Can You Hear Creatine Coming?!!

If you’re like me, Creatine as a therapeutic option for psychiatric & neurological disorders, has been stalking you for years. Lurking in the shadows, only showing its face occasionally to say, ‘Hey, I’m not all about body building and sports you know, you should check me out some time!’  But, haunted by the ghosts of yesteryear  & all the wanna-be-muscle-men I served working in retail in my 20s, and scared off by the very mention of ‘sports’, I have kept running briskly walking, beyond Creatine’s clutches. Until now.

The evidence of the essentiality of Creatine for healthy brain function is undeniable and together with a wealth of pre-clinical data which likens the impact of oral Creatine to both fluoxetine, in terms of its ability to stimulate and support healthy neurogenesis, and ketamine, in relation to its fast acting glutamate inhibition, we need to at last all finally face our friendly stalker!

Thrilling as this amassed evidence is, to date the number of actual RCTs using Creatine in mental health patients, including treatment resistant depression, bipolar affective disorder, schizophrenia etc. is still too few and their sample sizes suffer from ‘smallness’ to boot, making it clear that we a long way away from a clinical consensus.  Regardless, Creatine seems too important a therapeutic option to ignore while we await new larger studies and a trial of this supplement in many of our patients could be all the n=1 proof we need for its benefit to many.  The skill we need to develop now is being able to identify those patients most likely affected by CNS creatine depletion. But if we follow the trail of crumbs… they clearly lead us to those at risk, due either to impaired production (amino acid and micronutrient shortfalls, most commonly) or those experiencing increased requirements (vegetarians, vegans, the elderly, high histamine??)…we are likely to recognise our patients likely to benefit the most.

While our CAM dispensary already offers us some great nutraceutical & herbal options for helping our depressed patients, I am always on the look out for more.  Especially when these represent more upstream approaches…providing true building blocks for brain health, rather than just XXX the signals

Creatine and its colleagues (carnitine, choline and many micronutrients) fit this bill.  Building blocks are beautiful things.  Are a more ‘grassroots approach’ and accordingly, generally less expensive to boot.  I’m doing more and more augmenting of my most reliable CAM antidepressants, with creatine and select aminos these days and being rewarded with great results.  If you want to learn how to use Creatine supplements as part of a multi-pronged approach for your patients’ brains rather than their brawn…then there’s no better place to hear about it than here and, I guess, at last, there’s no time like now.   🙂

 

Creatine – The Brain Builder Part 2
Creatine for brain building over brawn, begs the question,  ‘What is the ultimate supplement regime when trying to maximise uptake into our mind not our muscles?’  So much important groundwork has been done in the field of sports science to determine basic bioavailability and pharmacokinetics of this nutraceutical, we can certainly borrow much from this – but what do we do differently?  This second instalment on ‘Creatine the Brain Builder’, does the complete number crunch for dosages and regimes, expected onset of action, necessary duration of use, cautions and contraindications and much much more!

When we recap the contemporary science of shared pathophysiology in mental health, we have: oxidative stress, impaired neurogenesis, monoamine deficits, glutamate excess, hypometabolism & mitochondrial dysfunction.  When we ask researchers which of these supplemental Creatine might be able to assist with, we get hits at each and every point.  Turns out, Creatine’s capacity for enhancing performance is not limited to athletes but can be capitalised on for anyone vulnerable to a CNS shortfall.  Ignored for far too long, this economic and impactful brain nutrient is coming to the fore for psychiatric and neurological disorders.

 

The latest Update in Under 30 has landed!!!

You can purchase Creatine – The Brain Builder Part 1 and Part 2 here.
If you are an Update in Under 30 Subscriber, you will find it waiting for you in your online account.
You can become an Update in Under 30 Subscriber to access this episode and the entire library of Update in Under 30 audio’s and resources here.

Hanging Out For The Histamine Handshake?!

Recently a mentee reported that when attending an in-person training event (remember those, everyone?!) she approached a sponsor’s stand, promoting practitioner training in the nutritional management of mental health, based on the pioneering work of American scientist, Carl Pfeiffer.  But when she and her nat buddy started asking questions, those manning the stand asked whether they were doctors and then, upon finding out they were naturopaths, encouraged them ‘to move along – this information isn’t for you then’. Or something to that effect…Ouch!

