Discussing Nutrient Formulas Without Naming Them: Who Benefits?

Bonnie Kaplan, PhDJulia Rucklidge, PhD
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We thank Dr. Rebecca Carey for her essay, so well-grounded in the scientific literature on gut and brain. With respect to her personal experience with her son, we are delighted that he is doing so well. The two of us could easily submit hundreds of other personal stories that are similar, describing lives transformed by broad-spectrum micronutrients (minerals and vitamins). But we won’t.

Instead, we would like to elaborate on a topic that is embedded in Rebecca’s essay: how very challenging it is for all of us interested in non-drug treatments to talk about nutrient formulas without sounding as if we are promoting commercial products.

The two of us writing this blog have been studying the two Alberta formulas, EMPowerplus and Daily Essential Nutrients (DEN), for many years. These formulas are similar in terms of their breadth, and both were developed for mental health and have been evaluated for mental health by scientists who are not funded by the companies. We have studied a few other formulas as well. But really, what we have been studying is the following concept: because the brain needs a broad spectrum of micronutrients for optimal metabolic function, we should treat brain health problems with that whole spectrum.

To study that concept, we need good broad-spectrum formulas, and neither of us is interested in going into the business of producing natural health products. What might surprise readers is how few nutrient formulas that supposedly target symptoms of mental health problems have been studied by independent scientists.

Is treating brain health with a broad spectrum of micronutrients a novel concept? It turns out that it is relatively new. When Bonnie and her colleagues reviewed about a century of research on micronutrients and mental health, they found that modest mental health benefits had been shown from treatment with some isolated nutrients.1 But it was not until about 15 years ago that research began on broad-spectrum micronutrient (BSMN) formulas, largely (but not exclusively) because of the Alberta companies. And in fact, the fallacy of looking for a single nutrient (or, magic bullet, as we have called it) has been a huge obstacle to research on nutrition and mental health.2

So why is there any problem with studying a bunch of micronutrients together, in a commercially available formula? As long as our studies are not funded by companies, and companies have no control over our research, our analyses, and the publication of our results, why are we accused of being biased? It is this principled position of staying arm’s length from commercial entities, now held by all the scientists studying the Alberta BSMN formulas, that sets us apart from how research has typically been conducted within psychiatry for so many years.

But no matter how often we report that we have no conflict of interest, we are falsely accused of being affiliated with one of the Alberta companies that developed the BSMN formulas for mental health, or of promoting their products.3 We have both had to endure various accusations, and even our universities being asked to provide evidence that we do not have any conflicts of interest. In all cases we have been exonerated of all accusations. In other words, we report we have no conflict of interest, and our readers and listeners call us liars.

We used to get upset personally: being accused of lying is not fun. But now we realize the very sad truth of such unfounded accusations: we are living in an era in which drug companies have so totally corrupted scientists and clinicians that our audience members cannot believe that there is any other way to ‘do business’ in the scientific world.

Bonnie remembers a time when drug companies were NOT responsible for educating physicians about medications, did NOT provide free food at medical rounds to entice more medical attendees, did NOT offer clinicians free trips to the Bahamas to hear a lecture on a new psychiatric medication, and did NOT offer money to scientists to allow their names to be listed as authors on papers they did not write about clinical trials that they did not conduct. But now, we have had 50 years of this corruption by pharmaceutical companies, and (as readers of MIA know all too well) the result is 50 years of experimenting by drug companies and psychiatrists on people with mental health challenges. As detailed in Bob Whitaker and Lisa Cosgrove’s latest book Psychiatry Under the Influence, physicians sadly receive much of their information on drugs directly from the pharmaceutical companies, highlighting the fact that these companies have essentially usurped education of physicians. It has been a huge betrayal of everything embodied in the term ‘evidence-based medicine.’

