Well, welcome everyone, this is Dr. Nikolas Hedberg, and tonight we’re going to be talking about herbal medicines for depression. A large number of Americans are taking antidepressants or some kind of medication for depression. I believe it’s getting close to about 50 percent of the population. So it’s a big issue, and I just want to shed some light on some of the causes of depression. We’ll talk about some of the herbs that can work well for depression. I’ll have some different nutritional and exercise strategies, so I think you’ll get some good ideas tonight about what’s best if you’re suffering from mild to moderate depression.
Okay, so I’m going to talk for a little bit, and once we’re done, and even during the presentation, you can type your question into the chat window and click send so I can see that, and I’ll be able to answer your question.
Causes of Depression
Okay, so of course the first thing we always do is we talk about the causes; any condition we’re talking about we want to focus on what’s actually causing the condition. And depression isn’t really the main thing that we’re looking at. Chronic inflammation; it’s interesting because the scientific literature is filled with papers connecting inflammation to all kinds of psychiatric disorders, especially depression. But the treatment really doesn’t focus on inflammation, even though the literature is filled with that as a causative factor.
Genetics of course, that can be things like defects in enzymes that metabolize and break down neurotransmitters like serotonin and dopamine. Amino acid deficiency, like tryptophan, which is the precursor to serotonin, and tyrosine, which is the precursor to dopamine. Hypothyroidism, one of the really big ones with depression, probably one of the most overlooked aspects of course. Lack of exercise, various environmental toxins, adrenal imbalances and then gut inflammation. What happens in the gut usually happens in the brain, so if the gut is inflamed, the brain will be inflamed as well.
Herbal Medicines for Depression
So if you tuned into my herbal medicines for fatigue webinar, you’ll see some overlap. It’s interesting, because a lot of the herbal medicines for fatigue actually work quite well for depression as well. So ashwagandha, also known as Indian Ginseng, is a pretty good mood elevator, it can help with depression. One of the reasons is because it enhances the conversion of inactive T4 into active T3, and we know that hypothyroidism can be connected with active depression. So a lot of other positives here: helps the body deal with stress, increased strength and stamina, improves memory, it is an aphrodisiac, can provide deep and restful sleep, it is an antioxidant, enhances the immune system. If you have a reaction to nightshades, which are like tomatoes, eggplant and potatoes, then use caution with ashwagandha. And about 500-2000 milligrams a day is a good dose.
So rhodiola, we also talked about in the fatigue webinar. A lot of the same properties as ashwagandha, and we’ll talk about Siberian ginseng here in a minute, but rhodiola will increase serotonin levels in the brain, and one of the common imbalances in depression is low serotonin levels. So serotonin is kind of that feel-good neurotransmitter. It’s really what makes you enjoy things, like the taste of your food, just events or activities that you like, just the feeling of enjoyment comes from serotonin, so when serotonin’s low, people get very blue, they get depressed, they don’t really like things as much as they used to, so it’s really important to get those levels up. Rhodiola can help that. It will also improve dopamine levels, and dopamine is also kind of a feel-good neurotransmitter, so when you accomplish something and you’re recognized for that accomplishment, that good feeling that you have inside is dopamine, and so imbalances in dopamine and serotonin can lead to depression and other issues like anxiety, sleep problems and things like that. So rhodiola’s got a lot of great properties here that you can see, about 200 milligrams two to three times a day works really well to improve your energy levels, you stamina, it helps you adapt to stress. It’ll also help your mood.
And then eleutherococcus, also known as Siberian ginseng, this was also in our fatigue webinar. Now, specifically eleuthero is an antidepressant because it has properties that inhibit monoamine oxidase. And that’s an enzyme that breaks down neurotransmitters in the brain, so it inhibits the metabolism of serotonin, so you have more serotonin sitting in the receptor, and so that’s how it works as an antidepressant. A lot of similar properties to rhodiola and ashwagandha. You can do the Russian protocol, which is a tincture from herb form, one teaspoon three times a day, or in the capsule, and that can work really well.
