Schizophrenia Defined

Many definitions seem confusing when it comes to defining schizophrenia.

Schizophrenia is a condition where the receipt of sensory information is distorted to the degree that the way one perceives the world (from the five senses, i.e. hearing, vision, touch, taste, smell) differs drastically from actual reality yet, it is perceived as real. When mis-information becomes the dominant sensory input, the output becomes distorted and we see that thinking becomes altered to the point where it is a thought disorder and bizzare thoughts and delusional thinking dominates. If you can’t recognize what is real, it becomes difficult to manage emotions, think clearly, communicate and make judgment calls.

Gradually we see more and more reports of hallucinations with strange and bizarre thoughts and behaviors. Such people begin to misconstrue reality and present with paranoid suspicions that others are out to harm them which may scare or frighten them. Behavior and speech can become quite disorganized. Behavior may appear so bizarre that one might think that these patients are on a street drug. Advancing cases can’t keep track of thoughts and trail off which is a symptom called ‘ideas of reference’.

In the state of sensory over-stimulation, emotions flatten out and ones expression becomes ‘wooden’. Onset is gradual and insidious but some symptoms can advance quickly when the biochemical upset starts to dominate. These patients tend to withdraw from the over-stimulation and prefer to be left alone. This is called ‘withdraw from society’.

Those affected are unfortunately often the young and intelligent portion of society.

Early Onset and hopeful Early Intervention

In the young we see the social development landmarks have not been well ingrained and many lose out in this regard. Early in the course of the disease however there is less brain tissue structure compromise and this makes for the best timing for intervention. Of course interventions vary.

Advanced clinical nutrition interventions in this early stage are the most promising in terms of positive outcomes if you look at the history of treatment. The Naturopathic Medical Research Clinic is offering an opening for patients in early stages of schizophrenia (in the first-episode of schizophrenia) to take advantage of such treatments. Secondary prevention aspects have been observed while using clinical nutrition for schizophrenia. The rationale for treatment is explained well in the following review on schizophrenia.  

Can Schizophrenia be Prevented

If you look at the definition of prevention we can see what we mean when we say we are helping you prevent a disease such as schizophrenia.

Primary prevention

Primary prevention methods of assessment and treatment would look to avoid the occurrence of schizophrenia.  At this point in time we can assume based on our positive response rates with clinical nutrition that yes it could be possible to prevent high-risk populations from preventing schizophrenia. This would be an amazing thing if society could benefit so greatly from a simple nutrient intervention. Health promotion efforts of this type are a thing of the future but, based on my clinical experience, I consider that primary prevention is possible.

At our clinic we have a rationale of treatment that would help high risk family members to lessen the likelihood of schizophrenia from occuring.  

Secondary Prevention

Secondary prevention methods of diagnosing, assessing (biochemical nutirent imbalances) and treating schizophrenia would look to intervene in the early stage before it causes significant harm or morbidity. Our clinic experience is that such cases respond extremely well in the majority of prodromal and first episode cases. Of course recognition of the pre-schizophrenic (prodromal) symptoms is a key component and here below we provide a snapshot look at what prodromal symptoms to look out for.

Prodromal symptoms to look out for include in descending order with the more frequent symptoms listed first include: reduced concentration, reduced attention, reduced interest/motivation/drive, depressed mood, disturbed sleep, anxiety, withdrawal from social situations, suspiciousness, deteriorated role functioning, and irritability. (This research article goes into great depth on the insidous nature of pre-schizophrenic symptoms as described above — Yung & McGorry: The prodromal phase of first-episode psychosis: past and current conceptualizations. Schizophrenia Bulletin 1996; 22(2): 353-70.)

Tertiary Prevention

In tertiary prevention you must interceed with a method that aims to reduce the negative effects of an existing disease state by aiming to restore function and reduce disease-related symptom complications. So this includes helping patients that are more chronic to lessen the degree and frequency of the main symptoms of hallucinations, delusions, emotional flattening and social withdrawal. Other aspects of a successful tertiary prevention treatment include may involve helping patients sleep better, concentrate better, and start to enjoy life and feel more motivated.

In chronic cases in our clinic we rate symptoms before and after treatment and have found a majority acheiving 40-60% improvement over the course of 2 years treatment. 

Quaternary prevention

Quaternary prevention methods aim to mitigate and avoid if possible the effects caused by use of unnecessary or excessive interventions in the health system. Here we see a great need in schizophrenic patients that come to us. They are often on medications and are experienceing side effects such as unwanted muscle movement effects and cardiovascular risks and other lengthy lists of putative symptoms caused secondary to neuroleptic treatment.  

Manganese/B3/C/EPA theray is for example, a great benefit to clients experiencing muscle movement side effects (EPS).

The end goal is to help alleviate these effects directly and by working with your MD to maintain the lowest effective dose of the medication causing the problem after acheiving 40-60% consistant improvement of symptoms.

Schizophrenia is more Common than you think

If you group 100 people from the general population you will find one schizophrenic. Globally this translates into about 70,000,000 schizophrenics world wide. Globally, 700,000 to 2,800,000 million new cases arise every year.

Who is affected with Schizophrenia

The most commonly affected are the young with an average of age of onset of 18 if you are male and 25 if you are female.

Impact on the Family Unit

Schizophrenia affects a person’s functioning in 3 ways:  it affects daily activities, the ability to function in an occupation and, the ability to function socially in relationships or otherwise.

Daily we see problems in self-care  in the following areas: dressing, grooming, bathing, looking after health related issues, and keeping the home environment in order and clean.

Socially we see strain on relationships due to the communication barriers. They exhibit poor communication skills and poor ability to sustain deep relations which require more advanced social skills and, we see a compromise in their ability to care for others.

Occupationally what do we see? We see poor ability to not only acquire but also sustain/hold a job. Poor social and cognitive skills are not desirable in today’s work environments so job tasks and responsibilities need to be if possible, tailored to the individual.  Work around the house can even be difficult for a schizophrenic and for students, homework and studying routines are often quite difficult to do.