While I know a little about the decision behind offering this training only to doctors and specialists at this time, and I do understand that organisation’s reasoning, I also want to reassure you, this doesn’t mean that Pfeiffer’s important work, and the efforts of those that have followed him, is out of bounds to others.

No one can copyright cortisol or TM TSH, right?  Equally, Histamine is his own man.  Carl Pfeiffer and others brought histamine, the neurotransmitter to centre stage and many of us working in mental health remain eternally grateful for this.  But CNS histamine has come a long way since then…and is currently a very hot topic in modern molecular psychiatry where they are always looking for new drug targets, given shooting at the previous ones, risked taking ‘an eye out’! The recognition of histamine as a key player in mood, cognitive and behaviour has been long overdue but is absolutely here now!  Just give this search term a whirl in PubMed: histamine AND psychiatry, and you’ll be hit with quite the crush of citations!

An abundance of important info at your fingertips…no secret handshake required.

It was, in part, this story that inspired me to record an Update in Under 30 on Histamine Imbalance in Mental Health.  Just the proverbial straw on the proverbial camel really, after years of examining, experimenting and experiencing the incredible results some patients can achieve when this imbalance is identified and redressed. So I’ve done my darndest to pull together those years of hands-on helping histamine imbalanced patients with the latest literature in under 30 minutes!! Surprise! I failed! There is a lot to convey but you’ll also be surprised by what I don’t say…there’s no infinitely long list of personality peculiarities that fit with too much or too little. Nor is there a didactic discourse about absolute treatment dos and don’ts.  I’m communicating the common ground between the original evidence, clinical empiricism and contemporary neuroscience. So this month, consider the ‘under 30’ bit, merely a ‘Serving suggestion’…which would necessitate you playing it 1.5 X speed…go on, I dare you!!😅

Update in Under 30: Histamine Imbalance in Mental Health

About 15 years ago I was introduced to Histamine as a neurotransmitter. Not the allergy mediator or the ‘basophil baddy’ but rather this prolific and potent neurochemical we all produce in our brains which, in the right amount, regulates almost every biological rhythm, helps with memory and mood & much more. Being able to recognise excesses or deficiencies of CNS histamine in mental health presentations and, ever since then, fine-tuning my ability to support patients with these, has changed my practise forever and has been the key to some of my patients’ greatest recovery stories.  Forever grateful to the pioneers of this model, 70 years on, the model is ready for a mini-makeover, to bring it in line with the current scientific understanding of histamine, methylation, genes and much more.  This recording, together with a hugely helpful clinical resource, will give you the confidence to recognise and remedy this important imbalance in mental health. If you want to download this recording click here.

Have You Met Your Hype-Guy?

About 15 years ago I was introduced to histamine, the neurotransmitter.  Before that, I only knew him (come on…it has to be, right? Histamine) as an immune molecule, an allergy mediator, a chemotactic agent of chaos! Given my interest & previous work in mental health, I knew the rest of the chemical cast pretty well. There was Sunny Serotonin, Dance-Party Dopamine, Nervous Noradrenaline & Go-Go Glutamate. So it came as a bit of shock to realise that an equally important member of this cast had never had a mention in all my previous education…

‘Hype-Guy Histamine’

With 64K neurons dedicated to its production & an extensive axon network all over our brains to ensure its excitatory effects are felt everywhere…I was a bit embarrassed we hadn’t met sooner!  I’m not Robinson Carusoe in that regard though, our awareness and recognition of this key neurotransmitter has been snail-like in its pace and progress. A recent review paper on the development and evolution of antihistamines kicks off the conversation with, ‘Oh, so histamine is just another neurotransmitter now’…which gave me a bit of a laugh.  Seems like we were all duped…even the dudes making the drugs to block it! But once I did meet Histamine, the neurotransmitter, it really did change my clinical practise, forever.  And as I have gotten to know him better and better over the last 15 years, how his excesses and deficiencies present in my patients and how best to manage these, I can confirm, it is far from the answer to every patient’s prescription for mental health but this an imbalance is evident, addressing it is exceptionally effective and I remain forever grateful to those that have contributed to my learning in this area, passing on the knowledge from its originators: Car Pfeiffer & Abraham Hoffer.  These pioneers of orthomolecular psychiatry gave Histamine a platform and presence that no one else had or would for decades still to come. 

