Archive for the ‘Treatment’ Category

Anti-Inflammatories Help Major Depression

By Odelya Gertel Kraybill Ph.D.

Anti-Inflammatories Help Major Depression

New study suggests that anti-inflammatories can mitigate MDD symptoms

Posted Nov 11, 2019

Odelya Gertel Kraybill Expressive Trauma Integration

A new study* published in the Journal of Neurology, Neurosurgery, and Psychiatry asserts the efficacy of anti-inflammatories in treating major depression. This adds to the mounting evidence that there is a connection between emotional functioning and inflammation.

An increasing number of studies have shown that depression and/or bipolar disorder are accompanied by immune system dysregulationinflammation, and high levels of cytokines. Researchers have found that inflammation triggers depression, almost like an allergic reaction.  (See link for full article)



More and more is coming out on the role inflammation plays in chronic disease states and Lyme/MSIDS is no acceptation. These patients are full of inflammation and addressing that inflammation is an important aspect of treatment.

Of course, the first step is to address the pathogens which are causing this, the second step is to aid the body in detoxifying these pathogens, and the third step is to support the body by supplementing with the things our bodies are deficient in – which varies from person to person. But, the last factor is this addressing the burgeoning inflammation caused by the war brought on by pathogens.

Here are some things that have helped me in my journey.  I pray they help someone else out there as well.

(Please read about melatonin in the first link under the comment section.  Melatonin is particularly good for the brain as it not only reduces inflammation but it protects the blood-brain barrier.)

For examples of effective Lyme disease treatment:  Please remember Lyme is the tip of the spear and patients are often coinfected with numerous pathogens all requiring different medications.  This is why effective treatment is overlapping in nature and given for a much longer duration than a few weeks.  This fact has not been accepted and embraced by mainstream medicine and until it is, patients are required to be treated by ILADS trained professionals who understand this complex illness.  For a great video on this:





Drug For Alcoholism Could Treat Lyme Disease

November 22, 2019

Ciaran Hughes endured "constant pain" for months, with doctors baffled as to what was wrong. [Photo: Supplied]Ciaran Hughes endured “constant pain” for months, with doctors baffled as to what was wrong. [Photo: Supplied]

A father who was bedbound by Lyme disease is finally back on his feet due to a drug for alcoholism.

Ciaran Hughes, 31, developed “constant” pain, “laboured” movement and a loss of balance in March while working in Indonesia.

Multiple tests both abroad and in his native Northern Ireland came back clear, including one for Lyme disease…(See full story in link above)


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Excerpt:  Disulfiram should certainly be prescribed with caution or avoided in patients with personal and familial antecedents of psychosis. Case reports are, however, not enough to guarantee the safety of a drug. Studies at larger scales are necessary. Some questions still remain unanswered.

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Non-Toxic Tips From the Experts: Clean Up Mold and Residual Spores

Time to clean up Mold and residual spores in your home? Non-Toxic Tips from the experts.

Mold Remediation Strategy of Dr. Lee Cowden -recommended to us by Dr. Doug Phillips

A USA board-certified cardiologist and internist who is internationally known for his knowledge and skill in practicing and teaching integrative medicine. He has co-authored many books and articles on integrative medicine and has pioneered successful treatments of cancer, autism, Lyme disease and many other illnesses.

Procedure for Space that has been physically remediated- after all the water leaks are resolved and the mold contaminated building materials are replaced with new uncontaminated building materials.

Use the Concentrate Liquid EC3 in the Portable Fogger to kill mold in the air of a building AFTER you have resolved all the water and environmental issues.


Portable Hand Held FOGGER

If the building has 8 rooms-

  • use about 2 ounces of the concentrate sprayed into each room.
  • A little more than 2 ounces for the big rooms and a little less than 2 ounces for small rooms.
  • If more than 8 rooms, you probably need to buy more than one bottle of the Concentrate.
  • All Closet Doors must be open in each room when fogging with the Ec3 concentrate.

