Is there any evidence for using micronutrients for the treatment of mental illness?
The notion that good nutrition is good for the brain is not a new idea. What is relatively new is that, until recently, there were very few well conducted studies examining whether a broad spectrum approach using doses of nutrients higher than what you could get out of a daily diet, could treat a mental disorder.
At my lab at the University of Canterbury, we have been studying the impact of micronutrients (vitamins and minerals) on mental health for the last decade. With more and more people suffering from a mental illness and not enough people getting better with conventional treatments, we need to investigate new ideas. We appear to have reached an impasse improving outcomes for mental health, despite improvements in other areas of medicine.
For the past several decades, this idea that nutrients might treat mental illness was received with great scepticism and even ridiculed. Some continue to believe that vitamins kill us, despite evidence(1) to the contrary.
And why would this approach even work? Many readers might consider the idea is too simple to be taken seriously. But the general premise is that our brains need nutrients to function and chemicals that are essential for good mental health, like dopamine and serotonin, require micronutrients, like vitamins and minerals. Agricultural practices have changed dramatically over the last 50 years such that our food is just not as nourishing as it was for our ancestors. Perhaps some people are genetically prone to need more nutrients than what they can get out of their food. Maybe giving nutrients in higher doses than what is present in the diet can correct metabolic errors that some people may have inherited. It isn’t that farfetched an idea; don’t forget, a million sailors died from scurvy in the 18th century, before Vitamin C was introduced as a treatment.
Scientific advancements in knowledge of micronutrients
Over the last decade the field has grown substantially. No single study should be interpreted in isolation. There are now over 30 double blind randomised controlled trials (RCT) using a variety of combinations of nutrients and doses across a variety of mental health conditions showing that we can induce a substantial and clinically meaningful change in symptoms just by using nutrients.
It takes two RCTs to put a drug on the market. There are enough RCTs completed internationally that this approach should already be mainstream for the treatment of stress, anxiety, low mood and aggression in prisoners. Sadly, good nutrition and additional nutrients are not on the menu in prisons and if you present to your GP with stress or low mood, chances are pretty good that you will be put on a medication. Most data across the world consistently show that about 10% of the populations are taking an anti-depressant. In some countries, this number is even higher.
There is a long way to go to improve the effectiveness of this approach. More research is required to determine if we can enhance outcomes with a more tailored approach. We are in the infancy of figuring out the mechanism of action. Can we use genetic and nutrient testing to determine the optimal dose and nutrients that someone may require to get better, based on their individual profile? Can we use microbiome analyses to determine what microbial strains are required to best heal the gut to optimise absorption of nutrients? Current and future technologies should allow us to greatly expand the number of people who benefit from a nutritional approach. Eat2BeNice plans to investigate all these mechanism of action.
It is encouraging that some people can have better mental health and more fulfilling lives simply by ensuring their brains receive adequate nutrients and that they will not have to experience the side effects associated with so many medications. Perhaps mental illness will be viewed as being at least partially caused by improper nutrition. Could such a shift influence the stigma associated with mental illness?
We could continue to ignore the data. Or we can embrace the idea, properly fund it, and see how far it can take us in curbing the national trends. Valuing the role of nutrition as part of addressing our mental health statistics must become part of our future. Thanks to the European Commission, this might just happen.
(1) Helen Macpherson, Andrew Pipingas, Matthew P Pase; Multivitamin-multimineral supplementation and mortality: a meta-analysis of randomized controlled trials, The American Journal of Clinical Nutrition, Volume 97, Issue 2, 1 February 2013, Pages 437–444, https://doi.org/10.3945/ajcn.112.049304