1
Q
What is the nervous system?
A
The controlling, regulatory, communicating system.
Composed of the CNS, PNS and a network of neurons and neurotransmitters
2
Q
Name 5 things that affect the NS
A
- Lifestyle (and environment)
- Nerve cell structure and function (cell mem integrity via EFAs, phosphos, myelin, antioxs, removal of toxins)
- Hormonal and Immune (oestrogen, testosterone, thyroxine, cortisol, adrenaline)
- Energy (flow of glucose and mito)
- GI Health
3
Q
What is the ‘gut-brain axis (GBA)?
A
Bidirectional comms between the central and enteric NS
The Vagus nerve connects the two and contains 80% afferent (sensory) and 20% efferent fibres.
4
Q
How do gut microbes interact with the GBA?
A
- Modulating NT prod. (e.g. serotonin functions in the GBA at both terminals
- Bacterial metabolites (e.g. SCFA support intestinal barrier, mucosal serotonin release and influence memory.
- Modulation of afferent sensory nerves
- BDNF (Brain derived neurotrophic factor) - gut microbiota can modulate BDNF function via CNS.
5
Q
How does the gut barrier function influence GBA?
A
- Diet can compromise the mucus layer allowing access of luminal microbes to extensions of dendritic cells by pathogens and commensals.
- This immune activation can lead to increased perm of the tight junctions.
- This can result in metabolic endotoxemia = immune activation.
- High levels of LPS are associated with neuroinflamm/depression.
6
Q
Name 3 factors influencing general nervous func.
A
- Inflam, oxidative stress, toxic load (infection, environmental toxins, b/glucose imbalance, obesity, increased intestinal perm, stress, ageing, nut).
- Decreased expression of neurotrophic factors (BDNF and NGF)
- Mito changes (inflam, oxidative stress, ageing, nut def)
7
Q
What is a neurotransmitter?
A
Chemical messenger released from a presynaptic terminal, causing an excitatory or inhibitory effect on a postsynaptic cell.
8
Q
How do you acquire NY synthesis?
A
From a specific substrate using nutritional co-factors.
9
Q
How do you balance neurotransmitters?
A
They need to be inactivated and removed via enzyme breakdown, diffusion or reabsorption.
Reuptake transporters are important mechansims (MAO/COMT)
10
Q
Name two reuptake transporters and how they work.
A
MAO: Breaks down monoamines: serotonin, adrenaline, noradrenaline, dopamine
COMT: Breaks down adrenaline, noradrenaline and dopamine using SAMe.
11
Q
What is serotonin?
A
A monoamine neurotransmitter produced by tryptophan.
12
Q
What does serotonin do?
A
It is a GI signalling molecule for mood, appetite, sleep (melatonin), blood clotting.
13
Q
What causes low serotonin?
A
- Insufficient nut status: Tryptophan and cofactors (zinc, iron, mg, folate, B6)
- Chronic stress: Hypersecretion of ACTH and cortisol. This alters proteins which maintain 5HT receptors reducing 5HT uptake.
- Dysbiosis: Can impact tryptophan metabolism and get serotonin prod which impact brain serotonin metabolism.
- Poor dig health
- Lack of sunlight: In periods of darkness, more serotonin is used to synthesise melatonin.
- Caffeine: Inhibits tryptophan hydroxylase
- Long term alcohol use: Reduces 5HT
- Sedentary: Exercise increases 5HT
- Heavy metals e.g. arsenic disrupts serotonin metabolism and mercury inhibits serotonin receptor binding
- Sex hormone imbalances e.g. low oest as oest normally increases tryptophan hydroxylase and inhibits MAO.
14
Q
What is the ‘Tryptophan Steal’?
A
This is where tryptophan is metabolised by the kynurenine pathway instead of the 5 HTP pathway so it shunts it to produce NAD and ATP at the expense of serotonin.
This upregs stress because QUINOLINIC ACID (the bi-product of the kynurenine pathway) is an excitotoxin and increases glutamate, hinders neural func and cases cell death.
15
Q
What reduces quinolinic acid?
A
ECCG, Green tea, curcumin, poms, garlic and saffron.
16
Q
Name 5 SNPs that increase the odds of LOW SEROTONIN.
A
- TPH1 - can result in constipation.