Medical doctors can and do diagnose clear nutrient deficiency diseases that are well known including phenylketonuria, (phenylalanine inborn error of metabolism), kwasikor syndrome (starvation state), beriberi (B1 deficiency), iron deficient anemia, and pernicious anemia (B12 deficient state). Medical doctors have a common respect for therapies that correct these overt nutrient deficiency diseases and supplement by means of nutrient-correcting therapy to support and/or prevent these problems.

Practitioners that go beyond the scope of assessment and treatment of the obvious nutrient deficiency diseases include naturopathic doctors, functional medicine specialists, and orthomolecular practitioners. These practitioners endorse nutrient-correcting therapeutics that are dependant on comprehensive assessments that go deep into the biochemical trends of deficiency states. Some of the tactics implemented in the treatment of schizophrenia for example are covered well in my 2008 review on schizophrenia.

Medical doctors also assess and treat obvious toxicity states such as wilson’s disease (inherited copper toxicity state). Toxicity states are also assessed by naturopathic doctors, functional medicine specialists, and orthomolecular practitioners. Such practitioners can pick up on non-inherited copper toxicity states by assessing lab findings with respective copper toxicity symptoms presentations common to for example depression, anxiety, bipolar, ADD, and OCD.

Similar Medically Defined Paradigms of Treatment

The following definitions may help us understand further the similarities between mainstream conventional pharmaceutical based medicine and naturopathic , functional, and orthomolecular medicine.

Functional Medicine

Medicine that assesses and intervenes with the aim of improving biochemical physiology to enhance emotional, cognitive, and physical health. Metabolic function is considered from an evidence-based scientific perspective. Systematic assessment covers key areas including environmental influences, mitochondria and oxidation energy states, mind-body connection, digestive health, inflammatory states, hormonal imbalance, and detoxification pathways. Functional medicinal treatment is considered a first-line of treatment in many countries. Treatment includes nutrients, herbs, natural non-synthetic products, and dietary intervention.

Naturopathic Medicine

Medicine that covers several methods of medical treatment but includes among other modalities, clinical nutrition and botanical medicine. Naturopathic assessment can cover all body system assessment and treatment modalities mentioned above in functional medicine.

Orthomolecular Medicine

A medical approach that looks foremost at nutrient- and diet- correcting aspects of assessment and treatment.

Functional, naturopathic and orthomolecular medicine are nutrient correcting therapies that consider genetic predisposition and environmental disease risk factors.

Mainstream Conventional  Medicine

Medicine that endorses the view that symptoms, lab findings and genetic histories can assess and diagnose a condition (or risk factors for a condition) which is then often treated with a synthetic drug or nutrient with a degree of specificity aimed at combating the disease state.

Laboratory Results are considered key in mainstream conventional (pharmaceutical-based) medicine as well as naturopathic, functional, and orthomolecular medicine

Laboratory results help us confirm and differentiate biochemical problems or to diagnoses conditions. Lab results can also dictate treatment. Here there is a solid common ground between mainstream, functional, naturopathic and orthomolecular medicine. The Symptoms Picture begins to make sense when you factor in the lab findings. Treatments based on symptom and laboratory findings have a clear aim to target the mechanism directly or indirectly as best they can to improve the quality of life of the patient.

The mainstream approach has a solid common ground with nutrient-correcting lab-based therapy. 

Separable and Inseparable Aspects

These approaches are inseparable but also with clearly distinct advantages.  For example:  potent drugs may be needed to abate overt ingrained chronic symptoms quickly when functional, naturopathic, and orthomolecular therapies can not;  nutrient-correcting therapy in first-episode schizophrenia can be pivotal in achieving profound symptom alleviation;  and nutrient deficiency aspects considered by functional, naturopathic and orthomolecular medicine are usually assessed and treated by looking at deficiency trends before they become ingrained.

Introduction

In 2005, I co-authored an updated English version of the book Minerals in Health and Disease (written originally in German) with Dr Klaus-Georg Wenzel MD, a neurologist and psychiatrist. It is an excellent desktop reference and copies of the book are available via the International Schizophrenia Foundation. 

Here in a chapter by chapter sequence, The Elementology of Mental Health (A to Z) will unfold with a similar format but with different content than Minerals in Health and Disease. Here you will see a compilation of clinical perspectives with specific attention to the elemental components, that is, the mineral and metal factors, pertinent to mental health. The focus is on the clinical treatment of schizophrenia, depression, anxiety, bipolar, ADD and OCD.  This look into the world of clinical ‘elementology’ describes the toxic and beneficial influence of elements on mental and physical health.  It describes associated symptoms and biochemical imbalances common to the physical body and the human mind. Environmental exposures are a key part of the discussion.      

Dr Ray Pataracchia ND BSc

Clinic Director

The Naturopathic Medical Research Clinic

Silver (Argentum – Ag)

Functions:

Not known 

Therapeutic application:

Topical astringent, improves wound granulation, anti-bacterial, disinfectant

Negative biological effect:

Silver can compromise inner organs and cause ”rheumatic” joint symptoms; in patients with a multiple heavy metal load it deters the initial progress of heavy metal removal.

Sources:

Eye drops that contain silver, dental amalgams (also contain tin and mercury), photography paper (silver –bromide, -iodide, and -nitrate), electrical products (silver is the most conductive metal), silver bearing production, silver- and gold-smith work (in nature, silver is often found with gold), and the handling of silverware, jewelry, decorative items, and sterling silver (often alloyed with copper; at one time used to make coins in the US). Silver is used in x-ray fixer solutions found in dental offices; the silver in such fixer solutions is reclaimed by chemical processing.

Silver in our body:

External skin contact can cause irritation and allergic dermatitis. Continual external exposure to silver can lead to skin and body tissues deposition. Silver can pigment the skin blue or black (argyria). Argyria is thought to be a relatively benign but permanent cosmetic skin condition.

