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Before you go on to find out what are the best alternative supplements, herbs or treatments for issues such as Depression and Anxiety, it is important to lay the groundwork and ensure you are taking in the right nutrients from your diet.
This well known vitamin has more functions than is generally known. It is essential for strong bones, immunity, but also this “sunshine” vitamin that is made in the skin when exposed to sunlight, also contributes to a sunny outlook.
The fact that most people are deficient makes it one of the most important vitamins to optimize. Main dietary sources include oily fish, eggs and fortified milk and cereals.
It has been researched to be especially effective in Seasonal Affective Disorder, a depressive condition affecting sufferers in the winter months of the northern hemisphere, hypothesised to be due to a lack of sunlight and therefore low Vitamin D production.
If you already get plenty of direct sunlight on your skin every day (without using sunscreen), chances are you would not benefit significantly from supplementation. However if you need to wear sunscreen, this also blocks Vitamin D synthesis in the skin. In places like Australia with diminished ozone, it can be difficult to get enough sun without sunscreen as melanoma (skin cancer) is a risk, so in this case improving the diet and taking supplements may be the answer.
Dosage: It is recommended but not essential that you get your levels tested with your physician, so you can track your progress. Optimal levels are also sometimes above normal dietary intake. In any case, successful scientific research into treating depression has used doses such as 2000-4000 IU per day for 1 month, and reduced by half for the following 2 months. 1000 IU is a good maintenance dose to be taken on a daily basis.
You may notice that you have more energy after taking your daily supplement, so it is best to take it in the morning.
There are multiple forms available, the most common of which is Vitamin D3 isolated from lanolin (sheeps wool), however there is also a vegetarian/vegan version made from lichen. Another alternative is Vitamin D2 which is made from various mushrooms. If you find one form or another intolerable, try another form.
Mechanisms: Among many others, one mechanism of vitamin D is that it induces synthesis of serotonin in the brain.
If you want to get into the nitty gritty, the active vitamin D metabolite, 1,25-dihydroxyvitamin D3 (1,25D) induces expression of tryptophan hydroxylase-2 (TPH2), the main enzyme involved in inducing serotonin (5-HT) synthesis in the body. 1,25D also functions as an indirect, molecular-genomic stage mimicking antidepressants such as SSRIs and MAO inhibitors, likely elevating serotonin in the central nervous system (CNS/Brain). (1)
This well known dietary mineral also has many functions above the well known few. Magnesium deficiencies are common in developed countries, so it is especially important to ensure your levels are optimal when dealing with and preventing mental health issues.
Deficiencies can also be caused by diabetes or other conditions. Excess calcium intake also contributes to low magnesium as the two compete for absorption. Apart from a lack of magnesium contributing to depression and anxiety, without enough, blood pressure can be elevated and insulin sensitivity decreased, possibly leading to more serious health consequences down the track.
Mechanisms: Magnesium has a calming, stabilizing effect on the brain, helping to facilitate serotonin neurotransmission, as well as mildly binding to GABA-A receptors like a mild natural tranquillizer, in a similar way to inhaled lavender essential oil. Magnesium is also an NMDA antagonist, an action which is being investigated as having antidepressant effects.
Dosage: There are many forms available. The most effective form for the brain is Magnesium L-Threonate by far, because it passes through the blood-brain-barrier most effectively. It also works the excellently for improving short and long term memory, cognition and general mental acuity. For general deficiency, other calming forms worth trying include Taurate and Glycinate. Malate and citrate are also good if you prefer it less tranquilising but can produce a laxative effect.
Omega-3’s refer to two essential anti-inflammatories for the brain and body called EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). These omega-3 fats are usually found in fish and phytoplankton and are available in fish oil as well as vegan algal oil supplements. There is also Flaxseed oil which is more traditionally used by vegans and inefficiently converts into EPA/DHA but it is recommended to use the Algal oil if you are vegan, because taking DHA and EPA directly is much more effective. It appears to notably improve mood in people with major depression. (2)
Mechanisms: EPA seems to be the most effective omega-3 fatty acid for improving mood.
Dosage: In general, 250mg of combined EPA and DHA is the minimum which can easily be obtained from fish intake alone. The American Heart Association recommends 1000mg daily.
In one study 1g of EPA demonstrated the the best antidepressant effect. You may need to experiment to find the right dose for you. Current evidence supports the finding that omega-3 with EPA ≥ 60% at a dosage of ≤1 g/d would have beneficial effects on depression. (3)
It is recommended to take a good B-Complex as B vitamins are essential to mental health.
However when choosing more potent or specific B-vitamins to supplement with, it is important to find out which you actually need for your body which is dependent on what’s called your methylation status.
There are over-methylators and under-methylators, each have certain identifiable characteristics and resultant treatment options. Taking too much of the wrong thing that takes methylation in the wrong direction for you can result in detrimental effects.
If you have high histamine (seasonal, dust allergies, pet dander, etc) and respond well to antihistamines, then you are most likely an under-methylator.