- TPH2 - impacts serotonin synthesis
- 5-HTT - reduces the effects of serotonin (SSRIs target these)
- MAO-A - high activity SNP leads to more enzymatic breakdown and lower sero
- VDR - Lower sensitivity to Vit D= less support for serotonin synthesis.
17
Q
What is low serotonin associated with?
A
Mood, anxiety, panic disorders, insomnia, eating disorders, OCD, addictions, IBS, migraines and constipation.
18
Q
What is GLUTAMATE?
A
A major excitatory NT that plays a role in memory and learning.
19
Q
What is GABA?
A
An inhibitory NT
20
Q
What happens if you have too much GLUTAMATE?
A
Linked to neurol injury and neurodegenerative diseases
21
Q
What happens if you have a GABA deficiency?
A
Anxiety, insomnia, alcohol cravings, panic attacks, palps, cold/clammy hands, seizures, carb cravings.
22
Q
What causes GABA def?
A
- Alcohol (inhibits GAD)
- Cofactor def: B6/MG
- Dysbiosis: Lacto and Bifido synthesise GABA and influence vagus activity
- Chronic stress: can reduce GABA
23
Q
Name 3 SNPs that contribute to GABA def.?
A
- GABRA2: Lowers sensitivity to GABA (linked to anxiety and alcohol use)
- GAD (glutamate): Impacts glutamate to GABA conversion.
- ALPL: Degrades B6
24
Q
What is dopamine?
A
One of the catecholamines for motor control, memory, cognition and reward seeking behaviour.
25
What does Dopamine depletion look like?
Parkinson's - rigidity, tremors.
The Parkinson's drug Levadopa crosses the BBB and converts to Dopa. B6 contraindicates this as it converts to Dopa but doesn't cross the BBB.
26
What does a Dopamine imbalance look like?
Anxiety, depression, low libido, restless leg syndrome.
27
What causes a Dopamine imbalance?
1. Insufficient dietary intake (B6, Folate, Fe - cofactors)
2. Chronic stress - increases adrenaline (SNS), reducing dopa
3. Sleep deprivation - downregulates DA receptors
4. High sugar
5. Drugs
6. Poor gut health and dysbiosis - DA produced in gut
28
Name 4 SNPS that contribute to dopamine imbalances?
1. MTHFR: Reduces methylfolate and can impact dopamine synthesis.
2. DRD2/4: Increases likelihood of addictive behaviours
3. COMT: Breaks down dopa
4. MAOB: Breaks down dopa
29
What is Acetylcholine?
Formed from mito acetyl CoA and dietary choline. Essential for mood and learning.
Major NT in PSNS
Healthy diet increases its release through Vagus Nerve
It is anti-inflam in the brain
Cortisol downregs it in the brain.
30
What makes up the 'NEURO NUTRITION DIET'?
1. Include B6, 12, folate, ZN, Mg, Ca, Tyrosine
2. Avoid processed food/refined sugars and sweeteners
3. Supplement with B-Complex/Omega 3
4. Increase diverse range of high fibre fruit and veg, pre and probiotic foods, oily fish and nuts and seeds
5. Reduce aggravants and pro-inflam foods: dairy, sugar etc
6. Avoid neurotoxins - lead, mercury, botox, glutamate
7. Support P1 & 2 pathways with antiox rich foods, cruciferous veg, methyl support (B6, 12, folate and SAMe)
8. Relaxation, exercise, sleep hygiene,
31
Name four nutrients that support nervous health
1. Phosphatidylserine: Integral to neuronal cell membranes (200-400 mg/d)
2. DHA: Modules PS synthesis (0.2-1.5g/d)
3. Turmeric: Neuroprotective and reduces inflammatory (1 tsp/d)
4. Lion's Mane: Stimulates NGF and decreases neuro-inflam. (1-6g/d)
32
What is depression?
Persistent feelings of sadness and hopelessness and loss of interest in life.
33
What are the S&S of depression?
Loss of interest
Low energy and self esteem
Worthlessness
Difficulty concentrating
Changes in appetite and weight
low libido
Disturbed sleep
Self harm and suicidal thoughts
34
What causes depression?
1. Bereavement / trauma / bad news
2. NT imbalances (nut. def, SNPs - e.g. serotonin TPH2
3. Nutritional - inadequate co-factors for NT prod.
4. Chronic stress - prolonged elevation in brain cortisol affects 5-HT transporters
5. Gut microbiome
6. Depleted butyrate producing bacteria
7. Chronic low-grade inflammation
8. Hypothyroid
9. Allergies
10. Toxicity (mercury/copper)
35
What's the natural approach to dealing with depression?
