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Commentary on Nutritional Treatment
of Mental Disorders
from Willam Walsh, Ph.D., formerly Senior Scientist, Pfeiffer Treatment Center www.hriptc.org I have given details of the slides of Dr Walsh`s recent lecture presentation on the first page of this site at www.omega3.20megsfree.com I found a short except from one of his 2008 lectures on Autism at www.youtube.com/watch?v=JMwrVY5etKs
(The following information is taken from Dr. William Walsh's discussion on Safe Harbor's "Integrative Psychiatry" email list for professionals. To preserve Dr. Walsh's wealth of information, we have posted his comments here, with the notation of added commentary [with the date] as discussion goes on.)
Index ADD/ADHD
Amino Acids
Anorexia
Antidepressants and Cancer
Autism B6
Bipolar Disorder
Candida
Celiac Disease
Choline
Copper
Coral Calcium
Crime & Violence
Depression
Downs
Fetal Alcohol Syndrome
Hair Analysis
Head Injury
Histamine
Hives
Metabolic Types
Metallothionein
Nutrient Therapy
Obsessive Compulsive Disorder (OCD)
Oxidative Stress
Paranoia
Placebo effect
Psychiatric Medications
Pyrrole Disorder
SAMe
Schizophrenia
Taurine
Womb Trauma
Zinc
ARTICLES A-E
ADD/ADHD We've treated more than 6,000 children & adults diagnosed with ADHD, ADD, or LD. There is a great variety of biochemical phenotypes within these broad classifications & completely different treatment approaches are needed. About 60% of these patients are high dopamine, low choline persons and thrive on choline-enhancing supplements. (10 Jan, 2003)
After testing & treating more than 6,000 ADHD patients, I've learned that most of these patients exhibit chemical imbalances which impact neurotransmitter concentrations and brain function. In this sense, ADHD actually is a brain disorder. In countless cases, we have seen the ADHD disappear after treatment for the imbalances. Also, there clearly is a strong genetic component to ADHD. To me, this is good news, since genetic differences are usually expressed as chemical differences.... and chemistry can be adjusted. Just because ADHD is a brain disorder does not mean that drug therapy is indicated. In my experience, more than 80% of ADHD patients respond beautifully to nutrient therapy aimed at normalizing brain chemistry & body chemistry. ADHD usually involves disturbed brain chemistry & imperfect brain function. However, drugs are not the answer in most cases.
We have seen more than 5,700 children diagnosed with ADD/ADHD and most of them were mis-diagnosed & didn't have it at all. Hundreds of these kids were extremely bright with terrific concentration for things they cared about. The major problems they experienced were boredom (number 1) and authority issues. Quite a few had OCD and oppositional/defiant tendencies which have nothing to do with ADD/ADHD. (6 Jan, 2003)
Is there a simple combination that's generally effective for ADHD?
Not really, since there are several phenotypes comprising ADHD and the treatments may be completely different and in some cases opposite. (13 Jan, 2003) A classic component of ADHD is impulsivity. Impulsivity leads to accidents & injuries. It would be very surprising if an ADHD population didn't have a higher incidence of injuries. To complicate things, bumps on the head resulting in brain trauma can worsen ADHD. (Feb 10, 2003) We've known for more than 20 years that the metallothionein protein system does not perform well in most ADHD patients. About 68% of them exhibit very poor control of Cu & Zn, based on lab data from more than 6,000 patients diagnosed with ADD/ADHD. Autism is different in that about 90% of patients exhibit Cu/Zn imbalances that are generally much more severe than in ADHD.
For several months, we have extended our metallothionein-promotion protocol to ADHD, behavior, depression, and schizophrenic patients who exhibit Cu/Zn imbalance. The informal results so far are very encouraging. However, we've not yet done a formal outcome study for these populations, and thus have no statistics yet.
We are considering applying MT-Promotion to Alzheimers & Parkinsons patients in the near future. Both disorders involve serious oxidative stress and abnormal trace metal levels. In addition, recent research has revealed a striking metallothionein deficiency in the brains of Alzheimers patients. (Feb 25, 2003) The two primary ingredients for paranoid schizophrenia are (a) elevated copper levels and (b) over-methylation. In our database of more than 6,000 ADHD kids, 68% have elevated copper in blood serum. Since most ADHD individuals have one of the two SZ prerequisites, it would be a surprise if the SZ incidence were not relatively high in the ADHD population. Fortunately, very few ADHD kids become schizophrenic. (March 10, 2003)
ADHD is a real condition, but grossly overdiagnosed in the USA. NIMH estimates that the incidence is about 4.75%. However, there are states like Utah and Virginia in which more than 20% of all children are receiving Ritalin or other stimulant medication. Many parents prefer a diagnosis of ADHD to having to focus on family dynamics that might be a contributing factor...... the prospect of a "magic bullet" drug is very seductive. I agree that most children labelled ADHD don't really have it! (March 25, 2003) Amino Acids If a person is low across the board in amino acids, supplementation with mixed AA's could be beneficial. However, if an individual is known to be deficient in one or two AA's, it might be better to supplement these apart from each other and from food.
There is a large volume of published literature that indicates competition between amino acids in passage through the intestinal mucosa..... the highest levels of absorption are achieved in the absence of other AA's.
Genetic differences in persons can result in great variations in nutrient requirements. If a genetic tendency for low AA levels is present, it might be impossible to eat enough food to supply what's needed. (Aug 18, 2003)
Anorexia We've treated many anorexics and find most of them to be undermethylated and zinc deficient. Our standard treatment regimes for these two imbalances are usually very
successful, especially in concert with quality counseling. (July 22, 2003) Antidepressants and Cancer The FDA requires that all psychiatric medications be tested in animal studies for possible enhanced cancer risk. These are usually done with rodents. However, medications are often approved even if the medication causes cancer in rats. The box score on three drugs is as follows:
Paxil: Male rats exhibited increased incidence of lymphoreticular tumors & cell sarcomas.
Prozac: No evidence of carcinogenesis.
Zyprexa: Mammary gland adenomas and adenocarcinomas found in rats, suggesting possible increased risk of breast cancer. Increased prolactin levels which has been associated with increased risk of hormonal cancers....breast, ovarian, etc. Also one of two studies indicated increased incidence of liver cancer. (Feb 24, 2003) Autism Autism involves a powerful genetic component, so the real question is whether these genetically autism-prone children are hypersensitive to mercury. Recent research has shown that autistics are severely depleted in metallothionein, a protein needed for the body & brain to cope with mercury & other toxic metals. There is a definite possibility that a mercury preservative in a vaccine could harm such a child.
