The Depression Sessions

[shijing]

Q&A: Gerald Roliz and Jill Carnahan (this was a live Q&A session, so the topics jump around a bit)

Gerald Roliz
thehealingbody.com, thepharmaceuticalmyth.com

Evista is used to prevent breast cancer, yet increases the risk for ovarian cancer. Evista works on estrogen receptors. When doctors prescribe meds, they often don’t mention the long-term risks. Use epocrates.com to check side-effects, and to find out what organ (liver or kidneys) will be stressed. Anyone who wants to adjust dosages, be sure to ask your doctor.

Osteoporosis – three important things:

1. Hydration: important to drink enough water.
2. 70% of bone strength is protein architecture, so protein is important too.
3. Minerals – important to have a balanced mineral source.

Ensure that endocrine system is strong and can incorporate organ meats/adaptogenic herbs. Any meds that work as estrogen agonists: xenoestrogens. This also includes PCBs.

One caller on Zoloft (SSRI) with Hashimoto’s: Zoloft lowers T3/T4. This is a specific case question, so one answer won’t fit everyone. Taking a hormone doesn’t necessarily restore function to thyroid gland; taking testosterone will also cause testicles to shrink because their workload has been reduced (involution). Involution happens over years because the gland gets “lazy”. If there’s too much T3/T4 in system, the pituitary tells the thyroid to lower production. The hypothalamus (upstream from the pituitary) can also be affected in this way. Each organ needs to be fed individually to strengthen it, and this eventually obviates the need for the medication.

Strategies for a person who has had stints to get off of meds: If they aren’t 100% “them” (transplants, pacemakers, etc), need to find out more. What was the cause leading up to the surgery? Inflammatory diet? Lots of trans-fats, etc? Lots of transplant patients have to be put on immunosuppressant drugs to prevent rejection. If not 100% “them”, there will have to be some compromises.

How to research who has funded studies and ulterior motives?: Don’t spend too much time figuring out “who’s the bad guy”, but you can look for authors and track them down. Example: when Gerald was at UC Berkeley, he interned at a well-known antioxidant lab. Professors who feel underpaid are vulnerable to receiving grants from biotechs, etc, and in turn selling their information. Look at who’s sponsoring a study and why, and use your intuition. Lots of studies are now being done on herbs, and a lot of people today don’t want to use them if they haven’t been studied; clinical studies are used as a tool to support your choices. Intuition: aren’t herbs that have been used for centuries better than synthetic drugs?

Societies with high-carb grain use: “Just Eat Real Food.” Societies studied by Weston A. Price – some are in blue zones (areas of the world with the highest concentrations of people on the high side of 100 years old). Vegetarianism in aboriginal societies varied widely – at the end of the day, removal of processed and refined groups is the most important thing. After that, macronutrients, etc can be discussed. If you’re fat-soluble vitamin deficient, ask how many nutrients are from fat, and if fat needs to be increased. If protein is deficient, then increase that. Some societies studied by Weston A. Price did eat bread and carbs, but traditional sprouted bread is very different from modern processed bread. Nevertheless, there was still a lot of fat consumption. Blue zone folks are similar in terms of lifestyle – they had family around them raising kids and community; more than just diet.

Reducing prescription drugs: If a drug is being prescribed to reduce the side-effects of another drug, you need to look at first drug. And why did that happen? You’ll usually find a combination of malnutrition and toxicity. A holistic practitioner will be more helpful here.

How do we fight the powerful drug companies (like SB277), and how can we get them to make safe/effective vaccines?: SB277 is a California bill that is designed to force every child who wants to attend public/private school to be fully vaccinated. The current recommendations for vaccination are enormous. If you had chicken pox as a child you’re now immune, but children are now needing to get continuous boosters (continuous revenue stream for companies). SB277 says that even if you’ve already had the chicken pox, you still need to get the vaccination. If you’ve gotten to 18 and not had the chicken pox, that’s a risk too. Homeschoolers are exempt, but not everyone can homeschool. Some parents had a child who experienced side-effects from vaccinations (SIDS, seizures, etc), and don’t want their other kids to experience that. What can be done? (1) Nonvaccinated kids can be supported in their immunity in terms of nutrition; parents can also be taught to read labels. Vaccinated kids have a higher incidence of food allergy. (2) Parents on modified vax schedule: also support immune system nutritionally and herbally. (3) Fully vaxxed: learn how to detox adjuvants, etc. Pharma industries own a lot of the politicians that support this bill. Start thinking how to work with holistic doctor for your kids.

