Micronutrients in Psychology: A Brief Overview of the Action of Vitamins and Minerals in the Brain
Michael Doty
November 9, 2011
Micronutrients in Psychology: A Brief Overview of the Action of Vitamins and Minerals in the Brain
“Let food be thy medicine and medicine be thy food”
― Hippocrates
One of the first things I remember learning about psychology was René Descartes’ theory of dualism, the idea that the mind and body are separate entities connected at the pineal gland. Science has come a long way since the 1600s, revealing tremendous interplay between the psyche and the physical body. The Human Genome Project provided a basis for beginning to understand the role of genetics in mental health and how nutrition can affect mental health through genetic and non-genetic pathways. Recent research has shown that nutritional deficiencies and imbalances may be responsible for many disorders and that by supplementing with the appropriate nutrients, we may be able to treat many of the aliments that are currently managed by pharmaceuticals (Kaplan, Crawford, Field, & Simpson, 2007, Masterpasqua, 2009; Rouse & Lanore, 2011; Skowron, 2011; White, 2009).
There are limitations to the concept of nutritional psychotherapy. The literature is far from extensive, though research in the field does seem to be increasing. As a result of limited research, the safety, efficacy, and dosing protocols are largely unknown. Based on a search of the websites for the American Psychological Association (www.apa.org) and the American Psychiatric Association (www.psych.org), nutrition does not seem to be considered a major component to mental health. The American Psychiatric Association did assemble a task force to investigate the efficacy complementary and alternative medicine (CAM) in the treatment of major depressive disorder. The task force found that some CAM treatments, including the use of omega-3 fatty acids, folate (vitamin B9), and S-adenosyl-L-methionine (SAMe), show potential, but require much more in-depth research (Freeman, Fava, Lake, Trivedi, Wisner, & Mischoulon, 2010). The task force found that the greatest risk the use of CAM might be delaying treatment with well-established methods (Freeman et al., 2010). A national survey found that the number of visits to CAM practitioners has exceeded the number of visits to primary care physicians (Lavretsky, 2009). This increase makes further research into alternative psychological treatments an absolute necessity. Future research will determine how effective nutritional therapy is in treating mental health concerns.
The research that has been done is promising. Many nutrients seem to have an impact on multiple disorders through many different pathways. Omega-3 fatty acids, for instance, have been shown to have an impact on depression, bipolar, schizophrenia, autism, anxiety, and ADHD (Freeman, Hibbeln, Wisner, Davis, Mishoulon, Peet, Keck, Marangell, Richardson, Lake, & Stoll, 2006; Sathyanarayana Rao, Asha, Ramesh, & Jagannatha Rao, 2008; Skowron, 2011). The role of B vitamins may be even more versatile, as they are required for modulating gene expression, healthy cell functioning, and the synthesis of neurotransmitters (Masterpasqua, 2009; Kaplan et al., 2007; Rouse & Lanore, 2011). All nutrients affect the brain structurally or functionally, but an in-depth analysis of each nutrient and its function is beyond the scope of this paper. With conciseness in mind, the focus will be to survey a select group of micronutrients that have shown clinically significant results in the research: vitamins A, B-complex (B1„B6, B9, B12, and choline), C, D, and E, iron, magnesium, zinc, iodine, SAMe, and omega-3 fatty acids.
Vitamin A is important because of its role in nervous system health and maintainence. It stabilizes cell membranes and protects nervous system tissues from damage caused by free radicals (Bourre, 2006). Vitamin A contributes to neuroplasticity, particularly in the hippocampus (Bourre, 2006). In vitamin A deficient animals, neurobiological alterations and spatial learning impairments have been observed (Bourre, 2006). Vitamin A levels need to be tested, as it competes with vitamin D at the receptor and may result in a loss of bone mineral density (Cannell & Lanore, 2011).
