Omega-3s Recommended as Adjunctive Therapy for Major Depression
Megan Brooks
September 25, 2019
A clinical practice guideline from the International Society for Nutritional Psychiatry Research (ISNPR) recommends omega-3 polyunsaturated fatty acids (PUFAs) as adjunctive therapy for major depressive disorder (MDD).
The value of omega-3 PUFAs in depression is “overlooked,” even though accumulating evidence supports it. This therapy “needs to be on the radar” of physicians, Kuan-Pin Su, MD, PhD, chief of the Department of General Psychiatry, China Medical University, Taichung, Taiwan, told Medscape Medical News.
Su, a founding member of the ISNPR and a strong proponent of “nutritional psychiatry,” organized a subcommittee of the ISNPR and invited the top 10 most-cited authors in the use of omega-3 PUFAs for depression to review the literature and develop the practice guideline on appropriate prescribing of omega-3 fatty acids for MDD.
The consensus guideline was published online September 3 in Psychotherapy and Psychosomatics.
Prophylaxis, Maintenance
The guideline emphasizes the importance of accurate clinical diagnosis and measurement-based psychopathologic assessments in the therapeutic setting when recommending omega-3 PUFAs for depression.
The guideline notes that there is a growing body of evidence demonstrating the efficacy of n-3 PUFAs as an adjunctive treatment for MDD. The guideline authors also note that omega-3s are safe and effective for accelerating the effect of antidepressants at treatment initiation and for augmenting existing antidepressant therapy when efficacy is inadequate.
With respect to formulation and dosage, the guideline recommends pure eicosapentaenoic acid (EPA) or a combination of EPA and docosahexaenoic acid, with net EPA starting from at least 1 g/day up to 2 g/day for at least 8 weeks as adjunctive treatment. Importantly, the authors note that the quality of n-3 PUFAs may affect therapeutic activity.
The guideline also endorses n-3 PUFAs as a potential prophylactic treatment for high-risk populations, in addition to standard medical care. The duration of acute n-3 PUFA treatment may be extended to include maintenance treatment to prevent recurrence.
Potential side effects, such as gastrointestinal and dermatologic conditions, should be monitored, and comprehensive metabolic panels should be obtained during treatment, the guideline authors note.
They call for further research into personalizing the clinical application of n-3 PUFAs in subgroups of patients with MDD whose omega-3 index is low or who have high levels of inflammatory markers.
The panel acknowledges in the guideline that there is ongoing debate on the benefits of omega-3 PUFAs for MDD. Meta-analyses have shown “only small but statistically significant effects,” the authors write.
They note that in three meta-analyses, the estimated effect sizes (standardized mean differences between n-3 PUFAs and placebo) ranged from 0.23 to 0.56, with wide confidence intervals (CIs).
However, small effect sizes have also been reported regarding antidepressant drugs compared to placebo (standardized mean differences, 0.30 – 0.47, with narrower CIs).
Given that currently recommended therapies for MDD have only small effects, the panel notes three “practical” strategies that should be employed to address the “unmet” need in depression treatment.
These include an open-minded attitude to integrative intervention; the application of personalized medicine; and a shared decision-making process based on balanced information to enhance treatment adherence.
Reasonable Approach
Commenting for Medscape Medical News, Timothy Sullivan, MD, chair of psychiatry and behavioral sciences at Northwell Health’s Staten Island University Hospital in New York City, said the recommendation constitutes a “perfectly reasonable practice guideline.
“The big picture, however, is that while there is a literature on the usefulness of omega-3s, average clinical experience hasn’t been as impressive. Clinicians generally haven’t been overwhelmed by the results. There are practitioners that favor them more than others,” said Sullivan.
“Conceptually,” he added, “what’s appealing about omega-3s is we know that depressive states are associated with dysregulation of the immune system, and agents like the omega-3s appear to have a role in helping to re-regulate or positively regulate the immune system and combat some of the metabolic effects of stress. But it’s still an area that we need to understand more about.”
The guideline authors were supported by research grants from the Ministry of Science and Technology, Taiwan; the National Health Research Institutes, Taiwan; and the Chinese Medicine Research Center from the China Medical University. Su is a founding committee member of the ISNPR, the board director of the International Society for the Study of Fatty Acids, and an associate editor of Brain, Behavior and Immunity. The original article contains a complete list of authors’ relevant financial relationships. Sullivan has disclosed no relevant financial relationships.
Psychother Psychosom. Published online September 3, 2019. Full text
Many people are surprised to learn that infectious diseases, including Lyme disease, are a major contributor to mental illnesses and cognitive issues.Research shows that children who have had an infectious disease are significantly more likely to have mental health problems as they grow up. In a study that followed over 3.5 million people, scientists found a 62% increase in the risk for mood disorders if a person had been hospitalized for any type of infection.
Lyme/MSIDS, PANS, PANDAS, & autoimmune encephalopathy can all be interconnected and we need knowledgable practitioners who can recognize this as it’s not going away anytime soon.
Summary: Inflammation appears to have a negative impact on attention and cognition.
Source: University of Birmingham
Scientists at the University of Birmingham in collaboration with the University of Amsterdam have uncovered a possible explanation for the mental sluggishness that often accompanies illness.
An estimated 12M UK citizens have a chronic medical condition, and many of them report severe mental fatigue that they characterize as ‘sluggishness’ or ‘brain fog’. This condition is often as debilitating as the disease itself.
