Pharma and crime (it’s not what you think)

A notable drop in crime in the U.S. in the 1990s, particularly violent crime, appears to have been mirrored by the introduction of new and more effective drugs to treat mental illness. That’s the conclusion of an intriguing National Bureau of Economic Research working paper, which takes as its starting point the fact that many of the presumed social, economic, and policy determinants of crime actually had little impact on this change, and so other factors may be responsible. As the authors note,

“One factor that has so far been ignored in the attempt to explain this recent drop in crime is a period of dramatic technological advances in the treatment of mental illness. As we summarize below, mental illness is a clear risk factor both for criminal behavior and for victimization. The decline in crime rates occurred during a period when many new pharmaceutical therapies became available to treat mental illness, resulting in exceptionally large increases in medical treatment of mental illness. For example, during the last two decades the use of antidepressants and anti psychotics has become increasingly common following a series of drug innovations in the late 1980s and early 1990s. The new drugs were marked improvements over the previous therapies in terms of side effects and efficacy, and their use has subsequently become widespread. Anti-depressants and anti-psychotic medications are now the 6th and 7thlargest therapeutic classes of drugs sold globally (IMS Health 2006), and by 2005 there were enough newer anti-depressants sold in the U.S to treat every man, woman, and child with a daily dose for almost two months.”

As the authors point out, it has long been established that people likely to engage in criminal behavior respond to incentives, but any such assessment of the risks and benefits may be undercut by mental illness.

“Mental illness may cause the afflicted to substantially discount the future, thereby lowering the deterrent effect of established punishments. This possibility is substantially related to Becker and Mulligan’s (1997) formulation of impatience. They observe that many people recognize their high rate of time preference as a weakness, and allocate resources to overcome that weakness. One might think of mental health treatment as just such an allocation. The expansion of treatment for mental illness can then affect crime not by changing the certainty or severity of punishment, but by changing the behavioral response to established costs.”

Given that severe mental illness is associated with delusional thinking, poor impulse control, narcissism, and altered perceptions of risk, it is not surprising to find correlational studies showing that those with severe mental illness are much more likely to be incarcerated in the past six months than comparable people in the general population. A study that followed all the children born in Dunedin, New Zealand over the course of a year found that those with mental illness were twice as likely to be violent.

So how much of an effect has the psycho-pharmacological revolution had on crime? The authors note that their paper is only a first step in an area of limited data, but they did find that “prescriptions for stimulants and antipsychotics [were] associated with relatively large reductions in violent crimes: 0.129 percent and 0.085 percent for every 1 percent increase in stimulants and antipsychotics, respectively.” The findings were statistically significant.

They also tested their model with the increased use of statins for cholesterol, to see if there findings might be confounded by broader changes in health care.  As the authors note, the growth  of drugs such as Lipitor and Crestor “was likely shaped by some of the same social, economic and policy conditions that led to the rise in pharmaceutical treatment of mental illnesses.”  The relationship between crime and statins was insignificant (and in some cases, positive).

Their conclusion of this long and fascinating paper are noteworthy:

“Our evidence suggests that, in particular, sales of new generation antidepressants and stimulants used to treat ADHD are associated with rates of violent crime, with weaker evidence that anti-psychotic medications played a role in declining crime rates. The magnitude of the elasticities estimated here are clearly small. We estimate that a one percent increase in the total prescription rate is associated with a 0.051 percent decrease in violent crimes. To put this in perspective, doubling the prescription rate would reduce violent crimes by 5 percent, or by about 27 crimes per 100,000, at the average rate of 518 crimes per 100,000 population. While doubling the prescription rate seems like a large change, it has been estimated that 28 percent of the U.S. adult population in any year has a diagnosable mental or
addictive disorder, yet only 8 percent seeks treatment (USDHHS 1999). Doubling the treatment rate would still leave a substantial portion of the ill untreated.”

hat tip – Andrew Sullivan

One Response to Pharma and crime (it’s not what you think)

  1. Andrew says:
    TREATING MENTAL DISORDERS A Neuroscientist Says No to Drugs By JOSHUA ROLNICK Elliot S. Valenstein has spent most of his career searching for biological explanations for behavior. Now, after more than 40 years, he is attacking the prevailing biochemical explanations for mental illness. “We have almost reached the point where there will be no limits to what people will believe brain chemistry can explain,” he writes in the introduction to his new book, Blaming the Brain: The Truth About Drugs and Mental Health (The Free Press). It’s time to stop blaming mental disorders on brain chemistry, he argues. In simple terms, the biochemical theory holds that clinical depression, schizophrenia, and other disorders result mainly from chemical imbalances in the brain. Drugs like Prozac and lithium are supposed to work because they correct such imbalances. In his book, however, Mr. Valenstein, an emeritus professor of psychology and neuroscience at the University of Michigan, argues that scientifically, the biochemical explanation of mental illness rests on shaky ground. Environmental and cognitive variables are as important as biology, he writes, and psychotherapy is often just as effective as drug treatments, which pharmaceutical companies, psychiatrists, and others have successfully promoted. Mr. Valenstein, a former chairman of Michigan’s biopsychology program, seems an unlikely crusader. In his years of research on rats and other laboratory animals, and in more than 140 scholarly articles, he studied how the brain and other biological factors, such as hormones, influence behavior. In the latter part of his career, the psychologist grew more interested in the history of his field — a history he has not always praised. In Great And Desperate Cures (Basic Books, 1986), he argued that scant scientific evidence supported the use of lobotomy to treat certain mental disorders, even though doctors and the public embraced the procedure in the 1940s. When Mr. Valenstein began his new book three years ago, he planned to write a history of brain-chemistry theory, not a critique. “I used to lecture to students and put together a reasonably coherent story,” he says. “I knew there were gaps, but this was an emerging science.” By the time he was halfway through writing the book, however, his skepticism had become unshakable. “I began to feel that the evidence that didn’t fit was becoming overwhelming.” A combination of factors gave rise to the acceptance of drug treatments for schizophrenia and other mental disorders, he argues. Researchers sometimes stumbled upon the drugs inadvertently, he writes. For example, one drug that is rarely used now, chlorpromazine, originally a synthetic dye, was one of the first antipsychotic medications, after scientists concluded that it might help treat post-surgical shock. “With no effective treatment of mental illness,” he writes, “almost anything that held out any hope was worth trying.” As scientists learned more about the brain and its interaction with certain drugs, theories emerged to explain several major illnesses. Schizophrenia, for example, was believed to result from too much activity of dopamine, a neurotransmitter. The theory evolved when scientists discovered that, on the whole, the more an antipsychotic drug blocked the action of dopamine in the brain, the more the symptoms of schizophrenia were eased, Mr. Valenstein explains. But researchers have failed to find direct evidence that dopamine is, in fact, too active in the brains of schizophrenics, he says. And although most antipsychotic