As previously stated, the B vitamins have a crucial function in the body as key factors in modulating genetic expression through the DNA methylation process. In the brain, B vitamins play an important role in the synthesis of neurotransmitters (Low Dog, 2010; Kaplan et al., 2007). Supplementation with B vitamins has been found to increase mood in healthy participants, while low levels have been associated in negative changes in cognition (Kaplan et al., 2007; Sathyanarayana Rao et al., 2008).
B1 (thiamine) is crucial to brain function, as it facilitates the metabolism of glucose, the primary fuel source for the brain (Bourre, 2006). Thiamine plays a role in the synthesis of acetylcholine, GABA, and glutamate and can mimic the action of acetylcholine in the brain (Kaplan et al., 2007). Low levels of B1 are associated with mood swings, depression, and Alzheimer’s (Bourre, 2006). In rats, thiamine deficiency is linked apoptosis in thalamic structures (Bourre, 2006). Doses as low as 50mg per day have been associated with improved mood, as measured by the Profile of Mood States questionnaire, and doses of 400mg per day have been shown to have an antidepressant effect by decreasing levels of monoamine oxidase (Kaplan et al., 2007).
B6 (pyridoxal phosphate) is a key factor in synthesizing dopamine, norepinephrine, epinephrine, histamine, and GABA (Kaplan et al., 2007). Reduced levels of B6 are linked to a reduction in the production of serotonin and GABA (Kaplan et al., 2007). Dr Jared Skowron recommends a dose of 0.6mg/kg of B6 daily as part of his naturopathic treatment of ADHD and Autism (Skowron, 2011).
Folate (B9), or folic acid, helps control plasma homocysteine concentration, which has been linked to depression (Low Dog, 2010; Kaplan & Shannon, 2007). Studies have shown that for every unit increase of homocysteine, the odds of depression increased by 4% (Low Dog, 2010). Folic acid plays a key role in the final stages of serotonin and norepinephrine synthesis, brain energy metabolism, and has been shown to slow the breakdown of tryptophan (Kaplan et al., 2007). Research has found that supplementing with B9 is associated with a reduction in clinical symptoms in patients with depression and schizophrenia and has shown promising results when combined with fluoxetine (Kaplan et al., 2007).
B12 is a cofactor in the formation of SAMe, the primary methyl donor in the synthesis of neurotransmitters (Kaplan et al., 2007). It also has a function in maintaining myelin (Kaplan et al., 2007). B12 deficiency has been known to cause neurological disorders, psychic disturbances, and hematological alterations (Bourre, 2006).
Choline is a precursor to acetylcholine and is a primary methyl donor for methylation reactions (Kaplan et al., 2007). Choline has been found to reduce manic symptoms in patients with rapid-cycling bipolar disorder (Stoll, Sachs, Cohen, Lafer, Christensen, & Renshaw, 1996).
Vitamin C is well known for its antioxidant effect. In the brain, it is required to synthesize norepinephrine from dopamine (Bourre, 2006). In rats, high doses have shown an anxiolytic effect (Bourre, 2006).
Vitamin D has been shown to be neuroprotective in the hippocampus and helps to modulate the transportation of glucose (Bourre, 2006). Insufficent levels of vitamin D have been associated with an increased risk for Parkinson disease and Alzheimer disease (Evatt et al., 2008).
Vitamin E protects cell membranes from free radical damage and has been shown to reduce amyloid beta peptides accumulation in the brain, which can lead to a reduced risk of Alzheimer’s disease (Bourre, 2006; Kaplan et al., 2007).
Iron is essential for the synthesis of ATP and oxygenation. It also plays a role in the synthesis of serotonin, epinephrine, norepinephrine, and dopamine and has been shown to increase dopamine and serotonin binding in the frontal cortex (Kaplan et al., 2007). Lab animals with iron deficiencies have been shown to have impaired dopaminergic functioning and low levels of D2 receptors (Kaplan et al., 2007).
