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Nutritional Supplements for Bipolar Disorder

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Do nutritional supplements, vitamins and minerals, actually help psychiatric disorders, like bipolar disorder, and improve mental function? Some doctors and researchers say they do.

Leave your drugs in the chemist's pot if you can heal the patient with food." Hippocrates.

In a study published in the July 2002 British Journal of Psychiatry, 172 young adult prisoners in maximum security were given supplements of vitamins and minerals roughly equating to the US recommended daily allowance (RDA), plus fatty acids. The average time for those staying in the study was 146 days. While there was no change in the placebo group, there was a 35.1 percent drop in antisocial behavior for those taking supplements for at least two weeks and a 37 percent drop in violent offenses.

Speaking at a symposium, "Mineral/Vitamin Modification of Mental Disorders and Brain Function" at the 2003 American Psychiatric Association's annual meeting, the study's lead author, Bernard Gesch CQSW of Oxford, noted that crime has increased seven-fold in the last 50 years. Over the same period of time, he reported, the trace element content in fruits and vegetables appears to have fallen significantly. According to the Centers for Disease Control, 79 percent of high school students eat less than five fruits or vegetables a day, and it is estimated that the ratio of omega-6 to omega-3 intake has increased six-fold since Paleolithic times.

The RDA was never meant to be regarded as optimal, more than one speaker reminded those at the same symposium. Instead, it is the minimum considered to prevent diseases such as scurvy or beriberi. According to a review article by Fairfield and Fletcher published in the June 19, 2002 JAMA, "most people do not consume an optimal amount of all vitamins by diet alone."

At the same session, David Benton PhD of the University of Wales, Swansea, cited his 1991 study where those who took 50 mg of thiamin (Vitamin B1) - nearly 50 times the RDA - reported improved moods and exhibited faster reaction times, with no change in the placebo group. The study population (female undergrads) were all well-nourished with no mood disorders. In another study, those on 100 mcg of the trace mineral selenium - twice the RDA - reported less depression, anxiety, and tiredness following five weeks than the control group. Finally, a 1995 study on young healthy adults found that 10 times the recommended doses of nine vitamins after 12 months resulted in improved performance on a range of cognitive functions in the females but not the males.

Do nutritional supplements, vitamins and minerals, actually help psychiatric disorders, like bipolar disorder, and improve mental function? Some doctors and researchers say they do.Dr. Benton related that the brain is arguably the most nutritionally sensitive organ in the body, playing a key role in controlling bodily functions. It is the most metabolically active organ, with two percent of the body's mass accounting for 20 percent of basal metabolic rate. With millions of chemical processes taking place, he went on to say, if each of these is only a few percent below par, it is easy to imagine some sort of cumulative effect resulting in less than optimal functioning.

Added Bonnie Kaplan, PhD of the University of Calgary: "We know that dietary minerals and vitamins are necessary in virtually every metabolic action that occurs in the mammalian brain."

According to William Walsh PhD, Senior Scientist at the Health Research Institute and Pfeiffer Treatment Center in Illinois, writing on Safe Harbor's Alternative Mental Health On-Line website:

"The brain is a chemical factory that produces serotonin, dopamine, norepinephrine, and other brain chemicals 24 hours a day. The only raw materials for their syntheses are nutrients, namely, amino acids, vitamins, minerals, etc. If the brain receives improper amounts of these nutrient building blocks, we can expect serious problems with our neurotransmitters."

For instance, some depression patients have a genetic pyrrole disorder which renders them grossly deficient in vitamin B6. Pyrroles bind with B6 and then with zinc, thus depleting these nutrients. According to Dr Walsh, these individuals cannot efficiently create serotonin since B6 is an important factor in the last step of its synthesis.

An outcome study of 200 depressed patients treated at the Pfeiffer Center found 60 percent reported major improvement and 25 percent minor improvement. Treatment complements medications, but as the patient begins improving meds may be lowered or gradually dropped. Stopping treatment will result in relapses.

Another article on Safe Harbor's website notes that depression can stem from any number of other conditions in the body, including hypothyroidism, heart problems, lack of exercise, diabetes, and the side effects of other drugs. Nutrient deficiencies include: Vitamin B2, Vitamin B6 (which can be low in those taking birth control or estrogen), and Vitamin B9 (folic acid). According to the article, 31 to 35 percent of depressed patients have folic acid deficiencies.

Other deficiencies affecting depression include Vitamin B12, Vitamin C (to a lesser extent), magnesium, SAM-e, tryptophan, and omega-3.

A 2003 Finnish study of 115 depressed outpatients being treated with antidepressants found that those who responded fully to treatment had higher levels of vitamin B12 in their blood at the beginning of treatment and six months later. The comparison was between patients with normal B12 levels and higher than normal ones rather than between deficient and normal. The study's lead author, Jukka Hintikka MD, told BBC News that one possible explanation could be that B12 is needed to manufacture certain neurotransmitters. Another theory is that vitamin B12 deficiency leads to the accumulation of the amino acid homocysteine, which has been linked to depression. A 1999 study found that both higher levels of B12 (compared to patients with deficient levels) and folate (vitamin B9 found in leafy green vegetables)corresponded with a better outcome.

A 1997 Harvard study supports earlier findings that show: 1) a link can be made between folate deficiency and depressive symptoms, and 2) that low folate levels can interfere with the antidepressant activity of the SSRIs. A 2002 Oxford review of three studies involving 247 patients found that folate when added to other treatment reduced Hamilton Depression scores by 2.65 points in two studies while a third found no added benefit, leading the authors to conclude "folate may have a potential role as a supplement to other treatment for depression."