The concordance of autism in identical twins is 60%. The recipe for autism appears to be (1) a genetic predisposition plus (2) an environmental insult. We've had a set of identical twins at our clinic in which one was a productive, high-functioning adult and the sibling was a mute autistic with wild mood swings who was institutionalized. (9 Jan, 2003) We have seen more than 2,000 autism-spectrum children.... and agree completely about the value of sensory imputs. I've become convinced that the primary problem in autism is not so much a damaged brain, but rather a brain that has not completely matured. PT, OT, etc shower the brain with stimuli which enhance development of new neuronal connections which are especially needed in the hippocampus & amygdala of autistics. Biochemical therapies which normalize the pruning, development, and growth inhibition processes in the brain are also vital. (Feb 3, 2003)
My clinic has seen more than 2,500 autism-spectrum children and I'm convinced that most of these kids have above average intelligence. We've seen many who were labeled "retarded" with IQ scores below 50..... who later had IQ scores above 120 following therapies such as CF/GF diets, metallothionein-promotion, normalization of the G.I. tract, behavioral therapies, etc. The problem is with the test methods, not the innate intelligence of the children.
Unfortunately, DSM-IV itself is perpetuating this myth! Page 67 of DSM-IV, Fourth Edition, Section 299.00 Autistic Disorder ......states the following: "In most cases there is an associated diagnosis of mental retardation, commonly in the moderate range (IQ 35-50). Approximately 75% of children with Autistic Disorder function at a retarded level."
DSM-IV should not give currency to the high incidence of inappropriate diagnoses of retardation nor to incorrect IQ scores for these difficult-to-test children.
Most traditional autism experts believe that autism is "incurable" and that the associated "mental retardation" cannot be reversed. This is so wrong!!! There are tens of thousands of families that despair upon hearing this pronouncement..... and just give up! Please continue your efforts to get the truth out --- It could make a big difference in the life of many of these children. (Feb 20, 2003)
For years, autism was the most difficult population for our clinic to work with, compared to persons diagnosed with behavior disorders, ADHD, depression, anxiety disorders, bipolar, or schizophrenia. However, this has changed following our discovery of the central importance of the metallothionein protein in ASD and development of metallothionein-promotion therapy
At Dr. Rimland's request, we carried out a small outcome study about 6 months ago which measured the impact of MT-Promotion for 46 patients. I presented the results at a D.A.N. "Think Tank" at which Dr. Amy Holmes' outcome results for MT-Promotion were presented by Stephanie Cave. There is no doubt that autism outcomes are far better at the Pfeiffer Center since MT-Promotion. Our group of 46 patients ranged from ages 3 to 18. A few of the families were unable to achieve compliance & a couple others gave up after a couple of days. More than 85% of the 41 families that achieved compliance reported impressive gains in cognition, speech, and socialization. More than 20% reported irritability and sleep problems, usually coincident with improved cognition or speech. Only 10% of the compliant families reported zero progress.
We found the greatest improvements were obtained with younger children, including a significant number whose autism was rapidly disappearing. However, our data showed definite (but slower) improvement in the autistic teenagers. A few examples: A mother from New Hampshire reported that her mute 17 year old daughter began speaking after 6 weeks of MT Promotion. A 13 year old girl from Virginia began talking after the first month. A 4 year old in Illinois who could only say a few words.... began speaking in complex sentences after 5 days of MT-Promotion. A socially isolated 7 yr old son of a doctor became very friendly & communicative during the first month. We now have many dozens of such outcomes.
Dr. Holmes' population was much younger than ours, and her results indicated even higher efficacy than we had achieved. It was nice to have efficacy confirmed by an independent third party. Early intervention is essential, but benefits are possible for the older children also.
We are organizing a much larger and more scientific outcome study which should begin in a couple weeks.
Children between 2-4 years of age generally respond within a week or two. Since their little brains are still actively engaged in the brain-cell pruning, development, and growth inhibition processes..... the impact can be much greater. Families of ASD persons over the age of 20 have reported nice partial improvement after our treatment, but we've yet to experience a case in which a 20+ year old became completely free of autism symptoms.
My guess is that once MT normalization is attained, a simplified maintenance therapy can be implemented. Also there is a very good chance that CF/GF diets, yeast therapies, digestive enzymes, etc, will become unnecessary at that time. However, at present we recommend these therapies be continued..... just in case the genetically-weak MT system cannot be fully normalized. We should know a lot more within a year or so. (Feb 22, 2003)
I believe this can all be explained by the fact that estrogen and progesterone enhance metallothionein, whereas testosterone suppresses it. Therefore, given the same genetic tendency for weak metallothionein function, females would be more protected against environmental stresses which can trigger autism as they would have more MT to combat stresses.
Also, if the environmental triggers of autism have increased in recent years, you would expect the disparity in male/female incidence to drop. In essence each autism-prone child has a threshold with respect to environmental insults. In boys the threshold in lower. As the environment worsens, we get higher up on the statistical bell curve in both males and females & the disparity should moderate.
In my opinion, a wide variety of environmental triggers can trigger autism, including oxidative stress (e.g., mercury), immune crises (e.g. multiple vaccines or serious illness), severe emotional or physical stress, etc. It is very possible that the stress of circumcision could cripple metallothionein & impair brain development, at least temporarily. I'm not aware of peer-reviewed evidence of differences in autism incidence between circumcised and non-circumcised children.
Stresses of all kinds deplete metallothionein..... In persons without metal-metabolism disorders, the stress automatically induces production of more metallothionein. In autism, the metallothionein system has gone AWOL. (May 17, 2003)
There is no longer any doubt that autism results from a combination of genetic predisposition and environmental factors. Identical twins reared apart have an autism concordance of 60%...... This shows a powerful genetic influence, but the fact that the concordance isn't 100% clearly shows that environment factors are also involved. I once tested a pair of identical twins (age 38) in which one was a successful professional writer & the other was an institutionalized severely-autistic mute young man who needed to be physically restrained. They were quite different from the day they were born.