Sliver that is carried into systemic circulation can damage organs and cause ‘rheumatic’ symptoms in the joints, ligaments, muscles and spine. Silver toxicity is also associated with anxiety, rapid exhaustion, headaches, memory loss, and nausea. In humans, silver over-exposure can cause heart problems and permanent nervous system and brain damage. Silver vapor exposure can irritate the respiratory tract, cause breathing problems, headaches and dizziness. In extreme cases vapors can cause confusion, staggering, drowsiness, unconsciousness, and coma/death. In lab animals, silver over-exposure can cause organ damage (brain, kidney, liver, eye, lung) and anemia.  

Copper and zinc are antagonistic to silver. In treating mental health conditions, both of these elements are of pivotal importance. Copper is used in catecholamine production and the executive functions of the frontal cortex including planning and thought processing. Zinc is involved in protein and neurotransmitter manufacture.

Silver in general is not too difficult of a heavy metal to remove. Removal requires optimal zinc dosing and thyroid support when indicated. Adequate concentrations of copper should be supplemented while dosing zinc as this will also help reduce the silver load.  

Silver in low concentration is an astringent and bactericidal. Its lunar caustic formation is corrosive. Silver drops are used to prevent gonococcal conjunctivitis, an eyeball/eyelid infection that can cause blindness in newborns.

Silver in our environmental:

This precious metal can be found naturally in mineral-rich areas of Canada, Mexico, Germany, Norway, Bolivia, and Honduras, in soil, plants, and mines and, by isolating it (indirectly as a byproduct) while refining other metals. Globally, in 1977, industrial waste accounted for the release of 2500 tonnes of silver to our environment. The environmental exposure of silver by industrial waste release is currently not considered a public risk.

For an in-depth look at toxicity, exposures, and environmental waste aspects associated with silver, I will refer you to the book Nano and Biocidal Silver: Extreme Germ Killers Present a Growing Threat to Public Health.  

Here we discuss the energy-mental health connection associated with food intolerances, environmental chemicals, and heavy metals. We provide a glimpse into a simple protocol strategy to detoxify and improve energy and mental health.

Food Intolerance related Energy Drops

The body has greater likelihood to treat large proteins as foreign especially if you are continually exposed to them over time. Foods that contain such large proteins that you can react to include wheat/rye/barley (the main gluten-grain sources), oats (contain gliadin, similar to gluten and not always problematic in Celiac Disease), corn (often contaminated with gluten), dairy/milk products, (which contain whey and casein) and other food items. An immune over-response can trigger a behavioral array of problems. Problems observed in the mental sphere include emotional disturbances, schizophrenia, depression, anxiety, bipolar, ADD & OCD. Physical problems observed include fatigue, heart/pulse rate racing, skin problems (the skin is the dumping ground of toxins that the body can not rid), digestive disturbances and joint problems).

In the case of ADD and hyperactive ADHD children researchers see gluten, dairy, sugar (‘saccharine disease’), dyes, flavors, additives, and preservatives playing a role.

A recent peer-reviewed PubMed article by Millichap and Yee shows one of many groups of researchers that consider the link between food intolerance and ADD/hyperactivity to be significant.

Many researchers are reporting difficulty introducing elimination diets but my experience differs. A 3 week elimination of gluten or dairy (a typical prescripotion at the second visit) can easily be done by giving patients advanced preparation.

Patients need to be educated clearly on how to do a food elimination (how to shop, how to make 7 winner meals that they like) and be given the time to shift lifestyle (often a month or two) so that they are comfortable with a brief lifestyle change.

You may feel better when you eliminate the food intolerant item for 3 weeks but simple re-introduction of the food item is the diagnostic clincher; those that react to re-introducing the food item are intolerant. If such patients eliminate the food item for 6 months they can try re-introducing it again and if they still react, they have a fixed allergy and likely need to eliminate this food thereafter. Those that do not react after 6 month elimination may do well rotating the food item by doing it every 3 or 4 days. 

In the case of schizophrenia, patients can become psychotic after eating oysters or chocolate chip cookies (gluten containing), though the major food intolerant instigators in this (and other mental health conditions) includes foremost gluten and dairy, then corn, eggs, soy, and secondary items (citrus, nuts, rice, etc).

An energy drop is a major sign of a food allergy. Eliminating offending items from your diet can mean the difference between remaining well, keeping symptoms at bay, and maintaining high energy throughout the day.

Environmental Chemical related Energy Drops

We get exponentially more and more environmental chemical exposure, direct and indirect.  Sources include food additives, pesticides, plastics, and household and industrial solvents. The majority of environmental chemicals are neurotoxic, that is, they have the ability to disrupt or destroy brain and peripheral nerve cell function, thereby eliciting indirect effects on our overall behavior, including our emotional/mood stability, our ability to concentrate, our ability to receive sensory information undistorted (important in schizophrenia), and our ability to remain calm, cool and collected (as opposed to being agitated or, in some cases, violent). Marijuana and other recreational drugs often contain neurotoxic contaminants. The list is extensive.

One’s sensitivity to chemicals varies and it is not uncommon to see an entire household exposed to the same conditions with only one or two members falling ill. The long-term effects are not seen in all members right away, but the down-the-road-effects can be ‘felt’ later with predispositions toward infertility, auto-immune conditions, cancer, and allergies surfacing after exposure to environmental stressors. 

The ability for the body to rid itself of the constant bombardment of environmental exposures is taxing on body systems, especially the immune and liver/kidney/bowel detoxification systems. Such dedication to toxic exposure removal will ultimately drain our energy supplies. The thyroid and adrenal glands are master glands that take a big hit here and when they weaken, chemicals deposit into tissue. The trigger for gland or organ weakening can be external stressors including a stress filled environment and pathogen exposures such as Epstein Barr virus (mononucleosis) or other viruses and bacterial invasions. Epstein Barr virus convalescence is associated with chronic fatigue.

Trichloroethylene (TCE) is another example of a neurotoxin. TCE is found in water supplies, schools, homes, adhesives/glues, photocopier exposures, floor polish, coffee, paint, dry cleaning liquids, carpets, ink, and fumigants. It is associated with energy depleting fatigue, dizziness, depression, Parkinson’s disease and psychosis.

