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If you had witnessed the friendly invasion of Vancouver's Waterfront Centre Hotel by the international coalition of orthomolecular physicians, naturopaths, scientists, journalists and interested citizenry, you would have concluded one thing: orthomolecular medicine has become respectable. Despite our pioneering years as a voice in the wilderness, we have now emerged at the leading edge of mainstream medicine. The conference was a truly international event, with delegates from around the world. Orthomolecular medicine has come far from its early domain of psychiatry–the conference included sections on cardiovascular disease, cancer, AIDS, as well as nutritional and environmental medicine. However, true to our roots, the treatment of mental illness was prominently highlighted. The spectrum of mental illnesses––schizophrenia, depression along with behavioural and learning disorders––were discussed at length at the conference by orthomolecular physicians who have devoted their lives to these specialties.
WILLIAM WALSH, PhD
William Walsh brought a wealth of information to the conference. He became interested in orthomolecular medicine many years ago as a researcher at Argonne National Laboratory in Illinois. He had been doing volunteer work for a prisoner assistance programme for convicts and ex-offenders at a nearby prison. As he got to know individuals and their families, he became aware of an interesting phenomenon. Some of the most violent and incorrigible prisoners seemed to have come from good stable families and had siblings who had turned out to be good citizens. Walsh began to wonder if perhaps the behaviour of some violent offenders was not the result of flawed life experiences but rather due to an innate biochemical disposition. Walsh founded the non-profit Health Research Institute with the intent of studying the possible biochemical links with behaviour. He drew volunteers from Argonne's immense pool of scientific talent and they began their first experiments, which were unsuccessful. A fateful break came for Walsh's group with an encounter with the late Carl Pfeiffer, a pioneer in orthomolecular research into schizophrenia. Pfeiffer encouraged Walsh and suggested that they would do well to examine trace elements––particularily copper and zinc–– as a cause of behaviour disorders. Walsh's group then conducted many experiments to determine the biochemical profiles of delinquent adolescents, hardened criminals and even serial killers. They discovered that behavioural syndromes were strongly correlated with four biochemical profiles, distinct enough to distinguish violence-prone individuals from normal controls simply by looking at their lab results. Walsh continued to work with Pfeiffer and founded the Carl Pfeiffer Treatment Centre, a thriving clinic for the orthomolecular treatment of schizophrenia, depression, learning and behavioural disorders and autism. Today they have the world's largest database of biochemical/behavioural profiles and have developed comprehensive treatment programmes.
BERNARD RIMLAND, PhD
Bernard Rimland, a world authority on autism, also spoke at the conference. His interest in autism began with his own son who was born with the syndrome. Rimland began researching autism which was a rare and poorly understood illness at the time. Eventually he wrote what has become the classic book on autism, and became interested in the use of vitamin B6 after hearing of its positive effects from parents who had tried it on their children. Convinced of the efficacy of vitamin therapy, Rimland has further refined his treatment protocols for autism and now uses a combination of vitaminB6, magnesium and Dimethyl Glycine, along with the elimination of food allergies. He noted that of the 16 double-blind studies on the use of B6 and other nutrients, every one of them achieved a positive response––an impressive record unmatched by drug treatments. Rimland estimates that 50% of autistic children who are put on this therapy, will derive great benefit from it. Rimland spoke of an epidemic of autism occuring today. This phenomenon is something any pediatrician will acknowledge as autism has come to be a regular presentation in any pediatric practice. The cause of autism is still a mystery. Rimland hypothesized that the syndrome may be the result of a multiplicity of factors: genetics (in the form of inborn vitamin dependencies), environmental toxins, or even adverse vaccine reactions. Today Rimland directs the Autism Research Institute in San Diego, California. He has recently organized an international symposium on autism. Thirty of the world's experts on autism convened in Dallas in January, 1996 and had issued a consensus report which catalogues the state of the art in autism treatment. This valuable report is available from Dr. Rimland's Institute of Autism Research, 4182 Adams Avenue, San Diego, CA 92116.
