Vitamins for Mental Health

Vitamins for Mental Health

Mood can be addressed with a number of supplements while focusing on a healthy diet and getting enough sleep.   Here are some of my favorites.

Probiotics

The gut proves again that it is the beginning of healing.  Probiotics are very specific, and I would recommend ProbioMood by Pure Encapsulations.  Researched strains that show improved mood are important, and all probiotics are not created equal.

Vitamin D3

Our mood has been unequivocally associated with Vitamin D3 levels.  Getting our levels above 50 ng/dL is essential for good mental health.  Doing this with a trusted source is important, as very few over-the-counter supplements do this right, as such a minute amount is required and easy to get wrong.

Fish Oil (EPA/DHA)

Fish oil works on a lot of important processes in the body but maybe none as important as brain health and mood.  Getting the right kind is important.  It is suspected that a large majority of Americans are deficient in this essential nutrient for mood.

Lithium

This is one of my all-time favorites when addressing mood with trace mineral amounts like 5-20 mg a day.  Lithium has numerous positive effects, but the brain and mood effects are amazing, as my blog points out.  This is a no-brainer for most people and has been helpful even with people on anti-depressants.

Amino Acids

These are the precursors of our feel-good neurotransmitters, serotonin, and dopamine.  5-HTP is a direct amino acid precursor to serotonin and bypasses a genetic issue in a lot of people that prevents tryptophan from converting to serotonin.  Take 5- HTP with a meal.  L-Tyrosine helps make dopamine which improves energy, focus, and mood.  Take L-Tyrosine away from meals.

Magnesium

A randomized controlled trial published in PLoS ONE in 2017 reported that magnesium supplementation improved symptoms of mild-to-moderate depression in adults, in a similar range as what is seen with the use of antidepressant medications.  Although a small study, it will only help per my clinical experience and I use PowerMag, 2-3 a day.

B-Vitamins

Having activated folate and other B-vitamins is essential as the body can immediately use them in the essential process of making neurotransmitters.   I do this with a good multivitamin, like PureGenomics Ultramulti, which has lithium, vitamin D3 (4000 IU),  and magnesium as well.  

Addressing past trauma through counseling, sleep, diet, stress, and exercise is also essential as you cannot supplement your way out of a poor lifestyle, but it can help to give you more leverage to improve your mood.

Magnesium Deficiency and Hypertension

Magnesium Deficiency and Hypertension

In clinical practice, one fundamental problem I identify is magnesium deficiency, especially in heart and vascular issues like hypertension. Unfortunately, some of the popular blood pressure medications used to treat hypertension cause even more issues with low magnesium, which makes blood pressure harder to control. Here we will explore some ways we can control blood pressure problems by increasing our magnesium levels.

How Does Magnesium work?

Magnesium is an essential nutrient responsible for over 300 enzymatic reactions in the body. Here we will focus on its effect on blood pressure regulation. Hypertension is when pressure is above normal in our blood vessels. Over time, this causes damage to the heart, brain, and kidney. Ultimately, we want a blood pressure that supports the blood’s delivery of nutrients and oxygen without causing damage.

The physics of blood pressure

The more relaxed a blood vessel will determine the pressure that is inside of it. The best way to think of this is that a relaxed blood vessel is a bigger pipe with less pressure, and a constricted blood vessel is a narrow pipe, leading to higher pressure inside. It is important to relax the blood vessel and make it bigger so we can lower the pressure.

Blood vessels have smooth muscles which can relax or contract depending on the needs of the body. When a bear is chasing us, the blood vessels need to contract to increase pressure and flow, and when we are watching Netflix in our favorite recliner, our blood vessels should relax.

How can we increase Magnesium levels?

It is estimated that 70-90% of Americans are Mag deficient, and the recommended dietary allowance (RDA) is insufficient. The reasons are caffeine, medications, soil depletion, and, frankly, the nutrient-poor American diet.

Here are some ways to increase magnesium:

  1. Decrease caffeine and alcohol intake.
  2. Avoid common medications that lead to lower levels of magnesium.
  3. Make sure your Vitamin D3 levels are appropriate.
  4. Have the proper balance of Calcium to Magnesium in supplements or diet. (Excess Calcium drives Magnesium levels down.)
  5. Eat more magnesium-rich foods such as almonds, pumpkin seeds, spinach, and avocados.
  6. Daily Supplementation.