drugs did restrict dopamine activity after a few hours, he writes, they had no therapeutic benefit for the first few weeks of treatment. As a result, Mr. Valenstein writes, one study found that the drugs helped only about 60 per cent of schizophrenics. Similarly, he says, antidepressants appear to help only 30 to 40 per cent of patients. Mr. Valenstein argues not that drugs never work, but that they do not attack the real cause of a disorder. Biochemical theories, he argues, are an “unproven hypothesis” — and probably a false one. The pre-eminence of drug treatments is no accident, he goes on. Pharmaceutical companies have a financial stake in their popularity, and promote them heavily among doctors and patients. Mr. Valenstein cites studies that examined some of the literature distributed by the companies and found that much of it contained misleading or unbalanced information. Drug companies are also the largest sponsor of medical research in the United States and Canada, Mr. Valenstein says. In some cases, they give complete freedom to researchers. In other cases, the contracts they require give them the right to exclude information from published reports, or to delay publication of the report itself. A spokesman for one company Mr. Valenstein criticizes, Eli Lilly and Company, declined to comment. Another, Pfizer Inc., did not respond to requests for comment. Psychiatrists, too, have supported the use of the drugs, he argues. For one thing, he says, an emphasis on medication allows psychiatrists to fend off competition from psychologists and social workers, who usually charge less for their services, but who cannot prescribe drugs. While that may not be the reason for their support, he writes, “there is little doubt that since the 1960s, psychiatry has increasingly emphasized biochemical factors as the cause of mental disorders.” Mr. Valenstein emphasizes that he does not intend to discourage patients from trying medication as one option. But he hopes that Blaming the Brain will open up a dialogue about the biochemical theory of mental illness, even as physicians feel increasing pressure to ignore other treatments, like psychotherapy, in favor of costly drugs that may have serious side effects and little benefit. Right now, he writes, “the theory is being pursued relentlessly on a path filled with many dangers.” Can psychiatry be retrieved from a biological approach? D B Double This article is written to counter the bias and domination of biological psychiatry, with the intention of stimulating a professional debate about its ideological basis. A psychiatrist who had recently managed to obtain her first consultant appointment told me that she may be “irretrievably biological” in her approach to psychiatry. Many would regard this outcome of her training as acceptable (Guze 1989) but there are problems with a biological approach to psychiatry (Kaiser 1996). I am concerned about conformist pressures to adopt a biological approach in training and that a self-critical view is discouraged. The point of this piece is to highlight such bias and not to attempt to provide a full critique. The need for voicing alternatives seems to be increasing as biological psychiatry becomes more hegemonic (Klerman 1990). Of course, the biological hypothesis has always been present in psychiatry, but it is now rare for trainees to consider its implications. The view that the phenomena of human existence can be understood in exclusively biological terms is obviously attractive. If psychopathology equals bodily dysfunction, aberrant behaviour and experience can be fixed in a natural substrate. Accountability for personal misfortune is shifted away from personal agency and the impact of relationships. The complexities of meaning are apparently made simple. Reducing relations between people to objective connections seems to make them more manageable. Biological psychiatry in its more expurgated version avoids radical reductionism by granting that environmental stressors are necessary precipitants of mental health problems on the basis of an antecedent “diathesis”. Biological predisposition, however, is an overriding factor in this aetiological eclecticism. The basic assumption of biological psychiatry is that mental illness is due to a biochemical imbalance which can be corrected by medication. The implication is that personal conflict and responsibility are avoided. Additional appeal of the biological approach comes from the apparent authority it provides for many practising psychiatrists in the clinical team. The understanding of basic bodily processes is knowledge that gives power to psychiatrists which is denied other clinicians. Trainees should be able to question the primary assumption that the kinds of biochemical processes that produce mental illness are essentially different from those that create thoughts, feelings and behaviour amongst the “normal”. What prevents them thinking critically about this hypothesis? The bias of medical training Medical training assumes a scientific mode of thinking. Medical students are not primed to realise that human behaviour may not follow rules of physical cause and effect. By the time trainees start psychiatric training they have been firmly indoctrinated in the belief that people can be explained and predicted. The weight of philosophical inquiry belies this view (Dilthey 1976). Students need to realise that it is legitimate to question whether an understanding of human nature can take the same form as the laws of natural science. It may come as a shock to medical students to be made aware of this potential because of the mindset which has been created by the unquestioning assumption that natural scientific methods can be applied to human behaviour. Even if students are not surprised, scientific education may have become so entrenched that it is too late for thinking to shift. I am, of couse, using science in the narrow sense of physical science. A broader definition of science would be the application of commonsense. It is in just this sense that medical training seems to be unscienific and mindless. I am aware that such a view will be dismissed as vague and uncertain. Traditional medical education has fostered in students the notion that uncertainty is a manifestation of ignorance and weakness. Factual knowledge takes precedence over critical appraisal. The inevitable denial and avoidance that result when the limits of rationalism are exposed in clinical practice are reinforced by patients who may expect them to be certain. This vulnerability is made particularly acute in psychiatry when patients try to express their desires and self-destructiveness and describe their abuse and past traumata. Clinical schools have sometimes said they want to recognise the importance of cultivating creativity and paying closer attention to students’ emotional development. Unfortunately, guidance in developing techniques to handle issues raised by uncertainty do not feature prominently in most curricula. In our “post-modern world” there is some truth in the statement that natural science on which medical training is based has now a greater acceptance of subjectivity and uncertainty. It was never realistic, however, to expect that the introduction of social science and medical ethics to undergraduate training would encourage the necessary adjustments to thinking and practice. A more profound focus on the person is required in medical training from the start of training. Of course, I am not encouraging a dualism of mind and body. Biological knowledge needs to be integrated with personal understanding. Enlightened attitudes can only be developed by being open to the limits of medical practice. A greater recognition of the anxieties experienced by all professional disciplines involved in the delivery of health care should facilitate better use of resources. This means clinicians must explicitly acknowledge and understand the importance of imprecision before such co-operation can be productive. The myth of biological psychiatry By the time doctors begin psychiatric training, they are enmeshed in medical indoctrination. There should be little surprise then about their unthinking acceptance of the biological model of mental illness. “Chemical imbalance” explains aberrant behaviour and feelings, as if it understands it. Medication is the simple response and the foundations of trainees’ worldview shake if the hypothesis is not true. The belief is so fundamental to the edifice of psychiatry that paradigms about neurotransmitters and receptors do not shift despite contrary pharmacological evidence. Most psychiatrists in their clinical work still think they are correcting dopamine imbalance