In our database of 2,500 autistics, about 30% of the families reported autism symptoms from birth with the remaining 70% of autistics exhibiting "regressive autism" with typical onset between the ages of 16 to 22 months.
Yes, the ratio of boys/girls has declined in the past 6 decades & the causes for the lessened maleness are certainly environmental. Also, there is mounting evidence that the overall incidence of autism has increased rapidly since 1990..... Again, environmental factors must be responsible. There is great public debate over the possible role of vaccinations or mercury preservatives in the vaccines. My personal opinion is that a wide variety of environmental stresses and toxins can contribute to the onset of autism. Your suggestion that circumcision and infant separation may be among them..... appears quite plausible. (June 9, 2003)
At the request of an autism parent group about 6 months ago, I checked out iron levels in our population of 3,000 autism patients. We found that autistic children exhibited higher serum iron levels than controls (non-autistic, healthy chidren). However, all of the differences occurred in about 1/3 of the autism population with the other 2/3 resembling the controls. The high iron kids were extremely high, the rest of the autistics were quite normal, and there was little or no "middle ground". It appears that a segment of the autism population has very abnormal iron metabolism (and abnormal ceruloplasmin).
My data essentially confirms the findings of the M.H. article. Iron free radicals (ions) represent the primary oxidative stress in the brain of most humans. Autism involves oxidative stress during early brain development. In theory, elevated iron in the brain could result in autism. A genetic inability to regulate iron might be causative in 1/3 of autism cases. (Sep 15, 2003)
We are engaged in a foundation-funded study measuring estrogen, progesterone, testosterone, and other hormones in autistic subjects and age/gender matched controls. We expect to have the first data in a few weeks.
This is an area of interest since (a) there have been several reliable reports of efficacy using progesterone cream for autistics, and (b) progesterone and estrogen promote synthesis of metallothionein & testosterone inhibits MT. If autistics exhibit consistently abnormal levels, we plan to develop a hormone-normalizing therapy. (Oct 29, 2003)
B6 The dangers of B-6 have been greatly overexaggerated. The original concerns began with a university study 25 years ago in which volunteer students were paid to take B-6 (pyridoxine hydrochloride) doses ranging from zero to 10,000 mg daily. After a few weeks, a number of the students taking doses higher than 5,000 mg/day reported a loss of sensation in areas of the skin. The study was stopped and in every case the symptom completely disappeared. This result became widely known & the side effect was identified as neuropathy.
Within a few years, similar neuropathy was observed in a small fraction of persons taking megadoses of 2,000 mg/day and for a while B-6 dosages were limited to 1,000 mg/day. Later, there were rare cases of persons who experienced temporary neuropathy with doses of a few hundred mgs. In the hundreds of neuropathy cases, the neuropathy completely disappeared after stopping the B-6. The effect a temporary one, and I'm unaware of
anyone ever being permanently "hurt" by B-6.
Persons who have normal metabolism of B-6 need only a couple of milligrams daily, which is easily obtained from their diet. However, there are many persons with metabolic disorders which result in innate B-6 deficiency.....These persons may need 100 to 1,000 mg/day of B-6
to normalize B-6 levels in the body. An example is provided by the genetic disorder pyroluria, in which B-6 is stripped from the bloodstream by kryptopyrrole/hemepyrrole molecules.
In a nutshell, most persons have no need for B-6 supplements, whereas innately B-6 deficient persons may need hundreds of mg/day to normalize B-6 activity. B-6 toxicity occurs only in persons who already have sufficient or elevated B-6 levels.
Another indicator of B-6 overload is the onset of vivid, troubling dreams. When that occurs in a patient, the B-6 dose can be lowered before neuropathy begins.
There are many nutrients that have serious dangers associated with overdose...... B-6 is not one of them. Examples of potentially-dangerous nutrients include the fat-soluble vitamins (A, D, E), copper, and selenium. (Feb 19, 2003) In the 1980's, I was collaborating with the late (and great) Dr. Carl Pfeiffer in developing nutrient programs for troubled individuals. In1986 we discovered that certain malabsorbers didn't respond well to B-6 in the form of pyridoxine hydrochloride, but were helped greatly by the P-5-P form of B-6. For about a year we used P-5-P exclusively in treating B-6 deficiencies..... However, we later discovered that certain patients responded better to pyridoxal hydrochloride than to P-5-P. Thereafter, we provided both forms of B-6 in treating B-6 deficiency. A typical B-6 deficient patient might receive 300 mg pyridoxine
hydrochloride and 50 mg P-5-P daily.
This practice has continued at the Pfeiffer Treatment Center over the past 13 years, with most patients receiving both "regular" B-6 and P-5-P. We tend to emphasize P-5-P for persons with malabsorption, maldigestion, or other gut problems...... with other patients receiving
a balanced mix of the two forms of B-6. (Feb 20, 2003)
I've worked with more than 3,000 patients who received at least 500 mg/day of B-6. I know of only 2-3 dozen cases in which neuropathy symptoms occurred..... In these cases we had incorrectly believed there was severe B-6 deficiency. In every case, the neuropathy disappeared after stopping the B-6. Nobody was harmed.
The incidence of skin neuropathy after megadoses of B-6 is rare, but real. The specter of permanent harm from B-6 appears to be a myth. I am unaware of a single case. (Feb 22, 2003) Bipolar Disorder Bipolar disorder is not a single condition, but an umbrella term which includes a number of very different biochemical abnormalities. I'm bothered by any attempt to generalize over the bipolar phenotypes & to blindly recommend any formulation or therapy for all of them. The key is to determine a patient's biochemical individuality, and to provide focused appropriate treatment. In our database of 1,500 bipolar patients, about 25% are overmethylated, 35% are undermethylated, and the remaining 40% do not exhibit a methylation disorder.
The three primary biochemical classifications of bipolar disorder are the following:
A. Undermethylation: This condition is innate & is characterized by low levels of serotonin, dopamine, and norepinephrine, high whole blood histamine and elevated absolute basophils. This population has a high incidence of seasonal allergies, OCD tendencies, perfectionism, high libido, sparse body hair, and several other characteristics. They usually respond well to methionine, SAMe, calcium, magnesium, omega-3 essential oils (DHA & EPA), B-6, inositol, and vitamins A, C, and E. They should avoid supplements containing folic acid. In severe cases involving psychosis, the dominant symptom is usually delusional thinking rather than hallucinations. They tend to speak very little & may sit motionless for extended periods. They may appear outwardly calm, but suffer from extreme internal anxiety.