And now every practitioner and their pet poodle seems to want to talk about Histamine!
But, my friends let me tell you, CNS Histamine imbalance has little to do with eating tuna, umami flavours and the state of your gut!

Hype-Guy Histamine is made on-site, in your brain.  We don’t import it in over the BBB mountain range.  So, in terms of a histamine imbalance in your neurochemistry, we need to narrow in on the noggin and get crystal clear about what could be behind such an imbalance and therefore how to tailor treatment to address each cause.  I owe a lot to those who first taught me this model and I think it’s time the model had a mini-makeover, thanks to our vastly improved understanding of Histamine, methylation, genes, mast cells, behaviour driven biology etc etc. etc.  that has been generated now mainstream medicine has finally met Histamine, the neurotransmitter! 🥳🥳 And now, be warned folks, contemporary psychiatric pharmacy has its sights set on histamine as a key target for new medication development and the improved management of mental health.  Better late than never, I guess.  Have you met your Hype-Guy Histamine?

 

Histamine Imbalances in Mental Health
About 15 years ago I was introduced to Histamine as a neurotransmitter. Not the allergy mediator or the ‘basophil baddy’ but rather this prolific and potent neurochemical we all produce in our brains which, in the right amounts, regulates almost every biological rhythm, helps with memory and mood & much more. Being able to recognise excesses or deficiencies of CNS histamine in mental health presentations and, ever since then, fine-tuning my ability to support patients with these, has changed my practice forever and has been the key to some of my patients’ greatest recovery stories.  Forever grateful to the pioneers of this model, 70 years on, the model is ready for a mini-makeover, to bring it in line with the current scientific understanding of histamine, methylation, genes and much more.  This recording, together with two hugely helpful clinical resources, will give you the confidence to recognise and remedy this important imbalance in mental health.

 

The latest Update in Under 30 has landed!!!

You can purchase Histamine Imbalance in Mental Health here.
If you are an Update in Under 30 Subscriber, you will find it waiting for you in your online account.
You can become an Update in Under 30 Subscriber to access this episode and the entire library of Update in Under 30 audio’s and resources here.

Is Copper the Culprit in ADHD?

Sometimes I think I must be psychic..or is that psychotic? Don’t answer that, it’s a bad Byron Bay in-joke.  I had literally just recorded my Update in Under 30 Copper in Kids and this excellent new study was published that same week, assessing and comparing trace minerals in age-matched ADHD and neurotypical kids. Snap! First, a moment of panic…because believe it or not, there are very few rigorous studies that have looked into this and so I had already read them all cover to cover and could confidently say, I had a grip on the literature. Gasp…’ will it have a different finding and challenge the much broader story about the excessive demonising of this mineral in kids health?’ Everyone take a big breath out…no. 

But if you’re someone who thinks you’re seeing Copper toxicity in kids, you can keep taking a big breath in and while you’re at it a huge bit of new information:

Copper Excess is Normal in Children.

Every investigation of blood Copper levels in kids has reached the same conclusion and this latest one by a Russian group of researchers renowned for their work in Copper agrees. So the ideas that we have about optimal in terms of mineral balance for adults may stand, but can not and should not be applied to children.  The elusive 1:1 relationship between Cu and Zn, for example, considered aspirational in optimising the mental health of big people, is absolutely not desirable or even healthy, in little ones. Why is it so? I hear you ask (…because you loved those old Cadbury chocolate ads with the crazy Professor as much as I did)  Well, essentially because kids need more Copper than us, as a simple result of their increased growth requirements: blood vessels, bones, brains…Cu is a critical player in them all and more.  And while we (and when I say ‘we’ I mean ‘I’) may be passionately passionate about Zinc’s importance, turns out, in paediatrics, it really does play second fiddle to Cu and should.

