Iron and restless legs

It is becoming more well known that iron status and restless legs are connected. Many times when I share restless legs information on my Facebook page, someone will comment with a reminder of this connection.

I love that we're making a nutritional connection with such an uncomfortable problem.

However, it is important to remember, as was confirmed in a recent article reviewing numerous accepted treatments for restless legs, that iron supplementation is most likely to help the condition if there is a standing iron deficiency. If iron status is adequate, "topping off", so to speak, isn't going to fix the problem.

So....

...if you've got restless legs and you haven't checked your iron status, might be a good idea.

...if your iron levels are low, try an iron supplement.

However...

...if your iron status is fine, and/or you've tried the iron and your legs are still moving,

...consider that there are other options that may provide more relief.

Nutrition is a great place to start, and being well-nourished before trying medication is always a great strategy, but don't stop there if it doesn't turn out to be the answer.

Yes, the solution can be worse than the problem

Stress exposure, and post-traumatic stress disorder, are horrible problems. I've seen them wreak havoc on peace of mind, careers, and relationships. I think sometimes, being on the outside looking at a friend, loved one, or patient going through something we'll never completely understand because we simply did not live through it, creates anxiety because we have no productive outlet for the compassion and healing we want to provide.

As much as the object of our concern may be struggling, and as hard as we may want to be the source of relief for their pain, we need to always be careful that the help we provide is not being administered on behalf of our own pain, and not the person who is truly suffering.

For example, consider this recent study, that looked at the consequences of administering alprazolam (Xanax), a benzodiazepene anxiolytic, to a stress-exposed individual.

Animals exposed to stress were then given alprazolam on two different schedules; one group was medicated for 3 days starting 1 hour after the stress, while the other group received the medication for 3 days starting a week later. Each group was tested for symptoms of PTSD 30 days after the initial trauma.

Those animals who were immediately medicated experienced immediate relief, with now observable problems at day 30. Sounds good, except that when the rats were exposed to the same trauma a second time, they had a greater "freezing response" (something that traumatized animals and people do in stressful situations).

Early exposure also disrupted normal stress hormone function both during and outside of the second stress exposure.

So while we might feel better giving someone medicine to help them feel better, we may actually be the only ones who feel better. In the long run, the person may suffer more and longer than if we'd let them process the trauma in the way the body is programmed to naturally do, providing a safe, supportive place to heal and only introducing chemical intervention if it is deemed absolutely necessary.

Matar MA, Zohar J, Kaplan Z, Cohen H. Alprazolam treatment immediately after stress exposure interferes with the normal HPA-stress response and increases vulnerability to subsequent stress in an animal model of PTSD. Eur Neuropsychopharmacol. 2009 Jan 22. [Epub ahead of print]

More on zinc and depression

In my last post, I described a study in which zinc was shown to enhance antidepressant activity. In this study, rats whose depression and anxiety-related behaviors had been successfully treated with antidepressants were then placed on a zinc-deficient diet.

What happened?

They started to act anxious and depressed again.

We live in a culture that has created the mentality that if you're not feeling well, you go to the doctor, she prescribes you a pill, you take the pill, and you feel all better.

Unfortunately, pills can only work some of the time. And they tend to work best when you're using them in conjunction with healthy self-care behaviors. As far as I know, and I am a voracious consumer of psychiatric and neurological research, there is no pill developed that will overcome what you choose not to do.

Medication, in most cases, should be considered an ADJUNCT to treatment, not the ONLY solution to a medical problem.

The whammy here is that when you're depressed, it can be challenging to feel like doing anything for yourself at all. If you're not up to "healthy living" but you ARE motivated to take your prescription medication...at least consider taking a zinc supplement alongside the prescription. They are easy to find and inexpensive.

And they just might be what determines whether you crawl out of that whole.....

...or feel hopelessly stuck there.

Whittle N, Lubec G, Singewald N. Zinc deficiency induces enhanced depression-like behaviour and altered limbic activation reversed by antidepressant treatment in mice. Amino Acids. 2009 Jan;36(1):147-58. Epub 2008 Oct 31.

A little red meat may help your depression

If you have depression, you are not depressed because there is a deficiency of antidepressants in your body...

...however...

...you may be depressed because you have some basic nutritional deficiencies. One mineral that is involved in numerous brain and nervous system functions, and that has been extensively studied with regards to its role in the development of depression, is zinc.

Various doses of zinc were recently shown to improve immobility time in rats. Immobility in a stressful situation is a common behavior in depression. (When you are not depressed, you have better decision making and response times when it comes to managing stressful situations.)