A team in the University’s Centre for Human Brain Health investigated the link between this mental fog and inflammation – the body’s response to illness. In a study published in Neuroimage, they show that inflammation appears to have a particular negative impact on the brain’s readiness to reach and maintain an alert state.
Dr Ali Mazaheri and Professor Jane Raymond of the University’s Centre for Human Brain Health, are the senior authors of the study. Dr Mazaheri says:
“Scientists have long suspected a link between inflammation and cognition, but it is very difficult to be clear about the cause and effect. For example, people living with a medical condition or being very overweight might complain of cognitive impairment, but it’s hard to tell if that’s due to the inflammation associated with these conditions or if there are other reasons.”
“Our research has identified a specific critical process within the brain that is clearly affected when inflammation is present.”
The study focussed specifically on an area of the brain which is responsible for visual attention. A group of 20 young male volunteers took part and received a salmonella typhoid vaccine that causes temporary inflammation but has few other side effects. They were tested for cognitive responses to simple images on a computer screen a few hours after the injection so that their ability to control attention could be measured. Brain activity was measured while they performed the attention tests.
On a different day, either before or after, they received an injection with water (a placebo) and did the same attention tests. On each test day, they were unaware of which injection they had received. Their inflammation state was measured by analyzing blood taken on each day.
The tests used in the study assessed three separate attention processes, each involving distinct parts of the brain. These processes are: “alerting” which involves reaching and maintaining an alert state; “orienting” which involves selecting and prioritizing useful sensory information; and “executive control” used to resolving what to pay attention to when available information is conflicting.
The results showed that inflammation specifically affected brain activity related to staying alert, while the other attention processes appeared unaffected by inflammation.
“These results show quite clearly that there’s a very specific part of the brain network that’s affected by inflammation,” says Dr Mazaheri. “This could explain ‘brain fog’.”
Professor Raymond says,
“This research finding is a major step forward in understanding the links between physical, cognitive, and mental health and tells us that even the mildest of illnesses may reduce alertness.”
Dr Leonie Balter the first author of the study which was completed as part of her PhD, concluded:
“Getting a better understanding of the relationships between inflammation and brain function will help us investigate other ways to treat some of these conditions. For example, further research might show that patients with conditions associated with chronic inflammation, such as obesity, kidney disease or Alzheimer’s, could benefit from taking anti-inflammatory drugs to help preserve or improve cognitive function.”
“Furthermore, subtle changes in brain function may be used as an early marker cognitive deterioration in patients with inflammatory diseases.”
The next step for the team will be to test the effects of inflammation on other areas of brain function such as memory.
ABOUT THIS NEUROSCIENCE RESEARCH ARTICLE
Source: University of Birmingham Media Contacts:
Beck Lockwood – University of Birmingham Image Source:
The image is in the public domain.
Selective effects of acute low-grade inflammation on human visual attention
Illness is often accompanied by perceived cognitive sluggishness, a symptom that may stem from immune system activation. The current study used electroencephalography (EEG) to assess how inflammation affected three different distinct attentional processes: alerting, orienting and executive control. In a double-blinded placebo-controlled within-subjects design (20 healthy males, mean age = 24.5, SD = 3.4), Salmonella typhoid vaccination (0.025 mg; Typhim Vi, Sanofi Pasteur) was used to induce transient mild inflammation, while a saline injection served as a placebo-control. Participants completed the Attention Network Test with concurrent EEG recorded 6 h post-injection. Analyses focused on behavioral task performance and on modulation of oscillatory EEG activity in the alpha band (9–12 Hz) for alerting as well as orienting attention and frontal theta band (4–8 Hz) for executive control. Vaccination induced mild systemic inflammation, as assessed by interleukin-6 (IL-6) levels. While no behavioral task performance differences between the inflammation and placebo condition were evident, inflammation caused significant alterations to task-related brain activity. Specifically, inflammation produced greater cue-induced suppression of alpha power in the alerting aspect of attention and individual variation in the inflammatory response was significantly correlated with the degree of alpha power suppression. Notably, inflammation did not affect orienting (i.e., alpha lateralization) or executive control (i.e., frontal theta activity). These results reveal a unique neurophysiological sensitivity to acute mild inflammation of the neural network that underpins attentional alerting functions. Observed in the absence of performance decrements, these novel findings suggest that acute inflammation requires individuals to exert greater cognitive effort when preparing for a task in order to maintain adequate behavioral performance.
Control inflammation throughout the body, not just in your joints.
Repair and rebuild the cardiovascular system.
Optimize blood flow & cleanses blood of debris
Prevent and dissolve blood clots by dissolving fibrin
Dissolve plaque in your arteries and dental plaque in your mouth.
Clean up your immune system.
Minimize the impact of allergies but breaking down and removing circulating immune complexes.
Improve the ability to exercise and speed up recovery times.
Kill bacteria, viruses, and other pathogens.
Accelerate recovery from sprains, strains, fractures, bruises & surgery
Help with arthritis
Help with detoxification
Improve body alkalinity
Help with sinusitis and asthma
Help reduce MS symptoms
Another supplement I’ve taken for years is melatonin, which according to Dr. Mercola, also reduces inflammation and is neuroprotective by strengthening the blood-brain barrier.