This new contribution to the Cu & Zn in ADHD kids debate did find that compared with neurotypical kids, their Cu:Zn was higher BUT – **and this is the really important bit **- as has been shown in a similar cohort before, the shift in relationship between the two was due in fact to lower Zinc levels NOT higher Copper. 

So, I guess when you think about it…Zinc perhaps really does still deserve all our loving attention we give it 😂…we just need to rethink the whole negative attention we tend to mistakenly give Copper! 

Copper, as a kingpin in angiogenesis, brain & bone building & iron regulation is a critical mineral during paediatric development. So much so, the kind of blood levels we see in a primary schooler might cause alarm if we saw them in an adult. So too their Zn:Cu.  But higher blood Copper and more Copper than Zinc are not just healthy but perhaps necessary during certain paediatric periods.  This recording redefines normal, low and high with a great clinical desktop tool to help you better interpret these labs, as well as reviewing the top causes and consequences of both types of Copper imbalance in kids. 
The latest Update in Under 30 has landed. You can purchase January’s episode, Copper in Kids here.
If you are an Update in Under 30 Subscriber, you will find it waiting for you in your online account.
-Your RAN Online Account has a NEW LOOK!!-
Next time your log in, you will experience a more user friendly way to search, view, listen and download your resources. Find out what’s new here.

 

‘Copper Excess’ In A Child?!….Really??

Copper deficiency happens in kids, so does copper toxicity and both are serious concerns, but do we know when to accurately call either?  First, we have to know ‘normal’. If we know what normal Serum Copper values look like in children, then we can easily spot those falling below or above this, right? That’s the first hurdle we tend to knock over and break a toe on!  Being a mineral whose levels vary widely in soil from country to country, globally, the differences in reference ranges are breathtaking & absurd. Add to that, that copper is a key mineral in kids, driving huge demand for it during key periods of development, so the range for pre-schoolers isn’t the same as the primary or high schoolers – not that your lab is flagging that. Unhelpful? Yes.  Dangerous, even? Potentially.

To diagnose ‘Copper Excess’ in a child is a big call to make.

One, because most practitioners are unaware just how much Copper a child really needs at each age & two, high copper is often a messenger for something else going on and then three,  the primary objective based on this diagnosis becomes to lower their Copper but we could be either shooting the messenger or missing the mark all together…right?

Copper excess does happen but not nearly as often as practitioners believe it does.  And in kids, the fall-out from such misdiagnosis is bigger. And missing a Copper deficiency? (because we’re not as well-trained to recognise it and because Copper has been sadly demonised)  Likely to have myriad negative impacts at this vulnerable age…almost none of which generate symptoms or a distinct clinical picture e.g. secondary iron deficiency, low neutrophils without necessarily compromised immunity.  But what about the holy grail get-out of jail adjective: ‘relative’. You know, ‘this is at least a Copper excess relative to their Zinc?’

Well, to form this opinion you’re likely calculating the Zn:Cu ratio and applying an ideal adult value of 1:1 but show me the primary evidence that supports this for kids…anywhere?  The Zn & Cu relationship shifts as we move through life-stages and in fact Copper is supposed to dominate through a lot of our childhood so…ummmmm…no.

HTMA Copper side-steps all of this?..double no.

I used to make the same mistake re Zn:Cu, I may have even taught you this?!🤦‍♀️  But as so often happens, a week spent in all the original scientific data and I’ve emerged a changed practitioner! Having been part of perpetuating this problematic premise in the past, I am determined to get the correct message out there to as many practitioners as possible.  So help me spread the word on Copper in Kids – by telling others that this mineral is so critical to kids compared with adults, they will often have higher levels than ‘us’ and that until you’ve applied the right age-appropriate reference range and ruled out confounders you can’t possibly make a call on Copper. I mean, we kind of knew this all along, with healthy pregnancy Copper values being exponentially higher being a giant clue. Turns out kids’ ‘Copper Age’ extends way beyond the womb.

