Monday, July 15, 2019

Comments by Bonnie Kaplan, PhD

Showing 39 of 39 comments.

  • David, I am very grateful to you for continuing to describe the horrible events that Paxil caused. Given the terrible losses you have suffered, it would be easy for you to withdraw and just try to rebuild your own life. But you continue to speak out, Truth to Power. People need to hear your story, again and again. And I love that you have written this in the context of school shootings, as I agree that you have a connection. This connection is one that the public needs to hear; the media needs to pay more attention; and policy makers have to begin considering when they decide to throw still more money at conventional medication treatment of mental challenges.

  • Dear registeredforthissite. Thank you for asking this question; perhaps we will make it the topic of our next blog. I disagree with most of the responses you have already received, because they focus on individual nutrients. What the research has shown very clearly is that we need to go back to basics, learn to cook from scratch, eat whole foods, and following the Mediterranean Diet is especially good. Therefore, guidelines might include: fish, 5-10 half-cup servings of fruits and veggies every dat, nuts and seeds, whole grains. Also, if you are not vegan, meat and dairy.

  • Hi to everyone again……I want to thank all of you for the mostly-respectful tone of the discussion we are all having. I want to end my own input with one particular point (below), and then spend my time writing our next blog!
    Here is the point — and I know you all know this already, but this is a reminder. MIA blogs address a zillion important topics (labeling, diagnoses, meds, social issues, etc). BUT UNTIL WE BEGAN THIS BLOG, NO ONE was talking about nutrition. And nutrition’s role in mental health happens to be our area of expertise, so we thought we would fill that void.
    But please accept that this is the only topic we are addressing. It does NOT mean that we think all these other issues are trivial — that is not the case. But our discussions together would be far more productive (I think) and constructive if people commented only on our topic when responding to our blogs. I hope that sounds reasonable!
    Now…Happy New Year to all, and I have about 5 more blogs to work on 🙂 so I probably won’t add anything further here.
    Best wishes, Bonnie

  • Thank you for raising this point, Elsie, as it had not yet come up in this discussion but it is an important one. There are now 2 excellent clinical trials out of Australia that show (in adults with depression) that perhaps as much as 50% of the symptoms can be alleviated by getting people to eat healthier diets. That is a very, very big effect, and so we always say that the first thing people should do is to eat healthier diets (and exercise etc). But we also have some pretty well-studied cases of people who were already eating healthy, whole foods diets whose mental health improved by taking nutrient supplements. So I think our goal, in terms of mental health, needs to be FIRST encourage better eating (as I often say, we can’t put the whole world on pills), but SECOND try nutrient supplements whose benefits have been proven by independent scientists.
    ANOTHER important aspect of this is….why isn’t a good diet enough for some people? And there are 2 aspects to consider: 1. There is good reason to believe that some people have inherited a need for more nutrients for optimal brain metabolism than other people need — individual differences! and 2. There is very good evidence that our fruits and veggies do not have as many nutrients as they did 50 years ago, and the likely reason is that our soil has been depleted of minerals……a topic we will be blogging on in the future.

  • Steve, and Julia — these are interesting comments. I’d like to tell you both about something that I now do in almost all of my lectures on Nutrition and Mental Health. I end with a section on societal issues, one of which is the “stigma of mental illness.” And I tell the story (published) of a boy we call Andrew (not his real name), who was severely psychotic at the age of 9 — delusions, visual hallucinations, auditory hallucinations, etc. And over several months all of those symptoms were resolved with broad-spectrum micronutrients. We have followed this boy now for 8 years, and he is still well….as long as he takes his nutrients. But one summer when he was a teenager he rebelled and refused to take them. So his hallucinations began to return, scaring the pants off of everyone in his family. So….what do you think: does Andrew have a mental disorder? Or….did he inherit the need for an unusually large amount of nutrients for optimal brain function? And if the answer is the latter (and I think it is), why would we ever attach a ‘disorder label’ to him? And finally: if we could offer every child FIRST the opportunity of taking additional nutrients, how many developing brains would we protect from the onslaught of psych meds, and also how many people would we save from ever having a ‘disorder label’ applied?
    One final comment tonight: Steve, the fact that Julia and others employ DSM category labels does not mean that we like them. But we feel so strongly that we need to be able to publish our data on nutritional treatments…….and most journals will not accept even a high-level study such as Julia’s recent ADHD clinical trial if it does not follow certain conventions…..like DSM criteria for disorders. But as she always points out, when people benefit from micronutrients, they tend to improve across the board. We are showing the importance of building healthier brains.