Medications associated with Magnesium deficiency

Some blood pressure medications and diuretics may actually cause low magnesium and ironically increase blood pressure. The most common of these is hydrochlorothiazide. I have not prescribed this medication in years because of its negative effects on magnesium retention.

Other popular medications contributing to deficiency are proton pump inhibitors like Prilosec and Nexium. I should not take these medications for over 2 weeks. They have a long list of conditions that manifest over time with prolonged use, including dementia.

Calcium aids the smooth muscles in the vessels to constrict blood vessels and increase pressure. Magnesium facilitates the signal to relax the smooth muscles. Many patients are put on meds to lower blood pressure called “Calcium channel blockers” such as Norvasc. What was the original calcium channel blocker? Magnesium. So, if we are deficient in magnesium, this relaxation is hampered, and pressure increases.

Lab testing for Magnesium deficiency

Unfortunately, serum lab tests are not very accurate for testing levels of magnesium.  The problem is that the serum level only shows what is in the blood and not in the cells where over 99% of magnesium lives. Levels have to be very low in your cells for this to show up in serum.

If magnesium is hard to test for, then how do we determine if we are magnesium deficient?

There is a high index of suspicion for inadequate magnesium intake because the list of conditions including muscle cramps, seizures, migraines, neuropathy, type 2 diabetes, and hypertension is long.

Adverse Effects of Magnesium

There is no such thing as overdosing on magnesium unless you have chronic renal failure. In that case, be very careful with supplementation. Otherwise, most people develop loose stools at first, which can be corrected simply by lowering the dose or using the more absorbable types of magnesium.

Types of Magnesium for Hypertension

There are many types of magnesium, and determining which one is right for you is important. It really comes down to absorption, and absorption is determined by what we combine the magnesium with. One of the least absorbed combinations is magnesium combined with oxide.  Magnesium oxide is sold inexpensively over the counter and is found in less expensive multivitamins. Unless you are constipated, I would recommend finding a more absorbable magnesium supplement.

Magnesium citrate is a better option and is more absorbable, and still very affordable.  It also helps with constipation, so I often use it when I want that benefit as well.

Magnesium combined with amino acids is helpful because the amino acids they are combined with are broken off and used. With magnesium glycinate, the glycine helps you relax and can help with anxiety.

Magnesium taurate is great for heart health, as the taurine amino acid is highly beneficial to the heart.

My new favorite is UltraMag Magnesium, from Pure Encapsulations, which gives you super absorbable magnesium and 1 capsule is almost equivalent to 2 of the pills of the formulations mentioned above.

Magnesium Dosages

Magnesium is inexpensive, about 60 cents a day, and has many other health benefits like:

  • Improving blood sugar levels
  • Relieving anxiety
  • Relieving constipation
  • Improving sleep quality

Regarding blood pressure, I would start with 1 pill at bedtime (magnesium helps with sleep) and increase every week until you get to 3-4 pills at bedtime (400-500 mg/day), or you can split them up to twice a day. If stools get loose, decrease by 1 capsule per day.

It takes up to 6 months of taking magnesium by mouth to get your body levels corrected if you are deficient.

Unless you have chronic kidney disease, try adding magnesium supplements to your routine and see the positive impacts for yourself.

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My Five Favorite Medical Myths

My Five Favorite Medical Myths

When you leave med school and residency, you are pretty sure you’re all that and a bag of tater chips. I did. Then, practicing medicine became a long and humbling journey. I’ve learned a lot, and I thought I’d share some falsehoods from my training, just in case these rumors are still circulating.

1. The body does things randomly. 

This is a common misconception in medicine. The doctor will say, “Oh, you have high blood pressure, well this pill will help lower it.” It may be true the pill will help, but high blood pressure is a reaction to a problem. It doesn’t just pop up.  You do not have a “pill” deficiency.  The question should be, “What is the body trying to tell us?” If we take the high blood pressure example, it may point to issues like nutrient deficiency like magnesium, or sleep apnea, or generalized inflammation, which leads to more diagnoses than just hypertension. The body is always talking to us. Functional Medicine helps us interpret what it’s saying.  

 

2. Nuts cause diverticulitis. 

This was passed down with relative authority in my training and was accepted as the truth by the medical community. We told patients to avoid nuts, popcorn, and fruit with small seeds. Diverticula are small pockets that form in the colon walls due to tissue weakness caused by increased pressure due to a lack of fiber. The assumption of nuts and seeds causing diverticulitis seems reasonable at first because small things fit in small pockets. The truth is, taking away the above foods takes away a great source of fiber for our good bacteria, which are essential for low pressure in the colon, and may increase your risk for diverticulitis. The research supports that these foods don’t cause diverticulitis.  

