Perhaps you’ve heard about one of the latest health buzzes when it comes to mental health – a cheeky enzyme known as MTHFR (methylenetetrahydrofolate reductase).

If you have a mutation in this gene then it can cause your methylation processes to work too much, too little, or not enough at all.  Methylation is essentially a process that occurs where DNA gets tagged with a ‘methyl group’ which lets the rest of the body know not to read that particular bit of DNA.  It’s also involved in the production of neurotransmitters, detoxification of chemicals, nerve health and processing of certain hormones and nutrients, to name just a few.

When the MTHFR genes work properly, you have adequate enzyme activity and that means you can more efficiently make proteins, use antioxidants, metabolize hormones, enjoy more stable brain chemistry, better eliminate toxins and heavy metals, and manage inflammation.  So if you’ve got a problem with this gene, it really can be a bugger.

How does it affect your mood?

Many people with the MTHFR gene experience mood imbalances.  This gene affects your mood in a few ways.

Reduced MTHFR enzyme means that you cannot make and recycle a very important antioxidant, glutathione effectively.  Glutathione is responsible for a vast array of activities in the body and low levels have been associated with conditions such as depression, inflammation, bipolar, chronic fatigue syndrome and autism.

If your body cannot methylate the chemical homocysteine (you can find out if this is too high via a blood test) that results in decreased production of SAMe.  This leads to decreased production of dopamine, serotonin and norepinephrine, neurotransmitters all responsible for mood balance.

If there is a reduced ability to detoxify chemicals and heavy metals (which is a factor for those with the MTHFR gene) this can also affect your mood.  Digestive and liver health can have an indirect affect on your mental health, for several reasons such as the health of your gut flora, increased inflammation and an impact on your neurotransmitters.  Digestive health problems have been linked to mental health problems in several studies.  Click here to read more.

A lot of people with MTHFR gene also have a condition called Pyroluria (also known as Pyrolle disorder, Mauve factor, Kryptopyrrole, Kryptopyrroluria.  People with this condition produce excess amounts of a substance called Pyrolles which bind to certain nutrients such as Vitamin B6, Biotin Zinc and GLA (an essential fatty acid).  There are several conditions associated with this disorder but namely it is involved in several mental health conditions such as Bipolar, Schizophrenia, Manic depression and ADD/ADHD.  This condition is also strongly linked to the state of the digestive system.

MTHFR and Folate

One of the main issues we have come to understand with MTHFR is that people with this gene cannot process folic acid into folate effectively and so cannot handle synthetic forms of the nutrient.  This can become a bit of an issue because synthetic folic acid is in pretty much every multi-vitamin, and a lot of foods are fortified with it.  If you are consuming synthetic folic acid and you can’t process it, it clogs up a lot of the pathways that require folate and as a result a lot of health complications arise.  You can also be prone to problems relating to deficiencies of folate, such as miscarriage and neural tube defects.

Photo by Braňo on Unsplash

People with MTHFR require a special activated form of this nutrient, the type found naturally in some foods.   How much depends on the level of the gene mutations present (there’s a lot of variety that you can have) and your diet and lifestyle can have a big impact on it as well – it’s completely possible to have this gene and be symptom free and healthy if your diet and lifestyle is fine, and the gene hasn’t been ‘switched on’ (usually by stressful events).  In Australia the closest to natural folate that we have available is folinic acid (calcium folinate) supplements, however this may still be difficult to metabolise for those who have very poor methylation.

Getting tested

If you suspect that you have this gene, then you can easily get yourself tested via labs such as Healthscope, Nutripath or 23 and Me.  You may like to get this organized with a health practitioner who is knowledgeable in the realm of MTHFR, so they can guide you with treatment if needed.

Learn more: MTHFR_Related_Health_Problems

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When your gut controls your mood: the gut-brain axis

From as early as the 1930’s, scientists were beginning to understand that the health of our digestive system could influence our mood.  The state of our intestinal lining and the balance of bacteria within our digestive system have a major role to play in the production of our neurotransmitters: chemical transmitters that tell our brain whether we should be feeling such ways as happy, sad, agitated, or calm.  But even though the research in this area sky-rocketed in the last decade and continues to grow every day, the concept of our gut-brain connection isn’t very well known.