1. Med diet - polyphenol and fibre rich foods feed the microbiota, reduces ox stress and anti-inflam.
2. Increase anti-ox to 8 portions a day! 50g of fibre, omegas
3. Tryptophan rich diet and optimise co-factors - zinc, b6, iron
4. Low GI diet, creating a small sustained increase in insulin to help tryptophan influx into the brain
5. Optimise digestion
6. Exercise outdoors
7. Address stress
8. Increase sunlight - increases 5-HT and Vit D
9. Breathing
10. Sleep hygiene
11. Sex hormone imbalances
36
Name 9 nutrients to help with depression.
1. B-Complex (50-150mg/d)
B6/12 & 5-MTHF for methylation and NT synthesis
2. St John's Wort (600-1200 mg/d)
Lifts mood - thymoleptic
3. Saffron (30 mg/2/d)
Thymoleptic
4. 5-HTP (100-300 mg/d)
Serotonin precursor but can cause GI side effects.
5. Omg3 (1000mg/d)
Maintain fluidity of neuronal cell membranes
6. Phosphatidylserine (100 mg/3/d)
Embeds in neuronal cell membranes supporting NT prod and post synaptic uptake.
7. Vit D
VDRs are located in brain regions including those implicated in depression.
8. Probiotics
Lacto and Bifo reduce dep. - reduce inflam cytokines, kynurenine/trypto ration
9. Turmeric (200-400 mg/d/ curcumin)
Inhibits MAO-A/B
37
What is bipolar depression?
Periods of major depression alternating with elevated mood. Manic episodes are more intense and longer.
38
What are the s&s of bipolar dep?
Lethargy and worthlessness
Psychosis - hallucinations
Excessive self-esteem, talkativeness, rapid thoughts, can't concentrate, distracted, reduced need to sleep, poor impulse control.
They have high everything apart from GABA
39
How would you support Bipolar dep. with nutrition?
1. Reduce food sensitivities
2. Med diet/low GL foods with high Omg3 and folate
3. Adequate protein for NT synthesis
4. Remove excess stimulants
5. Healthy fats
40
Which supplements would you consider for bipolar dep.?
1. Vit C (500-2000 mcg/d)
Lowers serum levels associated with NS disorders
2. B6 (20-150 mg/d)
Increases 5-HT NT
3. Folate & B12 (400 / 500mg /d)
Def causes elevated homocysteine levels, increased brain inflam and reduces available SAMe
4. 5-HTP (50-100 mg/d)
Supports 5-HT synthesis
5. Rhodiola Rosea (100-400 mg/d)
Adaptogen, increases BBB perm to precursors dopamine and 5-HT.
41
What is anxiety?
An umbrella term that includes:
Anxiety due to a medical condition
Substance-induced anxiety
Generalised anxiety
Panic
Stress
Social phobia
PSTD
42
What are the signs and symptoms of anxiety?
Palps
Shortness of breath
Chest pain
Sweating/trembling/shaking
Fear of losing control
Somatic symps: IBS, CFS, muscle pain
43
What causes anxiety?
1. Stressful situations
2. Chronic stress: Reduces GABA and increases adrenaline/noradrenaline
3. Genetic SNPs (Genes associated with HPA-Axis, GABA)
4. Nut defs - lack of cofactors for NT prod, especially B6, Mg, Zinc, EFAs
5. Inflam: increase in CRP linked to anxiety
6. Poor gut health - Dysbiosis affects gut-brain axis. Lacto/Bifo play a role in synthesis of GABA
7. Sugar / processed food - promote inflam/oxidation in neuronal cells and fluctuations in b/glucose.
8. Caffeine - depletes B-vits
9. Alcohol - depletes B-vits and decreases serotonin levels
10. Poor sleep, downregs dopa receptors.
44
What is the natural approach to anxiety?
1. Diet rich in antiox/anti-inflam foods
2. Fresh fruit and veg (phytos - blueberries, blackcurrants, red onion, brassica veg)
3. Protein for AAs for NT formation and b/glucose balance
4. Omg 6:3 ratio
5. Avoid caffeine/alcohol/sweeteners/refined foods
6. Support GABA - exercise/breathing
7. Gut health - pre and probiotics
45
Which 7 nutrients would you recommend to support anxiety?