We live in a funny world, where it is okay to mention drug names (either a brand name or its generic equivalent), and even names of psychotherapeutic methods (CBT, Open Dialogue), but as soon as you start to talk about nutrition, people become uncomfortable with using product names. Yet if we researchers do not specify the names of the formulas we study, then people may conclude that all formulas are similar. The formulas are not all the same, and readers need to know what is scientifically supported. Yes, it is true that you can buy cheaper nutrient formulas from a grocery store, but as Julia’s research team demonstrated,4 most over-the-counter products do not provide the nutrients in adequate doses or adequate breadth to meet the needs of a nutrient-depleted brain.

So the formulas are not the same, and the Natural Health Product (NHP) companies are not the same either. Bonnie once approached a very well-known NHP company with the suggestion that she do a study of one of their formulas that she had heard was helpful for stress and anxiety. She was rebuffed by the director of their scientific division who said (and this truly is a direct quote): “Why would we want to study it? We are making money.”

Other than the two Alberta companies, we know of no other NHP company that has chosen to direct all their energy and resources into creating a product for people with mental health problems. Their call centers demonstrate that fact: when the founding partners realized that psychiatrists would only rarely support patients who wanted to try BSMN treatment, they established telephone support lines to help people who were often desperately trying to get off of psychiatric medications that were causing them so many health problems. Yet instead of celebrating these companies in the world of mental health, we seem to scorn them. These two companies are tiny family-based entities, essentially nonprofit, and they have just one goal: to change the way people with mental disorders are treated.

We understand that people are uncomfortable if they erroneously think we are promoting a particular product. But we need to ask this question: who benefits from misleading people into thinking that just any nutrient formula will do? The answer, of course, is that the only ones who will benefit are the drug companies who make psychiatric medications. Because countless people have tried unsuccessfully to resolve their mental health challenges by buying one-a-day vitamin formulas at Costco, and the failure of their efforts inevitably leads them back to medication.

We do not mean to suggest that failure to achieve mental health wellness with nutrients in pill form is entirely due to taking the ‘wrong’ formula. Many people taking the Alberta formulas do not benefit either. There are many causes of psychiatric symptoms, and suboptimal nutrition is only one of them. But the fact remains that the Alberta formulas (DEN and EMPowerplus) are the most studied formulas in the world for the treatment of mental illness. This is such an important point. Do we not want our public to pay attention to the quality of science behind a treatment? Don’t we always talk about evidence-based medicine? By constantly dancing around the product names, we are, as Rebecca identifies, doing a disservice to those who need accurate information.

There are now about 35 peer-reviewed publications evaluating the use of these formulas for mental health, with many more in the pipeline; readers can request a list of the articles by emailing either one of us: [email protected] or [email protected]

Show 4 footnotes

  1. Kaplan BJ, Crawford SG, Field CJ, Simpson JSA. Vitamins, minerals, and mood. Psychol Bull. 2007; 133(5): 747-60.
  2. Rucklidge JJ, Johnstone J, Kaplan BJ. Single bullet madness – why do we continue to perpetuate this fallacy? (letter). Br J Psychiatry. 2013; 203 154-5.
  3. Rucklidge JJ, Frampton CM, Gorman B, Boggis A. Authors’ reply. The British Journal of Psychiatry. 2015; 207(5): 460-.
  4. Rucklidge JJ, Harris AL, Shaw IC. Are the amounts of vitamins in commercially available dietary supplement formulations relevant for the management of psychiatric disorders in children? N Z Med J. 2014; 127(1392): 73-85.

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33 COMMENTS

  1. It is interesting to note the articles written by Natasha Tracy, mental health writer, who tried the formula with no success. She reported her less than positive interactions with call Center support staff with no real medical training and indicated she had been threatened with legal action regarding her unflattering articles.Ultimately she had little good to say about the company and its products. She pointed out that there was a risk of “dangerous interactions” if the preparations were taken in conjunction with certain psychiatric medications and stated the many reported “adverse reactions” could have been the result of the withdrawal of “real medicines”. She had another article on the baby who died after his Truehope related family members failed to provide the appropriate medical care, relying on “natural” products.
    I think that Dr. Carey’s article was interesting, but I also believe her son “got better” largely bc of being taken off neurotoxic poisons he should never have been prescribed in the first place!

