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Alcoholism, Part 3 -- Fixing the Brain 2 By David Gersten, M.D.

. Last month we looked at the devastating impact that alcohol has on the brain. Every important neurotransmitter system is impaired by alcohol. Alcoholism brings with it three major toxins, namely: Alcohol (ethanol), acetaldehyde (a primary bre akdown product of alcohol), and tetra-hydroisoquinolines (THIQs). Acetaldehyde combines with neurotransmitters to make THIQs, which are addictive, morphine-like compounds. These three toxins act as pseudoneurotransmitters by binding to neurotransmitter receptor sites. When the alcoholic is drinking, his brain thinks there is enough serotonin, norepinephrine, dopamine, endorphins, acetylcholine, and GABA. But the brain has been tricked by alcohol and its two related toxins. As soon as the alcoholic stops drinking, his brain truly experiences serious deprivation of all major neurotransmitters. He resumes drinking because alcohol makes the brain believe, once again, that it has plenty of GABA, serotonin, and the other major neurotransmitters. In the last article, we went into detail about the process by which the brain is damaged, and reviewed the theory that disorders of GABA (gamma-amino-butyric-acid) may be the single most important factor in alcoholism. In this article, the focus will be on specific neuro-cognitive problems caused by alcoholism, and how we can treat those problems in a natural way. Before exploring these symptoms and problems, let me clear up a very important and controversial issue surrounding alcoholism. In order to move toward an understanding of how to cure alcoholism, let's start by addressing two important issues that are frequently misunderstood. First, let's talk about the alcoholic personality, the type of makeup that predisposes one to become alcoholic. Understanding this makeup will make it easier for you to know which kind of psychotherapy or support system will best suit you. Here is the answer. In 1984 a study of 650 young men showed that there was no evidence whatsoever that there is an alcoholic personality. So, folks you can throw out the notion that your mother, father, your abuse, neglect, or stress caused your problem with drinking. Alcoholism is not a psychiatric disorder and does not belong in the DSM-IV, the psychiatric bible of diagnosis. Secondly, you need to understand that support systems, including Alcoholics Anonymous (AA), according to a great deal of research, do not have better than a 5 percent cure rate. Mind you, I refer my alcoholic patients to AA. AA was never intended as a treatment modality. It is support and is profoundly helpful. But alcoholism is a physical disease. You cannot cure diabetes or cancer through support groups or psychotherapy, nor can you cure alcoholism through such support. I also don't buy into the nearly universal belief that alcoholism is an incurable disease. The point of this tongue-in-cheek discussion of the Alcoholic Personality is to help you finally set aside such a notion. There is not a Diabetic Personality or an Arthritic Personality. Similarly, alcoholism is a disorder of severely disturbed biochemistry. There is metabolic chaos from head to toe. In this article, we continue to examine and repair the metabolic chaos within the brain and nervous system that we began to heal in the last article. Treating Specific Neuro-Cognitive Problems Every neuro-cognitive, psychological, or mental-emotional problem is associated with specific neurotransmitter problems. Here is how you can address each of these major symptoms associated with alcoholism. Anxiety and Insomnia