If you have low histamine and antihistamines make you feel worse, you are likely an over-methylator.
Outside the USA it can be difficult to find a sufficiently potent product in the right forms to be helpful and effective. Therefore I recommend these forms:
This essential vitamin helps convert dopamine and serotonin from its precursors in the body and along with B12 keeps homocysteine levels in check. It also may improve memory and dream recall.
As to which form is best, Pyridoxine Hcl is recommended. The phosphorylated forms such as Pyridoxal 5’ phosphate (PLP) and pyridoxamine 5’ phosphate (PMP) get dephosphorylated back into pyridoxine, and the pool of free vitamin B6 is absorbed by passive diffusion; therefore there is no scientifically proven benefit to using these other forms. (4)
Dosage: The minimum intake is 1.3mg per day for adults, and the tolerable upper limit is 100mg per day for adults. It is recommended to start low and increase if needed. It is cautioned not to exceed the tolerable upper limit, as although normally safe, excessive sustained doses can lead to toxicity.
Vitamin B12 supports energy production and is also essential for methylation processes. Put simply, methylation helps us make neurotransmitters, such as dopamine, serotonin, adrenaline, norepinephrine and melatonin. Certain groups are likely to be deficient in B12, such as vegetarians and especially vegans due to the fact that fish, meat, poultry, eggs, and dairy products are the main dietary sources.
Forms: There are different forms of Vitamin B12 (which is cobalamin from the metal element cobalt):
Dosage: 1-2mg (1000-2000mcg) per day sublingually (dissolved under the tongue). For pronounced deficiency, up to 3mg (3000mcg) can be taken. A combination of Methyl & Adenosyl is recommended.
Folate has an essential role in the methylation process. Folic acid is the synthetic form that through a long process forms 5-MTHF (5-methyltetrahydrofolate) or L-methylfolate. Many people have a genetic mutation that prevents this transformation, but even without this mutation it is more optimal for the body to just supplement with the active form.
Folate is involved in creating S-Adenosyl Methionine (SAMe) indirectly in the body. As such, folate supplements show similarities to the SAMe supplement.
What does SAMe do?
SAMe supplements are often used to treat depression and anxiety. They are thought to work by increasing levels of neurotransmitters in the brain such as serotonin and dopamine.
However excessive or large doses of SAMe on its own has recently shown some evidence of carcinogenicity (potentially cancer causing) which is why I do not recommend this supplement. However in the natural and low amounts obtained by reasonable supplementation of folate in case of deficiency or non-optimal levels there is unlikely to be any such risk.
Keep in mind SAMe is formed naturally and used in the body and has plenty of benefits at normal levels. Creatine and trimethylglycine (TMG) also support SAMe by an alternate pathway.
SAMe in the body is usually synthesised from the amino acid L-methionine that you get in most proteins, so if you already have a high protein intake from any meats, fish, chicken and eggs, you should be getting plenty of it already. However you can still be low in folate on such a diet.
For vegetarians and vegans, plant based proteins often have less protein density so it is a good idea to calculate how much protein you are getting, or simply buy a plant based protein powder. Some good protein sources are peas, hemp seeds, nutritional yeast, soy, and even rice (Note: I do not recommend soy for men as it is estrogenic and works against testosterone).
Zinc is an essential mineral for the human body. It plays a role in many different processes including immunity and is also essential for proper brain development and function. It is involved in the synthesis of neurotransmitters, and helps to protect brain cells from damage. It even improves testosterone levels in men, which in itself is beneficial for mood.
Low levels of zinc have been associated with depression, and zinc supplementation has been shown to improve mood in both depressed and healthy individuals. Zinc deficiency has been linked to impaired cognitive function, and zinc supplementation has been shown to improve mental performance in both children and adults.
Mechanisms: The antidepressive effects of zinc are believed to be mediated by an increase in BDNF, which has been observed in the blood of depressed subjects given 30mg elemental zinc over the course of 3 months compared to placebo (6).
Zinc is also an NMDA antagonist (7), similarly to Magnesium. NMDA antagonists are under investigation as novel antidepressants.
Dosage: For depression – 30mg Zinc gluconate per day is recommended as used in this study. The brand used is Nature Made.
Normal doses are 5-10mg for daily health maintenance, 25-45mg for those at risk of zinc deficiency.
Superloading with up to 100mg per day is safe for 2-4 months only. Never superload when you have any risk factors for stroke or after a stroke. If in doubt check this. 40mg daily is the official Tolerable Upper Limit (TUL).
In the US, elemental weight is always used on the Supplement Facts panel. Outside the US, most supplements will do the same, however some may list the non-elemental weight and so are a lot less potent than you might think. For example, Zinc citrate is about 34% zinc so 50mg elemental zinc is 146mg zinc citrate.
You should now have a good sense of the first steps in your mental health journey. If you found this article helpful or have any comments or experiences of your own, please don’t hesitate to comment below!