in their treatment of schizophrenia with neuroleptics, despite the abandonment of the hypothesis by pharmacologists and the widespread acceptance of atypical neuroleptics onto the market. The amine hypothesis still figures at least in the background of psychiatrists’ use of antidepressants, encouraged by pharmaceutical companies’ rationales for the development of their products. Of course, I am not dismissing psychiatry’s base in medicine, which, for example, is useful for understanding the common physical complaints of psychiatric patients. Lack of self-criticism in psychiatry is stifling. Recognition by a trainee that there may be more factors than “chemical imbalance” involved in a patient’s problems may be dismissed as interesting “psychodynamics”. Failure to produce the correct diagnosis in the MRCPsych clinical examination is given more weight than an attempt to understand the patient’s problems, albeit in no more than one hour. When have trainees had demonstrated to them the power of suggestion, rather than the effects of medication, or had any acknowledgement of the influence and power of using medication? Doctors with a designated interest in the mind should be expected to be more aware than other specialities of the power of the placebo. And if so, they might realise that habituation to medication is likely to be common, perhaps particularly with drugs which are thought to improve emotional states. This recognition would help trainees to appreciate why so many people have difficulty discontinuing medication, and would provide an alternative explanation to recurrence of disease when symptoms present themselves on terminating treatment. Authoritarian attitudes are not conducive to self-criticism. Challenge to the structure of training is marginalised. Creating unhealthy, defensive doctors cannot be in the interest of patients. Narcissistic impulses will have to be renounced along with ideas of omnipotence, although there should be no fear that patients will no longer need services. And besides, how does a doctor relate to other disciplines who sense their vulnerability but have not the authority to challenge it? After all, it is the doctor who has knowledge about the body and other disciplines do not have accredited training in this field. Even if they can see the bizarreness and absurdity of biological psychiatry’s claims, they may be missing some information. In a power struggle it suits the psychiatrist to keep them thinking this way. Alternative Psychiatry The only solution to this predicament that I can see is that medical training should become interdisciplinary and psychiatric training adopt a Neo-Meyerian model (Double 1990). Entrenched vested interests make this outcome highly improbable. Trainees should be aware of the modern recent history of psychiatry. Although Adolf Meyer’s views never perhaps dominated psychiatry, they were a powerful influence in the first part of the century before they were eclipsed with the introduction of the plethora of modern psychotropic medications. Meyer argued with Kraepelin, suggesting a psychogenetic explanation for dementia praecox, so trainees should take courage if they appreciate that schizophrenia or any other mental health problem can be understood in terms of their patients’ life experiences. Meyer’s psychobiology is open to psychotherapeutic ideas, but distinct from them. Meyer played an ambiguous role in the acceptance of psychoanalysis in America (Leys 1981). He favoured commonsense use of language, rather than the theoretical conceptualisations of psychoanalysis. Both Meyer and psychoanalysis agreed on a dynamic interpretation of mental illness based on an understanding of psychological factors. Such a critique of modern psychiatry needs to be incorporated into medical training. Although psychotherapy and counselling are more readily recognised as an alternative to biological psychiatry, Meyer’s social perspective goes beyond the voluntary individual practice of psychotherapy. It seems I am proposing an antipsychiatric project and I think it is if psychiatry’s definition is ruled by biological psychiatry. I say this in an attempt to bring my message home rather than to allow it to be marginalised. Critical psychiatry needs to organise itself so that future generations of trainees are given more awareness of options in their practice of psychiatry (Critical Psychiatry Network Website 2000). References Critical Psychiatry Network Website. Dilthey W (1976) Selected Writings. Cambridge: Cambridge University Press. Double D B (1990) What would Adolf Meyer have thought of the neo-Kraepelinian approach? Psychiatric Bulletin, 14, 472-4 Guze S B (1989) Biological psychiatry: is there any other kind? Psychological Medicine, 19, 315-323 Kaiser D. (1996) Against biologic psychiatry. Psychiatric Times (December 1996) Klerman GL (1990) The psychiatric patient’s right to effective treatment: implications of Osheroff v. Chestnut Lodge. American Journal of Psychiatry, 147, 409-18 Leys R (1981) Meyer’s dealings with Jones: A chapter in the history of the american response to psychoanalysis. Journal of the History of Behavioural Sciences, 17, 445-465 D B Double, Consultant Psychiatrist, Norfolk Mental Health Care NHS Trust, 80 St Stephens Road, Norwich NR1 3RE and Honorary Senior Lecturer, School of Health Policy and Practice, University of East Anglia, Norwich NR6 5BE ORGANIC CONDITIONS THAT ARE COMMONLY MISDIAGNOSED AS MENTAL DISEASE Home The information on this website is not a substitute for diagnosis and treatment by a qualified, licensed professional. Blood Sugar Instability (Hypoglycemia) DR. HYLA CASS People with hypoglycemia are often treated as though they have simple depression and anxiety and are put on anti-anxiety agents such as Valium or Xanax. If they are extremely depressed as well as anxious, they are put on antidepressants such as Prozac. I’ve had people come to me on medication that wanted to go off of it. It turned out that they were hypoglycemic. You can replace antidepressants with amino acids, minerals, and cofactors, vitamins for amino acid metabolism. When depressed patients come to see me who are also hypoglycemic, I put them on a hypoglycemic diet, which is approximately six small meals a day. Also, I have them take chromium for balancing blood sugar. I also gave them magnesium, glutamine, and tyrosine. Tyrosine is an excellent natural antidepressant. It’s a precursor to the neurotransmitter norepinephrine, which is one of the brain chemicals that helps us feel good. DR. LEANDER ELLIS Hypoglycemia is a phenomenon that can be triggered by allergy, infection, exhaustion, or huge amounts of sugar that encourage the growth of yeast in the intestinal tract, which then, in turn, gives rise to some allergic effects and a variety of other subtle effects. I see hypoglycemia as a symptom of a larger problem, rather than as a disease. Most of the time there are other important causes to account for the roller-coastering of the blood-sugar levels. The most common one is probably candida, yeast. The next most likely cause is food allergy. Often, a person is not only gorging on sugar, but is allergic to sugar, is not only gorging on chocolate, but is allergic to chocolate. So you get a curious combination of candida, yeast mold, fungus allergy, and allergy to foods. You usually have to control these several elements, as well as to get adequate nutritional support, in order to quiet these symptoms down. Candida is a major factor in hypoglycemia, depression, and chronic fatigue that the medical profession has continued to ignore, despite the research. The major reason is that medicine is taught by prestige suggestion, meaning a doctor needs someone he or she trusts to tell him what is important. Unfortunately, the people that we have the most contact with after we leave medical school are drug company representatives. And so until a learned professor at an Ivy League medical school says that candida is a problem, it doesn’t exist. DR. WARREN LEVIN Hypoglycemia is a basic problem that is frequently stress-induced. When people take a large dose of sugar into the body (and one cola drink contains more sugar than the entire bloodstream), the level of sugar in the body goes way up. Now, the body’s entire commitment is to maintain balance or equilibrium; the technical word is homeostasis. The body produces a basic hormone called insulin that is supposed to take the sugar from the blood and deliver it into the cells, and when the sugar goes up very rapidly the body reacts excessively, resulting in too much sugar being driven out of the blood, and that produces low blood sugar, or hypoglycemia. The body then has to correct