  • It takes my breath away to see someone rant about nutrition as being “coercive psychiatry in just another form.” And it also saddens me to read a comment from someone who obviously has never felt the pain of hearing a child say that they really, really *want* to be a happier child who does not flip out every day.
    I wish people would stop using our blogs as an excuse to bash psychiatry and diagnostic labels (which we, also, dislike). If you cannot see the value of PREVENTING CHILDREN FROM BEING MEDICATED by first helping them improve their nutrition, please do not comment further.

  • Dear Dr. Joseph, Thank you for this synthesis of a topic I am often asked about in my lectures. My own reply relies on the prescient understanding shown by Linus Pauling in 1968 and 1972, in the following quote: “The genes for mental illness are likely the genes that regulate brain metabolism of essential nutrients.” Pauling, 1974, Am J Psychiatry; 131(11);1251-57 and Pauling, 1968, Science; 160; 265-71
    Now that we researchers in nutritional mental health (cf ISNPR.org) have published data demonstrating resolution of symptoms in psychotic disorders (1, 2), the genetics people would do well to re-visit their topic with a focus on brain metabolism, and determine which genes influence availability of cofactors for optimal enzymatic function.
    1. Mehl-Madrona L, Mainguy B (2017 epub ahead of print). Adjunctive treatment of psychosis with micronutrients. Journal of Alternative and Complementary Medicine. DOI: 10.1089/acm.2016.0215
    2. Rodway M, Vance A, Watters A, Lee H, Bos E, Kaplan BJ (2012), Efficacy and cost of micronutrient treatment of childhood psychosis. British Medical Journal Case Reports, 2012 Nov 9. http://casereports.bmj.com/sevendays?fdate=11/05/2012&tdate=11/11/2012

  • There is much good information in Bob’s essay and the comments above. But I do not understand why there is such blanket neglect of the (admittedly small) amount of research on the role of nutrition. There are studies showing the addition of fish oil following a first episode psychosis significantly reduces the probability of subsequent episodes; there are case reports supported by quantitative data showing complete resolution of hallucinations and delusions by broad-spectrum nutrient formulas. I know we need many more studies, but if ‘first do no harm’ is truly the guideline for early psychosis clinics, they should be implementing these simple and safe interventions before resorting to medication. And….they should be doing research on the topic! I’m available to consult.

  • 17 years ago my colleagues and I showed that the IQs of children with ADHD were normally distributed [1]. Interestingly, the reason we even investigated the question is because at that time there were many claims that children with ADHD were unusually intelligent. Seems sort of funny now.

    Thanks for writing this analysis.

    [1] Kaplan BJ, Crawford SG, Dewey D, Fisher GC (2000). The IQs of children with ADHD are normally distributed, J Learn Disabil, 33: 425-432.

  • We are grateful for the several positive and appreciative comments we have received these past couple of years, but we are writing in response to the many negative and off-topic comments. Some of these hostile comments range from calling us liars (continuing to suggest that we are affiliated with commercial companies), to being completely irrelevant to the topic of our blog.

    We do not know why our blogs constantly trigger hostile and irrelevant comments. We really don’t. And we don’t have time to respond to off-topic queries. For those wanting more information on Nutrition and Mental Health, we review the literature on that topic in our 3 part series on MIA – it can be accessed for free. Perhaps that information will help readers understand that we are writing about scientifically valid issues. We are not saying that other sources of information are NOT valid; we are simply writing to provide valid information on nutrition.

    We would like to continue writing for those who want information. But in the future, we shall ask that our blogs NOT BE OPEN TO COMMENTS.

    You can always reach us by email if you have genuine and relevant questions. Thank you for understanding.

