Glutathione Sublingual

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glutathione sublingual

A comprehensive approach to prevention and treatment of postpartum depression (PPD) and anxiety disorder after childbirth (EPP)

Raffelock Dean DC, L. Ac, CCN, DACBN, DIBAK

Hyla Cass, MD

Postpartum depression (PPD), postpartum anxiety (PPP) have become a national epidemic United States, affecting 15% -20% of all mothers, or women about 600.000 to 800.000 per year. (1) It is now estimated that more than 30 million Americans are on antidepressants or antianxiety medications. (2) Most of this 30 million are women who have one or more children. The likelihood of PPD increases with each successive child. (3)

The most common medical treatment for postpartum depression are SSRIs (selective serotonin reuptake) antidepressant drugs. Anxiety disorder after birth is most commonly treated by the benzodiazepine family of drugs such as Valium, Ativan, Xanax, and Klonopin. Reuptake inhibitors the combination of serotonin and norepinephrine (SNRIs) are also commonly used in postpartum depression. In the case of postpartum psychosis, antipsychotic drugs that use and are immediately necessary. Many women now have samples of SSRIs, as they are leaving the maternity ward. Most medical sources believe that the PPD is caused by an imbalance of brain chemistry and pharmaceutical intervention is the treatment of choice. While a certain percentage of women PPD sufferers need pharmaceutical assistance, they are much fewer are actually being received. Meta-Recent studies show that this is true. While it is clear that some women with PPD need and benefit of pharmaceutical intervention, our experience is an inclusive approach gives better results.

Disorder anxiety after childbirth is mostly treated

The most common symptoms of postpartum depression include:

1. Persistent feelings of hopelessness and / or anxiety;
2. Loss of energy and low levels of daily functioning;
3. Sleep and eat
4. Inability to concentrate, concentrating or making decisions;
5. Feelings of worthlessness, shame and guilt;
6. Feelings of indifference and / or resentment toward the baby;
7. Intrusive negative thoughts and / or obsessive concern in severe cases, this includes thoughts of hurting himself or baby
8. Reduced sex drive;
9. The loss of joy and appreciation for life;
10. Irritability or excessive anger.

Literature in general, outlines several types of postpartum disorders that have special characteristics beyond the typical symptoms of depression. These include:

1. Anxiety disorder after childbirth (EPP). Here, the main symptoms are excessive nervousness, hyper-vigilance, and racing thoughts some cases of panic. Panic attacks are particularly frightening, which often suffer believe they are dying, as they experience shortness of breath, dizziness and chest pounding.

2. Postpartum obsessive-compulsive disorder. Most often, this takes the form of obsessive thoughts or concerns on the infant and may be accompanied by compulsive behaviors such as constantly checking if the baby is breathing, constantly washing to protect the baby from germs, etc. The most disturbing obsessive thoughts are those in which the mother provides harm your baby in any way. These thoughts are unwanted, intrusive and frightening for the mother. It is important to emphasize that, except in very rare cases of psychosis (see below), these thoughts are not accompanied by any action. However, the mother may be so frightened by his own thoughts that keeps the baby and therefore their neglect. It's terribly difficult for new mothers to recognize that these thoughts, and as a result, many suffer in isolation.

3. Post-traumatic stress disorder. PTSD can occur in response to a real or perceived traumatic birth, or because past unresolved trauma-sometimes of a sexual nature-triggered during childbirth. A woman suffering post-traumatic stress disorder may have recurrent memories, dreams or memories of traumatic birth labor. She will be hyper-vigilant and startle easily, and is likely suffering from insomnia, irritability, poor concentration and lethargy. Women who have experienced a particularly traumatic birth often show signs of stress Posttraumatic and PPD.

4. Postpartum psychosis. This is the most extreme and rarest of all postpartum disorders. When this happens, mother loses touch with reality and its symptoms may include extreme for example, disorientation (not knowing who it is), delusional or paranoid thinking and or visual hallucinations hearing. The few, tragic cases where mothers have harmed their children while in a psychotic state have received enormous media attention. As a result, PPD many people mistakenly associated with psychotic symptoms and dangerous behavior. This is another reason why women do not receive help, they want to avoid be labeled with a disorder so stigmatized.

Premise item: Brand New Filling a mother after childbirth nutritional reserves has been ignored and must be an integral part of treatment for postpartum depression.