Several Hours Later-

  • After fogging is complete, run a portable HEPA /Charcoal Filter in the house for a few days.
  • Moving it from room to room, but NOT in the bedroom where people are sleeping at night.

At the Academy we use the Austin Air Filter Health Mate Plus – a good quality Hepa/Charcoal Filter

Quite and effective- easy to move and fits well in our space.

Dr. Cowdens recommended unit – Guardian Hepa Filter

If the area continues to have issues-

  • At the Academy we like the Air Reactor by HITech Air Solutions for areas that need constant mold, fungus, virus, clearning. Especially areas where you cannot remediate fully, in basements, warehouses, school gymnasiums, etc.
  • This unit is used by many sport teams to keep equipment free of shared germs.
  • The machine is run 24/7 or when you know you will be in the room you can run it in advance.
  • If a burning smell happens when you first use it, that is positive as it is neutralizing the toxins, and make a smell during the reaction taking place. Give it time to work.
  • Please also use binders, as those with mold and fungal infections can also experience a die off reaction at first.
  • Keep windows closed for best outcome.Ordered directly from the HiTech Air Solutions(See link above for pictures of machines and more information)


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Minnesota Medical Board Ties the Hands of Lyme-treating Doctors

Minnesota medical board ties the hands of Lyme-treating doctors

Nov. 25, 2019

What Happens if Lyme Disease Goes Untreated?

What Happens If Lyme Disease Goes Untreated?

BCA-clinic - late stage Lyme disease

Much of the attention given to Lyme disease currently centres around the diagnosis and treatment of the condition in an acute stage. But what happens if Lyme disease goes untreated? The symptoms of the condition, in its later stage, can be much more severe and debilitating, which means that recovery can be more challenging – even with appropriate treatment. Here’s some information on questions you might have about untreated or chronic Lyme disease.

What is Lyme disease?

Lyme disease is an infectious condition caused by the bacterium Borrelia burgdorferi, which was named after an American scientist named Willy Burgdorferi who researched the disease in the early 1980s). The condition is named after a town called Lyme, Connecticut in the US, where numerous people fell ill with similar symptoms of rashes and fatigue.

Lyme disease is most commonly contracted if you’re bitten by a tick that is a Lyme carrier. Common symptoms of acute Lyme disease include:

  • Skin rash (often a red, bullseye rash)
  • Flu-like symptoms (such as fever, chills, malaise, etc.)
  • Fatigue
  • Headache and stiff neck
  • Muscle soreness
  • Joint pain
  • Swollen lymph nodes
  • Sore throat

If the infection starts to spread throughout the body (without antibiotic intervention), you might start to experience additional symptoms, such as vision changes, heart problems like palpitations or chest pain, multiple rashes, or facial paralysis (also known as Bell’s palsy). Typically, early stages of Lyme disease are treated with antibiotics; more significant treatment is needed if the condition is not caught early on and has progressed to chronic Lyme disease.

Many people receive misdiagnoses when they first report their symptoms to their doctor because Lyme disease can mimic symptoms of other conditions like arthritis, depression, chronic fatigue syndrome and others.

BCA-clinic - Lyme symptoms
Image by Carolina Heza on Unsplash: Leaving Lyme disease untreated can mean you experience more severe symptoms.

What are the symptoms of late-stage Lyme disease?

Late-stage Lyme disease is one of the terms used when the condition has become chronic. This is generally after months (or sometimes even years) of the condition going untreated, where the Lyme bacteria has spread throughout the body.

