# Depression may be a Nutritional Disorder



## jurplesman (Jun 9, 2005)

There is now considerable evidence in scientific literature that there is a significant association between depression and insulin resistance. When people think of insulin resistance they immediately think of diabetes, because diabetes type II is is caused by receptors for insulin failing to push glucose across cell membranes. This may result in higher than normal blood sugar levels, called hyperglycemia, which may be responsible to various tissue damage in the body associated with diabetes.

We do not become diabetic overnight and there is usually a long period of insulin resistance that does not result in a high blood sugar levels but rather results in unstable blood sugar levels - going up and down -  and which affects our behaviour. This is called prediabetic or non-diabetic insulin resistance, also popularly called ‘hypoglycemia’ by people suffering from various symptoms associated with insulin resistance. The condition is familiar among doctors who use terms such as Syndrome X, glucose intolerance, hyperinsulinism and so on.

Dr George Samra of Kogarah (Australia) has designed a medical test that can diagnose non-diabetic hypoglycemia. This test should be very useful when we want to assess the risk of a person developing diabetes. More importantly the test can also point to some of the causes of mental illness, such as depression. It is described at our web site at:

http://www.hypoglycemia.asn.au/articles/testing_hypoglycemia.html

Another paper-and-pencil test is available known as the NBI (Search web site)

It is not yet well-known among most doctors, but it should be emphasized that it is not a test for Diabetes. It consists of a Glucose Tolerance Test taken over four hours, blood sample taken every half an hour after a glucose load. It is interested in finding the degree of variations in blood sugar levels. Sometimes blood sugar levels are within normal range, yet the patient may complain of hypoglycemic symptoms. The reason is that the test really tests the conversion of sugars in our food into biological energy (ATP) along the biochemical pathway called glycolysis. For instance, if there is an imbalance between zinc and copper levels, this will affect glycolysis and hence can cause an obstruction in energy production despite normal blood sugar levels. The end-product of glucose metabolism is biological energy (ATP)!

The question is: why is it that insulin resistance (hypoglycemia) may cause mental illness such as depression, as studies seem to suggest? It is true that not all people with insulin resistance will experience depression, but those who do are usually found to be hypoglycemic.

For the body to convert one molecule into an other, such as in the conversion of tryptophan (found in food) into serotonin, it requires an inordinate amount of biological energy to complete that conversion. It is known that the brain, although 2% of the body requires about 80% of all available energy in the form of glucose to carry out its chemical reactions in the brain. This is regardless whether we are asleep or awake. An active cell requires more than two million molecules of ATP per second to drive its biochemical machinery.

Thus without adequate amounts of biological energy the brain cannot produce serotonin. With inadequate amounts of serotonin the patient cannot experience happiness, relaxation and contentment, when they normally should. Serotonin is also involved with the appetite mechanism and hence a serotonin imbalance is often associated with problems of obesity. Besides excess unused blood glucose is eventually stored as fat cells. 

Because melatonin, the sleeping hormone that makes us sleep in conditions of darkness, is derived from serotonin, depression is usually associated with insomnia.

Brain cells deprived of energy, like that of oxygen, would soon die. When brain cells sense energy starvation, threatening the life of cells, it triggers the release of adrenaline and other stress hormones to raise blood sugar levels in a hurry. Adrenaline functions to convert sugar stores in the body (glycogen) back into glucose so as to feed the brain again. But adrenaline is also responsible for the unexplainable anxiety attacks, phobias, depression, mood swings, alcoholism and drug addiction, anger outbursts and the myriad of ‘psychological’ symptoms that go under the various diagnostic labels in psychopathology.

The non-drug treatment for hypoglycemia (partial insulin resistance) is going on a hypoglycemic diet, which like the diabetic diet is a high protein, low refined carbohydrate diet accompanied with various nutritional supplements involved with sugar metabolism.

Thus Depression turns out to be a NUTRITIONAL DISORDER!


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## David Baxter PhD (Jun 9, 2005)

> Thus Depression turns out to be a NUTRITIONAL DISORDER!


I think that's rather an overstatement.

I would agree that symptoms of depression can have more than one cause -- hypothyroidism comes to mind immediately. But I wouldn't jump from that to claiming that depression is a thyroid disorder.


