The two of us have had the honour recently of co-editing a special series on Nutrition and Mental Health for the journal called Clinical Psychological Science (CPS), one of the flagship journals of the Association of Psychological Science. The articles are just now beginning to emerge, and we would like to tell you about one of them because we think it is a landmark study.
Ever since Bonnie began studying the use of formulas that contain a very broad spectrum of minerals and vitamins (usually around 30 of them), and reporting (since 2001!) tremendous improvements in mood regulation, we have been challenged to find any negative adverse event attributable to the nutrients.
If we just step back a bit, it is probably easy to see why negative side effects would be rare. Humans have evolved to need minerals and vitamins (micronutrients) every single day — that’s why we have to eat. As long as the nutrients do not exceed tolerable upper limits with known toxicities, why would we ever think they would cause negative side effects? As we have written previously, an entire quart (litre) of blood perfuses our brains every minute our hearts are pumping – primarily to bring oxygen and nutrients to the incredibly dynamic metabolic pathways responsible for the functioning of that little 2-3 pound organ accountable for our thoughts, our consciousness, our lives as human beings. (Note: some of us wish we could eat just once a month or once a year, as described in some science fiction, but that’s just not in the cards given our physiological needs.)
What are the side effects of nutrient treatment?
So it was somewhat surprising 15+ years ago when Bonnie first began to be challenged (by psychiatrists in particular, who are always being asked about adverse side effects) to answer this question: what are the side effects of taking a broad-spectrum formula?
In all these ensuing years, the answer has not changed from her first observations: people repeatedly tell us that in addition to improved mental health and cognitive clarity, they sleep better and they experience relief of constipation.
Now, finally, we have evidence for the first of those two ‘side effects’ in the form of an excellent study in our special CPS series. Joanna Lothian from the University of Canterbury in Christchurch, New Zealand, carried out a study for her Master’s thesis (under the supervision of Julia as well as Neville Blampied, an expert on single case research) to determine whether a broad-spectrum formula actually did improve sleep, and if so, what characteristics of sleep changed. Joanna recruited 17 adults (14 of whom completed) suffering from sleep problems and randomized them first to a multiple baseline. That is, some had to wait one week for the intervention, some two weeks and some three weeks. This type of design allows one to monitor sleep and determine if time alone alongside intense monitoring has an effect on sleep patterns. Overall, the baselines were stable.
All participants then received 8 weeks of micronutrients (mostly vitamins and minerals) and their sleep was monitored over that period of time. Treatment completers reported that their insomnia improved substantially, and in addition, their mood, anxiety and stress ratings dropped as well. The change was determined to be both reliable (that is it was not due to measurement error) and significant (with very large effect sizes). Side effects reported were minimal. Given the chronic nature of the symptoms, spontaneous remission is highly unlikely. Further, knowing the side effects associated with pharmacotherapy, these results should be welcomed and encourage further research on this topic.
The trial was not double blind and so Julia’s University of Canterbury Mental Health and Nutrition Research Group is planning a blinded replication.
Why might micronutrients help insomnia?
Vitamins and minerals are well established as cofactors essential for the synthesis and metabolism of neurotransmitters. Furthermore, the link between insomnia and stress is well-established, and vitamin and minerals are intricately involved in the regulation of the stress response. Micronutrients may result in reductions in stress (we have excellent studies demonstrating the strong effect of nutrients on stress, both in nonstressed and stressed populations- indeed we have blogged about our work on the use of nutrients in recovering from natural disasters including floods and earthquakes) and thereby reduce insomnia. This may be especially important at times of high stress because such situations impose high nutritional needs, potentially impairing the maintenance of regular circadian rhythms, thereby adversely affecting sleep. Maintenance or restoration of adequate nutrition may, therefore, be particularly important for circadian rhythm recovery.
You can access the study here: http://cpx.sagepub.com/content/early/2016/05/21/2167702616631740.abstract
Bonnie & Julia,
how large are the effect sizes?
