Background history of the Patient
In September 2017, a 22 year-old man attended my clinic. He normally resides in the U.S but for the last two years he had been living temporarily in Australia with his aunt and uncle. He suffered from frequent, paranoid, and almost “psychotic” thoughts. Often, when he would see something or someone that was slightly out of the ordinary, he would automatically deduce something bad was going to happen. For example, if he saw a helicopter in the sky, he deduced that as helicopters often take very sick people to hospital, then this must be a sign that he will go to the hospital in the near future with some major sickness. Another example was when he found out that one of his favourite singers, residing in the US, with an identical first name, had lost his father to an illness. He automatically thought that his own father might die soon.
His aunt was very concerned. He was already attending a psychiatrist who diagnosed him with possible mild schizophrenia, and who was prescribing him with Lithium. However, despite minimal improvements in his condition, he was still having these thoughts frequently. His aunt had never been to a naturopath and was quite cynical. Yet, she didn’t know where else to turn.
Our Initial Consultation
At our first appointment, the aunt accompanied her nephew. She did most of the talking as the patient was very shy and did not give me much eye contact. When he did speak, he mumbled and was hard to understand. During the consultation he got quite agitated and alerted me that the souvenir koala that I had attached to my desk lamp was freaking him out. As a result, I quickly removed the souvenir causing him to calm down somewhat.
I took a thorough case history. He was addicted to carbohydrates, was highly constipated (going once per week for most of his life) and he was extremely lethargic. He also suffered from brain fog and poor memory. It also became clear that there was a family history of psychological issues, with his mother having some similar complaints.
Functional Pathology Tests Ordered and Results
I ordered an Organic Acids Test (OAT), which measures certain metabolites in the urine. The results strongly indicated yeast overgrowth, high oxalates, reduced intracellular antioxidants and vitamin B2 insufficiency, as well as mitochondrial and fat metabolism dysfunction. These markers might explain his carbohydrate addiction, his lack of energy, slower motility of his digestive system resulting in constipation, and even some of his abnormal thoughts, as the toxic by-products of yeast can alter brain physiology if they cross the blood brain barrier. Furthermore, while it is well-known that 80% of kidney stones are caused by oxalates, which form crystals resembling pieces of glass, and that they are a by-product of yeast overgrowth as well as present in some of the foods we eat, the crystals can also form in many other tissues in the body, including the brain, causing damage. Indeed, a large proportion of autistic children suffer from yeast overgrowth and, at least a third, have high oxalate values. Furthermore, the patient’s reduced level of detoxification as noted by his lower levels of intracellular antioxidants, coupled with his constipation, might indicate that he had a high level of toxins in his system, and these could possibly be crossing the blood brain barrier and entering the brain. The test also showed that the patient had a low serotonin to quinolinic acid ratio. Quinolinic acid is a potent neurotoxin and a by-product of a pathway that sets out to utilise most of the Tryptophan (an amino acid that is also needed to produce serotonin, our feel-good brain chemical, and melatonin, our sleep hormone), to produce vitamin B3, in the face of infection, inflammation and/or stress. Additionally, his test results showed indications of higher levels of dopamine compared to noradrenaline (dopamine, our motivation and focus brain chemical, is metabolised to noradrenaline, which not only helps produce the latter, but keeps dopamine levels stabilised). Symptoms of too much dopamine can include:
- Worry/ Anxiety
- Paranoia
- Psychosis
- Poor memory and brain fog
- Schizophrenia
- Aggression
- Insomnia
- Chronic pain
- High blood pressure
From these results we can also see some indications of methylation dysfunction and issues with DNA synthesis. More specifically, there could be gene polymorphisms (or mutations or SNPs) such as a variant in the MTHFR gene, causing an altered function in the enzyme, MTHFR, which is needed for neurotransmitter synthesis and energy production. Additionally there could also be a COMT SNP resulting in a slower-acting COMT enzyme. This enzyme is needed for the metabolism of dopamine, and if this neurotransmitter is not metabolised at a good rate, excess of the brain chemical can ensue.
Treatment
Over the next few months I prescribed anti-microbial herbs and certain supplements for his yeast overgrowth, and herbs and nutritional supplements for his brain health, energy levels, and constipation. He was also prescribed active B vitamins, minerals, digestive enzymes and binders to reduce his toxic load. Unfortunately, I was never able to order a genetic test for him, which would have given me deeper insights into his condition.
He was asked to exercise more, find ways to minimise his stress levels, drink at least 8 cups of water daily and eat more fibre. I was also able to convince his aunt to prepare meals that were gluten-free, dairy-free, sugar-free, low carbohydrate and high fat. There is mounting evidence that suggests that such a diet, high in fat and low in carbohydrates, improves energy levels and brain function, and reduces blood sugar irregularities. Over the time that I treated the patient, his aunt took the diet very seriously, and as she and her husband suffered from Type 2 Diabetes, she prepared the same meals for the three of them.