ABRAM HOFFER, MD, PhD
Dr. Hoffer drew upon his decades of research and clinical experience in his talk on the orthomolecular treatment of schizophrenia. Beginning with some case histories of striking recoveries from schizophrenia, Dr. Hoffer talked about the importance of diet and vitamins as a foundation for the treatment of schizophrenia. Dr. Hoffer also explained the problems encountered when drugs alone are used for the illness. Conventional treatments for schizophrenia can never resolve what he calls the 'tranquillizer dilemma." The crux of the tranquillizer dilemma can be understood by recognizing two facts. First, tranquillizers help patients with schizophrenia get better (but not well) by decreasing the intensity and frequency of some symptoms. However, if you give a normal person tranquillizers you make them sick. When persons with schizophrenia are treated with tranquillizers, they do at first tend to become better, but as they emerge from their illness, they begin to respond to tranquillizers as a normal person would–– that is, they begin to exhibit a tranquillizer-induced psychosis. When the physician attempts to control these side-effects, he does so by reducing the medication, but by doing so the schizophrenic psychosis reasserts itself. The person with schizophrenia spends the rest of his life somewhere in the continuum of these complementary psychoses. The common experience of so many people with schizophrenia has confirmed this. The cycle begins with schizophrenia's first strike, and follows with hospitalization, drug therapy, an ebbing of symptoms and discharge, the reemergence of schizophrenic or tranquillizer psychoses, rehospitalization and so on. Dr. Hoffer explained that these are the two alternatives which thousands of people with schizophrenia must choose from, but added that orthomolecular medicine has always offered a third alternative––a way to get well again. To underscore the reality of this third alternative, Dr. Hoffer invited Linda and Ian Taggert––a married couple who each had recovered from schizophrenia before they met and married––to address the conference. Linda and Ian stood before us and told of their lifelong struggle and victory over schizophrenia with orthomolecular treatment. Their stories echoed the experiences of so many others with schizophrenia. Both had been happy and promising young people before schizophrenia struck. Linda was an A student, studying at both Canadian and Spanish Universities, and active in many sports. Ian described his own childhood as wonderful, as he was the most creative and athletic child of the family. As their lives progressed, however, Linda and Ian had both been subject to a steady encroachment of depression and anxiety. Linda, who was working at a Toronto museum, suffered severe depression and loneliness and left Toronto for Montreal. Within a week of her arrival she suffered a breakdown and was hospitalized for one and a half years. Ian, then at university, began experiencing bouts of paranoia and withdrew socially. Eventually Ian recovered somewhat, but left university and worked at menial jobs to get by-first on a garbage truck and later on a farm in northern Ontario. It was while working on the farm that Ian, too, suffered a "break with reality." For three weeks he wandered the streets of Toronto, living in the bus terminal preoccupied with delusions and voices.
At this stage in their lives, Linda and Ian both received treatment which consisted of a range of neuroleptics and antidepressants. Psychiatrists gave Linda a host of tranquillizers to quell her symptoms but these made her feel terrible, and when she was discharged, she survived by working at clothing stores and restaurants. Another breakdown followed, and Linda was again hospitalized and discharged. Ian's parents managed to get him hospitalized as well, and he was given tranquillizers. His voices and thought disorder receded, but after he was discharged, Ian felt apathetic, unable to concentrate and could neither study nor hold down a job. With the help of their parents, Linda and Ian found the third alternative, orthomolecular medicine. After seven years of tranquillizers, Linda's parents brought Linda to the Brain Biocenter to see Carl Pfeiffer who prescribed an orthomolecular program. Six months later, Linda's thoughts were clear and she felt well again–she never missed work again and taught sking in the Laurentians for a year. However, after feeling well for so long, Linda stopped her vitamins and suffered a severe relapse. She again began orthomolecular treatment––this time under Dr. Hoffer's care–– and again became well and she remains well to this day. As Linda eloquently put it: " I am as healthy as the next person, and I now feel I have a lot to contribute to society, and can bring a lot of happiness to the world."
Ian was introduced to Dr. Hoffer's treatment program, and within two months both he and his family were amazed at the change.The voices and hallucinations ceased, and he was free of thought disorder and paranoia. He took up jogging again, and later travelled to New Zealand on his own. Ian has since earned a degree in history at the University of Victoria, completed one year of law school, and married Linda. Ian said at the end of his talk: "I am working part time, happily married to Linda, and we are self-supporting. I think all in all it's a very bright picture and I look forward to many happy years with Linda in the future."
And that was what the 25th International Conference was like. I came away from the conference assured that the ideals of orthomolecular medicine will never fade. After all, where else could you have found physicians and their recovered patients banding together as equals and missionaries of the cause?
–Greg Schilhab
Orthomolecular Frontiers
If there are some concepts in nutritional medicine which are particularly irksome to orthodox medicine, the relationship of food to mental illness must be near the top of the list. Physicians and nutritionists accept that patients can contribute to their own health by eliminating junk food from their diets. But what about dairy and wheat products? Are these foods not the antithesis of a junk diet? Conventional nutritional wisdom has made milk and wheat cornerstones of healthy eating without examining the roles that these foods may play in mental illness. The medical literature, however, provides some very good evidence to support the idea that these foods may worsen the symptoms of schizophrenia. These studies have suggested that a protein called gluten in wheat, along with casein proteins found in dairy products, may be significant factors in the exacerbation or genesis of schizophrenia.