Basis Approximation nutrition to PPD
The human body is entirely made up of nutrients. All muscles, organs, glands, bones, cells and the liquid is composed entirely of nutrients (Environmental toxins, however.) All neurotransmitters, hormones, biochemical structures and pathways are formed from nutrients.

No other normal physiological process consumes drains vital nutrients and postnatal over the body of a woman in the process of being pregnant, giving birth and caring for a newborn which may include breastfeeding. The fact that a mother's body donates all the nutrients needed to form the body of her baby is too often overlooked when it comes to the medical treatment of PPD. Not only is the placenta literally steal the body of the mother of all key nutrients needed to make the body of a baby but the placenta is formed from nutrients taken from the body of the mother. This is the main reason that many women following childbirth nutritional drainage and nutrient depletion of this syndrome can lead to postpartum depression and anxiety disorder.

Other factors contributing to leakage of nutrient reserves of the new mother are blood loss during delivery, sleep deprivation, breastfeeding, returning to work soon and the enormous energy extra is needed to care for a newborn with intense needs. If a pregnant woman or nutrient reserves of the new mother are too low, is much more vulnerable PPD and PPP experience because all the body's normal metabolic processes are totally dependent on nutrients. The preponderance of poor quality drug prenatal vitamins gives a significant boost to the trend of nutrient depletion.

Rarely is there any indication that the body's production of neurotransmitters depends entirely its nutritional precursors. (4) Nor are the causes of these nutritional deficiencies precursor discussed. Moreover, the interdependent relationship between hormones and neurotransmitters rarely taken into account by most physicians to consider treatment for PPD and PPP. The nutritional requirements of mitochondrial function, the importance liver function in the west and the prospects of this, and some individual nutrients such as Omega 3 fish oils, pharmaGABA, L-theanine, SAM, inositol, magnesium, and St. John's wort may also be helpful in the treatment of PPD and PPP. These are briefly discussed.

A comprehensive approach for the treatment of PPD can include nutritional therapies, hormone replacement therapy bio-identical, moderate exercise, a diet of nutrient density, adequate rest, counseling, psychological support /, Stress reduction techniques, eliminating caffeine, alcohol and other addictive drugs, and if necessary, pharmaceutical intervention.

Neurotransmitters Nutritional Precursors

Serotonin and tryptophan

The amino acid L-tryptophan is necessary for the body to produce serotonin. Ninety five percent of serotonin in the human body occurs in the intestinal tract. Approximately five percent is produced in the brain. Serotonin is produced in the intestinal tract not available for the brain because serotonin can not cross the blood brain barrier. L-tryptophan also do not readily cross the blood-brain barrier requires a carrier protein for transport into the brain. Consumption of simple sugars cell membrane changes in neurons of brain amino acid selectivity, allowing tryptophan to enter the brain more easily. Therefore, the craving for sweets is often a sign of deficiency of serotonin.

Serotonin has called mood lifting and soothing brain chemicals. inadequate levels of serotonin are associated with depression, anxiety, insomnia, irritability and weight gain. Serotonin-mediated depression usually contains an element of anxiety. Serotonin is considered an inhibitory neurotransmitter. Features include:

– The inhibition of glutamate on the excitability of different CNS regions
-To stimulate receptors on GABA neurons GABA itself conducted its inhibitory function
– Inhibition of the release of catecholamines dopamine, norepinephrine and epinephrine.

A comparison of the effects of optimal levels of serotonin to low serotonin levels reveals the following contrasts:

1) Hope / —— optimistic depressed
2) Calm Anxious ———
3) humor ——- irritable
4) ——— Impatient Patient
5) Reflective / thoughtful—–Impulsive/Reactive
6) Love / Care abusive ——-
7) Can focus attention span short ——
Creative / center blocked —— / scattered
9) Moderate consumption of carbohydrate carbohydrate overconsumption —
10) good sleep and dream recall — Insomnia and poor dream recall

Tryptophan is converted to its metabolite, 5 – hydroxy-tryptophan (5-HTP) which is then converted into serotonin. Niacin, iron and folic acid are necessary for L-tryptophan is converted to 5-HTP. The body also requires pyridoxal 5-phosphate with 5-HTP to make serotonin. Magnesium and riboflavin (B2) are required for the conversion of pyridoxine (B6) Pyridoxal-5-phosphate. Deficiencies in any of these nutrients may limit the production of serotonin. Numerous double-blind studies have shown 5-HTP to be as effective as antidepressant drugs with fewer side effects and more mild and most often better tolerated. (5.11)

Martin Hintz, MD Neuro-Research

A number of important factors contributing to lower L-tryptophan levels in many people, especially postpartum women, whose bodies are providing protein necessary to form another human body, these are the excessive levels of cortisol, epinephrine, norepinephrine, and dopamine. The proportion of L-tryptophan to other amino acids available in most foods is very low.