  • From both Julia and Bonnie:
    Thank you all for commenting so passionately on our blog. We are struck by the number of comments that raise concerns about the integrity of the companies that make the products we have studied. One important point of our blog is that we are not affiliated with any companies, and yet some writers have used their concerns about the companies as a way to dismiss the value of our research. Frankly, we do not understand why readers cannot grasp this point even though we make it often: we are not affiliated with any company on earth, and none of our research has ever been funded by any company. So comments about the company are not relevant to our blogs. And we do think it highly improper to bring up the tragic death of Ezekial Stephan in this context: the parents were charged with not taking their sick child to a physician quickly enough — which is so totally unrelated to Truehope’s nutritional products or our scientific research that we gasp at the insensitivity of raising this issue in the comments section.

    But back to our research: Some of you are clearly unhappy with our data (perhaps because you have not personally benefited from these formulas), but the research very robustly supports the use of micronutrients for the treatment of mental health symptoms. We do ask you all to consider that in order to forge ahead in science we must test ideas that are controversial and challenge our current way of thinking. This does not mean this approach works for everyone: after all, many factors contribute to the expression of troubling symptoms. But it does mean micronutrients confer greater health benefits than taking a placebo. This finding adds further weight to the growing evidence that optimizing one’s nutrient intake can protect us from mental health challenges. And for some people, dietary intake of nutrients is not sufficient: additional micronutrients in pill form can help some people. Why does this information irritate readers?

    We agree further research could refine the optimal ingredients required, but our research has helped put on the map the idea that mental health problems CAN be addressed through nutrition, offering an alternative to our current approaches. That has to be a good thing.

  • (Sorry for the delay in our replies)
    Yes, we certainly do know who Stephen Barrett is, as well as his Canadian buddy Terry Polevoy. They think they are God’s gift to the public, and that their mission is to ‘protect’ the public from health scams and frauds. I would like to avoid scams as much as the next person, but they have blocked legitimate scientific research in academic settings — why? because they are already made up their minds that it was impossible that the natural product could be beneficial. Does that make sense to anyone?

  • Sorry but I am just seeing this comment now, (). Promoting is not the right word at all. The thing is that EMPowerplus was the first broad-spectrum micronutrient formula to be studied intensively for its benefits for mental health — but it is not the only one. Now there is a second called Daily Essential Nutrients (DEN) which also has empirical support. And there will be more!! We researchers try not to even mention the names of products, because in our view we are studying a concept not a product — and the concept is that a good quality, highly absorbable BROAD-SPECTRUM micronutrient formula may help with psychiatric symptoms much more than any single nutrient. But when we do NOT mention product names, other people criticize us for not saying what we are studying. So we are always struggling with this problem — how to mention product names without sounding as if we are promoting commercial products.
    But there is one more problem with your comment — your anonymity. Addressing a person as () is very unsatisfactory, especially when that () cites websites that are terrible, hate filled places that oppose anything natural. It makes us wonder who you are and whether you are affiliated with them.

  • 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.

  • 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.

  • 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.

  • You raise an interesting point, bcharris. We study multi nutrient formulas: both broad spectrum and smaller spectrum (e.g., B complex). In none of those studies do we claim one-size-fits-all. We are totally convinced by the data published by Roger Williams, author of the book Biochemical Individuality. BUT…we also know that the current state of the science is such that there are no adequate measures of levels of micronutrients at the level of the brain. Even the simplest blood test of something like vitamin D is looking at peripheral blood. So the multi nutrient formulas are not ‘one-size-fits-all’ — what they are is a sort of shot-gun approach that helps to fill all the holes in a leaky boat, so they help lots of people. And, importantly, they are not megadoses, and any surplus is safely excreted.

    We agree that you should take the ‘cheapest effective’ nutrient formulas you can find. If you ever find one in a grocery store that is effective for mental health problems, do please let us know.

  • Thank you, Kevin, for explaining what we have said so many times: we do not promote any products, and we do not take money from any companies. There are people who have tried and continue to try to ruin our reputations by alleging the opposite, and we are frankly tired of dealing with that nonsense. Especially when the individual making the allegations hides under anonymity — I just assume it is another quack(buster). If the individual wants to email me, I will provide a list of the double-blind trials. But you will have to identify yourself.