Many patients develop chronic arthritis, as well as additional neurological and cardiac symptoms. These symptoms can also include:

  • Arthritis in the joints (sometimes near the point of infection)
  • Severe headaches or migraines
  • Vertigo or dizziness
  • Migrating pains that come and go in joints and tendons
  • Stiff, aching neck
  • Sleep disturbances (including insomnia)
  • Disturbances in heart rhythm
  • Mental fogginess and concentration issues
  • Numbness in limbs, hands, or feet
  • Severe fatigue

Because the infection has spread over time, antibiotics can be less effective; sometimes patients are required to enter hospital for stronger intravenous (IV) antibiotics. There are also cases where people are treated in the early stages of the condition but still do not respond to treatment for some reason. This is also known as post-treatment Lyme disease syndrome (or PTLDS). Researchers don’t have a definitive answer as to why some people develop PTLDS. People suffering from chronic Lyme disease often have significantly worse symptoms that can negatively impact their day-to-day lives.

Can Lyme disease go away on its own?

At this time, there is no research that supports the idea that Lyme disease will just go away on its own if left untreated. In fact, it seems like quite the opposite is true. Without proper intervention and treatment, the infection can spread throughout the body and the brain, causing severe symptoms.

BCA-clinic - IV
Image by Olga Kononenko on Unsplash: Chronic Lyme disease often needs to be treated with intravenous antibiotics in hospital.

Is Lyme disease fatal?

Unfortunately, in some cases, Lyme disease can indeed be life-threatening. In late-stage Lyme disease, the infection can wreak serious havoc on the body as a whole, but can be especially damaging to the nervous system. In some cases, patients have died of respiratory failure because of the long-term effects the infection has on the nervous system. The infection can also affect other parts of the body (such as the kidneys), which can also turn out to be fatal.

Another serious complication that people can experience is called Lyme carditis. When Lyme bacteria enter the tissues of the heart, carditis can occur; this interferes with the normal movement of electrical signals from the heart’s upper to lower chambers (a process that coordinates the heart’s beating). This results in what doctors call ‘heart block’, which can vary in severity from patient to patient and can progress rapidly. Lyme carditis can be treated with oral or IV antibiotics, and patients sometimes require a temporary pacemaker. There have been some recorded deaths from Lyme carditis as well.

There’s also one other cause of death that can be related to Lyme disease. Because the condition causes emotional issues and can lead to some significant psychological symptoms, Lyme disease patients are at an increased risk of suicide.

When should you get tested for Lyme disease?

In order to make sure that your Lyme disease doesn’t progress, it’s a good idea to get tested as quickly as possible if you think that you may have been bitten by a tick or if you notice some of the above-mentioned symptoms. There are blood tests to test for Lyme disease, and some labs (like BCA-clinic) can help give you an accurate diagnosis. Make sure to bring your concerns to your doctor right away so that they can test for Lyme disease. Getting an accurate diagnosis and then starting with effective treatments right away can mean that you can possibly avoid Lyme disease progressing into a chronic stage.

Leaving Lyme disease untreated can have a serious negative effect on your health, both physically and emotionally. Be sure to pay attention to any symptoms you might be having, as well as making sure to check for ticks on your body if you’ve spent time outdoors. Extra vigilance and taking steps to stay protected from ticks can mean you’re less at risk of contracting Lyme disease and less likely to suffer from the effects of letting the condition go untreated.

Featured image by Yohann LIBOT on Unsplash


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Treating Adrenal Dysfunction With Cortisol

Treating Adrenal Dysfunction with Cortisol

By Kent Holtorf, M.D. on Oct 17, 2019 

Originally Posted November 2012

Many people report feeling under constant pressure and stress which causes them to feel sluggish, irritable and fatigued. They are desperately trying to clear up that mental fogginess with coffee or other stimulants, just to crash worse afterwards. Does this sound like you?

Although it’s been widely accepted as the “common way of living in a working, modern society”, it is not normal.

Understanding Adrenal Fatigue

The adrenals are small glands that sit on the kidneys. They regulate many bodily processes through the production of hormones. The hormones produced by the adrenal glands help regulate blood sugar, immune function, and stress response. A disruption in the excretion of these hormones can lead to malfunction in these bodily processes and others.

Learn even more about the adrenals here.

