Nutritional treatments for obsessive compulsive disorder (OCD)

People often ask me if I can be of help for conditions like OCD, in addition to depression, anxiety, ADD, and so forth. My answer is always a resounding “yes!” although as with everything else results can vary from person to person.

When results are good, everyone is satisfied, and the next referral is just around the corner. However

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, when results fall short of expectations, it can lead to a lot of soul searching and disappointment on my part, and the patient often feels that there is no good alternative to drugs.

Recently the topic of natural treatments for OCD was discussed on an email list to which I subscribe. Most subscribers to this list are medical doctors, including many psychiatrists, and all have an interest in natural or integrative medicine.

The opinions expressed greatly validated my own beliefs and approach to healing this challenging condition. Current scientific opinion holds that OCD is the result of an imbalance between the neurotransmitters dopamine and serotonin, whereby there is too much dopamine activity in relation to serotonin. Read More »

Four interesting new supplements

These are supplements that have either been recently released or are new to me and are now available from my office.

Cereboost 6-hour: this supplement contains extracts from the herbs American ginseng, which improves focus and overall brain function, and Rhodiola rosea, which normalizes stress hormones, and therefore has a positive effect on irritability

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, impulsivity, and other related symptoms. This combination is fast-acting and seems to be very effective. Early reports have been that children are more organized and pay more attention, and adults are more able to multitask when taking it. Though my sample is small, so far no side effects were reported and only one child appeared not to tolerate it.

Though fast-acting the effects of this supplement wear off within approximately six hours of taking it, hence the name. While not a complete or long-term solution, it can be helpful as a brain booster when a little extra help is needed, or for children having trouble focusing in school.

XanthiTrim: this newly formulated supplement from Pure Encapsulations may turn out to be a major help for people trying to lose weight. With ingredients like decaffeinated green tea extract, pomegranate juice and seaweed it contains nothing that comes even close to being a stimulant or an appetite suppressant that could be harmful. What these ingredients all have in common is the ability to stimulate the body to burn fat. Therefore it is no surprise that in studies it was shown to enhance the weight loss effects of diet and exercise. Read More »

A Replacement for Natural High Is Being Developed

In addition to these four supplements, I used to carry a supplement called Natural High that many of my patients loved. It was highly beneficial for problems ranging from ADD to depression, anxiety, addictions and even sugar cravings. Unfortunately it was discontinued and has been unavailable for at least two years. I have now formulated my own supplement which, though different from Natural High, I believe will deliver the same benefits. This supplement is not in production yet and I still haven’t decided what to call it, but if you are interested in trying it, or used to be a fan of Natural High and have found nothing quite like it please call my office or email me and we will contact you as soon as we have it.

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6 supplements that really work

As a nutritionist I am very aware that some in my profession have a bad reputation for putting people on a long list of supplements that do little or no good. Whenever feasible, I always look for the smallest number of supplements that will do the job. Here are six supplements that I have found to be particularly effective either on their own or when taken with just a few other products.

If you like this article, post a comment below or email me and next month I’ll cover a few more of these supplements. There are probably a dozen more that could fit in this category.

1. BioEssence: immune system support
This was the first Chinese herbal combination I started to use in my practice based on the recommendation of a friend from Tennessee

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, Dr. Dan Kalb, who used to head the Family Practice department at St. Joseph Medical Center in Houston. It turned out to be incredibly effective for everything connected with the immune system. This includes rheumatoid arthritis, lupus, gout, skin disorders including eczema and psoriasis, not to mention allergies and asthma.

What amazed me the most about this herbal combination is that it does not work by suppressing the immune system, like western drugs for these conditions do, and has few or no side effects. I will not claim that is works in every case, but it does often enough, and when it does the results can be almost miraculous and remarkably fast.