The gut is linked to the brain

Did you know – When you were just starting to grow in your Mumma’s womb, your brain and your digestive system developed from the same lump of tissue.  During this process of dividing up cells (embryogenesis) this lump of tissue divides and forms our central nervous system and our enteric nervous system (this is the nervous system of our gut – sometimes called the second brain).  These two are connected by an important ‘wire’ – our vagus nerve.  This development can help us understand why there are so many similar chemicals and receptors in both our brain and our digestive system, for instance serotonin.

Gut bugs and your mood

As soon as you’re born, bacterial colonies start to develop in your digestive system.  Within the first few days, the bacteria starts sending messages to the nervous system and can actually determine our nervous system ‘set point’ long term (1).

When the balance of our gut bacteria (collectively referred to as the microbiome) is affected, this can affect your mood.  Studies have found that the microbiome can have a major impact on stress levels and anxiety (2).  In fact, by treating imbalances in our microbiota, it is possible to support a wide range of mental health disorders (3), (4), (5), (6), (7).

The second brain

The nerves in your digestive system are constantly speaking to your central nervous system.  If your gut is irritated for some reason – say you’ve eaten something that you’re intolerant to (like gluten, for example), you’ve generally got a bad diet, there’s an imbalance in your microbiome (that’s your collective gut bacteria, remember) or you’ve got an infection – this can create an inflammatory reaction and will certainly make you irritated as well.  We know that depression is both associated with, and worsened by inflammation.  This inflammation in the brain can be driven by inflammation in the gut, which can be caused by intestinal permeability (leaky gut) and bacterial imbalances (dysbiosis).  Treating leaky gut can help reduce the severity of depression (4), (8), (9), (10), (11).

Neurotransmitters in our gut

Serotonin is produced in large amounts in our digestive system.  In people with Irritable Bowel Syndrome (IBS) there is too much serotonin in their digestive system.  This is why antidepressants known as SSRI (selective serotonin reuptake inhibitors) can improve the symptoms of IBS: these act by reducing the amount of serotonin taken into cells in the rest of our body which allows more to get into the brain.  However anti-depressants can affect the gut negatively as well, because if you weren’t making enough serotonin in the gut in the first place, you’d end up with even lower levels in the digestive tract and so it can become irritated, affectively you’ll get a depressed gut (12), (13).

A vicious cycle

When your gut is upset, you feel upset.  But stress can affect your digestive system just as much as it affects your mood.  It can impair the secretion of digestive acids, slow down the motility of the gut, allows the unfriendly bacteria to grow, reduces your friendly bacteria and exacerbates intestinal permeability (leaky gut) (14), (8).  This is a recipe for an unhappy digestive system, and as you know this can then go on to send more messages to your brain: so you can see how the cycle continues.

People with gut problems are more likely to experience anxiety and depression.  Some studies have found a high proportion of anxiety in those with gut conditions such as Irritable Bowel Syndrome(IBS), Crohn’s disease and coeliac disease (15), (16), (17).

Helping the gut-brain axis.

By treating digestive problems, sealing leaky gut and balancing your microbiome it is possible to help with conditions such as anxiety and depression, and there’s even research showing the benefits of treating the gut in conditions like chronic fatigue syndrome, schizophrenia and autism (10), (18), (11).  Probiotics are one of your major tools when it comes to treating the gut, but it’s a good idea to consult with a health practitioner to make sure you’re getting the right type, and also to get a good gut healing treatment program to go along with it ⁽¹⁹⁾, (4), (9).