B. Overmethylation: This condition is the biochemical opposite of undermethylation. It is characterized by elevated levels of serotonin, dopamine, and norepinephrine, low whole blood histamine, and low absolute basophils. This population is characterized by the following typical symptoms: Absence of seasonal, inhalent allergies, but a multitude of chemical or food sensitivities, high anxiety which is evident to all, low libido, obsessions but not compulsions, tendency for paranoia and auditory hallucinations, underachievement as a child, heavy body hair, hyperactivity, "nervous" legs, and grandiosity. They usually respond well to folic acid, B-12, niacinamide, DMAE, choline, manganese, zinc, omega-3 essential oils (DHA and EPA) and vitamins C and E, but should avoid supplements of methionine, SAMe, inositol, TMG and DMG.
C. Pyrrole Disorder: This condition, also called pyroluria, is a genetic stress disorder associated with severe mood swings, high anxiety, and depression. The biochemical signature of this disorder includes elevated urine kryptopyrroles, a double deficiency of zinc and B-6, and low levels of arachidonic acid. Pyrolurics are devastated by stresses including physical injury emotional trauma, illness, sleep deprivation, etc. Symptoms include sensitivity to light and loud noises, tendency to skip breakfast, dry skin, abnormal fat distribution, rage episodes, little or no dream recall, reading disorders, underachievement, histrionic behaviors, and severe anxiety. They usually respond quickly to supplements of zinc, B-6, Primrose Oil, and augmenting nutrients.
To me, a bipolar patient who becomes "well" with greatly-reduced medication requirements may have achieved complete success. I don't believe that medication doses need to go to zero, as long as side effects are absent and long-term effects are minimal or absent.
Incidence of bipolar depression (diagnosis during lifetime):
TOTAL POPULATION OF ADOPTEES ... INCIDENCE = 4.5%
FRATERNAL TWINS SEPARATED AT BIRTH .... Concordance = 32%
IDENTICAL TWINS SEPARATED AT BIRTH .... Concordance = 80% We have seen more than 1,500 patients diagnosed with bipolar disorder, including a few hundred who presented with a diagnosis of "rapid-cycle" bipolar disorder. Many of the rapid cycle patients exhibited a severe pyrrole disorder as their primary imbalance. The key lab test is urine kryptopyrroles. Most "pyrolurics" are prone to high anxiety, severe mood swings, depression, and may be famous for their temper. Classic symptoms include aversion to eating breakfast, poor dream recall, sensitivity to bright lights & loud noises, abnormal fat distribution, poor short-term memory (often coincident with good long-term memory), and very poor stress control. (Feb 27, 2003) We have worked with more than 1500 bipolar patients & found that most have an atrocious diet. I remember one young man whose only dietary intake for the past month consisted of Pepsi and potato chips.
In our experience, best results are achieved with a two-step procedure: (1) biochemical treatment followed by (2) life-style changes including a better diet. We learned the hard way that most bipolars are incapable of life-style changes until after their chemical imbalances have been corrected (or at least lessened). Once real biochemical progress has been made, the patient is more functional and real dietary improvements can be achieved. Trying to everything at once tends to overwhelm the patient, and they usually give up. (March 6, 2003)
About 20% of patients labeled as bipolar have a pyrrole disorder (genetic) which is associated with (a) fatty acid abnormalities, especially depressed arachidonic acid, (b) strikingly weak immune function, and (c) severe metal oxidative stress. The definitive test for the pyrrole disorder is urinalysis for kryptopyrroles (Direct Healthcare Access is the lab, 847/299-2440). These patients might benefit greatly from therapy concentrating on zinc, B-6, and primrose oil (or borage oil). Omega-3 oils can make things worse because of the competition for Zn & B-6 between delta-5 desaturase and delta-6 desaturase.
If a patient has a pyrrole disorder he/she likely would have at least half of the following symptoms:
Poor stress control
Sensitivity to bright lights and/or loud noises
Preference for spicy or heavily flavored foods
Significant growth after age 16
Morning nausea
Tendency to skip breakfast
Poor dream recall
Emotional outbursts
Poor short-term memory, perhaps coincident with excellent L.T. memory
Diagnosis of "rapid-cycle" bipolar
Much higher capability & alertness in the evening, compared to mornings
Dry skin
Reading disorder. (March 27, 2003) DMAE passes the blood-brain barrier and converts to choline in the brain. Therefore it has cholinergic action & enhances formation of acetylcholine. As a result DMAE is generally very useful in treatment of high dopamine (low histamine, overmethylated) persons, but can seriously harm low dopamine, high histamine, undermethylated persons. We've seen more than 1,500 bipolar patients and confirmed that DMAE is generally effective for the overmethylated phenotype (25% of bipolar cases), but causes great worsening for those who are undermethylated (40% of bipolar cases). DMAE definitely should not be used indiscriminately for persons with serious mental illness. (Aug 15, 2003) Note from Dr O`Flaherty: As well as listening in Sydney to Dr Walsh`s lecture which included Pyroluria there was a longer lecture from Woody McGinnis M.D. I have now found most of his lecture on the internet and you can read it at www.alternativementalhealth.com/articles/pyroluria.htm Candida Another effective way to combat candida is using zinc therapy. Candida is killed by metallothionein (MT) proteins which are normally in high concentration in intestinal mucosa. MT is induced by zinc. Many persons with candida are low zinc and low MT persons. They usually exhibit low zinc in plasma, serum, or packed cells, but high zinc in hair. You can expect chronic candida problems until zinc is normalized. In a sense, zinc can be an effective weapon in your anti-candida arsenal. Typical anti-candida therapies (including dietary
restrictions) can manage the problem for a while....... Maintenance supplementation with zinc (after these interventions) can permanently fix the problem, in many cases, without the need to continue dietary vigilance. (Feb 5, 2003) Celiac Disease, Wheat and Dairy Sensitivity There are classic symptoms/markers of gluten intolerance which enable you to determine the small percentage that have symptoms consistent with this disorder. Examples are (1) compulsive, ritualistic behavior, (2) family history of malabsorption, (3) frequent, explosive bowel movements, (4) lethargy, (5) abdominal pain, and (6) Dermatitis Herpetiformis (skin disorder). One could screen the population for the presence of some of these markers of celiac disease & then perform diagnostic tests to nail it down. (11 Jan, 2003)
Severe wheat gluten intolerance can cause classic symptoms of schizophrenia, and amounts to about 4% of all schizophrenia diagnoses in the U.S. These persons usually become quite normal when placed on a gluten-free diet. Psychiatry continues to ignore the small, but significant, population, estimated at 100,000 to 300,000 Americans. These people are usually treated with atypical anti-psychotic medications, but simply need a dietary change to become free of symptoms. (11 Jan, 2003) Our Center has evaluated and treated nearly 20,000 persons. About 1,500 of them have reported terrible reactions to wheat and/or dairy. The wheat/dairy sensitive population is composed of two major groups:
Group A consists of those people who are truly allergic to these foods & must make the lifetime commitment to total avoidance of these foods. Failure to accomplish this could result in irritability, violent behavior, ADD, depression, anxiety, bipolar disorder, delusional disorder, schizophrenia, not to mention malabsorption & terrible physical health.