Endorphins and Schizophrenia
The body constructs the thousands of proteins it needs from chains of amino acids derived from the diet. There are 20 amino acids which form a kind of "alphabet" which the body can use to spell out anything from small peptides to large proteins for its needs. The body produces a particularly significant class of peptides called endorphins and enkephalins, which are extremely potent pain killing substances. The function of these molecules is to lock onto receptors in the brain, and abolish the perception of pain. Endorphin receptors are often heavily clustered in the frontal lobes and the lower limbic regions of the brain, and according to the dopamine hypothesis of schizophrenia, dysfunction of the frontal and limbic areas of the brain are the basis for the perceptual distortions in schizophrenia. Moreover, studies using drugs such as cyclazocine and nalorphine (termed "mixed agonist/antagonists") which artificially stimulate and supress the body's endorphin receptors have been known to produce profound dyphoria bordering on psychosis in patients.
Gluten and Endorphins
When cereal proteins are digested, gluten fragments which enter circulation happen to have a very similar shape to the body's pain killing enkephalin peptides, and produce the same combined stimulatory and suppressive activity as mixed agonist/antagonist drugs. Gluten therefore, by its molecular mimickry of endorphins and enkephalins, reacts with the brain's endorphin receptors in the same deletorious way as cyclazocine or nalorphine. Casein proteins in dairy products are also thought to have similar amino acid sequences to enkephalin, and also capable of interacting with brain receptors. The term "exorphins" (ie. exogenous endorphins) has been coined to describe these substances in relation to their pharmacological effects.1
Epidemiological Findings
Historical and anthropological studies examining the effects of wheat consumption on the incidence of schizophrenia have reported some interesting results. One historical study examined the incidence of schizophrenic admissions to hospitals in four countries during World War II. During the war years Finland and Sweden faced prolonged and severe shortages in wheat and rye. These two countries were compared to Canada and the USA–two countries which did not suffer significant grain shortages during the same period. When psychiatric admissions were analyzed, it was found that the rate of admissions for mental disorders other than schizophrenia increased in all countries, however in grain-poor Finland and Sweden, the incidence of newly diagnosed schizophrenia plummeted. 2 Anthropological studies comparing wheat consuming and non-wheat consuming cultures have also found interesting correlations. Historically, the incidence of schizophrenia in South Pacific inhabitants of New Guinea and Micronesia has been extemely rare, a phenomenon some researchers attributed to the traditional wheat-free diet of these cultures. Two researchers who gathered and analyzed data on 65,000 subjects discovered only two cases of overt schizophrenia. However, by the mid-20th century, the influence of missionary and trade activity had radically altered the diets of these people to a high grain western standard. The introduction of cereal grains to the diets of these people increased the incidence of schizophrenia to european levels, an equivalent incidence of 130 schizophrenic persons in a given population of 65,000.3 It would seem that these historical and cultural correlations would support the view that gluten has some kind of pathological effect on certain individuals with schizophrenia.
Experimental Evidence
Epidemiologists oft-repeated mantra "correlation does not imply causation" is meant to underline the fact that just because a correlation is found between two variables doesn't necessarily mean that one is the cause of another. However in the case of gluten, casein and schizophrenia, some enlightened researchers have built upon these correlational studies with experiments which further implicate the effects of exorphins.
Singh and Kay conducted a 12 week experiment with 14 schizophrenic patients designed to assess the effects of gluten-free diets and gluten challenge on psychiatric symptoms. This experiment was designed in three phases. In phase one, for the first four weeks patients were given a gluten and casein free diet, and every day received a 30 gram soy protein drink; In phase two, during the next four weeks the soy drink was replaced (without the knowledge of the patients) with a gluten-rich drink; and the last four weeks the diet was again reverted to a gluten and casein free diet. At the end of this study it was found in this group of patients, most of the measures of psychopathology deteriorated significantly during phase two when gluten was added to their diets, yet, the patients again improved during phase three when a gluten/casein free diet was again introduced.4 This experiment was repeated by Rice, Ham, and Gore5 with 16 schizophrenic patients and similar deteriorations and improvements were observed. There appeared to be a subgroup of about 18% of these patients who were very sensitive to gluten. One patient severely regressed during the gluten challenge phase, and two patients demonstrated remarkable improvements during the gluten-free phase of the diet and were even able to reduce their daily intake of medications. A third study was conducted by Dohan3 using 102 newly admitted schizophrenic patients. These patients were randomly assigned to receive either gluten/casein free diets or gluten/casein rich diets. The combined average length hospital stay of both goups was measured and found to be seven days. However, it was found that nearly twice the number (62%) of patients in the gluten/casein free group were able to be discharged earlier than this average, compared to only 36% of the high gluten/casein group.
