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Natural Mood Lifters: Nature's Blues Busters

Many people prone to depression have found that they can control their moods very well with natural supplements, which don't have the side effects of antidepressant drugs. The information that follows will help you to know which ones to take and the anticipated effects.

While SSRIs tend to increase the supply of neurotransmitters by inhibiting reuptake or by preventing their breakdown, nutritional supplements provide the basic "construction materials." If your mood problems are due to a deficiency in the materials that make up the neurotransmitters, then simply inhibiting their reuptake won't solve your problem in the long run. That is one reason why the drugs often stop working after awhile.

The key mood-enhancing herbs and nutrients are:

St. John's Wort Versus Antidepressant Drugs
St. John's wort: St. John's Wort: Wonder Weed
Imagine an antidepressant that is as effective as prescription drugs but has mild side effects, if any, and even boosts libido. Sound like a fantasy? It's not. You've just met St. John's wort, an herb taken by many thousands of people every day. In fact, in Europe, Hypericum perforatum is prescribed by doctors five times as often as Prozac.

Animal studies show that St. John's wort inhibits the reuptake of serotonin and possibly also of dopamine and noradrenaline. It appears to act like both SSRIs and tricyclic antidepressants, but without their side effects.

A 1996 review of twenty-three randomized clinical trials on St. John's wort, involving a total of 1,700 people, showed an equivalent response to antidepressants with minimal side effects. At a dose of 300 mg a day of a 0.3 percent hypericin extract, St. John's wort appears to help those with mild to moderate depression. There is even some evidence that doubling this dose can help those with severe depression. St. John's wort is also useful in calming your nerves and in helping you to sleep more soundly.

While hypericin has been generally accepted as the active antidepressant ingredient and is used as the marker in standardization, there is newer evidence that the hyperforin may actually be the more active antidepressant compound. As a result, you may begin to see more St. John's wort products on the market that are standardized to hyperforin, in addition to the usual hypericin.

Because St. John's wort was originally believed to work through MAO inhibition, some articles still list the MAOI food restrictions. However, it is now quite clear that St. John's wort in normal doses does not have this effect. But there are a number of cautions associated with the herb, as you'll see below. To put it into perspective, though: Most of the cautions here relate to a rather small minority of the population. Also, many common drugs and even grapefruit juice will have similar effects, since they activate the same liver enzymes that St. John's wort does.

St. John's Wort
How it works: Appears to inhibit reuptake of the neurotransmitters serotonin, norepinephrine, and dopamine; enhances GABA activity.

Positive effects: Enhances mood; acts as an antidepressant; combats anxiety in most people; helps regulate sleep.

Cautions: May cause allergic reactions, rashes, gastrointestinal problems, or sun sensitivity in susceptible individuals. Can cause anxiety or insomnia if taken too close to bedtime. Can reduce the potency of protease inhibitors (taken as treatment for AIDS) or cyclosporin (an immunosuppressant taken by organ transplant patients), digoxin (heart medication), or even birth control pills. St. John's wort has not been researched sufficiently to recommend it for use during pregnancy or nursing. If combined with 5 HTP, there's the possibility of serotonin syndrome – headache, an increase in body temperature, and heavy sweating. Seek medical help if this occurs.

Dosage: 300 mg daily of an extract of 0.3 percent hypericin, starting with one to two capsules or tablets in the morning with breakfast. If there is no change in mood after a week, add a third dose at lunch, for a total of 900 mg daily. You can also take it as two doses of 450 mg each, or take your entire daily dose in the morning, since the herb stays in the body for approximately 24 hours before being broken down.

L-Tryptophan: Lost And Found
We've already read about L-tryptophan. But what about taking it as a supplement? A once popular over-the-counter treatment for depression and insomnia, L-tryptophan was banned in the United States by the Food and Drug Administration in 1989, after a contaminated batch from Japan caused a serious illness called "eosinophilia myalgia syndrome" (EMS). Despite the fact that the exact cause of this outbreak was determined to be due to specific contamination, the FDA persisted in their declaration that L-tryptophan itself was unsafe. It is interesting to note that tryptophan continues to be available in infant formulas and in concentrated food formulas for those too ill to be fed normally.

One can at least speculate that the explanation for such an obvious inconsistency can be found in the enormous financial and political influence of pharmaceuticals companies, which would rather have you buy their prescription drugs for depression and insomnia. So perhaps the politics of prejudice against self-administered supplements played a role here.