44% of alcoholics suffer from anxiety. Anxiety and sleep disorders are closely related. Take GABA for anxiety. Serotonin is the main neurotransmitter that induces sleep. The amino acid L-tryptophan is the precursor to serotonin, so supplementation with L-tryptophan or 5-HTP (5-hydroxy-tryptophan) will help with sleep and anxiety. If you ever blacked out due to drinking, you have a tryptophan deficiency. Inositol, a B vitamin helps regulate serotonin and treats anxiety and panic disorder. You will also want to take P-5-P (pyridoxal-5phosphate, the active form of Vitamin B-6), for L-tryptophan requires P-5-P to get converted into serotonin. Vitamin B-3 (niacin or niacinamide) helps with serotonin chemistry. Niacin can cause a brief but uncomfortable skin flush, but niacinamide (another form of B-3) won't do that. Bill Wilson, the founder of Alcoholics Anonymous, became quite interested in nutritional approaches to treating alcoholism. In one study of 30 patients treated with Vitamin B-3, 20 were cured of all their symptoms in approximately two months. Bill Wilson was at the forefront of Orthomolecular Medicine. While his first huge contribution, AA, became widely accepted, the medical establishment did not support his claims about niacin, and so he continued his orthomolecular research outside of the mainstream. Tremors The amino acid, taurine, stabilizes nerve tissue, decreasing tremors as well as the risk of seizures. In addition, take calcium, magnesium, and B Complex. The amino acids, L-glycine and taurine, both enhance alpha brain waves, which are calming. So consider these two for tremors as well as anxiety. Depression At least 40% of alcoholics are affected by depression. People often blame their depression on what alcohol has done to their performance at work, social life, and marriage, not understanding that they have profound neurotransmitter problems. The two most important neurotransmitters involved in mood are serotonin and norepinephrine. We've already talked about the use of Ltryptophan to increase serotonin levels. This is what the SSRI anti-depressants do (drugs like Paxil and Zoloft). They increase serotonin levels. At least half of depressed people suffer from a norepinephrine depletion and not serotonin depletion, although many alcoholics have both of these anti-depressant neurotransmitters depleted. The amino acid L-tyrosine is the precursor to norepinephrine. Like L-tryptophan, L-tyrosine must be taken with P-5-P in order to get converted into its end product, namely norepinephrine. Both L-tyrosine and L-tryptophan should be taken away from meals and from other amino acids in order to get into the brain more readily. Omega-6 Essential Fatty Acid Defect Amino acids are not the only nutrients involved in brain chemistry. In alcoholics, there is a genetic defect in handling the omega-6 fatty acid gamma-linolenic acid (GLA), which converts into prostaglandin 1 (PGE1) in the brain. Orientals lack this genetic defect and, as a result, have an incredibly low incidence of alcoholism. Due to the genetic defect, the ability to produce PGE1 drops in the alcoholic brain. PGE1 is very much involved in mood. Alcohol helps the brain produce PGE1, by taking whatever meager supply of GLA that is present and converting it into PGE1. Over time, GLA and PGE1 drop. Because alcohol can mimic PGE1, the alcoholic drinks because his brain is asking for more PGE1, and so he succumbs to what his brain is demanding. By supplementing your diet with GLA, you can treat the depression caused by

GLA and PGE1 deficiency. If this happens to be your problem, GLA is a wonder nutrient. Gastro-Intestinal (GI) Tract and Brain While this is a complex subject, which must wait until next month for deeper analysis, for now I want to mention that alcohol damages the lining of the GI tract. Without a healthy GI tract, it is impossible to get an adequate, balanced supply of the vitamins, minerals, fats, and amino acids required to produce neurotransmitters and to maintain good overall brain health. The L-glutamine you will take to increase GABA levels in your brain is also extremely helpful in restoring intestinal health. Consider this: If you were to open up the GI tract, it would take up the space of two tennis courts. It is a huge organ with five major functions, namely: 1) absorbing nutrients, 2) keeping toxins out of the body, 3) manufacturing neurotransmitters, 4) acting as the first line of defense of the immune system, and 5) removing waste. The first four GI functions are impaired in alcoholism, and these four affect the brain for better or for worse. Few people know that the GI tract is like a second brain in that it produces huge amounts of neurotransmitters. It is also the largest part of our immune system. Ultimately the alcoholic will fully recover when his brain and GI tract have fully recovered. The liver, part of the digestive process, is often damaged in alcoholism. All nutrients absorbed through the GI tract pass through the liver. An impaired liver gives rise to poorly assimilated nutrients. Start taking the herb Sylamarin to begin liver repair. Vitamins and Minerals B vitamins, all of them, are important for healthy neurotransmitter function. Alcohol destroys B vitamins, so start supplementing with a good multiple B vitamin right away. B vitamins cannot be stored in the body, so they must be ingested and absorbed on a daily basis. Alcohol inhibits fat absorption, impairing absorption of the fat-soluble vitamins: A, D, E, and K, all of which are involved in wound healing. Calcium and magnesium help to calm the nervous system, decrease anxiety, improve sleep, and reduce withdrawal symptoms. These minerals stabilize the cell membrane of neurons, or nerve cells. The mineral, manganese, is needed for proper functioning of the B vitamins and also helps stabilize blood sugar. Amino Acids While each section of this article has discussed amino acids, as they relate to a particular symptom, it is important to now look at them as a whole. Amino acids are called the building blocks of life. The main purpose of DNA is to take amino acids and use them to build protein, neurotransmitters, hormones, enzymes and other tissue structures. Each gene in our DNA codes for one particular protein. There are 9 Essential amino acids, which means that we must ingest these from food: Arginine, Histidine, Methionine, Threonine, Valine, Isoleucine, Lysine, Phenylalanine, Tryptophan, and Leucine. The remaining 11 major amino acids are either Non-Essential, meaning our body can make these from other amino acids, and Conditionally Essential. Conditionally essential amino acids are those that our bodies ordinarily can make but due to a variety of stresses and illnesses, our bodies stop making these amino acidsat which point they become Essential and we must either ingest foods with those amino acids or take nutritional supplements. This group

