Moody Methylation – Nutritional Support for Depression
Article adapted from Bioceuticals Clinical Insights, February 2017 Issue

It is estimated that 45% of Australians will experience a mental health condition in their lifetime (Beyond Blue 2016.) In any one year, around 1 million Australian adults have Depression (Beyond Blue, 2016.) Depression is the leading cause of disability worldwide. According the World Health Organization (WHO), depression affects about 121 million people. Untreated depression can lead to suicide, and the WHO estimates that 850,000 people worldwide commit suicide every year. Their estimates project that depression will rise to second place in the global burden of disease listing by the year 2020 which is quite alarming.

Depression is the prolong period of feeling sad, moody or low. Its experiencing these emotions quite intensely for weeks, months or even years. Although we all experience these feelings from time to time, Depression is a serious condition that affects your physical, mental and social health.
Common allopathic treatment includes prescribing anti-depressant that work on correcting the underlying imbalance of neurotransmitters such as Serotonin, adrenalin, melatonin, and cortisol which play a key role in mood regulation.

It’s interesting to note that the majority of depressed patients do not experience remission when treated with a first line antidepressant (Fava M, J Clin Psychiarty, 2010.) Therefore, we must address depression from a multi-pronged and a multi-dispensary holistic approach.

A holistic perspective
Naturopathic and Holistic medicine strategies look at mental, emotional, physical and spiritual aspects of the person to address their concerns.
First of all, we must look for a cause or causes. Conditions such as Anemias, thyroid disorders, MTHFR polymorphisms, other genetic predispositions, prolonged stress, glucose (blood sugar), adrenal function, zinc, magnesium, B12 and folate status, vitamin D, just to name a few, should all be addressed according to blood work and clinical picture.
In conjunction with phycological counselling, general treatment includes diet and lifestyle changes such as managing stress by including meditation and exercises like yoga, walking and tai chi. We need to limit inflammatory foods that may increase gastro-intestinal permeability. Increase vegetables to increase antioxidant status, include zinc rich foods such as pumpkin seeds, oysters, chickpeas, almonds and cashews. Include magnesium containing foods such as dark leafy greens, nuts, seeds, fish, beans, avaocados, yoghurt, and bananas.

A deeper approach to treatment – supporting methylation

When it comes to deeper treatment of depression, clinical nutrition can offer a lot. The adjunctive use of standardised nutraceuticals has the potential to modulate several neurochemical pathways implicated in depression and improve the inadequate response to anti-depressants. Looking into the methylation cycle and what nutrients it depends upon is an important key in this.
Danny Urbinder, Head of Education for Bioceuticals explains that “methylation is the essential biochemical process involving the addition of methyl groups to a vast range of compounds in the body. These methylation processes are important for normal gene function, detoxification, cardiovascular health, regulation of inflammation and energy production.”
It is also of high importance in the brain. There, methylation plays a critical role and is responsible for the production of all these ‘feel good’ neurotransmitters and hormones mentioned before. If this process of methylation is impaired, the critical balance between hormone and neurotransmitter production and metabolism is affected, adversely impacting mood and cognition. This can be a major cause of depression.


Key nutraceuticals in methylation

SAMe
S-adenosylmethionine (SAMe) is found in every living cell in the body where it functions as one of the chief methyl donors. Its involved in more than 100 reactions. It has a particularly important role in the metabolism of neurotransmitters including serotonin, dopamine and noradrenalin. Low SAMe levels have been found in patients with low moods and supplementing leads to raised serotonin (Braun, Choen, 2010). There are numerous clinical trials that show its beneficial effects on mood including being used in major depressive disorders (Levkovitz, 2012) and that as a supplement it is successfully used in the treatment of depression in conjunction with antidepressants (Krzystanek, 2011.)

Vitamin B12
Vitamin B12 is involved in the synthesis of SAMe and is also required by the brain for the synthesis of neurotransmitters. It is an essential nutrient for maintaining normal healthy mood and cognitive function (Linus Pauling Institute 2003.) Low levels B12 can result from eating a poor diet or not being able to absorb what you consume. Older adults, vegetarians and people with digestive disorders such as celiac disease or Crohn’s disease may have trouble getting enough B12.
Foods high in Vitamin B12 include shellfish, liver, fish, crab, fortified soy products (tofu, soymilk), fortified cereals, red meat, dairy, cheese, and eggs. If you are vegan or vegetarian and suffer low moods, it’s important to get your B12 levels checked regularly.

Folate
Folate it tied up with B12 in its function. Its deficiency is common in depressed people, with approximately one-third of depressed individuals having an outright deficiency (Miller AL, 2008.)
Folate is necessary for the proper biosynthesise for the monoamine neurotransmitters (the ones benzodiazepine class of anti-depressants are working on.) Folate also maintains SAMe’s levels in the system through this process of methylation.
Depressed individuals with low serum folate also tend not to respond well to selective serotonin reuptake inhibitors (SSRI) antidepressants drugs. Correcting this insufficiency by dosing folate with the SSRI results in a significant better antidepressant response (Miller AL, 2008.)

In a review by Coppen et al., in the Journal of Psychopharmacology 2005, they found both low folate and low vitamin B12 status were found in studies of depressive patients. Low plasma or serum folate has also been found in patients with recurrent mood disorders treated by lithium. A link between depression and low folate has similarly been found in patients with alcoholism.
Folate is found naturally in a wide variety of foods, including vegetables (especially dark green leafy vegetables), fruits and fruit juices, nuts, beans, peas, dairy products, poultry and meat, eggs, seafood, and grains. Spinach, liver, yeast, asparagus, and Brussels sprouts are among the foods with the highest levels of folate.

Despite the progressive increase in the number of antidepressants, many patients with major depressive disorders continue to be symptomatic. The adjunctive use of standardised nutraceuticals is proving to be an effective, safe and well-tolerated treatment strategy, as well as dietary and lifestyle changes. Supporting or at least investigating the methylation cycle is necessary for a holistic approach to mood disorders for deeper healing.

Written by Tegan Wallis – Naturopath, Ayurvedic consultant and Yoga teacher
If you would like to make an appointment with Tegan please visit here for more info
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