lodi
Cognitive and physiological effects of Omega-3 polyunsaturated fatty acid supplementation in healthy subjects
European Journal of Clinical Investigation. Vol 35, Iss 11, pages 691–699, Nov 2005

Pnina Greena, Haggai Hermeshb, Assaf Monselisec, Sofi Marom, Gadi Presburger, Abraham Weizman
Red cell membrane omega-3 fatty acids are decreased in nondepressed patients with social anxiety disorder
European Neuropsychopharmacology. Feb 2006; 16(2): 107-113

Harauma A, Moriguchi T.
Dietary n-3 fatty acid deficiency in mice enhances anxiety induced by chronic mild stress.
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Jadoon A, Chiu CC, McDermott L, Cunningham P, Frangou S, Chang CJ, Sun IW, Liu SI, Lu ML, Su KP, Huang SY, Stewart R.
Associations of polyunsaturated fatty acids with residual depression or anxiety in older people with major depression.
J Affect Disord. 2012 Feb;136(3):918-25. Epub 2011 Nov 21.

Kiecolt-Glaser JK, Belury MA, Andridge R, Malarkey WB, Glaser R.
Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial.
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Kinrys G, Coleman E, Rothstein E
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Kulkarni SK, Bhutani MK, Bishnoi M.
Antidepressant activity of curcumin: involvement of serotonin and dopamine system.
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Lakhan SE, Vieira KF.
Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review.
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Malsch U, Kieser M.
Efficacy of kava-kava in the treatment of non-psychotic anxiety, following pretreatment with benzodiazepines.
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McBride S, Graydon J, Sidani S, Hall L.
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Pittler MH, Ernst E.
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Pittler MH, Ernst E.
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Ross BM, Seguin J, Sieswerda LE.
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Brian M. Ross
Omega-3 polyunsaturated fatty acids and anxiety disorders
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*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Mood Boosts Elder Brain Power

pleased-manWhen you’re in a good mood, it’s almost amazing what you can accomplish. This has little to do with emotions and even less with temperament. The former are short-lived and specific, and may be turned on by a single stimulus. The latter are characteristics that are seemingly innate rather than learned. Moods may be disarrayed, as in depression and bipolar disorder, and are subjective, although they may be inferred by conduct or body language. Many things can trigger a bad mood, and what disturbs one person might be ridiculous to another. In some circles, bad mood is believed to originate when one’s ego becomes threatened by a situation, event or condition beyond his control. Foul moods can interfere with many of our individual enterprises and ventures, not the least of which are the mental acrobatics that have seen us through thick and thin from youth to the extremes of middle-age. With age there may come decline, physically, emotionally and mentally. But we may have more control over this than previously thought. Is it possible that we can improve physical health, which will improve mood, which will improve mental faculties?

We already know that diet and exercise can enrich physical well-being and probably extend life…and the quality of life as we live it. Newspapers, magazines, the internet, television programs, and even the beauty parlor help to deliver information about longevity and agelessness. With a little thought, it’s possible to separate the wheat of the message from the chaff. The time at which old age begins is subjective, and ranges from sixty-five to the mid seventies, depending on whom you ask. Most of us believe that old age is for other people. That attitude will bless you with almost-eternal youth.

A vagary of aging is the diminution of working memory and instant decisiveness. The invincibility of youth gives way to the deliberations of middle-age and eventually to the tentativeness of senior citizenship. The culmination of this time line puts us on the game board square labeled “moody” or “testy” or “cranky.”  Modern research tells us that good mood can counterbalance these vagaries, and that trivial gestures, like giving a person a small bag of candy, can help to improve performance on tests of decision making and working memory.

In an interesting work done at Decision Research, in Oregon, good mood in twenty-three seniors was engendered with a bag of candy and a Thank-you card as a reward for agreeing to take part in the study. An equal number of seniors received no reward, and were considered the control group. Both groups were assigned to individual computers. The candy group saw happy faces and smiling suns on their sky-blue backgrounds. The control group saw neutral round images with no facial features. In tests of speed and accuracy that entailed experiential, sequenced learning, the candy group made significantly better choices than the neutral group. An extension of this mode to real life is analogous to meeting a person for the first time, and having to decide if she or he is trustworthy. What the study suggests is that people in a good mood are able to make such a determination faster and more accurately.