    • Great points @truth. I even purchased a Truhope product AFTER I already knew of Natasha Tracy’s complaints, but BEFORE the baby’s meningitis death and the trial/conviction. I had an open mind to the products but we found them unremarkable. A ‘mentally’ healthy kid requires more than a single product. I was also gobsmacked that a highly trained gastroenterologist allowed her child to be psych-diagnosed, psych-drugged, and had never heard of the gut-brain issues that us mere laypeople had been reading about for years. Speaks volumes about the abject failure of conventional medicine to teach its MDs to think for themselves.

  2. Understanding nutrition and gut health are very important areas to explore when looking at ways to ENHANCE recovery from severe forms of psychological distress.

    HOWEVER, we must be VERY CAREFUL to not fall into the trap of exaggerating its importance or reinforcing Biological Psychiatry’s own dangerous and faulty theories of “broken brain” chemistry.

    First off, it is doubtful that bad nutrition can be the ultimate cause of severe psychological distress OR its cure. If we promote such a view we are dangerously close to promoting the “chemical imbalance” theories of “mental illness” by the current oppressive “mental health” system. That is, a view that good nutrition will somehow “correct bad brain chemistry etc” or create a better environment for brain chemistry “to normalize…” etc. If we are not careful we are in danger of promoting false hope for people (and their families) who are seeking recovery for themselves or their loved ones.

    While there may be some more rare examples of people having severe distress related reactions to toxic chemicals and substances within our environment, it is more OVERWHELMINGLY THE CASE that what gets described as “mental illnesses” represents human conflict with a stressful and trauma filled (and/or perceived) environment.

    And more importantly, RECOVERY from these negative and harmful experiences in life must ultimately be UNDERSTOOD AND ADDRESSED in each person”s own experience and timetable for recovery. This may, or may not, require therapy, but most certainly will require A SUPPORTIVE ENVIRONMENT to nurture one’s recovery.

    It is here where good nutrition and gut health may be an important ENHANCEMENT or ADDITIONAL SUPPORT for such recovery by aiding a more suitable INTERNAL BODY ENVIRONMENT for such recovery, but NOT the PRINCIPLE MEANS for such recovery to take place.

    A person in recovery will STILL have to address the original traumas that began their conflict with their environment AND the subsequent traumas that took place when they encountered AN OPPRESSIVE “MENTAL HEALTH” SYSTEM that added to, and reinforced, earlier traumas. There can be no SUBSTITUTE OR SHORTCUT for doing this work.

    I am raising the above points, NOT as a criticism of the authors but only to help clarify important topics of discussion when dealing with nutrition and gut health.

    The authors made the following VERY IMPORTANT statement :
    ” we are living in an era in which drug companies have so totally corrupted scientists and clinicians that our audience members cannot believe that there is any other way to ‘do business’ in the scientific world.”

    This is oh so true! And unless and until we ELIMINATE, ONCE AND FOR ALL, the profit motive from all scientific, medical, and social supportive endeavors in our society, we WILL NOT be able to fully understand extreme forms of psychological distress in our society OR provide the means and overall supports necessary to promote ultimate recovery options.

    Richard

  3. http://www.cbc.ca/news/canada/calgary/jury-trial-truehope-toddler-dies-trial-underway-1.3479460

    The elephant in the room is the baby’s meningitis death after the family refused to get it conventional medical treatment and tried to treat it with ‘natural’ remedies. Seeing as the family and business are closely related, it’s impossible for consumers to not connect the company, the natural-health products, and the baby’s death. Maybe this anonymous, unnamed push-back the authors allude to and that they complain is about ‘brand-naming’ is actually concern about a company that’s had years of negative online and mainstream press?

