Dear Pharmacist,
Last week, you gave a ‘Dumb’ Award to “anti-depressant drugs and the doctors who prescribe them for every woman who is tired or tearful.” I struggle with depression, and my medications don’t help. Can you elaborate?  –D.D.  Tacoma, Washington

Answer: You and millions of other people will get shuffled from one psychiatrist to another, and one drug to another, and you will remain on the ‘medication merry-go-round’ until you feed your brain what it’s hungry for.

For many online readers who did not read my column last week, I will re-post my exact comments about anti-depressants and the dumb award here:

Dumber Award:   We have a tie between anti-depressant drugs and the doctors who prescribe them for every woman who is tired or tearful.  Of the various ‘happy’ chemicals naturally produced in our body, serotonin is the one most likely to be raised by anti-depressant drugs.  But research shows that depression may be caused by elevated stress hormones, low vitamin D levels, diabetes or insulin-resistance (diagnosed or not), low progesterone hormone, niacin or folate deficiency or exposure to plastics.  So what’s up with all the drugs? Their side effects are depressing if you think about it -problems achieving orgasm, low sex drive, insomnia, suicidal thoughts and heart palpitations.  Anti-depressant drugs don’t fix the underlying cause for neurotransmitter deficiencies and doctors should be conducting lab tests to determine the cause for emotional instability before prescribing pills and dismissing you.

I stand by these comments though I realize that my column left many readers curious about what they could be doing to improve their emotional health and ability to cope with stress.

Anti-depressants such as Zoloft, Prozac, Cymbalta, Celexa, Lexapro, Paxil, Wellbutrin, Effexor and so forth, DO help some people, and I am not going to knock these very effective drugs.  That said, as a class, these medications are incapable of correcting underlying nutritional deficiencies, hormonal imbalances or neurotransmitter imbalances.

Medications artificially -and temporarily- lift brain chemicals, and they have numerous uncomfortable side effects that some people experience during treatment.  The most common side effects associated with prescribed drug therapy may include nausea, insomnia, constipation or diarrhea, low appetite, headache, weakness, restlessness, trembling, shaking, abnormal dreams and changes in taste perception.  Sexual dysfunction is another real problem associated with prescribed anti-depressants, although some drugs are less disruptive than others.  Problems such as decreased sex drive, inability to climax are two common issues that cause people to go off their medications.  It gets a little more disturbing when you think about pediatric patients who are taking prescribed anti-depressants.  Only after many years of prescribing, the Food & Drug Administration (FDA) conducted a review (2004), and they studied 2,200 children treated with SSRI anti-depressants.  They found that children taking the SSRI medications experienced suicidal thinking and thoughts of self-harm, suicidal attempts at TWICE the rate of those taking placebos (sugar pills).  In response, they decided to strengthen safety warnings and forced drug makers to place a “black box” warning on these drugs alerting prescribing physicians that these medications may increase the risk of suicidal thinking.

There is a press-release entitled “FDA Launches a Multi-Pronged Strategy to Strengthen Safeguards for Children Treated With Antidepressant Medications” which can be read here:

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2004/ucm108363.htm

The intention of this column is not to frighten you, or shock you, it is to help raise awareness for dietary supplements and vitamins and herbal extracts which could be effective and safer than medications.  Everything you read here, needs to be fully discussed with your doctor.  One more thing, as you are reading this, you may be tempted to just stop your anti-depressant medication but DON’T.  Never suddenly stop prescribed medications based on anything I say, especially with anti-depressants because you could suffer dangerous withdrawal side effects. Ask your doctor to help you wean off if you are determined to get off prescribed drugs, don’t just suddenly stop them.  Some integrative medical doctors help their patients get through the withdrawal effects by advising them to begin natural anti-depressant nutrients/herbs (which I’ll get to in a minute) while weaning off the prescription drugs, but again, getting off prescribed anti-depressants and on to natural ones is between you and your physician(s).  I am only providing education for you.

And while I’m educating you about depression, I found an interesting section in the book, Dr. Bruce Lipton’s book “The Biology of Belief” (Hay House 2008).  I’ll quote straight out of his book:

“In a 2002 article in the American Psychological Association’s Prevention & Treatment,  “The Emperor’s New Drugs,”  University of Connecticut psychology professor Irving Kirsch found that eighty percent of the effect of antidepressants, as measured in clinical trials, could be attributed to the placebo effect. (Kirsch, et al 2002)

Kirsch had to invoke the Freedom of Information Act in 2001 to get information on the clinical trials of the top anti-depressants:  these data were not forthcoming from the Food and Drug Administration.  The data show that in more than half of the clinical trials for the six leading anti-depressants , the drugs did not outperform placebo, sugar pills.  And Kirsch noted in a Discovery Health Channel interview that “the difference between the response of the drugs and the response of placebo was less than two points on average on this clinical scale that goes from fifty to sixty points.  That’s a very small difference.  That difference clinically is meaningless.”

Having fresh perspective on this really makes you question the value of medications and if they honestly can help enhance mood, improve emotional wellness or mental stability.  If this is true, and you are suffering day to day, and questioning your life on Earth, then do read on.  I may have some eye-opening possibilities for you, that really work!  Keeping it very simple, I’m going to give you a brief characterization of each brain neurotransmitter/hormone so you will see how important these compounds are.  Let’s meet the primary players in emotional wellness:

Serotonin
Serotonin is famous as the neurotransmitter/hormone that is most often ‘lifted’ by pharmacological drugs known as Selective Serotonin Reuptake Inhibitors (SSRI’s).  It is synthesized from tryptophan via chemical reactions. Serotonin is thought of as a brain hormone, but surprise… 80% of this so-called “happy” brain chemical lives in your gut, and when you eat food, gut cells known as the enterochromaffin cells release the serotonin so your digestive tract contracts. Serotonin happens to help us regulate GI function, but it also improves mood, learning, memory, cognitive function, self esteem and feelings of joy.  Lifting serotonin could relieve pain too.  Numerous prescribed antidepressants work along this pathway. Serotonin is a “monoamine” (MAO) neurotransmitter that is also targeted by many anti-psychotic, anxiolytic and anti-migraine medications.  You are supposed to be able to make serotonin naturally in your body, but you can’t if you become deficient in certain nutrients, vitamins or amino acids. Our serotonin levels are affected by diet, no surprise here. An increase in the ratio of ‘tryptophan to phenylalanine and leucine’ will increase serotonin levels. Fruits with a good ratio include dates, papaya and banana. And this is interesting.  Foods with a lower ratio of these amino acids inhibit the production of serotonin and therefore leave you at greater risk for depression. These foods include whole wheat and rye bread. One more reason to eat gluten-free (but haven’t I asked you to do this a hundred times over the years?)