–Lea
Report comment
Thanks for asking. The effect size pre to post 8 weeks for sleep was 3.45. Note that this is not controlling for a placebo as there was no placebo arm. The true effect size of nutrients is likely lower but given how large the mean change was, it is likely still a large effect.
Report comment
Where would I find information on what product was used in the study?
Additionally, what evidence do you have that side effects are rare from micronutrients? The reason I am asking is I am very sensitive to even small doses of many supplements. Also, many people who are withdrawing from psych meds or who have completed the process find they are quite sensitive to so called harmless supplements.
Thanks!
AA
Report comment
If you email the corresponding author, Neville Blampied, he can give you information on the product studied. [email protected]
Report comment
Thanks, I will do that.
Report comment
I didn’t reply about your question on side effects. Evidence for our studies comes from the lack of difference in side effects being reported between placebo groups and active groups. If there were side effects to be associated with the active form, then there would be a group difference. There isn’t.
Report comment
If you’re a “psychiatric”, you have to watch out for supplements containing copper, which is found in many commercial multivitamins and is potentially bad in excess for the depressed and the dysperceptive, despite being an essential micronutrient (I have first hand experience with this, having my first serious taste of being bonkers in Michigan’s copper country, where the drinking water was high in copper). I’d find these copper containing supplements dubious for those coming off antipsychotic drugs and antidepressants (where the individual actually can have an early form of the schizophrenia syndrome).
Report comment
This problem with copper-containing supplements could also appear in the last trimester of pregnancy, where maternal serum copper stays high for several months after birth (post-partum psychosis, anybody?), where supplementation with B6, C, zinc and magnesium may be necessary.
Report comment
It is wonderful that there are people who study nutrition. It is a real topic of study. There are actual nutrients that can be examined.
But “Mental Health”? What is that? Is it anything more than a metaphor?
When we speak about the human mind, the adjective derived from the word “mind” is “mental,” but the word “mental” and the word “mind” are not referring to an organ. The organ, one that is miraculous, mysterious, and rarely used to its full capacity, is called the “brain.” It is important to understand the difference between the two, and how one relates to the other.
When a human being ingests nutrients or micronutrients, these particles may benefit the organ that is called the “brain.” This is certainly a wonderful thing. Human beings should eat well, exercise, and get plenty of deep sleep. We should take care of all of our organs. We should thank God for the miracle of the human body, and the miracle of the organ known as the brain.
But we should also exercise our minds until they are capable of producing thoughts that coincide with reality. As we exercise the mind, it might become strong enough to ask questions such as: What is “mental health”? Is it a measurable thing? What is the mind? Perhaps if we eat more spinach, we can then ask the question: What is psychology? Who were the foundational thinkers of psychology? Were they good people? Why? or Why not?
We might even begin to ask: What is psychiatry? What is the history of psychiatry? Has anything good come of it?
These are questions that might be asked by strong minds even when the organs are deficient in micronutrients. In fact, even to a nutrient deficient brain, the answers to these questions might come through study and reflection. Certainly good nutrition is a desirable thing, but the answers to these questions would remind the person, whether his or her brain is swimming with micronutrients or not, that as wonderful as micronutrients are, they can never truly solve metaphysical problems. Micronutrients do not correspond with metaphors such as “mental health” or “mental illness.”
It seems as though no matter how many micronutrients a person consumes, he or she may never fully exercise his or her mind to the extent that it produces the kind of thinking that would allow him or her to answer more fundamental questions. The answers to the more fundamental questions would make the question of micronutrients obsolete, or at least the answers would relegate the study of micronutrients to its proper field, namely, the health of the physical body and the organs thereof.
In other words, until one is able to answer the question: What is mental health? or What is mental illness? He or she has not begun to think clearly. What use are micronutrients to brains if people refuse to use their minds?
Report comment
No, but they can indirectly tune your mind by tuning, or helping to tune, the organ that supplies it.
Report comment
You speak in mysterious metaphors. It is a radical claim that one can “tune” the brain, but it is even more radical to insist that “tuning” the brain will “tune” the mind. But even if such “tuning” could be accomplished, would the tuning be sufficient to help the “tuners” to “tune” in to the real questions? Perhaps not.