Working memory is linked to learning outcomes, encompassing the recall of instructions and the ability to complete an activity based on them. It boils down to how much information you can hold onto at one time. This function is important to decision making. The seniors in the happy group fared better than the others (Carpenter, 2013). It can be such that those who are suddenly elated forget their aches and pains and their trials and tribulations, thus vouching for the promises of a good mood. If good mood improves memory, then being able to remember might just improve mood, particularly for those beleaguered with cognitive interruptions.

Lots of factors can throw the body out of balance, but if you are chemically balanced, your moods will also be. It has been established that positive feelings facilitate working memory and decision making. Nutrients can do the same, especially if they are proportioned to maintain stable blood sugar. Because some seniors are prone to the loss of gustatory sensation, eating may be a chore rather than a pleasure, in which case nutrient supply may be shallow. Supplementation with at least one nutrient–vitamin B6, for example—has been found to improve storage of information (Deijen, 1992).

When the elderly are able to cheer each other on, as in a community setting, they are more apt to comply with those dietary interventions aimed at physical and mental maintenance. That flavor enhancement induces appetite by overcoming perceptual losses has been demonstrated at home and institutional settings (Schiffman, 1993), and the inclusion of essential fatty acids, whether from foods or supplements, has been found to enhance cognitive function (Yehuda, 2012) and, thereby mood (Parker, 2006) (Stahl, 2008).

Keeping Grandpa or Grandma in a good mood is essential to family serenity. In a time when several generations might live together, this could be as simple as letting them control the remote. Trading Ed Sullivan reruns for peace of mind is probably worth it if Gramps can simultaneously offer a compelling review of last Sunday’s pot roast dinner.

References

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Eric Eich
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*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Vitamin C and Mood

oj-drinking-womanFor a long time, emotions and logical thought have been portrayed as competing processes, with emotions depicted as obstacles to effective decision making. On the other hand, emotions and cognitions might work together to determine our behaviors. Whether or not one controls the other is still a question. If puppy dog eyes can influence a decision or alter a mood, well, “Aw, come on. Please?”  The rigidity of doctrine can be tempered by the plasticity of human thought and behavior, right? If so, a good mood can change outcomes, or at least change the behaviors that affect the outcomes.

Despite their best efforts, even positive people get in bad moods. It could be lack of sleep, or maybe being overworked or overwhelmed. Perhaps there is regret for having done something…or having done nothing. Emotional responses happen so quickly that it becomes a challenge to put a space between feeling and doing. Have you ever snapped at someone for no reason? Or fibbed and said you’re feeling great when you really felt like screaming? Maybe it’s time to figure out what’s standing between you and a smile, and to rewrite the story that precipitated the bad mood. The mood is yours. There’s no need to share it.

Nutritional deficiencies, mostly caused by poor diet, play a part in mood. Junk food equates to junk mood. Edible things devoid of nutritional value, washed down with sweetened, flavored and carbonated distilled water can make you feel depressed, irritable and sick. It’s little wonder that short tempers abound. Recent study has confirmed the importance of micronutrients to the expression of mood, and vitamin C is one of them. Hypovitaminosis is a term that describes vitamin deficiency, though most often associated with vitamin D. It happens when the system is unable to absorb the right amount of vitamins from food or supplements, and results in a number of medical conditions, like scurvy, beriberi, or pellagra, among others.

Vitamin C deficit is not very common in the general population, but does show up in cancer patients and in those with conditions that inhibit absorption. Age, poor diet, medications and obesity are contributing factors. The widowed elderly, for example, often do not eat properly because they don’t cook for themselves. Community settings can make a difference in their nutrient balance.