of amino acids includes: Alanine, Asparagine, Aspartic Acid, Cysteine, Glutamine, Glutamic Acid, Glycine, Proline, Serine, Taurine, and Tyrosine. The fact is that both Non-Essential and Conditionally-Essential amino acids can become Essential when we are stressed or sick. In other words, our bodies stop making these. Amino acids participate in every chemical reaction in the body, but let's focus on how they are involved with brain chemistry. Ordinarily, the letter L precedes the name of an amino acid, but I will skip that formality here. The only regularly used amino acid with a different form is DL-phenylalanine, which is used to alleviate pain. Tyrosine is the precursor to the neurotransmitters dopamine and norepinephrine. If you are deficient in norepinephrine, you may feel depressed, anxious, sleep poorly, and have poor concentration, poor memory, and a host of other cognitive problems. In general, supplementation with tyrosine will bring norepinephrine levels back to normal and will alleviate some or all of these symptoms. Before taking tyrosine, or going on an amino acid program, lab work should be done for amino acids, and thyroid function should be checked, since one of tyrosine's functions is to produce thyroid hormone, or thyroxin. In my opinion, the best laboratories for analyzing amino acids are Great Smokies Diagnostic Labs, MetaMetrix, and Doctor's Data. The best amino acid tests have 41 sub-tests, which provides an enormous amount of useful information. Dopamine, also made from tyrosine, is a feel-good neurotransmitter. The dopamine receptor site is where cocaine and amphetamines work. Dopamine mediates the feel-good of sexual orgasm. If you have too little dopamine, you are not likely to feel cheerful. If you have too much, you are likely to experience anxiety, fear, or paranoia. So, dopamine needs to be kept in careful balance. More is not necessarily better. Tryptophan is the precursor to serotonin. Low serotonin levels will lead to depression, insomnia, and some cognitive impairment. Taurine is an amino acid that is a direct neurotransmitter, stabilizing nerve cells (neurons) as well as heart cells. In alcoholism, it is useful in stabilizing an agitated brain, and in helping to prevent tremors and seizures. Glutamine is the precursor to another amino acid, GABA. GABA is another feelgood neurotransmitter and is the most calming of all neurotransmitters. Alcohol toxins dramatically impair GABA and GABA-receptor sites. As mentioned previously, GABA may be the key to understanding alcoholism. Like GABA, glycine is an inhibitory neurotransmitter, producing a calming effect. Other amino acids play a role in brain chemistry, but the ones you've just read about are the most important. Amino acid chemistry is very complicated. It took me ten years of study and amino-acid testing before I began to get a handle on it. Don't just play around with amino acids. Look carefully at the recommendations in this article and in the last one, and remember that, while taking tyrosine (which will usually lift depression and brain fog), don't forget to focus on healing problems with digestion. If you have a healthy GI tract, you will be able to absorb most of the amino acids you need from a healthy diet. A final word about amino acid therapy. A multi-amino acid is going to help alcoholics. These contain all the essential amino acids in relatively high doses, as well as the non-essential amino acids. Some multi-amino acids are formulated to assist with problems of muscle weakness. Others are formulated

to help people with blood sugar problems. Whatever you do, do not buy amino acids from health food stores. These aminos are usually made in India and China, can be contaminated with impurities such as arsenic, may not have the amino acids in the capsule as promised, and may have nutrients in the capsule that are not supposed to be there. Buy nutraceutical grade amino acids. The Internet is the best and easiest place to find nutra-ceutical grade amino acids. Nutraceutical brands include Montiff, Pure Encapsulation, Thorne, and Allergy Research, to name a few. This article and the last one have given you a strong dose of knowledge about alcoholism and brain chemistry. In the next issue, we will look at non-brain problems of alcoholism, including: hypoglycemia, candidiasis, allergy, and adrenal exhaustion. David Gersten, M.D. practices nutritional medicine and psychiatry out of his Encinitas office and can be reached at 760-633-3063. Please feel free to access 1,000 on-line pages about holistic health, amino acids, and nutritional therapy at www.aminoacidpower.com. Mleko cickovog semena Individuals who wish to target fatigue and lethargy should avoid taking a combination of L-tyrosine and L-tryptophan. These two amino acids compete for the same brain receptors, and the combination may cancel out the energizing effect of L-tyrosine. Read more: http://www.livestrong.com/article/213-smart-shoppingltyrosine/#ixzz1dh0mwAom