Copper, as a kingpin in angiogenesis, brain & bone building & iron regulation is a critical mineral during paediatric development. So much so, the kind of blood levels we see in a primary schooler might cause alarm if we saw them in an adult. So too their Zn:Cu.  But higher blood Copper and more Copper than Zinc are not just healthy but perhaps necessary during certain paediatric periods.  This recording redefines normal, low and high with a great clinical desktop tool to help you better interpret these labs, as well as reviewing the top causes and consequences of both types of Copper imbalance in kids. 
The latest Update in Under 30 has landed. You can purchase January’s episode, Copper in Kids here.
If you are an Update in Under 30 Subscriber, you will find it waiting for you in your online account.
-Your RAN Online Account has a NEW LOOK!!-
Next time your log in, you will experience a more user friendly way to search, view, listen and download your resources. Find out what’s new here.

 

When the Body Attacks the Mind

 

Following an important weekend of discussing mental health from a more balanced perspective (that’s my new less provocative term for ‘integrative’ or dare I even mumble…holistic) in Perth for ACNEM, I remain alert but not alarmed of how much is still to be revealed in this area.   Recently, for example, in our mental health dedicated mentoring group, we discussed a case of a somewhat atypical schizophrenia presentation in a middle-age female migrant.  Fortunately, I co-chair these sessions with an incredible clinical psychologist who was quick to pick up that no CNS auto-antibodies had been tested, and given the peculiarities of the case they should have. This is a relatively new area, in terms of more mainstream acceptance of this as a differential in some psychiatric presentations and provision of these tests now through mainstream labs, but it would appear it is far from common knowledge.   Then I read this brilliant article and…well I think we all need to read it.  Here are some snippets…

Scientists had previously noted that certain autoimmune diseases, such as lupus, were associated with psychosis. And they’d begun to suspect that some infections might, by activating the immune system, contribute to psychiatric conditions. But Dalmau provided meticulous proof that the immune system could attack the brain. The development of a test for the disorder, and the fact that very sick patients could recover with treatment, prompted a wave of interest in autoimmune conditions of the central nervous system. In total, scientists have identified about two dozen others—including dementia-like conditions, epilepsies, and a Parkinson’s-like “stiff person” syndrome—and many experts suspect that more exist…

Robert Yolken, a scientist at Johns Hopkins University, estimates that about one-third of schizophrenics show signs of immune activation (though he adds that this could be related to other factors, such as smoking and obesity). And autoimmune diseases are more common among schizophrenics and their immediate families than among the general population, which could hint at a shared genetic vulnerability.”

There are some potent practical take-homes in this article embedded especially within the story of an 11-year-old boy who was admitted to hospital with profound psychiatric features – initially misdiagnosed and managed as BPAD and later found to have autoimmune encephalitis.  First and foremost: psychiatric conditions develop gradually.  When there is an acute onset in the absence of an acute trauma – the possibility of a biological (esp autoimmune) driver should be elevated in your differentials. And the mother of this boy, now aged 21 and having undergone 5 relapses and recoveries in between, virtually echoes the thoughts and findings of Carl Pfeiffer half a century ago, when she says, “Too often, psychosis is seen as the disease itself but psychosis is like a fever, it’s a symptom of a lot of different illnesses.” Important for thought.

Milk Madness – Is it a thing?

Could dairy intake in susceptible individuals be a risk promoter for mental health problems?  In addition to evidence of the exorphin derivatives from certain caseins interacting with our endogenous opiate system discussed in part 1, we now look at the evidence in support of other milk madness mechanisms.  Specifically, the IgG and IgA antibodies about what this tells us about the patient sitting in front of us about their gut generally and about their mental health risks, specifically.  The literature in this area dates back to the 1970s but the findings of more recent and more rigorous research are compelling. Find out more here.

Pyrroles…I Recant!!!

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This year has been a steep learning curve but this is exactly as I had hoped and planned for.  I strapped myself in for my roller-coaster ride,  a series of intensive upskilling initiatives undertaken with mentors and experts in specialist areas, and I haven’t hurled yet or screamed loud enough to make the operator stop the ride (seriously this happened to me in about 1997 on a Pirate Ship in Rosebud!)…but I have come close 😉 

One of the really big lessons has come from getting more into the science behind pyrroluria and urinary pyrrole testing again.  What motivated me to tackle this spikey beast?  Well, like many people who have been introduced to the concept of pyrrole testing and pyrrole driven mental health presentations – I had a lot of questions that hadn’t been adequately answered.  Those gaps left me with some uncertainty about the validity of this investigation and about the interpretation of the results.  I also have introduced this pyrrole theory to many naturopaths and hence feel a responsibility to polish up my knowledge on this and set the record straight.

