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Montana Integrative Medicine :: Bozeman, MT

Depression

Depression is a clinical diagnosis, meaning lab tests are not used to identify depression. Symptoms vary from person to person and causes changes in thinking, feeling, behavior, and physical well-being, including difficulty concentrating and making decisions, forgetfulness, negative thoughts (e.g., pessimism, poor self-esteem, excessive guilt, self-criticism), self-destructive thoughts, sadness, loss of enjoyment or interest in activities, decreased motivation, apathy, lethargy, irritability, decreased libido, fatigue, and insomnia.

The biochemical pathways for depression and energy production are well documented. Without being too complicated, the mood-lifting hormone serotonin is produced in the body by transforming the amino acid tryptophan into serotonin, and requires vitamin B6 and magnesium to do so. Phenylalanine, an amino acid, is transformed in the body to dopamine and epinephrine, which are required for energy and mood. These conversions require iron, vitamin B3, vitamin B6, copper and vitamin C. Other biochemical deficiencies that are associated with depression are iron-deficiency, hypothyroidism, vitamin B12 deficiency, folic acid deficiency, and more.

People with many other conditions may also be suffering from depression. Many cases of depression have been evaluated and effectively improved with this nutritional biochemical approach. Dr. Neustadt has charted more than 95% success rate with depression in his clinic. Other conditions with depression as a major component include Arthritis, Seizure Disorder, Irritable Bowel Syndrome (IBS), Lyme Disease, Migraine Headaches and Multiple Sclerosis.

This page contains the details of five cases where the major complaint was depression:

  1. Post-Partum Depression in a Thirty-five Year Old Woman
  2. Depression in a Fifty-two Year Old Woman
  3. Depression in a Twenty-six Year Old Woman
  4. Depression in a Twenty-three Year Old Man
  5. Endogenous Depression in a Fifty-two Year Old Woman

Case: Post-Partum Depression in a Thirty-six Year Old Woman

A thirty-six year old woman suffered from severe post-partum depression after the birth of her first child. The pregnancy had been difficult, with multiple serious but non-fatal complications, such as nausea and vomiting of pregnancy (NVP), insomnia and pruritic urticarial papules of pregnancy (PUP). She also underwent an emergency cessarian section, and suffered from mastitis which caused excruciating pain each time she tried to breast feed and which landed her back in the hospital for forty-eight hours of intravenous antibiotics. The pain from the mastitis was so bad that she started to not even want to look at her newborn or feed him because she could only associate both with pain. This poor woman had been through a lot and was suffering from post-partum depression. As an emergency response, she was prescribed Prozac (fluoxetine), to try to lift her out of her depression. It worked, and along with discontinuing breastfeeding and curing the mastitis to eliminate the pain, she began to feel better. However, she also started to gain weight, a common side effect of Prozac.

She decided to try and discover the underlying causes of her depression and correct them so she could feel better naturally and discontinue her antidepressant. She took the MetaCT 400 test, which revealed:

Low CoQ10, required for energy production
Multiple low essential and non-essential amino acids, which can cause depression, poor blood sugar control and fatigue




Multiple, low intracellular minerals, required to produce mood-elevating hormones, energy and regulate blood sugar
Low vitamin D, which has been associated with depression, as well as increased risk for colorectal and cervical cancer and for infections
Low omega-3 fatty acid, associated with depression
Functionally low levels of vitamin B6 (xanthurenate), required to produce mood elevating hormones, and folic acid (formiminoglutamate), a cause of depression

Low-normal marker for serotonin (5-Hydroxyindoleacetate). Low serotonin is a cause of depression.

This case illustrates is how the conventional approach to treating depression misses the underlying causes of depression and massive underlying biochemical causes that can occur after pregnancy. Pregnancy is a tremendous stress on the body, and it is well documented that pregnancy increases a woman's risk for nutritional deficiencies and subsequent depression. In some ways, this is therefore not abnormal, it is part of the spectrum of biochemical changes that can occur in pregnant women.

This patient was put on a three-month program of dietary modifications and targeted nutrient therapy to correct the nutritional deficiencies and resultant biochemical abnormalities. Two weeks after starting the program she was able to discontinue her Prozac and three years later she is still fine and not taking any medications.

Case: Depression / Insomnia / Migraine Headaches in a Fifty-Two Year Old Woman

A 52-year old woman presented to Dr. Neustadt's clinic, Montana Integrative Medicine, with a life-long history of depression. She had suicidal thoughts as young as five years old, and attempted suicide once in the past. She also experienced insomnia and occasional migraine headaches.

She was unable to work because of her depression and had been taking 20 mg of Lexapro daily for the previous two years. Despite the medication and seeing a counselor, her depression was worsening. She also complained of abdominal gas and bloating, mood swings, anxiety, fatigue, apathy, irritability, poor concentration, and difficulty making decisions. She had no history of suicide attempts. She also complained of difficulty losing weight.

Her biochemical testing revealed functional deficiencies in nutrients required to generate energy and lift mood.