Results I saw with this product gave me the incentive I needed to study Chinese herbal medicine, and I am glad I embarked on this project because it is now enabling me to help many more people in ways I couldn’t do before.
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Nutritional treatments for mental health: a very interesting seminar

I recently attended a seminar at a beautiful location near Lake Tahoe in California. The topic was Micronutrient Treatment and Research in Mental Health. The two main speakers were Bonnie Kaplan, Ph.D., a University of Calgary researcher who has been investigating the effects of nutritional products in mental health, and Boston psychiatrist Charles Popper, MD.

Dr. Popper was described in the seminar materials as a Child and Adolescent psychiatrist with many professional accomplishments in the field of psychopharmacology, or the use of psychiatric drugs, often in combination, to treat mental disorders. This led me to wonder, while I was on my way to the seminar, if half of the seminar would be dedicated to praising modern drugs.

As it turned out Dr. Popper does have a wealth of experience and knowledge of psychiatric medications, but he no longer uses them, or uses them very sparingly and only when absolutely necessary. Instead, for the past decade Dr. Popper has been treating psychiatric patients with nutritional supplements. Those who come to him on medications are rapidly transitioned to nutrients alone, and only for a minority of patients does he prescribe tiny doses of pharmaceuticals.
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Is it TV that causes criminal behavior in children (or is it what they eat in front of it)?

The debate over whether watching crime shows on TV instigates crime will probably never end. Supporters of this theory hold that impressionable youths copy behaviors they see on TV.

An article recently published in the Archives of Pediatrics and Adolescent Medicine suggests that the link between TV and crime may have a different cause: junk food. Yes, because as it turns out children who watch a lot of TV also consume vastly more junk food than their peers, possibly because of ads they see or maybe just because they just sit around all the time.

Is this just a wild theory designed for the joy and comfort of nutritionists like myself? Not so, at least if you pay any attention to the dozens of studies that link junk food diets with violent and antisocial behaviors.

In one of the studies researchers looked at jailed chronic offenders aged 13 to 17. After analyzing their diets researchers found that they consumed on average 63% of the iron, 42% of the magnesium, 39% of the zinc, 39% of the vitamin B12, and 34% of the folic acid recommended by the US government.

The researchers then gave half the subjects a supplement containing the vitamins and minerals they were missing and the other half a placebo. They also counseled all the all the youths about the importance of healthy diet and then made healthier meals available to all.

Sure enough, all those who heeded the advice and changed their diets experienced a drop in violent episodes. Those who changed their diets while receiving a placebo experienced a 50% drop – which seems pretty amazing to me – but the ones who were given the vitamin and mineral supplement in addition to changing their diets experienced an 80% drop in violent events. Of course no change was observed among inmates who did not change their diets.

Not only did the number of violent incidents drop, researchers also recorded brainwave patterns through EEG and found marked improvements after 13 weeks on supplements.

Read more about this at: http://society.guardian.co.uk/health/comment/0,,1765619,00.html and at www.monbiot.com (scroll down to “Feeding Crime”).

A world awash in chemicals

We have long suspected that chemicals interact with one another, creating destructive synergies, but this has been difficult to prove since very few studies have ever looked at the combined effects of multiple chemicals. This applies not only to chemicals in the environment, like pesticide residues or plastics, but also to medications, most of which are also chemical compounds. Although medications are studied for safety, these studies are only performed on one medication at a time, even though they may very well interact with one another and with other chemicals thereby creating new compounds with different and unknown safety profiles.

Now the tip of the iceberg may be starting to emerge, as a new study from Duke University looked at the interaction between the pre-term labor drug terbutaline (Bethine), for which one million prescriptions are written every year, and ubiquitous pesticide residues. The study used rats, but it is very likely that the results apply to humans as well since rats have consistently been shown to be more resistant to chemicals than we are.
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Nutritional therapy found to moderate violent behavior

A study of nutritional therapy in children suffering from violent behavior was recently completed at the Pfeiffer Treatment Center (PTC; see their website at www.hriptc.org) near Chicago and was published in the journal Physiology and Behavior (2004 Oct. 15; 82 (5): 835-9).