    Regardless, there is nothing exceptional about any single product. The tone of this post is puzzling. This supplement won’t be found to be a magic bullet any more than any other single thing in a vacuum. Integrative/Functional medicine has been pointing the way for years now to the importance of nutrition in ‘mental’ health, so there’s nothing new there. More importantly, Integrative/Functional practitioners have been showing the way in the larger picture of a healthy, ‘integrated’ human.

    ( I tried a Truhope product for my child. We found it unremarkable. I have no complaints about it, but didn’t purchase it again.)

  4. Sounds like snake oil to me, and as has been mentioned, plays into the whole red herring of “brain chemistry” and how to best treat non-existent diseases. Brain health is really irrelevant to psychiatry, which is in the business of social control, not health.

    • Absolutely right. There’s a lot of fraud in the pushing of these so-called natural supplement combinations, particularly when knows that certain fairly common cheap supplements will work just as well, if not better, than these expensive poseurs, for a number of conditions. I pay no more now, for sugar and starch free niacin, than I would have, 40 years ago.

    • Yes, it’s a VERY expensive product. And I have no way to know its efficacy for my child – it’s impossible to identify a single food, supplement, vitamin, or protocol when you are using many at a time – but it didn’t clearly help in any way that warranted its cost for us with a limited family budget. So, like @bcharris I pick and choose for the supplements that have the best profiles for my child’s issues (Bs, D, zinc, magnesium, omega-3s, sometimes the ‘calming’ ready-made supplements, and others peripherally) and meet my budget. But a crap-free, gut-healthy diet is VERY important for kids’ brains-guts.

  5. As someone who has hacked her own “diagnosis” and come off the psych drugs – I have examined EMPower and TrueHope (years ago) and other combination “shotgun approach” supplements – here’s what I found:

    These products work through sheer luck.

    They are a shotgun approach of multiple aminos and nutrients, with few or no adjustments for individual methylation or need. Some of the aminos are paired which should not be (NAC / GABA) – or which would be more effective with NAC in AM and GABA in PM (I note that the Truehope contains no aminos, but other scatter gun products do). There is little adjustment for morning vs evening formulas – for example many practitioners recommend no B6 after 2 PM or it could interfere with sleep cycles (that’s one of the more plentiful ingredients). There are myriads of interactions and rules, and these products do not consider them.

    While the companies proclaim: “why would we want to study them? We’re making money.”

    Some people need more niacin, some do better with fish oil (not in these products). In my studies of my own mental, emotional and physical health, my ratios are unique to me. There is no “standard dose” of Zinc or Niacin, for example. And if you take more of these combination tablets to increase your zinc or Niacin, you might take too much B6. Using Truehope as an example, most of us are overloaded with copper – so putting copper in a supplement is an indicator that they do not understand the connection between copper and mood.

    Copper opposes zinc. Having them both in the same product is counterproductive. Excess copper is associated with strong emotional states. Additionally, the Truehope contains a token amount of Magnesium – something which people healing from psych drugs are deficient in. In fact, Magnesium is the #2 nutrient deficiency in the USA.

    So – the combinations are wrong, the nutrients are wrong. Thank you AA for posting the link to the ingredients so that I can refresh my memory.

    It’s a shotgun approach – “if we throw all these nutrients at this, something will hit, and it will work, and it will fly off the shelves.”

    The best benefits in supplementing are received by individual nutrients in individual amounts, customised to the individual. Unfortunately, it’s hard to run a double blind, placebo based trial, when every person has an individual supplement plan.

    • Yes, great comment. This is a big issue. If I won the lottery I would run, not walk to my favorite Integrative neurologist and have him do a whole Cyrex lab on my child. Like you said, everyone’s different and requires different levels of different things; and plus their bodies are reacting to their environments all the time as well. As it is, I have to read and read and read and hope I’m delivering efficient levels of the correct things. Fingers crossed all the time. At least what we know about diet now (ideas first promoted over 10 years ago) helps a lot.