Melatonin is responsible for your sleep/wake cycle and it plays an important role in fighting inflammation and weight gain
It affects your immune system, gut health, pain level, blood pressure and recovery from stroke and traumatic brain injury
You can naturally boost your melatonin levels by getting at least 15 minutes of sun exposure in the morning, among other ways
Melatonin has a safe track record with few adverse reactions, but its long-term effects are unknown; supplementation may not be safe for those taking certain medications or dealing with specific health conditions
Your body is a complex organism requiring quality sleep to function optimally. Your body’s circadian rhythms are a combination of biological clocks regulating everything from your metabolism to psychological functioning. One sure way to cause dysregulation of your biological clock is to skimp on sleep.
Although you have a master clock in your brain to synchronize bodily functions, every organ and cell has its own biological clock as well. In a stunning discovery published in 2017, researchers found half your genes are controlled by circadian rhythms that turn them on and off in a cyclical wave.
The whole-body circadian rhythm is largely dictated by your pineal gland, which is responsible for secreting melatonin or N-acetyl-5-methoxytryptamine. This hormone normalizes your circadian rhythm as it signals your body it’s time for sleep. The production of melatonin will depend on how much and when your body absorbs light.
The gland is located near the center of your brain and usually starts secreting melatonin near 9 p.m. Without an adequate amount of sleep and exposure to sunlight, your levels will naturally drop. Researchers have found an association between melatonin and rising levels of inflammation.
Melatonin Reduced Inflammation and Obesity Markers in Mice
In a combined effort, scientists from universities in Brazil and Italy1 sought to identify the role melatonin may have in improving disorders commonly found in those who are obese. The researchers used mice who were induced to become obese and treated them for 10 weeks with melatonin.
The objective was to determine if the hormone could effectively delay or block the damage from eating too much. The researchers found multiple results supporting their theory that melatonin supplementation could have a significant effect on the animals, including reducing triglyceride levels and total and LDL cholesterol levels.
They also found that supplementation prevented larger weight gain by reducing the formation of fat tissue and increasing the capacity to break down white fat. This combination of effects helped to prevent the hypertrophy of fat cells caused by excessive eating.
Additionally, the researchers noted the supplementation reduced a characteristic inflammatory process found in obese subjects where macrophages infiltrate adipose tissue. The mice also experienced a reduction in inflammatory related factors through a decrease in gene expression.
Overall, at the end of the 10-week trial, the group of mice eating an excessive amount without melatonin gained 49% body mass over the control group that ate a normal diet. The group of mice supplemented with melatonin increased their body mass 28% over the control group, but 13% lower than the group eating excess food without melatonin.
The researchers believe the data suggest that melatonin could be considered as a therapeutic agent to help mitigate the metabolic and inflammatory conditions triggered in those who are obese.
The Importance of Melatonin to Sleep/Wake Cycles
As with many hormones and chemicals in the body, melatonin has more than one function. The best known role it plays is in controlling your sleep/wake cycle. This well-publicized function may be due to the fact that sleep plays a significant role in your overall physical and mental health.
An estimated 40% of Americans are sleep deprived every day, with many people getting less than 5 hours of sleep per night. Millions struggle to fall asleep and others find it challenging to stay asleep. Some wake up too early in the morning.
Melatonin is a marker your body uses to influence what time of day or night it thinks it is. This happens regardless of the actual time. During a normal night of sleep, levels stay elevated for about 12 hours. As the sun rises, the pineal gland reduces production until the level in your blood is hardly measurable.
If you experience disruption to your circadian rhythms, your body will produce less melatonin and you will experience poor quality sleep. This can happen to those who work the night shift, have jet lag or are exposed to light during the night.
Melatonin Benefits More Than Sleep
A deficiency in this hormone may come with profound biological risks, such as potentially having higher levels of inflammation, a weaker immune system and an increased chance of developing cancer. The hormone interacts with receptor proteins that help control the different stages of sleep and are present in other organs and immune cells.2,3
Additionally, melatonin is a potent antioxidant that can raise the levels of other antioxidants, such as glutathione. Melatonin plays a role in the health and survival of mitochondria,4 your body’s powerhouse, where energy production takes place at a cellular level.
Melatonin has shown some promise for pain control in those suffering from endometriosis. In one study,5 10 mg per day decreased pain by 39.8% and dysmenorrhea by 38.01%. Topical application may help prevent sunburn,6 while oral supplementation was 150 times more effective at treating tinnitus as compared to other drugs. Melatonin may also play a protective role in:7
Melatonin does come in supplemental form, but it’s also possible to raise your levels naturally. Researchers recognize nonpharmacological approaches to insomnia include better sleep hygiene, physical exercise and mindfulness meditation.
It makes sense to engage in simple habits to increase your natural production and improve your overall health and sleep without adding supplements. Four simple strategies include:
• Sunshine during the morning — Melatonin is affected by your exposure to light and dark. When it’s light, production of melatonin naturally drops. Getting at least 15 minutes of sunlight in the morning hours helps to regulate the production of melatonin, dropping it to normal daytime levels, so you feel awake during the day and sleep better at night.
• Sleep in the dark — Your body produces and secretes melatonin in the dark, helping you to go to sleep and stay asleep. Sleeping in a completely darkened room, without lights from alarm clocks, televisions or other sources will improve your sleep quality.
