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NUTRITION AND CLINICAL DEPRESSIONHEALTH SYSTEMS EDITIONdoses of L-tryptophan. 5-hydroxytryptophan(a direct precursor toserotonin) has been offered as analternative. The amino acid tryptophanis the precursor for serotoninand it is found in largeamounts in milk and turkey (seeTABLE 2). Serotonin controlsmood, sleep, sexual ability,appetite, and pain threshold.Increasing serotonin can liftdepression and end insomnia. 8Prostaglandin E1and DepressionAnother biochemical cause ofdepression is a genetic inability tomanufacture enoughprostaglandin E1 (PGE1), animportant brain metabolitederived from essential fatty acids(EFAs). The problem is the resultof an inborn deficiency in omega-6 essential fatty acids. Alcoholstimulates temporary productionof PGE1 and lifts the depression.When drinking is stopped, PGE1levels fall again and depressionreturns. To banish it, the patientsturn again to alcohol. Thus, adownward spiral toward alcoholismbegins.During the past 15 years,researchers have found that ifthey restore the PGE1 levels tonormal range in patients sufferingfrom alcoholism, they caneliminate both the depressionand the need to drink for relief.Research showsthat nutritionaldeficiencies inbrain chemistrycan result indepression, anger,hopelessness, andparanoia.This can be achieved with a substancecalled gamma-linolenicacid, which can be easily convertedto PGE1. 9The Effect of NutritionResearch shows that nutritionaldeficiencies in brain chemistrycan result in depression, anger,hopelessness, and paranoia. Thisis because the connectionTable 2Important Points About Tryptophan• Tryptophan alone will not be converted to serotonin. To ensure that it isproperly used, you must also take vitamins C and B 6.• Tryptophan is converted to niacin before its final conversion into serotonin.If your body is deficient in niacin, the tryptophan you take will supply youwith niacin, not serotonin. For this reason, it is a good idea to take a B-complex vitamin daily. This will give you both vitamin B 6and niacin andallow the tryptophan to be converted to serotonin.• Unlike serotonin, tryptophan (or more accurately, its breakdown product 5-hydroxytryptophan, or 5-HTP) can pass through the blood–brain barrier.Thus, supplementation of tryptophan would appear to be a simple and naturalalternative to selective serotonin reuptake inhibitor drugs.• Since it is not stored in the body, tryptophan cannot accumulate to toxiclevels. Taking high doses of supplements containing tryptophan, however,can produce some side effects such, as drowsiness, increased blood pressure,and bad dreams.between depression and vitaminand mineral deficiencies is oftenmissed. A closer look at the dietof patients suffering fromdepression indicates that theirnutrition is far from adequate.They make poor food choicesand frequently select foods thatcontribute to depression. 10The B-complex vitamins areessential to mental and emotionalwell-being. They cannot be storedin our bodies, so we dependentirely on our daily diet to supplythem. B vitamins aredestroyed by alcohol, refined sugars,nicotine, and caffeine. Continuedvitamin C deficiencycauses chronic depression,fatigue, and vague ill health, andinsufficient amounts of mineralsalso cause mental problems. Therelationship between vitamins Band C and minerals and depressionis shown in TABLE 3.CarbohydratesCarbohydrates, or polysaccharides,play an important role in thestructure and function of anorganism. In humans, they havebeen found to affect mood andbehavior. Food rich in carbohydratestriggers the release ofinsulin in the body. Insulin facilitatesthe release of blood sugarinto the cells, where it can be usedfor energy, and simultaneouslytriggers the entry of tryptophan tothe brain. Tryptophan in the brainaffects neurotransmitter levels.Consumption of diets low incarbohydrates tends to precipitatedepression, since the production ofthe brain chemicals serotonin andtryptophan, which promote thefeeling of well-being, is reduced. Itis suggested that low glycemicindex (GI) foods such as somefruits and vegetables, whole grains,and pasta are more likely to providea moderate but lasting effecton brain chemistry, mood, andenergy level than the high GIfoods. 10HS-32U.S. Pharmacist • November 2009 • www.uspharmacist.com