You can take eleuthero, ashwagandha, and rhodiola in combination, or you can take them individually. So here’s a new one, St. John’s wort, also known as hypericum perforatum, and St. John’s Wort, probably the most popular natural anti-depressant remedy that you’ve heard of. So a Cochran systematic review in 2008 found that St. John’s wort was found to be just as effective as anti-depressant medication for mild to moderate depression. So, some good research there, it’s highly effective. It’s actually also anti-viral, more specifically for the herpes viruses, so it can work well for herpes infections. St. John’s wort also promotes relaxation, so it may help with sleep. It can work well as a capsule or a tincture. You definitely don’t want to combine St. John’s wort with antidepressant medication, that’s definitely a major contraindication. So you want to do approximately 900 milligrams a day. Usually it’ll come in about 300 milligram capsules, 0.3 percent hypericum standardized extract, so that’s about the milligram dose and the percent standardization you want to see. St. John’s Wort; some people will notice a difference right away, but sometimes you have to take it for a while, like up to four to six weeks for it to really start to kick in, but very safe, very effective, just don’t combine it with medication.
Okay, let’s talk about maca, or Peruvian maca. It is known as Peruvian ginseng. So you’re probably seeing some commonalities here in the ginseng family, because ashwagandha is Indian ginseng, eleuthero is Siberian ginseng, and now we have Peruvian ginseng. And so in the journal Menopause in 2008, they did find it effective for anxiety and depression in post-menopausal women. Another study in the BMC Complementary and Alternative Medicine 2006, they also found it beneficial for depression in everyone who took it, so that’s men and women of all ages, and maca’s also been known to improve memory, stamina, energy, so again you’re seeing some commonalities with the other ginsengs. Menstrual problems, menopausal symptoms, and maca is extremely popular to increase sex drive, improve libido, it can also help with erectile dysfunction, and it will increase sex drive in both men and women. And it will also enhance function in men. It doesn’t work for everybody, some people it works really well, as will all herbs, some will work well and some won’t. But maca, about 1500 milligrams, up to 3000 a day is a good rule of thumb for maca, also known as Peruvian ginseng.
So those were kind of the main herbs. We talked about the adaptogens that we went over in the fatigue webinar, and then we talked about St. John’s wort and maca. I just want to go over just a few bonus ideas for you.
The first is omega-3 fatty acids from fish oil. There’s a lot of studies on fish oil, it has a lot of wonderful health benefits, and one of them is that it does work quite well on depression and enhancing mood. And fish oil can be taken in capsules. I prefer the triglyceride form, I use a high potency triglyceride form from Moss Nutrition. It’s called Epadhahp Select, so that’s a high potency EPA and DHA, which are both omega-3 fatty acids.
Okay, SAMe, also known as s-adenosyl methionine. This is just a really interesting compound. It can help support the liver, it can help with joint pain, but it’s highly effective for improving mood, so very very beneficial for brain function and improving mood. Most people who take it, they’ll notice relatively quickly and improvement in their mood overall. Folic acid. It’s important to get tested for what we call MTHFR, the methyl tetra hydro folate reductase, it’s a genetic polymorphism. If you have it, it means you have difficulty metabolizing folic acid, so you have to take the methylated form of folate. It usually comes in the form of a 5 MTHF, 5 methyl tetra hydro folate, and so basically the methylated folate is already activated, so it doesn’t matter if you’re able to activate folic acid or not, if you take the methylated form, because it’s already activated for you.
Feel Like You’ve Tried Everything?
So, if you’ve tried a lot of different things, if you’ve tried the herbal medicines for depression, you’ve tried the dietary changes, you’ve tried exercise, and you’ve tried supplementation, it’s worth getting the MTHFR test, because taking methylated folate can really turn some people around very, very quickly. 5HTP, also known as 5-hydroxytryptophan. And so 5HTP is a precursor to serotonin. The pathway starts with tryptophan, and the tryptophan is converted to 5HTP, and then 5HTP is converted to serotonin, and then serotonin is converted to melatonin, so you have to have B6 to properly metabolize 5HTP, so if you take a lot of 5HTP and you’re not taking B6, you’ll actually deplete your body of B6, and that’s not a good thing, so they need to be taken together. And vitamin B6 is also a good supplement for depression, and that’s because it’s involved in this pathway, so it’s involved in converting 5HTP into serotonin.