the balance again, and it can be an emergency. If the blood sugar goes too high, it is not an emergency; the body can tolerate it. But the brain requires a certain level of blood sugar to function, so when the blood sugar starts plummeting–and it can sometimes drop at a frightening rate–the body calls forth its emergency hormone, adrenaline. Adrenaline was designed to protect us against the saber-toothed tigers. It mobilizes all sorts of bodily functions. One of the things it does is to dump sugar from the liver into the blood very rapidly. However, adrenline also causes what we call the fight-or-flight reaction, associated with the state of fear. We get a rapid heartbeat, dry mouth, sweating, fear, and a sense of impending doom. Now, suppose someone has an ice cream sundae and a few hours later he sits down to read the funny papers and all of a sudden he gets this terrible reaction. He goes to the doctor and says that he was just sitting there, reading the paper, when, all of a sudden, he got sweaty and his heart started pounding. The doctor tells him that it is all in his head and that he has a Prozac deficiency, and with this Prozac prescription he will be fine. We have to stop thinking that way. Headaches are not a Darvon deficiency, depression is not a deficiency of Elavil, and until doctors realize that the body’s biochemistry is an exquisite balancing act, and start treating it with great respect, we are in a lot of trouble. Hypoglycemia is not a disease; it is a symptom requiring a search for an underlying cause. WILLIAM: A PATIENT OF DR. ALAN SPREEN I had been seeing a psychiatrist for depression and was on medication–and still am. I noticed that while the medicine took care of certain symptoms, it seemed to have no effect on an enormous number of them. I used to be a body-builder back in the early 1980s, so I had some experience with nutrition. I went to see Dr. Spreen because I noticed that my hypoglycemia was acting up; I noticed a direct correlation between what I ate and how I felt. When I went to see him, I was complaining of really severe panic disorders, irritability, and difficulty in concentrating. I went from having an excellent memory to no memory at all. Also I had such fatigue it felt like I was walking in Jell-O all the time. I’d sleep 12 hours a day and get up with no energy at all after sleeping. I’d be tired the whole day. The first thing Dr. Spreen did was to give me injections of B12. Immediately I noticed a difference. As soon as I’d walk into the gym to work out, my energy was there. In the morning I felt really good. But I was still plagued sometimes by panic attacks. So he put me on a high dose of tyrosine, which is one of the free-form amino acids. I took up to seven grams a day and noticed a real strong response. Tyrosine is also related to the thyroid because one of the products the thyroid needs for normal functioning is tyrosine. He also put me on a low dosage of thyroid, a quarter grain a day. I took that and noticed immediate results. With that and the tyrosine, I felt like a new person. This experience showed me that even though a doctor may be treating you for depression, he might be missing the things that might lead up to the depression or that might go hand in hand with it. Many books that I’ve read–in particular, Carlton Frederick’s New Low Blood Sugar and You–say that when there is any mental disorder present, hypoglycemia is going to be right there along with it. But the medical community doesn’t accept that hypoglycemia is as predominant as some nutritionists say it is because the doctors are thinking about the organic forms, which are much rarer. But with the diet that we are eating nowadays, which is high in carbohydrates and low in basically everything good for you, hypoglycemia is manifesting itself in great numbers. As a child, I ate a diet that was full of carbohydrates–all sorts of sweets and sugars–and had a lot of the symptoms that are associated with hypoglycemia: I was hyperactive and had asthma. You see, hypoglycemia can trigger asthma attacks. Since I’ve started working out and watching my diet, the asthma has gone away. For the panic attacks, Dr. Spreen suggested vitamin C. I took vitamin C powder, which is ascorbic acid, in the morning. I probably took 15 to 20 grams a day. It was almost like taking a sedative. It calmed me right down. My thought patterns straightened out; I was calm; and I wasn’t as irritable and fidgety as I had been. I balanced out the rest of my nutrients with a mineral supplement and a good vitamin supplement high in the B spectrum. I take an additional B complex with pantothenic acid on the side because Dr. Spreen thinks that most people don’t have enough B vitamins in the diet. I’m inclined to agree with him, since I’ve followed his advice and noticed an enormous positive response. Candidiasis DR. RAY WUNDERLICH A very high percentage of the people I see who are depressed also have imbalances like an overgrowth of candida. It is like thyroid disease. If you took all the women in my practice, from 70 to 75 percent of them would have thyroid disease, and an even higher percentage would have some form of candida, which is yeast overgrowth. A good example is a TV reporter I saw this morning. After coming in to film a segment in the office, she got personally interested in what I do. She is 40 years old. We did a mineral analysis on her and found that she is deficient in five nutrient minerals. She is a perfectly normal, functioning individual of 40 years of age. But when you examine her carefully, it turns out that she has recurrent vaginal yeast infections, some bloating, some gas and indigestion, and she has taken antibiotics: a classic profile of a candida patient, which is all too common. In a place like Florida, where it is so humid and molds and yeasts grow so readily, it is almost an epidemic. DR. WALT STOLL The immune system sees the world in black and white. Something entering your body that it comes in contact with is either you or it is not you. If it is you, the immune system is not supposed to attack, and if not you, then it is supposed to attack. One of the things that your digestive tract does is to break down things from the environment into particles small enough for you to absorb without alerting your immune system that they came from somewhere else besides you. But if, for example, your gut is not doing the job perfectly, and it leaks a particle of protein (a peptide) that is large enough to alert the immune system, in your joints, muscles, or ligaments, for instance, then your immune system can’t tell the difference between the protein particle from outside and the one in your tissues, so it attacks both. Let’s imagine that every time you have corn, for example, you don’t break it down perfectly and one of those peptides leaks out of your intestine. Your body attacks the corn peptide, but it’s also attacking the peptide in your muscle, ligament, and joint (that is identical to the corn peptide). And we feel that as arthritis, tendonitis, or other conditions. If you stop the process, the immune system settles down in 3-1/2 days, and you begin showing improvement. The first example I heard of was about 10 years ago. If you took someone with rheumatoid arthritis or took a group of these patients and put them on a fast, 75 percent of them would improve within a week. You can’t keep someone on a water fast forever, of course; but here is a dramatic illustration of the fact that there is another cause that we could work with. We don’t necessarily have to be stuck with gold shots, cortisone, and a crippling future. There are a number of things that make the gut more permeable to peptides. Stress is one of them. We know not to go swimming right after we eat, because there is not enough blood supply in the body to adequately supply both the intestinal tract and the muscles. When your blood supply is concentrated in your intestinal tract trying to digest your meal, if you try to go for a vigorous swim, you can’t get enough blood in the muscles, resulting in cramps and, possibly, drowning. When you are chronically stressed–and most stresses are not psychological but environmental–your body deals with it with a fight-or-flight response, which makes your muscles get a little more chronically tight and active. Your body concentrates more blood supply into the fight-or-flight area and then takes away the blood supply from the intestinal tract. The intestinal lining replaces itself on the average of about every 14 hours, so it requires a heavy blood supply. If you are chronically stressed for long enough, eventually the intestinal lining functions less normally, which of course produces other