If you get up during the night to use the bathroom, it’s important to keep the lights off so you don’t shut off your production of melatonin. Also, wear blue-light blocking glasses after sunset to avoid blue-light exposure.
• Lower your stress level and your cortisol level — The release of melatonin is dependent on the release of another hormone, norepinephrine. Excess stress and the resulting release of cortisol inhibits the release of norepinephrine, and therefore the release of melatonin. Stress-reducing strategies you may find helpful before bed include yoga, stretching, meditation and prayer.
• Increase foods high in magnesium — Magnesium plays a role in reducing brain activity at night, helping you to relax and fall asleep more easily. It works in tandem with melatonin. Foods containing higher levels of magnesium include almonds, avocados, pumpkin seeds and green, leafy vegetables.
Supplementation and Potential Negative Effects
The beneficial effects associated with melatonin suggest it may primarily have a function as an antioxidant. In speaking with Time magazine, Helen Burgess, co-director of the Sleep and Circadian Research Laboratory at the University of Michigan, said:8
“Some of the emerging science is showing that in people with higher levels of inflammation — which could be because they’re obese, or because they’re in the [intensive care unit] for a transplant — melatonin in the range of 6 mg to 10 mg may decrease markers of inflammation.”
The authors of past studies have associated a deficiency in melatonin with obesity. It also may address inflammation, as supplementation has been associated with lowering oxidative stress and regulating adipokines involved in the inflammatory process. While believed to be relatively safe for up to 18 months, the long-term effects are largely unknown.
Possible negative interactions have been suggested for those with epilepsy or those taking Warfarin, a blood thinner. Melatonin is sometimes used in children to benefit those with sleep disorders, but long-term effects in children are also unknown. There has been some research suggesting that using melatonin during puberty may interfere with natural production of the hormone.
Researchers leading one study cautioned that supplementation should be limited in those with attention deficit hyperactivity disorder. They suggest considering the supplement only for those who also have chronic insomnia. It’s crucial to remember that melatonin is a hormone, and long-term supplementation with hormones can have unknown effects on the body.
In addition to the strategies listed above to boost your natural production, you may benefit from sleep habits information in my past article, “Top 33 Tips to Optimize Your Sleep Routine.”
5 Effects of Stress on the Mind and Body + 10 Tips to Reduce Stress
by Holtorf Medical Group
5 Effects of Stress on the Mind and Body & 10 Tips to Reduce Stress
We all hear about stress these days and how bad it is for our health. Many people consider stress a part of modern life and learn to live with it, but stress is not normal and it can be overcome! You just need to learn how.
Originally Posted November 2016
Updated October 2019
Knowing the far-reaching effects of stress, not only on our psychological well-being, but also on our entire bodies, can help us remember to prioritize stress management and other self-care practices.
Stress, Cortisol, and Adrenals
You may have heard these terms used together, but are not sure how they are connected. Stress is any kind of outside factor that our body perceives as a threat to our safety or well-being. Many people think this only refers to emotional stress or trauma, but it also includes physiological stress on the body, such as infection, traumatic injury, or a poor diet. Stress can also include environmental factors like exposure to chemicals and other toxins.
Cortisol is one of the hormones that our body releases in response to stress. It is probably the one most commonly associated with stress, even though there are others involved.
While this can be a very useful and sometimes life-saving response to a threat, problems can begin to occur if stress becomes frequent or chronic. As the adrenal glands become over-worked, they eventually can’t keep up with the body’s demands for the various hormones they’re responsible for.
How Stress Affects the Body
Here are a few of the major ways the mind and body are affected by chronic stress.
Mood
The adrenal glands produce more than just cortisol. They also produce neurotransmitters such as adrenaline (epinephrine), norepinephrine, and dopamine. Neurotransmitters are chemical messengers that help regulate things like mood, performance, weight, pain perception, and sleep. Depending on the degree to which the adrenals have been affected, the neurotransmitters become unbalanced in various ways.
Let’s take dopamine, for example. If dopamine is too high, someone may experience anxiety, hyperactivity, or paranoia. If someone has low dopamine, it can lead to addiction, cravings, or depression.
Hormones
In addition to neurotransmitters and cortisol, the adrenals also produce small amounts of the sex hormones, estrogen and testosterone (and their precursors). Along with balancing out hormones based on a person’s gender, sex hormones also help keep the negative effects of too much cortisol in check, acting as an antioxidant. But once the adrenals become chronically over-worked, more and more of the precursor materials (used to make sex hormones) get diverted to make cortisol, resulting in a decrease in sex hormones.
This results in lowered libido and other symptoms related to hormonal imbalances, such as premenstrual syndrome in women or erectile dysfunction in men.
Blood Sugar Regulation
When cortisol is released, the hormone glucagon is signaled and insulin is suppressed. Glucagon controls glucose storage in the liver so that glucose can be released into the blood. Insulin is the hormone that regulates the amount of glucose being taken from the bloodstream into the cells.
During chronic stress, the cells start to become resistant to insulin, leaving blood glucose levels elevated. This is why insulin resistance is the precursor to type II diabetes.
A few symptoms of insulin resistance include inability to lose weight, high cholesterol and triglycerides, cognitive dysfunction, and elevated blood glucose or insulin levels.