Adrenal fatigue is a chronic condition wherein the adrenals are incapable of supplying the hormones needed for healthy bodily function. There are a number of potential causes for this dysfunction including physical trauma, a stressful professional or personal life, hormone imbalances, chronic illnesses, chronic infections, and sleep deficits. These and other physiological stressors trigger adrenal activity. If the adrenals continue to experience an increased demand, they will eventually become exhausted and incapable of sustaining healthy function.

Learn more about the causes of adrenal fatigue here.

The Symptoms of Adrenal Fatigue

Low levels of adrenal hormones, specifically cortisol, can result in symptoms such as:

  • Hypoglycemia
  • Fatigue
  • Muscle aches
  • Sugar or salt craving
  • Shakiness relieved with eating
  • Moodiness
  • Food sensitivities
  • Allergies
  • Recurrent infections
  • Dizzy when standing
  • Low blood pressure
  • Decreased ability to handle stress
  • “Brain fog”
  • Swollen ankles that are worse at night
  • Muscular weakness
  • Difficulty getting out of bed
  • Wiped out with exercise
  • Inability to tolerate thyroid replacement

Learn more about the symptoms of adrenal fatigue here.

The Role of Cortisol in Adrenal Function

The most important anti-stress hormone in the body is cortisol. It protects the body from excessive adrenal fatigue by:

  • normalizing blood sugar: cortisol increases the blood sugar level in the body, thus providing the energy needed for the body to physically escape threat or injury in order to survive. Cortisol works in tandem with insulin from the pancreas to provide adequate glucose for energy.
  • anti-inflammatory response: cortisol is a powerful anti-inflammatory agent. It is secreted as part of the anti-inflammatory response. Its objective is to remove and prevent swelling and redness of nearly all tissues.
  • immune system suppression: cortisol influences most cells that participate in the immune reaction, especially white blood cells. It suppresses white blood cells, natural killer cells, monocytes, macrophages and mast cells. It also suppresses adrenal fatigue.
  • vaso-constriction: people with low cortisol have low blood pressure and reduced activity to other body agents that constrict blood vessels.
  • physiology of stress: people with adrenal fatigue can not tolerate stress and will then succumb to severe stress. As their stress increases, progressively higher levels of cortisol are required. When the cortisol level cannot rise in response to stress, it is impossible to maintain the body in optimum stress response.

Cortisol sustains life via two opposite, but related, kinds of regulatory actions: releasing and activating the existing defense mechanisms of the body, while shutting down and modifying the same mechanisms to prevent them.

Using Cortisol to Safely and Effectively Treat Adrenal Fatigue

In the right situation and using the right dose, hormone replacement can be of great benefit for people with adrenal dysfunction. Medical science is just beginning to find out that a person can feel horrible and function poorly even with a minimal to moderate hormone deficiency that is clinically undetected by routine blood tests. This is evident in the case of adrenal fatigue.

Some physicians, notably Dr. Jefferies in the mid 1980s, have advocated low dose cortisol as safe for long-term use. Dr. Jefferies found that as long as the adrenal hormone level is kept within the normal range, the main toxicity that a patient might experience was a slight upset stomach, due to the body not being used to having the hormone come in through the stomach.

In an article published by Dr. Kent Holtorf in the Journal of Chronic Fatigue Syndrome about therapeutic doses of cortisol for patients with fibromyalgia and chronic fatigue syndrome, he states:

“Because treatment with low physiologic doses of cortisol (< 15 mg) has been shown to be safe and effective and routine dynamic ACTH testing does not appear to have significant diagnostic sensitivity, it is reasonable to give a therapeutic trial of physiologic doses of cortisol to the majority of patients with CFS and FM, especially to those who have symptoms that are consistent with adrenal dysfunction, have low blood pressure, or have baseline cortisol levels in the low or low-normal range. (…) Physiologic replacement of cortisol at doses of 5 mg to 15 mg a day are safe, with little or no associated risk. Such physiologic doses don’t carry the risk of adrenal and immune suppression or bone loss, which are well known risks of pharmacological doses of corticosteroids. Cortisol treatment carries significantly less risk and a greater potential for benefit than standard treatments, such as antidepressants, muscle relaxants, anticonvulsants and narcotics.”

