Theresa's Struggle with Depression

Warning Signs of Depression

Theresa had been leading a fairly normal life for 34 years, until she began to experience the following symptoms:
  • Increased stress symptoms while at work
  • Fatigue
  • Depression
  • Anxiety
  • Insomnia
Theresa’s primary care provider ordered multiple tests, but everything came back normal. She was prescribed the gamut of depression and anxiety medication. After many trips to the doctor and four months of psychotropic drugs, fatigue medication and mood stabilizers, she felt even worse. Theresa was being treated for her symptoms—surface level—and no one was digging deeper to find the root cause of her recently onset depression. Until she came to me.

Functional Evaluation to Determine the Reason for Depression Symptoms

I applied pressure to the different functional evaluation digestive points. With tenderness ranging from 0 to 10, ten being most tender, Theresa scored a 10 on all digestion points including stomach acid liver, gallbladder, pancreas, and small intestine.

Lab Testing to Identify Body System Imbalance(s)

Organic Acids Test (OAT): Click here to view OAT Results.
  • Low neurotransmitter metabolites– indicated a decreased production of serotonin and dopamine.
  • Abnormal Vanilmandelate and Homovanillate markers - indicated decreased production of adrenaline and dopamine. It is also why Theresa felt anxious. 
  •  Low markers for 5 Hydroxyindoleacetate acid (5-HIAA) – indicated higher than normal turnover of serotonin and a depletion of the amino acid tryptophan.
  • Normal kynurenate and quinolinate markers – indicated the depletion of tryptophan was due to inflammation.
  • High Xanthurenate – indicated a B6 deficiency.

Findings: Neurotransmitter Dysfunction

Neurotransmitter Dysfunction can be caused by genetics, stress, inflammation, toxins and/or diet. Theresa’s OAT test results showed abnormal Vanilmandelate and Homovanillate markers. This can be the root cause of symptoms like her fatigue, anxiety, inability to deal with stress, and sleep disturbances. This is likely the reason Theresa began to feel depressed. Her primary care provided started her on antidepressants, also known as Selective Serotonin Reuptake Inhibitors (SSRI’s). However, the SSRI’s did not help because they were not addressing the root cause of the problem. Vanilmandelate and Homovanillate neurotransmitters can become abnormal due to HPA-D (formerly adrenal fatigue), low protein consumption, or poor protein digestion and malabsorption of amino acids.
 
Theresa’s OAT results also revealed decreased levels of 5 Hydroxyindoleacetate acid (5-HIAA), the main metabolite of serotonin. Serotonin controls mood, behavior, appetite, sleep, and bowel contractions. Low levels of 5-HIAA indicate excessive turnover of serotonin and a depletion of tryptophan, which is the amino acid needed to make serotonin. The root cause of this can be stress or depression medication. Both of these factors were a major part of Theresa’s life by the time she came to my office for her first visit.
 
The OAT results revealed further information regarding Therea’s amino acids. The normal levels of kynurenate and quinolinate indicated the depletion of tryptophan was due to inflammation in Theresa’ body. Tryptophan is crucial in the production of serotonin. If tryptophan is low, serotonin will be low. The testing also found high Xanthurenate levels indicating a B6 deficiency. Vitamin B6 is needed along with amino acids to make neurotransmitters. Stress and digestion were clearly major root causes of Theresa’s symptoms.
 
Though she was eating a healthy diet with the necessary proteins for amino acids, Theresa’s body wasn’t digesting properly. Low levels of amino acids due to stress and digestion issues were the root cause of inhibiting neurotransmitters in her brain—this dysfunction created her depression.

Lifestyle Change Recommendations

  1. Nutrient-dense, gluten-free diet that addresses all of the macronutrients:
    • 40% protein
    • 30% fat
    • 30% carbohydrates
  2. Drink 4 liters of pure water daily
  3.  Light exercise (walking, yoga) and resistance training
  4. Daily practice of mindfulness via meditation to reduce stress
  5. Introduction of better sleep habits—strict bedtime, no alcohol or caffeine before bed, etc. 
  6. Incorporation of daily supplements and digestive aids

Individualized Treatment Plan

  1. Daily low-level, free-form amino acids
  2.  Daily digestive supplements
    • Digestive enzymes
    • Betaine hydrochloric acid
  3.  Vitamins to assist amino acids with production of neurotransmitters
    • Vitamin B6, B12, and P5P (activated B6)
    • Whole Raw Vitamin C

Results

Within two weeks of following the above protocol, Theresa was feeling better. In four weeks she reported she was “back to herself,” simply because we treated her as an individual, not a symptom.
 
Based on the findings of the OAT and her history of high stress, I recommended Theresa follow up with me for GI testing to rule out abnormal bacteria and potential parasites. I also wanted to double-check her adrenal and HPA axis to further ensure a balance in her digestion and neuroendocrine system. Stay tuned for updates to Theresa’s case study to hear about these findings and how they furthered her healing and had a positive impact on Theresa’s life.
 
NOTE: While this client gave us approval for sharing details, all names have been changed to protect the identity of the client.
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