Outcome of Treatment
It didn’t take long for me, his aunt and uncle, and, even outsiders, to notice the change in my patient’s personality. He was now fully engaged in our consultations. He loved when I made up his herbal mixtures and would ask me questions about the process. His eye contact was better and his speech was much clearer. Furthermore, he did not seem to mind the koala souvenir, which I tested him with. Indeed, once I even found him idly playing with it. Additionally, his aunt “complained” about him being very cheeky at home. Something he definitely wasn’t before he came to see me. He lost quite a bit of weight, was having a bowel motion every day or every second day, was taking daily walks and did not feel the need to sleep in the middle of the day. Most importantly, he was having less paranoid thoughts. When he did have the thoughts he was able to calm himself down and rationalise what he had seen.
Unfortunately though, he did not mention my involvement or my treatments to his psychiatrist. The specialist understandably thought that his treatment was successful as he also observed the massive change in the patient’s demeanour and personality. The doctor advised my client that although Lithium has certain side effects, the benefits greatly outweighed the risk, and he should stay on it for a lifetime.
Now I am not saying that the Lithium didn’t help. But it certainly wasn’t helping to any large extent when I first saw him, and he had been on it for quite a while before starting my treatment.
New Symptoms
A couple of consultations prior to his return to the US, he complained of urinating much more frequently than normal. I was baffled at what could be causing this symptom. I rummaged through my books to see if any of the herbs or supplements prescribed were contributing to this excess urine output. I was somewhat concerned. One day, after still not finding a credible link, I had an idea that maybe it was the Lithium he was taking that was responsible. Sure enough, this medication causes kidney damage over time and is the reason why many psychiatrists no longer prescribe it. It dilutes the urine excessively. From my extensive research into the side effects of this drug, it appears that Lithium can lead to kidney failure in as little as 10 years from onset with continuous usage. My patient was only 22. Did this mean that at the age of 32 he might be on dialysis? I advised my client that maybe he could ask his psychiatrist to change his medication to something similar that had less side effects. This did not eventuate either here or back in the US.
Present Day Progress/Decline
After approximately 6 months of treatment, my patient returned to his home in the US. Despite all the great improvements in his health issues here in Australia, with no real support from his parents in the US (who had no understanding of my treatment), no one preparing and cooking his special meals, and limited access to my treatment protocols, he has slipped back to how he was before coming to me. Interestingly, when my patient complained of the return of his frequent psychotic thoughts, the US psychiatrist who was loathe to increase the dosage of the medication due to its harmful side-effects, advised him to just manage his thoughts better! Really!! My patient was well aware that his thoughts were abnormal, but the dysregulation of biochemical pathways and toxic overload were making these thoughts beyond his control.
Over the next few months my patient would occasionally ring me from overseas and inform me of his health status. I asked him to get his father to contact me, because I believe that his support would be paramount to his recovery. However, not only did that not happen, I have not heard from my patient since.
Conclusion
What are the lessons that we can learn from this case study?
- Firstly, family support is so important for overcoming health conditions. Without it, the risk of relapse is much higher.
- Nutritional and lifestyle intervention are paramount adjunct treatments for effective management and treatment of psychological conditions. Medication alone is insufficient, and many times might not even be needed if diet and lifestyle are optimum. Indeed, there have been studies that have shown an increased association between children and adolescents who were consuming excess foods with low nutrient content, with aggression, psychiatric distress and violent behaviours. Furthermore, research has also identified depression as a co-morbid condition in approximately 50% of the elderly who have nutritional inadequacies.
- Functional pathology tests can give us deeper insights as to what is going on in the body. This test provided illumination and substantiation in black and white of what was going on in the body, which both made my treatment more effective, and increased compliance from the patient. I was really sorry that I was unable to order a genetic test. The results might have improved his parents’ awareness of the origins of his condition and improve support for his ongoing treatment, once he returned to the US.
- You would think that if an individual has psychological issues the problem lies solely in the brain. But as you can see from this case, and from most cases I have seen, most conditions start in the gut and can be attributed to multiple factors occurring in different parts of the body. The understanding of the factors involved can drastically improve the long-term management or reversal of the said condition.
- All health practitioners should be working together in a collaborative fashion. My patient should have informed his psychiatrist of what he was doing, and as I was not informed of the psychiatrist’s details I was unable to contact the specialist myself. His aunt admitted to me that if my patient had told the doctor, he would advise him to stop attending my clinic. Unfortunately, for many specialists out there, this might actually have been the case. How sad!!
If you are suffering from a psychological condition and are fed up with the side-effects of the medication and lack of progress, please do not hesitate to contact me.