L-Tryptophan Essential For Mental Health

Tryptophan (L-Tryptophan) is an amino acid naturally present in the body and essential for human life. Like certain other amino acids, it is called "essential" because the body is not capable of producing it, so we must ingest it. Although plentiful in protein foods, cooking and processing easily destroy it so that deficiencies are fairly common. As a precursor for the mood-regulating molecule, serotonin, a deficiency of L-Tryptophan could seriously affect your emotional health. Tryptophan (L-Tryptophan) is used for treating: Depression Suicidal Depression

Anxiety Insomnia Aggression Appetite (to curb the appetite) Pain Migraines Premenstrual Syndrome Bulimia Parkinsons's Disease Obsessive-Compulsive Disorder Nightmares General Dosage 500 - 1,500 mg once or twice a day between meals or before bed When and How it can be taken Works best taken at least an hour before and and at least an hour after you have eaten a protein meal, thus "between" meals It is not harmful to take it with other proteins, it's just that other proteins compete with the tryptophan to get into your system Taking with juice or fruit or other carbohydrate may actually help absorption

Nutritional Co-factors(supplements that help tryptophan work better) Niacinamide (Vitamin B-3) - 100-500mg Tip: Niacinamide can decrease irritability and argumentativeness Tip: Niacinamide can increase your sense of humor Vitamin C - 500mg or more Vitamin B-6 (pyridoxine) - 25-50 mg Vitamin B-6 (pyridoxine) is very important for the metabolism of amino acids - most people should be taking some of this nutrient as a supplement anyway Tip: Along with B-6 (pyridoxine) the addition of 25-50 mg of P5P B-6 (Pyridoxal 5' Phosphate, another form of

Vitamin B-6) can really help. P5P B-6 should be obtainable from your Nutritional Doctor or local Health Food Store. I may offer it for sale on this site at a later date. Caution: For most people, B-6 can cause a nasty tummy ache on a completely empty stomach - suggest taking it with something in your stomach - juice, fruit, chip, cracker, crust of bread... Caution: Be sure to read up on B-6, individual needs vary greatly - some people need a lot more, and you can take too much of B-6 The amino acid Tyrosine (L-Tyrosine) taken with L-Tryptohan is often helpful for many emotional disorders - please read about it. Magnesium can help Aren't you taking some anyway ? St. John's Wort The herb, Hypericum Perforatum taken with Tryptophan & Tyrosine and co-factors was very helpful 10 years ago, for my own suicidal depression, although I no longer need to take it.

For Best Results, Learn About Supplements Although nutritional supplements are extremely safe - you should not take them randomly. If you don't know what you are taking and why you are taking it - you will stop and not know why. Read and Learn - Take good care of yourself and get a gradual nutrient education. No one else knows as much about you, no one else will care as much about you - than you. If you are depressed and don't "love" yourself now - do it as if you are caring for someone else you do love. Sure - you can ask your doctor - but... most regular M.D.'s * don't know much about nutritional supplements act like there is something wrong with taking them act like there is something wrong with you for thinking for yourself

*(Unless you are lucky enough to have a doctor who thinks for him/herself !) If you don't ask your doctor, find some nutritional books written by doctors.