Report comment
I rather agree with you, Slaying, the problem is in the lack of logic behind the moral acceptability of the DSM theology that it’s okay to defame people with scientifically invalid DSM disorders, then torture, and murder millions of people with the psychiatric drugs. Rather than in how to cure people of scientifically invalid disorders.
Although, no doubt, people do experience the symptoms of the DSM disorders. But the medical evidence does now seem to indicate much of this is due to the over “medication” of people, based upon the fraudulent DSM disorders, while doctors ignore or deny real life stressors. Rather than any other etiology.
Report comment
I can’t believe the people behind madinamerica, who are always so critical of psychiatry and its so-called “research” and “clinical studies” because they’re manipulated, unreliable and essentially invalid, would now publish this article on supplements and micronutrients as if it were pure science that they work and cure conditions like chronic insomnia, anxiety and mood disorders. Apparently, the “evidence” is in a small-scale study with 17 participants, most if not all of whom are probably firm believers in the benefits of supplements anyway (placebo effect, anyone?) and the improvements are all self-reported, so it seems, instead of objectively measured. Also, it is very dangerous to promote or even suggest supplements to a person who is either taking psychiatric drugs or who came off them recentely. Since coming off my prescribed drugs, I cannot even tolerate most natural foods including super healthy ones like broccoli, let alone supplements. One day a friend offered me fruit juice she bought at the store. I thought: ok, what harm can it do? Within 10 minutes after drinking it I had to lie down because the whole room was spinning and I felt like I was going to collapse any minute. So I asked my friend to show me the bottle and yep, there it was: fruit juice with added vitamins and minerals. So there you have your negative adverse events. No supplements for me, thanks! I’ll stick with natural foods like vegetables, fruit, meat and fish (meaning the ones I can tolerate since psychiatry ruined my brain and body).
Report comment
You’d have to ask an orthomolecular patient. There are several hundred thousand by now, but you’re not likely to easily find them if you don’t live in a city big enough to have a functioning Schizophrenics Anonymous chapter- they don’t usually do well without members on nutrient therapies.
Report comment
It just occurred to me- you could also go to the Orthomolecular Health (name of site) website. It’s a Canadian site, less timely than MIA, but more optimistic. The site has a list of Canadian practitioners, which has grown quite large over the years.
Report comment
Thank you, Bonnie and Julia, for the work you do in studying the effects of nutrition on mental health. I also want to thank you for continuing to post the results of your research on Mad in America despite the criticism you receive from some readers here.
My son has been doing much better since he started eating better and taking Vitamin D supplements. Improving diet and taking supplements may not work for everyone but it does work for some and is something that I wish more doctors would pay attention to. My son was psychotic for six years before he was finally referred to a nutritionist who recommended the Vitamin D. It made a huge difference in his moods and behavior.
Report comment
Thank you for your kind words. Many of the people commenting are very well-meaning but do not comprehend the necessity of feeding our brain cells and our whole-body mitochondria with micronutrients every minutes of every day. There is no single vitamin or mineral that is required (but kudos to your son’s success with vitamin D!!); we need them all for optimal brain metabolism.
Report comment
What’s the point of criticising psychiatry for their over-simplifying things and their medicalizing the human experience with nonsens talk like “chemical imbalances” and miracle drug solutions and such, when clearly some of these critics are doing exactly the same by searching for a similar miracle solution in fad diets and food supplements unsupported by science (neither by common sense). Surely stress, anxiety, depression and mood issues have many other causes than just a lack of vitamins, minerals and amino acids??? What about the social context? Difficult life events? Maybe it’s because we are not feeling at our best emotionally that our bodies digest foods differently? Simple example, I know that when I’m nervous my stomach is easily upset. That has nothing to do with what I’m eating but rather with the emotional state I’m in. In a more relaxed state my stomach is just fine.
I am not against diets as such. Eathing healthily has helped me tremendously. But why should we add stuff to what nature already offers us in the form of plain foods? It doesn’t make sense. There shouldn’t be any need to take extra supplements if you are eating the right foods already.
