The evidence suggests that the nutritional approach it not only more effective than anti-depressant drugs it has nothing like the risk of often quite serious side-effects. Optimum nutrition plus psychotherapy is the way forward, not drugs with a proven record of potential harm. So, why not do it?
Well, you could argue that there’s not enough research to conclusively prove all these benefits. The trials are quite small, although well designed. That’s true to an extent and it’s also unlikely to change since there’s little profit to be made from non-patentable nutrients such as omega 3, folic acid or 5-HTP. Psychiatrist Dr Erick Turne from the Mood Disorders Center in Portland, Oregon, who uses 5-HTP in his practice, says: ‘Unfortunately, because 5-HTP is a dietary supplement and not a prescription pharmaceutical, there is comparatively little financial incentive for extensive clinical research.’
What’s more most GPs are also unfamiliar with this kind of food-based medicine. “A GP receives virtually no training in nutritional approaches to depression. It’s an obvious oversight given the wealth of evidence,” says André Tylee, professor of primary care mental health at the Institute of Psychiatry. But that is no reason why you shouldn’t try it yourself with the help of a trained clinical nutritionist.
The Building blocks: Most of these studies used 300mg of 5-HTP, however we ideally recommend starting with 100mg, or 50mg twice a day. 5-HTP is best absorbed either on an empty stomach or, ideally, with a carbohydrate snack such as a piece of fruit or an oatcake. Otherwise, make sure you eat enough protein from beans, lentils, nuts, seeds, fish, eggs and meat, which are all high in tryptophan. If your motivation is low you could also supplement 1,000mg of tyrosine.
The Catalysts: test your homocysteine level, which can be done using a home test kit (If your level is above 9mmol/l take a combined ‘homocysteine’ supplement of B2, B6, B12, folic acid, zinc, and TMG, providing at least 400mcg of folic acid, 250mcg of B12 and 20mg of B6. If your homocysteine score is above 15mmol/l double this amount. Also eat B vitamin rich whole foods – whole grains, beans, nuts, seeds, fruits and vegetables. Folic acid is particularly rich in green vegetables, beans, lentils, nuts and seeds while B12 is only found in animal foods – meat, fish, eggs and dairy produce.
Fish oils: You need about 1,000mg of EPA a day for a mood boosting effect. That means supplementing a concentrated Omega 3 Fish Oil capsule providing 500mg, twice a day and eating a serving of any of the above fish three times a week.The most comprehensive review and meta-analysis of 19 trials on patients with mild and major depression ‘concludes that ‘the use of omega-3 fats is effective’ both in patients with major depressive disorder and milder depression’.
A stable fuel supply: Eating a diet that will stabilise your blood sugar (known as the Low GL diet) and supplementing 600mcg of chromium. Supplements generally come in 200mcg pills. Take two with breakfast and one with lunch. After a month reduce to one with breakfast and one with lunch. Don’t take chromium in the evening as it can be stimulating.
Dig deeper by reading The Feel Good Factor for all the evidence to support this approach, and its comparative effectiveness and safety compared to the conventional treatment of depression.
Working with Your Doctor
Much of what we recommend you can either do for yourself or seek the guidance and support of a nutritional therapist. However, the process of weaning yourself off anti-depressants is something you need to do with the support and guidance of your doctor. We recommend that 5-HTP not be taken in significant amounts, above 50mg, if you are on an anti-depressant – 5-HTP helps the body make serotonin while SSRI anti-depressants stop it being broken down. If your doctor is willing to wean you off anti-depressants it helps, at the same time to wean you on to 5-HTP, gradually building the daily amount up to a maximum of 300mg, but no more than 100mg before your are completely off the anti-depressant. In our experience this minimises and shortens the withdrawal effects that many people experience coming off anti-depressants.
The Brain Bio Centre in London treats people with depression using a Food is Medicine approach.
Come to my Optimum Nutrition for the Mind workshop to learn more.