 

3. A calorie is a calorie.  

If I could get this belief to die, I would be a happy provider. “If you want to lose weight, eat less the 1400 calories a day” was the mantra they taught me. It didn’t matter where those calories came from. No one seemed to understand different foods cause totally different hormonal responses. For example, 100 calories from vegetables/ protein cause leptin release, curbing hunger and decreasing fat deposition. Sugar does just the opposite. You release ghrelin, which increases appetite, and fat deposition because of the insulin spike. Also, your genetics are a factor in determining which calories are best for you. For some people, monounsaturated fats like avocado cause weight loss, whereas saturated fat like coconut oil causes weight gain. You need to understand your genetics if you are going to understand why a calorie is just not a calorie. Even without your genetics, you can make your calories go a lot further by choosing to eat whole foods.

 

4. What you eat is irrelevant to your health. 

When I left med school, the knowledge about the GI tract’s role in our immunity was in its infancy. That it is associated with diseases like arthritis, depression, anxiety, asthma, allergies, and so on was not being taught. Our diet has everything to do with our body’s “random” actions. If you have a medical issue, the diet is the first thing to change.  Over 90% of our immune system activation occurs in the small intestine, and an overactive immune system drives all the diseases listed above and many more. It makes sense to start here. You’ll usually see amazing results if you remove the most inflammatory foods like sugar, gluten, and dairy.

 

 5. Vitamins make expensive urine. 

This is a saying in medicine that is as old as the hills. I still hear it often, and the literature doesn’t support it. Here is an example of why this is not true-90% of us are deficient in choline and need supplementation. 

Here is a list of things choline does for us: 

  • Unborn children have improved stress resiliency and improved cognition 
  • It prevents fatty liver disease
  • improves mentation and helps fight memory loss. 

Surprise! It’s not expensive at all and definitely does not go into your urine. There are countless minerals like magnesium, vitamins like zinc and vitamin D3, and supplements like curcumin, resveratrol, and omega 3’s, to name a few where research shows supplementation makes a huge difference. Now absorption matters here, and the quality of the supplements determines bioavailability, but this is complete crap that “vitamins make expensive urine.” 

I’m glad for all these myths now. Having believed them and then finding out they weren’t true, I assume nothing and research everything now. 

Five Ways to Take Control of High Blood Sugar

Five Ways to Take Control of High Blood Sugar

Did you know diabetes and cancer are diseases of ‘too much energy’? Yes, we need to make energy to live. But when that energy production yields excess waste products and we cannot remove them, it causes trouble. Every engine, (in this case, cell mitochondria) produces waste. But, if we are eating lots of antioxidants, like berries, fish, and vegetables, exercising, and getting enough sleep then this should not be an issue. When waste products accumulate, they cause inflammation, and the body reacts by leaving the blood sugar high. So, elevated blood sugar is a sign the body is not running efficiently.

Elevated blood sugar is a symptom, and not a cause of disease. Research does not support the notion these diseases are inherent, so when you make good lifestyle choices, you take control of your health destiny.

Here are five basic things you can do to cool down the inflammation and improve your cellular health:

  1. Avoid simple sugars. Men should eat only 35 grams a day and women only 25 grams. The average American consumes 3-5 times this amount.
  2. Exercise- even 15 mins a day of walking helps improve antioxidant status and lowers blood sugars. A little goes a long way.
  3. Eat high antioxidant foods- “A higher intake of fruit, especially berries, and green leafy vegetables, yellow vegetables, cruciferous vegetables or their fiber is associated with a lower risk of type 2 diabetes.”
  4. Lower your blood sugar with supplements like magnesium and berberine. There is a new Berberine with In-Sea2 that slows the absorption of sugars, lowers blood sugar, and helps with weight loss.
  5. Support your mitochondria. Taking antioxidants like resveratrol, Co-Q 10, and Liposomal Glutathione, are helpful. Add a good multi like PureGenomics Multivitamin to be sure you have enough Bs on board.

Follow these tips to jack up your antioxidant status, lower your inflammatory responses, and get great sleep to keep the garbage going out to the curb. Your mitochondria will thank you!