Conclusions
From the above studies it would seem reasonable to assume that gluten and casein have a negative effect some individuals with schizophrenia, which is reversible upon instituting a wheat and dairy free diet. This is one many examples of illness being the result of individual maladaptation to certain foods which are nonpathogenic in the majority of the population. Elimination diets should be a valuble adjunct in ruling out cryptic gluten sensitivity in schizophrenia
–Greg Schilhab
References
1.Klee W, Zioudrou C et al: Exorphins: Peptides with Opioid Activity Isolated from Wheat Gluten, and their Possible Role in the Etiology of Schizophrenia. In eds. Uspin E, Bunney WE, Kline N: Endorphins in Mental Health Research. 1977: 209-218.
2. Dohan FC et al: Is Schizophrenia Rare if Grain is Rare? Biological Psychiatry. 1984; 19: 385-399.
3.Dohan FC: Schizophrenia: Possible Relationship to Cereal Grains and Celiac Disease. In eds. Sankar siva DV, Schizophrenia: Current Concepts and Research. New York. PDJ Publ. 1969: 539-551.
4.Singh MM, Kay SR: Wheat Gluten as a Pathogenic Factor in Schizophrenia. Science, 1976; 191: 401-402.
5.Rice JR, Ham CH etal: Another Look at Gluten in Schizophrenia. Am J Psychiatry. 1978:135; 1417-1419.
Canadian Alzheimer's Team hails Melatonin as the "First Effective Treatment"
A team of psychologists from the University of Kingston Psychiatric Hospital says it has found "the first effective treatment for Alzheimer's disease." Tests on nine Alzheimer's patients showed that oral administered melatonin resulted in an improvement in mental activity and normalized fragmented sleep cycles. The researchers said that the tests, which were funded by the Alzheimer Society of Canada, showed "encouraging results." Although the researchers stressed that melatonin is not a cure for Alzheimer's, it has improved things for patients and will improve the life of family caregivers.
Toronto Star, Oct. 23, 1996
Treatment Outcomes of Typical Antipsychotic Drugs
An illuminating discussion was presented in the medical publication Journal of Clinical Psychiatry concerning the actual recovery rates with drug treatments. In this discussion it was noted that response rate to neuroleptic drugs in schizophrenia is often quoted to be 70%. However, the more accurate measure of "good recovery of social function" which is, after all, what matters most to persons with schizophrenia, still does not exceed 40%. Where does this disparity come from? The authors state that although neuroleptic drugs suppress positive symptoms thus reducing the number of hospitalizations, the overall social course of schizophrenia is much more closely associated with negative symptoms upon which drugs have little or no effects. As Dr Breier summarized, "For 40 years we have had a class of drugs that at best reduces symptoms but does not lead to profound improvement. This shapes the way physicians practice. They have lowered their treatment goals to keeping patients stable and out of the hospital. Generations of psychiatrists have not had very ambitious goals for schizophrenia; they did not really have the right tools."
J Clin Psychiatry 1996; 14: 3-5.
Free Radicals Implicated in Alzheimers Disease
Alzheimers disease is associated with tangled insoluble deposits of the peptide beta-amyloid in certain parts of the brain. The question of how these deposits manage to accumulate in the brain may now have an answer. Researchers believe that in a process similar to the development of atherosclerosis, beta-amyloid interacts with free radicals and constricts and damages the lining of blood vessels, and leads to its accumulation in these vessels.
These researchers suggest that vitamin E which protects blood vessel linings against oxidative attacks and counteracts the adverse effects of beta-amyloid, may be beneficial in both the prevention and treatment of Alzheimers disease.
Nature. 1996; 380: 168-171
Here is an interesting comparision of organic vs commercially produced food. Sometimes we fail to realize that even diets rich in fruits, grains and vegetables, are not necessarily nutrient-rich diets.
Depression and Natural Medicine. by Rita Elkins. Woodland Publishing Inc. Box 160, Pleasant Grove, Utah, USA 84062. 1995. Paperback, 228 pages.