An excess of cortisol, adrenal gland hormone (a very common problem in psychological stress and physiological states) negatively affects the production of serotonin and the sensitivity of four different ways:

1. Excess cortisol significantly decreased the number of serotonin (5-HT 1A) receptors. (12)
2. Excess cortisol inhibits serotonin receptors. (13, 14)
3. Excess cortisol increases serotonin reuptake. (15)
4. Excess cortisol causes tryptophan oxygenase (TO) to metabolize tryptophan to kynurenine, leaving less tryptophan to become serotonin. (15.16)

If cortisol levels are too low in the amygdala, serotonin no longer has an inhibitory effect on activity glutamatergic, suggesting that cortisol plays a key role in maintaining mediated serotonergic modulation. (16,17) This may be another factor for participation of insomnia in PPD.

Added to the reasons that serotonin deficiencies are increasingly common and contribute to PPD is an overabundance of stress-related of catecholamines. Epinephrine, norepinephrine, serotonin and dopamine also deplete because monoamine neurotransmitter serotonin is supposed to balance these three monoamine excitatory neurotransmitters. The stress a person experiences more, the body increases production of catecholamines in an attempt to respond to this stress. This requires a body after childbirth to produce even more serotonin – although precursors nutrient deficiencies can interfere with production.

The use of 5-HTP as a precursor of serotonin has important nutritional advantages over tryptophan. 5-HTP easily passes directly through the blood-brain barrier without the need for a carrier protein, allowing easier conversion into serotonin in the brain. Sublingual forms of 5-HTP work faster. The varying doses of 25 mg per day to 300 mg per day or more.

A deficiency of vitamin B6 (pyridoxine), which is required for the synthesis of serotonin, is often in premenopausal female patients with depression. (18) Replacement of B6 deficiency, is an important aspect of treatment that can increase PPD the production of serotonin in the brain. (19) The use of vitamin B6 metabolite, pyridoxal 5-phosphate instead of B6 is suggested especially when magnesium and / or deficiencies of riboflavin are suspected or confirmed. There is some controversy whether it is better supplement 5-HTP and 5-phosphate pyridoxal together or taken separately, the completion of a waiting period of two hours. Our clinical experience suggests that be fine to complete together. Many products, including a combination of 5-HTP and the P-5 P-are available.

There some controversy about the concurrent use of SSRIs and serotonin nutritional precursors. Pharmaceutical companies seem adamant about avoiding this and often mentioned the possibility that the serotonin syndrome, a dangerous condition usually derived from the combination of serotonin enhancing drugs, especially MAO inhibitors with medicines, herbs or nutritional precursors that also enhances the activity of serotonin. Serotonin syndrome symptoms may include nausea, pain headache, agitation, diaphoresis, hypertension, tachycardia and hyperthermia that can go over 104 F. This seems a remote possibility at best if only used 5-HTP or the use of 5-HTP in combination with an SSRI medication. (20)

SSRIs appear not only to keep serotonin in the synapses of the neuron and inhibition reuptake, but also pulling the nutritional precursors of serotonin storage vesicles and reuptake ports. In fact, in our experience clinic, many women with PPD do better when taking 5-HTP and P-5 P-together with SSRIs SSRIs alone. Precursor of serotonin deficiencies may be the reason that SSRIs do not work for some, the work and then stop working for others, and why it is not unusual for a woman with PPD, we established two or more different SSRIs over time. SSRIs do not a net increase of serotonin and they need enough serotonin available in order to have enough to re-uptake.

Dr. Dean catecholamines Raffelock-table

Catecholamines are predominantly energy and mood when it occurs at the appropriate levels. Synthesis of catecholamines occurs in the CNS, adrenal medulla and peripheral sympathetic neurons. Norepinephrine and dopamine act primarily as neurotransmitters in the CNS. Adrenaline acts primarily as an adrenal hormone to mobilize energy.