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## ThatLady (Jun 9, 2005)

Agreed, Dr. Baxter. I think it's a bit of a stretch to blame ALL depression on ANY one thing. Some depressed people may be so because of a thyroid deficiency, others because of hypoglycemia, and still others for reasons of which we are not yet aware. There's a great deal of study left to be done in this area. It's always dangerous, in my opinion, to jump to the conclusion that the reason for something as common as depression has ultimately been found, because it tends to stop people from searching for other possible causes.


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## jurplesman (Jun 9, 2005)

Dear Dr Baxter, 

If you would have read:
"What is hypoglycemia" at our web site you would have seen that hypothyroidism is one of the factors in depression and which is also responsible for a flat curve hypoglycemia. Besides there are many other medical conditions that have depression as a comorbid condition. I suppose you would be aware of that.

I know I represent the psychonutritional point of view that may conflict with mainstream medicine and psychology. I find that such statements such as " blame ALL depression on ANY one thing" rather demeaning and symptomatic of therapists that have little understanding of the nutritional aspects of mental illness.

Psychonutrition is an evidence based science and if you want to criticize it then show me evidence that "insulin resistance is NOT significantly associated with depression".

Please also read:

"Research evidence for hypoglycemia" at our web site.

It is just a new approach backed up by much scientific evidence, requiring some knowledge of nutritional biochemistry.  I would have expected that a new angle on mental illness would be welcomed at this discussion board. It is a broader view of mental illness then the conventional drugs and/or psychotherapy model. 

Please also consult:

Alternative Mental Health

I hope that you do allow a discussion on the nutritional aspects of mental illness to be part of this discussion board. If this falls outside the scope of this board, just let me know and I will refrain from visiting this board in future.


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## ThatLady (Jun 9, 2005)

Heh. In the first place, I'm not a therapist. I'm a Registered Nurse and well aware of the nutritional aspects of both physical and mental health. However, I do not believe it's a good idea to put all one's eggs in one basket. While some people might suffer depression because of nutritional deficiencies, others might have completely different reasons for being depressed. While good nutrition certainly cannot hurt these people, it won't necessarily treat their depression.

I'm a firm believer in good nutrition. I simply do not believe it to be the ultimate answer in all, or even most, cases of depression.


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## jurplesman (Jun 9, 2005)

Hi ThatLady

You might come to a different conclusion if you had the opportunity to test depressed people for hypoglycemia. In my career spanning over 30 years we have tested thousands of people, with mental illness, depression, alcoholicsc drug adicts, OCD, PTSD, violent offenders, compulsive gamblers and so on and on. We found that the majority proved postive to the GTTH. The test is not very well known among conventional doctors but complemenatry doctors are aware. Please understand that hypoglycemia is caused by Insulin Resistance

Please read:

Dr George Samra, THE HYPOGLYCEMIC CONNECTION II" (search our web site)

He is some more evidence:

Insulin Resistance and Depression

Bech P, Raabaek Olsen L, Jarlov N, Hammer M, Schutze T, Breum L.  A case of sequential anti-stress medication in a patient with major depression resistant to amine-reuptake inhibitors. Acta Psychiatr Scand. 1999 Jul;100(1):76-8. PMID: 10442443

Timonen M, Laakso M, Jokelainen J, Rajala U, Meyer-Rochow VB, Keinanen-Kiukaanniemi S. Insulin resistance and depression: cross sectional study. BMJ. 2005 Jan 1;330(7481):17-8. Epub 2004 Dec 16.

Chiba M, Suzuki S, Hinokio Y, Hirai M, Satoh Y, Tashiro A, Utsumi A, Awata T, Hongo M, Toyota T. Tyrosine hydroxylase gene microsatellite polymorphism associated with insulin resistance in depressive disorder. Metabolism. 2000 Sep;49(9): 1145-9. PMID: 11016895

Holden RJ. Schizophrenia, suicide and the serotonin story. Med Hypotheses. 1995 May;44(5): 379-91. Review. PMID: 8583968

Huerta R, Mena A, Malacara JM, de Leon JD. Symptoms at the menopausal and premenopausal years: their relationship with insulin, glucose, cortisol, FSH, prolactin, obesity and attitudes towards sexuality. Psychoneuroendocrinology. 1995;20(8): 851-64. PMID: 8834092