Magnesium is used in over 300 reactions within the body, from metabolism and energy production to the synthesis of nucleic acids and ion transportation (Kaplan et al., 2007). In the treatment of bipolar disorder, magnesium taken along with antipsychotics has resulted improvements in manic symptoms and in lower defective doses for the antipsychotics (Lake, 2011). Magnesium has been shown to be as effective as lithium for some bipolar patients and has been used in conjunction with lithium, haloperidol, and clonazepam (Kaplan et al., 2007). Skowron recommends a dose of 6mg/kg of magnesium daily for the treatment of ADHD and Autism and 65-400mg/day for depression and insomnia (Skowron, 2011).
Many studies have found that zinc levels are low in people with clinical depression (Sathyanarayana Rao et al., 2008). Animal studies have shown that zinc deficiency results in a loss of neurons and, consequently, a reduction in brain volume (Bourre, 2006). Increased zinc concentration in the hippocampus of rats has been observed in animals treated with imipramine, citalopram, and electroconvulsive therapy (Kaplan et al., 2007). One randomized, placebo-controlled trial found that treatment-resistant patients with depression taking imipramine had significantly reduced depression scores when they supplemented with zinc (Low Dog, 2010). A recent study on zinc’s use for ADHD found that zinc combined with amphetamine resulted in an optimal dose (in mg/kg AMPH) was 307% lower than in the placebo group (Arnold et al., 2011).
Iodine’s role in the regulation of thyroid hormones makes it very important to mental health. Low levels of iodine lead to hypothyroidism, a condition that can mimic several mental illnesses (class notes). Moderate iodine deficiency has been shown to lower IQ by 10-15% (Bourre, 2006, McNeil, 2006). Iodine deficiency has been identified as the “leading preventable cause of mental retardation” (McNeil, 2006).
S-adenosylmethionine (SAMe) is used in the production of neurotransmitters (Sathyanarayana Rao et al., 2008). It is also used in the methylation of homocysteine to methionine (Lavretsky, 2009). High levels of homocysteine have been link to depressive symptoms (Low Dog, 2010; Kaplan & Shannon, 2007).
Omega-3 fatty acids make up a large portion of the brain (Sathyanarayana Rao et al., 2008). Its effect on the body’s inflammatory response have led to promising results in all levels of physiological research, from DNA methylation and telomerase protection to inhibiting tumor growth (Rouse & Lanore, 2011). A metaanalysis on the psychological benefits of omega-3s found statistically significant results in the treatment of unipolar and bipolar depression and promising results in the treatment of schizophrenia, major depressive disorder, borderline personality disorder, and ADHD (Freeman et al., 2006). A Japanese study found that children and adolescents with the lowest intake of fish (and therefore low levels of omega-3s) were more likely to experience depressive symptoms than children of similar ages who ate more fish (Skowron, 2011). In adults with bipolar disorder, omega-3 fatty acids taken in conjunction with mood stabilizers have been associated with significant improvements in depressive symptoms (Lake, 2011). In children and adolescents with bipolar I or II, a reduction in both depressive and manic symptoms have been observed with mood stabilizer/omega-3 combinations (Lake, 2011). Symptoms of ADHD have been shown to improve by as much as 25% with the addition of omega-3 fatty acids to treatment (Skowron, 2011).
The role nutrients play in mental health has only begun to be discovered. The research that has been completed in recent years compels the author to believe that future studies will revel that diet coupled with exercise and healthy lifestyle choices is the primary defense against mental illness. Even though the efficacy of using vitamins and minerals is still largely unknown, the literature on the negative effects of nutrient deficiency on the brain is enough evidence to convince many people that something as simple as a daily multivitamin has benefits that far outweigh the financial cost of adding supplements to personal healthcare regimens. Scholars in the field of epigenetics suggest that nutrition and lifestyle choices can effect multiple generations (Masterpasqua, 2009; Rouse & Lanore, 2011). In this case, it is plausible that through maintaining optimal micronutrient levels, successive generations may see a lower prevalence of psychological disorders. Further research is required to explore the intricate relationship between micronutrients and mental health, but judging from our current understanding, the future looks bright.
References
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