In this study, more than 200 children were individually evaluated and given nutritional supplement programs based on their specific needs. The evaluation phase included a history and exam, as well as a series of laboratory tests selected on the basis of PTC’s 10-year experience treating psychiatric disorders with nutrition and inspired by the work of the late Carl Pfeiffer, PhD, MD (detailed in his book “Mental and Elemental Nutrients”).

Results were dramatic; upon re-evaluation four and eight months after starting the program, more than 90% of participants had improved, with roughly 60% becoming symptom-free.

As impressive as this study may seem to many, it would be rapidly dismissed and considered “anecdotal” in mainstream medicine because it is an outcome study and not a double-blind study. In outcome studies patients are evaluated before and after treatment, as they are in double-blind studies, but none are given a sugar pill instead of the real treatment and both patients and doctors know what is being done.

The problem is that individualized nutritional therapy simply does not lend itself to analysis by double-blind study. This leads to a vicious cycle where vitamin therapy is considered quackery because there are no “valid” studies, which are not do-able, and the studies that are done are summarily dismissed. As inflexible as this position may appear, it reflects a deeply ingrained bias against natural and nutritional treatments.

In my work, I have long corresponded with the scientists at PTC and use evaluation criteria and nutritional therapies that are very similar to theirs.

Seasonal Affective Disorder (SAD) and Vitamin D

If you suffer from SAD, the end of daylight savings time is always bad news. SAD is characterized by symptoms of depression that flare up in the winter months when daylight hours decrease. It is far more prevalent up north, but I have seen it even here in Houston.

Since lack of sunlight obviously has something to do with SAD, treatment often involves daily exposure to bright white fluorescent light. However, this approach often doesn’t help and so many doctors just prescribe antidepressants.

An interesting theory is that it is not the lack of sunlight that causes depression, but the resulting vitamin D deficiency. Several studies appear to support this view.

In one study, 37 patients with marginal blood levels of vitamin D were given either 600 or 4,000 IU per day of vitamin D3 for three months, December through February. After this period, all patients reported improved wellbeing, with the higher-dose group faring significantly better (Nutr J 2004 Jul 19; 3 (1): 8).

In an older study, 15 patients with SAD were randomly assigned to receive vitamin D or daily light therapy. In this study only the group receiving vitamin D recovered (J Nutr Health Aging 1999; 3 (1): 5-7).

Last January I wrote about the many benefits of vitamin D (click on “Vitamin D” on the topics list of the Newsletters page on my website to view the full article). This vitamin plays important roles in calcium and bone metabolism, immunity, and protection from critical illness. If you suspect you are prone to SAD, that may be one more good reason to have your blood levels of vitamin D tested. The correct test to measure your vitamin D levels is one called “25-hydroxy vitamin D.” It is also important to ignore the lab’s reference ranges because they are based on the average of a vitamin D-deficient population. Instead, a good range is between 35 and 50 ng/ml.

If your levels are low, consider supplementing with vitamin D3, the most natural and safest form of this vitamin. Supplements in the range of 4,000 to 6,000 IU per day are safe for adults and probably necessary to reestablish adequacy if you are deficient. However, if you take high doses, it is important to monitor your blood levels of vitamin D through periodic testing and regular communication with your healthcare professional. Excessively high levels of Vitamin D can have toxic effects that could include kidney stones. Once an adequate level has been established, long-term maintenance intake of 1,000 IU per day has been shown to be safe (Am J Clin Nutr 2001; 73: 288-94).

Fish oil and mental function

The benefits of fish oil have been attributed to two fatty acids that are abbreviated as EPA and DHA. These play many important roles in the body: they contribute to the structural integrity of cell membranes and are converted to substances called eicosanoids that act as hormones, promoting normal communication between cells (including brain cells) and controlling inflammation. When early research showed lower rates of depression and mental illness in people who ate more fish, scientists studied the human brain and found it contains significant amounts of DHA. They concluded that DHA is best for the brain and EPA plays other roles in inflammation and heart health.