The adrenal glands are part of the hypothalamus-pituitary-adrenal-thyroid-axis (HPAT), sometimes just referred to as the HPA-axis. Here’s where the thyroid comes into play.
The adrenals are regulated by the hypothalamus and pituitary glands. When cortisol is released under stress, the hypothalamus and pituitary, which work in a feedback loop with cortisol, slow down their production of hormones. Unfortunately, this also slows down thyroid function since the hypothalamus and pituitary regulate thyroid hormones as well.
Stress can also negatively affect the enzyme that converts inactive thyroid hormone (T4) to active thyroid hormone (T3). There are a few other mechanisms involved in the stress/thyroid dysfunction connection as well. Hypothyroid symptoms such as cold extremities, dry skin, depression, and constipation often indicate sub-optimal adrenal function. Most likely, thyroid treatment will be less effective if the adrenals are not addressed as well.
Stress triggers inflammation. Our body knows that chronic inflammation is damaging, so it compensates by slowing down the immune system in order to keep the inflammation in check. The immune system is also directly suppressed during stress since it is one of those “unnecessary” functions when we’re in “fight or flight” mode. This also affects thyroid health since a suppressed immune system can activate viruses capable of attacking and damaging the thyroid.
As you can see, so many functions in the body are interconnected and related back to adrenal function and the stress response.
10 Tips to Reduce Stress and Improve Your Health
This is only a brief overview of the effects of stress on the body. Chronic stress has also been linked to cardiovascular disease, Alzheimer’s disease, and cancer. It is estimated that as much of 80% of the population has weakened adrenal function.
Since there are different stages of adrenal dysfunction that require different treatments, it is a good idea to seek out a knowledgeable health care provider who can test your adrenal function and related hormones. Since many doctors only recognize adrenal disorders such as Cushing’s and Addison’s disease, you may need to search someone out who takes a more in-depth look at adrenal function using functional tests such as a salivary cortisol test.
There are some things you can do to help reduce stress which include:
Take Control of Your Thoughts
Many people have tons of negative thoughts in their head on a daily basis, without even being aware of it. This creates a stressful state and anxiety that keeps fueling your hormonal imbalances. A technique known as “thought‐stopping” can help you halt negative, obsessive thoughts.
The first step is to literally call a halt to this train of thought (like saying the word “Stop!” out loud or to yourself). Next, choose a positive thought on which you’ll focus instead. This way you’re swapping a negative, stress‐inducing thought for a positive one. To increase emotional comfort, it’s imperative to practice reassuring and realistic self‐talk (saying something along the lines of, “I am feeling anxious / irritable now, but I have the power to calm myself down.”).
Apply Self-Soothing Techniques
There are many physiological changes that are triggered, when we are faced with a stressful situation. Our breathing quickens, adrenaline is secreted, and our heart begins to race. This is called the fight or flight response – a natural survival mechanism intended to help us escape danger. However, when the threat is imagined, the fight/flight response is unnecessary and damaging to your health. Many people with chronic stress remain blocked in this state of alert, without being able to snap out of it.
Luckily, there are techniques you can learn to reduce your response to stress, like deep breathing techniques, muscle relaxation exercises and meditation. Deep breathing can help with a rapid heart beat. The most commonly utilized strategy is breathing by contracting the diaphragm, a horizontal muscle in the chest located just above the stomach cavity.
Using muscle relaxation exercises you can induce a relaxed state and physical comfort, by tightening and releasing muscles, beginning with the largest muscle group. Meditation is also a powerful way to bring back a peaceful state to your body and clearing up your mind from erratic and negative thoughts.
Check Your Diet
What does stress have to do with eating? A whole lot! What we eat and drink largely impacts our emotional state. Stimulating foods and drinks like coffee, sodas, chocolate, and alcohol can cause anxiety, trigger panic attacks, and increase feelings of nervousness and irritability, as well as trembling and shaking. Deciding to go “cold turkey” by abruptly eliminating caffeine is not always recommended since it can lead to withdrawal symptoms. You might experience headaches, restlessness, and irritability. So it’s better to decrease caffeine consumption gradually by replacing it with tea for example.
Regular alcohol consumption can also generate a lot of biochemical imbalances in your body, like blood sugar dysregulation, liver problems and dehydration, which add to the stress burden your body needs to handle.
Get Moving
By choosing your appropriate exercise routine you can reduce stress, improve mood, enhance self-esteem, and increase energy levels. Be careful not to over exercise, which can actually contribute to your stress level.
It’s a known fact that during exercise, the body releases chemicals called endorphins and norepinephrine, which interact with receptors in the brain. These chemicals determine euphoric feelings, reduction in physical pain and the ability to deal with stress more efficiently.
Get More Sleep
Losing just a few hours of sleep increases feelings of stress, anger, sadness, and exhaustion. It’s a vicious cycle since because of stress you might not be able to fall and stay asleep, but lack of sleep is also generating stress.
So try to get a solid seven to eight hours of sleep a night, and don’t feel bad about also adding a nap in the afternoon on days when you’re feeling especially drained. Go to sleep before 10 – 11 PM and don’t use the computer or watch TV before it, since these can interfere with your melatonin production and make it harder to fall and stay asleep.
Listen to Music
By choosing a type of relaxing music which you prefer, you can help the body and mind dissipate stress. Research has shown that classical music may help you unwind and improve your mood. You can also experience therapeutic CDs of “binaural beats,” which are meant to calm the mind and body and where different frequencies call forth different moods.