Catecholamines affect most organ systems. When levels are excessive, catabolic, and can lead the body to metabolize its own nerve, muscle and bone tissue. Low levels can lead to depression, fatigue and increased weight.

Dopamine: Dopamine is the precursor of the catecholamines norepinephrine and is found in both the CNS and adrenal medulla. Its functions include the function motor and posture, cognitive function (attention, concentration, working memory and problem solving), and feelings of pleasure. Dopamine can act as an inhibitory neurotransmitter or excitatory input in response to afferent signals.

Norepinephrine (noradrenaline): CNS norepinephrine mediates mood regulation, drive, ambition, learning and memory, alertness, arousal and focus. Clinically, there is usually an inverse relationship between norepinephrine (excitatory) and serotonin (inhibitors). When serotonin is low, too norephinephrine is upregulated, resulting in "fight or flight" responses that lead to anxiety and / or panic attacks. Overexpression of norepinephrine in the CNS is clinically associated with anxiety, aggression, irritability, mania or bipolar disorder immunosuppression and hypertension, lower norepinephrine is associated with atypical depression, with symptoms of fatigue, hypersomnia, hyperphagia, lethargy and apathy.
(21.22)

Epinephrine (adrenaline)-dependent synthesis of epinephrine and norepinephrine is converted into epinephrine by methylation.
Hans Selye (1974) s described the third phase of the "General Adaptation Syndrome" for stress (23):

Phase I: the alarm reaction: cortisol adrenaline high / high

Phase II: Resistance: high cortisol / low DHEA, adrenaline variable

Phase III: Depletion: reduction in cortisol, epinephrine and DHEA
adrenal exhaustion is an important factor in depression associated with chronic or severe stress.

A woman suffering from PPD should be closely questioned about their symptoms, SSRIs are routinely given to women who have hypoadrenia way that involves the adrenal cortex and / or bone, or function low thyroid (see below). Low glucocorticoid and / or catecholamine levels may cause symptoms of fatigue, malaise and depression. (24.25)

Many women with PPD require pharmaceutical products and / or nutritional supplements to address deficiencies in both serotonin and catecholamines. Nutritional therapies to maintain catecholamine balance are:

§ DL-phenylalanine and L-tyrosine, the amino acid precursor of epinephrine, norepinephrine and dopamine. DL-phenylalanine also helps increase endorphins, which are in the mood. PP Many women diagnosed with bipolar disorder respond well to therapy high dose of DL-phenylalanine (26) together with the precursors of serotonin and high dose (6 grams per day) of omega-3 fatty acids as fish oils. (27)

§ L-cysteine, sulfur, iron and folic acid, necessary for the conversion of L-tyrosine to L-dopa.

§ pyridoxal 5-phosphate, necessary for the conversion of L-dopa into dopamine. Copper and vitamin C are required to convert dopamine into norepinephrine. Pridoxal acid-5-phosphate, vitamin B12, and folic acid are required to convert norepinephrine in epinephrine.

Gamma-aminobutyric acid (GABA)

Inhibitory neurotransmitter GABA is the most important and widespread in the brain. Low levels of GABA are particularly important to look for when anxiety and insomnia were included in the display the symptoms of PPD / EPP. GABA is essential for balancing the excitatory neurotransmitter and hormones such as cortisol, epinephrine, norepinephrine and glutamate. Too much excitement without adequate inhibition of GABA can lead to: (28)

– Insomnia
– Restlessness
– Irritability
– Anxiety
– Panic Attacks
– Attacks

Working GABA in the clinic is to induce relaxation, tranquility and sleep aid. Where there are glutamate receptors (powerful excitatory neurons), GABA receptors will close. GABA allows only the most important signals pass and dampens excitatory or off strange signals with excitement when GABA levels are adequate.

Benzodiazepines (Valium, Klonopin, Zanax, Ativan, etc) and pharmaceutical products such as Ambien and Sonata sleep working on GABA receptors, as moderate consumption of alcohol. L-theanine, lactium (milk peptides) L-glutamine, taurine, and bio-identical progesterone can act as nutraceuticals / hormone agonist GABA. The drug is an inhibitor of GABA reuptake Gabatril as extract Valerian. A new product called nutriceutical pharmaGABA seems to perform better than synthetic GABA effective results.