imbalances. The normal bacteria that are supposed to grow sometimes get out of balance and allow candida to move in and flourish. This damages the lining further and so things leak even more. I’ve been doing this kind of medicine for 15 years and in my experience this syndrome is the main cause of brain fatigue, or “brain fag,” as it is called. By the time I see most of my patients, they have had everything else tried unsuccessfully on them and a large percentage of them have this syndrome as their basic cause. If the patient is willing to follow directions, within a few weeks they already see enough improvement so that they know they are doing the right thing. Within a few months, they’ve usually improved enough so that they can handle it for themselves. My procedure is to first collect all the medical records that the person has accumulated up to that time, so I don’t have to repeat any tests that have already been done. If some things have obviously been missed, then I try to fill in the gaps. There are labs around the country that do a pretty good job of looking for parasites, candidiasis, low magnesium, and other disorders that are either not done or done poorly by conventional labs. I look at the entire chronological history of the patient for a couple of weeks before their appointment and try to think of anything that might have influenced their health that might show a pattern of change over time. Then we have the regular data bases that we use in conventional medicine to look for other kinds of patterns and have them keep a record of their usual diet and anything special that they ingest for a week or so. Then I put all those pieces together with a general physical exam and see if the pattern suggests some of these other causes. Finally, when I get a picture and it’s pretty obvious what is happening, I educate the patient sufficiently so that he or she is willing to try the therapy. I tell them to do it very carefully so we are sure that if they don’t get well it is because we are wrong and not because they didn’t do it right. Generally I can predict within a few days how long it is going to take for the person to start feeling better. I have them keep a record of their symptoms so that they can watch their own progress and improvement. As you get better, frequently you forget how badly you were feeling before. Unless someone lives with a patient, it’s hard to assess exactly where you are as a patient begins to improve. The treatment depends upon the cause, of course. If the person has candidiasis, then it is relatively simple and straightforward to treat. A strict diet is necessary for a while. I will probably have to give them some digestive enzymes to correct the poor protein metabolism, until they can do some relaxation techniques to get the blood supply back to the intestinal tract, which usually takes from three to six months. If it’s candida, I usually use some Nystatin, a prescription anti-fungal agent, to try to directly attack the candida problem. If the person hadn’t been absorbing things too well for a while I might use some concentrated nutrients with antioxidants to try to replenish the body with what it needs to repair itself and improve its own immune function. ELLEN: A PATIENT OF DR. STOLL I have suffered from chronic candidiasis since I was about 13. We think it might have been linked to my taking massive doses of sulfa drugs for kidney problems when I was younger. I can’t remember a time since I was 13–and I’m 31 now–when I didn’t have a yeast infection. There may have been two- and three-week periods when I wasn’t suffering from symptoms, but I always, to some extent, had a very severe yeast infection. I went to conventional doctors and they gave me the typical vaginal and topical cremes, and basically patted my hand and told me to come back and see them in two weeks. It seemed to help during the time that I used it, but invariably the infection came back, often twice as bad after I stopped the treatment. So after a while, I simply avoided going to see any physician and just lived with it, unless my symptoms got so severe that I just had to go see someone. Eventually, I went for a Pap smear and a nurse practitioner suggested that I read a book called The Yeast Syndrome. It wasn’t until I read the book and got Dr. Stoll’s name out of it that I even connected my physical ailments with my mental health. I had always been moody and prone to periods of depression and there was a history of depression in my family. I never needed to be hospitalized, but I felt that some of these bouts, especially during my adolescent and college years, were extremely severe. I suffered mood swings and would have described myself as having a very volatile personality. But after going to Dr. Stoll, who started me on oral Nystatin, changed my diet, and used various supplements to correct my nutritional and physiological deficiencies, within about 60 days I felt like a totally different person. In fact, my husband commented that it was like being married to a different person. In hindsight, I can see that as my candidiasis symptoms were eradicated, my mental symptoms disappeared. So I use mental symptoms now as a red flag. If I start seeing personality changes within myself, I take a look at what I’ve been eating lately and how I’ve been feeling, and make some changes there. Then I seem to get back on track. I have learned that conventional treatments that just treat the symptoms are not going to help you. You have to look for the root cause of your ailments. There is help out there to be found. You simply have to find someone like Dr. Stoll who knows how to treat your illness, comply with their recommendations, and you will get better. CYNTHIA: A PATIENT OF DR. STOLL Ever since I began modeling in New York about 15 years ago, I’ve had tremendous difficulty with depression and also with hypoglycemia, which was then a very fashionable disease. I was constantly on a diet and constantly in doctors’ offices for yeast infections and digestive and stomach problems. I visited a lot of doctors who would tell me it was all in my head and send me to psychiatrists. I spent the better part of 20 years going from doctor to doctor for various things, having my husband tell me that I was a hypochondriac and feeling like one, and also working things out in therapy trying everything that I could until I went to Dr. Stoll. In the beginning, Dr. Stoll didn’t find out that I had candida. Part of working with Dr. Stoll is learning to take responsibility for your own health, and that was a big switch in my life. Part of my health that was causing me a big problem was dental, so I went and had a lot of dental surgery done and came back to Dr. Stoll sicker than I have ever been in my life, with tremendously severe headaches. I felt as if someone was banging a steel hammer inside my head. And I was angry, even though I had been working with feelings in therapy. So I wasn’t afraid of expressing my feelings, which was good, but I felt angry all the time. Dr. Stoll had me do a stool test, and it came out that I had an abundance of candida. At the time, Dr. Stoll explained to me that when you do dental work, research has shown it will exacerbate candida. In its way, this problem was a gift to me because in the past, I had only half-believed that I had candida. I didn’t make a commitment to getting better. This time, within two months after taking Nystatin and vitamins, and doing aerobics, and going to an emotional therapist to make sure that I got everything worked out, I was a different person. I felt so totally different, that it gave me the vantage point to look back over the previous 20 years of my life and say, “Oh, if only I had known all of this then, I wouldn’t have done all of that.” I had spent my life running down the wrong roads. And it was such a relief because it allowed me to really begin to live. Now I have my little ritual. I take my vitamins and do my aerobics, and make sure that I keep my house environmentally clean of gases and pollutants that exacerbate the condition. The change in how I felt was like going from 2 percent to 98 percent well. It was so dramatic. NANCY: A PATIENT OF DR. STOLL My youngest child was born with a lot of health problems–nothing life-threatening, but he was just sick all the time. He lived on antibiotics from the day he was born until he was about five years old. He cried all the time and never slept. Most people don’t think of an infant as being depressed, but when a baby cries all the time, you could say he was depressed, or in an anxious state, or in a state of pain. It was certainly very stressful for the both of us. As it turned out, most of his problems