L-tryptophan, which is currently available only by prescription, usually comes in 500-mg capsules. The recommended dose is 500-1,000 mg, or up to 2,000 mg daily. You can take 500 mg or so in the morning, and 500-1,500 mg one hour before bedtime if you need help in falling asleep. The enzyme tryptophan hydroxylase, which converts tryptophan into 5-HTP (see below), depends on folic acid and vitamin C. 5-HTP is turned into serotonin, with the aid of the cofactors biotin, vitamin B6, and zinc, and the enzyme 5 HTP carboxylase. Make sure you are getting enough of these cofactors by supplementing with a high-potency multivitamin. Also, a carbohydrate snack, such as fruit, acts as a vehicle to transport it into the brain. Since other amino acids or proteins will compete for the same space, don't take tryptophan with protein-rich foods.

L-tryptophan
How it works: Raw material or precursor for the neurotransmitter serotonin.

Positive effects: Elevates mood; promotes relaxation, emotional stabilit, healthy sleep-wake patterns, deep sleep, dreaming, and creative imagination.

Cautions: May cause nausea, headaches, constipation, and other gastrointestinal problems in certain people, especially in high doses. It should not be taken during pregnancy, with MAO inhibitors, or in cases of the autoimmune disease lupus. It is inadvisable to take both tryptophan and SSRI antidepressants except under medical guidance.

Dosage: 500-1,000 mg two to three times daily for the treatment of depression or insomnia. Best absorbed away from protein and with a carbohydrate snack. Take a B-complex vitamin that contains 50 mg of B6, and a minimum of 15 mg of zinc. If used for insomnia, take the dose one hour before bedtime.

5-HTP (5-Hydroxytryptophan): Out Of Africa
In 1995, 5-HTP – the metabolite of tryptophan, a step further along in the metabolic pathway – became available as an extract from seeds of the African shrub Griffonia simplicifolia. Like L-tryptophan, it is converted into serotonin, inducing relaxation, elevated mood, and sleep. It may be even more useful than tryptophan, because much of the tryptophan we eat is processed along different biochemical pathways. 5-HTP is a direct precursor of serotonin and also enters the brain more easily. Unlike tryptophan, it can be taken with food and other supplements, including amino acids, with no interference. It still needs vitamin B6 as a cofactor for conversion to serotonin.

Not surprisingly, results in treating depression with 5-HTP have proven more effective than with tryptophan. For example, a double-blind trial headed by Dr. Poldinger at the Basel University of Psychiatry gave thirty-four depressed patients 300 mg of 5-HTP and twenty-nine patients fluvoxamine (Luvox), an SSRI antidepressant. Each patient was assessed for his or her degree of depression using the widely accepted Hamilton Rating Scale, plus his or her own subjective self-assessment. At the end of the six weeks, both groups showed a significant improvement in their depression. However, those patients taking 5-HTP experienced a greater improvement in each of the four criteria assessed – depression, anxiety, insomnia, and physical symptoms – as well as the patients' self-assessments. 5-HTP had outperformed the best antidepressant. Given that 5-HTP is less expensive and has significantly fewer side effects, it is extraordinary that it is almost never prescribed by psychiatrists.

The dose of 5-HTP is one-tenth that of L-tryptophan. It is available in both 50- and 100-mg capsules. For anxiety or depression, the dose is 50-200 mg a day, taken in divided doses. Some people report drowsiness if they take 5-HTP during the day, so use caution to determine your best daytime dose. In fact, especially if you're having trouble sleeping, you can take 50-200 mg of the daily dose at bedtime. Since there are few studies on the long-term effects, it is best taken for a month or two at a time only, with a few weeks off before restarting.

5-HTP (5-hydroxytryptophan)
How it works: Direct precursor for the neurotransmitter serotonin.

Positive effects: Induces relaxation; elevates mood and sleep; suppresses appetite; promotes healthy sleep-wake patterns and emotional stability, dreaming, and creative imagination.

Cautions: Some people report nausea, anxiety, and agitation at very high doses. Rarely, sensitive individuals may feel anxious at even normal doses, in which case they should stop. Do not take 5-HTP with SSRI antidepressants except under medical guidance.

Dosage: For daytime use, 50-100 mg two to three times daily. For sleep, 50-200 mg one hour before bedtime. Take about 50 mg a day of vitamin B6 as a cofactor.

Phenylalanine And Tyrosine: Dynamic Duo
Phenylalanine and tyrosine are amino acid precursors to noradrenaline, adrenaline, and dopamine.

Phenylalanine is converted to tyrosine, which is then converted to dopamine, and then to noradrenaline. They require as cofactors the vitamins niacin, B6, B62, folic acid, and C, plus the minerals zinc, magnesium, copper, iron, and manganese. The most effective form of phenylalanine for mood enhancement is DLPA, which has proven as effective as tricyclic antidepressants.

Most of the research on people's moods is conducted by pharmaceutical companies while they are developing new drugs. Experiments are first run on laboratory animals. Then people suffering from depression are recruited as their test subjects. As a result, we don't have much "official" information on the effects of these substances in "normal" people, who want to take products simply to boost their mood. But our own clinical experience shows us that these are great mood boosters, even when there is no obvious problem.