The latter half of the 20th century has seen a virtual epidemic of mental illness afflicting our society. Few people realize that not only is depression the most common expression of mental illness, it is also the most likely to go unrecognised and left untreated. Rita Elkins has written this small yet concise book as a guide to help master the unique challenges involved in surviving depression. Elkins begins by explaining what depression is and the very significant grip it holds on our society. Accurately defining and recognizing depression is a central focus here, and she includes a simple questionnaire as a fast diagnostic tool. We are taught the differences between reactive and endogenous forms of depression versus the normal ebb and flow of emotions.
There is much material devoted to the relationship between brain biochemistry and nutrition, and especially their interdependence. This begins with examining the effects of high calorie, nutritionally empty foods, the negative influence of sugar, caffeine and other "social drugs" on neurotransmitter levels which influence mood. The mood altering consequences of the body's valiant attempts to counter these insults are familiar: carbohydrate cravings, fatigue and hypoglycemia.
The contribution of orthomolecular medicine to the treatment of depression follows in the chapters dealing with the effects of vitamins, minerals, amino acids, herbs and light on mood. Elkin's book provides nice, compact summaries on all of the well-researched antidepressive nutrients. The B vitamins, especially B6; amino acids such as phenylalanine and tyrosine; and the minerals magnesium and manganese are examined in detail. The physiological basis of Seasonal Affective Disorder (SAD) as a cause of depression is explained along with information on how light, instead of drugs, can be used for treatment.
There are some causal factors in mood disorders that are well outside of the medical orthodoxy, and these too are discussed in the chapters on environmental medicine. Severe depression can be the consequence of many underlying physical diseases such as thyroid disorders or yeast infections. A not insignificant portion of depressive disease is simply the side-effect of the hunderds of many commonly prescribed drugs today. Having succeeded in rejoining body and mind, Elkins draws spirit into the fold. The book closes with many ideas on the integral role of the spirit in recovery, using the examples of meditation, music therapy, breathing, and the importance of spiritual belief. This is a small book about a vast subject, yet there is little ground which is not well covered. Elkins is skillful in bringing the complex physiology and biochemistry of depression to the level of general interest and yet preserves enough detail to empower the person who wants to work with their health care provider. Those who have experience with long-standing depression are likely to be well-versed in the frustrations of finding quality care. This book addresses this reality. The emphasis on comparing the principles, practices and tools of orthodox and complementary medicine, allows us to see how much choice we really have in the case of depression
Review by Greg Schilhab
Dear CSF,
I was a schizophrenic who suffered from hallucinations, severe perceptual problems and paranoia. These were so bad that at one point I believed I had died. I also suffered from tension, anxiety and hypermania. Anxiety attacks were so bad that I would constantly feel severe chest pain whenever I was threatened by social situations, and my condition became life-threatening whenever I was under stress. Adrenalin was continually present in my system, and I suffered from constant hallucinations and wild delusions.
Since I read an article in the Journal of Orthomolecular Medicine regarding zinc and manganese in the treatment of schizophrenia, I am recovering from what appeared to be a 15 year nightmare.
I will explain to you the relief I have received during my present vitamin and mineral therapy.
Week 1: 10 mg zinc, B complex vitamins. Hypomania relieved. Emotional content regained.
Week 2: 20 mg zinc, B complex vitamins.Quick relapse, reduced zinc back to 10 mg.
Week 3: zinc 15 mg, B complex, vitamin B6, 50 mg Feeling better., confidence returning, social functioning better.
Week 4: 30 mg zinc, B complex, vitamin B6, 50 mg , manganese 50 mg Tardive dyskenesia gone, nervous system symptoms relieved, anxiety gone, hallucinations gone, social withdrawal gone
Week 5: Progress fine.
Week 6: Insomnia gone.
All that is left of my original symptoms is my paranoia, and I understand that the paranoia will be relieved in about 12 months. It does appear that the schizophrenic body cannot efficiently absorb zinc, so it is possible that by constantly taking my supplements, I will be able to handle the stress of employment
J.C.
Sudbury, Ontario
Nutrition & Mental Health (ISSN 1199-7699) is published quarterly by the International Schizophrenia Foundation, 16 Florence Avenue, Toronto, Ontario, Canada, M2N 1E9. Phone (416) 733 -2117, Fax (416) 733-2352. E-Mail centre@orthomed.org Copyright by the Canadian Schizophrenia Foundation. CSF Membership is $30.00 per year which includes a subscription to Nutrition & Mental Health. The contents reflect the views of the individual writers and not necessarily those of the editor. It is recommended that treatment of all health problems be undertaken in consultation with a qualified Health Professional.
Managing Editor: Steven Carter
Editor/Production: Greg Schilhab