Alternatives to vaccination?: Depends on definition of “immunization”. Go to healthsentinel.com and look at charts – Suzanne Humphries. Disease/death rates were already in decline before advent of vaccines. This gives the true solutions to improving immunity: improved sanitation/hygiene, improved nutrition. Eat specific foods/herbs. 4 immune system organs: bone marrow, spleen, thymus gland, liver. Eating these (or taking glandular supplements) will provide your immune system with building blocks.

Hyper-insomnia: If diet is good, keep doing what you’re doing. Also work with holistic doctor. Can be affected by parasites or toxicity. Eating specific foods to regenerate nervous system: raw fats, fermented fats, brain, spinal column. Challenging to get certain foods, so use certain whole-food companies. Some products are only available through practitioners. Anything can cause anything: parasites can cause ADHD, so can leaky gut (incl. leaky blood-brain barrier) or biofilms.

What is your take on synthetic vitamins vs whole-food sources?: Modern pharmaceuticals all came from nature – urethane was the first. Before that, people got medicine from plants and herbs. Companies isolated an active component and patented a synthetic version. Nutriceuticals (synthetic nutrients) are the same -- avoid nutriceuticals as much as possible. Is there a time and place to use them? Yes, but let’s start with food and herbs first. Brands used: Standard Process, Premier Research Labs, Garden of Life, Jarrow, Gaia Herbs. Food labels are the industry brainwashing us to eat processed food: just eat real food.

Getting off HCTZ – gaining water weight: Body creates physiological compensations. Whenever there’s physical or emotional trauma to the body, it will try to adapt. If it’s a chemical, the body first tries to excrete it through the kidneys. The purpose of diuretics is to dehydrate the patient. The body will naturally try to retain water. Water’s not the cause of high blood pressure. Fermented foods are the most powerful food for the kidneys. Eat kidney. Work with certain herbs to strengthen kidneys.

Can asthma be cured?: Did you have it when you were born? If you weren’t born for it, consider looking at diet and chemical exposure up until the point they were diagnosed. Energy healing, acupuncture, chiropractic is also good.

Jill Carnahan

Can you heal the gut without going dairy/gluten free?: Need to go to root cause: bacterial overgrowth? Parasites? Yeast? The number one trigger is gluten. The biggest thing is readiness to change, and taking gluten out is essential. For 99% of people, gluten needs to go.

Yogurt: Commercial yogurts are loaded with sugar, not organic, not raw, don’t always have probiotics. Making your own is the best. Also use goat yogurt or use coconut milk for those who are sensitive to cow’s milk. Use probiotic starters. Do yogurt every day unless it gives you gas/bloating, which means it’s feeding the wrong bacteria. VSL #3 is a prescription brand (900 billion) for people with Crohn’s, etc. Get rid of hand sanitizers and play in the dirt – that exposure trains the immune system when we’re young, and lack of exposure lead to asthma, autoimmune disease, etc. Will post a list of bacteria and what they feed on her blog and FB.

Pesticides: Eat 100% USDA organic. 98% of Canadian women had glyphosate in breast milk. Strawberries are always on the top of the list of glyphosate foods. It’s stored in fat and hard to get rid of – sweating is important: exercise, sauna. Binders: psyllium. Glyphosate disrupts cytochrome (phase one detox of liver), and this impairs the ability to get rid of other chemicals. It also binds minerals so we can’t access them. An apple today has 1/5 or 1/6 the level of magnesium that it used to. Glyphosate also binds serotonin.

Do food sensitivities go away when you heal the gut?: Even after you heal the gut, you may still remain sensitive to gluten, dairy, and eggs; it may be partially genetic. Other foods like pineapples and nuts may stop bothering you, but be cautious with them.

Food additives/colorings: avoid them all. Red dye #40 is associated with ADHD. Aspertame, Splenda, sucralose have a profound effect on the brain and gut. Any coloring – red, blue, you want to avoid. If gluten-sensitive, watch out for starch. 80% of medications have lactose. Check medication insert for inactive ingredients.