That's exactly what fluoxetine (Prozac), paroxetine (Paxil), imipramine (Tofranil), desipramine (Norpramin), and bupropion (Wellbutrin) do!

When zinc and antidepressants were administered together, immobility time was reduced by more than either therapy produced on its own.

Practically what that says is that:
(1) if you are at risk for, or have had a history of depression, emphasizing high-zinc dietary choices and/or zinc supplementation would be a smart strategy, and
(2) if you are on an antidepressant, supplementing with zinc would be important to be sure that you get enough medication to do the job without getting so much that you set yourself up for detrimental side effects.

In fact, it seems to me that it should be an automatic recommendation of any physician, when prescribing an antidepressant, to write "zinc supplement" in the script as well...

FYI, your best sources of zinc include: red meats, liver, and oyster. And, when the originating soil is in good condtion...wheat, sweet corn, lettuce, beans, nuts, almonds, whole grains, pumpkin seeds, sunflower seeds and blackcurrant. That's a lot of different options, something for practically everyone, meat eater or not!

Cunha MP, Machado DG, Bettio LE, Capra JC, Rodrigues AL. Interaction of zinc with antidepressants in the tail suspension test. Prog Neuropsychopharmacol Biol Psychiatry. 2008 Dec 12;32(8):1913-20. Epub 2008 Sep 11.

Your medications and your genes

DNA and genetics are not my areas of specialty but I found this study very interesting and wanted to share it. Anyone who does have expertise on this...please respond!

Alprazolam (Xanax), a popular tranquilizer, was recently reported to "intercalate" with DNA. I'm providing a link to a Wikipedia piece on what intercalation is...in short, I gather it means that somehow Xanax incorporates itself into the structure of DNA itself. Which would mean, that it potentially changes how the DNA expresses itself. This finding prompted the research to issue caution about the random use of Xanax.

Makes me wonder when I see all these medications that are associated with weight gain, if other medications have the same ability? And it also makes me wonder if other compounds, even certain foods, might also affect DNA structure and function.

It's a whole lot more complex than "eat less and exercise more"...which is why I love reporting on this specialty so much! There is always something new and different to share that provides a potential answer to someone doing a Google search.

Saha B, Mukherjee A, Santra CR, Chattopadhyay A, Ghosh AN, Choudhuri U, Karmakar P. Alprazolam intercalates into DNA. J Biomol Struct Dyn. 2009 Feb;26(4):421-30.

Do we need a kindler, gentler football?

I'm going to let the New York Times do the talking today. I hate to see stories like this, because every time I do.....I wonder how we could use some simple nutritional therapies to minimize the chances of this kind of tragedy? I don't think it's all about nutrition, but I do think a good chunk of it might be.

http://www.nytimes.com/2009/01/28/sports/football/28brain.html?th&emc=th

Here's hoping some day, someone in a place to take action on that sentiment, has the money and the connections to actually do so.

Alzheimer's, sleep, and diabetes--three very interesting amigos

I didn't realize until reading this abstract that Alzheimer's disease affects sleep patterns as well as memory. It makes sense, since adequate sleep is necessary in order to retain memory of information gained during the day.

The medication reviewed in this article is galantamine (Reminyl), and the authors suggest that it is important to time medication administration in order to gain maximum effectiveness and sleep. And, that certain medications help (and interfere with) sleep more than others.

Disrupted sleep can worsen diabetes. Since many people with Alzheimer's also have diabetes--in fact, the two diseases are starting to be recognized as being very strongly linked to each other--this connection between sleep and medication can be very important to understand.

My guess is that if you are on this blog looking for information about Alzheimer's, it is a loved one, not you, that the information is for. Here is the bottom line:
1. If your loved one had problems with sleep before being recommended or placed on medication, it might be a good idea to check with the prescribing physician to be sure this was taken into account when choosing which Alzheimer's medication to prescribe.
2. If your loved one has developed changes in sleep habits since starting an Alzheimer's medication, be sure to let the prescribing physician know.
3. If your loved one's diabetes has become worse despite diligent attention to medications and food intake, consider the influence of sleep or lack thereof.
4. Be sure to ask your physician and/or pharmacist if there is a time of day your particular medication needs to be taken for maximum effectiveness.

Nieoullon A, Bentué-Ferrer D, Bordet R, Tsolaki M, Förstl H. Importance of circadian rhythmicity in the cholinergic treatment of Alzheimer's disease: focus on galantamine*. Curr Med Res Opin. 2008 Dec;24(12):3357-67.