Fluoride in toothpaste and tap water and chlorine in tap water, pools, and hot tubs also have known toxic effects including emotional disturbance.

Heavy Metal Toxicity related Energy Drops

Toxic metals in the environment also disturb ATP production at the cellular level so we need to address this if our aim is to improve energy and mental health. In schizophrenia, depression, anxiety, bipolar, ADD, and OCD we see low energy with heavy metal toxicity as a primary syndrome. The greater the heavy metal load the greater the diversity, frequency and intensity of symptoms (including fatigue).  

Toxic metals are minerals that have no known necessary function in the body, and in fact are very harmful.  Examples are mercury, copper, lead, cadmium, aluminum and arsenic. Toxic metal sources are found in air (industrial pollutants), food, and water.  Targeted lab testing is ideal for detecting toxic metal exposure.

Toxic metals deplete zinc which is needed for normal brain function and neurotransmitter production.

Copper is important in development and frontal cortex executive functions (catecholamine cofactor) but in toxic levels can be overstimulating and neurotoxic. Copper toxicity is associated with schizophrenia, depression, anxiety, bipolar, ADD, and OCD. Also linked to copper is post-partum and hormonal depressions.

Mercury also causes mental disorders (anger, irritability, memory decline, mood disorder, psychosis, behavior disorder) and immune compromise.  I see many cases of auto-immune conditions stemming from mercury toxicity including Hashimoto’s and Grave’s thyroid disease, rheumatoid arthritis, and food allergies.

For a full review of all toxic metals and essential minerals, you can refer to the book Minerals in Health and Disease . I co-authored this book in 2005.   This book reviews the A-Z of macro minerals, trace minerals,  and toxic metals. It is a desktop reference for clinical practitioners and lay people. This book is available for order through the International Schizophrenia Foundation.

Detoxification to improve fatigue

A variety of detoxification therapies exist and the list is exhaustive: infrared sauna, coffee enemas, colon cleansing, specialty detoxification machines, clay baths, salt baths, detoxification patches, etcetera. We strongly recommend the least costly approaches. 

Our detoxification approach focuses on botanical liver support and maintaining adequate bowel movements to rid toxins.

The majority of metals are removed via liver-bowel. Botanical medicine and magnesium therapy are key to maintaining adequate bowel movement frequency. Low thyroid states compromise bowel removal so this needs to be optimized in a comprehensive detoxification protocol. Colonics are recommended in those cases that are having difficulty removing copper or who have returning metal loads.

Mercury uses the kidney route of removal and is removed effectively with glutathione and patented thiols (sulphur containing molecules that aid phase 3 detoxification). If the kidney route of removal is blocked, R-lipoic acid is useful.

Cells making energy from glucose

All cells of the body, including brain cells, make energy out of glucose which can be derived directly out of carbohydrates or indirectly via proteins and fats (gluconeogenesis). Inside the cells of the brain and elsewhere we see the direct need for chromium and B3 (glucose tolerance factors) to activate insulin to take sugar into cells. We also see the need for B-vitamins (B3, B6, B5) and mineral cofactors (magnesium, manganese) to aid the cells’ powerhouse (the mitochondrial glycolytic cycle) to produce ATP.

So if you are nutrient deficient and your diet does not supply adequate nutrients then it is difficult to produce ATP and mental health suffers.

Does your body make energy too fast or too slow?

Everybody has a different rate of making energy and this process needs to be in balance.

Do you have a fast metabolism? People that break sugar down too fast (fast metabolizers/oxidizers) produce metabolites that disturb the body and can result in fatigue if prolonged.

From a mental state perspective fast oxidizers are prone to ADD, irritability, anxiety and panic (in some cases mania). Fast metabolic rates are seen in children that have ADD and while the body can sustain this state it often gives out and vacillates to a slower state.

Do you have a slow metabolism? When the sugar isn’t broken down fast enough (slow metabolizers/oxidizers) tiredness is readily seen.

From a mental state perspective slow oxidizers are prone to psychosis or schizophrenia, poor motivation, apathy or disinterest, depression,  OCD, mania or bipolar, or lethargy and spaciness with brain fog.

What does Hair Tissue (Cellular) Mineral Analysis (HTMA) tell you about energy metabolism?

There are specific slow and fast metabolic trends that we can pick up using HTMA. Fast metabolizers have higher potassium and sodium (nervous system stimulating minerals) levels in cells, levels which are assessed using HTMA. Fast metabolizers are often calcium and copper deficient. Their calcium versus phosphorous ratio is often depressed.

Slow metabolic types on the other hand, have higher magnesium and calcium (nervous system sedative minerals) levels in cells, levels which are also assessed using HTMA. Their calcium versus phosphorous ratio is often elevated.

Using HTMA testing in conjunction with blood testing?

Hair analysis is a key part of a comprehensive battery of testing done as a standard of care at the Naturopathic Medical Research Clinic (NMRC). HTMA allows us to factor in and compare the tissue (cellular) metabolic and deficiency state versus the blood borne metabolic state. HTMA factors in information to assess minerals (copper, zinc, manganese, molybdenum, selenium, etc), heavy metals (lead, organic methyl mercury, cadmium, aluminum), thyroid and adrenal related mineral ratios, and protein breakdown (catabolic) states. When used in conjunction with blood findings which are transient and mostly extracellular, HTMA levels can be quite revealing. The top nutrient imbalance syndromes assessed at the NMRC are listed on our syndromes web page.

For example, we see about 70% of copper toxic cases with high copper in cells (tissue), where it has a higher attraction (affinity), and low copper in the blood. This is a classic example of bio-unavailability, a compartmentalization of a mineral in toxic levels in the brain and liver where it likes to reside at the expense of peripheral deficiency; that is a toxicity and deficiency state. Compartmentalization also occurs during bacterial infection (e.g. strep infection) where iron comes out of blood and deposits in tissue to avoid blood bourne bacteria that uses iron for survival. During periods of bacterial infection we see depleted blood iron levels that normalize after the infection subsides.