Norepinephrine
Norepinephrine is primarily responsible for communication between your nerve cells, and also for your ability to experience the famous “fight or flight” response. Norepinephrine is sometimes shortened to norepi (pronounce “nor- epee”) and it is synthesized from dopamine, another neurotransmitter that affects mood.  Norepinephrine is associated with arousal levels, and so too much of a good thing can cause worry, anxiety, phobias, restlessness, fears of crowds, insomnia and so forth.  Too much norepi can also increase heart rate and blood pressure -this can be dangerous. Finally, too much norepi has been tied to panic attacks and it’s easy to see why.  Balance between all your brain hormones are crucial to emotional wellness.  With depression, you have to think imbalance of norepi to other brain hormones, or perhaps too little norepi production.  When you fail to produce enough norepinephrine, you may find it harder to focus and pay attention (think attention-deficit… and in fact, many ADHD drugs lift this chemical).  Low levels of norepi are also associated with poor memory, depression, low levels of arousal,

GABA

A brain neurotransmitter that helps us relax. This substance has to be in balance with glutamate or mood suffers. GABA is involved in sleep too. GABA is a quieting hormone, and for this reason it is useful in helping to prevent seizures (an excitatory state).   Deficiencies of GABA could lead to trouble coping, feeling anxious, stressed out or depressed.   You can buy dietary supplements of GABA at any health food store nationwide and many people take this with good effect.  The big debate is whether GABA supplements really work because the molecule is very bulky and can’t penetrate the blood brain barrier.  This reminds me of shopping last week, I watched a lady who was clearly a size 8 shoe struggling and practically breaking sweat to squeeze her foot into a size 6 and 1/2.  Ain’t gonna happen!   It’s the same with GABA, it can’t get through the blood brain barrier very well.  Soon enough, I will tell you which two inexpensive nutrients get into the cells, and allow you to produce the GABA yourself.

Dopamine

Dopamine is your pleasure hormone, it is associated with feelings of happiness, even more so than serotonin in my opinion.  Dopamine is the chemical most associated with rewards and enjoyment, it gives us that ‘high’ so-to-speak, which then causes us to want to keep doing a particular activity. Think compulsive gambling, sex and so forth.  Cocaine happens to stimulate levels of dopamine too.  As it pertains to depression, it is the imbalance of this hormone to the others, or a decreased ability to utilize it, or produce it.  So low levels of dopamine are associated with depression and when you give the body precursors (such as tyrosine or levodopa) the effects works very fast, much faster than prescribed anti-depressants which usually take 4 to 8 weeks to exhibit optimal effects.  Dopamine is the substance that is associated with Parkinson’s disease (low levels) and schizophrenia (higher than normal levels).  Drugs that are ‘dopaminergic’ meaning they behave like dopamine act outside the brain, not inside.  In other words, if you want to increase brain levels of dopamine, you can’t give it as a drug, you have to give precursor nutrients and amino acids so they can slip inside the ‘blood brain barrier’ get into the brain and then the brain can ‘bake the dopamine’ out of the recipe ingredients that you provide.  Got it?

Now, how about some solutions?

With your physician’s approval, you can try one or two of the dietary supplements below, or you can buy a combination formula for enhanced effects.  A combination ‘multi-tasking’ formula may be more cost-effective too, and there are several high-quality brands to think about.  One of them is Deproloft   which I will talk about at the very end of this column.  It is sold nationwide through doctor’s offices (they must order for you), or you can buy it online yourself anywhere, and at the maker’s link: http://www.thorne.com/Products/Mood-Sleep-Support/prd~SF743.jsp

For some people, even one or two of the substances below can have a positive impact on mood. The reason is that some of the compounds below (such as Vitamin C or 5-MTHF) are needed to drive a chemical reaction in the body that forms our mood-boosting hormones.  Without these simple, inexpensive nutrients, the chemical reaction comes to a screeching halt so the  mood-boosting hormones don’t form.  See, it’s very simple chemistry but unfortunately, the vast majority of physicians are educated at conventions that are pharma-funded so it’s all about the next best drug, rather than simple biochemical reactions.  I’ll give you some new perspective and natural choices.  All of these are available over-the-counter, at many health food stores, some pharmacies, online or through your physician’s office.  Here we go:

Vitamin C- You need vitamin C to make dopamine, norepinephrine and serotonin.  Without C, you will run low on these crucial happy brain chemicals.  Did you hear that? Inexpensive, over-the-counter vitamin C can be tremendously useful in helping you make more happy brain chemicals.  I need to be clear however, supplementation with vitamin C is just one option, you need many other nutrients to make these chemicals, so it’s not just about C levels.  Vitamin C is sold everywhere nationwide.  Buffered forms seem to be less irritating to the gut.  Dosages vary (500 – 2,000 mg ascorbic acid per day should be okay, ask your doctor).  Also, an herb called “Camu Camu” is a fantastic way to get natural vitamin C.  It is a dietary supplement that is extracted from the Camu Camu berry and it is probably THE richest source of vitamin C, botanically-speaking.  You can find vitamin C at any health food store and pharmacy, the Camu Camu is a little bit hard. This is not a commercial, I just want to give you some of the best options.Here are two sites that I have purchased some from myself:
1. Whole World Botanicals “Royal Camu” http://www.wholeworldbotanicals.com/info_royalcamu

2. Live Superfoods
http://livesuperfoods.com/powders/LSF055.html

Vitamin B1-It has an important effect on the release of serotonin and norepi. The body uses this vitamin to help convert glucose, into fuel and if there isn’t enough, you can develop fatigue, depression, irritability, anxiety, and even thoughts of suicide. Deficiencies can also cause memory problems, low of appetite, nervousness, psychosis, insomnia, and gastrointestinal disorders.  People who drink alcohol (even one glass a night) are usually deficient in this B vitamin. (There is a lot more information about vitamins like thiamine (and symptoms of deficiency in my Drug Mugger book sold at Amazon. Here’s the link: http://www.amazon.com/Drug-Muggers-Keep-Medicine-Stealing/dp/0981817319/ref=sr_1_1?ie=UTF8&s=books&qid=1264347483&sr=8-1 ).  A typical thiamine dosage is 100mg daily, but sometimes it is best to take B1, along with other B vitamins so you have all the Bs on board. This is fully explained in Drug Muggers. The idea is to not tilt the other Bs out of balance when you take full dosages of one particular B.