Food sensitivity tests: IgG 4 is not sensitive enough. US Biotech is accurate – a small company that does IgG, IgE, IgA. Cyrex does multiple foods (array #10).

GMO: corn, soy, sugarbeet, papaya. Wheat isn’t GMO, but see Stephanie Senef about glyphosate and wheat. Proteins in wheat combine with glyphosate and create a new immune response, leading to celiac and gluten intolerance. Gluten: wheat, rye, barley are not GMO, but still sprayed with glyphosate. All autoimmune disease patients are taken off wheat and gluten – proven link between gluten and autoimmunity.

Binding toxins: clay, charcoal, psyllium husk, chia seeds. Biocidin makes a good GI detox: combination of clay and charcoal.

Fecal transplants: wave of the future, but who’s a good donor? Natives of Borneo or New Guinea? The FDA has limited who can do it – mostly only gastroenterologists are doing it.

Parasite testing/treatment: sushi, swimming in lakes, streams, or hotel pools are all potential sources of parasites. Many reside in liver, pancreas, or even brain. Start with stool test – also blood test. Work with good doctor who understands anti-parasitic meds (including colloidal silver), because they can affect your good bacteria. Don’t want to be on harsh meds long-term.

If born C-section: Give children probiotics and homemade yogurt. For someone with SIBO – if you’re already overgrown in the gut, fermented foods can actually feed the bad guys. Decrease toxic exposure.

Candida: an opportunistic organism -- need to eat clean. Candida can appear many places, and won’t necessarily show up in a stool test. Acid reflux can occasionally be due to candida. Staying on extreme ketogenic diets long-term may kill off part of microbiome, and you need to have some carbs to feed the good flora. Candida tends to have worst die-off symptoms. If you’re having a bad reaction, slow down because you’re overloading your body’s ability to get rid of toxins. Typical symptoms are brain fog, fatigue, sluggishness, gut symptoms. Pantothene is very good for detoxifying acetylaldahyde. Molybdenum is good for detoxing excess sulfur. Water is important. Epsom salt baths – magnesium and sulfate (2 detoxifiers), and sauna are also good.

Xylitol and other sugar alcohols: Xylitol will stay in lumen and feed the wrong kinds of microorganisms if you have bacterial overgrowth.

Zoloft/thyroid problems: probably a binding issue. Thyroid should be taken 2 hours away from food/drink.

Sulfur intolerance: Cruciferous vegetables are loaded with nutrients. People with SIBO won’t tolerate foods high in FODMAPS/sulfur. The FODMAPS diet starves bad bacteria, but you don’t want to remain on it forever. Gas and bloating = not good for you. Sulfites (wine, dried fruit), sulfa drugs, cruciferous veggies, MSM, ALA, NAC might be problems. CBS upregulates sulfur, and a mutation will lead to sulfur methylation that is too fast which will lead to sulfur intolerance.

Histamine intolerance: people with MTHFR or DAO mutations can have trouble breaking down histamine; yeast and bacteria can lead to same; mast-cell destabilization: mold is a mast-cell destabilizer.

 

[shijing]

Andrea Nakayama
Reframing Depression: 
A Functional Nutrition Approach

replenishpdx.com
holisticnutritionlab.com

Husband was diagnosed with cancer, and began working with cancer at first. Attended workshop with Natasha Campbell-McBride on gut-brain relationship, and started working with patients with mental health issues: functional nutrition approach, like Mark Hyman, David Perlmutter, etc. Functional medicine focuses on root causes of illness, not just signs and symptoms. There are a few principles of functional medicine – one is that patient/practitioner become a therapeutic team. Many functional practitioners enjoy having patients that are aware, rather than those that treat them as God or only want what’s advertised on TV.

Reframing as it applied to depression/mental health issues: revamped social medicine matrix into functional nutrition matrix. Depression is a downstream issue that can be very complex – what we need are some frameworks to start thinking through. Not everything works for everyone, and these frameworks help you figure out why.