Inability to burn fat for energy
Decreased ability to use sugars to produce energy
Functional vitamins B1, B2, B3 and B12, and folic acid deficiencies

Deficiency in the amino acid methionine and low-normal threonine

Food allergies


She was instructed to avoid the foods to which she was allergic, provided specific dietary recommendations and dietary supplements to give her body the nutrients it was lacking. Two weeks later, at her first follow-up appointment, she reported that she was following the treatment plan diligently, that her mood was "shockingly stable," and that she was not experiencing much depression or anxiety at all. After six weeks on the program she reported continued improvement in her depression and that her pants fit looser on her.

Over the course of the three-month treatment plan, the patient’s condition markedly improved. She was able to discontinue her Lexapro, her abdominal discomforts resolved, her energy improved, as did her tendency toward irritability and angry outbursts. Overall she reported that she felt much better and more decisive. She was able to resume working and even returned to college for a degree in nursing. Her depression did not completely resolve, and she ended up getting back on an antidepressant medication—Welbutrin. However, what this case demonstrates is that improvement occurred to the point where a woman who was completely debilitated and unable to participate in life was subsequently able to feel better and start a career.

Case: Depression / Fatigue / Post-Nasal Drip / Migraine Headaches / Gas & Bloating / Brain Fog / Postural Hypotension / Weight Gain in a Twenty-six Year Old Woman

A twenty-six-year-old woman presented with a three-year history of depression and fatigue. She also complained that colds would linger longer for her than in others, and that she had post-nasal drip “almost all the time,” pre-menstrual migraine headaches for the past eight years, abdominal gas/bloating, brain fog, orthostatic hypotension (getting light-headed when she stood up) “all the time,” and an increase in ten pounds of weight in the past couple of years, which she could not lose despite how much she exercised. She rated her energy at three out of ten, with ten being best.

Her MetaCT 400 test results revealed (1) deficiencies in all ten essential amino acids; (2) iron deficiency (low ferritin); (3) multiple mineral deficiencies; (4) elevated free radial damage to cell membranes (elevated lipid peroxides); (5) low vitamin D (risk factor for breast cancer); (6) low omega-6 series fatty acids; (7) functional vitamin deficiencies for energy production; (8) impaired liver detoxification pathways; (9) intestinal bacterial and fungal overgrowth; (10) and severe food intolerances to milk, casein (a protein in milk), and eggs (white and yolk), as well as moderate intolerance to ginger.

Food allergies to dairy, eggs and ginger



Amino acid deficiencies

Low minerals
Low serotonin production (low 5-Hydroxyindoleacetate), associated with depression. Serotonin production requires tryptophan, vitamin B6 and magnesium.
Low Coenzyme Q10, a vitamin required for energy production, and an antioxidant
Elevated free radical damage to cell membranes
Vitamin D insufficiency
Low omega-6 series, polyunsaturated fatty acids
Intestinal fungal (candida) infection

This woman was placed on a comprehensive nutritional medicine program consisting of a combination of diet and nutraceuticals, and it was recommended that she receive counseling. After two weeks on the program she reported that her energy had already increased and that she no longer experienced post-nasal drip. After six weeks on the program she reported that her energy had increased to 9 out of 10, with 10 being best. She had no post-nasal drip, no migraine headaches, no abdominal bloating and she no longer got lightheaded when she stood up (postural hypotension). Her depression had also completely resolved.

Case: Depression in a Twenty-three-year-old Man

A twenty-three-year-old man came to see Dr. Neustadt complaining of suffering from depression. He would sleep ten to twelve hours daily and would wake up repeatedly during the night. His energy was five out of ten, with ten being best, which he characterized as “low.” He had been experiencing this low energy level for five years. He did not exercise, and his stress was nine out of ten with ten being worst, secondary to “government and world issues.” He had been divorced and had partial custody of his three-year-old son. When asked about his mood, he replied, “I hate people.” His affect was flat during the first appointment, although he was very honest and forthcoming with his emotions and in discussing his feelings. He had no history of suicidal ideation or attempts.

His test results revealed:

During the treatment plan, his depression completely resolved, and his energy increased. After six weeks on the plan, he characterized his mood as “happy.” He also reported that he had no more stress, his sleep was “good,” and he did not wake up during the night anymore. Additionally, his energy had increased to eight out of ten, with ten being best. He mentioned after twelve weeks on the program that the few times that he did not comply with the dietary recommendations on the treatment plan that he felt a return of his symptoms.

Case: Endogenous Depression in a Fifty-two-year-old Woman

A fifty-two-year-old woman presented to Dr. Neustadt’s clinic, Montana Integrative Medicine, with a life-long history of depression. She had suicidal thoughts as young as five years old, and attempted suicide once in the past. She also experienced insomnia and occasional migraine headaches. Her biochemical testing revealed functional deficiencies in nutrients required to generate energy and lift mood. She also complained of difficulty losing weight.

She was instructed to avoid the foods to which she was allergic, provided specific dietary recommendations, and given dietary supplements to give her body the nutrients it was lacking. Two weeks later, at her first follow-up appointment, she reported that she was following the treatment plan diligently, that her mood was “shockingly stable,” and that she was not experiencing much depression or anxiety at all. After six weeks on the program, she reported continued improvement in her depression and that her pants fit looser on her. After three months, she reported complete resolution of her depression for the first time in her life.