5-MTHF- It’s another B vitamin and B vitamins play a crucial role in helping ease and prevent depression.  B vitamins cannot be stored in the body, they have to be taken in, through food or supplementation. This B vitamin is the biologically active form of folic acid and 5-MTHF is worth hunting down. It helps make happy brain chemicals. Why not just take folic acid? Because many people have a genetic problem turning folic acid into 5-MTHF and so they become deficient. If you become deficient, you will not be able to form happy brain chemicals properly and so you may become depressed or develop a serious type of mental health disorder that would be improperly diagnoses. A prescription version of this is sold at pharmacies, called Deplin so you can see that folic acid, and more specifically 5-MTHF is crucial to mood, so much so that drug makers even recognize it’s value. I’ve got a smart bunch of readers so I’m going to give you just a tad more science (in case you want to discuss this with your doctors)…. 5-MTHF happens to help you ‘methylate’ which just means that it helps you to detoxify.  Because it helps you to methylate (pronounced “meth-ill-ate”) it converts this toxic chemical called “homocysteine” into something useful called “methionine.”  Taking it one step further, your body converts the methionine into S-adenosylmethionine or SAMe (pronounced “sam-ee”).  Guess what, SAMe is known to relieve depression and is well-studied.  The point is, if you have no 5-MTHF, you can’t make natural SAMe in the body.  SAMe is sold at health food stores and pharmacies nationwide, or I would offer you an online link to help you.  It’s easy to find/buy, although many practitioner’s feel that it’s action on the body may be short-lived and that it’s highly unstable.  SAMe fine to take, and effective as far as I’m concerned but I think taking 5-MTHF is better overall. Further, 5-MTHF helps you to process estrogens more safely (it helps you form higher levels of 2-methoxyestradiol, which is thought to be an anti-cancer form of estrogen).  There is more about this in my new ebook, “Breast Cancer Protection” sold at my website (http://dearpharmacist.com/?page_id=832 .  If you are concerned about breast or prostate cancer, this ebook could save your life. It will teach you about 8 different natural supplements that you can buy over-the-counter.

Niacin- If you run out of this B vitamin (vitamin B3) it could produce serious mental health problems including psychosis and dementia. Niacin (B3) is involved with the dopamine transmitter pathway.  Deficiencies of vitamin B3 can produce agitation and anxiety, as well as mental sluggishness, schizophrenia and depression. Holistic practitioners often recommend vitamin B3 (niacin) as part of a treatment plan for psychiatric problems, including schizophrenia.  One more thing, niacin deficiency can also cause high cholesterol so if you are depressed and have high cholesterol, you may have an undetected (subclinical) niacin deficiency.  It’s usually save to take niacin, although many people experience a hot-flushing sensation, but you should make sure you have your doctor’s approval.  He may want to order a specialized nutrient test on you (such as those offered by SpectraCell or Genova Diagnostics) to see if you are clean out niacin, or any other nutrient.  Here are their websites and phones so you can plug in your zip code and find a provider near you.  Also, any doctor can become a provider if they choose, just have to fax in a license:
SpectraCell http://www.spectracell.com/   800-227-5227
Genova Diagnostics: http://www.genovadiagnostics.com/    800-522-4762

Glutamine & Vitamin B6 (taken together)- Some practitioners suggest taking L-glutamate capsules along with vitamin B6, because those two ‘ingredients’ make up the recipe for your body to make GABA.  The glutamine and B6 slip easily into the cell, and that’s when the cooking starts.  Both glutamine and B6 are widely available at health food store. Ask your doctor what dosage is right for you.

Magnesium- Some people think that replenishing magnesium could be the cure for depression without doing anything else.  I agree that magnesium is powerful when it comes to mood enhancement, but I’m not convinced that it’s all you need.  Magnesium has a role in minimizing migraine headaches too, Without enough magnesium to keep an eye on serotonin, serotonin starts to overact and constricts blood vessels and releases pain chemicals such as substance P and prostaglandins, contributing to migraines. Normal magnesium levels help to prevent the release of these pain chemicals and also blunts their effect.  Clearly magnesium plays an important role in the brain.  It also helps the body manufacture brain neurotransmitters.  The biggest issue I have with magnesium is how doctors measure it.  They mistakenly take serum magnesium levels, but this needs to be measured intracellularly.  You can find magnesium supplements at health food stores nationwide.  If you want to take this orally, I prefer you get the chelated version, it will say “magnesium chelate” or “amino acid chelate” on the label.  Magnesium glycinate is another form that is easy to absorb from the gut.  I think the easiest way to get magnesium is through the skin.  For real.  Magnesium goes right through the skin.  I just bought a spray bottle from “Ancient Minerals” and it works really good.  You can apply it to your skin, and this is cool… it can be sprayed on you while you are getting a massage because magnesium has a muscle relaxing effect on the body.  So it helps your mood, and your muscles, and also blood pressure.  This is the brand I bought, but if you find another good one, please let me know: http://www.ancient-minerals.com/?gclid=CMfJs_yXvJ8CFRghnAod4zcIMA#magnesium_oil

Tyrosine and Iodine- These substances help you make thyroid hormone and low thyroid is a common overlooked cause for depression.  Tyrosine also happens to be a precursor to the brain chemical, dopamine which is your ‘happiness’ hormone.  Tyrosine is sold widely at health food stores, and so is iodine.  I like the brand called “Iodoral” because it is a combination of iodine and iodide so it’s a more natural type in my opinion.  I usually have to buy mine online or at local compounding pharmacies because I can’t find it at chain pharmacies.  I found it at Amazon.com http://www.amazon.com/Life-Extension-Iodoral-180-tablets/dp/B002R3EFFO) and you can google this online to find other sources.

