“What would you say if I told you your son’s mood and behavior problems were due to his genetics?”  – therapist of one of my patients

“Mental health can be affected by diet and stressful life events, but the dominant factor is often genetic or epigenetic differences in brain chemistry.” – William J. Walsh, PhD

What does it mean to have a mood, behavior, or learning problem due to genetics?

I have talked and written before about how the building blocks for our neurotransmitters are amino acids and other nutrients. Possibly more important though is the number and activity of transporter proteins that allow (or don’t) optimal neurotransmitter activity at synapses. Genetic expression, or production, of transporter proteins affects the activity of neurotransmitters. The most commonly talked about example of this has to do with methylation (commonly tested for with genetic testing companies such as 23&Me). Methylation of genetic material called chromatin inhibits production of some neurotransmitter transporters. Undermethylators tend to have reduced serotonin activity and a tendency for depression, whereas overmethylators can have excessive dopamine activity and a tendency for anxiety. Importantly, genetic testing for MTHFR, COMT, or other SNPs do not tell if a person is undermethylated or overmethylated.

Genes and Epigenetics

You have probably heard that having a genetic predisposition for something, for example heart disease, does not determine the eventual development of heart disease. This is true for mental health, and all of genetics as well. Genetic testing does tell you what your genetic code is, but it doesn’t tell you how your genetic code is being expressed. Epigenetics is the system that determines gene regulation and expression. Epigenetics, not genetics, tells us how a system is likely to be functioning. While epigenetic instructions are established in the womb and generally persist through life, environmental insults (ie: physical inury, illness, toxic exposures, powerful medications, emotional trauma, or a combination of influences) can alter the epigenetics through oxidative stress, in the womb or at any point in life, and this is the cause of the manifestation of many physical and mental disorders.

Nutrients Affect Genetic Expression

The good news is that there are simple blood and urine tests that can tell us how a system is functioning (expressing), and gene expression can be influenced by certain nutrients. Biochemical therapy looks for and identifies specific nutrient or chemical imbalances that are known to be the most commonly involved in a myriad of mental health diagnoses. While certain imbalances, such as being over or undermethylated, are commonly associated with anxiety and depression, respectively, it is usually not that straightforward. Every individual is unique, and most people with an existing diagnosis don’t fit neatly into one category of biochemical imbalance; rather they may involve a combination of a variety of imbalances.

High-Incidence Chemical Imbalances

  • Pyrrole Disorder

    • Pyrrole disorder (or pyroluria) is detected by the presence of elevated kryptopyrroles in the urine. This test represents a marker for functional deficiencies of Vitamin B-6 and zinc, and elevated oxidative stress.
    • Symptoms include: poor tolerance of physical and emotional stress, poor anger control, frequent mood swings, poor short term memory, reading disorder, morning nausea, absence of dream recall, frequent anger and rages, depression and high anxiety.
    • Treatments are based on the individual’s age, body weight, lab results, severity of symptoms and ability to metabolize supplements.
  • Histamine

    • Histamine is a marker for methylation status.
    • When histamine is elevated, clinical features include depression, obsessive-compulsive (OCD), perfectionism, seasonal allergies, competitiveness, and internal anxiety.
    • When histamine is too low, there is a tendency for high anxiety, panic disorder, depression, chemical and food sensitivities, music/artistic ability, and empathy for others.
  • Copper

    • Copper is an essential trace element but excessive levels are toxic to the body.
    • Copper overloads tend to lower dopamine levels and increase norepinephrine in the brain. Imbalances in these important neurotransmitters have been associated with anxiety, postpartum depression, ADHD, autism, violent behavior, paranoid schizophrenia and bipolar disorder.
  • Zinc

    • Zinc is a trace metal essential for all forms of life.
    • It enhances behavior control to stress and helps maintain intellectual function, memory and mood levels.
    • More than 90% of persons diagnosed with depression, behavior disorder, ADHD, autism and schizophrenia exhibit depleted zinc levels.
    • Zinc deficiency has been associated with delayed growth, temper control problems, poor immune function, depression, poor wound healing, epilepsy, anxiety, neurodegenerative disorders, hormone imbalances and learning problems.