Last but not least, in our local area we reputedly have a ‘pyrroluria plague’ at play – every man woman and their dog is getting this diagnosis and it had added not only to my misgivings about testing but also my concern about misdirected & unsafe treatment. (more…)

Mental Health Assessment for the Integrative Practitioner

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I became interested in working in mental health not entirely of my own free will.  I guess you could say, it had made it’s way into my world via family members and friends as well as my own problems when I was younger. So when I was at uni and I came across any information about mental illness, whether it was pathology or prescription, it was when I undoubtedly resonated most strongly with what I was learning. I’ve had some great opportunities throughout my career to feed my interest, met some wonderful mentors and some other powerful teachers who were often my patients. It’s now become a running joke among my teenage children that all my friends are either psychologists or have some sort of mental health diagnosis, ‘…and what does that say about you?’ they love to add teasingly.  Well it says a lot probably: that I enjoy people who are comfortable talking about the psychology of our lives and ourselves, that I deeply appreciate that to be human is to suffer and we all suffer it’s just a question of degrees and the bravest of us share that with others.  Lastly, I think it tells you that I live in the real world with real people 🙂 (more…)

Top 10 Investigations in Mental Health Patients

One of the most common questions I’m asked is whether I have a ‘set list’ of tests that I request for every patient.  Of course there is no ‘one size fits all’ in health & each patient presents with their own novel combination of issues & investigative challenges, however, years of clinical experience have taught me which pathology parameters are the most clinically meaningful.

Asking yourself, ‘Will the results of this test determine my thoughts about treatment & therefore ultimately the clinical outcome for my patient?’, before referring for any investigation is a good habit to get into.

Many of us are increasingly aware of the changing environment around pathology testing, which includes reduced access to some tests in mainstream pathology.  Rbc folate has had its subsidy withdrawn which means if we request this we’re now likely to receive a serum value or nothing.  But does this matter? (more…)

End of Year CD Clearance

As we head rapidly towards the change over of our calendars we would like to offer you a special on the very best educational recordings from 2014 – buy 2 CDs before Jan 31st and receive one complimentary Premium Audio Recording of your choice  OR purchase 4 CDs and receive a 3 month Premium Audio subscription for free

It’s been a busy year during which Rachel has delivered 7 very successful new seminars in the area of mental health and  beyond, most notably fortifying her role as a leader in the field of diagnostics and pathology interpretation.  This has included collaborations with ACNEM, Biomedica, Health Masters Live, MINDD and Nutrition Care, however, each recording is classic Rachel – full of fresh perspectives on diagnosis & treatment, colourful analogies  & humour.  In case you missed some of these this year or want a copy for keeps – here’s a quick summary of the 2014 recordings included in this end of year offer: (more…)

Mental Health – The Real Story

“Two great speakers – inspirational in the first half and bang on in the second – I now know how much I don’t know”

Just out now in time for Christmas…no seriously though… this year I had the good fortune to team up with Biomedica and in particular Rachel McDonald and we delivered a 3 hour seminar called Mental Health in Holistic Practice.  The intention behind this collaboration was to shift the education focus for practitioners from a prescription based approach, to one really about the clinical reality of managing mental health clients.  Probably most of you will agree that the ‘treatment’ counts for only a portion of the positive outcomes in your patients and this is particularly true in clients challenged with mental health issues. After more than 20 years in practice working in this area, I’m keen to share what I’ve learned so other practitioners can get there much much faster! (more…)

I’m coming to Sydney!

So far this year I’ve been doing most of my presenting online which has been fantastic because we can all be in our PJs and no one’s the wiser (except now!!) but I do miss the face to face seminars where sometimes the real magic happens thanks to the two-way dynamic between you and me!