From the perspective of Chinese medicine, serotonin and GABA would Yin (relaxing, harmonizing, cooling, nutrition, hydration, inhibitory) and catecholamines would be Yang (energizing, mobilizing, warming, excitement, drying). In both Eastern and Western perspectives, it is important to balance the opposing groups of chemicals in the brain establish equilibrium. A woman with PPD, which now has more energy, but can not sleep is as unhappy as a woman who can sleep now, but even more lethargic than before treatment.

Balance is the key neurotransmitters. Balance of neurotransmitters and hormones is clinically more effective.

Hormone neurotransmitter interactions

The relationship between neurotransmitters and hormones in the PPD is often overlooked. Neurotransmitters and neuropeptides are necessary to mediate the hypothalamic production of stress hormones, allowing the pituitary gland to properly conduct the orchestra hormone. The hypothalamus is considered a key part of the midbrain, the "emotional brain", so it is no wonder why imbalances in neurotransmitters and hormones can negatively affect emotional states.

Thyroid hormones. Catecholamines and thyroid hormones are closely related in many of its functions. L-tyrosine, along with iodine, is the precursor of thyroglobulin and thyroid hormones T 3 and T-4. A depression without anxiety, with the predominant symptoms exhaustion and difficulty stringing together multiple positive thoughts, is more associated with low adrenal (29) and / or thyroid function (30-32) and generally does not respond well to SSRIs or serotonin precursor nutritional therapy.

It is well known that low thyroid function can cause depression and fatigue physiological. Dar T3 induces an increase in serotonin, and in animals with hypothyroidism, the synthesis of serotonin is reduced. (33) T3 seems to desensitize presynaptic autoreceptors serotonin. (34) However, the peak day of the TSH, observed during the circadian rhythm physiology, is serotonin dependent. (35)

The function thyroid and serotonin function are interdependent, both clinically and biochemically. optimal performance depends on optimal thyroid levels of serotonin. balance optimal serotonin depends on the optimal thyroid function. TSH increase depends on adequate stimulation of serotonin hypothalamic TRH, which allows an increase TSH. (36) Suppressed TSH can now more accurately represent low serotonin states that any real assessment of thyroid function truth. Hormone thyroid triiodothyronine (T3) increases and accelerates the effects of antidepressant drugs. Fluoxetine + T3 are better in desensitizing 5-HT autoreceptors hypothalamus than one. (37-39)

Estrogen: A growing body of evidence points to the importance of estrogen on serotonergic function. (40) Estrogen inhibits the reuptake of serotonin. (41,42) Treatment with estrogens have been shown to improve so selective serotonin (5-HT 1A-mediated) responses in the hippocampus (43,44) Estrogen increases the firing activity of 5-HT (serotonin) neurons in both male and female rats. (45,46) In summary, estrogen appears be the nature SSRIs.

At present, there is much controversy concerning estrogen HRT. The HERS and WHI studies have raised the dispute without make the important distinction between estrogen and pharmaceutically altered bio-identical, nor is any distinction between progesterone and progestins. The clinician dares to be well versed in the art in terms of risks versus benefits of HRT. Many women with PPD may benefit from low doses of estrogen bio-identical HRT if indicated and the potential benefit outweighs the risks.

Progesterone: Bio-identical progesterone has an effect anti-depressant/anti-anxiety known. During pregnancy, the placenta produces large amounts of progesterone, increasing blood levels many times before pregnancy levels. Post-partum, this resource has suddenly gone, along with its soothing effects on the nervous system of the mother.
Allopregnanolone is synthesized by the reduction of progesterone by the enzyme 5-reductase and 3-hydroxysteroid dehydrogenase (3-HSD). Allopregnanolone is one of the most potent modulators of GABA receptors known. (47,48) has behavioral and biochemical allopregnanolone similar to ethanol, barbiturates and benzodiazepines. (49.50)

bio-identical progesterone can be very useful for women with PPD with anxiety and insomnia. Using PharmaGABA and progesterone bio-identical at the same time is often very useful to relieve anxiety and sleep problems.

DHEA: DHEA increases the activity of serotonin neurons. (51) DHEA also increases dopamine and norepinephrine synthesis via tyrosine hydroxylase mRNA. (52) Because of this, DHEA may be useful in some forms of PPD. DHEA also inhibits GABA and thus an antagonist of GABA. (53) Clinically, if the use of DHEA causes insomnia and irritability, it's likely that the patient is deficient GABA and this must be addressed before proceeding to complete the DHEA.