As for taking supplements when in withdrawal or post withdrawal from benzodiazepines or other psychoactive drugs, just read on the support forums for a couple of minutes and you’ll see that supplements are very poorly tolerated in general. They haven’t cured a single person from the withdrawal syndrome. Only time heals.
Report comment
The point is that there are probably a great many things that must be taken into account in order to find healing from what is labeled as “mental illness”. This is exactly what I like about MIA; it brings together many different disciplines and people from different experiences and areas so that people can become aware of the things available to help oneself with. What these women talk about is not the only thing that people can use but many people find it very useful. I’m not going to put them down just because I may not buy into the idea of taking supplements. Just because they write about it here doesn’t mean that I have to run out and try everything that they write about here. Let people have some choice in their lives!
Report comment
Stephen,
I don’t disagree that there should be choice in people’s lives. But the point that Elsie is trying to make which I agree with by the way is this site doesn’t seem to apply the same critical analysis to alternative programs as we do to psychiatry.
If a psychiatrist posted a study on this site about the effectiveness of psych meds with a sample size of 17 and then told us to go back and review the other studies, we would be outraged. And if he/she said there weren’t any side effects, we would cry foul. But for some reason, we don’t apply the same scrutiny to alternative folks.
Report comment
Because of biological individuality. There’s no one size fits all diet, any more than there are one size fits all clothes (unless wearing a tent is a fashion statement). Although physically withdrawing someone from alcohol with niacin (not the amide) is no problem, the benzodiazepines are all fat soluble, so it takes months to get off them. Were I to have to supervise one of these, I’d use mega B3 and C, plus B100’s and magnesium (750mg/day), starting the would-be withdrawal person on the B3 first (to get them used to flushing) and run that up to several grams per day before they stopped using the drug and then slowly lowering the dose of drug when they began to feel sleepy (raising the B3 if they began to feel jittery). Even with simples, you’ll notice this isn’t for amateurs.
The “new” antipsychotic and SSRI’s are a different story. You might try increasing the intake of tryptophan, along with lots of B6 and magnesium, but I don’t know squat about the “new” antipsychotics, other than they can make you fat and stupid.
Report comment
Our experience of the use of nutrients to help people go through withdrawal differs from yours, but thank you for your comment. And our knowledge of the insufficiency of nutrient content in foods also differs from yours.
Report comment
Bonnie and Julia – Thank you for your work. Can you mention a few articles which summarize your general/basic supplement/vitiamin lrecommendations? I am well aware that no one size fits all, but would be interested in your general range of recommendations. Despite working at the healthiest diet possible, and usually being able to get adequate sleep, I’m always on the lookout for new ideas.
Thanks.
Report comment
If you email me I can certainly provide you with some resources…Julia
[email protected]
Report comment
Thanks to everyone for reading the post. For those who are complaining that this is just one unblinded study of 17 adults and therefore we cannot make any inferences from it, I encourage you to read ALL of the studies on nutrients that have targetted psychological symptoms and then realise that we keep observing these similar findings over and over and over again, in all kinds of different designs, samples, countries. The design used in this study is actually a very robust design and well accepted in the scientific field. I encourage those who are sceptical of it to contact Neville Blampied directly to have a debate about the validity of the design and also to read the article in its entirety. We have written in previous blogs about the evidence for using micronutrients to assist with psychological symptoms and the third video on our series posted on Mad in America does go through all the evidence to date. For those sceptics, please watch the series in its entirety and then come back to us about whether there really is no evidence for this approach as a viable way forward for some people.
Report comment
I, for one, was taking many supplements while on psychiatric drugs, at the recommendation of my mother, due to prior easily recognized iatrogenesis. And think the supplements may have saved my life, since my psychiatrist had me on drug quantities and combinations that are unethical, according to some of the medical literature (the drugs I was prescribed were known to cause anticholinergic toxidrome poisoning). Thus, I have no doubt the supplements can, at times, help people on psych meds.
