Silent Diseases and Mood Disorders

By Jurriaan Plesman, BA (PSYCH), Post Grad Dip Clin Nutr

For many people it is difficult to believe that nutrition has anything to do with "mental illness". Mood disorders may appear out of the blue, without any apparent cause. Often a stressful event may be a trigger, leaving a person with a lasting emotional turmoil, apparently quite unrelated to one's diet. Mood disorders may be of many forms, from anxiety attacks, depression, Obsessive Compulsive Disorder (OCD), Post Traumatic Disorder (PTSD), to addiction. But let us focus on depression as one example of the many mood disorders.

It is important that when we talk about depression, we must make a distinction between "environmental" depression and "endogenous" depression. From a client's point of view, he is usually aware of the causes of "environmental" depression (such as rejection in love, death in family, grieving or traumatic event). In environmental depression, the person may often benefit from counselling or “talk-therapy”. In clinical depression, on the other hand, the client is most often NOT AWARE of the causes and this may lead him to seek professional help. Nevertheless, both environmental and endogenous factors can operate in tandem, but in that case we need to treat the biological factors first, before considering “psychological” factors. We need a healthy body to be able to deal with stress.

The evidence is overwhelming that "endogenous" depression, sometimes called "clinical depression", is nearly always due to some inner biochemical abnormality, although it may have psychological elements. Talk therapy and/or drug therapy often fails to bring permanent relief for the majority of patients. See studies.

I have said that one of the major factors triggering a depression or anxiety or a mood disorder is insulin resistance, a silent disease, and in particular pre-diabetic insulin resistance or hypoglycemia. See References. This can cause brain energy starvation triggering the release of excess adrenaline, a hormone that functions to convert glycogen (sugar stores) back into glucose, so as to feed the brain again. (See image) Insulin resistance interferes with the production of biological energy (ATP), necessary in the production of feel good neurotransmitters such as serotonin. Of course, this is not the only factor, there are many others. This can easily be established by carrying out a 4-hour glucose tolerance test as explained at our web site. We have found that most clients responded positively to this test, supporting the notion that a mood disorder is primarily a biochemical disorder. Other scientists have found the same:

"Many books that I've read - in particular, Carlton Fredricks's "New Low Blood Sugar and You" - say that when there is any mental disorder present, hypoglycemia is going to be right there along with it. Gary Null Page 264

Silent Diseases at the root of mood disorders

One need to understand that many of the underlying metabolic disorders affecting our minds are silent diseases, meaning that the person is not aware of the existence of the illness. Apart from insulin resistance, a typical example is the "Syndrome X" or the "Metabolic Syndrome", which is a combination of abnormal medical conditions such as hypertension, high triglycerides, insulin resistance and obesity. Usually, a person becomes only aware of the existence of this disease when his doctor measures his blood pressure and "discovers" that he has "high blood pressure". The reason appears to be that hyperinsulinism can cause magnesium to be dumped in the urine, upsetting the delicate balance of intracellular magnesium and calcium ions that regulate blood pressure, thereby contributing to hypertension. RAS Hemat Page 38.

Several authors have reported a significant association between metabolic syndrome and depression, Scott D Mendelson et al, 49 G Medeiros-Net et als.,1017 Gaetano Crepaldi et als., 7, Richard A Bermudes, 32

Depression associated with Metabolic disorder is more at risk of heart disease as well as type 2 diabetes. Vnitr Lek. 2009 Jul-Aug;55(7-8):650-2

Anxiety, panic attack and depression may be associated with certain heart conditions such as mitral valve prolapse.