were allergy-related. He had ear infections, bronchitis, very severe eczema, and his digestive tract had become very permeable. Within a month after I had taken my son to Dr. Stoll, and we had begun replacing his intestinal lining through treating his candidiasis and watching his diet, I began seeing some improvement. Six months later, he was a totally different child. We were a totally different family. At that point, I recommended that my mother-in-law go see Dr. Stoll as well, because my child had inherited all these allergy problems from my mother-in-law. She had severe asthma and emphysema, as well as a multitude of other problems. She had gotten to the point where she was extremely depressed because she thought that she was dying. I think that had I not gotten her to Dr. Stoll, her life would have ended years before it did. She was so sick that she would crawl out of bed in the morning to a chair, and just wheeze and cough all day long in that same chair. She could do no housework, she no longer had a driver’s license, and she didn’t go anywhere. She spent more time in the hospital than she did at home anyway. This would depress anyone. So I took my mother-in-law to Dr. Stoll and within a month or two, she started showing tremendous improvement. Within about four to five months, she was a totally different person. It literally turned her life around. She took the driver’s test and got her driver’s license again. She bought herself a car and became very active among senior citizens. The depression was gone. This lady just turned around. She had a totally different personality. She had been on 13 different drugs at the time that I took her to Dr. Stoll, for a multitude of problems, and he probably got her off three-fourths of them. Her attitude changed tremendously, as did my youngest child’s. BOB: A PATIENT OF DR. STOLL I had been sick for 25 years and was just slowly getting worse. At my worst, I passed out and wrecked my car. It was really hard to work and I was getting very depressed. I went to the local doctors, the local hospital, and even tried five days at the Mayo Clinic. They sent me back with sleeping pills and tranquilizers, and told me that it was all in my head. Finally I went to Dr. Stoll, who was the tenth doctor I’d seen. He read over my history in about five minutes and said, “Well, I can almost guarantee you that I know what is wrong with you.” He sent off a stool sample, which is an $80 lab test. When it came back, it confirmed his diagnosis. I had candida and giardia, little parasites eating holes in me. I went through this whole process of changing my diet and treating the candida and giardia and in about three months, I got better. I thought I was cured so I started eating the same old junk, and got sick again. I did that about twice. So it really took me about a year to get totally cured. But now it has been about two years and I am completely cured, thanks to Dr. Stoll. No words can describe the joy of living in a healthy body after being sick for a long time. It had gotten so bad that I had decided to commit suicide. My wife wouldn’t leave me and I was dragging her down. I was borrowing money from my family just to keep going and the Mayo Clinic had said that it was all in my head. I had no reason to think that I was ever going to get better and I was continually getting worse. So I decided to commit suicide. And I remembered when I was a kid that our dad always told us, “Kids, if you ever want to commit suicide, that is okay, but there is only one acceptable method. And that is starvation.” So I said to myself, “Fine, all I have to do is stop eating for about three months and I will be dead. That sounds real good to me.” So I did. I stopped eating, and of course after about two days of not eating my symptoms went away. At the time I didn’t realize that it was the food that I was eating that was contributing to my being so sick and depressed. So I got to feeling better and started eating again, and got sick again. To people out there who are really, really depressed and have decided to just chuck it all in, I say, starvation is the only way to commit suicide because you may find that if you stop eating, your symptoms may go away. Plus you’ve got plenty of time to reconsider. I can now eat almost anything except sugar–meaning sucrose–honey, and potatoes. I can eat fructose, corn syrup, and any other forms of sugar. When I was at the Mayo Clinic, we went through five days of tests and at the end of it I had a list of possibilities. One of those possibilities was food allergies. And I said, “I’m here, you have this nice big laboratory, why don’t you test me for food allergies?” The internist, who acted like the director of the show, got mad. He said, “You don’t have food allergies, and I’m not going to test you for it.” So that’s the kind of people I was dealing with at the Mayo Clinic. I have toyed with the idea of going back to the Mayo Clinic or writing them a letter, but I don’t because I have this feeling that they are just going to put my letter aside and say, “Oh, another hypochondriac.” Dr. Stoll has been persecuted by the Kentucky Medical Board for years for that very reason. Some of his patients went back to their old doctors after they were cured and told them what had been wrong. Some of these other doctors were powerful and greedy. They got so embarrassed and mad that they filed charges against Walt Stoll with the Kentucky board. There has never been a patient complaint against him; it was from other doctors. So going back to your old doctor and explaining can sometimes have very negative repercussions. GAIL: A PATIENT OF DR. STOLL For ten years my husband suffered with what was diagnosed as acute, chronic gastritis and depression. For a long time, we didn’t link the two. So he was treated for gastritis and suffered several endoscopies, and for his depression took lithium, Prozac, you name it. Neither condition got much better. We eventually decided that he should stop taking all those heavy-duty drugs because they seemed to be doing more damage than good. Finally, we heard about Dr. Stoll and he diagnosed my husband as having candidiasis. With the use of the anti-yeast medication Nystatin, and diet and vitamin therapy, he got better on both counts–the gastritis and the depression–very rapidly. We saw a change within about two months. We had spent ten years, going from doctor to doctor and hospital to hospital, trying to figure out what was wrong. He had been hospitalized with panic attacks; he had really been put through the mill. After all of that, his treatment and cure turned out to be quite simple. DR. AUBREY WHIRL Over a period of years I noticed that patients with candida manifest multiple symptoms. As an allergist, I would of course see patients with asthma, hay fever, and skin rashes. But I began noticing that many of these patients with allergies had other problems such as respiratory and gastrointestinal symptoms. Another complaint I see quite frequently is people just not feeling good. They’re tense or headachy. They’re tired and weak. They have a tendency to depression and fatigue. They’re forgetful and unable to concentrate. In actuality, these problems are often manifestations of a subtle disruption of immune function in which there’s an overgrowth of yeast and an increasing allergy to mold. How We Get Candida The body is the source of the candida allergen. We normally live with candida, which inhabits the skin and gastrointestinal tract. A problem arises when there is an imbalance of the candida caused by an overgrowth. When there is more candida than there should be in the gastrointestinal tract, the body absorbs more of the candida antigen. You accelerate the problem by adding foods with mold and by breathing mold in. A Combination of Treatment Approaches I place patients with multiple symptoms on a mold- and yeast-free diet that eliminates foods such as milk and dairy products, particularly cheese. Milk and dairy products are contaminated with mold, and mold is used in the process of cheese-making. I also eliminate yeast breads and yeast foods, as well as vinegars, since these contain a lot of mold allergens. If a person is eating a lot of sugar, if they’ve taken a lot of antibiotics, if they’re not eating a good diet–then the candida is more apt to grow. That person is likely to have more candida antigen released into their system. You have to use a combination of approaches in treating patients with candida. Number one, you have to have a good, nutritious diet. It can’t be loaded with alcohol and sugar. It has to be composed of broad-spectrum healthy foods. Number two, you have to put them on the mold-free diet. Number