Eleuthero extract- This is also called “Siberian Ginseng” adaptogenic herb which helps the body cope with stress, while improving concentration and feelings of well-being. It’s an herb that has been used in Chinese medicine for over 2,000 years.  You won’t get an overnight effect with this one, you have to take it for several months, and you have to make sure you have a high-quality source (many brands are adulterated).  This botanical can help reduce fatigue and increase stamina.  Eleuthero is thought to relieve depression by nourishing the adrenal glands.  This is incredibly important and many traditional doctors don’t pay much attention to worn out adrenal glands.  Women who are tired, stressed and juggling a job, kids, debt, caregiving, etc. etc. tend to burn out their adrenal glands and just need nourishment for them, in order to feel well again. Drugs won’t help.  Eleuthero to the rescue. It is beneficial when the HPA (hypothalamic-pituitary-adrenal axis) is depleted, and the symptoms of which include fatigue, stress, weakness, memory loss, and sore muscles associated with the low functioning of the endocrine system.  Eleuthero can help balance dopamine, norepi, epinephrine and serotonin.

Progesterone- Progesterone is made in the body, it’s not the same as the drug Provera.  Natural progesterone has a calming effect and balances estrogen which has more of a stimulating effect.  A healthy woman will have the proper ratios of these each day of the month, and the ratios fluctuate depending on the time of the month, and the age of the woman. Progesterone is produced in women along with estrogen during the reproductive years and is often referred to as the ‘great balancer’ due to its important role in keeping estrogen and overall hormone levels in balance with one another.  Around the age of 40, your hormone balance changes in preparation for menopause which usually occurs around the age of 50. During these 10 years, estrogen levels fluctuate erratically and eventually decline to half of your youthful levels, but progesterone which is needed to keep estrogen in balance, can plummet to nearly zero.  The condition of progesterone deficiency is sometimes referred to as “estrogen dominance.” You can tell if you have this problem by symptoms most of the time.  Women are deficient in progesterone (estrogen dominance) may develop anxiety, depression, irritability, hot flashes, night sweats, weight gain, insomnia, osteoporosis & low sex drive. Pre-menopausal women may have PMS, breast tenderness, migraines, mood swings, bloating, and heavy periods.  Doctors may want to conduct hormone testing to detect the imbalance and this may include urine, blood or saliva analysis.  My fear is that they will fail to tell you that natural progesterone is available over-the-counter, and instead, prescribe a medication which only mimics the effects, and causes dangerous side effects.  Natural progesterone is sold at health food stores, as a cream which you can apply to your skin.  And it’s also available to doctors (and you) through compounding pharmacies, but bear in mind that bio-identical progesterone is not the same as synthetic medications like medoxyprogesterone, Provera or PremPro.   Those are not bio-identical so if your doctor tells you that you need this hormone, buy it OTC and apply it to your skin on the neck, chest, inner arms, breasts or thighs.  Dosages are on the bottle.  Natural cream versions (sold OTC) may lift depression if it’s related to estrogen dominance (progesterone deficiency).  If you apply progesterone and find that your hot flashes worsen, that usually means that you need to work on fixing your overworked adrenal glands for a few months, and calm the estrogen down, before trying the progesterone again.   I really like Emerita’s brand “Pro-Gest” because it is paraben-free and contains vitamin E, sweet almond oil and other natural ingredients.  You can buy it at most health food stores, and if you want to learn more click on their website: http://www.emerita.com/

Vitamin D- People with depression or SAD (seasonal affective disorder) are usually deficient in vitamin D.   I could write a book on this one.  There are many many studies to prove that D deficiency is associated with depression and the vitamin/hormone is sold OTC.  It has a profound effect on balancing the brain neurotransmitters mentioned above.  There is a little debate over the what the healthy range is but you can have it measured.  If it’s less than 50 ng/ml, I would start treatment.  Most traditional doctors would not agree with me, and would say that if it’s less than 35 ng/ml, begin treatment.  The best form of vitamin D to take is D3, or cholecalciferol.  It will say this on the label.  A typical dosage that could help you if you have depression would be 2,000 to 10,000 IU per day, taken in the morning.  To learn more about vitamin D and it’s relationship to depression, go to this website, The Vitamin D Council: http://www.vitamindcouncil.org/depression.shtml Another good source for vitamin D is cod liver oil.  There are good-tasting versions available at most health food stores, plus there are softgels so you don’t have to take a liquid if you don’t want to anymore.

Essential Fatty Acids- These are good fats. A common sign of deficiency of essential fatty acids (EFAs) is depression.  The EFAs offered by fish oils, krill oil, flaxseed, hempseed and cod liver oil all offer something special to help improve communication of the nerve cells, and help nourish the cell membrane which is extremely important in brain function and emotional wellness.  If the cell membrane isn’t healthy, it can’t get rid of wastes, and it can’t properly send nerve signals.  There are studies that hint that EFA therapy may be better than drug therapy. No surprise to me.  If you want to take fish oils or cod liver oil, try about 1,000 mg once or twice daily with food.  Nordic Naturals makes a very high quality brand (free of impurities) which is sold pretty much everywhere. In case you can’t find it, or you live remote, you can just go to their website: http://nordicnaturals.com/
To bring in flaxseed, go to your health food store and buy some ground flaxseed (or buy the seeds and grind them yourself in a coffee bean grinder).  Sprinkle about 1/2 a tablespoon every day.  Additionally, buy hulled hemp seeds.  I love this, and eat about a tablespoon every single day!  These are also sold at health food stores, and they taste amazing.  Larger health food stores carry hemp seed oil, and hemp seed butter.

5-HTP- Tryptophan is an essential amino acid. Your body can’t make it.  When you get tryptophan from foods and supplements, your body converts it to 5-hydroxytryptophan, or 5-HTP.  You can also buy supplements that contain 5-HTP, either as a stand-alone product of 5-HTP, or a combination formula that contains a little bit of it.  Why does this matter so much?  Because 5-HTP goes through the blood brain barrier and gets into the brain.  It gets converted to serotonin there.  If you recall, serotonin is one of your brain neurotransmitters.  If you want to make this conversion process easier, take 5-HTP with some vitamin B6 which pushes the reaction along faster.  Vitamin Shoppe makes a good brand called “5-HTP with B6” and so does Doctor’s Best called “5-HTP Enhanced with B6 and C.”  A typical dosage range is 50mg – 300mg, follow label directions for the product you buy.