Group B consists of persons who have severe reactions to wheat and/or dairy solely because of a genetic or acquired oxidative stress condition. Fix the oxidative stress in the G.I. tract & the food sensitivities disappear. Moreover, merely avoiding wheat/dairy will provide only partial benefits to this group..... because the untreated oxidative stress could result in toxic metal overload, yeast overgrowth, copper dysregulation, weakened immune system, abnormal levels of dopamine and norepinephrine, impaired hippocampal and amygdala function, etc. The net result can be behavior disorders, depression, severe mental illness, frequent infections, and an increased tendency for cancer.
In summary, most Group A persons can be successfully treated with dietary restrictions alone. Persons in Group B must have therapy which focuses of normalizing the level of oxidative stress. (Sep 2, 2003)
Choline Phosphatidyl choline is also very effective in protecting DHA/EPA from free radical oxidative stress..... another good reason to take it. In my experience DMAE is especially effective for increasing acetylcholine levels in the brain, since it passes the blood/brain barrier & converts to choline. I like to use this for overmethylated persons who have excessive dopamine and norepinephrine levels. However, enhancing acetylcholine activity must be avoided in persons who genetically are overloaded in this NT. Choline, DMAE, and phosphatidyl choline can cause nasty symptoms in these persons (about 10% of the population).
Persons with innately high acetylcholine levels tend to be very terse and sometimes nearly catatonic. They have very high anxiety, but usually keep it inside. They also usually have a history of seasonal allergies, perfectionism, and OCD tendencies. Increasing acetylcholine activity can be a disaster for them.
Those deficient in acetylcholine usually present with nervous legs, are prone to pacing, and are quite voluble. Their misery is plain to everyone. Therapies to increase acetylcholine activity can be extraordinarily helpful for this population. (March 6, 2003) Copper A complication is that blood levels of copper can be very low in persons who have severe copper overload. The classic example is Wilson's Disease in which the liver accumulates huge amounts of copper. These same Wilson's patients usually exhibit very LOW levels of Cu in blood.....also the exhibit extraordinary low levels of ceruloplasmin. Is essence their blood contains little copper, but the blood Cu is predominantly in "unbound" form.
Years ago, we mistakingly thought low blood serum or RBC copper levels meant Cu deficiency..... and in a few cases we cautiously gave Cu supplements in an attempt to correct the situation. Most of these patients reacted badly to the Cu. Proper evaluation of copper status requires both serum Cu and serum ceruloplasmin tests.
Hair mineral copper is very valuable for behavior disorders and ADHD patients, but is of far less clinical value for autism, bipolar, and schizophrenia populations.
Giving supplemental Cu to patients is a risky business. It should be considered only in those who exhibit sufficient ceruloplasmin to accomadate between 80 and 95% of the Cu present. (April 10, 2003)
Selenium deficiency itself could result in a nasty copper elevation. Metallothionein at the intestinal mucosa and in the liver is the primary agent which regulates copper in the body. Selenium is needed for efficient metallothionein functioning.
Carl Pfeiffer of Princeton, NJ tested more than 25,000 persons for copper & reported that Cu toxicity was common, but Cu deficiency extremely rare. We have investigated the metal-metabolism of about 20,000 persons & found the same thing. I admit there are theoretical rationale for expecting copper deficiency, but it rarely actually happens.
Hair analysis ALONE is a very poor way to assess copper status. I say this after (a) evaluating more than 100,000 hair analyses, (b) developing the first high-quality hair standards (loaned to NIH and other researchers), and (c) performing numerous double-blind, controlled experiments involving hair chemistries. Findings of high Cu levels in hair are compromised by the many external sources of Cu which cannot be completely removed by washing. Low levels of Cu in hair and/or blood often are coincident with dangerous overloads of Cu in liver. Hair Cu values can provide information of clinical significance, but by itself
is not clinically decisive.
Serum Cu indicates the total amount of Cu in serum. Serum ceruloplasmin indicates the fraction of serum Cu that is bound as ceruloplasmin. A simple calculation (paying attention to the assay units) yields the numbers for comparison. Most copper experts agree that the normal or "healthy" situation is to have about 80 to 95% of the serum Cu present as ceruloplasmin.
A high fraction of "unbound" Cu is a good indicator of oxidative stress and low metallothionein activity...... and also a warning to NOT to supplement with Cu, even if serum/RBC/hair levels of copper are low. In addition, one should consider possible environmental sources of Cu,
expecially drinking water and swimming pools/jacuzzis treated with copper sulfate (to kill algae).(April 11, 2003)
The ceruloplasmin analysis indicates the amount of Cu properly bound to this protein (Should be 80-95% of total serum Cu). If serum and hair Cu are low, a high proportion of "unbound" Cu is a warning signal that there might be a Wilson's Disease-like situation...... Low serum/hair copper, but severe Cu overload in the liver. In some cases, testing for
possible Wilson's Disease is indicated.
Usually, the question is whether there is a Cu overload. The incidence of true Cu deficiency/depletion is very low. (April 14, 2003)
High copper females respond very well to therapy with zinc, B-6, P-5-P, C, E..... However the Zn should be introduced slowly..... for example 25 mg....50 mg.... 75 mg..... and given either at bedtime or after the evening meal. B-6 and P5P should be given before noon. Failure to phase in the Zn slowly would be likely to result in temporary worsening of symptoms over the first few weeks.