Three frameworks:

1. The Story. With depression, we can really get caught up in our story. ATMs: antecedents, triggers, mediators. Antecedents are genetics – there are a lot of genetic antecedents to depression, anxiety, etc. What happened with others in our family? What was mother’s pregnancy like? (Mother’s stress and its effects on adrenals, etc, can express in baby through methylation issues, etc. Gender can also be important, as can age.). The important thing to know about genetics is that they don’t determine the outcome – diet and lifestyle controls what genes express or don’t express. There can also be deeper genetic issues – transfer proteins > serotonin/dopamine receptors. Gather information through questionnaires, conversation, etc. In order to sail a ship, you have to know whether the world is flat or round. A functional approach is seeing the whole person, being a detective. Triggers are interesting – “my life was different before I went to Mexico and got that bug” or “after I got pregnant and had a baby”. Most people with autoimmunity problems can identify some point like that. Metabolic issues are also important – the change probably happened to the brain first, and it later manifested as depression. Act like a journalist. First thing to do with a client: detailed timeline and symptoms – what was going on when you first started experiencing symptoms. After intake session, do a detailed timeline session, and then create a matrix. That allows going into a session with a more comprehensive idea about a patient vs what the doctor wants to do for the patient. Different clients have different reactions – some of them have tried everything, and will be in tears because someone is finally listening to them. It’s important to serve the people who haven’t been heard, and who have tried everything. Mediators: important for depression, because factors can be identified. Triggers were the initiators, mediators happen on a regular basis. Gluten can be a mediator. How do I feel when I eat protein, or eat breakfast in the morning? How about lack of sleep, or socialization? Identifying these things give personal lifestyle tools. Flying can be a mediator – more symptoms are expressed when flying. The most common mediator is exercise, and it’s more effective than SSRIs. Diet is second (gluten, dairy, sugar).

2. The Soup: everything that’s going on internally, our physiology. Six main pillars: gastrointestinal function, inflammation and immunity, detoxification, structural balances, hormones and neurohormones, oxidative stress. We can’t think in ‘-ologies’. They all work together – when looking in matrix format, figure out what falls into different areas and what the patient is doing in that area. If we haven’t addressed a certain area, it’s a sign that we might want to look there. If someone’s stuck in the detox area, it can look like a number of things: skin, gut, liver, colon, methylation issues. Hormones and neurohormones are deeply related to the liver. These detox organs should be attended to throughout the year; these organs are often overworked. Structural issues: lots of accidents or blows to their body? Use osteopath, chiropractor, help make structural shifts. This is another way to partner. It takes a team to address chronic health issues – if depression isn’t going away, it’s time to dig, and a team can work together and support each other. They keep each other accountable and discuss the case together. Gut and brain: vagus nerve, chemicals involved in blood-brain barrier. Many factors also involved with inflammation. More and more people need to peel back the onion – they don’t need the practitioner to throw up their hands and just start prescribing chemicals. How much is done depends on how complex the issues are, how much they can afford, etc. Muddy waters need to be cleared to see what needs to be addressed. Many things are always changing: stress, hormones, etc. We need to know how to manage ourselves and make adjustments. Hormone problems – always go back to digestion. Testing with hormones is important. It’s important to understand it’s all connected – you can address leaky gut, but not have addressed all parts of the matrix.

3. The Skill: the part we often skip to, but we don’t want to do that. When we see someone promoting a supplement, we do the same thing by assuming that one pill will make everything better. Looking at Skill alone without first examining Story and Soup is a violation of the patient. Five areas: sleep and relaxation, exercise and movement, nutrition and hydration, stress and resilience, community and networks. Knowing about each of these categories and responding to individual needs can be important. For example, different people can respond differently to carbohydrates; some people need more than others. Everyone is different. We can’t just acknowledge that, we really need to dive in to bioindividuality. Community and network – many people who are depressed isolate themselves. Some people are more communal, some are more agentic – there are different needs for both isolation and community. Online communities can fill a need – connecting with people who have the same experiences can make a real difference.

Perfect system for combating depression: Core areas: Diet (Enough protein, which breaks down into amino acids? Enough fats, and can we utilize them? Anti-inflammatory, low-glycemic protocol (different for each person))? Elimination diet is key – remove gluten, dairy, sugar, then go on from there. Sometimes people eliminate too much and become nutrient-deprived. People can have difficulty digesting protein or fats, etc, so we need to make sure the diet clears those muddy waters.