Save MONEY, and take a GREAT combination formula

Deproloft- This is a combination product made by Thorne Research. I like this company because  they do not use magnesium stearate in their products, an inert ingredient used to make supplements that some people are sensitive to.

Deproloft is sold online at Thorne Research, one of the world’s premier nutraceutical companies and they ship all over the world.    Order at

http://www.thorne.com/Products/Mood-Sleep-Support/prd~SF743.jsp

or call 1800 228 1966

The ingredients include many of those mentioned above, as well as St. John’s wort and Rhodiola, two fantastic botanicals when it comes to mood enhancement.  What I like in particular about this product could work from so many different angles,  it may ease depression if it is the result of any of the following problems:

—Low thyroid  (it contains iodine and tyrosine)

—B vitamin deficiency (or genetic defects that don’t activate the B vitamins, all the Bs are active as in 5-MTHF and P5P rather than B6)
—Adrenal fatigue (it has adaptogenic herbs like eleuthero, rhodiola)

—Low dopamine, norepi, serotonin or GABA (it offers the precursors to these hormones so you can make it intracellularly).

This is a great product, I have tried it myself to see effects and for me, I noticed effects after just a couple  of weeks  I confess, I don’t take this chronically because depression is not something that I suffer from, however, when I tried this product, I really liked the ‘calm alertness’ and more refreshing sleep that I got.  My friends who need it, and take it refuse to ever go without it.   Important savings worth mentioning-It’s approximately $35 for 120 caps, so Deproloft is more cost-effective than trying to buy each ingredient buy itself.  The dosage is 1 or 2 capsules once or twice daily. Read the label to be sure.  If you take Deproloft, you may not need anything else but in case you do, add in omega 3 fatty acids (fish oil) for even more mood enhancement.  You could also bring in vitamin D, however, the Deproloft all by itself is very effective.

Vitamin C (as Ascorbic Acid)

Vitamin B6 (as Pyridoxal 5′-Phosphate)

Folate (as 5-Methyl-tetrahydrofolate)

Vitamin B12 (as Methylcobalmin)

Iodine (as Potassium Iodide)

Rhodiola extract (root) (Rhodiola rosea)

St. John’s Wort extract (flower) (Hypericum perforatum)

Eleuthero extract (root) (Eleutherococcus senticosus)

L-Tyrosine

5-Hydroxytryptophan

Gamma-Aminobutyric Acid (GABA)

Pantethine

Amoryn- I have not tried this formula, but it looks great on paper.  It is a combination product that contains B6, B12, Folate, vitamin D3, St. John’s wort, 5-HTP, selenium, zinc and others.  Here’s the link so you can take a look for yourself. If you try this, please give me your feedback about it.  I think this one can also address feelings of depression from various different angles, just like Deproloft.
The link online is: http://www.natures-remedies.com/fastpage/fpengine.php?templateid=12&menuid=1&editstatus=&tempidx=6&restemp=b%3A0%3B&catid=1&fPpagesel=2
It is a New Zealand product, so shipping to America may be very high.  I’m including it because I have many friends overseas, especially in Australia and New Zealand, so this particular product may be ‘local’ to you.

With any dietary supplement, ask your doctor if it is right for you. Remember, if you are feeling blue, there is always something you can try.  Please don’t give up.  Know that you are loved and needed, and for every door that closes, another opens.  The wheels of life keep turning.  Please -no matter how desperate you feel- know that there are options.  I’ve done the best I can to list the most effective, well-researched items, and there are more that are not even listed here.  If you are feeling overwhelmed because I’ve mentioned so many choices for you, then try one of the multi-tasking combination formulas (such as Deproloft). If you are not feeling any better after about a month, add in some fish oils.  If that doesn’t help you, get your hormones tested and see if your estrogen/progesterone ratios are off (or DHEA/cortisol)….. and if those are all normal, ask your doctor to check your thyroid hormone levels.  You may be have hypothyroidism.

Did You Know?
A new injectable prescription drug, Actemra has just been approved for rheumatoid arthritis. Here is a link to read more about this new medication: http://arthritis.about.com/od/brms/a/actemra.htm

Dear Readers,

After I presented last year’s dumbest healthcare ‘awards,” I received your emails and chuckles for months afterwards.  Sometimes, ridiculous things happen in the medical industry, so at this time, I’d like to present my second annual ‘Dumb Awards’ in Medicine:

Dumb Award: The first ones goes to (drum roll please)… the Federal Communications Commission for allowing both pharmaceutical and fast-food commercials to blast our airwaves. Just chill out, squeeze some Cheez Whiz on your foot-long sub, and watch “The Simpsons.” During commercial breaks, all of the disorders that afflict your friends and relatives (not you) will become apparent. Watch TV with new eyes okay? You will first notice lots of junk food commercials -which promote disease- followed by drug commercials and attorneys offering their services to people injured by drugs.  Eventually, the news comes on so you can learn about the newest approved drug. Hysterical!

Dumber Award:   We have a tie between anti-depressant drugs and the doctors who prescribe them for every woman who is tired or tearful.  Of the various ‘happy’ chemicals naturally produced in our body, serotonin is the one most likely to be raised by anti-depressant drugs.  But research shows that depression may be caused by elevated stress hormones, low vitamin D levels, diabetes or insulin-resistance (diagnosed or not), low progesterone hormone, niacin or folate deficiency or exposure to plastics.  So what’s up with all the drugs? Their side effects are depressing if you think about it -problems achieving orgasm, low sex drive, insomnia, suicidal thoughts and heart palpitations.  Anti-depressant drugs don’t fix the underlying cause for neurotransmitter deficiencies and doctors should be conducting lab tests to determine the cause for emotional instability before prescribing pills and dismissing you.

Dumberest Award: Yes I spelled “dumberest” that way on purpose, and please throw confetti here… The Centers for Disease Control, who in September 2009, recommended that “All people with suspected or confirmed influenza who require hospitalization be treated with Tamiflu or Relenza.”  By December 2009, based on a number of scientific studies, scientists concluded that the benefits of this anti-viral treatment were grossly over-estimated, because it could only shorten the length of illness by approximately one day.  Whoop-dee-doo! Potential side effects include: Vomiting, diarrhea, abdominal cramps, arrhythmias, nightmares, dizziness, headache, fatigue, delusions, hallucinations, altered level of consciousness, and seizures. Spare me.