Effectiveness of Treatment The information provided here is basic, general, and not specific to any particular illness. Tryptophan alone is not always effective for depression since a deficiency of serotonin is not the only cause of depression.
Piridoksal 5-fosfat (P-5-P) je aktivna forma vitamina B-6, koji primarno slui kao enzimski katalizator u mnogim telesnim funkcijama, ukljuujui energetski metabolizam, miini razvoj i oporavak i neurotransmiterske funkcije (podie nivo serotonina, norepinefrina, GABA-e, dopamina i dr.). Na osnovu mnogih istraivanja, FDA istie da vitamin B-6, kao deo izbalansirane ishrane siromane zasienim mastima, moe da smanji rizike od pojave kardiovaskularnih bolesti. Bez adekvatne koliine vitamina B-6 aminokiseline iz hrane koju unosimo nemaju mnogo koristi za organizam. Vitamin B-6 kontrolie njihovu apsorpciju, metabolizam i transformaciju. On takoe uestvuje u metabolizmu masti i ugljenih hidrata, u proizvodnji crvenih krvnih zrnaca i antitela, neophodan je za apsorpciju i iskoristljivost pojedinih minerala, a ima ulogu i u pravilnom funkcionisanju preko ezdeset enzimskih sistema u organizmu. Vitamin B-6 se u hrani nalazi u svojim prirodnim oblicima, piridoksinu, piridoksaminu i piridoksalu. Kada se na molekul piridoksala doda fosfatna grupa, nastaje piridoksal 5-fosfat, koji organizmu slui kao koenzim za mnoge procese, na primer za transaminaciju (balansiranje odnosa amino i organskih kiselina), za dekarboksilaciju (uzimanje karboksilne grupe aminokiselinama), kao i za spajanja dve aminokiselina u jednu ili raspadanje pojedinih na dve. Cilj suplementacije vitaminom B-6 je da se u organizmu stvore dovoljne koliine njegovog aktivnog oblika, piridoksal fosfata. Ukoliko iz nekog razloga obini B-6, koji se najee javlja u obliku hidrohlorida, nije dovoljan u tu svrhu, najbolje je prei direktno na suplementaciju njegovim aktivnim oblikom - piridoksal 5fosfatom (P-5-P). Piridoksin hidrohlorid (obian B-6) da bi doao u upotrebljiv oblik za organizam, mora da proe kroz dve faze. Prva je fosforizacija, koja se odvija u prisustvu magnezijuma pomou adenozin trifosfata (ATP), gde nastaje piridoksin fosfat, a druga je njegova oksidacija pri kojoj je neophodno prisustvo vitamina B-2 (riboflavin), da bi se pretvorio u poeljan aktivan oblik, P-5-P. Ako je kod nekoga nivo B-2 nizak, proizvodnja P-5-P moe da bude smanjena i do 60%. U klinikim studijama uoeno je i da se prilikom primene vitamina B-6 poveava nivo magnezijuma na elijskom nivou, kao i da osobe sa slabom

retencijom magnezijuma imaju poveane potrebe za vitaminom B-6. Da bi suplementacija vitaminom B-6 bila efektnija, a proces dobijanja aktivnog oblika B-6 u organizmu skratio, nutricionisti ee preporuuju za suplementaciju vitamina B-6 njegov aktivni oblik P-5-P. Osnovna funkcija P-5-P je pospeivanje delotvornosti enzima koji zavise od njegovog prisustva, a njih je u ljudskom metabolizmu prisutno vie desetina. Laboratorijska analiza aminokiselina u krvi ili urinu verno pokazuje da li ima potrebe za dodatnim unoenjem vitamina B-6, odn. P-5-P. Poviene vrednosti samo nekih od vie destina aminokiselina senzitivnih na B-6 (alanin, aspartat, glicin, serin, tirozin, valin, leucin, izoleucin, homocistein, cistationin, alfaaminoadipinska kiselina, beta-alanin itd.) mogu da budu znak da je potrebno vee prisustvo koenzima P-5-P i da je poeljna suplementacija. Piridoksal 5fosfat ima sve osobine vitamina B-6 i moe da: deluje kao antidepresant olakava simptome PMS pojaava imunitet i potencijalno smanju rizik od nastanka raka uestvuje u odravanju zdravog nivoa eera u krvi doprinese spreavanju nervnih i konih oboljenja pomae stvaranje miine mase i reparaciju miinog tkiva

Pomanjkanje vitamina B-6 javlja se najee kod trudnica, dece, kod osoba u poznijim godinama i kod nekih bolesti. Nedostatak vitamina B-6 mogu da izazovu: kontraceptivna sredstva, alkohol, neki antibiotici, lekovi za regulaciju krvnog pritiska, ali i mnogi drugi lekovi. Postoji jo nebrojeno mnogo stanja u kojima bi suplementacija P-5-P ili B-6 mogla da bude od koristi, jer je ovaj vitamin umean u ogroman broj telesnih funkcija. Samo neke od njih su: depresivna stanja, nervoze, problemi u uenju, hronini umor, ispucale usne, akne i dermatitisi, slab imunitet, slabost u miiima, anemije i dr. Preporuena doza: 1 tableta 1 do 2 puta dnevno iz obroke. Piridoksal fosfat (P-5-P), kao i vitamin B-6 u obliku piridoksin hidrohlorida, sinergijski deluje sa magnezijumom i riboflavinom (vitaminom B-2).

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