SAMe: Turning on the Lights
Recently, there has been a great deal of media attention focused on the natural compound SAMe (s-adenosyl-methionine), pronounced "Sammy." A new "convert" to SAMe, 35-year-old Marisa, shares the following experience:

I had been feeling just "blah" for what seemed like years. I read about St. John's wort and took it for a few months, 300 mg, three times daily. I felt somewhat better, but something was still missing. Then I added SAMe, 400 mg a day. It's like someone turned on the lights. I felt like a kid again, playing, being happy, and not as burdened as I had become.

For those of you with no mood problems, but just wanting to feel a little high, you can expect a similar experience. An appropriate dose, discussed below, on an empty stomach can put a spring in your step, a sparkle in your eye, and a grin on your face.

Placebo-controlled, double-blind studies show that SAMe is equal or superior to antidepressants and works faster, most often within a few days (most pharmaceutical antidepressants may take three to six weeks to take effect), with no significant side effects. Instead, SAMe has side benefits: It is an effective treatment for degenerative joint disease, fibromyalgia, and liver problems. According to one comprehensive review of all the studies, 92 percent of depressive patients responded to SAMe, while only 85 percent responded to antidepressant medications.

If you stop taking SAMe suddenly, you'll experience no withdrawal reaction – a common pitfall when antidepressants are stopped abruptly. SAMe also protects your liver, in contrast to the potential liver damage triggered by some tricyclic antidepressants.

Except for the adrenal and pineal glands, the liver contains the most SAMe of any body organ. In the body, the liver depends on SAMe for regeneration, detoxification, bile production, and the essential biochemical processes of both methylation and the production of glutathione, the liver's natural antioxidant. SAMe aids the liver in neutralizing toxins, carcinogens, and free radicals. This slows the aging process, including that of the brain.

That's not all. Research shows that SAMe treats the fatigue, inflammation, and pain associated with fibromyalgia, a puzzling and hard-to-treat condition. Patients have reported significant benefits from taking 400-800 mg of SAMe daily, including improved sleep, reduced fatigue and pain, and enhanced mood. All in all, quite a remarkable nutrient!

How much should you take? SAMe should be taken on an empty stomach, preferably one hour between meals, and at least 20 minutes away from other supplements. If you experience nausea or gastrointestinal problems, reduce the dose and take it with meals although the food will somewhat cut its potency.

Start with 200 mg once or twice daily, which will often be enough. If you don't see results in a few days, you can gradually increase the dose by 200 mg every three days, up to a maximum of 400 mg four times daily (1,600 mg). Then, once your mood feels stable, you can gradually reduce your intake to a lower maintenance dose. In general, the longer SAMe is used, the better the results.

To enhance production of the SAMe precursor, methionine, you need to take its cofactors vitamins B6 (50 mg), B12 (1,000 mcg), and folic acid (800 mcg). Rather than taking the cofactors along with SAMe, they can simply be taken as part of your daily multivitamin regimen.

A limiting factor in SAMe's use has been its high cost, especially at doses as high as 1,600 mg a day. Don't skimp on quality, though. Purchase it from a reputable company, in pharmaceutical-grade enteric-coated tablets. Refrigerate it whenever possible. In comparing products by potency and price, look for the amount of active ingredient on the label. For example, 200 mg of s-adenosyl-methionine butanedisulfonate provides only 50 percent or 100 mg of SAMe.

A word of caution: Though this effect is not reported in the literature, higher doses can cause irritability, anxiety, or insomnia in some people. In this case, lower the dose, but if the effect continues, stop taking it. By the same token, SAMe's antidepressant activity may trigger a manic phase in individuals with bipolar disorder, so they should not take SAMe unless under medical supervision. The same cautions apply to the use of TMG (below).

Trimethylglycine (TMG): More of the SAMe
The body can also make SAMe directly from trimethylglycine (TMG), which is much less expensive. While it has not been as extensively researched as SAMe, the fact that it is a direct precursor of SAMe would predict that its effect would be similar.

TMG is also known as "glycine betaine," not to be confused with "betaine hydrochloride," which is used to help increase stomach acid. TMG turns homocysteine, a substance toxic to the heart, into SAMe and methionine. This process also yields DMG (dimethylglycine), a well-known performance and energy enhancer, which thus doubles TMG's benefits. DMG can also be used, generally in sublingual tablets that dissolve quickly under the tongue.

Extracted from sugar beets, TMG is also found in broccoli and spinach. Except for the cautions listed above, it has no reported side effects other than brief muscle-tension headaches, and only if it is taken in large quantities without food. Optimal doses needed to raise SAMe are 1,000-3,000 mg per day. In a combination formula, 250-500 mg is enough.

