Part 3 of 5: Depression and the Brain-Gut Axis

I try not to talk about depressing things. My intention is to motivate and empower you towards living a positive life with authenticity. However, being that I am sharing with you the full gamete of syndromes affected by the brain-gut relationship, I can’t avoid this serious topic. Depression is very real and is currently one the top causes of mortality in the United States. I’m sharing with you some of my knowledge I have gained over the last 10 years studying functional nutrition and hormone balancing, as well as a some valuable books that I recommend reading (see bottom of article) if you have any concerns for yourself or your loved ones about brain function and gut health.

In Dr. David Perlmutter’s book “Grain Brain” he references a paper presented by C.J.L. Murray and A.D. Lopez to the World Health Organization stating that by 2020, depression will become the second largest cause of suffering, next only to heart disease. Perlmutter states that depression is the leading cause of disability worldwide (page 160).

I believe more and more people are suffering from undiagnosed depression, simply because the demands of our lifestyle today and the expectations we place on ourselves.  Our nervous systems are stressed and before we know it, this level of unhappiness becomes the new norm.  This impairment in brain function then leads to poor lifestyle choices.

I’m going to try to not get too technical here but this is important….(The frontal cortex!)
The part of the brain directly involved with depression is the frontal cortex. Why do we need to know this? Well, because it is the largest lobe of the human brain and it also defines our personality and governs our ability to reason, suppress impulses (violent behavior, ADHD), fine motor coordination (handwriting), mental sharpness, cognition (learning new skills, languages) and muscle coordination (sports, dance). Any impairment of these abilities as well as depression is an indication of frontal lobe involvement.  (So, make sure your bike and other sports helmets fit snugly over your forehead!)

Remember in Part 1, I talked about Neurotransmitters? (click here for that article)

According to Dr. Datis Kharrazian he states in his book “Why Isn’t My Brain Working” depression is simply the decreased firing of the front lobe and the frontal lobe is saturated with receptor sites for the neurotransmitter, serotonin. Poor serotonin activity leads to inner rage and anger, depression, inability to fall into deep restful sleep, depression from lack of sunlight, loss of pleasure in life. (pg 309). A diet including sufficient amino acid tryptophan is necessary for healthy insulin response. Tryptophan can be found in beef, liver, chicken, turkey, lamb, salmon, halibut, spinach, shrimp, scallops. People who constantly skip meals or who are hypoglycemic are at risk for low serotonin production because they cannot deliver enough glucose to the brain.

Dopamine, another neurotransmitter, has many functions in the brain including mood and motivation. It is associated with the “pleasure system” of the brain. Proper dopamine synthesis relies on a diet rich in the amino acid, phenylalanine (sources:  beef, fish, eggs, pork, chocolate, turkey, oats, cheese) as well as keeping a healthy blood sugar regulation (not skipping meals, eating sufficient protein in each meal). Insulin resistant and hypoglycemic individuals experience abnormal insulin spikes which lead to impaired dopamine synthesis.  Anemia, B6 insufficiency, folic acid impairment, methylation issues and liver disease can impair the action of dopamine in the brain.  Now wait a minute, before running out and stocking your cabinet with iron and B6 vitamins, I recommend you call a physician trained in functional nutrition. You want to first address the underlying mechanisms causing any nutritional deficiencies such as a leaky gut or infection.  In my practice, I use specific questionnaires to assess function of the different parts of the brain and brain health (neurotransmitter status) as well as a metabolic questionnaire. This enables a more specific recommendation in terms of supplementation, if any, and diet.
(Ok, notice how often I mention the importance of healthy blood sugar- insulin resistance and hypoglycemia? Keep reading!)

Coming Soon!  I will be posting a free self-test  for you to determine whether you may have nutritional deficiencies for the brain and signs and symptoms of brain function impairment. Stay tuned by following my blog (sign up for health articles) for the announcement.

Researchers and Scientists are saying your Gut is your Second Brain!
Well, by now we know the brain talks to the gut and the gut talks back to the brain! Good sourced probiotic supplements (I recommend dairy –free) in sufficient amounts support your healthy bacteria and in turn, influence your brain behavior. They are involved with producing, absorbing and transporting serotonin, dopamine and nerve growth factor.  The gut sends out hormonal signals to the brain relaying messages of fullness, hunger, and pain from intestinal inflammation. So now we see why it’s so important to have healthy gut!  Which strains of probiotics are essential? I recommend at least a variety of 10 strains but make sure it includes lactobacillus, acidophilus and bifidobacterium. At least ten billion per capsule at least one per day is a good start, however it is best to check with a functional nutrition practitioner for your specific needs.

LOW Cholesterol and Depression:
Dr. Perlmutter references a study in his book “Grain Brain” (page 162), which states there are numerous studies demonstrating depression runs much higher in people with low cholesterol (both dietary induced and statin-induced). I explain to my patients that ALL hormones are made from cholesterol. Skipping meals (hypoglycemics), insufficient dietary protein intake may put you at risk for low cholesterol. People taking statins are artificially lowering their cholesterol  and can become much more depressed and as well impair their ability to make sufficient vitamin D. Low vitamin D levels is not only linked to weak bones but also to higher risk of diabetes, cardiovascular disease and depression.  In my practice I have seen patients who present with low energy, lack enthusiasm, unmotivated and somewhat depressed and when I look at their labs, their serum total cholesterol is below normal. In functional nutrition a heathy total cholesterol level is between 150 and 199. Why is this important again? Cholesterol provides the precursors (building materials) to make phospholipids which are fatty compounds. These fatty compounds make up the majority of your brain!

GLUTEN Sensitivity and Depression:
Gluten sensitivity is a massive topic of discussion.  In terms of this article, I want to stress that gluten sensitivity is an immune response.  This immune response turns on inflammatory chemicals which can attack the brain. So, basically if the brain function is impaired, neurotransmitter function is impaired (remember, dopamine and serotonin?), leading to depression! Gluten sensitivity is not principally a disease of the small bowel as many think. In his book, “Why Isn’t My Brain Working?” (page 158), Dr. Datis Kharrazian states “No single dietary protein is  more potent trigger of neurological dysfunction and neurological autoimmunity than gluten (the protein found in wheat).”  All autoimmune disorders (Hashimoto’s Thyroiditis, Rheumatoid Arthritis etc) benefit tremendously from a gluten free diet.

There are a lot of mechanisms and factors impacting our mood. One of the underlying mechanisms that cause impaired brain function as you may have noticed is impaired blood glucose regulation. This is another important reason to eat at regular intervals (don’t skip) and eat sufficient quality protein.  Depression can cripple our ability to function on a day to day basis, not only impacting our lives but the lives of those around us. If you have any concern regarding mood, motivation, sleep, appetite, please contact your health care professional.  You may also contact me by clicking HERE to send a message.  The comprehensive brain function and brain nutrition questionnaires are used within my consultations.

Next Week’s Article: Part 4: Brain, Gut and its effect on the Thyroid

References and Resources:
I recommend two powerful and informative books on this subject matter: Grain Brain by Dr. David Perlmutter, 2013 and Why Isn’t My Brain Working? By Dr. Datis Kharrazian, 2013. Click HERE to visit my Amazon store for a direct link to these resources!