  6. And JanCarol, thank you for your great analysis of EmpowerPlus. Speaking of individual supplement plans, I need at least 2200IU of D to feel somewhat decent. I probably need more but am having an issue of tolerance.

    This particular supplement only has 384IU of D which for most people would be a horribly deficient amount. Of course, folks could supplement with D but for the price they charge, I would expect it to have alot more of the vitamin in it.

  7. Thank you Bonnie and Julia for all that you are doing to improve the health of many, and to provide more natural options to address mental health issues. Anyone who understands the basic physical properties of the brain and body would easily surmise that nutrition could impact health in a variety of ways, including psychologically. As you noted, there is no such thing as a cure all. But no doubt that your efforts and of those like you, who strive to conduct science in an ethical, service-oriented manner, will provide many with hope where there was little or none before.

    • James

      Come on, you can do better than that. Where do you stand on some of the controversial issues that this blog has raised? What is your response to some of the commenters above?

      Richard

    • It is awesome that these doctors are looking into alternatives.

      But I’m flabbergasted that these complex supplements are being taken seriously by medical professionals.

      When the simples, as Wallenfan posted (and I cannot find them, but received email notification of them) should always be the first go-to.

  8. This is an interesting article, but I have to disagree with the premise that a mixture of vitamins and micronutrients such as rare minerals is good for health. First of all, it is well-known that artificial vitamins are mostly excreted with urine, they are not assimilated by the body. Second, a mixture of chemicals is not “natural” and therefore cannot be expected to improve health, mental or physical if we are talking about natural health. Multivitamins are not different from a mixture of drugs. Third, dietary supplements do not address the problem of bad nutrition. Your health will improve if you reduce consumption of unhealthy foods (fast food, fried meat, coffee) and start eating healthy foods most of the time (fruits, veggies, whole grains, boiled meat, fish, nuts, etc.). If a person consumes fast food mostly and adds multivitamins to this diet, I don’t see why his or her health would improve.

    Because many diseases go into remission without any treatment and because the course of a disease may go up and down (regardless of treatment), some people will become convinced that a dietary supplement improved their health, when in fact it’s just a coincidence with the natural progression of the disease. This effect should not be confused with the so-called placebo effect, which does not exist according to several well constructed studies. The effect of placebo is usually confused with the natural course of a disease, which becomes obvious if you compare a placebo group with no-treatment group (there is no difference in most cases, see the studies by Hrobjartsson A.).

    There are many beneficial and free (or cheap) interventions that anyone can do to improve their health and which do not involve ingestion of artificial chemicals be that vitamins or prescription drugs. In my view, it would be worthwhile to try to organize clinical trials of these treatments instead of dietary supplements, which seem to be a dead end.

    I use the interventions listed below on a regular basis and can say that they have an instant strong effect on both physical and mental health. Some of them probably work because of hormesis (not to be confused with homeopathy).

    1. Gradual cold shower (not a sudden one; can be preceded by a moderately hot shower). It has an instant mood-lifting effect and a stimulant effect (documented in various studies too).
    2. Hyperventillation exercise (stimulant effect).
    3. Breathholding exercise (sedative effect).
    4. Fasting on water or without water for 24 to 48 hours a week.
    5. Complete colon cleansing once or twice a year, followed by a course of a good multi-probiotic.
    6. Nasal washings.
    7. Use a tongue scraper regularly.
    8. Good-quality balanced nutrition. Avoid dietary supplements and food additives.
    9. Physical exercise that does not require will power or time: a stationary bicycle in your home makes exercise extremely easy.