Medicine seems unable to predict and treat Syndrome X or the Metabolic Syndrome at its root. The reason could be that medical fraternity seem to be in denial about the existence of hypoglycemia following a statement made by the AMA in 1973. See: Marilyn Light. The test for hypoglycemia as mentioned above, would help doctors to diagnose it. Both Syndrome X and hypoglycemia (or pre-diabetic insulin resistance) are difficult to treat without drugs, hence conventional medicine centers around the use of drugs - practically the only form of "treatment". Conventional medicine does not encourage to use non-drug treatments that are available. Allopathic medicine seldom solves the problem. In fact, orthodox medicine has been in denial about the existence of hypoglycemia for many years. (See also: Hypoglycemia: A Forgotten Disease by Dr George Samra --> page 6)

While early diagnosis and treatment leads to improved outcomes, diabetes remains undiagnosed in up to 50% of patients. MJA 2007 186(10):500-503.

Marilyn Light claims 10 - 25% of population is afflicted with hypoglycemia Marilyn Light. Not only that, for insulin resistance to develop into full-blown diabetes may take up to 20-30 years. Derek LeRoith et als. page 1151.

This reinforces the notion that it is a "silent disease" with dire consequences to one's physical and mental health, such as Eating Disorders.

Thus a person may have been suffering for many years from a silent disease, which can be triggered into full-blown depression, by an environmental stress situation.

Another silent disease affecting the mind is a food sensitivity to α-gliadin which is a component of gluten that can cause celiac disease, Rosalinda T Lagua, 92. Undiagnosed celiac disease is a common factor in the development of Alzheimer's disease, Schizophrenia or Down's syndrome. Chris M Reading at al 2004 This applies to many other allergies and food sensitivities. Linda Knittel et al, 61, EW Cutler, 8, Gary Null, 116, Allergies: The Food and Disease Paradigm by Dr George Samra.

Other examples of a silent diseases are related to various illnesses of the the digestive system, that can affect the mind. A good illustration is the Leaky Gut Syndrome. When the bowel is inflamed, the gut lining becomes permeable and toxins are absorbed into the blood stream. This gives rise to many immunological reactions, among these symptoms of mood disorders. Partially digested molecules act as antigens - recognized as foreign substances by the body - that provoke an immune reaction. . RAS Hemat ,394,

Hemat argues that:

"The lining mucosal cells of the digestive tract have a high turnover rate such that the whole layer of surface cells may be renewed in 3-4 days. An inability to manufacture adequate building blocks (in this case, glucosamine "amino-sugars") will cause the intestinal wall to "thin" and allow toxins and not fully digested proteins into the blood stream." Hemat 41-2

There is strong evidence to support that depression is linked to the Leaky Gut Syndrome. Matthew Hogg, Maes M et als. 2008, Diseases associated with the Leaky Gut Syndrome are: inflammatory bowel syndrome or Irritable Bowel Syndrome(IBS), acne, eczema, psoriasis, AIDS, cystic fibrosis, liver disease, rheumatoid arthritis, asthma, celiac disease, lupus, fibromyalgia, Chronic Fatigue Syndrome (CFS), autism, food and chemical sensitivities. Louise Tenney, 14 and Elizabeth Lipski, 25

See also Altered Immunity & The Leaky Gut Syndrome by Dr Zoltan P Rona HYPONL 2003 page 7.

Allergies of the nervous system - that are closely related to gut diseases - can cause a diverse behavioural disturbances, including headaches and migraines, learning disabilities and depression. Hidden food allergies seem to be a common cause of attention deficit hyperactivity disorder (ADHD) and they may also be a causative factor in epilepsy, schizophrenia and depression.

"Depression is one of the most commonly noted symptoms of brain allergy. "When one is relieved, so is the other", observes Abram Hoffer. Treatment of the allergy will, in most cases, 'cure', the depression." Syd Baumel (2000) p. 63 Treatment of allergies is a specialist branch of nutritional medicine and is best left in the hands of specially trained nutritional doctors. It can also be related to heavy metal intoxication.

For further reading see:

Migraines and Headaches by Dr Joachim Fluhrer go to page 3

Allergies: The Food and Disease Paradigm by Dr George Samra

Allergies, Intolerance, Sensitivity by Dorothy Schultz --> page 8

Finding Your Allergies by Jurriaan Plesman

Books on Allergies

Multiple Chemical Sensitivities (MCS)… by Dr Mark Donohoe

There is ample evidence that Parkinson's Disease is closely associated with depression. Books. For additional nutritional treatment of Parkinson's Disease see Health notes and Herbs2000.