An important point is that, unlike many other natural and synthetic antidepressants, SAMe and TMG are safe to take during pregnancy and nursing. There are also no reported negative interactions with other medications, such as antidepressants. This makes them particularly useful for elderly people who are often on a variety of medications and are also more sensitive to side effects. SAMe can be used safely with other natural supplements, too, including St. John's wort.

SAMe (s-adenosyl-methionine) and TMG (trimethylglycine)
How they work: Naturally occurring molecules, donate methyl groups in manufacture of neurotransmitters.

Positive effects: Enhance neurotransmitter activity; act as natural mood enhancers and stimulants.

Caution: Higher doses may lead to irritability, anxiety, insomnia, and nausea. SAMe's antidepressant activity may lead to the manic phase in individuals with bipolar disorder (manic depression), so monitor carefully.

Dosage: 200 mg of SAMe once or twice daily, between meals, increasing gradually to a maximum of 1,600 mg a day if needed; or 500-3,000 mg of TMG once or twice daily.

Omega-3 Brain Fats: The Fish Connection
You've learned how important the omega-3 fatty acids are for health and, as it turns out, for happiness. The omega-3 fatty acids, EPA and DHA, are found in fatty, carnivorous fish such as herring, mackerel, tuna, and salmon. In countries where there is higher fish consumption, there is a lower rate of depression. Also, diets and drugs that severely lower cholesterol tend to exacerbate omega-3 deficiency, causing depression, whereas supplementing omega-3 fish oils has proven effective in elevating mood. There is also a correlation between the incidence of depression and heart disease, and both are associated with omega-3 fat deficiency.

To ensure an optimal intake of the essential omega-3s, eat fatty fish three times a week. Otherwise, take an omega-3 fish oil supplement providing 500-1,000 mg of EPA plus DHA, daily. Most fish oil supplements provide around 400 mg of EPA plus DHA, so you'll need two a day. If you are vegan or vegetarian, eat one tablespoon of flaxseeds a day and one tablespoon of flaxseed oil.

EPA and DHA
How they work: Build material for neuron membranes and neurotransmitter receptor sites; enhance neural transmission; increase serotonin levels.

Positive effects: Improve learning, memory, and modd in depression, bipolar disorder, and dyslexia.

Caution: None.

Dosage: 500-1,000 mg a day, as combined EPA/DHA fish oil supplement, or eat fatty fish three times a week as an antioxidant.

B Vitamins and Minerals: Food for Thought
Some of your brain's best friends, the B vitamins, have many roles to play in ensuring optimal brain function. They are vital for delivering oxygen to the brain and protecting it from harmful oxidants. They also help turn glucose into energy within brain cells and help to keep neurotransmitters in circulation. Vitamins B6, B12, and folic acid are most important in terms of enhancing mood.

Vitamin B6 (Pyridoxine)
Vitamin B6 has an important role in brain function: it's essential for the manufacture of neurotransmitters, such as the conversion of tryptophan into serotonin, and tyrosine into dopamine. As you learned, a deficiency in these important neurotransmitters can cause depression and other problems. One study showed that about one-fifth of the people with depression who took part were deficient in vitamin B6. We suggest you take 20-100 mg a day.

Vitamin B12 (Cyanocobalamin)
Essential for the health of nerve cells, the usual dose of vitamin B12 is 10-1,000 mcg per day. Since there is a decrease with age in a stomach substance called "intrinsic factor," which is required for the absorption of vitamin B12, deficiency of B12 is a major cause of mental deterioration and confusion in older people. They may benefit from taking much higher amounts, such as 1,000 mcg daily, and from taking a form that is easier to absorb, such as tablets or liquid that dissolve under the tongue.

Folic Acid (Folate)
Like vitamin B12, folic acid is essential for oxygen delivery to the brain. Deficiency in either results in anemia. In high doses, folic acid has been shown to substantially lessen depression and symptoms of schizophrenia. You need about 400 mcg daily.

It is important to remember that B vitamins should be taken in combination to avoid possible side effects. For example, too much vitamin B6 on its own can cause neurological problems. If you want to supplement a specific B vitamin, take it along with a multivitamin containing all the other B vitamins for balance.

From a biochemical perspective, here's what to do to enhance your mood, but do bear in mind that low moods can be due to psychological factors as well.

Action Plan for a Natural Mood Lift
From a biochemical perspective, here's what to do to enhance your mood, but do bear in mind that low moods can be due to psychological factors as well. Once these basics are met, and you still need a boost, there are specific supplement recommendations. Some mood-enhancing supplement formulas combine many of these nutrients. The ideal doses are less when combined than when taken in isolation. Remember, the supplements listed below should be taken one (or two) at a time to start. Give the products a few weeks to begin working and only then try to add new ones. Do not start by taking them all together.

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