So guess what?  I’m coming to Sydney on the 31st August (and then Brisbane 6th September and then Melbourne 13th September) to touch base with many of you again.  I’m joining forces with Rachel McDonald from Biomedica to talk about the real world application of naturopathy in mental health conditions.  (more…)

Something on my MINDD

I briefly mentioned in a previous post Dr. Robyn Cosford’s inspiring opening speech at this year’s MINDD conference.   A key point she made was the growing gap between what’s regarded as normal and what is actually healthy. 

Having worked in general practice for decades, Robyn provided us with one illustration after another – Type 2 diabetes, previously called adult-onset diabetes, now not infrequently diagnosed in primary school aged children; delayed speech and learning difficulties in male toddlers which many increasingly regard as ‘normal’; precocious puberty in girls; escalating rates of depression and anxiety in children and adolescents…Robyn asked us as practitioners to be vigilant about helping patients to distinguish between what has become perceived as ‘normal’ and what is actually healthy.

In my MINDD presentation this year I talked about the mental health challenges faced by young men and I expressed a similar concern: that when we witness extensive aberrant behaviour in young men we are prone to rationalise it.  Are we mistakenly attributing these signs of dis-ease in males as simply being an initiation into Australian culture?  When you hear of young men exhibiting binge drinking behaviour, does it set off the same alarms as it would if your patient was female and if not….why not? 

As part of a broader discussion of the issues, I presented two cases of young men with mental health problems – both from very different sides of the tracks, one gifted and the other a struggler but one of the features they shared included the way their use of alcohol & other substances had passively been condoned by society instead of being seen as a call for help.  We can help these young men but only once we’ve acknowledged there’s a problem. So now I’m extending Robyn’s plea and ask you to be vigilant in making the distinction between ‘normal’ and healthy… when mothers relay stories of their son’s ‘antics’, when brothers, cousins & uncles temporarily ‘go off the rails’,  when young men reluctantly present for a quick fix…

If you missed the presentation and are interested in the full recording check out  https://rachelarthur.com.au/product/new-young-white-men-mental-health-challengers-face-mindd-conference1hr-total-50/

 

P5P V Pyridoxine supplements – when and why?

I’ve been curious about the push towards using so-called ‘active forms’ of B vitamins over the last 10 years in nutritional medicine – particularly with regard to B6 (pyridoxal-5-phosphate) and B2 (riboflavin 5’-phospate aka FMN) in light of substantial research demonstrating that these phosphorylated forms will in fact be dephosphorylated prior to uptake in the small intestine (Gropper, Smith & Groff Advanced Nutrition & Human Metabolism 2005) – so initially it seemed we were being encouraged to pay more for something that ultimately gave us less of the same vitamin. Funnily enough the only established scientific way to ensure uptake of the active forms in their intact active states is to use very high doses – however supplements containing either active B6 or B2 consistently offer very low doses compared with the regular supplements, so this seemed to rule this out as an explanation.

In spite of my scepticism & encouraged by the Pfeiffer approach, I got into using P5P and had to suspend my disbelief in the face of good clinical results.

However finally at the MINDD conference last week, scientist Woody McGinnis at last made sense of this riddle for me!

McGinnis, who some of you might know as previously being a key researcher at the Pfeiffer Institute which specialises in nutritional and integrative management of mental health & behavioural disorders, confessed that he had also struggled with concept of P5P supplementation from a scientific perspective until Bill Walsh suggested that this form was particularly indicated for the ‘lean malabsorbers’.

What Woody essentially took from this was that patients with leaky guts could absorb the P5P intact &  would ultimately benefit from this form.  Adding to this is my understanding that the dephosphorylation process for P5P in the gut occurs via ALP – a zinc dependent enzyme found in the brush border of the small intestine…so here you have the double whammy – if your patient is a malabsorber AND zinc deficient (which of course commonly go together) they are the ones picking up the P5P perfectly and for the rest of us perhaps the pyridoxine will do.

Woody also attested to this with his story of his own pyrroluric son who initially only responded to P5P but in his teens (with significantly improved gut health) appeared to stop responding – at which point Woody switched him to the higher dose pyridoxine with fantastic results…..Aaahhhh at last my scientific curiosity has been quenched! 🙂