Honorable Mention: To Kellogg’s for making packaging claims last May to the effect that Cocoa Krispies can boost your child’s immune system. They timed their campaign around the swine flu  outbreak so parents would know what to feed their kids (wink). I agree with Kellogg’s that increasing the amounts of vitamins in food can promote health, but even the FDA viewed the Kellogg’s claim as ridiculous and made them stop. What’s next, soda pop posed as healthier because it’s made with cane sugar instead of high fructose corn syrup? Hurry, hurry, for a limited time you can now buy Pepsi-Cola Throwback.   Puhleeze!

Dear Readers,

Americans deem January 1st as a magical day to help us kick bad habits. The frenzy of self-improvement begins at the stroke of midnight on December 31st when everyone sings “Auld Lang Syne”  though no one knows what the song means. All this partying makes people sick during the festivities, and email me the next morning about what to take for the hangover.  Personally, I think the song should be, “Who Let the Dogs Out.”

Fine, call me Scrooge because New Years is no big deal to me. I’m much happier tucked in my jammies at midnight than boozing myself into oblivion and throwing up on my Macbook. Don’t you think it’s ridiculous that people suddenly become resolute and make promises to themselves (or others) while inebriated, hoping to find a designated driver? I mean seriously!

How to lose weight or quit smoking are the two most frequently asked questions that I receive for my syndicated column each year. My answer is always the same, “Choose to.” The idea of staying thin, not smoking, reducing stress, and remaining debt-free are great concepts. Honor these concepts every day, not just January 1st and next 3 weeks until you give up.  If you realized that every day was sacred, it would take the pressure off and you would make a firmer commitment rather than procrastinate until January and fail by February.

You have the power to do anything you choose to, at any time. I don’t know anyone that has made a New Years resolution and stuck to it.  I do however, know people that made a resolution on some other day and succeeded. For example, a man who quit smoking after a heart attack,and a woman who decided she loved her daughter more than junk food and lost 45 pounds. Years ago, I decided to limit contact with ‘friends’ who constantly complain about their drama but refuse to take solutions or change their circumstances. Resolutions such as these should be made for good reasons, not just because it’s New Years. I am certain that many situations and health matters can be healed.  It doesn’t require a prescription, patch or pill – it requires a choice.  I’d like to propose my 5 steps to make positive changes in your life:

1. Choose what you want for yourself (this is often different than what your spouse wants for you). It’s okay if you need assistance from a personal trainer, a weight loss center, a physician,   dietary supplement, etc.

2.  Believe that you deserve.

3.  Consistently make choices that support your new decision.  At every meal, or every family gathering, you  may have to make a choice.

4.  Surround yourself with people who support your choice, not sabotage it.

5. Ignore the incessant mind chatter -it’s your primary obstacle.  Keep repeating, “My healing is  in progress,”  or “I can do it.”  My research suggests that staying positive like this has one primary side effect – miracles!

Dear Readers,

Here are the most interesting FDA-approved items for 2009.  I wish you all a very happy new year!

Adcirca (tadalafil) tablets, Rx: Sex pills may help you breath easy!  Adcirca is just Cialis renamed. It treats pulmonary arterial hypertension (PAH) which causes excessive pressure in the arteries of the lungs. PAH symptoms include chest pain, dizziness, leg swelling and feeling lightheaded during mild exertion.  Take a guess what the most prominent side effect of this drug is. If you can’t figure it out, your wife will.

Mycocide Nail Fungus Test Kit, OTC:  The first at-home screening kit to help you diagnose toenail/fingernail fungus -though most people see a yellow-green discoloration.

Qutenza (capsaicin 8%) transdermal patch, Rx:  A strong skin patch of chili pepper extract used to treat nerve pain from shingles (PHN). One patch works for 3 months. Lower dose capsaicin patches are sold at most pharmacies.

Besivance (besifloxacin), Rx:  Eye drops which treats eye infections like ‘pink eye.’

Savella (milnacipran), tablets, Rx:  Used for fibromyalgia, this medication works similar to the  anti-depressant, Cymbalta.

ClearEars, solution, OTC:  For people prone to swimmer’s ear, this product may dry your ear before infection occurs.

Ulesfia (benzyl alcohol) lotion, Rx: An insecticide-free lice treatment which basically asphyxiates the lice to death.

Gelnique (oxybutynin) gel, Rx:  It’s the skin cream version of the oral drug called Ditropan, which treats overactive bladder, incontinence or urgency.

Kapidex (dexlansoprazole) capsules, Rx: When Prevacid lost it’s patent and went generic this year, the makers launched an extended-release version of the same drug, giving you longer-lasting relief, and them too!  It treats severe heartburn, esophagitis and GERD.

Vectical (calcitriol) ointment, Rx:  It’s just vitamin D for your skin, used to treat psoriasis. A different drug, Stelara (ustekinumab) injection, also got the thumbs up from the FDA this year.

Lysteda (tranexamic acid) tablets, Rx:  It’s an anti-clotting drug used in women with heavy periods.  While I don’t discount the effectiveness of this medication, I still feel it’s more important to address the underlying hormonal imbalance of menorrhagia (which is often excess estrogen or progesterone deficiency).

Uloric (febuxostat) tablets, oral, Rx:  Used to manage gout (excessive uric acid).

Zegerid OTC (omeprazole and sodium bicarbonate) capsules:  It used to be prescription only. This combo drug marries Prilosec with sodium bicarb (baking soda) for serious GI problems.

Pennsaid (diclofenac sodium) solution, Rx:  Rub it on your knee for arthritis pain; it’s the same ingredient used in Voltaren tablets.

Dysport (abobotulinumtoxinA), injection, Rx:  It’s similar to Botox  and can smooth frown lines and treat cervical dystonia.

Twynsta (amlodipine and telmisartan) tablets, Rx:  This combination drug treats hypertension; it’s the marriage of Norvasc with Micardis in a single pill.

Afinitor (everolimus) tablets, Rx:  It may slow the growth of kidney cancer.

Apidra (insulin glulisine), injection, Rx:  This insulin helps control mealtime blood sugar spikes, and it works fast so make sure you have glucose tablets on hand in case you get hypoglycemic.

Dear Readers,

Since this column prints during the holiday season, I’ve decided to write about the greatest gift we an give, love. Experiencing love can make you feel better because it causes you to release endorphins. In a day and age where prescribed anti-depressants are top-selling drugs, a little love can go a long way.