Related articles:

• Probiotic stress busters: http://www.naturopathnsw.com.au/probiotic-stress-busters
• Depression starts in the gut?:  http://www.naturopathnsw.com.au/depression-begins-in-the-gut
• What is Dysbiosis: http://www.naturopathnsw.com.au/what-is-dysbiosis
• Fermented foods (foods to stop bloating and farting): http://www.naturopathnsw.com.au/foods-to-stop-bloating-and-farting-fermented-foods
• Enhance your health with probiotics: http://www.naturopathnsw.com.au/enhance-your-health-with-probiotics
• The benefits of soaking and sprouting: http://www.naturopathnsw.com.au/the-benefits-of-soaking-and-sprouting-plus-a-sprouted-chickpea-hummus-recipe

Works Cited

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If you experience anxiety, you are not alone.  Conditions like anxiety and depression are becoming increasingly common.  In Australia and New Zealand about 20% of adults will experience a mental illness at some stage in their lives.    3% of Australian adults experience anxiety in a year (this is high!) and 55 to 60 % of these are women.  The higher incidence of women with anxiety may be due to the fact that men seek treatment less frequently.  The average high-schooler today has the same level of anxiety as the average psychiatric patient in the early 1950’s. We are getting more anxious every decade.

When we are presented with a stressful situation it is normal to feel some anxiety, however it is when this becomes more prolonged or severe that anxiety is considered to be a ‘disorder’.  Anyone who has experienced anxiety knows that you can’t just “stop worrying” or “snap out of it” – if it was that simple then it wouldn’t be such a problem.  Thankfully, there is much that can be done.  One of the first steps to overcoming anxiety is understanding that it’s not ‘all in your head’, but learning about the condition, and then taking steps to get better by seeking help.

 WHY?

There are several types of anxiety, such as generalised anxiety disorder (GAD), panic attacks, obsessive compulsive disorders, post traumatic stress disorders and phobias.  These can be caused by slightly processes in the body, and will give different symptoms as well.

Given the increased pressure we have on ourselves with work, finance, family, relationships and not to mention all the scary things the media warns us about, it’s no wonder that anxiety is so common.  Support networks (groups of people that we can turn to who listen to and understanding our concerns) used to exist in greater strengths, however with everyone’s busy lives and the impact of technology on social interactions we are no longer able to ‘debrief’ as we once were, and so our stresses are exaggerated and not dealt with properly.

There are many different causes and triggers of anxiety (so many that it could fill a book) so I will only list some of them.

• Neurotransmitters are chemicals which allow our neurons to communicate with the rest of our body by an electrical signal.  If there is an imbalance in these, we can get a problem with mood.  Serotonin, Glutamate, GABA and Dopamine are most often involved with anxiety.  The way that we make neurotransmitters is like a factory line – we start with protein and there are several steps along the way where certain vitamins and minerals add bits and pieces to get the final product.  If something goes wr0ng with that factory line, you get neurotransmitter imbalances.
• Emotional triggers.  This doesn’t really need explaining.
• Hormonal imbalances.  Many women (and their partners) are well aware of the affects of PMS on mood.  Anxiety and depression are very common around ‘that time of the month’.
• Blood sugar level fluctuations.  When your blood sugar levels drop it can cause feelings of anxiety, so eating a low GI diet is important to prevent anxiety.
• Diet : deficiencies.  What you eat can affect your mood.  A lot.  There are a few vitamins and minerals in particular that have very important roles in making our neurotransmitters (think of the factory line mentioned before), and if you are missing one or any of these then the process either doesn’t occur, or goes in the wrong direction. 
• Diet : triggers.  Food intolerances, caffeine or other stimulants, preservatives and additives can trigger anxiety via a complicated chemical process which ultimately – you guess it – disrupts that neurtransmitter factory line.
• Digestive problems.  Did you know we make most of our neurotransmitters in our digestive system?  It makes sense then that digestive problems can upset the subtle balance of these neurotransmitters, affecting your mood.  Most people with IBS have probably noticed this connection for themselves – have a stressful day, and your gut suffers (and vice versa).  Liver issues can also be connected with anxiety, potentially via their effect on intestinal health and bilirubin toxicity, even though some conditions such as Gilbert’s syndrome are frequently labelled as being symptom free.
• Toxicity (e.g. heavy metals)
• Inflammation.  A lot of mental health conditions are now being linked to other auto-immune/inflammatory conditions, and depression itself is considered to be an inflammatory condition.

WHAT CAN I DO?

 Seek help!

According to a research paper from the Lancet published in 2006, despite the great number of pharmacological options less than half of the patients suffering from panic disorder experience a full and sustained remission.  What should we take from this disappointing fact?