Our next blog: I’m so tired: Part 3

Food Intolerance related Energy Drops

Environmental Chemical related Energy Drops

Heavy Metal Toxicity related Energy Drops

Detoxification to improve Fatigue

Energy is intimately related with mental health. Lack of energy and tiredness/fatigue/exhaustion can either be an aggravating or causative factor of mental health conditions. It is said “If you have energy you can’t be depressed”. This is true in general of all mental health presentations including the majority of cases of schizophrenia, anxiety, depression, bipolar, ADD, and OCD. Without energy molecules the brain can’t do its job. Orthomolecular nutrient correcting treatments are ideal for energy maintenance.

From glucose the body makes ATP (adenosine triphosphate), the energy molecule used to drive most all non-passive metabolic processes.

At the root of the problem, from a clinical perspective, we therefore see the need to improve energy metabolism by assessing and treating energy associated nutrient imbalances.

Hypoglycemic energy fluctuations

The brain is a demanding organ with its need to maintain high blood volumes and a ready supply of glucose (sugar). Brain function is the first to suffer when there is a glucose supply interruption. In glucose deprived (hypoglycemic) states our brain has reduced abilities and it becomes difficult for the brain to make neurotransmitters on demand to regulate mood, thinking and perception (sensory input of information received from the environment). This occurs often in people with low protein diets as protein provides a slow and steady release of sugar to the blood stream (gluconeogenesis). To meet the nutritional demand for high quality protein, meat and eggs tend to be the high quality protein sources of choice.

Hypoglycemic symptoms

Hypoglycemia affects our mental and physical state.

Common hypoglycemic symptoms include tiredness/fatigue, confusion, poor decision making, irritability, criminal behavior, schizophrenia, and mood disorders (depression, anxiety, bipolar mood swings). 

Poor digestion, poor nutrient absorption, poor energy

It makes sense that we support our body in its efforts to absorb food efficiently in order to derive energy. We can do this by having good eating habits and eating high quality foods. From food we get the nutrient building blocks and cofactors needed to manufacture ATP, so you have energy on demand. Basic building blocks are derived from a sufficient intake of fat, protein and carbohydrates.

Do you eat high quality food sources?

High quality food is also important. Many grocery stores are full of processed food items in the center isles, so it is best to spend more time shopping on the periphery. Organic food and hormone free meat can improve your energy level as well because the body spends less time detoxifying pesticides and synthetic hormones.

With a carbohydrate dominant diet (the North American way) we suffer the consequences of having an inadequate supply of building blocks from protein and fat. Fat for example, is the scaffold for hormones such as thyroid hormone. Every meal therefore should contain adequate meat or eggs to provide a quality source of protein and fat.

Good eating habits

Good eating habits aid digestion and improve the likelihood of better nutrient absorption. Good eating habits include taking the time to eat regularly, eating protein (versus high carbohydrate) whole food snacks, eating warm foods and drinks (versus eating right out of the refrigerator), sitting to eat (versus eating on the run), and avoiding junk food and foods that make you sick. Drink water throughout the day without ice; adults should consume around 2 liters of water a day. Eat fruit away from meals. Remember to eat your greens and a colourful array of vegetables. 

In our next blog: I’m so Tired: Part 2

Cells making energy from glucose

Does your body make energy too fast or too slow?

What does Hair Tissue (Cellular) Mineral Analysis (HTMA) tell you about energy metabolism?

Medical mainstream is now beginning to embrace the concept of nutrient or nutritional therapy for schizophrenia, depression, ADD, anti-social behavior and Alzheimer’s dementia. Orthomolecular medicine is a part of this movement as it is a nutrient and diet therapy that provides endogenous, already existing substances that the body uses, essential or non-essential, to correct your biochemical or physiological state. Using the right nutrients in the right amount is a corrective process from which the term ‘ortho’ is derived.

In the most current 2012 Spring 15(3) issue of The Journal of Addiction and Mental Health issued by the CAMH, we see a solid mention of nutrients having a role in mental health. A UK organization called Sustain is now trying to advocate agricultural and food practices and policies that improve our health. They have initiated The Food and Mental Health Project in partnership with the UK Mental Health Foundation (MHF). In this project they looked at over 40 years of peer-reviewed medical archives to determine the link between nutrients in diet and mental health (brain function).       

The Food and Mental Health Project found that “people who miss one or more elements of a healthy diet or who eat too much saturated fat or other harmful elements seem to be at higher risk of developing attention-deficit/hyperactivity disorder, Alzheimer’s disease, schizophrenia, depression and antisocial behaviour”. This Project also found, as is the main thrust of orthomolecular thinking, that nutrients “only work if a wide range of other nutrients are also available in the right amounts and in proportion to one another. These nutrients include polyunsaturated fats, particularly the omega-3s; minerals, such as zinc, magnesium and iron; and vitamins, such as folate, a range of B vitamins and the antioxidant vitamins C and E”.

This article mentions that despite the fact that poor physical health is clearly associated with junk food intake, policy makers are idle to curb junk food commercialization. In the same vain, Sustain admits that they “made the common mistake of believing policy makers when they say they base their decisions on scientific evidence. A cursory look at any government policy will show, at best, only a tenuous link with evidence. Much more influential are money, the lobbying power that comes with it and the desire of most politicians to keep their jobs”.

The good news is that scientific results mean something to medical mainstream psychiatric researchers.

Psychiatric medical practitioners are now more and more open to entertain the concept that humble nutrient interventions have potential. For your appraisal, I report on the use and response of nutrient therapy in the treatment of a variety of mental health conditions including schizophrenia, depression, anxiety, bipolar disorder, ADD and OCD.

Have you ever eaten a good meal and felt great or mentally healthy afterward? If your energy feels really good after eating certain foods then this is a good indicator that you are eating the right stuff!