Lack of friendly bacteria and/or probiotics possibly due to over-prescription of antibiotics or any of the digestive illnesses may be responsible for depression. 2 studies on probiotics.

"Absence of hydrochloric acid in the gastric juice is a common symptom in depressive neuroses. It is frequently associated with mental fatigue, persistent worry and strain especially in persons with a congenital unstable psyche. The symptoms are very vague, lack of appetite, fullness after eating, gaseous eructations and diarrhea is more common than constipation. Pain is absent." Source

For a list of drugs and medications that may be responsible for depression see here ---> Page 7

Adrenal exhaustion is one of the silent diseases affecting the blood glucose supply to the brain. “Insufficient glucose available to brain tissues contributes to many neurological symptoms of Adrenal Fatigue, including sleep disorder, brain fog, anxiety, and depression.” Drlam.com May, 2009

And let us not forget hypothyroidism as a silent disease affecting the mind. It is shown as a flat curve sugar reaction in a four hour Oral Glucose Tolerance Test (Type 4 Hypoglycemia). This will naturally affect the conversion of sugar to biological energy called ATP, essential in the production of normal neurotransmitters. Hence this silent disease is associated with depression BJ Cohen , 92. It is possible to test yourself at home for hypothyroidism with the Basal Temperature Test for Hypothyroidism.

Menopause, when the body ceases to produce estrogen and progesterone, may be responsible for depression and mood swings in a proportion of menopausal women. Schnatz, PF et als. (2005) PubMed

Another depression-related illness is pre-menstrual syndrome (PMS), which is closely related to hypoglycemia. "Some women experience symptoms premenstrually that are similar to those produced by hypoglycemia or low blood sugar..abnormalities in glucose metabolism" Ethel Sloane p 112 For natural treatments see here and here.

Andropause is a collection of symptoms, including fatigue, decrease in libido, lack of concentration, mood swings, anxiety that is experienced by some middle-aged men. It has been attributed to a gradual decline in testosterone. Andropause correlates directly with depression, irritability, mood disorders and memory loss in mid-life crises. Google Scholar

Gastric ulcers caused by Helicobacter pylori may contribute to postpandrial symptomatic hypoglycemia PMID: 10505722 and thereby may contribute to mood disorders.

Dementia, Alzheimer’s Disease, Depression and Vitamin D deficiency linked.

"One real possibility, the health observer pointed out, is that depression and dementia share some common cause. He said vitamin D may be the link between the two." Source Food consumer 7/6/2010

"Depression is associated with an increased risk of dementia and AD in older men and women over 17 years of follow-up." PMID: 20603483

Among a groups of 282 residents it was found that there was a significant association between depression and deficiency of vitamin D (the sun shine vitamin), Witte J G Hoogendijk et als (2008)

See also Alzheimer's Disease

Megaloblastic Anemia, Pernicious Anemia or Iron Deficiency Anemia due to vitamin B12 and folate deficiency and/or iron deficiency affect red blood cells carrying hemoglobin (iron-containing pigment of red blood cells), that carry oxygen from the lungs to tissues. These can be responsible for “psychological” symptoms such as fatigue. Iron is needed to make optimal amounts of ATP. (WA Lishman,559) They are examples of other silent diseases that could be responsible for depression, dementia and epilepsy. For a list of nutrients, deficiency of which can cause depression see RAS Hemat 165. See John Fry et al 208 on anaemia and how it contributes to depression and S Cembrowicz et al, 143 on various routine blood tests used in treating depression. Various studies on folate deficiency and depression and 23 JOM studies

Heavy metal toxicity is another factor that can contribute to mood disorders.