If you think about it, hearing “I love you” is important but it really must be supported with actions. For example, when you arrive home, your dog shows you love at the front door. It licks you, jumps all over you and wags its tail so hard it could break a hip. It never says the word love, but is there any doubt in your mind how much you are loved by your pet? Likewise, your dog could care less if you say “I love you” a thousand times because this feeling is demonstrated when you give it a pat, a belly scratch or a doggie bone. Do you see now that love has to be supported by actions in order for the feeling to be conveyed?

When you experience loving thoughts, feelings or memories, your heart rate and breathing patterns improve. Brain waves deepen and intensify too, and the positive effects of relaxation, meditation and focused positive thinking has been well studied.  For sure, feeling loved by those around me gives me longer-lasting euphoria than any drug I can think of.

Most of us believe that we act kind and loving throughout the day, but do we? Take notice of your own attitude while you’re driving, shopping, or checking out. Some relatives or friends end their phone call or visit saying “love you” yet they show little interest or compassion for your life. Sometimes they only act nice when they need something. Do these people honestly love you, or do they just say they do? Actions speak louder than words.

Let’s express more kindness to people instead of behaving as if we are the stars of our own movie and everyone else is just an extra. If we didn’t use the word for a day, but relied solely on our behavior, would people walk away from us feeling loved? Some might.  Recently, I gave a hand-made gift to a person who works at a local shop. She always has goodness emanating from her when I check out. My gesture was to say thank you for being such a beautiful soul though I never said that, nor did I say I loved her. She became teary-eyed and hugged me long and hard. She may have received the present, but I got the gift. The story of your life eventually gets summarized to a dash between two very important dates. Make that dash matter because it is what everyone will remember about you.  So what is my prescription for you? Just love.

Dear Pharmacist,

I celebrate Hanukkah and my husband celebrates Christmas?  Why am I telling you this?  We both have big families and the food doesn’t stop for 2 weeks solid!  I have worked hard all year to lose 24 pounds and I’m scared to gain back all the weight. Any ideas?  –P.D.  Hollywood, Florida

Answer:  Since you’ve had years to practice juggling holiday buffets (just like me) you can hoard the matzoh balls like a gerbil while you drive to the next house for some holiday turkey.   For sure, the makers of Tums, Prilosec and Imodium are delighted this season because everyone has indigestion, heartburn or diarrhea.

I think it’s the holiday stress that causes us to indulge in feel-good foods.  Eating rapidly is another contributor to the development of holiday love handles. When we eat fast, we don’t give our body enough time to release leptin which is an extremely important hormone released by fat cells. It acts like an appetite suppressant because it helps us feel full. Leptin tells you when to stop eating.  But some people -especially the overweight- have resistance to the leptin signal.  If your body doesn’t recognize leptin, you will keep eating and eating.  So rule number one is to eat slowly, and wait 15 – 20  minutes after the first plate.  Hopefully, you will feel full (thanks to leptin) and you won’t need a second helping. Here are a few other suggestions:

-Avoid fried food.

-Only have a ‘bisel’ of the potato latkes or mashed potatoes because the carb rush will send your pancreas (and insulin levels) into a tizzy. Elevated insulin can lead to memory loss, heart disease, inflammation and cancer.

-Eat one desert only, don’t nosh on everything. Eating sugar makes you crave more sugar and contributes to poor GI function.  Honestly, after all your hard work, I would pass on the Christmas cookies.

-Bring your own natural sea salt because it provides healthy iodine, magnesium, selenium and other minerals not found in table salt.

-Don’t stuff yourself to please the host. I totally relate here. To this day, my mom will tap the window of my car as we’re backing out of the driveway, just to give us a To-Go bag.  What I really want is a barf bag. And when I get home, there’s a message from dad on my answering machine, “You will make your mother happy if you come for breakfast and eat all the left-overs.” Oy Vey!

-Wine.  Hmm, one glass if you must – make it red.

-A few supplements that are good at busting food/sugar cravings include chromium, glutamine, B-complex, probiotics, digestive enzymes, 5-HTP and guggul.

-Exercise.  It helps you make cellular powerhouses (mitochondria) which burn fat and sugar for you.

Did You Know?

Proton-pump acid blockers -used for ulcers and reflux disease- increase a person’s risk for developing pneumonia according to several studies.

Dear Pharmacist,

I’m taking Norvasc, Atenolol and a statin cholesterol drug, Crestor.  The side effects are intolerable. Do you know of any natural ways to lower blood pressure?

–T.E.  Salt Lake City, UT

Answer: You have many options, but I only have space to elaborate on one impressive option -beets. They pack a crimson punch like no other veggie because they contain powerful compounds that may reduce blood pressure, promote bile flow, ease digestive disorders, improve heart disease, lower cholesterol and prevent cancer. I can’t name one drug from my pharmacy with a bio like that. And a bunch of beets is only 4 dollars!

In our heavily medicated country, it’s considered bizarre to tell a person to drink beet juice for blood pressure. The expectation is that you need to take Norvasc or Atenolol to get well, am I right? We have become  programmed to take super drugs, not superfoods.

Studies point to amazing heart-healthy benefits. Beets even look like hearts if you think about it. They lower blood pressure by increasing levels of ‘nitric oxide’ in your blood vessels. The anti-platelet action of beets reduces risk for blood clots. Beets can dissolve inorganic calcium deposits that clog up your pipeline. Beets can lower total cholesterol and triglycerides by 30 and 40 percent, respectively while increasing those good HDLs!  Has your statin done that for you?  They are rich in folic acid and betaine, two substances which neutralize inflammatory chemicals like C reactive protein, homocysteine and interleukin 6. With all this in mind, I’m thinking fewer strokes and heart attacks, are you?

A 2008 study in Hypertension found that drinking two cups of beetroot juice reduced blood pressure by up to 10 points for 24 hours!  There were no major side effects. Blood pressure medications often cause dizziness, weakness, body aches, muscle cramps,  arrhythmias, heart attack and stroke.  Wait, it gets better.

That beautiful purple-reddish color of beets occurs because of a compound called “betacyanin” which has demonstrated itself as a powerful cancer-fighter, especially against colon cancer. In one study, animals with colon cancer were fed beet fiber and researchers noticed an increase in the activity glutathione, which helps rid your body of toxic cancer-causing poisons. In another study, beets increased the number of cancer-destroying cells in the colon (CD8 cells) and the animals in the study showed fewer pre-cancerous changes. Beet juice may negate the effects of eating processed meats laden with dangerous “nitrosamines.”  Envision less stomach cancer.