McCarty MF. Enhancing central and peripheral insulin activity as a strategy for the treatment of endogenous depression--an adjuvant role for chromium picolinate? Med Hypotheses. 1994 Oct;43(4): 247-52. PMID: 7838010

Morley JE. The elderly Type 2 diabetic patient: special considerations. Diabet Med. 1998;15 Suppl 4: S41-6. Review. PMID: 9868991

Okamura F, Tashiro A, Utsumi A, Imai T, Suchi T, Hongo M. Insulin resistance in patients with depression and its changes in the clinical course of depression: a report on three cases using the minimal model analysis. Intern Med. 1999 Mar;38(3): 257-60. PMID: 10337937

Okamura F, Tashiro A, Utumi A, Imai T, Suchi T, Tamura D, Sato Y, Suzuki S, Hongo M. Insulin resistance in patients with depression and its changes during the clinical course of depression: minimal model analysis. Metabolism. 2000 Oct;49(10): 1255-60. PMID: 11079812

Palinkas LA, Lee PP, Barrett-Connor E. A prospective study of Type 2 diabetes and depressive symptoms in the elderly: the Rancho Bernardo Study. Diabet Med. 2004 Nov;21(11): 1185-91.  PMID: 15498084

Prestele S, Aldenhoff J, Reiff J. [The HPA-axis as a possible link between depression, diabetes mellitus and cognitive dysfunction] Fortschr Neurol Psychiatr. 2003 Jan;71(1): 24-36. Review. German. PMID: 12529832

Raikkonen K, Matthews KA, Kuller LH. The relationship between psychological risk attributes and the metabolic syndrome in healthy women: antecedent or consequence? Metabolism. 2002 Dec;51(12): 1573-7. PMID: 12489070

Ramasubbu R. Insulin resistance: a metabolic link between depressive disorder and atherosclerotic vascular diseases. Med Hypotheses. 2002 Nov;59(5): 537-51. PMID: 12376076

Salazar MR. Alpha lipoic acid: a novel treatment for depression. Med Hypotheses. 2000 Dec;55(6): 510-2. PMID: 11090300

Willey KA, Singh MA. Battling Insulin Resistance in Elderly Obese People With Type 2 Diabetes: Bring on the heavy weights. Diabetes Care. 2003 May;26(5): 1580-1588. PMID: 12716822

Wolkowitz OM, Epel ES, Reus VI Stress hormone-related psychopathology: pathophysiological and treatment implications. World J Biol Psychiatry. 2001 Jul;2(3): 115-43. Review. PMID: 12587196

Wright JH, Jacisin JJ, Radin NS, Bell RA. Glucose metabolism in unipolar depression. Br J Psychiatry. 1978 Apr;132: 386-93. PMID: 638393


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## David Baxter PhD (Jun 9, 2005)

jurplesman said:
			
		

> I know I represent the psychonutritional point of view that may conflict with mainstream medicine and psychology.


I don't think there is any inherent conflict. But I do think the claims you are making about that viewpoint are misleading and dangerous.



			
				jurplesman said:
			
		

> I find that such statements such as "blame ALL depression on ANY one thing" rather demeaning and symptomatic of therapists that have little understanding of the nutritional aspects of mental illness.


I don't know how you can complain about the quoted statement or claim that it is demeaning aftet you opened this thread (see top of page) which the statement:



			
				jurplesman said:
			
		

> Thus Depression turns out to be a NUTRITIONAL DISORDER!


That certainly sounds as though you are attempting to "blame ALL depression on ANY one thing" to me. You also made similar sweeping and misleading or false statements in other posts.



> Psychonutrition is an evidence based science and if you want to criticize it then show me evidence that "insulin resistance is NOT significantly associated with depression".


I have never made the claim that nutritional or endocrinological factors are never implicated nor that they are never associated with depression. But I do and will continue to object to statements which portray those factors as the single cause of depression, because that is a dangerous oversimplification which, if taken as fact, might very well lead to unnecessary suffering for depressed patients and possibly more drastic outcomes including suicide.


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## ThatLady (Jun 9, 2005)

I'm well aware of the connections. As I've said in another thread, this is by no means a new concept. It's been around for quite awhile. While it has its good points, and may be useful to some patients, it is not a panacea for all patients and should not be touted as such.


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