Some heavy metals - such as cobalt, copper, iron, manganese, molybdenum, vanadium, strontium, and zinc - are essential to health in trace amounts. Others are non-essential and can be harmful to health in excessive amounts. These include cadmium, antimony, mercury, lead, and arsenic - these last three being the most common in cases of heavy metal toxicity. Heavy metals toxicity can be diagnosed by scalp hair analysis. For more information see Gibson (2005) page 380. For the effects of mercury used in dentistry see Dental Causes of Systemic Disease by Dr Robert Gammal at Page 2.

It is interesting to note that most harmful heavy metals are in the same group 12 in the Periodic Table of heavy metals as zinc. Zinc is an essential co-enzyme in the metabolism of glucose. Rosalind S Gibson (2005) page 712. Copper and zinc levels should be in balance. If there is an excess of copper, this will lower zinc levels and will interfere with the ten step glycolysis of glucose to pyruvate. This will affect the production of biological energy called ATP and hence hinder the production of feel good neurotransmitters. This may explain the occurrence of hypoglycia which is characterised by having hypoglycemic symptoms, although blood sugar levels may be normal in a four hour Glucose Tolerance Test for hypoglycemia as designed by Dr George Samra (Kogarah).

Orthomolecular psychiatrists claim copper overload can be gradually relieved by copper-lowering supplements: manganese, molybdenum, calcium, magnesium, vitamin C, bioflavonoids and most of all, copper's natural antagonist, zinc. Syd Baumel 37. Since B6 (pyridoxine) is an important player in detoxification Sally Kirk et als. p 188, it needs first to be converted to an active form called pyridoxal-5-phosphate (P5P) (or PLP), by a zinc containing enzymes R Hemat p34. This again ties zinc (or lack of it) to heavy metal toxicity. See notes on pectin.

But the same phenomenon may occur in the case of cadmium toxicity. The binding of cadmium to metallothionein is stronger than that of zinc, and hence excess cadmium displaces zinc Samual A Berne 2001 Page 50, One may wonder whether vulnerability to heavy metal intoxication may cause mood disorders by virtue of its displacement of zinc or be caused by its deficiency. The exact relationship between heavy metals toxicity and depression has still not firmly established. Hypoglycia as a source of mood disorders has also been discussed in my book "Getting off the Hook" at page 18.

Interclinical Laboratories in Australia provides a comprehensive Hair Tissue Mineral Analysis service. Here are some books on detoxification of heavy metals. See pectin and detoxification.

See also: Detoxification through exercise and breakfast video by Dr Joseph Mercola

People with rheumatoid arthritis, systemic lupus erythematosus, and ankylosing spondylitis, although strictly not silent diseases, are more likely to suffer from neuropsychiatric disorders Sundquist et als. 2008

Most inflammatory bowel disorders such as IBS, Crohn’s Disease and Celiac disease are associated with psychiatric disorders. Roger Jones 5, ER Greig et al. 774, Cosimo Prantera et al 456 , TM Bayless et al 570

It is obvious that digestive disorders interfere with the absorption and metabolism of important and essential nutrients necessary in the production of the right hormones and neurotransmitters.

Depression, anxiety, and moodiness are also symptoms of candidiasis, an other "silent disease". Burton Goldberg et als., 621, Allen C Bowling, 66 Stephen E Langer, 240. Hypoglycemic people are at risk of candidiasis and therefore may be a co-morbid condition among alcoholics..

Statin drugs can cause mood changes

"While the medical establishment continues to push the suppression of cholesterol levels to abnormally low levels, it is not widely known that there is a significant amount of evidence linking low cholesterol to aggressive behavior and depression." Source

There are countless other silent diseases, such as fibromyalgia (SR Pillemer et al, 48), hypercalcemia, or hypocholesterolemia due to statin drugs, leading to Coezyme Q10 deficiency, that may affect blood sugar levels and lead to mood disorders. There are a number of other diseases, that unwittingly may affect the mind. To explore these, please go to: Diseases associated with Emotional Disorders. See also: Medical tests of depression.