  • This is one of those gotcha moments! Thank you, BPDTransformation. The fact is that we agree that the DSM categories are mostly fictional, and so we usually talk about micronutrients helping with mental health challenges/symptoms. But we live also in the academic world, and in order to get any article published EVER, we have to use the DSM terminology. Living in 2 worlds can be confusing, and so sometimes the language slops from one to the other. Sorry about that, but it’s our reality.

  • Yes, radames, we consistently endorse eating the best possible diet. But we have shown that some people who report eating excellent diets experience remission of psychiatric symptoms when ingesting broad-spectrum micronutrients in PILL form. This is not theoretical: we are both empirical scientists. And it is not even strange: the phenomenon has been well-documented for ~50 physical ailments too. These inborn errors of metabolism can be treated with nutrients to the point that symptoms are completely ameliorated. This information should not be ignored just because some people want to promote healthy eating. Lets promote health eating AND micronutrient supplementation (when needed) to maximize mental health!

  • Thank you so much, to everyone, for the kind comments and the interesting discussion! Yes, we shall soldier on, because nutritional treatment of mental disorders is the core of our academic research programs, and because we have seen transformations that are breathtaking, and because we know that lots of people reading our posts do, in fact, enjoy reading them. And thank you for further helping us understand the basis of some of the hostile comments — that helps too. And we shall cherish the one by Steve McCrea on October 9: “You must be doing good work if they are threatened enough to go on the attack!”

    We will address some of the remarks together………
    1. Madmom made an interesting point: “some people may identify trauma or grief as the chief source of their mental distress, others may identify with having a nutritional deficiency.” And of course, both (and other factors too) can be true. But what is interesting about nutrition is that it can serve as a buffer to enhance our resilience to trauma. There is tons of research on this topic (perhaps we should make it the subject of a future blog), but one *could* even say that optimal nutrition accounts for much of our resilience and ability to cope with the many hard knocks that life presents. (And thank you, Amnesia, for commenting on this later in the posts.)

    2. Thanks to Amnesia for the comment about Abram Hoffer, a true giant in the field and a pioneer denied the honour he deserved in life. We do not acknowledge his contribution often enough! But as Rossa Forbes mentioned in the very next comment, not everyone benefits from the eclectic approaches proposed by Dr. Hoffer and his orthomolecular followers. (Of course, there is NO treatment, nutrient or otherwise, that provides benefit to everyone — we are all too individual!).

    3. We are sorry to hear of Rossa Forbes’s relative who relapsed while taking lots of nutrients. Relapse is something that both of us keep watching for in all of our studies, and when it does happen, we try to figure out what might have changed to explain it. Julia documented the relapse of a young woman who did well on the micronutrients and then suddenly her symptoms returned. In that case, it was determined that a yeast infection had likely resulted in inflammation and as a result poor nutrient absorption. Once the yeast infection was aggressively targeted with probiotics, olive leaf extract and change of diet, both the yeast infection and the psychiatric symptoms disappeared. We have seen other people show a re-emergence of symptoms when taking an antibiotic (which affects health of the gut), getting sick (which means the body needs more nutrition to recover from illness and stay well), starting a new exercising programme (it has been hypothesized that exercising can release medications that have been stored in fat cells), or being inconsistent with taking the nutrient pills. But we also have documented people staying well for years — indeed, our early work was not even submitted for publication until we had two years of follow-up information.

    4. One of Rossa Forbes’s other comments made us chuckle. We so much appreciate your final words of encouragement and your insistence on staying open-minded. But what we find is one of the biggest obstacles to opening people’s minds is that they are searching for what you referred to as a magic bullet! There is none. That is precisely the reason we favour studying (and using) a broad spectrum of all the vitamins and minerals that we have evolved to need.