three, you have to place them on Nystatin therapy for approximately two weeks. DR. RICHARD TAN I have been diagnosing a lot of patients with candida, and sugar affects them greatly. Quite a few patients that I am seeing have memory lapses, are forgetful and depressed, and they have seen other doctors who diagnose the depression and give them antidepressants. When I go over all the system reviews, I find that it is more of a systemic problem; along with the candida, they also have some sinus problems, achy bones and joints, stomach upsets, and gas. They often say that they have cravings for sugar or foods that contain sugar, as well as bread. I have a survey form that I go through. In my scoring system, after awhile, if the score goes up high, then I strongly suspect that they have candida. So then I explain my hypothesis and start to treat them. I put them on a diet program plus some anti-fungal medication. When they come back after two weeks, they say that they haven’t felt so well in a number of years. This quick recovery is a revelation to me. I keep on seeing this type of patient. And every time I treat one, I am still amazed at how different they become after awhile, at how much they improve. The estimate is that about one-third of the population has candida. I would say that among my patients about 15 or 20 percent have candida in varying degrees. Patients with candida should avoid all processed foods, and those with sugar, such as soft drinks. Get back to the basics. Grow your own garden if you can. If not, maybe go to a health food store, where you can buy organic, unprocessed foods. While most Americans eat too much fat, people with candida need to be more concerned with sugar than with fat. If you eliminate nutritionally poor foods, you will often be surprised at how your taste for things changes as your diet changes. Chronic Fatigue DR. ALAN SPREEN The big buzzword of today is chronic fatigue syndrome. This refers to the kind of incredible fatigue that makes people unable to get out of bed in the morning for weeks at a time. Most fatigue onsets slowly. A person gradually feels less energy than they had a few months or years previously. They just can’t do the things they did before. Physical and emotional fatigue go hand-in-hand. Fatigue tends to affect mental functioning, so that a person feels that their memory is not as good as it once was. I consider that type of fatigue biochemically based. I’m sure it’s in the genes that some people wear out faster than others. Food Sensitivities, Fatigue, and Mental Health Food sensitivities often manifest themselves as cravings. We try to get people off the foods they crave. Chances are they may be sensitive to these foods, which can manifest as fatigue and mental states tied to fatigue, such as irritability or frustration. Depression is another commonly experienced reaction to fatigue. People think they’re getting old or sick or that they’re dying because they don’t have the energy they once had. And depression causes a domino effect. Once people are depressed they don’t care to do anything. If they don’t do anything their self-worth decreases. They feel worse and worse. We try to take a complete approach. We find that as ingestion improves, with proper foods and supplemental digestive enzymes, fatigue tends to diminish. Subsequently, energy levels and clarity of mind improve. People can concentrate better. They can remember things better because their mind isn’t experiencing brain fog from all of the toxic junk floating around in their system. We ask people to give us two weeks. We want them to stop eating the foods they crave the most. If there is anything they feel the day just isn’t complete without, we tell them that that’s what they need to give up first. Once they give that up, if their fatigue worsens for the next two or three days–they become more irritable, they pick fights with family members, their self-worth diminishes, they feel like they’re not getting anywhere, they have more intestinal problems–I can almost guarantee that that food is a major part of their problem. Once they get past that hump, which I call withdrawal–we witness true withdrawal when people are sensitive to whatever they were ingesting–they tend to feel much better afterwards and everything seems to improve. Their peace of mind improves; they are less fatigued; their depression tends to decrease, if it’s not true clinical depression from some other cause; their energy level increases; sleep improves; and their relationships are better. Their state of mind seems to domino the other way where everything becomes better. It’s not a panacea but it’s a place to start. A Nutritional Approach to Regaining Energy Our efforts here are to optimize a person’s biochemical intake nutritionally so that they can make the best use of whatever genetic disposition they have and overcome fatigue. Of course, there’s always the possibility that fatigue represents the onset of something serious like cancer or something else. Our approach to treatment is to consult on a nutritional basis, doing something aside from whatever diagnosis a person might have from their primary physician. We don’t work as a primary physician. Normally I start by taking the known stressors out of the diet. The first three are sugar, sugar, and sugar. When people eat a lot of refined sugar, the body tries to bring the sugar level down. Their sugar levels bounce up and down, up and down. They’re getting highs and lows, which make their mind fog up and prevent clear thinking and memory. This is a frustrating situation. When people get frustrated they get irritated. When they get irritated they pick fights or get depressed. Their self-worth goes down or they hit their wife or smack their kids when they really don’t mean to. Sugary items alone are usually a major part of most people’s diets and a hard thing to stop. After that we do other simple things. We ask people to eat foods in their natural state, not refined foods like simple carbohydrates. If a person stays on junk all the time–eats 12 candy bars a day, three cokes or more (with 17 spoons of sugar in each soft drink), and smokes and drinks and gets stimulants in other bad foods–taking a multivitamin just isn’t going to do the trick. I try to get people off caffeine (found in coffee, soft drinks, and cocoa) and theophylline (found in tea). A person who fights that and says, “Gee doc, just don’t take away my coffee in the morning,” or “Don’t take away my chocolate,” has just picked the thing that they will have to give up the most. I don’t consider coffee a food. It’s a toxin but people do drink it, so we do have to consider it a food item. I give people vitamins and supplements that they hopefully will absorb. If their absorption is not good they may require digestive enzymes, additional acidophilus, or stomach acid supplements. We find that people straighten out to a large degree if they straighten out what goes into their mouth. And it’s rewarding. Some of the nutrients we use to overcome fatigue are the following: B Vitamins. I almost always recommend that a person with fatigue start with a B12 shot, the old “quack” remedy that most doctors consider a placebo and don’t like to even talk about. I try to get a B12 shot into anybody that mentions fatigue because it’s cheap, harmless, and easy, and the results are so good. I’m batting about three out of four that just with a B12 shot people can feel more energy within a day. B complex is needed today more than ever before in the American diet. The foods most of us eat are almost totally refined. Most of our carbohydrates have been processed, resulting in nutrient loss. At the top of the list are B complex vitamins. All of the B vitamins work together, predominantly to help with the assimilation of carbohydrates. When that’s removed, people use up their B complex stores in the body, which are somewhat limited, being water-soluble. If they ate unrefined foods, they would have what is required in the food for the assimilation of that food. So I give both B complex in a supplement and extra B12 if fatigue is a problem. Plus I try to get people off refined sugar, refined white flour, refined pasta, and anything else that might stress the body. Herbs. I’m not an herbalist but I’m using herbs more and more in my practice. To boost mental function, I use ginkgo biloba, probably the number-two herb after ginseng. We’ll give a trial of that to people who say they don’t remember things the way they used to, and to children with learning disorders. We’ll try the herb for about six weeks. If the person doesn’t feel a noticeable difference in that time we’ll conclude that it probably doesn’t work