Many mind-altering silent diseases may be caused by between 50,000 - 100,000 chemicals released into the environment,(RE Hester et als.132) beginning with petrochemical fertilisers and pesticides used in soil by big pharma-dominated agriculture and food production. Heavy metals - by-products of he industrial society - can lead to a wide array of psychological problems. RAS Hemat 194. Most of these toxins find their way to rivers and the sea, where they contaminate fish we eat. This could easily be avoided if organic farming be universally adopted based on the science of soil biology that would render soils more productive. Dr Maarten Stapper. Videos by Dr Maarten Stapper about Biological Farming

Pyroluria: Carl Pfeiffer, believe that excessive excretion of pyrroles and porphyryns in the urine - as a result of improper hemoglobin synthesis - may be responsible for various mental disorders. It is claimed that kryptopyrrole increases the excretion of zinc, manganese and vitamin B6, (Carl C, Pfeiffer (JOM, 1983) thereby interfering with the synthesis of neurotransmitters and hormones. For more information see Nutritional Healing by Blake Graham

Wilson's disease is an inherited disorder of copper accumulation. The basic defect is a failure of excretion of excess copper in the bile by the liver for loss in the stool. The accumulating copper causes damage primarily to the liver and the brain. Patients typically present in the second to the fourth decades of life with liver disease, a neurological disease of the movement disorder type, or a wide array of behavioural disturbances. Possible treatment with zinc and molybdenum PMID: 8521757, JOM articles

Coming back to the problem of insulin resistance, the chicken-and-egg question is, which came first insulin resistance or obesity.

The Insulin Resistance and Obesity controversy.

A recent report May 2009 by the Australian Bureau of Statistics indicated that about 68 % of adult males and 55 % of adult females were classified as being overweight or obese. Most of the medical literature claims that obesity is the primary cause of insulin resistance (Marshall Stevens Runge p 524, Pamela et als p340, Bray GA et al. p.656), but I tend to question this. If obesity is the cause of insulin resistance, then what causes obesity, apart from the outdated theory of excess caloric intake versus caloric expenditure. Hales et als. 419. As Russell Faris et al. write:

"Research shows that only one person in twenty, and perhaps only one person in a hundred, ever loses weight and keeps it off while dieting. In the long run, diets makes us fat" Russell Farris et als. The Potbelly syndrome page 2. See also: 3 studies

The link between diabetes and obesity may be the presence of insulin resistance that is commonly found in these two disorders. Goran MI et al. p180

Recent findings indicate that impaired mitochondrial ATP production may predispose people to obesity, and we know that ATP is ultimately derived from glucose. Ultimately insulin resistance develops in obesity because alterations in partitioning of fat between adipocytes and the muscle and liver. Magnus D Johansen page 102. Intracellular starvation of biological energy can also lead to depression. Henry Osiecki --> page 6. ATP derived from glucose is needed in the formation of various neurotransmitters. RW Beck, 59

No one has demonstrated that obesity causes insulin resistance. All we really know is that insulin resistance is simply more prevalent among people who are heavier. In fact, we just may have the whole causal relationship backward - rather than obesity causing insulin resistance, it might be that insulin resistance is causing obesity. JE Oliver p.118 & R Farris et als.p.2

The reality is that a low carbohydrate and high protein diet such as the Hypoglycemic diet, Atkins diet, South Beach diet and Zone diet have been shown to lose more weight at 6 months on the diet. In addition, there tended to be fewer dropouts in the low-carbohydrate groups with increased high density lipoprotein (HDL ) and markedly decreased triglycerides concentrations. Fiebach p.1429

There is considerable evidence that the consumption of saturated fats contributes to obesity and coronary heart disease (see references), however some authors assert that there is "no satisfactory or reliable evidence to support the idea that saturated fat causes heart disease, or diabetes or obesity. So it appears that the science on this issue is not as yet settled. See notes.