Brain foods have constituents that support brain function. These foods often contain ‘smart nutrients’. The right combination and quantity of nutrients is what orthomolecular (nutrient correcting) treatment is all about.

Dietary intervention has benefits and also limits in terms of correcting mental health conditions that are moderate to severe. The nutrients derived by supplements (B-vitamins, minerals, etc) often sway the balance to a degree that would not be easily achievable with our current poorer quality food supply and certainly not with the current carbohydrate and processed food dominant North American diet. If you really want to address concentration, especially if you suffer from schizophrenia, depression, anxiety, bipolar, ADD, or OCD, we recommend our targeted orthomolecular treatment protocol as this is the Cadillac version of assessment and treatment.

Smart Food Principles to Consider

Many of the principles discussed are described in my Top Orthomolecular Syndromes webpage.

Consume caffeine in moderation

Caffeine is OK in the morning in moderation if tolerated. Caffeine is found in coffee, tea (even green tea), chocolate, some medications, and energy drinks. Caffeine reflexively releases cortisol, that sympathetic hormone that makes you run away from a tiger, the ‘fight or flight’ hormone. Caffeine is therefore a stimulant. Caffeine has been shown to boost IQ, increase alertness, and help people focus. Some people however do poorly with caffeine in my experience and these are usually those who are over-stimulated in the morning or have high morning cortisol levels.  Again targeted lab testing would be necessary to rule out this possibility. If caffeine is used in excess this reduces the adrenal glands ability to regulate stress responses and you get jittery and hypoglycemic. In these cases, adrenal adaptogens or tonics may be more beneficial than caffeine. Caffeine should be consumed before 4pm to avoid overstimulation at night.

Consume sugar in moderation

Sugar, as supplied by dietary protein gluconeogenesis, provides brain cells with fuel all day. In Oriental medicine, it’s best to eat sweets in the morning when digestive processes are more receptive to assimilating sugars, not later in the day. If you have night time sugar cravings it’s often a sign that you have poor protein intake. High quality protein is simply meat (poultry, fish, beef, occasional pork) and eggs.

Eat protein for breakfast

Yes, this seems intuitive but many people negate breakfast and opt for quick alternatives that contain little, if any, protein. I assess many cases with poor diets and the number one trend is low protein intake with especially poor intake at breakfast. Many even skip breakfast. Students perform better when they eat breakfast meals and studies show better attention and short-term memory. I always ask clients how their brain can make adequate neurotransmitter without protein. As mentioned above, meat and eggs are your best bet as whole grains, fruit, and dairy are high in sugar. If you aim for every meal to provide 40% protein, 40% carbohydrate, and 20% fat, you are doing well.

Don’t eat foods that make you sick

It is possible to benefit most by eating food items that your immune system tolerates well (i.e. not foods that you react to such as gluten or dairy) and is supported by, versus meals with food intolerant substances that tax your immune system and pass toxins to the blood stream and brain and make you feel worse. The corollary of this scenario is that some people really love foods that they may be intolerant to and this reinforces their need to continue eating that substance but, with continued exposure delayed responses occur unbeknownst to most that can present in various ways either affecting the physical body and/or mental state.

Smart Foods:

Blueberries

These are high in antioxidants to thereby help prevent brain cell membrane breakdown from free radicals such as heavy metals (mercury, copper, lead, aluminum, cadmium, etc). Blueberries are beneficial in Alzheimer’s and improve our ability to learn.

Fish

Fish are high in omega-3’s (DHA, EPA) which are flexible essential fats (EFA’s) that sit in brain cell membranes and provide the anchoring structure to which protein receptors (neurotransmitter receptors) attach thereby exposing them adequately to the environment. You have lower risk for Alzheimers, age-related memory decline, and strokes if you have adequate omega-3 intake.  Of course some people have mercury toxicity and added mercury load from fish can aggravate their condition so in such cases I often limit fish intake. The mercury testing that I do can tell you if the mercury you have comes from organic sources such as fish or inorganic sources such as dental amalgam fillings or immunizations. In either case, an elevated mercury level warrants dietary elimination of fish until it is corrected. Otherwise, two servings of fish a week are recommended. Tuna contains vitamin B3 but we would need to eat a lot of tuna to get high levels to address conditions such as schizophrenia. Vitamin B3 opens up brain circulation and is associated with reducing mortality. Salmon and cold water small fish with teeth are the best fish to eat.

Seeds and Nuts

Nuts are high in plant based essential fats which are useful. The body needs to convert this good fat into a useable form which is an added step but still helps. Nuts are also high in vitamin E which is a great antioxidant for the brain and enhances cognition. Protein derived from nuts and seeds are helpful but are not as high quality as are proteins derived from meat or eggs.

Dark Chocolate

Dark chocolate (high cocoa butter content) has flavonoids that reduce vitamin E breakdown. Caffeine in dark chocolate has benefits as mentioned above but should be eaten before 4pm to avoid night time overstimulation.

Avocados

I love avocados. Avocados are high in good fats that reduce cardiovascular risk and therefore indirectly improve blood flow. High unsaturated fat content in avocados offers a slow sugar release profile which is an added benefit here as well.

Shellfish

Shellfish and avocados are high in copper which is needed for catecholamine neurotransmitter production of adrenaline which is essential in the frontal cortex for executive functions, planning, memory, etc.

Discipline is often the furthest thing from your mind when you are busy or have a condition such as schizophrenia, depression, anxiety, bipolar, ADD or OCD.  For some patients it is a monumental chore to sustain focus for extended periods.  Protocols at our clinic are intended to be simple and understandable despite the fact that they often address upwards of four biochemical syndromes at a time. The relief that can be obtained by following these protocols can be immense, so we encourage all patients to do their best while we work to address your individual needs.

Right from your first visit to our clinic, patients are provided with a one-page typed plan and compliance calendar. I provide an extra copy of the plan for the fridge. Compliance is huge in my book. I would argue that we could learn almost as much from a patient who strictly follows a supplement plan as I could by following lab results alone.