Biochemical nutrient therapy plus other therapies

There are no silver bullets. If you deal with a mental or cognitive health issue, you likely have coping mechanisms (healthy or otherwise) in place. We all have our patterns. Biochemical nutrient therapy, like other therapies such as diet, exercise, mindfulness, breathwork, herbal medicines, hydrotherapy, pharmacoptherapy, etc, is a tool – a big tool, but a tool. To get the most out of it, use it in conjunction with psychotherapy in order to learn new patterns and routines that support your mental health goals.

Work with Meghan Van Vleet ND in Boulder CO

If you are interested in this type of mental health support, please give me a call:

720-340-0193.

I am happy to work collaboratively with psychotherapists, psychiatrists, primary care providers, and other care providers.

 

Sources:

Walsh, William. Nutrient Power: Heal Your Biochemistry and Heal Your Brain. Skyhorse Publishing, 2014.

Walsh, William J, and Malcolm Sickels. Mastering Brain Chemistry Physician Education Workshop, 27-30 Apr. 2019, Evanston, IL.

As a naturopathic doctor, I have been intentional about the way I live. I eat well and regularly get enough sleep. I have always maintained an active lifestyle, beginning with competitive gymnastics as a child, backpacking, marathon running, bike commuting, trail running, yoga, and I am the mother of 2 children. Yet, at 45 years old I had suffered 3 ankle breaks in 3 years and chronic to sometimes acute back pain that stopped me in my tracks for days to weeks, stealing my fitness away. I wondered how someone who works so hard at health and well-being could be suffering this way. Was I really just getting old?

What is aging?

What is aging, other than the passage of time? In 2013, researchers characterized aging as a progressive loss of physiological integrity, leading to impaired function and increased vulnerability to death, and even identified 9 hallmarks of aging. Among these hallmarks are a variety of genetic and epigenetic effects (epigenetics has to do with whether or not a gene is actually expressed), plus:

  • mitochondrial dysfunction (mitochondria are the powerhouse of every cell in the body)
  • cellular senescence (oxidative stress and cell death)
  • stem cell exhaustion (stem cells are what the body uses in order to repair itself)
  • altered intercellular communication (endocrine, neuronal, and immune system signaling declines)

Naturopathic Medicine With Meghan Van Vleet ND

While in my practice I use therapeutic modalities to effect all of the hallmarks, in this blog post I focus on the bulleted hallmarks above. Why? Because as my astute colleague, Tyna Moore ND, DC has elucidated, these are all associated with sarcopenia, or diminished lean muscle mass. We know that breathing, eating well, drinking plenty of clean water and getting exercise are components of a healthy lifestyle. But you may not know that building muscle mass, specifically, is incredibly beneficial, far beyond physique and weight. In other words, yes, we can build muscle as medicine.

What Lean Muscle Mass Does For Us

Besides making a person strong, which has many benefits of its own, having and maintaining lean muscle mass:

  • Increases cognitive function via BDNF
  • Helps maintain blood sugar regulation and insulin sensitivity
  • Reduces inflammation
  • Increases metabolism
  • Increases testosterone (beneficial for both men and women)
  • Increases Human Growth Hormone (commonly prescribed for weight loss)
  • Helps in the conversion of thyroid hormone from the inactive to the active form
  • Increases mitochondrial synthesis (remember, mitochondria are the powerhouses of our body)
  • Reduces pain (most notably back pain, but also neck other joint pain, fibromyalgia pain, etc)
  • Improves immune function
  • Offers better prognosis if confronted with a cancer diagnosis
  • Increases bone density
  • Improves mood
  • Increases adaptive abilities to various stressors as we age

Who would not want all of that? More importantly, I bet there is something specific in that list that you could use more of. Most all conditions could benefit from increased muscle mass.