    5. Jon Keyes raised an incredibly important point, and we agree 100%: work on diet first. And Monica Cassini also weighed in this. We cannot imagine a world in which everyone is solving their nutritional problems with pills — or at least we do not WANT to imagine it!! We must learn to cook and eat healthy food. But Jon and Monice: there is good reason to believe that there are some people who have inborn metabolic needs for unusually high amounts of nutrients — so there is also a place for supplements. (And we know you both agree.)

    6. MadinCanada describes a son who relapses frequently, and is taking various ‘expensive vitamins.’ But I wonder if your son has tried the broad spectrum formula that is most supported by scientific data?

    7. To Ted Chabasinski we say: yes, yes, and yes! Drug companies are a major force and an obstacle. But we can’t spend our time worrying about them. We feel quite determined to reach the public — they are the ones who will lead the way.

    8. Askye, you are suffering and some of the others have offered suggestions to you. We think your situation illustrates the unfortunate fact that there is no way lab tests can accurate reflect what is happening in every part of our bodies — especially the brain! Some of Julia’s publications address this topic and show that nutrient levels are poor predictors of response to treatment.

    9. To Amnesia again: perhaps we will address pyroluria and the genetic variant MTHFR in the future – thanks for the suggestion – Julia is collecting data on this in her current study.

    10. Fluffybunny seems to be over-interpreting our meaning, so obviously we need to communicate better (‘hostility comes in response to the claim that healthy foods and supplements alone will cure everything and make your life wonderful and grand’). Actually, this is one of the reasons we never use the ‘C’ word (Cure) that one of the other commentators suggested. But optimal nutrition to promote optimal health, with healthy eating and supplements as needed, can do a great deal to remit mental health symptoms and to improve resilience and coping skills for some people. It is then up to individuals to seek counselling to learn those coping skills, and to develop an understanding of the dynamics important in their own lives. (And by the way, we do not scoff at the importance of childhood trauma. As someone else said, everything matters —- everything.)

    11. Ssenerch endorses some of fluffybunny’s comments and refers to diet and broad spectrum supplementation again as a magic bullet, implying that we are excluding everything else. We are not! Please keep in mind that we cannot address every topic in every blog (childhood trauma, stress reactions, need for psychotherapy and support, etc, etc, etc). But it has been known for decades in both laboratory animals and humans, that better nutrition results in better resilience and coping.

    12. And finally, a comment to all of you. Thank you again for your support and interest. We do not always have time to reply to every comment, but we are delighted that you are helping and supporting each other. If you are interested in the nutrition issue for yourself, we recommend that you: a) do all that you can to improve your diet, and b) if you want to take supplements for mental health, we urge you to take one of the ones that has been studied. There are zillions of people who want to sell you pills, and most have not been scrutinized by any government or by any scientist. A study done by one of Julia’s graduate students documented the very low doses of nutrients in supermarket variety vitamin pills as compared with those used in research studies. Not all pills are created equal!

    Some additional references:
    • Rucklidge, J. J., Harris, A., & Shaw, I. (2014). Are the amounts of vitamins in commercially available dietary supplement formulations relevant for the management of psychiatric disorders in children? New Zealand Journal of Medicine, 127, 73-85.
    • Rucklidge, J. J. (2013). Could yeast infections impair recovery from mental illness? A case study using micronutrients and olive leaf extract for the treatment of ADHD and depression. Advances in Mind-Body Medicine, 27(3), 14-18.

  • It is terrific to hear of the successes of dietary changes, because this of course should be the first step anyone takes: improve your diet. But some of our studies have indicated that even people who eat really excellent diets with lots of fruits and veggies are still symptomatic, and adding vitamins and minerals in pill form benefits them. Why? We have theories, and we have models based on inborn errors of metabolism already demonstrated in the realm of physical health. But there is much research still needed.

  • Thank you for raising a common misconception, which enables us to clarify it publicly. Neither Bonnie nor Julia has any financial connection with any company manufacturing a natural health product. Neither of us has ever been employed by or paid by any company, including Truehope Nutritional Support or Nutratek. And by the way, MiA also doesn’t have any financial interest in these companies and they currently do not even accept advertising of any kind.