But I believe the real problem is in believing in the DSM stigmatization system itself, since the DSM disorders have no scientific validity or reliability. I do believe your research is more valid, than that of the pharmaceutical industry today, however. Because, of course, nutrients are better than the “torture” / “wonder” drugs of today’s psycho / pharmaceutical industries. IMHO, God put what we needed on this planet to survive, and the corporations who are destroying such for profit are the problem, not the solution.
Report comment
More metaphors. “Psychological symptoms.” “A way forward.” Is there anyone out there who is actually listening? Is there anyone in Mad in America who understands what this is really all about? Good grief. Willful ignorance is incurable. Not even the best vitamins could fix it.
Report comment
I hope I didn’t confuse the issue for you, having more experience with mega-nutrients (I have done alcohol withdrawals for others). The bit about supplemental copper was a Carl Pfeiffer item, a good forty years old. I’m interested in non-drug benzodiazepine withdrawal, although I certainly hope I don’t have to supervise one myself, on the street. The little bit on SSRI stoppage was theoretical. The MIA folks are just going to have to get used to more of this from folks like us, but I don’t want to snow them.
Report comment
No confusion — thanks for your concern. I think the copper ‘story’ is not yet complete. Obviously the vast majority of the public has no difficulty with copper as long as it is balanced in a proper ratio with zinc (no one would take copper alone, I think). But there are some people who do not apparently have Wilson’s disease (a copper storage disorder) who still report having to avoid copper.
Report comment
Carl Pfeiffer wrote a number of papers discussing copper and mental symptoms, but , unfortunately, they were all in the Journal of Orthomolecular Psychiatry and its successor, the Journal of Orthomolecular Medicine, which are treated like pornographic magazines by web sites like Medline. I am also North American, subject to its geological peculiarities, while I notice you’re British (as well as the bios, “sceptic” and a few other spelling and grammatical differences for someone who only skims the bios).
Report comment
To all: if you are unwilling to consider the information that nutrition is a key part of the mental health story, perhaps you should stop reading our blogs. But if you are willing to consider that this is an important area, follow Julia’s suggestions — it is impossible to cover much in a blog, but our 3 lectures on the MadInAmerican continuing education program may be helpful for you. Here is the link:
http://madinamericacontinuinged.org
You have to register, but they are free if you do not want/need CME credit.
The two of us try to stick to evidence-based comments, as you will see in those lectures.
Report comment
Although I’m more familiar with the work of Abram Hoffer, et. al., as you can tell by the different techniques you and I will consider for things, I’ll read your blogs. You’ll still get flak from some readers, who’ve confused pharmaceutical psychiatry with nutritional medicine, but it is they who will have to accept the reality so plain to geeks like us.
Report comment
Why don’t you have the integrity to tell people to adopt a plant based diet?? you know it is the only real solution, it’s the only thing that works, we need to look on the whole diet, not only small part of the picture, therefore supplements are not the answer, only a plant based diet, and smoking cessation can be the answer! you doing a very bad service for the public that suffers from mental disturbance by not telling them what they really should do!
http://nutritionfacts.org/video/plant-based-diets-for-improved-mood-and-productivity/
http://nutritionfacts.org/video/gut-feelings-probiotics-and-mental-health/
http://nutritionfacts.org/video/plant-based-diet-mood/
Report comment
Thanks for your comment. I wouldn’t just recommend a plant based diet as the research doesn’t just support that approach for wellness. Indeed, there is a a large body of literature supporting the Mediterranean diet as protective for developing mental illness as well as a potential way forward to treat mental illness. I encourage you to look at Felice Jacka, Sanchez-Villegas and Akbarely’s work on this diet and its relationship to mental health. Of course this diet includes fish and meat. Also a study came out suggesting that some meat is good for your mental health, Felice Jacka documented that Women Who Cut Out Red Meat Twice As Likely To Suffer Anxiety/Depression – see: http://www.karger.com/Article/Abstract/334910.
Based on all my readings on diet, I don’t believe there is a one size fits all. Different people seem to benefit from different dietary patterns. It is important that we tell the public about what the research says, and that would include the studies you point out but not solely confined to those. Thanks Julia
Report comment