This all seem to point into the direction of a much simpler explanation that insulin resistance is the primary cause of obesity and not the other way around. It seems to me that obesity can be explained simply because insulin resistance blocks the absorption of glucose and other nutrients, which are then accumulated in the body first as glycogen. When glycogen stores reach its limits it is then converted to fat cells. P Atluri et als. p 251

This all goes to show that mood disorders are often associated with obesity, which can lead some people to eating disorders. For a 1 ½ hour lecture on the influence of sugar and especially cheap High Fructose Corn Syrup (HFCS) by Dr Robert H Lustig listen to lecture“Sugar: The Bitter Truth” below under videos.

A Princeton University research team has demonstrated that all sweeteners are not equal when it comes to weight gain: Rats with access to high-fructose corn syrup gained significantly more weight than those with access to table sugar, even when their overall caloric intake was the same. Science Daily 22 March 2010. Insulin resistance, hypoglycemia associated with obesity. 7 JOM studies.

Figure 1: Sugar intake and obesity prevalence

Figure 2: Consumption of high fructose corn syrup (HFCS) and obesity.

Figure 3: Eating fat does not raise blood glucose.

Figure 4: Eating fat does not raise insulin levels.

Figure 4: Percent of population with healthy weight and obesity

Figure 5: % of population being obese in various countries.

Figure 6: The more we walk the less obese.

Figure 7: Obesity increases with age.

Figure 8: Obesity among the poor and the wealthy

Delusions

The person who is suddenly struck with a mood disorder would not be aware that what he believes triggered his "mental illness" is not so much an environmental stress situation, but rather an undiagnosed underlying biochemical disorder, reaching a breaking point. Mood disorders are often accompanied by delusions, just as in the more serious mental illnesses. A phobic reaction to a lift deludes the sufferer into thinking, that the elevator causes the anxiety reaction. It is often a delusion to think that a low self-esteem is the cause of depression, whereas in fact it may be simply one of the symptoms. We are often deluded into thinking that our anxieties and depressions are caused by stressful childhood experiences that has imprinted a “deeply” learned reaction patterns of learned behaviour stemming from the past. It is not difficult for an unscrupulous therapist to unwittingly reinforce these false beliefs and delusions.

An environmental stimulus, that can be either mild of severe, may have been festering for many years, can become the trigger for a full-blown "mental illness" as one of the symptoms of the underlying biochemical abnormality. It is often a delusion to think that the environmental event is the real cause of the abnormal mood reaction. It is even more unlikely that a person will associate his illness with a nutritional disorder, because his diet has not noticeably changed and he has been deluded into believing he has been on a "healthy diet" all his life. Most diabetic people tend to believe they were on a "healthy diet", until the day they are diagnosed diabetic. Nowadays, it is difficult for any person to be on a healthy organic diet, in a world where most people eat processed foods. Most people with "Syndrome X" seem to believe that they are on a "healthy diet". Most people with a mood disorder find it difficult to associate their illness with nutrition and most will deny that it has anything to do with nutrition. Here the delusion could well become a denial!

This also explains, why the illness does not necessarily mean that all hypoglycemics are depressed as is often assumed, just as "not all animals are dogs". You can be hypoglycemic without being depressed, but you could have anger control problems instead.

When the underlying biochemical disorder is triggered into action by a severe stressful event - usually called a trauma, as in a car accident or following war experiences - and the reaction lingers on over time it can be labelled a "Post Traumatic Stress Disorder (PTSD)". The sad irony is that both client and his/her therapist usually believe that the illness is caused by the traumatic event - real or imagined - and most of the useless therapy is now spent on drugs and analyzing the "psychological" causes of PTSD. When a person is suffering from a long period of endogenous stress it is not difficult to induce false memories by means of "Recovered Memory Therapy (RMT)". See also Post Traumatic Stress Disorder and Nutrition here for an alternative approach.

Thus if we want to be serious about treating "mental illness", clients and therapists have to realize that most mood disorders are endogenous. If you have any philosophical doubts or objections about this, then at least a therapist should be obliged to eliminate any physical or medical causes of mood disorders, before he can claim it is "psychological". Unfortunately, most psychotherapists are not trained to do this.