We need to realise that what causes anxiety is not the same for everyone.  Treatment of anxiety and other mental health conditions needs to be holistic.  By this I mean that all the factors that combine to cause anxiety need to be addressed, and that treatment should incorporate different methods to do this, such as counselling, nutrition, herbal medicine, massage and acupuncture to relieve the symptoms of anxiety and address the underlying causes.

Complementary medicine can do marvellous things for anxiety, however if your anxiety is severely debilitating then medication may be necessary in the short term.  It is advisable not to self prescribe as anxiety and depression require specific doses and quality of herbs which are difficult to find in the retail range, and there are interactions between some medications and herbs which should be avoided.

There are many different treatment options available giving you plenty of choice and whichever one you choose it is most likely you will get some relief – choose a therapy that you have an affinity with and combine it with a cognitive therapy (e.g. counselling, hypnotherapy or meditation) and you’re on the right path.

Don’t lose hope – if you seek help then you can regain control over your anxiety.

Some tips to help you along your way

Meditation is one of the oldest and most effective ways of managing anxiety and mood disorders.  Research has shown that people who take conventional medications for anxiety who also meditate have a better result.  This is a good practice to incorporate into your daily ritual to help manage anxiety.

Breathing techniques are a very important part of managing anxiety.  A lot of people don’t breathe correctly, which is usually a habit we don’t even realize we have.  Some of us are chronically bad breathers as a result of growing up with breathing conditions such as asthma or sinus disorders.  This incorrect way of breathing can worsen anxiety, often leading to hyperventilation.

Your diet can have a strong impact on anxiety, both positively and negatively.  To begin with, simply reduce the foods that can trigger anxiety (see above) and try to increase your intake of nourishing foods like good fats, vegetables and whole (intact and unprocessed) grains – preferably organic.  For further guidance consult a naturopath or nutritionist.

Exercise.  Walking, jogging, swimming, pilates, yoga.  Get moving – it does wonders for burning up your stress hormones and clearing your thoughts.

Keep Rescue Remedy or Emergency Essence handy to use if you have an acute episode.

Mindfulness exercises are a great technique to ‘unclutter’ your mind.  There are plenty of different techniques available (just do an internet search) but the core of the technique is that you are concentrating solely on what is happening at that moment in time.  Mindful eating is a great habit to get into – it improves stress as well as digestion.

Works Cited

• Brito, D. B. (2012). Bilirubin Toxicity. Retrieved from http://www.ff.ul.pt/FCT/RECI/BIM-MEC/0188/2012/1.pdf
• Charles L. Raison, M., Christopher A. Lowry, P., & Graham A. W. Rook, B. M. (2010). Inflammation, Sanitation, and ConsternationLoss of Contact With Coevolved, Tolerogenic Microorganisms and the Pathophysiology and Treatment of Major Depression. Arch Gen Psychiatry, 67(12), 1211-1224.
• Hechtman, L. (2011). Clinical Naturopathic Medicine. Churchill Livingstone Australia.
• Leahy, R. H. (2008, April 30). Anxiety: How Big a problem is it? (Psychology Today) Retrieved April 21, 2012, from http://www.china-consult.com.au/2010/09/17/anxiety-how-big-a-problem-is-it/
• Mindfulness in Everyday Life. (2007, January). (Black Dog Institute) Retrieved April 21, 2012, from http://www.blackdoginstitute.org.au/docs/10.MindfulnessinEverydayLife.pdf
• Overeview of mental illness in Australia. (n.d.). Retrieved from http://www.responseability.org/site/index.cfm?display= 134563
• Roy-Byrne, P. P., Craske, M. G., & Stein, M. B. (2006). Panic Disorder. Lancet, 1023-1032.
• Satish A. Eraly, M. P., Caroline M. Nievergelt, P., Adam X. Maihofer, M., Donald A. Barkauskas, P., Nilima Biswas, P., Agorastos Agorastos, M., . . . Team, f. t. (2014). Assessment of Plasma C-Reactive Protein as a Biomarker of Posttraumatic Stress Disorder Risk . JAMA Psychiatry, 71(4), 423-431. Retrieved from http://archpsyc.jamanetwork.com/article.aspx?articleid=1833091&resultClick=3

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