Begin and End the Day Right
In the morning, in order to make intelligent use of your energy for the day, take some time to reflect, meditate, read or better yet take a nature walk, away from computer and TV. You could do the same in the evening, or just simply delight in the rare pleasure of doing nothing. These can ease the stress of too much computer or office time, counteract overstimulation and boost your mood.
Doing Something Fun
Doing something fun always gets postponed due to the avalanche of responsibilities we have during the day. But without a balance in your life, frustration and so stress might arise. It’s been found that creating artwork, crafts or making time for a hobby helps to relax, can be very stress-reducing and takes your focus away from your own thoughts and worries.
Get a Massage
Massage is a great way to loosen the muscles that are habitually affected by stress. Think about all the frowning and scrunching of your face muscles and how relaxing it is to work on these! Essential oils can calm, center, and energize you by reducing the effects of stress and mental fatigue. You can give yourself a massage, while taking small breaks from your work, or you could have a professional massage to benefit your whole body.
Include Adaptogens
A class of herbs called adaptogens help your body to cope more effectively with the demands and stress of everyday life. They provide a sustained sense of calm, and while they increase energy, with the exception of Chinese ginseng, they are non-stimulating. Some of the most used adaptogens are: ashwagandha, rhodiola, holy basil, schisandra, shatavari, eleuthero.
Because of the great impact stress can have on overall health and well-being, it’s important to implement stress-reducing habits. Additionally, partnering with a knowledgeable physician to help address any underlying adrenal fatigue can prove very beneficial. Your mood, hormones, thyroid, blood sugar, and immune system (among other things) will be much healthier for it!
At Holtorf Medical Group, our physicians are trained to utilize cutting-edge testing innovative treatments to design a treatment protocol that is personalized to you. If you are experiencing symptoms of adrenal fatigue, give us a call at 877-508-1177 to see how we can help you!
References
1. NIH. “5 Things You Should Know About Stress.” National Institute of Mental Health.
2. Mayo Clinic Staff “Chronic stress puts your health at risk.” Mayo Clinic.
3. APA Staff. “Stress effects on the body.” American Psychological Association.
4. Dartmouth Undergraduate Journal of Science. “The Physiology of stress: Cortisol and the hypothalamic-pituitary-adrenal axis.”https://sites.dartmouth.edu/dujs/2011/02/03/the-physiology-of-stress-cortisol-and-the-hypothalamic-pituitary-adrenal-axis/
5. Harvard Health. “Understanding the stress response.” Harvard Health Publishing – Harvard Medical School.
6. Mayo Clinic Staff. “Stress symptoms: Effects on your body and behavior.” Mayo Clinic.
7. Josh Axe, DC, DMN, CNS. “7 Adaptogenic Herbs or Adaptogens that Help Reduce Stress.” Dr. Axe.
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**Comment**
This article is one of the best articles I’ve read on how stress affects the body and what you can do about it.
Lyme/MSIDS patients are in a war of epic proportions where nearly every single thing in their bodies is haywire. We need to do all within out power to reduce that stress.
The next step is precisely what this article recommends – partnering with an experienced practitioner who will help you uncover your specificimbalances. This looks differently on everyone but typically involves the thyroid and other hormone and mineral imbalances. I know of one patient who felt nearly well just by addressing the thyroid. People often don’t understand that the thyroid is the body’s thermostat and that if you have hypothyroidism (low amounts of thyroid hormone) your body’s temperature will be low allowing infections to proliferate. Address the thyroid and you’ve effectively made it tougher for pathogens to survive.
Taking appropriate supplements. Patients often complain about their Lyme literate doctor requiring them to take copious amounts of supplements. Unfortunately, they are usually right because of damage & imbalances caused by the infection(s). The goal; however, is to only take what is required.
Diet is key. This too is very individual, with some only improving by eliminating gluten, dairy, and all sugars. https://draxe.com/nutrition/elimination-diet/ This step often turns patients around entirely. Remember – food is medicine.
All the ideas in the article are very helpful and include listening to calming music.The first thing I do in the morning is turn on a relaxing music channel on Pandora. An example would be the George Winston channel. For more on binaural beats: https://www.binauralbeatsmeditation.com/the-science/
Binaural Beat demonstration. You need ear phones to listen.
If you prefer music:
Regarding essential oil diffusing: https://thetruthaboutcancer.com/diffusing-essential-oils/ After I turn Pandora on, I set up my essential oil diffuser with whatever blend I’m in the mood for. For a relaxing bedtime blend called “Counting Sheep”: 9 drops lavender, 4 chamomile, 2 frankincense, 2 bergamot. This would be for a large room. Divide in half for a small bedroom. For a grounding smell try “Peace & Harmony”: 4 drops patchouli, 4 vanilla, 3 orange.
