Identification of what is driving anxiety and depression is essential for successful treatment. People can have both constitutional (genetic) or acquired (lifestyle / environmental) triggers. The major contributing factors include:
MTHFR AND METHYLATION
Approximately 50% of the population have a mutation on the MTHFR gene. The role of this gene is to encode the MTHR enzyme that catalyses the synthesis of 5-methyletetrahydrofolate (methylfolate), which is the active form of folate the body uses. Methylfolate is the only form of folate that crosses the blood brain barrier, and is essential for mental health. Methylfolate is a cofactor for the production of serotonin and dopamine, which are neurotransmitters involved in the regulation of mood. Research indicates that 70% of depressed patients have a genetic variant on MTHFR.
Methylation is also important for the balancing of neurotransmitters, as well as reducing oxidative stress and inflammation, both of which we now know contribute significanlty to depression. Methylfolate is only one of the important nutrients involved in methylation, others include Vitamin B12, Vitamin B6, zinc, choline and methionine. Deficiences in these nutrients will hinder the proper functioning of the methylation pathway.
Pyroluria, also referred to as kryptopyrroles or pyrroles, is a biochemical imbalance in the body, causing a build up of pyrroles, which are waste products produced by the breakdown of haemoglobin. Haemoglobin is the oxygen-carrying protein within red blood cells.
Everyone makes pyrroles, however some people produce excessive amounts of pyrroles which can be a problem as these pyrroles bind and inhibit the utilisation of zinc and Vitamin B6. Zinc and B6 are essential nutrients for mood. They are cofactors for the production of all the important neurotransmitters, serotonin, dopamine and GABA .
When you have low zinc, it can allow copper to become too high. This is because zinc and copper act in an antagonistic manner. High copper can also be due to inflammation, oxidative stress and high oestrogen. When copper is too high it can shunt dopamine into adrenalin which in turn increases cortisol release causing anxiety, irritability and panic attacks.
There is an increasing amount of research indicating that inflammation is a major cause of depression and anxiety. Inflammation occurs as part of the immune system’s response to physical injury, wounding and infection. When the body recognises one of these threats it sends inflammatory cytokines to the site of injury or infection to help the body fight off the virus or bacteria. This inflammatory response can also be triggered by modern day threats such as loosing your job, divorce, lack of financial security, relentless work stress, relationship issues, social isolation, social rejection, and lack of self worth.
Pro-inflammatory cytokines are able to communicate with the brain and initiate depressive behaviour such as sad mood, fatigue and social withdrawal.
These pro-inflammatory cytokines are more likely to get through to the brain when there is a leaky blood brain barrier. The blood brain barrier is layer of cells and blood vessels that protects the brain by allowing only very small particles in and out of the brain as needed and to keep out anything that might damage the brain. The blood brain barrier can become leaky (ie have holes in it allowing larger unwanted particles through to the brain) from chronic stress, excessive alcohol intake, elevated blood glucose, environmental toxin exposure, elevated homocysteine due to B Vitamin deficiencies or MTHFR gene mutation, as well as poor diet and antioxidant status.
Other significant drivers of anxiety and depression include:
- Dysbiosis (imbalance between good and bad gut bacteria)
- Thyroid disorders
- Food intolerances
- Hormone imbalance
- Histamine excess or intolerance
- Elevated blood glucose and insulin resistance
- Poor diet
- Nutrient deficiences
- Chronic stress
- Excessive alcohol intake
- Sleep disturbances
It is essential to identify ALL the underlying causes of anxiety and depression. There are numerous functional medicine tests available to assist in uncovering the pathological drivers. Testing may include blood pathology, DUTCH hormones, organic acids, pyrroles testing and comprehensive digestive stool analysis. Treatment includes diet and lifestyle modification, supplements and herbal medicine.
CONTACT JOANNE KENNEDY
Sydney Naturopath, Joanne Kennedy is available to assist with natural anxiety, depression and stress solutions. For appointments please call 0400 658 003 or email Joanne at firstname.lastname@example.org.