She should avoid estrogen therapy, drink bottled water, and limit high-Cu foods like chocolate, carob, and shellfish.
If her primary imbalance is the Cu overload, very little improvement is likely during the first 3 weeks..... followed by striking improvement thereafter. If the patient is clearly better during the first week, this is probably due to overcoming the pyrrole disorder. In her case, you might get
a nice initial improvement which is partial in nature..... followed by a plateau of several weeks before more progress is made. (April 14, 2003) Crime & Violence We've spent the past 25 years studying behavior disorders and have accumulated the world's biggest & best chemistry database for behavior. We have about 100 separate chemical assays of blood, urine, and hair for more than 12,000 behavior-disordered persons, including
participation in 28 forensics studies of folks like Charles Manson, Richard Speck, Henry Lee Lucas, and James Oliver Huberty. This database clearly shows violent, delinquent persons to have striking biochemical differences, compared to the general population. The late & great Carl Pfeiffer helped me over the last 12 years of his life to development biochemical, non-drug treatments for these chemical imbalances.
The Pfeiffer Treatment Center was named for Carl Pfeiffer, MD, PhD of Princeton, NJ .... for his great contributions to our work. He died 6 months before the Center opened in 1989.
The Pfeiffer Center has completed several outcome studies measuring efficacy of this treatment system. The latest one involves 207 consecutive patients in which we carefully determined the frequency of physical assaults and destruction of property before & after treatment. I've completed a manuscript for this study which will be published in the journal, Physiology and Behavior, hopefully within 4-6 months. The results are quite spectacular
This study indicates excellent efficacy for young persons.... 0-16 yrs of age.... with sharply declining efficacy at older ages. The decline seems to coincide with the onset of drugs & alcohol abuse. I am sorry to say that our experience with adult ex-convicts is not very good & the information you received about 95% success in overcoming recidivism in violent criminals is not true. However, about 90% of compliant YOUNGER violent/delinquent persons
respond very nicely to the Pfeiffer therapy.... About 60% of these report complete elimination of assaults and property destruction, with the other 30% reporting excellent partial improvements. Maybe some day we'll be smart enough to help the older offenders too.
We believe that America's best hope for effective crime prevention is early identification of at-risk youths and effective treatment before their lives are ruined. I'm certain that stimulant drugs and/or psychiatric medications are not the answer. (Feb 6, 2003) Many years ago I did a study examining chemistry differences between male siblings in which one was a violent delinquent and the other a well-behaved child. We balanced age and birth
order and accepted only those who lived in the same household and attended the same school.
I clearly remember a family living in the squalor of Chicago's south side black ghetto...... The father was in Stateville Prison for murder.... the mother was a prostitute who sometimes entertained her "guests" at home in the presence of the children. The boys were age 10 and
11 and both had suffered physical and sexual abuse from the customers. I've never seen a worse environment..... I remember being very nervous just driving into the neighborhood.
The 10 yr old was oppositional, defiant, cruel, truant, and was already in a violent gang. However, his 11 yr old brother was quite amazing...... a well-behaved, polite young man who was an excellent student and also class president. For years I wondered how such a miracle could have happened.
We eventually found 24 families that included an "all-American boy" and a "child from hell". The ill-behaved children had clear chemistry abnormalities whereas the well-behaved ones generally exhibited expected trace-metal levels.
This experiment was a watershed experience for me. For the first time I knew that environment wasn't the only causative factor in behavior disorders and ADHD..... that disordered biochemistry (probably genetic) also played a role.
In studying nearly 10,000 behavior-disordered children & adults since that time, I've learned the following:
1. A child born with ideal body/brain chemistry is nearly indestructible, and may thrive in a terrible environment.
2. A child with a MILD chemical predisposition to violence may turn out fine, if the environment is good and there are resources for counseling, etc. The same child might wind up in prison if born into poverty or an otherwise terrible environment.
3. A child born with a SEVERE chemical imbalance will exhibit terrible behavior, even in an ideal environment. You can't just "love away" a severe brain chemical imbalance. My group once visited and tested Charles Manson at San Quentin prison..... his chemistry was so extraordinarily aberrant that I am convinced that if adopted into a different family, Manson would have turned out the same. (July 28, 2003)
In the beginning, we had no way of knowing if the biochemical differences were a causative factor or simply an association. I decided the quickest way to find out would be to correct the aberrant chemistry of the violent children to see if the behaviors changed. 10,000 behavior patients later, I can report that the bad behavior in young children usually disappears completely when the chemistry is balanced. Children under the age of 10 usually correct beautifully without counseling of any kind. However, older children (14+) benefit greatly from counseling, behavior mod, conflict resolution, etc after the chemistry is corrected. I'm not sure if this is because of an ingrained negative self-image, poor social skills, or problems in breaking the bad behavioral habits. All I know is that counseling/therapy seems necessary with teens, even after the chemistry has been normalized. We've also learned that adult criminals generally fail to achieve enduring benefits with our biochemical (non-drug) therapies. Most are back in jail within 5 years. We are on a mission to identify the at-risk children and intervene with effective therapy before their lives are ruined. The window
of opportunity (for severe cases) begins to close in the early teen years. Drug and alcohol abuse may be major factors in this phenomenon.
Most children with a predisposition to bad behavior have chemistry imbalances which are fairly mild, and for this large group..... environment and life experiences rule. For them, early traumae might be the deciding factor. (July 28, 2003)
Coral Calcium The calcium in Coral Calcium is mostly calcium carbonate, which provides the highest amount of calcium absorbed per unit volume. CaCO3 is 40 w/o calcium and is quite dense. Many manufacturers claim higher calcium absorption on a percent basis for low density products like calcium glycinate. A lot of this is deceptive marketing. A capsule of calcium carbonate will result in more calcium in your bloodstream than a same-size capsule of any other form of
calcium.
That's the good news about CaCO3. The bad news is that CaCO3 can result in nasty stomach & intestinal problems in sensitive persons. In some cases, all hell can break loose. In my opinion, CaCO3 (not Coral Calcium) is the best option for persons who don't experience side effects..... lowest volume to swallow down and lowest cost. For sensitive persons, some of the calcium blends are very absorbable with reasonable volume, low cost, and minimal
side effects.