Below I list the tools that help patients adhere to the orthomolecular lifestyle of discipline. I consider that our clinic has one of the best models of compliance in practice.

What you can do to stay on track

Follow your one-page typed plan, put a copy on your fridge and on your supplement cabinet/box

These one-pagers list the supplements to be taken at various times of the day, for example on waking, breakfast, dinner, and bedtime. At the top we have a ‘To Do’ list for lab to be done or questionnaires to be filled out along with dates. The next scheduled visit is listed and, if a phone consult is needed in between, that is mentioned. The diet is provided at the bottom of the page along with any special instructions (e.g. elimination diets). If you are travelling abroad you can take this plan with you along with the supplements if a luggage inspection is requested.  On this one-pager I often work out optimal dosing times that provide the best benefit to the patient. For example, adrenal tonics need to be done no later than 4pm, cortisol lowering protocols for optimal support may need to be provided earlier in the day as well as near bedtime, iron and vitamin C need to be done together and away from other minerals, etc. 

Use your compliance calendar daily

This calendar allows you to record all events on a daily basis per month with the benefit of keeping all health related information in one place. We want you to record all aspects that influence your quality of life. This gives us something concrete to judge how well you are doing and where we need to make improvements. Events that may require recording include sleep quality, dream recall (a reflection of memory acquisition), concentration/focus, mood changes, hallucinations/paranoia, body temperature, blood pressure, bowel movement volume/frequency, illness/injuries, life stresses, diet changes, food reactions, and doses started/missed.  

Get a custom supplement formulation

Rather than taking individual supplements from different supplement bottles with all the fillers, we consider it easier and better to do an all-in-one supplement when possible to cut down on the number of pills and to make it easier to do. These custom formulas are available as powders or capsules. We have a handout for patients who are doing powders so they can mask the acidic taste by mixing them with sugar-free flavor crystals, juices or textured substances.  I am often impressed with how clients fill out these calendars and provide me with details that would otherwise have been lost. Sometimes this level of monitoring provides me with the details needed to adjust the plan in a way that provides the best results.

Rely on Case Management to keep you on track

Communication is an amazing thing. Often and as needed our case manager issues phone calls and emails to clients to ensure that they adhere to their schedule, that they keep on track, collect lab samples on time, obtain their body temperature as needed, and fill out questionnaires and forms as needed.  

Follow your Handouts, they are intended to make protocols simple to follow

We try to keep things simple and this has been an ongoing process, but over the past decade we have narrowed down our instructions to the point of simplicity.  

Remember that many mental health disorders take months or years to develop and if they are ingrained and alter your biochemical or physiological state, you need to address these issues head on. Do your best to remain compliant in your endeavor to achieve orthomolecular health.  

Yours in health,

Raymond J Pataracchia BSc ND (Doctor of Naturopathic Medicine)

Topping the list of nutritional orthomolecular therapies is the elimination of gluten. This is recommended for cases of schizophrenia, depression, anxiety, ADD, and OCD.

The West is the Best … a common saying but few know that along with the cultural diversity of Westernization came an agricultural mono-cropping boom. The food industry launched widespread availability of low cost wheat and gluten containing products into our local grocery stores. Wheat-derived gluten-based fillers bulk up foods and add structural elasticity. The list of gluten-filled products is endless … junk food, candy, gravy, meat, pasta, pizza, bread, etcetera. Too much of one thing however, is not good for the body. Gluten protein overload had to be dealt with by the end-user, us, the consumer. An immune response from the individual consumer was inevitable. Our metabolisms, especially if genetically predisposed, often refuse to accept constant bombardment of big proteins. Large proteins such as gluten (or dairy’s casein and whey) are just as much not considered a part of ‘self’ as are the proteins of pathogenic bacteria which trigger mild to severe immune responses. Immune responses vary, some are immediate and others not uncommonly are delayed. This is the accepted basic premise behind food allergies including gluten. Food allergies are also called food sensitivities, food intolerances, or in the context of mental health, brain or cerebral allergies. The treatment is dietary elimination and gluten diets are simple and effective if you implement good purchasing and cooking habits and, limit your intake of the more processed gluten-free products.

Abstract 1

Cascella NG, Kryszak D, Bhatti B, Gregory P, Kelly DL, Mc Evoy JP, Fasano A, Eaton WW. Prevalence of celiac disease and gluten sensitivity in the United States clinical antipsychotic trials of intervention effectiveness study population. Schizophr Bull. 2011 Jan; 37(1): 94-100. Epub 2009 Jun 3. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Meyer 144, Baltimore, MD 21287, USA. PubMed free full text article.

Celiac disease (CD) and schizophrenia have approximately the same prevalence, but epidemiologic data show higher prevalence of CD among schizophrenia patients. The reason for this higher co-occurrence is not known, but the clinical knowledge about the presence of immunologic markers for CD or gluten intolerance in schizophrenia patients may have implications for treatment. Our goal was to evaluate antibody prevalence to gliadin (AGA), transglutaminase (tTG), and endomysium (EMA) in a group of individuals with schizophrenia and a comparison group. AGA, tTG, and EMA antibodies were assayed in 1401 schizophrenia patients who were part of the Clinical Antipsychotic Trials of Intervention Effectiveness study and 900 controls. Psychopathology in schizophrenia patients was assessed using the Positive and Negative Symptoms Scale (PANSS). Logistic regression was used to assess the difference in the frequency of AGA, immunoglobulin A (IgA), and tTG antibodies, adjusting for age, sex, and race. Linear regression was used to predict PANSS scores from AGA and tTG antibodies adjusting for age, gender, and race. Among schizophrenia patients, 23.1% had moderate to high levels of IgA-AGA compared with 3.1% of the comparison group (χ(2) = 1885, df = 2, P < .001.) Moderate to high levels of tTG antibodies were present in 5.4% of schizophrenia patients vs 0.80% of the comparison group (χ(2) = 392.0, df = 2, P < .001). Adjustments for sex, age, and race had trivial effects on the differences. Regression analyses failed to predict PANSS scores from AGA and tTG antibodies. Persons with schizophrenia have higher than expected titers of antibodies related to CD and gluten sensitivity.