Doing something fun seems frivolous to many patients but is so important. Unfortunately with Lyme/MSIDS, we tend to revolve around our illness. Doing something to break away from this is so important for our mental health. Whether you enroll in an art class or just buy Play dough to mess around with at home – do it. I’ve found plants relax me. My house has turned into a literal green house through the years. I love dirt! Another thing you could simply incorporate into your habits is coloring: https://www.psychologytoday.com/us/blog/modern-mentality/201803/are-adult-coloring-books-actually-helpful
Word of warning: It is often the case that when initially starting Lyme/MSIDS treatment patients are extremely sensitive to everything including light, sound, and smells. It’s always important you listen to YOUR body and although the suggestions in this article are good, they may not be good for you at the moment. If you are sensitive it’s a sure sign your body is seriously fighting a war and you need to assist it in anyway you can and often that means sunglasses even in the daytime, and eliminating ALL smells and sounds. The goal is to move past and heal from sensitivities so you can enjoy the suggestions listed here.
Final note and the best advice I was given: “Don’t be depressed about feeling depressed.” I heard this from someone I contacted online who reached the other side of health who was willing to advise me in my desperation upon starting treatment and feeling so incredibly lousy. This advice helped me more than many things as there are some seriously dark days in treatment where you think dying would just be easier. Treating for this monster is unlike anything you’ve ever done before and will require serious dedication on your part. I encourage you to find a local support group for support and ideas on your journey.
Some of the best help through the years for me has come directly from patients.
This Finnish doctor uses herbs to heal Lyme disease and co-infections
By Marjo Valonen, MD
It was the happiest moment of my life, to hold my twin babies for the first time. I am so glad that I didn’t know what was ahead of me: that I would be bedridden and seriously ill for years. That I couldn’t walk, play with my kids, or have the strength to sing to them. Even smiling at them would require all the energy I could muster.
Ever since I was six years old, I wanted to be a doctor. Everything about humans and human health interested me. My first dream was to be a brain surgeon, but when I was actually working as a surgeon, I realized that this wasn’t quite what I wanted. I aspired to understand the whole human body, instead of settling for any single specialty. My thirst for knowledge drove me instead into looking at traditional Chinese medicine and then integrative medicine.
Unexplained symptoms
So, when I fell so ill after giving birth to our twin boys and one and a half years later to our daughter, I was confused. Confused, because I thought that I already knew so much. I consulted countless colleagues, the best in their field, but no one knew what was wrong with me. And sadly, it seems that not knowing, is for many doctors, too difficult a burden to bear. They didn’t think: oh wow, this is something I don’t know, let’s study more and find out! Instead, they got angry at the patient that dared to have symptoms or illness that they didn’t have answers for.
My symptoms included extreme fatigue. Even keeping my eyes open felt like too much work. If I tried to get up and walk, I fainted. So, confined to my bed, I relied on my husband for everything. He brought me my food, carried me to the bathroom, took care of our three small children and maintained his own work outside the home. He is the real hero of this story!
Wracked with pain, I had sinus infections – with pus constantly oozing out of my sinus cavities – for which I underwent numerous operations. However, when doctors couldn’t find anything wrong with my lab tests, they told me that I was just imagining it all, that it was all in my head, and that I was causing myself to be ill. One colleague even said to me, “You’re just lazy. You don’t want to work.”
The search for a cure
The worst of it lasted about two years. After that, I was able to sit and walk a bit, but I still couldn’t do much. I started searching for answers on the Internet and reading recommended books. I did everything I could think of: I healed my gut, I found many food intolerances, balanced my hormones, and supported my thyroid and adrenals.
Finally, I ran into the question of chronic infections. I ran tests on myself and confirmed my suspicion of having Lyme disease. It turns out I had loads of other infections, as well. That started me on the next step of my journey back to health: finding out how to treat these infections.
Initially, I was told that I had to treat it with antibiotics. This didn’t sit well with me – with how I think about life and how we should treat our bodies. But I eventually decided to try antibiotics, since that was the conventional procedure. ILADS is doing great work regarding Borrelia, and I tried the combination of antibiotics suggested by ILADS. But they were too hard on my gut. My system just couldn’t handle them.
The Cowden Protocol
I started looking at herbal solutions. I loved learning about the many different ways herbs can help and support us. I tried many different protocols but none of them worked very well for me. Then, I heard from my colleague Dr. Armin Schwarzbach about the support protocol developed by Dr. Lee Cowden, called CSP (Cowden Support Program). Imagine my joy and gratitude when after a month or two I started feeling better. I could walk and hug my kids and enjoy life!
Sharing my own healing with others
At last, after such a long period of professional inactivity, I began seeing patients again. As I encountered those who had the same problems that I had, I used the Cowden Protocol with them. We’re still amazed at how well it works! I’m glad that I was able to find a way to help my patients without having to use antibiotics.
Typically, patients don’t have many positive test results at first. These usually appear after a short period of initial treatment. When you give patients herbs, their immune system starts fighting against the infection. Some patients are so sick when they first come to my office that their immune system is totally shut down and can’t fight anything. In that situation, all results will be negative.
If their doctor doesn’t know this and understand the underlying mechanisms, they will just look at the negative lab results and declare the patient healthy, when in fact these are the sickest cases needing the most help and support. That is why the diagnosis needs to be based on clinical picture and symptoms, not just lab results.
Of the symptoms, pain and fatigue are typically the worst part of being ill. We ask them to rate both between 0 and 10, with 10 being the worst imaginable. We do this at the beginning of treatment, and we then follow their self-assessments.
Sometimes, both objective lab results and subjective self-assessments improve at more or less the same rate. When that happens, we’re really happy and can trust that the treatment is working. One or the other isn’t enough. If the lab results are great, but the patient is fatigued and in pain, then the infection might just be hiding somewhere. Then, you have to sort of dig it out.