A significant advantage of Coral Calcium is the presence of a multitude of micro-nutrients that are unavailable in most supplements. Things like praesodymium, erbium, etc. Every year we discover another micro-nutrient with a vital function in the body. The "good" impurities in a natural product like Coral Calcium could be significant. Of course the "bad" impurities such as lead or mercury MUST be at a negliglble level for the supplement to provide benefits. (April 17, 2003)
Depression
After getting extensive biochemical data on more than 3,000 persons diagnosed with clinical depression, we found that 95% of them fit neatly into one of 5 separate biochemical classifications. Depression is not a single condition, but an umbrella term covering several completely different conditions. Anyway, we believe we have identified the 5 primary phenotypes..... each with their own classic symptoms and each with completely different treatment needs.
1) High Histamine (under-methylated)
40-70 is optimum histamine range for mental health considerations. Histamine is an important neurotransmitter which affects human behavior. This syndrome often involves seasonal variations in depression, obsessive-compulsive behavior, inhalant allergies, and frequent headaches. In severe cases involving psychosis, the dominant symptom is usually delusional thinking rather than hallucinations. They tend to speak very little and may sit motionless for extended periods. They may appear outwardly calm, but suffer from extreme internal anxiety. Most OCD patients with both obsessive thoughts and compulsive actions are in this category. Associated with under-methylation, which results in low levels of important neurotransmitters such as serotonin, dopamine and norepinephrine. Treatment focuses on the use of antifolates such as calcium, methionine, SAMe, magnesium, zinc, TMG, omega-3 essential oils, B6, inositol, and A, C and E. The dose of inositol is 500 to 1000mg. Choline is anti-dopaminergic and often makes undermethylated patients worse. Also bad are DMAE, copper and folic acid. Three to six months of nutrient therapy are necessary to correct this chemical imbalance. Symptoms will return if treatment is stopped. Two good labs for whole blood histamine are LabCorp and Quest. Also use a special absolute basophil count as a methlyation marker. The count must be direct and not differential. Alcian blue dye is the preferred staining agent. Best lab for this test is Direct Healthcare Access in Glenview IL 847 299 2440
2) Low Histamine (over-methylated)
Low-histamine depressives are usually nervous, anxious individuals who are prone to paranoia and despair. No seasonal allergies, but many food allergies and chemical sensitivity. Low libido. Obsessions but not compulsions. Heavy body hair. Nervous legs. Grandiosity. Many have a history of hyperactivity, learning disabilities and underachievement. They are over-methylated which results in elevated dopamine and norepinephrine levels. Treatment focuses on B3, C, B12 and , with about 2-4 months required for correction of the imbalance.. Also DMAE, choline, manganese, zinc, omega-3 essential oils, C and E. They should avoid methionine, SAMe, inositol, TMG and DMG.
3) Pyroluria
A stress disorder characterized by pronounced mood swings, temper outbursts, anxious depression. Inability to eat breakfast, absence of dream recall and frequent infections. The biochemical signature of this disorder includes elevated urine kryptopyrroles, a double deficiency of zinc and B-6, and low levels of arachidonic acid. Devastated by stresses including physical injury, emotional trauma, illness, sleep deprivation. Sensitivity to light and loud noises, dry skin, abnormal fat distribution, rage episodes, histrionic behavior. They also have low levels of arachidonic acid. Treatment centers on correcting a double deficiency of B-6, zinc essential fatty acids and augmenting nutrients. It is believed to result from abnormal hemoglobin synthesis which depletes the body of these nutrients. A positive response often occurs within the first seven days of treatment, with 1-2 months usually required for correction of the imbalance.
4) High Copper (Hypercupremia)
If your level is above 140 mcg/dL, you would profit from getting rid of the excess copper. The most common depression phenotype for women. History of hyperactivity, tinnitus, and skin sensitivity to metals. Females with this condition usually have significant PMS and are prone to heightened depression during hormonal events such as puberty, gestation, childbirth and menopause. A woman's copper level more than doubles during the 9 months of pregnancy, apparently to enhance angiogenesis in the fetus. Women with an innate tendency for copper overload are prone to post-partum depression or post-partum psychosis. Estrogen increaases creuloplamin and copper levels and results in zinc depletion. Very elevated norepinephrine levels, elevated copper and low ceruloplasmin. Elevated norepinephrine/dopamine ratio. Most get worse after chocolate which is very high in copper. This condition is non-existant in males. Serum copper levels above 140 mcg/dl High NE and ADR levels can result from overmethlyation, probably genetic, elevated serum copper, and low folate/B12 levels. Hypertension is associated with high NE and ADR levels. Using folate/B12 will reduce hypertension and anxiety and depression. They often report a worsening of depression after estrogen or multiple vitamins. Most hypercupremics get worse if they overdose on chocolate. Treatment focuses on release of excess copper from tissues, promotion of copper excretion, and stimulation of metallothionein (a metal-binding protein). Many patients report a worsening for three weeks followed by steady improvement. Nutrient support is zinc, manganese, vitamin C and B6. Nutrients should be introduced gradually to avoid side effects. Use 25mg of zinc initially, then 50 then 75 as tolerated. A total of 60 to 90 days is usually required to correct this imbalance.
The list of things to avoid include the following:
1. Multiple vitamins/minerals containing Cu
2. Enriched foods with Cu added (learn to read the labels)
3. I recommend that she drink bottled water.
4. She needs to avoid swimming pools/jacuzzis treated with algicides containing copper sulfate.
5. The primary foods to avoid are chocolate, carob and shellfish.
5) Toxic Overload
This syndrome often involves a sudden, prolonged bout of depression without apparent reason and without a prior history of depression. Toxic substances which are capable of producing depression include lead, cadmium, mercury, and a wide variety of organic and inorganic chemicals. Treatment varies with the type of toxic material involved, and care must be exercised to avoid flooding the kidneys with toxins during the early stages of treatment. Heavy-metal overloads can be corrected quickly by in-hospital chelation, or more slowly using biochemical treatment. Organic chemical overloads require liberal use of antioxidants along with avoidance of the offending substances.