Beets may color your urine or stool slightly pink; that’s harmless.  If you have oxalate kidney or gallstones, limit intake of the leafy beet greens because they contain oxalates. Beets themselves are probably fine but ask your doctor.  I’ve posted a few beet recipes at my website and facebook. While I prefer you eat fresh beets/juice, beetroot juice and oral supplements are sold at most health food stores.

Did You Know?

Most prescribed pain medications cause constipation, dizziness, drowsiness and dependence.

1 small beet (washed, peeled and shredded)

Directions: Put the grated shredded beet on top of your green salad instead of carrots. Or into soups, or a few on top of your scrambled eggs.  Why not? It’s so easy you’ll wonder why you haven’t done this for years!  Keep them shredded and ready in a storage container so you can just use whenever you want them.

Suzy’s Craveable Beet Salad

3 medium sized beets (washed, peeled and chopped into bite-sized cubes)

2 cups fresh spinach leaves

1/4 cup coursely chopped walnuts

1 Tablespoon unheated oil (I use hemp seed or flax seed oil)

1 tablespoon vinegar (Balsamic or Apple Cider)

Sea salt and pepper to taste

Hemp seeds (hulled, you can buy them at any health food store)

Squeeze of lime or lemon

1/4 cup feta cheese (optional)

Directions:  Boil the chopped beets for about 15 – 20 minutes on medium-low heat.  They should be tender to but not squishy.   Toss in the spinach leaves for the last 3 to 5 minutes just to wilt.  Then, drain the water off (or save it for a base in which you can make soup in later).  Combine the cooked beets with all the ingredients and stir.  You can play with this recipe if you like fresh herbs and grow them or buy them.  In my home, we like  to add a few leaves of basil or dill… (or rosemary) whatever is in bloom or in the fridge

Christmas Slaw (Beet Cole Slaw)

5 or 6 medium sized beets (washed, peeled, shredded and cooked)

1/2 head of cabbage (I use Savoy)

1/4 cup oil (I use hemp seed, grape seed or pumpkin seed oil)

1/4 cup Apple Cider Vinegar

Juice of half a lemon

About 1/2 tablespoon agave or honey (sorry, I never measure… this is to taste)

Grated fresh orange peel (about 1 teaspoon)

Sea salt & pepper to taste

2 Tablespoons Golden Raisins or ‘Craisins’ (optional)

Directions:  Cook the beets and cabbage slightly.  You can boil them for about 15 minutes, that’s easiest. You want them crisp tender, kind of like cole slaw or maybe just a little bit more tender than that. You can roast them too, but this adds more fat to the recipe because roasting requires that you drizzle the veggies with oil.  So I usually boil them for a bit. This works perfectly.  While the beets and cabbage are simmering, add all the other ingredients (except raisins) in a bowl and whisk vigorously or use a blender gently for a minute. Pour the dressing over the beets and mix well.  Add the raisins (or Craisins) if you like added sweetness.

Beet Juice

4 celery sticks

2 zucchini

1 apple

1 beet

1/2 inch ginger (optional)

Directions:  Juice together in your juicer or Vita-Mix. It will not taste as good in a blender because it gets gritty and chunky however some people like that for the fiber effect.  I use a Vita-Mix because I prefer it smooth.  The ginger will give it a lot of spice, so this is optional and recommended for people who have painful arthritis, knee pain or ailments involving the stomach (for which ginger is famous for).  You can adjust the veggies to your palate.

Dear Pharmacist,

I had a mastectomy this summer and I am scared to lose my other breast too.  I recently found out about you and bought your “24-Hour” book and it has some information, but I want more guidance, specifically as it pertains to breast cancer.  What else can you tell me?

–N.L.  Seattle, Washington

Answer: When it comes to breast health, two important factors are your weight and your hormone balance. Let’s start with weight. Studies prove that estrogen promotes cell proliferation in breast tumors. Those flabby abs can increase production of cancer-causing hormones, including a dangerous form of estrogen.  This could be summarized:  Fat causes cancer.

Now, about the hormones. The important ones like DHEA, testosterone, progesterone and estrogen have to remain in balance like a see-saw. Progesterone is useful to women who have excessive amounts of estrogen because it offers hormonal balance, but it has to be used with caution.

Estrogen breakdown is even more crucial than the total amount of estrogen you have! When estrogen breaks down in the human body, it can form several smaller molecules.  The safest by-product is called “2-methoxyestradiol.”  Other estrogen by-products are not as friendly in the body, and may increase your risk for cancer.  I’ll call those ‘bad’ forms 4 and 16 estrogen to keep things simple.

Your body probably makes a larger amount of the cancer-causing 4 and 16 estrogens, relative to the anti-cancer 2 estrogen. My hypothesis can be verified if take a urine test offered by Genova Diagnostics called the “Complete Hormones” test which measures levels of the 2, 4 and 16 estrogens.

I interviewed one of the nation’s leading experts on natural hormone replacement, Dr. Douglas Hall, M.D. of Ocala, Florida.  This OB/GYN is also a functional medicine physician, and uses his  impressive educational background to treat men and women with hormone imbalances and protect them from prostate/breast cancer.

Dr. Hall explained, “Many factors affect how a hormone is altered BEFORE it enters your cells and alters the cell’s activity.  For example, the estrogen levels in breast tissue may be 27 times greater than what is in the blood stream, and it may be a relatively unsafe metabolite.”

Here’s a secret: You can affect the way you break down estrogen and reduce your risk for cancer with inexpensive supplements or foods. You can increase your production of 2 estrogens with broccoli and rosemary extract, flax seed, folic acid and a few others.  I fully explain this, mammography, herbs, vitamins and dozens of natural ways to protect against breast/prostate cancer, in my new e-book, “Breast Cancer Prevention,” available at my website, www.DearPharmacist.com.

Testing levels of estrogen by-products (rather than total levels) may be a better indicator of cancer risk.  Unfortunately, most doctors only measure total hormones, so ask for this special urine test.

Did You Know?

Try natural “Tea Tree Oil” suppositories to treat a vaginal yeast infection or bacterial vaginosis.