However, research failed to confirm this view. When the effects of EPA and DHA were compared in double-blind studies, EPA provided clear benefits whereas DHA did no better or marginally worse than placebo. This was seen in a number of conditions including schizophrenia and bipolar disorder (1). In a study of depressed patients who did not respond to standard medical care, pure EPA at a dose of 1 gram per day was found to be an effective treatment (2). The same dose of EPA was also found to provide some degree of help in borderline personality disorder, a condition that is usually non-responsive to drug therapy (3).

Leading fish oil researchers now believe that DHA only plays a structural role in the brain, whereas EPA contributes to its function (4). There is a critical need for DHA during fetal development and early infancy – the fact that DHA is found in breast milk is clear evidence of this. Past this early period, the need for DHA is limited and too much of it seems to actually have an adverse effect on moods.

Until recently, pure pharmaceutical-grade EPA was only available for research purposes, and all the fish oil on the market contained varying concentrations of both EPA and DHA. Now, the innovative Canadian supplement manufacturer Advanced Orthomolecular Research (AOR; see www.AOR.ca for more information) has introduced a pure EPA supplement called EPA Brite that is also available here in the online store.

(1) Schizophr Res 2001 Apr 30; 49 (3): 243-51, Prostaglandins Leukot Essent Fatty Acids, 2003 Dec; 69 (6): 477-85, Prostaglandins Leukot Essent Fatty Acids, 1999 May-Jun; 60 (5-6): 329-37
(2) Arch Gen Psychiatry, 2002 Oct; 59 (10): 913-9
(3) Am J Psychiatry, 2003 Jan; 160 (1): 167-9
(4) See The Omega 3 Connection, by Andrew Stoll, MD

Could You or Your Child Be Gluten-Sensitive?

Gluten is a protein found in commonly eaten grains, including wheat, rye, barley and oats (however, the gluten in oats is different and can be tolerated by some gluten-sensitive individuals).

Gluten sensitivity has been found to cause celiac disease, a severe developmental disorder. The association between gluten and celiac disease was discovered by pure coincidence during World War II when some children with the disorder “miraculously” recovered when deprived of wheat, only to relapse when wheat was reintroduced in their diet.
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Major campaign focuses on children’s health catastrophe

The Center for Children’s Health and the Environment, founded by a group of physicians and scientists from the Mount Sinai School of Medicine (New York City), recently began running full-page ads in The New York Times addressing the current crisis in children’s mental and physical health and its possible underlying causes. Ad themes and related information, including lengthy scientific papers on which the ads are based, can be found on the authors’ website at http://www.childenvironment.org.

The authors and sponsors of the ads, all listed on the website, belong to conventional medical and research communities and have the highest credentials. Every statement contained in the ads is supported by extensive scientific data, although this information is generally not reported in the media and most of us are not aware of it.
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Multi-vitamin mineral supplement treats intractable bipolar disorder

In this small pilot study (Am J Clin Psychiatry 2001 Dec;62(12):936-44) 11 patients with severe bipolar disorder, some of whom did not respond to standard medical treatment, were given a single high-dose multiple vitamin and mineral supplement on a daily basis. After six months on this regimen, researchers found that average symptom reduction ranged from 55% to 66% and the need for medication decreased by more than 50%. In some cases the supplement replaced psychotropic medications and the patients remained well.

According to researchers there are two possible explanations for the effectiveness of the supplement. One is that bipolar disorder stems from an inborn error of metabolism that leads to a critical need for high doses of vitamins and minerals, and the other is that a certain group of people may be especially vulnerable to vitamin and mineral deficiencies in the food supply and may develop the condition as a result of inadequate nutrient intake.

This small study is now being followed by a large-scale randomized, placebo-controlled study.