Serum lab tests may hold a clue to depression and other mental health conditions
Depression affects a large number of people worldwide. The COVID-19 pandemic has led to a significant increase in depression cases. Many people lack access to treatment options due to overbooked psychiatry practices and facilities or due to lack of funds. Additionally, many patients are resistant to current antidepressant therapies. New diagnostic and therapeutic options are in dire need.
A recent study investigated the physiological factors linked to depression using serum laboratory tests. Based on the results, patients received personalized micronutrient supplementation (precision supplementation) for two months. The study author considers it unwise to use random supplements without prior testing or to self-supplement and without consulting one’s treating physician, because our “bodies don’t work like refill bottles”.
Serum laboratory testing
The study aimed to identify fluctuations in micronutrients that are known to negatively affect the central and peripheral nervous systems. According to long years of academic medicine and textbooks alike, a range of micronutrients act as precursors and cofactors in the biosynthesis of neurotransmitters, and do have a direct impact on the functioning of the nervous system.
This first small study examined the main known parameters to be linked to depresssion, along with some standard tests to be used to establish a generic impression of the overall health condition. The parameters used were:
- total blood count
- CRP (C-reactive protein, a marker for inflammation)
- Vitamin B9/folate
- Vitamin B12
- Vitamin C
- Vitamin D (25-hydroxy vitamin D: calcidiol)
- DHEA-S (dehydroepiandrosterone sulfate, as a as an indicator on stress and on the overall availability of neuro-active steroid hormones).
Outcomes
Out of the total 17 participants involved in the study, 11 exhibited varying degrees of depression, while the remaining six participants formed the healthy control group. It’s worth noting that all nine individuals who showed signs of micronutrient deficiency or insufficiency were among those experiencing depression (11 participants). Interestingly, the two participants who did not display any deficiencies had already been receiving supplements before the study commenced.
None of the six healthy participants exhibited any signs of micronutrient deficiency or insufficiency. However, it’s important to approach the results with caution due to the small sample size. While these findings provide intriguing insights, it’s important not to draw broad conclusions from this limited data.
The clear differentiation observed between participants with depression and those in the healthy control group is quite remarkable. Yet, it’s unlikely that this level of distinction will hold up in larger studies. The study yielded results that were notably more pronounced than anticipated.
It’s crucial to emphasize that addressing micronutrient deficiencies is a concern for all cases, not exclusively for individuals with depression. While this study sheds light on the potential connection between depression and micronutrient levels, further research is needed to establish a comprehensive understanding.
Research-backed lifestyle factors contributing to depression
The study encompassed a standard set of lifestyle recommendations that participants were encouraged to adhere to. These guidelines aimed to improve various aspects of their well-being. For instance, participants were advised to enhance sleep quality by refraining from exposure to bright lights before bedtime, including those emitted by TVs and mobile phones. Additionally, incorporating even minimal physical activity, such as a 30-minute walk, was found to have a positive impact. The importance of adopting a diet centered around fresh, unprocessed foods while avoiding highly processed or fast food options was also highlighted. Furthermore, the study emphasized the significance of reducing social isolation by aiming to interact with at least one person daily.
What’s particularly noteworthy is that these lifestyle adjustments, pertinent to addressing depression, can seamlessly be integrated into one’s daily routine. Essentially, they form a standard set of recommendations that hold value for everyone, whenever feasible.
Comprehensive list of parameters, derived from cofactors of dopamine and serotonin biosynthesis
The study also offers an extensive array of parameters that warrant consideration in laboratory testing. These parameters stem from the essential precursors and cofactors involved in dopamine and serotonin biosynthesis pathways, as well as various other processes within the nervous system. Notable elements encompass dopamine and serotonin precursors, such as phenylalanine and tyrosine, and cofactors like vitamin B3, iron, folate, tetrahydrobiopterin, vitamin D, and vitamin B6, which play pivotal roles in dopamine biosynthesis. The synthesis of adrenaline from dopamine necessitates cofactors such as vitamin C, copper, folate, S-adenosyl methionine (SAMe), and magnesium. Meanwhile, serotonin synthesis relies on precursors like tryptophan, along with cofactors including vitamins B3, B6, iron, folate, tetrahydrobiopterin (BH4), and vitamin D. Serotonin release is modulated by EPA (cosapentaenoic acid), while DHA (docosahexaenoic acid), components of omega-3 polyunsaturated fatty acids, affect receptor function. Melatonin synthesis from serotonin involves cofactors like folate and SAMe. It’s essential to note that self-supplementation, particularly with omega-3 and amino acids, should be approached cautiously due to potential interactions with existing antidepressant medication. Ultimately, the appropriateness of testing and supplementing should be determined by the treating physician in all cases.
Factors implicated in nervous system function include deficiencies in thiamine (vitamin B1), which can impair cellular function through reduced ATP production. Additionally, the prevalent issue of vitamin B12 deficiency can lead to neuropsychiatric symptoms and impact the outcomes of depression treatment. Ascorbic acid (vitamin C) assumes a critical role as a cofactor in the biosynthesis of dopamine, adrenaline, and serotonin, as well as in iron metabolism. Similarly, ergocalciferol and cholecalciferol (vitamin D) are indispensable for dopamine and serotonin synthesis and are frequently encountered vitamin deficiencies. For details see table 5 in the study linked below.
The study’s findings hold promise for driving further research, advancing treatment methodologies, fostering drug development, and enhancing public health initiatives. The comprehensive list established by this study lays the groundwork for the formulation of systematic screening protocols designed for patients exhibiting depression symptoms. These protocols could greatly inform future research, medical care, and clinical practices. The field of psychiatry and psychotherapy stands to witness improved outcomes as they no longer contend with the underlying limitations posed by existing micronutrient deficiencies.
Potential for drug development and improved therapeutic outcomes
The research includes a call to pharmaceutical companies to offer trustworthy and high-quality products in the market that physicians can prescribe with confidence. Presently, the supplement industry is mainly controlled by food corporations like Nestlé, along with many anonymous and unlicensed suppliers. Although there is a demand for all types of products, having safe and quality-assured supplements would be advantageous for both patients and medical professionals.
Conclusion
By targeting deficiencies in essential precursors and cofactors required for neurotransmitter biosynthesis, as well as micronutrients crucial for optimal nervous system function, in combination with readily adoptable lifestyle adjustments, this approach presents a potential complement to current antidepressant therapies, potentially enhancing treatment outcomes. Subsequent research endeavors should prioritize the evaluation of the comprehensive range of indicators and delve into the efficacy of personalized micronutrient supplementation as a strategy for managing depression. This investigation should encompass a larger and more diverse sample size than the one utilized in this preliminary study.
Literature:
Mader, I.M. Recovery from (treatment-resistant) depression after lifestyle changes and micronutrient precision supplementation: a preliminary field study in patients. BMC Psychol 11, 229 (2023). https://doi.org/10.1186/s40359-023-01263-7