Cure or remission?
Can Lyme disease be fully cured? Or, must we be content with tolerable remission of active symptoms? This is a good question.
I think that we can get our patients cured in such a way that Lyme doesn’t affect their life anymore. The question of whether or not we can ever be totally rid of Borrelia microbes cannot really be answered, since they can spread everywhere within the body. However, we all carry all sorts of microbes and parasites within us, at all times. That’s life. The question is, “Who is in charge: you, or the microbes within you?”
I agree with the assessment of the American cardiologist Dr. Thomas Levy: namely, that Borrelia is normally a commensal bug, requiring an already compromised autonomic nervous system to become infectious.
I contracted Lyme in the womb, from my mother. I carried it within me throughout my early years without noticing it. After the twin pregnancy and the birth of my daughter, during which I had many complications, my immune system took a hard hit. And, that’s when “the enemies” got the upper hand, moving from the incubation state to the acute one.
The immune system is key
I am convinced that my role as a doctor is fundamentally to support my patients’ immune systems. Only then can these microbes be defeated. Sometimes my patients express their concerns about ticks being everywhere. I remind them at those times that we can’t live in a bubble. Some have famously tried it, but it isn’t a very good solution. We neither can nor should stop our children from running and playing in the woods. The best thing is to take care of our own body and immune system so that we are strong enough to resist all of this.
This leads to the whole idea of preventative wellness. This is where medicine is seen not so much as treating diseases as helping people so they do not become ill in the first place. That’s one of the reasons why I think Dr. Cowden’s program is simply genius, because the use of antimicrobial herbs is constantly changing, affecting different kinds of microbes – not just Borrelia, but also the co-infections. The antimicrobial herbs, moreover, are complemented by detoxifying and anti-inflammatory ones, as well as herbs that support energy production. Some people think that it’s enough to take antibiotics or even antimicrobial herbs. But, that’s just killing pathogens. I advocate a much wider approach, one that supports the whole system. Uprooting is not enough. You have to replant.
What happens after symptoms disappear?
Our patients receive an ongoing maintenance program from us for the rest of their lives. By the time that they are fully functional again, we’ve known them for several months or, in the harder cases, several years. So, we usually have acquired a good idea of their genetic composition and their ability to withstand these things on their own. Hence, someone with a robust constitution may need only a basic multi-vitamin and some detox and supporting herbs.
On the other hand, a very fragile person might need other things to support them. I myself have genetic problems with my immune and detox systems, but I’m doing fine with herbs. I am still taking selected herbs as well as some important immune supporting supplements and I’ll never give them up! By taking care of myself, I can live a normal life.
In fact, I travel throughout Europe teaching about herbs. When I speak at conferences and other venues, I like to share patient cases. They are real life, allowing me to demonstrate what we are doing and how well it’s working. I give detailed information on what herbs I use and in what dosages. My mission, the reason why I’m going around Europe, and now also the States, talking about herbs, is to teach other professionals how to help others in the same way.
So, what began as my own personal interest has become my life’s work.
The future of medicine
I believe we’re living already the future of medicine. It’s so great that we have researchers like Professor Eva Sapi, of the University of New Haven. So, we’re constantly getting more information on how herbs work. Of course, there are always those people who think that herbs can’t possibly be that effective. They need to be reminded that the Nobel Prize for Medicine was given in 2015 to Professor Tu Youyou, a pharmacologist at the China Academy of Chinese Medical Sciences in Beijing, in recognition of her work with the herb Artemisia annua. Also, about 50% of conventional medicines are developed from natural substances, including herbs. But, since you can’t patent something derived from nature, then medical companies have to change or break these substances in order to obtain patents and then charge big prices for their products.
On antibiotics
Returning to the question of antibiotics, I think we often use them irresponsibly, which leads to the loss of their efficacy. Bacterial resistance has become a big problem. It is much more difficult for bacteria to develop resistance to an herb, though, which may have tens or even hundreds of different substances with which it fights bacteria.
It’s quite easy for a bacterium to develop resistance to an antibiotic, since it is just this one thing against which it has to fight. But when you send hundreds of things against that bacterium, it has a much harder time developing effective resistance.
I don’t think it’s wrong to use antibiotics when they are needed. The problem is when we use too much of them, for minor conditions. We’re also giving them to our livestock, which results in indirect antibiotic exposure for us. What was designed to help us is really hurting us.
Bringing back hope
Lyme and co-infections can be devastating. Not just to the person who falls ill, but for their loved ones as well. Our family has been through it, and that is why I want to share my story and share my knowledge. I don’t want anyone to have to go through as much pain and suffering as I had to.
With the herbal and supplemental protocols that we use at our clinic, we’ve been able to help even the worst cases of Lyme and co-infections. Even those that have been taking antibiotics for years, without getting better. So, I don’t want anyone to lose hope – there is still lots that can be done. It may take some detective work to find the right protocols, but I am a living proof that it is possible!
Marjo Valonen, MD, is medical director of Astris Medical Centerin Helsinki, Finland. Her clinic specializes in tick-borne and other chronic infectious illnesses. She has also lectured widely at Lyme-related conferences.
NEUROSCIENCE NEWS
Madison Area Lyme Support Group 
Written
on November 7, 2019