What is Sarcopenia?

Sarcopenia translates literally as “poverty of flesh” and refers to the muscle loss that typically begins between 30-40 years old. That is 8% loss of muscle mass per decade until the age of 70, and then it increases to 15% per decade. Arguably, with the population spending more and more time in front of devices, this is likely starting even younger. There is a relatively new term for seemingly thin people with poor, fatty muscle mass: TOFI – Thin outside, Fat Inside. TOFI refers to the finding that many people with a seemingly good BMI actually have fatty infiltrate in their muscles, classifying some as obese despite being thin. Folks with TOFI have all the health risks of the outwardly obese.

The Best Way to Build Lean Muscle Mass

The best, most efficient & comprehensive way to build muscle mass and functional strength is with strength training with free weights. Weight machines artificially isolate muscle groups and force movements that aren’t functional in nature, ie: don’t reproduce movements of your daily activities that you want to be strong in. Strength training with free weights requires the coordinated use of multiple muscle groups spanning multiple joints throughout the body and prepare the body to be strong in the face of everyday physical challenges. Additionally, using free weights increases grip strength; poor grip strength is a major risk factor for a fall.

Lean Muscle Mass Reduces Risk of Falls

Interestingly, the strongest risk factors for a fall as a person ages, all of which can be positively affected by strength training with free weights, include:

  • mobility impairment
  • reduced knee, hip, or ankle strength (strong, coordinated muscle groups surrounding a joint increase joint strength)
  • reduced grip strength
  • Difficulty arising from a chair (think loaded squats)
  • Number of medications (see list of benefits of maintaining lean muscle mass above)

Build Muscle Mass Safely

The key to efficiently building lean muscle mass though is to do it safely, which requires a trainer, at least to start. Using free weights properly 2-3x/week as part of an active, healthy lifestyle is the key to “everyday fitness”, as Karen Harbour of Bella Strength in Boulder, CO calls it. Because the pain of sore muscles is different than the pain of inflamed joints, this everyday fitness is what can enable a person to do work around the house, the yard, maybe schlepping kids (or grandkids) & all their stuff, go on long runs, or whatever your jam is…without causing acute or chronic pain. You might be getting older and beginning to feel or show more vulnerability, but that doesn’t mean you can’t do something about it.

Frailty Syndrome

I realized that at 46 years old, I was developing “frailty syndrome”, which is a viscious cycle:

Pain/injury –> loss of full mobility –> deconditioning & loss of muscle mass –> pain/injury

Additionally, I realized that for at least 3-4 years, around the time that my youngest child was too big to pick up regularly, that I had not lifted anything heavy with regularity as part of my daily activities.

Aha moments of clarity mobilize me into action. I headed to the gym for the first time in my life to see if they might help me with my everyday fitness. Only six weeks in and things are changing for me. It is a slow and steady road, and I am glad to be on it and taking charge of my health in a whole new way.

Lean Muscle Mass Can Benefit You

Consider your own trajectory. Do you experience chronic or sometimes acute pain? Are you prone to injury? Are you fit-but-fragile like I was, or maybe you just lack strength. Now consider again the list of benefits maintaining lean muscle mass offers your overall health and well-being and whether or not you are in need of any of those benefits. I encourage you to consider adding strength training into your wellness routine.

Wellness with Meghan Van Vleet ND in Boulder CO

If you need support with your health goals, give me a call: 720-340-0193

 

SOURCES:

Grimbly G, Saltin B. The ageing muscle. Clin Physiol. 1983;3(3):209-218.

Institute of Medicine (US) Division of Health Promotion and Disease Prevention. “Falls in Older Persons: Risk Factors and Prevention.” The Second Fifty Years: Promoting Health and Preventing Disability., U.S. National Library of Medicine, 1 Jan. 1992, www.ncbi.nlm.nih.gov/books/NBK235613/.

López-Otín, Carlos, et al. “The Hallmarks of Aging.” Cell, U.S. National Library of Medicine, 6 June 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3836174/.

