Why what you think you know may not be accurate.

December 14, 2023 | Dr. Joel L. Young

Nutrient deficiencies are implicated in many mental health disorders, including depression, anxiety, eating disorders, and bipolar disorder. Eating foods high in omega-3 fatty acids, Vitamin D, and B vitamins can have positive effects on both physical and mental health. If adequate amounts are not obtainable through food, adding supplements to your daily routine may be a viable option. In addition to medication management and therapy, medical nutrition therapy is a vital adjunct to the management of many mental disorders. 

Essential Fatty Acids and Mental Health

Essential fatty acids make up two fatty acid families, the omega-6 family (derived from linoleic acid) and the omega-3 family (derived from linolenic acid). These fatty acid families contain substances that are critical for generating energy and processing body fats. They are also needed for the creation and function of cell membranes and the proper development of organ tissue.

The consumption of omega-3 fatty acids can also have effects on your mood. Scientists who have analyzed epidemiological studies of several countries suspect that when smaller amounts of omega-3 fatty acids are consumed, the rates of anxiety and depression increase. Omega-3 fatty acids may actually inhibit neuronal signal transduction pathways in a manner similar to that of lithium carbonate and valproate, which are two highly effective treatments for bipolar disorder. Omega-3 fatty acids have also been used in the treatment of ADHD in children, along with adolescents and young adults in reducing minor and serious aggressive behaviors.

The United States Department of Agriculture, the United States Department of Health and Human Services Dietary Guidelines for Americans, and the World Health Organization recommend a minimum of 250–500 mg combined EPA and DHA each day for adults.

Essential fatty acids are also found in foods with high lignin content, including flaxseed, soy beans, whole grains, nuts and seeds, and raw vegetables. If you eat several servings a day of these foods, you are likely to obtain an adequate supply of essential fatty acids. If you are not consuming these foods, consider consulting with your doctor about supplementation. 

Did you know, individuals who struggle with mental disorders require higher amounts of essential fatty acids? Please note that individuals who have bleeding disorders, managed on anticoagulants, need to avoid these supplements and moderate their intake of essential fatty acids. These individuals should consult with their primary care physician for advice regarding these recommendations.

Vitamin D and Mental Health

The vitamin D receptor and vitamin D metabolizing enzymes are expressed in the brain. Vitamin D is also involved in the neurobiological pathways, which may affect one’s mental health. The active metabolite 1,25(OH)2D3 is thought to affect dopamine and serotonin levels in the body that regulate pleasure centers and mood. Therefore, because vitamin D is important to healthy brain function, insufficient nutrient levels may play a role in depression and other mental illnesses. If vitamin D is deficient in infancy, this may be implicated in schizophrenia.

Vitamin D is produced by the human body when it is exposed to sunlight. Vitamin D is also added to milk and other foods, and is available in small amounts in fatty fish such as tuna, salmon, and mackerel; beef liver, cheese, and egg yolks. Added supplements are often needed for teens and adults as Vitamin D intake can be difficult to achieve with diet alone. The recommended dietary allowance is 4,000 IU (age nine and up). Infants require 1,000 IU daily. A total of 10 to 15 minutes of sun exposure three days per week is generally enough for the body to meet its vitamin D needs. These recommendations can be more difficult to meet in the winter months.

Folate, B-12, Other B Vitamins, and Mental Health

A high homocysteine level, also called hyperhomocysteinemia, can contribute to arterial damage and blood clots in blood vessels. High homocysteine levels usually indicate a deficiency in vitamin B-12 or folate. Adequate levels of B-12 and folate are required for the production of serotonin, dopamine, norepinephrine, and epinephrine. Psychiatric disorders that may be diagnosed in individuals having B-12 deficiency include depression, bipolar disorder, panic disorder, psychosis, phobias, and dementia. Elevation of homocysteine in individuals with bipolar disorder correlates with lower levels of vitamin B-12 and folic acid.

Alcohol abuse is known to cause severe deficiencies in folic acid, vitamin B6, and thiamine (vitamin B1). Lack of these nutrients can result in anemia, causing the individual to experience cold intolerance, lethargy, and dizziness, along with frequent headaches and shortness of breath. Thiamine deficiency is especially dangerous, as it increases one’s chance of developing neurological conditions like Wernicke-Korsakoff Syndrome.

On another note, methylenetetrahydrofolate reductase, or MTHFR, is an enzyme that breaks down homocysteine. The MTHFR gene that codes for this enzyme has the potential to mutate, which can either interfere with the enzyme’s ability to function normally or completely inactivate it. People have two MTHFR genes, inheriting one from each of their parents. Mutations can affect one (heterozygous) or both (homozygous) of these genes. There are two common types, or variants, of MTHFR mutation: C677T and A1298C. Symptoms vary both among individuals and depending on the type of mutation. People usually do not know that they even have an MTHFR mutation, unless they experience severe symptoms or undergo genetic testing. MTHFR mutations can manifest as ADHD and mood disorders. It is important for these individuals with MTHFR gene mutations to consume enough folate, along with adequate vitamin D, B6, and B12.

1. Foods high in vitamin B12 include: pastured eggs, nuts, and beans.
2. Folate-containing foods include: broccoli, brussels sprouts, leafy green vegetables (such as cabbage, kale, spring greens and spinach), peas, chickpeas and kidney beans, and cereals fortified with folic acid.
3. Vitamin B6 containing foods include: pork, poultry (such as chicken or turkey), some fish, peanuts, soya beans, wheat germ, oats, and bananas.
4. Thiamine (B1) containing foods include: enriched, fortified, and whole-grain products such as bread, cereals, rice, pasta, and flour, wheat germ, beef, pork, trout, eggs, legumes, nuts, and seeds.

Many puzzle pieces contribute to mental health; nutrition is most certainly among these pieces.