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Our Top 4 Supplements to Support Mental Health and Complement Ketamine Therapy

While we advocate for a balanced diet where one should ideally obtain the recommended dietary allowance of nutrients from food, achieving this in practice can be challenging and inconvenient. Ensuring that we consume all essential components of a healthy diet can feel like an ongoing chore. Through supplements, we aim to enhance overall health, performance, and mental well-being. In essence, our objective at Innerbloom Ketamine Therapy is to assist our patients in achieving optimal mental and physical health. Today, we'll share our top four supplements for mental health and their potential benefits for mood, cognition, pain, and sleep.

Omega-3 Fatty Acids: Anti-Inflammatory and Antidepressant Benefits

Omega-3 polyunsaturated fatty acids (PUFAs), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are primarily found in fish oil and marine algae. Research indicates that omega-3 PUFA supplementation can effectively help alleviate symptoms of depression.

Several mechanisms of action have been proposed, but the role of omega-3 PUFAs in treating depression might be primarily attributed to their anti-inflammatory properties. Evidence suggests that inflammation is associated with symptoms of depression, pain, and other immune-mediated diseases, such as multiple sclerosis and rheumatoid arthritis.

Formulations with a majority of EPA (over 50% EPA) demonstrate greater efficacy than those predominantly containing DHA, underscoring the importance of checking the supplement label. Dosage also plays a crucial role, with higher doses not necessarily implying better results. Research recommends a daily intake ranging from 720 mg to 1000 mg for optimal results in addressing depressive symptoms. To provide context, a 1g/day supplementation is comparable to consuming about three servings of salmon weekly. It's worth noting that dosages exceeding 1g/day of omega-3 PUFAs might inhibit liver enzymes responsible for metabolizing antidepressants, such as selective serotonin reuptake inhibitors (SSRIs).

Vitamin D for Mental Health

Vitamin D is crucial for bone metabolism and various physiological processes within the body. A deficiency in vitamin D is widespread, particularly among Black Americans, women, individuals aged 20-29, and during the winter months. It's estimated that over 40% of the US population has a vitamin D deficiency. This deficiency is a significant risk factor for leading causes of death in the US, including depression, cardiovascular disease, and cancer.

Vitamin D supplementation seems to alleviate depressive symptoms, notably in individuals with major depressive disorder and women experiencing postpartum depression. While further research is essential to ascertain whether supplementation beyond the recommended daily allowance (600 IU for those 19 years of age and older, and 800 IU for those over 70) benefits depression, recent meta-analyses have indicated that vitamin D can be therapeutic for depression when a deficiency exists.

Studies have demonstrated that vitamin D3 supplementation increases serum vitamin D concentrations more effectively than vitamin D2. Moreover, many consider vitamin D3 the preferred source because it is naturally produced in the skin and found in foods like eggs, cheese, fish, and mushrooms, as opposed to foods artificially fortified with the vitamin.

Magnesium for Depression, Anxiety, and Sleep

Magnesium is involved in hundreds of enzymatic reactions in the body and serves important roles for heart, muscle, bone, hormone, and immune function.  Food sources of magnesium include dark leafy greens, dark chocolate, nuts and seeds, fatty fish, avocado, rice, and soybeans. Low magnesium levels have been associated with several chronic health conditions, including diabetes, cardiovascular disease, and chronic pain.   Magnesium deficiency is common, and to make matter worse, without sufficient magnesium levels, vitamin D is inactive.  Poor diet along with coffee and alcohol intake has been found to deplete magnesium storages.  

Studies have shown an association between low levels of magnesium and symptoms of depression.  There also appears to be benefits of magnesium even in individuals without a deficiency.  The mechanisms by which magnesium can improve mood and sleep are unknown, although magnesium supplementation increases production of the brain-derived neurotropic factor (BDNF). As the growth factor, BDNF has been shown to mediate the rapid antidepressant actions of ketamine and is thought to play a key role in neurogenesis.  Does magnesium act synergistically with ketamine?  This is still to be determined!

There are a few options and forms of magnesium which includes magnesium taurate, glycine, malate, threonate, & citrate. Magnesium glycinate is most easily absorbed in the small intestine and is good option, with research supporting its effects on anxiety and other mental health disorders. Doses between 200-400mg per day appear to be optimal for improvements in mood and sleep.

My preferred form of supplement magnesium is magnesium L-threonate, taken at a minimum dosage of 144mg daily. Why magnesium L-threonate? It can cross the blood-brain barrier and may help with Catechol-O-Methyltransferase (COMT) gene mutations. Such mutations lead to reduced COMT enzyme activity. Under typical conditions, this enzyme assists in breaking down dopamine, along with stress molecules and hormones like epinephrine (adrenaline), norepinephrine, and estrogen. While dopamine is essential for memory, attention, and judgment, excessive amounts can result in undesirable behaviors such as increased competitiveness, aggression, and poor impulse control. Elevated stress molecules might contribute to anxiety, tendencies towards binge eating, insomnia, addiction issues, and symptoms related to high estrogen levels. Consuming magnesium L-threonate might help restore enzymatic activity to some extent, potentially reducing the unwanted symptoms or behaviors mentioned earlier. Additionally, it's worth noting that between 40-50% of the population is born with a reduced capability to metabolize adrenaline effectively. How can one determine the presence of this gene mutation? Pharmacogenetic testing, such as that offered by the Nutritional Genomics Institute, is one way to investigate.

Creatine Monohydrate for Cognition, Memory, Mood, and More

Creatine is best known as a sports supplement, with research showing that it improves strength, enhances recovery, and can help with injury prevention.  However, what most do not appreciate is that creatine can play important roles in cognition, memory, mood, and overall brain function.

“Clinical studies in neurological conditions such as Parkinson’s Disease have indicated that creatine might have an antidepressant effect, and early clinical studies in depressive disorders—especially major depressive disorder —indicate that creatine may have an important antidepressant effect” – Creatine for the Treatment of Depression.

Creatine is naturally found in foods such as red meat, fish, poultry, and pork. It boosts phosphocreatine stores in both muscles and the brain. These additional stores facilitate the production of more ATP, the primary energy source for the body. ATP can be rapidly exhausted during periods of high energy demand, whether from physical exertion or emotional stress. Feelings of intense anxiety, depression, or other mood fluctuations can lead to fatigue and a sensation of 'brain fog'. The brain's performance is compromised without sufficient ATP, especially during times of stress or activities demanding high energy.

The recommended daily dosage of creatine is 3-5 grams of creatine monohydrate. We believe that "loading" is unnecessary and may result in unwanted side effects, such as bloating and gastrointestinal discomfort. However, without loading, it's important to note that it will take 3-4 weeks to fully optimize creatine stores for maximum benefits. While various supplement creatine products (buffered, HCL, ethyl ester, etc.) claim superior effectiveness, we recommend the proven, effective, and cost-efficient option: creatine monohydrate.

Blue supplement bottle, capsules of vitamins, and a bowl of blueberries

Conclusion

Science has advanced significantly, enabling us to enhance both our physical and mental well-being. We are fortunate to live in an era where we can access knowledge that elevates our quality and functionality of life. The ultimate aim is to boost vitality, ensuring more years of robust, productive, and fulfilling life. Today, we've highlighted four primary supplements that can enhance cognition, mood, pain, and sleep. While ketamine therapy can notably alleviate depression, anxiety, and pain, ensuring that the body has no deficiencies and maintains optimal nutrient levels may work in tandem to amplify the overall healing process.

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