Point 1

So there is medical recognition that a severe mental illness population of schizophrenics, in this example, have a definate biochemical imbalance with the way that their bodies deal with wheat, rye, and barley proetins. 

The IgG Elisa Gluten antibody screen, if done here, may have shown greater prevalence of food intolerance among schizophrenics. In clinic I only do IgG/IgE Elisa  antibodies measures if patients want to see results on paper before doing diet changes. Thew down side to testing is that it has limitations and every 4 or 5 patients tested will show negative results due to the complexity of the immune system but, just because the test didn’t show it, doesn’t mean it doesn’t exist and affect the patient profoundly. 

So I encourage gluten elimination because its actually more accurate. If you simply commit to elimination diet for 3 weeks you will see if you feel better (mental state, digestion, energy) and, when you re-introduce gluten, if your symptoms come back, and this is reproducable (i.e. even inadvertant consumption of gluten provokes negative responses), its diagnostic. I see a trend of about 50+% of schizophrenics having some degree of gluten sensitivity and this is typically determined easily by a simple elimination diet trial.

Abstract 2

Dickerson F, Stallings C, Origoni A, Vaughan C, Khushalani S, Leister F, Yang S, Krivogorsky B, Alaedini A, Yolken R. Markers of gluten sensitivity and celiac disease in recent-onset psychosis and multi-episode schizophrenia. Biol Psychiatry. 2010 Jul 1;68(1):100-4. Epub 2010 May 14. (Stanley Research Program at Sheppard Pratt, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland 21204, USA.)

BACKGROUND: Increased immune sensitivity to gluten has been reported in schizophrenia. However, studies are inconsistent about this association.

METHODS: The sample of 471 individuals included 129 with recent-onset psychosis, 191 with multi-episode schizophrenia, and 151 controls. Immunoglobulin (Ig)G and IgA antibodies to gliadin and to tissue transglutaminase, and IgG antibodies to deamidated gliadin were measured. Quantitative levels of antibodies in the psychiatric groups were compared with controls. All participants were categorized as to whether their levels of antibodies met standardized cutoffs for celiac disease. HLA DQ2 and HLA DQ8 alleles were detected by real-time polymerase chain reaction.

RESULTS: Individuals with recent-onset psychosis had increased levels of IgG (odds ratio [OR] 5.50; 95% confidence interval [CI] 2.65-11.42) and IgA (OR 2.75; 95% CI 1.31-5.75) antibodies to gliadin compared with control subjects. Individuals with multi-episode schizophrenia also had significantly increased levels of IgG antibodies to gliadin (OR 6.19; 95% CI 2.70-14.16). IgG antibodies to deamidated gliadin and IgA antibodies to tissue transglutaminase were not elevated in either psychiatric group, and fewer than 1% of individuals in each of the groups had levels of these antibodies predictive of celiac disease. There were no significant differences in the distribution of the HLA DQ2/8 alleles among the groups.

CONCLUSIONS: Individuals with recent-onset psychosis and with multi-episode schizophrenia who have increased antibodies to gliadin may share some immunologic features of celiac disease, but their immune response to gliadin differs from that of celiac disease.

Point 2

Gliadin is a big protein and it is found in oats and, it is structurally similar in to gluten. Here in this research we see IgG gliadin antibody tests showing significant elevations in schizophrenia. This shows that gliadin food intolerance is a real entity in schizophrenia. Gliadin is therefore important to eliminate in schizophrenic populations. Indeeed, I see a majority of schizophrenic cases with gluten intolerance who also need to avoid gliadin (oats).  The Gluten IgG or IgE antibody test was unfortunately not assessed here. This important research effort tells us that gliadin is associated with but not necessarily a causative factor of schizophrenia. If the patient feels better eliminating oats then I say this is a step in the right direction. I have patients that become psychotic quickly after eating gluten or gliadin containing products and this negative response reinforces their need to avoid foods (negative reinforcement behaviour) containing these big proteins. Negative responses not only keep my patients compliant, but it also puts them in a position to acheive greater mental health.  

Abstract 3

Dohan FC. Genetic hypothesis of idiopathic schizophrenia: its exorphin connection. Schizophr Bull. 1988;14(4):489-94. (Medical College of Pennsylvania, Eastern Pennsylvania, Psychiatric Institute, Philadelphia 19129.)

This brief overview proposes a testable oligogenic model of the inheritance of susceptibility to idiopathic schizophrenia: “abnormal” genes at each of a few complementary loci. The model is based on my assumptions as to the likely genetic abnormalities at possibly four or five interacting loci that would permit exorphins, the opioid peptides from some food proteins, especially glutens and possibly caseins, to go from gut to brain and cause symptoms of schizophrenia. Exorphins may reach the brain cerebrospinal fluid (CSF) in harmful amounts because of their genetically increased, receptor-mediated transcellular passage across the gut epithelial barrier plus decreased catabolism by genetically defective enzymes. A schizophrenia-specific, genetically enhanced affinity for exorphins by opioid receptors influencing dopaminergic and other neurons would permit sustained dysfunction at low CSF exorphin concentrations. Tests of each postulated genetic abnormality are suggested. This model is supported by a variety of evidence, including a significant effect of gluten or its absence on relapsed schizophrenic patients, the high correlation of changes in first admission rates for schizophrenia with changes in grain consumption rates, and the rarity of cases of schizophrenia where grains and milk are rare.

Point 3

The clinical trials mentioned in this article show clear psychotic worsening with exposure to gluten and psychotic improvement without exposure to gluten. The geographic distribution of schizophrenia is not uniform and we see more schizophrenia in areas of the world where grain consumption is higher.

As a side note it is important to recognize dairy allergies as well, not only in schizophrenia, but also in depression, anxiety, ADD, and OCD. I find significant dairy intolerance in about 10 to 20% of my schizophrenic cases as determined by diet elimination.