Testosterone: increased firing of raphe serotonergic neurons in the area, increasing mood. (54)

Mitochondrial function

of Lab-Ion Metametrix Group Brochure

inefficient mitochondrial function may limit the production of ATP, the less energy and contribute to the cause physiological or depression. Over 90% of total cellular oxygen consumption is used as fuel for mitochondrial metabolism. Mitochondria must transfer a large number of electrons to produce energy. Mitochondrial dysfunction can affect all organ systems, including neurons and glands.

Dietary fats, carbohydrates and proteins all must be converted into acetyl coenzyme A (acetyl CoA) before entering the Krebs cycle and electron transport chain. Nutritional precursors for fatty acids, glycerol, and cholesterol to enter the Krebs cycle and generate ATP are riboflavin (B2), L-carnitine, niacin and biotin. Thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), biotin, alpha-lipoic acid required for carbohydrates and proteins to enter in the Krebs cycle in mitochondria.

Within the Krebs cycle, cysteine and iron are necessary to convert cis-aconitate to isocitrate. Niacin, magnesium and manganese are required to convert isocitrate into alpha-ketoglutarate. The amino acids glutamine, histidine, arginine, glycine and proline are necessary to form alpha-ketoglutarate. The thiamine, riboflavin, niacin, pantothenic acid, and alpha lipoic acid are required to convert alpha-ketoglutarate to succinyl-CoA. The amino acids isoleucine, valine, methionine, and are required to form succinyl-CoA. Magnesium is required to convert succinyl-CoA to succinate. Riboflavin is needed to convert succinate to fumarate. Tyrosine and phenylalanine amino acids are required to form fumarate. Niacin is needed to convert malate to oxaloacetate.

All these nutrients are necessary to produce 36 units of ATP per molecule of acetyl-CoA in the Krebs cycle. A major shortcoming of any of these essential nutrients can cause mitochondrial dysfunction and contribute to fatigue and depression.

Niacin and coenzyme Q10 are required for oxidative phosphorylation (electron transport chain, ETC.) Normally, the ETC produces another 3 units of ATP in mitochondria, in addition to the Krebs cycle 36. A deficiency in any of these can also reduce ATP production and contribute a physiological depression.

Mitochondrial dysfunction is often overlooked in the treatment of PPD. A study of postpartum women showed a comprehensive program of post-natal nutrients, including many of the Krebs cycle / oxidative phosphorylation nutrients, relieved symptoms of mild postpartum including many to moderate PPD.

Liver Detoxification

NUTRITION: A Functional Approach-Jeffrey Bland, Ph.D

For many centuries, Chinese medicine is related to dysfunction of the liver meridian anger, irritability and depression. From this perspective, repressed anger often leads to depression. Concepts such as increased heat in the liver and liver Qi stagnation are used to describe how defective function Liver meridian can dramatically alter emotional states. When the flow of electrons within a meridian is up or down-regulated, the person in charge of organs after that meridian will become dis-eased. Many practitioners of Chinese medicine are taught to consider the liver the seat "emotional body" because This strong correlation of liver dysfunction with negative emotions.

In the East the term "hot liver" is used to describe someone who has anger problems. The use of English depressed "to describe one who is irritable. From the standpoint of Western medicine, most physicians are aware of how a first alcoholic liver cirrhosis can cause irritability and finally depression.

In the last two decades much more information has surfaced regarding the phase one and phase two liver detoxification pathways. These pathways contribute greatly to the ability of body to excrete toxic exogenous and endogenous chemicals. Environmental toxin levels (xenobiotics) are becoming increasing and requires that the liver plays an important role in their excretion.

Added to this burden of detoxification are the internal production of stress hormones and other substances more requiring chemical body excretion. All of these chemicals require that the liver has the proper nutrients to facilitate their excretion.

The first phase consists of liver detoxification of oxidation, reduction, or hydrolysis. The cytochrome P450 mixed function oxidases perform the function most important start of detoxification of these exogenous and endogenous toxins. Phase I liver detoxification requires an adequate supply of nutrients, enzymes and antioxidants. This list includes riboflavin, niacin, pyridoxine, folic acid, cobalamin, glutathione, phospholipids, carotene, vitamin C, bioflavonoids, flavonoids, vitamin E, selenium, copper, zinc, manganese, CoQ10, and the nutrients contained in thiols, Pycnogenol, and silymarin.