BTW, chocolate has 4 separate ingredients that can worsen malaise/depression in some people: (1) sugar, (2) caffeine, (3) copper, and (4) milk. The most significant of these for females is usually copper. Unfortunately carob has even more copper than chocolate.
Many depression patients experience striking cycles in which their depression may wax for months or wane for months. It's really hard to evaluate treatment efficacy for such persons since the patient may deteriorate during effective treatment or improve while experiencing placebo or a harmful therapy. (30 Dec, 2002) Histamine assays for depression were introduced by Dr. Carl Pfeiffer of Princeton, NJ in the 1970' and 1980's. My clinic has found whole blood histamine to be very useful & has used this assay more than 30,000 times.
First of all, the analysis must be done for whole blood (not plasma, serum, etc), strictly adhering to the sampling protocol. We presently use LabCorp but in the past Quest also had proficiency for this assay.
The reference "normal" range for mental health is 40 to 70 ng/dL. Levels above 70 indicate undermethylation, whereas levels below 40 suggest overmethylation.
Undermethylated depressives thrive on l-methionine, calcium, magnesium, B-6, Zinc, and Vitamin C. In severe cases, up to 3,000 mg/day of methionine and 2,000 mg/day of Ca may be needed. However, we also like to routinely run a homocysteine test to assure the safety of the methylation protocol. This population is believed to result in low serotonin activity. This methylation therapy is quite slow in taking effect.... and often 6-8 weeks pass before
progress is obvious
Overmethylated (low-histamine) depressives thrive on folic acid, B-12, niacin (or niacinamide), B-6, Zinc, Manganese, DMAE, and Vitamins, C and E. In severe cases, up to 5,000 mcg/day of FA may be needed. Response is more rapid with this phenotype, with clear progress usually by week 4. This population is believed to have an innate tendency for elevated serotonin, dopamine, and norepinephrine levels.
This test can also help guide psychiatrists in selection of psychiatric medications. For example high histamine persons may do quite well on SSRI's, but low-histamine persons usually reactly very badly to SSRI's and are better candidates for benzodiazapines.
We like to augment the histamine blood test with an "absolute basophil" test offered by Direct Healthcare, Inc. The histamine assay can be affected by antihistamines and other medications with AH properties. The reference range for ABC's is 30-50.
We have an enormous chemistry database for depression..... more than 90 chemical assays for each of 3,200 persons with clinical depression. We find that 90% of depressives may be divided into five biochemical classifications, each requiring a different treatment approach. Two of these depression phenotypes are undermethylation and overmethylation. (June 2,
2003)
Estimated incidence of hypercupremia in our depressive population:
Females: 45%
Males: 3%
Overall: 30% (We have more females than males in our depression database)
As you can see from the numbers, hypercupremic depression is generally a female event. We are about to publish a database study which shows that hypercupremic feamles are especially prone to post-partum depression and post-partum psychosis. Many of these high-Cu females get worse on anti-depressants, but respond beautifully to nutrient therapy which normalizes Cu and Zn levels. (June 11, 2003) Down's
We are not a Down's clinic, but I have researched Down's biochemistry in past years. One common factor is elevated levels of serum copper and insufficient levels of serum ceruloplasmin. We did an exploratory outcome study following treatment of 24 Down's patients about 10 years ago and the results were the following:
1. Better general health
2. Much better behavior control and moods
3. No detectable improvement in cognitive function.
If this person were in my family, I would have the following tests run: serum copper, serum ceruloplasmin, and plasma zinc. If the expected metal-metabolism imbalance were evident, a simple and inexpensive formulation of vitamins and minerals could normalize the metals. I would expect that the violence would disappear and that he would have a better life. (Aug 21, 2003) Essential Fatty Acids Borage Oil is a good source of omega-6 oils. I think the widespread use of Primrose Oil results from widely publicized treatment successes with schizophrenia in England & the USA in the 1970's and 80's. I would choose the one with the highest arachidonic acid level. (Sep 28, 2003)
I once collaborated with Dr. Doug Bibus, a Minnesota fatty-acid expert, on a study of 87 schizophrenics. Bibus' lab provided reliable chemical analysis for about 60 fatty acids.
We reported the results at a national meeting of the Americal Oil Association (not petroleum) & plan to publish the results in a journal. We found that 75% of schizophrenics were somewhat elevated in omega-6 oils, and significantly depleted of omega-3 oils. However, the pyroluric schizophrenics comprised the other 25% and exhibited severe deficiency of arachidonic acid and other omega-6 oils.
We've had considerable success in using PUFA's (poly-unsaturated fatty acids) to treat persons with mental illness, but have found that omega-3 and omega-6 oils can cause clear worsening if given inappropriately. Pyrolurics need omega-6..... whereas most other patients need omega-3. There is a competition between o3 and o6 for zinc, B-6, and the delta 5,6 desaturases. The ideal would be to identify a person's biochemical individuality, with respect to PUFA's, then treat accordingly.
We've met several pyrolurics patients who reported a setback after omega-3 supplements. Most of them turned out to be pyroluric.
Kennedy-Kreiger Institute in Bethesda has a lab that performs a reliable PUFA assay. Direct Healthcare Access in the Chicago area has an excellent kryptopyrrole assay for determining presence or absence of pyroluria. (Oct 14, 2003)
If you look at the reaction cascades for omega-3 and omega-6 beginning with ALA and LA.... both cascades require B-6 and Zn, which may be in limited supply. If a person is overloaded in one of the omega's and depleted in the other.... supplementation with the omega already in excess will result in less B-6 and Zn availability and a worsening of the levels of the depleted omega.
About 60% of schizophrenics exhibit low omega-3 levels. About 20% of SZ patients (those with severe pyroluria) exhibit extremely low AA and DGLA levels and thrive on Primrose Oil or other forms of omega-6. The remaining 20% do not exhibit PUFA anomalies.
The low omega-6 patients are very different from other schizophrenics and the general population. Classic symptoms include: Extremely dry skin (remember that the oils are the waterproofing of the skin), raised nodules on the back of the upper arm, abnormal fat distribution, plus the symptoms of pyroluria itself.... These include severe mood swings, stress dyscontrol, sensitivity to light and loud noises, poor immune function, little or no dream recall, reading disorder in childhood, craving for spicy/salty foods, poor appetite in the AM, etc.
My preference is the RBC membrane assay for the PUFA's. (Oct 20, 2003)
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