Minerals, Vitamins and Mental Health -what a Holistic Psychiatrist Wants You to Know
Biochem was my favorite class in medical school. It was cool to open up cadavers and see how small a deflated lung is. It was interesting to learn about DNA changes resulting in rare diseases. But biochemistry was astounding. When I realized that all our aliveness could be boiled down to chemical reactions that sustained human life, I was in awe. You know how America runs on Dunkin'? Turns out our bodies run on biochemical reactions. There are 37 billion trillion biochemical reactions taking place in our bodies every single second, to be precise about it.
I remember the exact moment I learned that we need adequate vitamins in our diet because without them, enzymes (which bring together two separate molecules and combine them into something new during biochemical reactions) can’t function. For example, vitamin K is required for the biochemical reaction of forming blood clots. Without enough of it, we'd bleed out.
Another revelation stunned me: the brain is the most metabolically active organ in the body. Metabolism is all the chemical processes that occur within a living organism in order to maintain life. The brain, which accounts for only 2% of our body weight, uses 20% of our energy while at rest. You know the feeling of being tired after doing thought-intensive work? The brain was churning out extra biochemical reactions to do all that thinking! Because it's so biochemically active, the brain is very susceptible to mineral and vitamin deficiencies. When there are deficiencies, the brain tells us that it doesn't have the raw materials to function well through mental health symptoms of anxiety and depression—low mood, going over the same thoughts over and over, difficulty fully engaging with life. It can also show up in physical symptoms of numbness or muscle weakness.
There's a large body of research showing that "depression is a multifactorial disorder which can arise through an imbalance of numerous trace elements and vitamins." Both research and clinical experience have shown that:
There is an association between the amount of a nutrient in a diet and depressive or anxiety symptoms.
There is an association between serum level of minerals and depressive or anxiety symptoms.
Minerals have antidepressant or anxiety-lowering effects.
Supplementing psychiatric medication with minerals can improve how effective the treatment is.
Let's delve into the function of some crucial minerals to both prevent and treat mental health symptoms.
Zinc
Regulates the storage and release of neurotransmitters.
Acts as a neuromodulator, meaning it influences the activity of neurotransmitters, such as glutamate and GABA. Brain cells use neurotransmitters to communicate with each other.
Magnesium (Mg)
Is necessary for the enzyme tryptophan hydroxylase to function, which converts tryptophan to 5-HTP, which is then converted to serotonin.
Is required by the enzyme tyrosine hydroxylase, which converts tyrosine to L-DOPA, which is then converted to dopamine.
Is needed by the enzyme dopamine-β-hydroxylase that converts dopamine to norepinephrine.
Iron
Is required to make hemoglobin, which delivers oxygen to the brain.
Is required by the enzyme tyrosine hydroxylase, which converts tyrosine to L-DOPA, which is then converted to dopamine.
Is needed by the enzyme that converts dopamine to norepinephrine.
Is involved in the production of succinate, which later becomes GABA.
Vitamin B12
Is needed for the function of an enzyme called methionine synthase, which ultimately produces SAMe, necessary for the synthesis of dopamine and norepinephrine.
SAMe is also necessary for the regulation of serotonin receptors and transporters, which balances the amount of serotonin in our brains and bodies.
Vitamin D
Is necessary for converting tyrosine to L-DOPA, which is then converted to dopamine.
Regulates the genetic expression of the enzyme tryptophan hydroxylase, which converts tryptophan to 5-HTP, which is then converted to serotonin.
Modulates the enzyme choline acetyltransferase, which makes acetylcholine, another neurotransmitter.
Importantly, we can't produce minerals or vitamins ourselves, so we need to eat them consistently and in adequate amounts. Deficiencies of minerals and vitamins are most commonly due to inadequate dietary intake and sometimes higher need because of genetic variations or medications being taken. "A Western-style diet high in processed foods (including processed meat, white bread, sugar) is associated with a higher incidence of affective disorders compared to a traditional diet (including fruit, vegetables, whole grain foods)." Affective disorders include depression and anxiety.
In short, our Standard American Diet is calorie-rich but nutrient-poor, leaving us fed but malnourished in regards to basic nutrients. This is because processed foods always have fewer minerals and vitamins than unprocessed foods due to the way they’re made. Unfortunately, due to ubiquitous poor farming practices, the soil that grows our fruits and vegetables is not as nutrient-dense as it was years ago. This can result in nutrient deficiencies even in those doing their best to eat mainly whole foods.
It’s important to note that no mineral or vitamin works alone in the human body. For example, the synthesis of dopamine requires iron, magnesium, zinc, vitamin B6, vitamin B9, and vitamin C. Interestingly, vitamins and minerals are not found in isolation in fruits, vegetables, or meat, but rather always in combination. Humans have evolved eating these whole foods, meaning that our bodies are used to getting the combinations of minerals and vitamins naturally found in them. Thus, the best source of vitamins and minerals is whole foods, and the second-best source is supplements.
Now that we know that low levels of minerals and vitamins contribute to mental health symptoms, we must include their evaluation in mental health treatment. Unfortunately, most conventional mental health providers are well-meaning but uneducated in this realm—most medical schools provide 5 hours of nutrition teaching. If they haven’t sought out further training, they don’t know the importance and effectiveness of evaluating and treating the many potential causes of mental health symptoms, including vitamin and mineral deficiencies, and stick to just prescribing psychiatric medications.
Holistic psychiatrists use specific lab testing in combination with narrower result ranges to determine which minerals and vitamins are deficient. Then they recommend repletion through supplements to recalibrate the imbalances as soon as possible, with a diet full of whole, nutritious foods being the ultimate goal. In addition, holistic psychiatrists take into account bioindividuality, meaning that we all vary to a degree in our biological makeup and requirements. In regards to minerals and vitamins, this means that although there are minimum daily intake amounts everyone needs, some may need more than others. For example, the right amount of zinc for Sally may not be enough for Joe. There are several reasons for this. Magnesium is used up more quickly in those experiencing stress, birth control depletes vitamin B12, and seizure medications deplete folate (vitamin B9), to name a few. Additionally, Joe may have a genetic alteration that makes a certain biochemical reaction proceed quicker than Sally's, resulting in a higher need for all the minerals and vitamins involved.
The bottom line is that deficiencies in minerals and vitamins are risk factors for and known causes of mental health symptoms, including depression and anxiety. Making sure we have adequate amounts in our brains and bodies through lab work must be a part of mental health treatment. Although the connection between nutrient deficiencies and mental health symptoms is well-established, most psychiatrists or primary care physicians who treat people for mental health symptoms don't check for them. A holistic psychiatrist emphasizes the multifactorial nature of mental health, knows nutrient deficiencies are often part of the picture, and always tests for them, ensuring that each contributor to mental health symptoms is being addressed.
I created Brain-Body Psychiatry to bring you better mental health treatment through holistic psychiatry.
We all need support, guidance, and accountability in making and sustaining positive changes.
Brain-Body Psychiatry provides the tools and takes the time to guide you to your full potential.
If you’re interested in this approach, I am very excited to work on this together.
With care,
Dr. Luisa Cacciaguida
Sources:
Essential elements in depression and anxiety. Part I
Essential elements in depression and anxiety. Part II
Disclaimer:
This blog post is intended to be informative and does not replace individual medical advice. Always consult with your healthcare provider or a professional for any personal medical decisions or concerns you may have. Everyone's health situation is unique and should be evaluated by a healthcare professional.
This blog post is designed as a general guide. This is not a substitute for personalized medical advice, nor is a patient-physician relationship established in this blog post.