Three key areas: (1) Methylated B vitamins are very important – amount and type are different for each person. Many people have polymorphisms and can’t break down folate, and when these start to express they can cause downstream problems. There can be a problem with nutrients, or with quantities of nutrients. This will be more trial and error if no testing is done – go low, go slow. A person’s response to a nutrient goes into the matrix. (2) Probiotics: bacteria are critical, probiotic supplements are related to brain health. (3) Essential fats – omega 3s, omega 6s (evening primrose oil).

Probiotics: multi-strain is best. GutPro probiotics are multi-strain and hypoallergenic. Gradually bring in greater variety, eat probiotic-rich food (kefir, kim chi, fermented foods, some kinds of kombucha).

Lifestyle: exercise is key. Even if housebound, you can use computer and go online. Don’t worry about specifics at first – just move. Meditation can be good, but again, everything is individual. Yoga, CrossFit, etc can all be good – dancing can be better than running for some people. Find the form of exercise that works for you. Sleep is hugely important and often overlooked – weight, hormones, mental health all affected by sleep. Sleep restores liver. Get to bed as close to 10:00 as possible.

In the fall: thyroid program coming up, looking at Hashimoto’s and thyroid issues through a functional lens.

 

[shijing]

Jillian Teta
The Microbiome-Mood Connection

fixyourdigestion.com
Twitter: @JillianTeta
Book: Natural Solutions for Digestive Health

Key players: Central nervous system, the enteric nervous system, the microbiome/gut flora. The enteric nervous system is a plexus of nerves that starts in the lower esophagus that goes through the gut and ends at the anus. It is equal in complexity to the spinal cord. It regulates all the minutiae of digestion: do sphincters open/close, how much fluid is active, how much pressure exists, etc. If all nerves for digestion ran through spinal cord, it would be huge. Digestion isn’t under conscious control – gut and enteric nervous system takes care of all that. The microbiome – the 100 trillion beneficial bacteria – interact with enteric system in addition to hormones, etc. A disordered gut (including flora) can feed back onto the CNS and vice versa. Lots of gastrointestinal disorder can be correlated with anxiety, depression. 90% of serotonin receptors are in the gut. It initiates peristalsis – the rhythmic muscular contraction in gut. We don’t know how much serotonin we need or if there’s a reservoir – lots of unanswered questions. David Grundy has done research that show gut flora and serotonin in GI tract, ENS, and CNS interact with each other via the vagus nerve: vaso-vagal reaction. There are dozens of serotonin receptors in different tissues – at least seven kinds of serotonin receptors in gut, but probably more. Functional bowel disorders: constipation, diarrhea, etc.

Gut bacteria and their metabolites (communicative molecules): in communication with EC (enterochromafin) cells. Spore-forming bacteria and their metabolites are interacting with EC cells, which make serotonin (spore-formation is a survival mechanism). If some forms of bacteria are too many, it can lead to obesity. Everyone’s microbiome is unique, including those of identical twins. Some are beneficial, some are commensal (neutral), and some are problematic. Questions to ask: Vaginal delivery or C-section? Breast-fed or bottle-fed? What were our first solid foods? Travel? Geography? Age? Exercise? Someone who is obese has less-diverse flora; more diversity is better.

Wrong types of bacteria or wrong ratios: If dysbiosis (overgrowth of bad guys) is present, they are imposing on ENS and creating inflammation and leaky gut. This can absolutely influence mental state and aggravate depression. Inflammatory state driven by bad gut flora: increased inflammatory gut molecules, leaky gut (intestinal barrier becomes more permeable), and particles can end up in brain.

How to know if you have dysfunction in gut? Stool testing to check for fingerprint. Lactobacillus is good, bifidobactor is also good. Fermecutes (bad) and other kinds can be pro-inflammatory. Activity of bacteria aren’t just driving serotonin production; if bacteria are disordered (instead of eating fiber, they eat mucosal lining), this can initiate an autoimmune response to serotonin – we don’t know why. The body is tagging serotonin to be neutralized, and we don’t know the complete implications. Disordered serotonin and serotonin-signaling is a component of depression. We cannot make tryptophan ourselves – we rely on plants and bacteria (or get it from meat where animals got it from the same). If we eat GMO wheat, corn, sugar, soy – glyphosate disrupts pathway in plant cell that makes tryptophan, which can make our tryptophan conversion deficient; this can lead to things like diarrhea. It’s like our body overshoots, and things go too fast. More people are eating GMO and Round-up treated plants, so this is an increasing risk.