Phase II detoxification is liver conjugation pathways in hepatocytes. Amino acid conjugation (binding) of the toxins requires glycine, taurine, glutamine, ornithine and arginine. Sulfation requires amino acids containing sulfur or elemental sulfur. Sulfation is required to break down and combined estrogen, DHEA, thyroxine, cortisol, catecholamines, melatonin, ethanol, bile acid, tyramine, cholecystekinin, cerebrosides and others. Glucuronidation requires magnesium and B6 to break down estrogens, other steroids, melatonin, and many xenobiotics.

Methylation requires B12, B6 and folic acid to break down and eliminate catecholamines, histamine, and many drugs and xenobiotics. conjugation of glutathione helps detoxify heavy metals and numerous xenobiotics. Glutathione requires glutamate, glycine, cysteine and N-acetyl-o-cysteine plus selenium and vitamin C for their formation. Acetylation, another detoxification pathway, requires B2, B5, molybdenum, and vitamin C to make your function.Sulfoxidation transforms toxic sulfite to sulfate molecules usable.

Mothers in the U.S. have high toxic load as evidenced by the levels of toxins in breast milk. (55) If the liver is overloaded and unable to perform its many tasks detoxification, this may contribute to PPD.

Omega-3 fatty acid deficiencies and PPD

A deficiency of omega-3 fatty acids has been linked with depression. (56-59) Numerous studies have demonstrated the efficacy of fish oil supplementation in depression. (60.61)

The human brain is 60% fat. The quality of the fats that make the neurons have a significant impact on brain function including mood. A relative deficiency of omega-3 flexibility acids in comparison with the more rigid omega-6, saturated, and cis-trans fatty acids impairs the function of cell membranes and their ability to selectively allow the passage of molecules in and out of neurons. The brain is composed of fatty acids and uses more than any body structure. DHA – mentioned by Allport as "the Queen of fat "(62) – is responsible for the fastest moving cell. As the primary structural fat and cognitive brain, DHA also affects states of mind.

The brain of a developing fetus, nerves, eyes, skin and cell membranes require omega-3 oils, especially DHA. Placenta selectively eliminated omega-3 mother's bloodstream through the placenta from mother often leaving significantly deficient in these essential oils. (63,64). The recommended dose of omega-3 fish oils in the treatment of PPD is 6-12 grams per day.

Hypericum perforatum (St. John's wort):

More twenty-five double-blind studies have shown the herb St. John's wort to produce results as good or better compared with SSRI drugs with side effects much less. (1965-1971) in Germany, where hypericum is a prescription drug and covered by insurance, more than 20 million taking this herb for depression. One of the benefits of take St. John's wort is an increase of serotonin. (72)

SAM (S-adenosylmethione):

SAM is a methyl donor in the production of monamines, the neurotransmitters and phospholipids such as phosphatidylserine and phosphatidylcholine. SAM serves as a precursor of glutathione, coenzyme A, cysteine, taurine and other essential compounds. SAM is involved in the conversion of methionine sulfur is important in homocysteine metabolism.

Compared with other antidepressants, SAMe tend to work faster and more efficiently, with virtually no negative side effects. In fact, SAM has ancillary benefits, including improved of cognition, slowing the aging process, improves function and less pain, and liver protection. (73)

Normally, the brain synthesizes the appropriate SAM on the amino acid methionine. As a supplement SAMe in depressed patients increases serotonin and dopamine levels, improves membrane fluidity and improves the binding of neurotransmitters to receptors (74,75). Numerous double-blind studies demonstrating the effectiveness of SAMe for depression. (76-78) The suggested dose of SAM the treatment of depression ranges 400-1600 mg daily.

Inositol

Depressed patients have lower levels brain inositol. (79) Inositol is helpful to maintain healthy serotonin metabolism, and in so doing helps treat many conditions such as depression, agoraphobia, panic Disorder (80-82), and obsessive compulsive disorder (83).
Research shows that taking 6-12 grams of inositol daily for four weeks significantly improved mood and reduces the severity of depression. (84-86) inositol can be safely used with antidepressants. (87)

L-theanine

L-theanine is known to increase GABA levels and has an anti-anxiety and improve cognitive function. (88) L-theanine may also normalize dopamine levels, which are often depleted by various stresses. (89) L-theanine significantly reverses glutamate-induced toxicity. (90)

The integration of high quality, high potency prenatal and postnatal Systems Nutrients in Prevention and Treatment of Depression postpartum anxiety

Clinically, it is imperative that higher quality, greater power, plus a comprehensive prenatal postnatal nutrient systems for use in the treatment and prevention of postpartum depression. It is common knowledge in many 3rd world countries the recovery period after birth is 24 months since this is the amount of time women are told to wait between pregnancies and to replenish their bodies and avoid many health problems after childbirth. These women have more support from the community and extended family, which also significantly reduces the incidence of PPD.