And then magnesium, probably one of the most overlooked antidepressants, but with such a large population of people in America who are magnesium deficient, if everyone got their magnesium levels up, there’d probably be a lot less depression, a lot less mood disorders. Magnesium also just kind of calms down and relaxes the nervous system and the muscles, so it just helps everything kind of calm down or relax, but it can help with mood, if your mood is low. So we have people do p.h. testing, and if their p.h. is very acidic, then we supplement with magnesium glycinate, and potassium bicarbonate, to get their p.h. more alkaline.
So of course, with any condition, you want to identify the underlying cause, and we mentioned some of those in the beginning. Is it hypothyroidism? Is it chronic inflammation? Is it a genetic defect in folate metabolism? Is the digestive system inflamed because of gluten or other food sensitivities, or because of infections, etcetera etcetera. So we want to find the underlying cause first, because taking these remedies, it’s really not fixing the problem. These are just Band-Aids. They’re good as helpful short-term solutions, but they’re really not long-term solutions.
A study out of Duke University, this was many, many years ago, I think back in the nineties, they compared exercise to antidepressant medication, and it was just as good. So exercise. As mentioned before, you definitely don’t want to combine these with antidepressant medication. They can interfere with that, because some of these are quite powerful, they work so well that if you combine them with medication that can cause problems. Talk to your doctor about trying any of these remedies, and there’s a whole book written about the connection between hypothyroidism and depression, so there’s a strong connection there, and since thyroid is very, very often overlooked, or misdiagnosed, because the diagnosis is just based on a blood test, looking at TSH, thyroid stimulating hormone, many people with hypothyroidism are just overlooked and depression is a consequence of that.
So just kind of a simple way to see if your thyroid’s really functioning well is the Basil body temperature test, and I have a guide on how to do that on my patient resources section of the website. It’s a nice explanation of how to do it and a chart, and so look at your chart over about a week or two. If it’s consistently low, then your thyroid is probably low and needs support, or if you see a lot of peaks and valleys, a lot of ups and downs, ups and downs, and it’s low, then the adrenal glands are probably the primary cause of the thyroid imbalance. That’s just kind of a little trick that you can look at on your own, because some people’s thyroid issues are related to adrenal dysfunction and not the thyroid gland. Okay, so I just want to open it up for questions. If anyone has a question, all you have to do is type your question into the chat window, and I can answer that.
Questions and Resources
And we’ll just wait a minute for those to queue up, but we may not have any questions tonight. This webinar is being recorded, so it will be up on the website drhedberg.com, and it will also be put up on YouTube. Okay, here’s our first question. “How does hypothyroidism cause depression?” It’s a really good question.
So, number one, thyroid hormone controls the metabolism of neurotransmitters in the brain, so we can trace this all the way back to amino acid metabolism, because thyroid hormone, basically what it’s doing is it gets into your cells, and then it controls metabolism of sugar and fatty acids and amino acids, so it’s like the core of everything. So if you have say a protein deficiency, or you’re unable to metabolize protein well, then you may have some amino acid deficiencies, like tryptophan, or tyrosine, and then that will lead to low serotonin or low dopamine, which can lead to depression. And that’s kind of the main thing is we’re looking at amino acid metabolism as the core issue with hypothyroidism.
Okay, so if you have another question about herbal medicines for depression, just type that into the question box of the chat window, and I can go ahead and answer that. Okay. It doesn’t look like we have any more questions, so if you feel I did a good job, if you’d like to view this webinar again, like I said, it will be recorded and put up on drhedberg.com and YouTube, so look for that. Thanks for joining us everyone, and we’ll see you at our next webinar. Take care.