Finding a Doctor that Understands Adrenal Fatigue

The adrenals are a critical component of healthy bodily function. Adrenal fatigue result in dramatic repercussions on your physical, emotional, and mental health. Treatment of adrenal fatigue should be tailored to you and your specific needs and can include low dose cortisol, adrenal glandulars, vitamin C, Pantothenic acid, licorice, and chromium.

At Holtorf Medical Group, our physicians are trained to provide you with cutting-edge testing and innovative treatments to find the answers you deserve and a treatment plan 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!


1. Kent Holtorf, MD. “Diagnosis and Treatment of Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysfunction in Patients with Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM).”

2. Kent Holtorf, MD. “Adrenal Fatigue Testing.”
3. Kent Holtorf, MD. “Adrenal Fatigue Treatment Options.”
4. William McK. Jefferies. “Safe Uses of Cortisol.” Book.

How the Adrenals and Thyroid Are Connected

By Holtorf Medical Group on Oct 15, 2019 11:40 am

Hormones are one of the most influential elements of wellness. These chemical structures relay messages throughout the body to regulate numerous functions. There are multiple systems responsible for production and regulation of hormones. Two of the most important being the adrenals and the thyroid. In addition to be essential for healthy bodily function, these two systems have a significant degree of influence on one another. Therefore, to better maintain wellness it is important to understand the role of the adrenals, the thyroid, and their mutual impact over each other.

What are the Adrenals?

The adrenals are small but highly influential organs located just above both kidneys. These are the glands responsible for controlling the body’s stress response as well as producing hormones essential for healthy bodily function. Some of the most notable adrenal hormones include pregnenolone, adrenaline, estrogen, progesterone, testosterone, DHEA, and cortisol – learn more about the adrenal hormones here. These and other adrenal hormones regulate areas such as metabolism, physical ability, libido, energy level, stress response, and much more.

Learn even more about the adrenal glands here.

What is the Thyroid?

The thyroid gland is located at the base of the neck. Like the adrenals, the thyroid regulates important areas of health including metabolism, mood, weight, neurological function, energy level, and more. The thyroid completes this complex task through the secretion of thyroid hormones. The most well-recognized thyroid hormones are thyroxine (T4) and triiodothyronine (T3). These hormones help to determine the activity level of virtually every cell and tissue in the body. It is for this reason that some refer to the thyroid as the body’s gas pedal.

Learn even more about the thyroid here.

Identifying Arenal and Thyroid Imbalances

Disruption of either the thyroid or the adrenals can result in a cascade of dysfunction throughout the body. There are several ways in which the adrenals and the thyroid may become dysfunctional including physical damage or trauma, chronic mental or physical stress, and chronic illness. These factors can contribute to hormonal imbalances that encourage the development of serious dysfunction such as adrenal fatigue and hypothyroidism.

Many symptoms of adrenal fatigue and hypothyroidism are shared. Because of this, it is common for patients to be misdiagnosed. Fatigue, poor sleep quality or insomnia, depression, PMS, brain fog, sensitivity to cold, weight gain, forgetfulness, and loss of libido are just some of the shared symptoms of adrenal dysfunction and hypothyroidism. If you experience some, or all, of these symptoms, it is important to assess both adrenal and thyroid function.

The Shared Influence of the Adrenals and the Thyroid

Although they are two different systems, the adrenals and the thyroid have a great deal of overlap. Typically, this is beneficial as both systems can support each other. However, because they are so closely related, if one system fails or malfunctions it often leads to disruption of the other.