Moore, Tyna. “Muscle as Medicine: Balancing Health Through Strength Training” OANP 2019.

 

We all know the stoner stereotypes: an unmotivated dude living in mom and dad’s basement, content passing time on video games and munching Cheetos, a free-loader.

Given that classic perception, have you begun to wonder what is behind the current CBD craze? It seems to be touted almost as a silver bullet – good for whatever ails you.

Maybe you have been curious but might be intimidated to go into a pot shop. Or maybe you have visited a pot shop but found yourself overwhelmed and confused by all the options and have reservations about the advice given by the folks selling the product. Maybe you brought home a hemp product from the grocery store yet are unsure how to take it.

You wonder if it really is beneficial or even if it’s safe.

This post briefly sheds some light on the history of marijuana and its medicinal uses, research and current understandings, and then examines CBD as a treatment.

Background on CBD with Meghan Van Vleet, Naturopathic Doctor in Boulder, CO

Cannabis has been used for centuries. It was actually approved by the FDA until the early 1940’s, but as a medical aid, it was not used reliably because products were too inconsistent, offering variable results.

THC and CBD are cannabinoids and are found in both hemp and cannabis plants. Once they were identified and research on cannabinoids began, scientists discovered that the human body actually manufactures its own cannabinoids. These self-made cannabinoids, termed endocannabinoids, work with receptors found in every tissue in the body.

This system of cannabinoids and receptors in the body has been identified as ‘the endocannabinoid system’; it is highly complex, constantly in flux, difficult to study, and unique from one individual to another.

Additionally, the therapeutic effects of THC and CBD are extremely dose dependent: too low a dose may offer no benefit, whereas too high a dose can cause adverse effects. The beneficial dose is a narrow window.

Adding to the overall complexity, there exists not just one cannabinoid in any hemp or cannabis plant, rather each plant is known to contain several cannabinoids so far, and likely more will yet be discovered. Each of these cannabinoids acts differently in the body.

CBD: Is it Good For What Ails You?

Current understanding of our endocannabinoid system is that it tries to create balance for several human functions:

  • appetite
  • sleep
  • relaxation
  • how we remember and forget
  • pain-sensation

The complexity of the endocannabinoid system lends itself to having therapeutic potential for many different states or conditions. In fact, Endocannabinoid Deficiency Syndrome exists as a recognized medical malady; its associations include conditions typically resistant to pharmacotherapy such as migraines, fibromyalgia, irritable bowel syndrome, and post-traumatic stress disorder.

As the research continues, cannabinoids are now being prescribed and used to effectively treat pain, anxiety, depression, insomnia, any neural inflammation, autoimmune states, and more; further, it has effects on the urinary tract as well as the digestive tract.

Not surprisingly, in populations over 60 years, it may reduce the need for polypharmacy and many over-the-counter medications.

CBD safety

Cannabidiol (CBD) is the cannabinoid that has been most studied. It does not induce tolerance or dependence.

That said, the greatest therapeutic effect comes from a full-spectrum preparation – meaning a variety of cannabinoids, even trace amounts of THC. This is called the Entourage Effect and speaks to the synergy and therapeutic potential of all of the cannabinoids in a given plant when administered as a whole. For example, CBD can counteract some of the psychoactive effects of THC.

The most commonly reported side effect of non-psychoactive (<.3% THC) preparations is sleepiness, in which case dosing in the evening is optimal.

THC is known to delay brain maturation and should not be used prior to 25 years of age. After 25 years, adverse effects of THC are significantly reduced, but can still cause temporary impairment with psychoactivity.

Importantly, cannabinoids are metabolized by the liver and also effect serotonin. While these facts are not contraindications for use, they are important considerations for use and medication monitoring.

