What do you think of Sam-e for mood disorders?

Melinda

Hi Melinda,

While the mechanisms of SAMe’s antidepressant effects has not been fully determined, there is some biological rationale. SAMe is the primary methyl donor in the central nervous system and a number of neurotransmitters and biogenic amines, fatty acids, phospholipids, and other chemicals must accept methyl groups from SAMe for activation. Therefore, it is thought that the observed antidepressant effect is due to SAMe’s influence on neurotransmitter metabolism, membrane fluidity, and receptor activity. Both serum and cerebrospinal fluid levels of SAMe are reported to be low in depressed patients, although reports were not consistent.

However, even though controlled clinical trials for depression have been largely positive, apparently the majority of trials have significant methodological flaws limiting their clinical usefulness. Also note that a large number of those trials (if not the majority) used intravenous or intramuscular injections.

If you’ve tried other natural products without much success, SAMe is worth a try. If you’re taking any other medications (especially other anti-depressants or drugs for diabetes), make sure you are under the care of a Naturopathic Doctor before self-prescribing SAMe.

Stay healthy!

Dr. Know

Is it OK/Safe/recommended to take digestive enzymes and probiotics together?

Kathryn

Hi Kathryn,

Yes, as long as the probiotics are acid and bile resistant (such as the DDS line from Inno-Vite are), then there are no concerns when taking digestive enzymes. These strains are able to survive everything our digestive tract can throw at them and still survive and and colonize our digestive tract.

Hope this helps. Stay healthy!

Dr. Know

Read your article “Licensed to Krill” If it becomes too popular are we advocating a “license to kill” the baleen whales which I understand – krill is their only food. Even if there is an abundance of krill at present – there was also an abundance of cod when the white man fist came to N America – so many all you had to do was lower a basket and haul it up full At least if we use Salmon we can grow them in farms if we have to not that I agree with farms in the sea but it can be done on land if Omega is that important to sustain human life – yes I do take Omega 3 from wild Alaskan salmon until we fish them all out.

Cheers

John W.

Hi John,

Yes, it is true that the Antarctic ecosystem is very dependant upon krill as a primary food source and for this reason there are very stringent controls to ensure ecological- and environmental-friendly harvest of krill.

The management and control of the krill population is led by the 25-state member Commission for the Conservation of Antarctic Marine Living Resources (CCAMLR), which is the official and reliable international organization responsible for krill fishery management.  No shortage of Antarctic krill has ever been forecast by CCAMLR.

Facts:

• Many studies have been undertaken and they show that the biomass of Antarctic krill, one of the world’s most abundant biomass, may amount to 500 million tonnes. This standing stock is subject to annual natural reproduction providing renewable krill for predation, natural mortality and human exploitation.
• The precautionary catch limit set by the CCAMLR was 6.6 million tonnes for 2008 and is reviewed annually. It was increased from 4.9 million tonnes in 2005/06 based on the results of recent surveys.
• The annual natural reproduction of Antarctic krill is at least several hundred million tonnes constantly renewing the standing stock and granting sufficient krill for all marine mammals and fish, birds and human exploitation.

• Less than 120,000 tonnes (less than 2% of the precautionary catch limit) is actually harvested, which means that the catch limit is unlikely to be reached in the foreseeable future.
• The precautionary catch limits on the krill fishery are under constant review by the Scientific Committee of CCAMLR which uses an ecosystem approach to management.

• Antarctic baleen whales are estimated to consume 85 million tonnes per year.
• Again, less than 120,000 tonnes of the annually set total catch limit of 6.6 million tonnes are harvested by fisheries.

Also, keep in mind that the bulk of the annual catch is used by the feed industry (e.g. fish farms). So you can see, even if the popularity and demand for krill oil (for human nutrition) increased dramatically by 50-fold, we’d just be approaching the precautionary catch-limit.

Hope this helps clarify your concerns. Stay healthy!

Dr. Know

Thanks for posting this advice, Dr. Lee. You are very knowledgeable on the topic of depression. Also, thanks for mentioning music therapy as a safe, non-threatening mode of treatment. There are many ways you can use music actively or passively to address depression and anxiety. And all treatments are individualized. Looking forward to reading more of your posts.

Kat F.

I have been dealing with depression (possibly bipolar) for years. Is there anything you can recommend?

Rob M.

Hi Rob,

First, let me be clear that since I am not your physician, I cannot legally – nor ethically – give you specific recommendations without seeing you as a patient first. However, here are some general guidelines that may help point you in the right direction. Before self-prescribing anything, I would always recommend a consultation with your Naturopathic Doctor.

St. John’s wort has been extensively studied in Europe over the last two decades, with more recent research in the United States. Short-term studies (one to three months) suggest that St. John’s wort is more effective than placebo (sugar pill), and equally effective as tricyclic antidepressants (TCAs) in the treatment of mild-to-moderate depressive disorder. Comparisons to the more commonly prescribed selective serotonin reuptake inhibitor (SSRI) antidepressants, such as fluoxetine (Prozac) or sertraline (Zoloft), are more limited. However, other data suggest that St. John’s wort may be just as effective as SSRIs with fewer side effects. Since numerous adverse drug interactions are possible, caution is advised, when taking St. John’s wort.

Another one is 5-HTP, which may help balance serotonin in the body. Serotonin is the brain chemical associated with sleep, mood, movement, eating and nervousness. While cells outside the brain, such as platelets in the blood and some cells in the intestine, produce and utilize serotonin, all serotonin used by brain cells must be made within the neurons themselves. When serotonin is not properly constructed within the brain, the result can be irritability, aggression, impatience, anxiety and depression. The results of numerous studies in humans suggest that 5-HTP may aid in the treatment of depression. Again, numerous drug interations are possible, so exercise caution.

Music has been referred to as an ancient tool of healing. Many different forms of music intervention have been used to reduce depression and anxiety in a variety of medical conditions and medical procedures. There is evidence that music therapy may increase responsiveness to antidepressant medication. In elderly adults with depression, a home-based program of music therapy may have long-lasting effects for mood enhancement. In depressed adult women, music therapy may lead to reductions in heart rate, respiratory rate, blood pressure, and depressed mood. Music therapy is generally known to be safe.

While the above are geared to the depressive phase, for the manic phase, you can try things like GABA, which can be found alone or in products like Inno-Beauty Sleep. GABA is the main inhibitory neurotransmitter in the brain, and while it hasn’t been extensively studied for the manic phase of bipolar disorder, theoretically, it makes a lot of sense. It’s great for calming the mind without being a sedative, and therefore, used in cases of insomnia, stress, and even to assist in meditation.

Dr. Lee Know