Most prenatal vitamin supplements are not sufficient to fully supply the developing baby and mother with the power and quality of nutrients for feeding pregnancy and the postpartum period. These nutrients are highly dependent process.
A randomized, double-blind, placebo-controlled clinical trials in a comprehensive program of post-natal nutrient called After Baby Boost showed excellent results, better than 14 common symptoms after delivery as postpartum depression, anxiety, insomnia and mood swings. The parameters measured were breast tenderness, strength, muscle cramps, depression, dizziness, fatigue, headaches, insomnia, irritability, joint swelling and pain, mood swings, nervousness, palpitations, sweating, temperature changes (Hot or cold), vaginal dryness and water retention.

After Baby Boost contains high potency vitamins and minerals including CoQ10, alpha lipoic acid, 2 grams of fish oils with three antioxidants to prevent rancidity, night and minerals (calcium and magnesium citrate). The placebo used was a prenatal vitamin leader.

After the baby significantly boost prenatal vitamins exceeded in all 14 categories of symptoms, which indicates that the majority of postpartum women require more comprehensive, more powerful replacement of nutrients that provide prenatal vitamins. (91)

Obstetricians seldom emphasize the importance of a high quality, nutrient dense diet. Neither prescribing high quality prenatal vitamins. Women often say, "You is eating for two now, so eat whatever you want. "Currently, only 300 extra calories per day are needed during pregnancy. It is important that these calories are rich in nutrients. Unrestricted carbohydrate consumption contributes to obesity and may contribute to metabolic diseases such as depression physiological and even diabetes in pregnancy.

PPD Integrative Treatment

It is hoped that the reader becomes more aware of this simple concept: The body of a baby is exclusively composed of nutrients donated by her mother's body. Since all physiological processes and chemicals (neurotransmitters, hormones, routes metabolic, etc.) are responsible nutrients, nutritional deficiencies can often be the root cause of PPD. While antidepressant drugs are needed to some, the long-term solution often requires an inclusive approach well thought out including (a) the replacement of reserves through nutritional supplements, (2) psychotherapy and / or delivery / PTSD and EMDR therapy, (3) getting enough sleep (often very difficult with a child again), (4) moderate exercise, (5) respiration Deep abdominal or meditation, (6) community support, (6) a diet of nutrient density, and (7) pharmacological treatment as necessary

REFERENCES

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About the Author

Dr. Dean Raffelock D.C., L. Ac., CCN, DACBN, DIBAK has been a clinical nutritionist since 1977. He is Vice President of Research and Development for www.soundformulas.com , a nutritional company dedicated to helping pregnant and postpartum women receive optimal nutrition before, during, and after giving birth. He is the formulator of After Baby Boost™ the world’s first and only clinically tested comprehensive, postnatal 3 bottle nutrient designed to help new mothers fully replenish the nutrients donated to form their baby’s body. He is also the formulator of Before Baby Boost™, the world’s first truly comprehensive 3 bottle prenatal vitamin system. He is the lead author of the book A Natural Guide to Pregnancy and Postpartum Health (Avery, 2003). He is President of Sound Formulations, LLC-a consulting company that formulates and manufactures nutritional products for numerous nutriceutical companies. Dr. Raffelock has a multi-disciplinary practice in Boulder, Colorado and may be reached at DrDeanR@soundformulas.com , Soundformulations@gmail.com.

Hyla Cass, M.D. is a board-certified psychiatrist, former Assistant Clinical Professor of Psychiatry at UCLA School of Medicine, and author of several books, including Natural Highs, 8 Weeks to Vibrant Health, and Supplement Your Prescription. A member of the Medical Advisory Board of the Health Sciences Institute and Taste for Life Magazine, she is also Associate Editor of Total Health and served on the board of California Citizens for Health. Dr. Cass has also served as president of Vitamin Relief USA (www.vrusa.org). She has a clinical practice of integrative medicine and psychiatry in Pacific Palisades, CA. For more information, see her website: www.drcass.com.

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