Some CBD products may worsen allergies in an allergic individual

CBD during pregnancy and lactation

Animal models show no adverse results in pregnancy, however, there exist no human studies in pregnancy and therefore CBD is not considered safe. Endocannabinoids are normally found in breast milk of women not using marijuana or any other cannabinoid, but research shows that THC consumption is disproportionately concentrated in breast milk and poses potential threat to brain development in the baby. Additionally, unlike alcohol that clears the breast milk fast enough to “pump & dump”, cannabinoids persist in breastmilk for up to 6 days after a one-time use/dose.

Do more “official” routes of access to CBD products exist?

The passage of medical marijuana laws is nearly pervasive throughout the United States. In states like Colorado we have legalized marijuana and blanket access to a wide variety of products and potencies, medical card or not. Many CBD products are derived from hemp rather than cannabis (marijuana) and are often available at a standard grocery store (containing <.3% THC).

Meanwhile, despite widespread access to the public, there are very strict guidelines regarding cannabis research & access to funding. Often the products that are available are not the same ones that are being researched.

The industry is not highly regulated, and more often than not the people disseminating information to the consumer are not medically trained. All of this makes navigating the use of cannabinoids for therapeutic effect difficult.

Guidelines for Selecting a Cannabinoid Product

Product selection can be daunting and takes some investigation to be thorough. Many products do not contain what they say on the label.

Read labels carefully and ask for a Certificate of Analysis issued by a third party, and then read it carefully as well. Make sure that it was issued for the lot/batch of the product you are considering.

Generally speaking, a full-spectrum hemp product is a good place to start because full spectrum products often offer greater benefit at lower dosages due to the entourage effect, and hemp has only trace amounts of THC. Dosing should “start low and go slow” in order to determine the optimum dose. Avoid blended products available targeted to solve particular problems, such as sleep, for example until you have determined your optimal dose.

Naturopathic Medical Advice on Taking a CBD Product from Meghan Van Vleet, ND

Many doctors today are still unfamiliar with and wary of using any kind of CBD product. Find a doctor who is educated on products, dosing, interactions, conditions that may or may not benefit from taking a cannabinoid, as well as someone who is willing to work with you to help you find the right product and dosage for you.

If you have a CBD product sitting at home but you don’t know how to take it, if you have been considering trying a CBD product to help you reach your health goals, or if you wonder if a condition you are dealing with makes you a good candidate to try CBD, give me a call: 720-340-0193

 

A staggering one out of every ten Americans take an antidepressant. That means even here in sunny Boulder, CO, we have a lot of folks getting a chemical assist.

A Naturopathic Approach Compared To Western Medicine

All medication comes with unintended side effects. For some, unpleasant side effects are significantly disruptive – they may feel like completely different people on medication. Undoubtedly, medication has its place and is a useful tool, yet it only treats one aspect of a person.

A naturopathic approach seeks to discover the root biological factors of disturbed mental health, and treats the person holistically, in an attempt to normalize brain biochemistry and function, rather than override it.

If you are suffering from anxiety or depression, consider working with a naturopathic doctor.

Functional, Integrative Medicine in Boulder, CO

In my naturopathic practice, I have a functional, integrative approach. I collaborate with psychotherapists, psychiatrists, as well as primary care providers.

While a psychotherapist’s main focus is often talk therapy (among other specialized modalities, e.g. EMDR), a psychiatrist specializes in psychiatric medications and all of their nuances. Both types of practitioners today are likely familiar with how

  • Lifestyle (nutrition, exercise, etc)
  • Family history
  • Biological factors

contribute to mental health.

However, not many psychotherapists or psychiatrists are familiar with the long list of biological factors/stressors that could actually be causing (or at least contributing) to one’s depression, anxiety, or other mental health issues.

Naturopathic Insights into Depression and Anxiety with Meghan Van Vleet, ND

Your doctor is likely not looking at these factors, and often when they do, they do not look with a lens of functional medicine understanding.

A naturopathic approach takes into consideration a diverse set of factors, including:

  • A person’s story and symptoms
  • Lifestyle
  • Family history
  • Physical exam findings
  • Targeted laboratory testing.