    On the subject of nutrition, if I could, I would also study so-called functional foods, i.e. foods that have therapeutic effects, rather than multivitamins. Some examples of functional foods are raw fish and raw meat. The trick is to make them safe for human consumption using some kind of novel sterilization technology. Pascalization for example, is pretty close. It kills most bacteria and parasites while keeping the meat and fish almost raw. These foods are not socially acceptable at present because of the long-standing ban, but I can say that they have a strong positive effect on mental state and should be effective against depression and ADHD. Whereas cooked meat has been proven to lower mood, cause constipation, increase fatigue, increase the risk of cancer (because cooking of meat generates carcinogens), and to overload kidneys, raw meat does not have these negative effects. On the contrary it elevates mood. In my experience, going on a raw diet for a few weeks is a reliable way to experience hypomania.

    There are also some strongly sedative lifestyle changes, which in my view can replace sedatives and neuroleptics. A hot environment (including an extra layer of clothes) causes fatigue and apathy and sedates well. Can be combined with moderately hot baths and showers. I already mentioned breathholding exercises (but paradoxically they can cause a panic attack in some patients with anxiety). A diet consisting of whole-grain bread and water only has an excellent sedative effect (if you add boiled meat, you may also become depressed pretty quickly). A ketogenic diet has been shown to be effective against schizophrenia and bipolar disorder in some small studies.

    In conclusion, there are more interesting interventions than dietary supplements for people who wish to take psychiatry in a new direction.

    • Or an old direction, as hot and cold hydrotherapy were practiced a century ago.

      Thought I suspect that *voluntary* hydrotherapy might be a new twist.

      In a segment on “The Doctor Who Gave Up Drugs,” BBC – he tried to help a woman withdraw from her antidepressants with coldwater bathing. It was definitely mood enhancing, confidence building.

      I’ve used this in pain management to some success.

      But your bread would make me sick, and a diet without meat starves my brain and adrenals. We are all individual.

      • >>But your bread would make me sick,

        That’s exactly how a neuroleptic treatment should make you feel 🙂

        Seriously, I used to avoid bread and would go for years without it, until I found through trial and error that bread helps with self-control. Around 2009, I spent a week on nothing but bread and water and despite my expectations I did not feel bad. There were no negative effects on either physical or mental health, aside from slowing and low capacity for work.
        After my experiments with hypomania (cold showers plus a raw diet), bread quickly brings me down to earth.

  9. You raise a very important point – the cost. Believe me, that is at the forefront of the research. The ONLY way to have governments or health insurance take a treatment seriously and consider funding it is to have research clinical trials. And as we have pointed out so many times, the only way to have those trials taken seriously is to conduct them independent of the companies that make the products. That’s why we do what we do. You have to understand that drugs are equally expensive (if not more so if one takes into account the negative effects on income, contribution to physical health issues etc) but we often don’t appreciate the expense because accessing drugs is often covered by our public health care system (at least it is in Canada and NZ). So the fact that the government might pay 400 dollars an hour for a patient to see a psychiatrist is not factored into the cost when comparing meds to nutrients. The fact that even with medications someone is unable to work is not factored into the cost of the medications. And then if the drug causes an arrhythmia, then the cost associated with investigating that (several thousand) is not factored into the cost of the drug. When nutrients work, these costs are unlikely to arise.

    Also, we are not convinced that the testing (like for methylation) is at a stage where it is that useful. Others might disagree, but the research is not as advanced as we might like to think it is. We are looking into that issue right now in NZ and might have further information on the topic in a year or so. Understand that we have not ONLY studied the truehope products, there are others we have also studied that don’t differentiate on their B12, like Daily Essential Nutrients. Whether both forms are needed is up for debate.

    With more data, we can then lobby governments and politicians to consider covering this as part of the health care system. At this point in time, we have chosen to allow Big Pharma to monopolize treatment options for families. So how do we change the system and include nutrition as part of our care of those who are ill? Because ultimately the fact that drugs are covered and nutrients aren’t is what makes this option appear so unaffordable. We can’t realistically ask the companies to give it away for free! I am not involved in the costs and not here to defend the costs, but generally as a consumer, we know that cheaper products tend to have cut corners.

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