    It would be lovely if we (Bonnie and Julia) could just provide a description of the various nutrient formulas we have studied with no commercial name, but that would be like publishing an article examining the effects of ‘a stimulant’ without specifying that it is methylphenidate. It just makes no sense. So we specify the commercial name(s), but always state the fact that we are not in a conflict of interest. Also, it makes sense to name the formula being evaluated; in this case, a package of micronutrients that are, in fact, being offered for the specific purpose being tested and therefore warrants investigation as to the legitimacy of the claim. This also allows people to know the specific nutrients that were used.
    As for your accusation that EMPowerplus is excessively costly, that concern is best raised with the manufacturer. We would just point out that there are many formulas that you can buy at a lower cost, but to the best of our knowledge none of them has been shown to have significant mental health benefits. Perhaps they do, but there is no way to know. Ultimately, it’s up to you to decide for yourself what evidence you need to be satisfied that it is worthwhile making a purchase.

  • My flippant answer is: “Yes, it has always been an uphill climb”! But let me be a little more nuanced than that.

    In *physical* health, it has been an up-and-down climb. Take a look at the Fairfield and Fletcher articles that mentioned: “…it appears prudent for all adults to take vitamin supplements” —- and the next round of studies will probably show that again. It always depends on the spectrum of nutrients, the dose, the methodological design, etc.

    In *mental* health, it think it has been a totally uphill climb, and continues to be. Watch for our next blog, in a few days! And thanks for your comment.

  • hi — thanks for your interest. You are correct that folate and folic acid are not the same. Folate is the term for the naturally-occurring form; folic acid is the synthetic form. Folic acid, therefore, is the form found in most multivits, in fortified foods, and in most research articles. My understanding (maybe I should say *assumption*) was that they were absorbed and metabolized the same. I’m sorry, but I can’t offer any evidence on either side of that issue. But if Dr. Hyman’s article said that some people cannot absorb/make use of the synthetic form, that comment is different from the issue you are raising — the possibility of somehow feeling ill from eating folic acid-fortified flour.

    I would like to point out that the amount of folic acid in fortified bread is quite small. I found varying estimates on the web, but in Canada where we fortify bread, you would not likely get more than 20-30 micrograms. In comparison, the RDA for adults is in the range of around 400.

    So that makes me wonder about the related topic you raised: did you feel better when you stopped eating bread because you are gluten sensitive? That sort of sounds more likely to me, but I suspect you are trying to figure out whether that is the case. Best of luck to you!

  • Thanks for noting your appreciation of our posts — so far we have had a lot of fun writing them. (Though it is going to become a bit more of a struggle in the next few months because of commitments and travel that both of us are tied up with.)
    As we have mentioned in a previous blog, there is excellent nutritional epidemiologic data showing a relationship between the type of food a person eats, and the likelihood that they will report symptoms of depression/anxiety. Some of those studies (references were in that post) specifically use the label ‘Mediterranean diet’ to contrast a healthy, whole foods diet to processed/packaged/western diets. Consistently, the Mediterranean diets have been associated with better mental health.
    Having said that, I must also note that all of those particular studies are on large populations — not individuals. So we have a long way to go yet before we can draw conclusions that generalize to everyone.
    The message for the individual right now? A Mediterranean diet appears to be generally healthier or mental and physical health than is a diet of processed, saturated fat foods.

  • Thanks for your interesting questions. Julia and I can legitimately claim to know a wee bit about nutrition and mental health (which is why we write this blog), but frankly, I don’t think either of us would claim to know enough about chelation and detoxification (the 2 other items you raised) to offer a knowledgeable comment.
    Regarding your comment about paying attention to macronutrients before paying attention to micronutrients — I don’t think we should consider it to be an ‘either-or’ choice — all are extremely important. And for those who do not have sufficient funds to get good quality food, all of these deficiencies are huge problems.

  • Julia and I are not really surprised, but we are delighted, to see so much interest in the topic of nutrition and mental health. This is an area where the public seems to be way ahead of the mental health professionals.
    Thank you to everyone taking the time to write comments. We won’t often have the time to respond to each of you, but your ideas will likely influence our future posts. Bonnie Kaplan