In acute care situations, as in a short-term hospital stay, hypovitaminosis is more common than one might think, and malnutrition of vitamin C (often accompanied by vitamin D) has been linked to mood disturbances and cognitive upset. In these cases, doses as little as 500 mg twice a day resolved issues with psychological distress and irascible mood (Wang, 2013). Because vitamin C is water-soluble, it needs to be replaced regularly. Most animals can make their own. Humans, apes and guinea pigs cannot. Without it, the body cannot make collagen or the neurotransmitter norepinephrine.

It’s not completely clear if hypovitaminosis C results from outright deficiency or from tissue redistribution as part of the acute-phase response. Investigations stand on both sides of the street (Evans-Olders, 2010). This response is an innate body defense during acute illness and involves the increased production of certain blood proteins, appropriately called acute phase proteins. Once activated, these substances cause the release of inflammatory molecules, the most well known being C-reactive protein (CRP), a marker unexpectedly related to mood disorders in the presence of even low-grade inflammation (DeBerardis, 2006) (Luukinen, 2010). Since CRP is also associated with increased risk of cardiovascular involvement, reducing it is a prudent objective on two fronts. Vitamin C was found to be as effective as statin drugs in lowering CRP levels by more than 25% in a study of individuals whose inflammatory markers put them at risk for a cardiac event (Block, 2009). In patients with active disease, such as cancer, intravenous vitamin C was found to have a salutary effect on CRP and pro-inflammatory cytokines (Mikirova, 2012).

Decrease in blood vitamin concentrations is common to the acute-phase response, but is more common because people fail to get the nutrition they need to maintain optimum health. A glass of orange juice just won’t cut it. Not only are mood and cognitive ability worthy of adequate nutrient intake, but also total physiological function. Supplements have been shown to improve mental processing and response to stress, to reduce fatigue, and even to attenuate psychological and physical damage from noise (Angrini, 2012), including high blood pressure (Fernandes, 2011). Vitamin C now has an identified mechanism of activity beyond that of anti-oxidant. It enhances mood.

References

Amr M, El-Mogy A, Shams T, Vieira K, Lakhan S
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Angrini MA, Leslie JC.
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Block G, Jensen CD, Dalvi TB, Norkus EP, Hudes M, Crawford PB, Holland N, Fung EB, Schumacher L, Harmatz P.
Vitamin C treatment reduces elevated C-reactive protein.
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De Berardis D, Campanella D, Gambi F, La Rovere R, Carano A, Conti CM, Sivestrini C, Serroni N, Piersanti D, Di Giuseppe B, Moschetta FS, Cotellessa C, Fulcheri M, Salerno RM, Ferro FM.
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Evans-Olders R, Eintracht S, Hoffer LJ.
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Fernandes PR, Lira FA, Borba VV, Costa MJ, Trombeta IC, Santos Mdo S, Santos Ada C.
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*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Feeling Anxious? Maybe Not

anxious-womanGood for you. You’re going to Disney World. But don’t say you’re anxious about it. It’s okay to be anxious about going to the dentist. It’s understandable that you’d be anxious about your debut at an IRS audit. Unless you‘re terrified by the characters, you’re eager, not anxious, about visiting Walt’s place. To be anxious is to be afraid, apprehensive, uneasy, or distressed, but not enthusiastic. Anxiety is a disorder with more than one characterization. It can display as panic disorder, obsessive-compulsive disorder, post-traumatic-stress disorder, social anxiety, and a few others, including various phobias. It’s even possible to be anxious about being anxious, to the point that the subsequent distress precludes a normal life.

A common emotion, anxiety is felt by most humans once in a while. Taking a test, facing a novel problem at the office, or making a difficult decision is enough to get you anxious. Being lost in a strange town makes you feel like a rat in a laboratory maze. These little upsets are supposed to go away. If they cause a lingering burn, it’s time to talk about it. Frustration with a task can cause anxiety, and anxiety about doing it in the first place can cause frustration, which then perpetuates the cycle. Replacing uncomfortable cognitions with calming thoughts—something you can learn to do yourself—is one path to serenity.  The Roman Emperor Marcus Aurelius wrote about dealing with frustration and anxiety two thousand years ago. So, this isn’t a new challenge. However, what is new is the discovery that the ninety percent of the cells that compose the body have the potential to respond to anxiety. These would be the intestinal bacteria that have the uncanny ability to communicate with the brain, a conclusion attributed to evolution but more than likely decided at the ontogeny. That a bidirectional communication system between the gut and the cerebrum exists has been established, and that it influences brain development and behavior through complex signaling mechanisms is amply defined (Diaz-Heijtz, 2011) (Collins, 2012) (Chen, 2013).

