MindCheck is the Weekly Wednesday Kids Mental Health series with Dr. Ray Pataracchia N.D. MindCheck provides in depth information on the orthomolecular approach to coping with mood and/or behavior disorders. The MindCheck Health Series is endorsed by the Mindful Network - ‘A Better Future for Children’s Mental Health’.
In a busy world we want to makes things simple but there is no magic pill when it comes to vitamin-mineral supplementation and you often find regimens that involve several pills a day.
Vitamin Compliance in a Frenetic Age
In the course of successful nutrient treatment the number of pills can be reduced to a maintenance level, a level that involves fewer pills (often 2-8 pills) a day. Maintenance is however initiated after we have achieved biochemical/physiological balance of body systems by, for example, addressing the top 15 syndromes of mental health.
Common ‘Barriers to Compliance’
What about those with problems swallowing pills, those who get nauseous swallowing pills, or those who are so busy that they find it hard to take pills more than once a day? If you have trouble swallowing pills it may be due to commonly seen iron deficient mental health conditions. Others that have problems swallowing that are not iron deficient may find it rectified if they place water or juice in their mouth first, then put the pill in their mouth, then swallow. Dosing with a sizable protein meal often alleviates nausea. As far as being too busy to dose pills the only approach is to dose a minimum of twice a day; once in the morning and once at dinner or in the pm.
Why isn’t there a one pill solution to most all mental health conditions?
There is a cartoon in my office that shows a huge pill carried in a wheel barrel by a doctor in a white coat and the caption ‘your diet was so bad that this is the smallest pill I could find that could possibly help you’. So the answer is that the human body has a lot going on and we have to be proactive to support all body systems involved and all syndromes that influence the mental state.
Medical understanding of mental health conditions at this stage in history is still one of confusion because the causative factors involved are numerous and unknown (idiopathic). What follows is that many treatments attempt to alleviate suffering by taking a nip off the symptoms or by targeting the brain at the brain cell receptor level, a level that none of us will ever completely understand.
The ‘magic’ all-in-one pill ideal
Although non-drug practitioners remain hopeful that they can help mental health conditions, they are realistic. Unlike drugs, ‘natural’ treatments will often require more than 3 pill doses a day. To get around this, there alternative formats of supplementation that can be used, for example custom compounding (below).
How many times a day do I have to take pills?
For a vitamin-mineral regimen to take effect, it often has to be dosed at least twice a day.
1) Nutrients are typically provided in food and it follows that these nutrients need to be dosed with meals – yes, supplements are intended to be a supplement to the meal; and since we typically eat three meals a day, it follows that our bodies are used to receiving nutrients in divided doses throughout the daytime. Probiotics are also dosed with meals so the high acid content of your empty stomach doesn’t destroy them.
2) Vitamin-mineral constituents are more concentrated in supplements than in the food that we eat. Today the nutrient quality of food has significantly deteriorated when we compare its quality to that of the pre-processed food age. Therefore the exact nutrient(s) required to balance body systems is quite often much higher than that provided by diet. Vitamin C is high in red bell peppers oranges and potatoes and since these are often tolerated that’s great they can be a regular part of the diet but there are times when vitamin C needs to be much higher as for example when we are removing a heavy metal, fighting a viral infection, experiencing high stress, or if we are hallucinating.
3) Nutrients are also predominantly water soluble (except vitamins DEAK, essential fats, and liposomal nutrients) and as such, need to be provided in divided doses throughout the day to maintain optimal therapeutic ranges.
High Compliance with Custom Compounding
A custom compounding solution exists for most all situations. We can put almost everything into one mixture and provide it in powder form. Powders can be put into juice or shakes, or mixed with foods that have texture. What can’t be put in these all-in-one powders (fat soluble oil-based ingredients), if needed would have to be dosed separately. Powdered mixtures are about the same cost as buying individual supplements.
Liquids are available but costly. Sublingual under the tongue formats are often well tolerated so that is an option as well. Transdermal skin applications are available and in some cases are better absorbed than oral formats; these are not overtly expensive but unfortunately not all nutrients can be provided in this format. Another option is liquid botanicals/herbs that can be dosed with juice or on their own. Alcohol from liquid herb mixture dissipates when mixed in water but for those that have extreme sensitivities some herbs come in non-alcohol (glycerin) formats. Vitamin injection therapy is somewhat impractical and beyond the reach of most clients from a cost and compliance perspective. IV therapy is expensive and needs oral supplementation adjunct to maintain optimal dose levels.
The quest to find the right combo that a patient can do is often dependent on the eclectic skills of an open-minded health professional in choosing a dosing format of choice for you and working with a good custom compounder.
Putting all your eggs in one basket
Wait until the layers of problems have been determined and effectively treated before committing to a batch of custom made pills. At that point it’s a practical solution. Early on when we are treating a bunch of vitamin deficient syndromes we need to use individual vitamins to allow dose flexibility.
Targeted treatment reduces the number of pills
The key to reducing the number of pills is to determine the vitamin deficient syndromes important to you? Targeted treatment is the answer here and combined with the compliance techniques described herein, it is a best case scenario.
Dosing Times away from meals
Most herbs and amino acids are better absorbed away from meals but there are exceptions. Sleep nutrients and herbs are best done close to bedtime. When you are doing a regimen that is done on waking or at bed time it is often easier to keep these products next to your bed stand or in your bedroom.
Typed one-page plans are the way to go
This is something that I learned in my early years of practice. One-page typed plans lay out what is to be dosed, at what dose, and when. This immensely increases compliance.