The adrenal glands are responsible for regulating the body’s stress response. When we experience stress the adrenals release cortisol. The increase in cortisol triggers elevated immune activity, increased inflammatory response, heightened physical ability, and greater alertness. These are all beneficial qualities when handling stress in the short term. However, constant activation of the adrenals encourages further release of cortisol. Excess cortisol can negatively affect thyroid function and contribute to hypothyroidism. In part, this is why many individuals suffering from chronic stress also experience a decline in thyroid function.

For the thyroid to effectively regulate bodily function, T4 must be converted to T3 and interact with tissues throughout the body. Studies show that certain adrenal hormones play an important role in the conversion process of thyroid hormones. Additionally, some experts suggest that adrenal hormones are needed to effectively deliver T3 into cells and tissues. Therefore, poor adrenal function and a lack of adrenal hormones may inhibit thyroid activity resulting in symptoms of hypothyroidism.

Both systems play a significant role in maintaining healthy metabolic activity. If either system faulters, the other must work harder to make up the difference. For example, if metabolic activity is failing due to an underactive thyroid, the adrenals must work harder to maintain proper metabolic function. If thyroid function remains defunct, the adrenals will ultimately become exhausted resulting in adrenal fatigue. With these two systems exhausted, the body is almost certain to experience a significant and long-lasting decline in functionality.

The Importance of Treating Both Thyroid and Adrenal Dysfunction

Because hypothyroidism and adrenal fatigue both involve hormone deficiency, the conditions are treated in a similar fashion. The most common approach is to administer hormone therapy based on the individual needs of the patient. For example, if thyroid dysfunction is suspected, a patient may be given thyroid hormone supplements to increase their hormone values. Similarly, if adrenal signs point to adrenal fatigue, a doctor may recommend cortisol or other adrenal hormone supplements.

When treating the adrenals or the thyroid it is critical that diagnosis is accurate. For example, in the presence of adrenal malfunction, thyroid hormone therapies may actually cause greater disruption. This is because thyroid medication accelerates metabolic activity, which can place greater stress on the adrenals thereby contributing further to adrenal fatigue . Ideally, if a patient is presenting symptoms of either adrenal dysfunction or thyroid disease, both systems are evaluated, and a full gamut of tests are run to assess relevant hormone values.

Learn more about the importance of treating both thyroid and adrenal dysfunction here.

Finding a Doctor That Understands the Adrenal-Thyroid Connection

The body is composed of an intricate web of interlocking systems, many of which have direct influence on one other. An excellent example of this is the relationship between the adrenals and the thyroid. Both systems are integral to overall bodily function and exert their influence through the production of hormones. Due to their high degree of interconnectivity, dysfunction of one can have a dramatic negative impact on the other. Therefore, if symptoms of either adrenal or thyroid dysfunction develop, it is important to consider and assess both systems. Being aware of the close relationship between the adrenals and the thyroid and their important role in bodily function can help you better preserve their function and maintain greater wellness.

At Holtorf Medical Group, our physicians are knowledgeable in both thyroid and adrenal dysfunction, and how the two are connected. Because of this, they are able to provide you with cutting-edge testing and innovative treatments to find the answers you deserve and a treatment plan that is personalized to you. If you are experiencing symptoms of thyroid or adrenal dysfunction, give us a call at 877-508-1177!


1. Victor Parsons, DM and Ian Ramsay, MD. “Thyroid and adrenal relationships.” Postgrad. med. J. (May 1968) 44, 377-384.

2. Seck-Gassama et al. “Serum cortisol level variations in thyroid diseases.” Dakar Med. 2000;45(1):30-3.
3. Amy Myers, MD. “The Adrenal-Thyroid Connection.” Amy Myers.


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Omega-3s Recommended as Adjunctive Therapy for Major Depression

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


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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.

This is happening more and more, yet is considered to be rare:  Two stories are presented in this link – Susannah Cahalan’s story from the book, “Brain on Fire,” who had a similar auto-immune brain issue, and then the story of Patrik who had Lyme disease which morphed into Autoimmune encephalopathy.

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.