Through this comprehensive picture, a naturopathic doctor may gain insight on what might be contributing, or causative, factors in a person’s experience of depression or anxiety.

Naturopathy Considers Biological Factors with Mental Health

Biological factors may include:

  • Poor diet/nutrition
  • Blood sugar imbalance
  • Chronic stress
  • Hormonal imbalances
  • Allergies
  • Food sensitivities
  • Dysbiosis and/or leaky gut
  • Lack of exercise
  • Less than optimal sleep habits
  • Environmental toxin exposure
  • Copper overload
  • B6 deficiency
  • Zinc deficiency
  • Methyl/folate imbalances
  • Amino acid imbalances
  • Undetected chronic infections.

If any of the above are affecting you, discovering and resolving these issues can go a long way toward helping you feel like yourself again.

Naturopathic Treatment

Naturopathic treatment plans always address the whole person/whole body, and include nutrition (both food and supplements), herbal medicine, hydrotherapy, as well as prioritizing, goal setting, and help strategizing a pathway to whole body wellness.

Treat the Whole Person

It is a core naturopathic principle to “Treat the Whole Person”. What exactly does this mean? To start, it means that there is no one-size-fits-all solution. The doctor approaches each patient as an integrated whole being rather than a set of symptoms to be treated individually.

For example, if someone has chronic inflammation and trouble sleeping, a conventionally trained doctor might offer an anti-inflammatory and a sleeping pill. In treating the whole, I might address pain, but also

  • reduce input to inflammatory pathways with diet & lifestyle recommendations
  • support anti-inflammatory pathways with nutrition and herbs
  • Explore all of the reasons that might cause a person to have trouble sleeping (racing mind, what they ate for dinner, unsupportive bedtime routines, chronic stress, etc).

We can address these things knowing that if we uncover the cause of sleep disturbance, it will go a long way towards lowering inflammation.

Treating the Whole Person for Mental Health

A naturopathic approach to mental health would be similar. Lifestyle habits and routines affect mental health and well-being, as illustrated by many of the causative/contributing factors listed above.

What are your habits, routines, and patterns? Do they serve you and your goals?

Are you a creature of habit or do you “go with the flow?” Both are fine, but also have their limitations.

If your routines are interrupted by forces outside of your control, how do you react? If you can’t exercise are you cranky? How do you compensate?

Does “going with the flow” mean that you’re eating on the fly? What are you eating when you are in a hurry? Equally important, how are you eating? Are you too busy to take time out of your day to relax while you eat?

Working towards Mental Health with Meghan Van Vleet, ND in Boulder, CO

When I work with my patients, I educate them. We prioritize and problem solve by organizing their days to be proactive, rather than reactive.

To start, I have my patients identify their “Bare Minimums”: the bare minimum you need every day/week/month/year to support your own well-being.

Next, I support them in creatively achieving their bare minimums for well-being. For example, a bare-minimum of exercise on any given day might be a 10-minute brisk walk, knowing that some movement is better than none at all.

Bare minimums are highly individual and change from one stage of life to another, depending on each person’s circumstances. Often little adjustments can have great effects, and little successes pave the way for greater opportunities. Over time, little changes add up.

Opportunity, Not Quick Fixes in Mental Health

To summarize, mental health can be challenging, yet with any challenge exists an equally great opportunity! While a naturopathic approach is not always a quick fix, it may be surprising to discover that the pharmaceutical approach to mental health is not always quick either. It often takes time, patience, trial, and error, as well as a skilled psychiatrist to find the right medication and dosage for an individual.

Naturopathic Treatment of Mental Health Leads to Whole Body Health

Addressing the whole person is a treatment for longevity. Conversely, the long-term use of many pharmaceuticals has increasing detrimental effects such as dependence (in the case of sleeping pills); dementia or foggy brain (in the case of some anxiety medications). From a holistic perspective, mental health can be the herald for whole body health.

If you are struggling with mental health and are interested in this whole body approach, call me today and we can develop treatment options that are right for you.

720-340-0193