Nutritional Supplements for Mental Symptoms
Supplements should be used with consideration to the whole person. It's not a question of what supplement is good for depression or anxiety, but rather, what nutritional blocks does the individual have.
This is a partial list of some more common supplements used with people with mental symptoms. Other supplements can be helpful as well depending on the case. This list is not meant to be exhaustive, but will be updated over time.
L-tyrosine and 5-HTP
Amino acid precursors to neurotransmitters dopamine and serotonin. Commonly used for depression, anxiety and other mental symptoms.
Often these work well together in about a 10:1 ratio of l-tyrosine to 5-htp. Both may help with mood, and food cravings. At times l-tyrosine may be give for low energy as it a precursor to adrenaline (epinephrine) as well as dopamine. 5-htp is also used for sleep, typically help when someone can not fall alseep. It is a precursor to the sleep hormone melatonin as well as serotonin.
Vitamin B6 is needed for the conversion of both l-tyrosine and 5-htp into neurotransmitters. Tyrosine also needs copper for conversion. 5-htp utilizes zinc for conversion into serotonin.
Our brains are made up of fat. In fact, 80% of the dry weight of the brain is fat. Therefore a diet rich in healthy fats is essential for good neurological function.
There are 2 main types of long chain fatty acids in fish oil.
- Docosahexaenoic acid (DHA) is more specific for brain and neurological function.
- eicosapentaenoic acid (EPA) is considered more specific for inflammation.
Thiamien is needed for blood sugar control (along with chromnium) and proper pH. On blood tests, high CO2, or elevated anion gap ((sodium + potassium) - (CO2 + chloride)) indiate a need for vitamin B1.
Low leves of B6 can contibute to depression, anxiety other mental symptoms and PMS. B6 is also related to our dreams. Low B6 can result in poor or even no dream recall. High B6 is associated with nightmares. So if bad dreams and nightmares is already a problem it's best to avoid.
Vitamin B6 is available is several forms. The P5P form does not have to be activated by the liver.
B12 is essential for proper nerve cell function. Signs of low B12 can be seen on lab tests as elevated MCV or MCH. Another test for MMA (methyle malonic acid), can serve as a functional marker for B12 need.
Often B12 is given as high dose injections. However supplemeting with B12 instead works just as well. Often B12 is given as sublingual tablets for better absorbtion.
Folate and MTFR gene mutations
Folate is essential for neurotransmitter production.
To keep things simple, there is a compound called tetrahydrobiopterin or BH4. BH4 is needed for the following conversions:
- Phenylalanine to tryrosine
- Tyrosine to l-Dopa (which is then converted to dopamin, norepinehphrine and epinephrine)
- Tryptophan to 5-htp (which is then converted to serotonin)
- Arginine conversion in nitric oxide pathway
Folate is needed to activate BH4. So a lack of folate can impaire the body's ability to make certain neurotransmitters.
Symptoms of such a deficiency include depression and anxiety. These can be quite severe and effect children.
Lab tests which indicate this is a problem include:
- Abnormalities in folate, include very high folate on lab tests. Yes, high folate can indicate the body is not able to utilize it, the causing severe symptoms of folate defieincy. In these cases it is important to supplement with the active form of folate, 5-mthf, and not folic acid (which the body must first convert to 5-mthf in order to use).
- Low serotonin (low 5-HIAA on lab test).
- Low catacholamines (epinephrine, norepinephrine). Urine test is available for fractionated catecholamines.
MTHFR is the enzyme that activates folic acid. So without this enzyme the body can't use folic acid not matter how much is taken as a supplement.
There are several genes which are associated with this enzyme not working:
- CC677 homozygous normal
- C677T heterzygous
- 677TT homozygous abnormal (associated with schizophrenia, bipolar and depression). 
- AA1298 homozygous normal
- A1298C heterozygous
- 1298CC homozygous abnormal
So is this a genetically determined factor for metal illness?
While the evidence is clear that these gene mutations are a factor to consider, not everyone wtih the gene mutations has symptoms. So while this is important information to have, and it can greatly help some people, we need to still keep in mind that this is one factor to consider.
Zinc is needed in hundreds of enzymatic reactions, and is one of the most common deficiencies people have. In my practice I test zinc status by having clients taste a zinc solution. If it tastes sweet, or like water that indicates a need for zinc. A bad metallic tastes indicates they don't need zinc.
Sometimes the mineral lithium can be helpful with mental symptoms. Although more commonly known as a drug, it is available in very small doses as a supplement. Supplement doses can be effective and do not have the side effects common with prescription lithium.
 Peerbooms OL, van OsJ, Drunkker M, et al. Metaanalysis of MTHFR gene variants in schizophrenia, bipolar disorder and unipolar disorder. Evidence for a common vulnerability? Brains Behav Immun. 2010 Dec 24.