Increasing diversity: eat a high-fiber diet. Eat veggies and a wide variety of veggies (soluble and insoluble fiber). Because everyone’s microbiome is unique, you need to find what works for you. If you can’t digest certain fibers, don’t give up on all fibers. Incorporate fermented foods (kombucha, kim chi, sauerkraut, yougurt and kefir if you tolerate caseine, miso, Bubby’s pickles). Also buy best-quality animal products that you can source and find. Organic butter, dairy, pasteured eggs, free-range meats. High amounts of poor-quality saturated fats reduce bacterial diversity. Certain beneficial gut flora hunt and kill pathogenic bacteria, keep other bad bacteria in check, and stimulate and train your immune system. Eating poor-quality fats reduces that diversity, so it's important to find free-range meat with as little chemicals and antibiotics as possible.

Judicious use of antibiotics: if you suspect you need an antibiotic, you need to confirm you actually have a bacterial infection, because they are indiscriminate killers. Too many antibiotics also foster resistance – eating meat raised on antibiotics will do the same thing. Doctors need to be better about this. 40% of prescribed antibiotics are not warranted. Antibacterial soaps and sanitizers are not the answer. It may lead to an increased amount of allergies. Essential oils are good: thyme, tea tree, oregano. But we don’t need to be constantly sanitizing our hands – it’s good during flu season or when around a sick person.

Probiotics: yes, if there are symptoms. Psychobiotics: targeted bacteria used to help optimize expression of hormones and inflammatory responses. You need to find the right ones for you: trial-and-error. The study of the microbiome is the study of poop. With dietary change, microbiome shift occurs in 1-3 days. Probiotics aren’t permanent residents of the gut, but while in transit they coach the permanent residents and also train the immune system.

Identify and eliminate food sensitivities – elimination diet. (1) Major players: soy, gluten, dairy, corn, nightshades, legumes; (2) less common: egg, citrus, tree nuts. Also assure appropriate motility – not too fast, not constipated. A stool test is good to rule out dysbiosis, SIBO, parasites, etc. Take steps to ensure integrity of gut lining – leaky gut, etc. There are a couple tests you can do for leaky gut (Cyrex labs). You can treat preemptively for leaky gut – glutamine, etc. We can boost and support serotonin production by supplying building blocks: 5-HTP; B6, B12 are serotonin-sensitizing agents. St John’s Wort boosts serotonin production and sensitivity.

Constipation and depression: if gut is disordered, CNS can be disordered and vice-versa. If someone has chronic constipation, they’re not feeling good – the microbiome will then select species that promote a slower-moving gut. Toxins can play a role – if the bowel is constipated, the liver is constipated. A good fix is magnesium glycinate in the evening, and magnesium ascorbate with a lot of water in the morning. Smooth Move tea is good for someone in a tight spot – brew it half-strength (quick fix). Balancing the autonomic nervous system helps to balance the ENS. Downtime and time to rest – sleeping – leisure walks, relationships with people, having boundaries, meditation, mindfulness, training in radical responsibility all soothe the CNS. 25% of Americans are constipated because people don’t do these things.

Getting off of SSRIs: SSRIs force the body to dump serotonin into the synapses. As a natural consequence, because body is built on feedback loops, the body registers too much serotonin and stops making it and also pulls in receptors. Endogenous production and receptor density both decrease because drugs are hijacking the system. It’s not like giving insulin to a diabetic. If you put people without depression on high enough doses of SSRIs, they would have withdrawals and couldn’t come off. When you remove the drugs rapidly, you have all kinds of rebounds and other negative consequences. Taper slowly – and use other things (5-HTP, B6, B12, St John’s Wort, etc) to ease the transition. Serotonin levels are completely individual. Exercise and high-fiber diets have similar effects, so it’s hard to pin depression solely on serotonin. Tapering should be done under supervision of a doctor.

 

[shijing]

This is a follow-up video where Sean Croxton interviews Daniel Kalish -- it's based around a program that Dr. Kalish is offering, but there's also a lot of useful information in it so I thought it would be worth posting. The video was supposed to only be available for a week, but I just checked and it's still up:

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Also, a belated thanks to everyone who posted their notes on sessions earlier in the thread :)