for them. The nice thing about this type of remedy is that it’s harmless. If it doesn’t work, all people lose are a few dollars; it hasn’t done them any harm. I tend to think that herbs with a 2000-year history have done people some good. Some botanicals that worry us are at the opposite end of the spectrum. We want to get these substances out of the body. Non herbal teas and coffee bother us because they are artificial stimulants. They make people feel good momentarily but harm them in the long run. We compare it to the difference between feeding a horse right and whipping a horse. You can make a horse work harder for awhile with the whip, but you’d better feed him or he won’t continue to work. We try to get the whips out of there and enhance nutrition instead. If we can help a person to sleep we can help him or her to think and feel better when awake. Valerian is an herb that has been used for years to help with sleep. Sometimes we mix that with taurine, which is not an herb but an amino acid. These two agents together tend to help people relax, although this does not work all the time. This combination is not nearly as good as tryptophane, which was removed from the market a few years ago. There was a really shameful campaign to have it removed by people who claimed tryptophane caused a toxicity reaction. But the toxic reactions had nothing to do with pure tryptophane at all. Tryptophane produced wonderful results. It was the best help for depression, sleep disorders, and mood swings. But I understand that tryptophane is still available out of this country. There are a lot of herbals that help to alleviate individual complaints. I’m not an herbal expert but I’m getting more and more involved with herbs. I’m finding that herbalists past and present, dating back to the Indian medicine men and ancient Chinese, knew what they were doing. Hormone Imbalance DR. RAY WUNDERLICH When we assess people’s hormones and glandular functions with good chemistry, we can help make them less sensitive to the toxic assaults of the environment. While there are no such things as panaceas in medicine and we want to beware of unwarranted enthusiasm and zeal, the hormone DHEA is probably the closest thing to a panacea in medicine that we have found as of yet. It is the so-called “mother hormone” of the adrenal which is antidepressant and seems to be able to counter a lot of the allergic reactions that we see in people who are accumulating toxic insults as they age, decade after decade. This adrenal hormone declines from the age of 20 to death, due to illness and aging. By intervening with appropriate does of the adrenal hormone DHEA, we can reverse many of the allergies and immune susceptibilities that we see in people over 25 years of age. Mental functioning is also impaired in people who are low in the adrenal hormones, especially in DHEA. When these hormones are down, people are chronically fatigued. They have difficulty getting into mental gear, making decisions, seeing options, and fighting off the chemical assaults found in their environment. We can measure adrenal function in the saliva and the blood, and we can show that it increases with supplementation, just as we can do with a thyroid deficiency. People who are low in thyroid are frequently tired and constipated, and they have dry skin and sluggishness of thought. Recent studies suggest that even among hyperactive kids, at least 10 percent have thyroid disorders and auto-immune thyroid disorders. And so glandular function is extremely important with regard to mental function, feeling well, and being able to make decisions on a daily basis. Here’s a typical case that I have treated. A 40-year-old woman was having marital difficulties and had been seeing a counselor for a couple of years for this problem. While she did need to straighten out her interpersonal relationship, that wasn’t causing her physical and emotional problems. She was deficient in adrenal hormone. She was tired and irritable and couldn’t get through the day. She couldn’t manage the children. They would get on her nerves and she’d fire off at her husband. I tested her blood level of DHEA and found that it was more than two standard deviations below the mean. I put her on a very minimal dose of DHEA, and within two or three months she had discharged all of her counselors and her husband called me to tell me what saviors we were. These are some of the miracles we see. Not every case is going to be a miracle cure. But some cases of chronic depression, irritability, and premenstrual syndrome are related to adrenal dysfunction, with low levels of the mother hormone of the adrenal gland. This is particularly so in people with low-blood-sugar symptoms. We believe that this DHEA is kind of a baseline hormone. It feeds all the other systems, including the ones that regulate the sugar balance in the body. It can also serve as a precursor to the sex hormones–both the female and male hormones–as well as to the electrolytes, the salt and water hormones of the adrenals. It is highly individual in its response, but it is a major reactor that we didn’t know about some years ago. The effects of DHEA have been well-researched; it has an anti-cancer, anti-viral, and anti-depressive effect in animals. People have improved through the use of herbs, vitamins, and minerals, which have probably been supporting the body’s function of this hormone, among others. People who are tired when they get up in the morning, who have reactions to sugar, who have to eat frequent meals, who have family histories of low blood sugar or diabetes or alcoholism frequently have low adrenal function. Vitamins and herbs that help support the adrenal function and the precursors of the adrenal function are vitamin C, pantothenic acid, B-complex, licorice, and Siberian ginseng. Nutrient Imbalances in the Body and Brain DR. HELEN SCHLEAGLE I have had a lot of clinical experience with controlling moods by using amino acids. Right now, I am quite concerned about the current effort by the FDA to ban amino acids, which takes away the right of individuals to help themselves. In a sense, it’s like banning proteins, which is ludicrous. So I hope that people will fight this reactionary effort on the part of our government to make amino acids available only through physicians–which will cost a person far more. I have treated patients with amino acids for almost 20 years to control moods, depression, anxiety, and memory problems, and I continue to be amazed at their efficacy. I usually use them in combination with proper diagnosis and treatment of other conditions. The first step I take with my patients is to make the correct diagnosis. Usually, by the time people get to me, they have already been many places and tried many drugs, and I am the end of the road for them. So these patients don’t have simple, straightforward kinds of problems. They usually have multiple-system problems, for instance, chemical sensitivities, viruses, food sensitivities, auto-immune problems, parasite problems, fungus, and so on. So first I find out what is going on. When a patient comes to me, I always do an amino acid panel so that I can measure 42 different aspects of amino acids in their body. There are 22 amino acids, but I am also measuring metabolic breakdown patterns that might indicate connective tissue or auto-immune disease, chronic viruses, chemical sensitivities, candida. All these conditions can be determined or are hinted at by the amino acid pattern. While it is an extensive process, it does seem to find the cause at the root of some very puzzlingly complex physical and mental problems that patients are experiencing. Then I remove the offending agents, such as chemicals or candida- or yeast-inducing foods, or drugs (many people have drug-induced auto-immune problems). We have to clarify and clean up their environments and their diets. For depression, I use tyrosine, which is an amino acid that raises norepinephrine, a major brain chemical that maintains good mood, drive, motivation, and concentration. Glutamine makes glutamic acid, one of the two major brain fuels, and is important for memory, focus, and concentration. I use these two amino acids for depression combined with the active form of B6, which controls the absorption, all metabolism, and conversion of amino acids into all their various end products, such as neurotransmitters, antibodies, digestive enzymes, muscles, and tissues in the body. I also give my depressed patients a basic multivitamin with minerals. Many depressed people are magnesium-deficient, so I’ve been using a relatively large amount of magnesium in my practice.

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