1. Mg (200-400 mg/d)
Co-factor for GABA synthesis
2. Zinc (15-45 mg /d)
Essential for GABA synthesis
3. B-Complex (50-150 mg /d)
Essential for NS function and NT prod. via methylation. B6 especially important for conversion of glutamate (excitatory) to GABA (inhibitory)
4. Vit C (500mg / 3/ d)
Co-factor in glucocorticoid synthesis, reduces anxiety by reducing oxidative stress.
5. Theanine (50-200 mg /d)
Inhibits glutamate reuptake and increases GABA
6. Lemon Balm (300-600 mg/d)
Raises GABA levels
7. Passionflower (1 tsp)
Modulates GABA pathways
46
What is insomnia?
1. Difficulty falling asleep (sleep onset)
2. Frequent / Early waking (sleep maintenance)
47
How does sleep work?
Melatonin regulates sleep and rhythm. SAMe is released in prolonged periods of darkness, increasing serotonin to melatonin.
Excessive stress response results in high cortisol, making it hard to switch off.
48
What causes insominia?
Sleep onset: Anxiety, worries, fears, stress
Sleep maintenance: blood sugar imbalances, sleep apnoea, meds, alcohol, high stress, depression
49
How can you support insomnia?
Sleep hygiene , exercise and weight mgt
Support serotonin - melatonin conversion and GABA with tryptophan, MG, B6 rich foods and probiotics
Tart Montmorency cherry juice
Avoid stimulants
Passion Flower to help you fall asleep - GABA receptor affinity
50
How do you support addiction?
Assist with detox - p1, 2 and elimination pathways
Support inhibitory NT levels to prevent cravings
Support energy prod. to prevent cravings
Repair damage to body
Vit C and liquorice for adrenal support
Methylation support, tyrosine for dopamine and other nTs
Polyphenols to support the liver
51
Which nutrients would you use to support addiction?
1. 5-HTP 100 mg / d to support serotonin levels during withdrawal
2. Taurine 2000 mg / d to support relaxation and improve liver function
3. B Complex (50-150 mg / d replacing lost B1 and B5 due to alcohol
4. Mg >400 mg / d for relaxation and anxiety and energy and B1 availability to NS
5. EPA/DHA 1000-3000 mg /d fats for neuronal cells.
52
What is a migraine?
A recurrent neurological headache involving multiple networks and regions in the head.
53
Signs and Symps of migraines?
Mod - sev headaches, pulsating and throbbing < 72 hours preceded by tiredness and bowel changes
Nausea / vomiting, photophobia
An aura
54
Causes of migraines
Diet - allergies/intolerances
Inflammation - due to poor sleep, obesity, metabolic endotoxemia
Stress
Toxic overload
Oestrogen imbalance and OCP
Excess histamine
Low DAO levels
Gut dysbiosis
GBA
Nut def: Cofactors that support mito - B2,3,12, vIT d
Low Mg
Low Sero
55
What is the natural approach to migraines/
Blood sugar balancing
Remove trigger foods
Probiotics to down reg histamine
Quercetin to inhibit histamine release and lower ox stress
Support serotonin levels with tryptophan rich foods
Support GABA with digestive support - bitters
Increase Omg3 to reduce frequency of migraines
A multi vit with CoQ10 to cover nut def.
56
Which nutrients would you use to support migraines?
Mg 200-400 mg / d - alters neurotransmitter secretion
B6 50-100 mg / d Modulating effect on GABA and serotonin
5-HTP 100 -200 mg / d Supports serotonin levels and reduce migraine freq.
57
What is neuralgia?
Pain in the distribution of nerve or nerves often burning /stabbing
Sciatic neuralgia - compression w. pain in buttocks / back of leg with pins and needles
Trigeminal neuralgia - chronic condition affecting an or all 3 branches of the trigem nerve - sudden pain in face.
58
Causes of neuralgia
Structural
Infections - herpes / EBV
Inflam - poor posture/diet/obesity
MS
Chronic stress - SNS - muscle shortening
59
Natural approach to neuralgia
Anti-inflam diet
B1, 6 (GABA), 12 (myelination)
St John's Wort - inhibits serotonin and GABA reuptake
Omg 3 for inflam