The connection between gut and brain is controlled by the vagus nerve, which is the longest cranial nerve, passing through the neck and thorax into the abdomen, where it directs motor and secretory impulses of the viscera—your innards. Stimulation of this nerve can instigate activity in a body process known as the HPA axis (Hosoi, 2000) (O’Keane, 2005), the hypothalamic-pituitary-adrenal axis, the control center for most of the body’s hormones, one of which is the steroid hormone cortisol. Cortisol is used as a biomarker for psychological stress (Djuric, 2008).  In response to physical or mental stress, the hypothalamus produces corticotropin-releasing factor, which binds to specific receptors in the pituitary gland, where adrenocorticotropic hormone (ACTH) is made. ACTH then moves to the adrenals to direct the secretion of cortisol. The idea behind cortisol is to break down body tissue to be used as energy. When rampant, it breaks down lean tissue to liberate amino acids that can be used to raise blood sugar. In adipose tissue, cortisol breaks fats into fatty acids and glycerol, which also elevate blood sugar.

To calm this activity in a kind of physiological riot control, the body enlists the major inhibitory neurotransmitter, called gamma-aminobutyric acid—GABA—to slow down the firing of nerve cells in the brain. Emily Dean, M.D., a psychiatrist practicing in Massachusetts, likens GABA to a glass of wine in front of a fire, to restful sleep, or to tranquility and yoga (http://www.psychologytoday.com/blog/evolutionary-psychiatry/201206/do-probiotics-help-anxiety). Paints a nice picture, eh? Negative alterations in GABA receptor expression are implicated in the development of anxiety and depression, which are comorbid with functional bowel disorders.

It’s been hypothesized that probiotics are able to make compounds that enhance the brain-gut link by acting as delivery vehicles for neuroactive substances, with each neurochemical being related to a specific strain of intestinal flora (Lyte, 2011). The strain Lactobacillus rhamnosus is known to modulate the immune system by manipulating tumor necrosis factor alpha (TNFa) and Interleukin 8 (Ma, 2004), two cytokine signaling molecules related to immunity and inflammation. In mouse studies performed in Ireland a couple years back, those animals preloaded with L. rhamnosus were spared a frantic response to physiological insult and stress, contrasted to their cage mates denied the probiotic, whose cortisol levels were extreme (Bravo, 2011). As expected, mice whose vagus nerves were severed had no similar neurochemical and behavioral effects, indicating the vagus nerve as the major thoroughfare between gut bacteria and the brain (Ibid). Even in the absence of insult, mice treated with lactobacillus presented with higher levels of anxiety-reducing receptors, the observation of which could not be made until their sacrifice. A lactobacillus, then, reduces stress-induced levels of corticosterone (the rodent equivalent of cortisol) by normalizing the HPA axis (Gareau, 2007).

The HPA axis helps to regulate physiological processes that include temperature, digestion, immunity, mood, sexuality and energy usage, besides controlling your response to stress, trauma and injury. If, as believed, the hypothalamus is involved with fibromyalgia and the adrenals with chronic fatigue syndrome, the use of a probiotic to tend to the HPA axis should ameliorate these assaults. If GABA plays a major role in the HPA stress response (Herman, 2004) (Cullinan, 2008), and if GABA production is enhanced by lactic acid bacteria (Dhakal, 2012), then a five-dollar treatment for anxiety is at hand.  Not only L. rhamnosus, but also L. brevis (Li, 2010), L. reuteri (Ma, 2004), and strains of Bifidobacteria (Barrett, 2012) work to produce GABA. This should settle once and for all that not all bacteria are bad.

References

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*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.