Schizophrenia may be caused by a body chemical or by a life crisis, but in both cases, a nutritional approach can do wonders.

Much of modern psychiatry rests on the assumption that mental illness is a biological or genetic disease. Nowhere is this more evident than with schizophrenia, a catch all term used to describe individuals who supposedly have lost contact with reality, and suffer from delusions, hallucinations, illogical thought processes and generally disturbed behaviour.

The “sick brain” theory justifies the medical approach to mental illness, with its armament of powerful antipsychotic drugs, lobotomy or electroshock (see box, p 2). As Peter Breggin says in Toxic Psychiatry (Fontana 1993), “If irrationality isn’t biological, then psychiatry loses much of its rationale for existence as a medical speciality.”

In some cases medicine may be correct in blaming body chemistry, but in seeking the cause in the brain itself, it could be fingering the wrong culprit. A growing number of studies suggest that some of the behaviour that we label “schizophrenic” may be caused or exacerbated by food allergies or nutritional deficiencies.

The most well known advocate of this approach is the late Dr Carl Pfeiffer of the Brain Bio Centre in Princeton, New Jersey. Dr Pfeiffer postulated that most psychotic patients have either abnormally high or low levels of histamine the body chemical mobilized in allergic reactions which is vital to the functioning of the nervous system. He also found that they were likely to have too much copper and deficiencies in zinc and other nutrients. By manipulating their diet and adding supplements, Dr Pfeiffer has achieved notable improvements in many patients.

One of the most thorough researchers into this area is Dr Melvyn R Werbach, assistant clinical professor of psychiatry at University of California at Los Angeles School of Medicine. With his permission, WDDTY has excerpted from the most important findings of his research into nutritional influences on mental illness.

Remember that Dr Werbach’s findings are simply meant to be a source book of evidence, not a treatment programme. Never suddenly stop taking drug treatment before you are certain that nutritional problems have been sorted out or psychotic symptoms may recur. Anyone suffering from psychosis should work in tandem with a trained professional who will examine your dietary history and investigate nutritional deficiencies with appropriate laboratory tests, before launching into any nutritional therapies. It’s vital to work with someone highly experienced, as too much of certain nutrients (such as folic acid) can actually bring on symptoms of schizophrenia.

WDDTY does not advocate that people with major psychotic problems ignore all drug therapy, which used judicially can be life saving in the initial stages of the illness and is sometimes the only means of leading a normal life. However, investigating food sensitivities and nutritional deficiencies can be a first port of call in treating schizophrenics, if not the root cause. Nutritional doctors Stephen Davies and Alan Stewart have found that correction of the underlying nutrient imbalances, food allergies and hormone shortages “can, but not always, result in being able to gradually withdraw, in a controlled way, the antipsychotic medication without relapse”.

Some research suggests that foods, especially those containing gluten and milk or dairy products, may contribute to schizophrenic symptoms. Wheat or milk could trigger mental illness, because amino acids contained in these foods are similar to a substance, melanocyte stimulating hormone release inhibiting factor (MIF), that alters brain activity (N Engl J Med, 1982; 307 (14): 895).

One experimental double blind study of 22 severely disturbed hospitalized patients, including 16 paranoid schizophrenics, given a gluten free diet for six weeks showed initial improvement in five scores on a profile rating. Two of the paranoid schizophrenics who had shown improvement relapsed when gluten was reintroduced into their diet (Br J Psychiatry 1986; 148: 447-52).

Another study found that the blood of certain psychotic patients given gluten produced a substance (leukocyte migration inhibition factor) similar to that of celiac (gluten intolerant) patients, even though there was no evidence among the schizophrenics of malabsorption in the gut, as occurs in true celiac disease. The study concluded that gluten may be involved in the biological processes in the brain in certain psychotic individuals (Am J Psychiatry 1979; 136 (10): 1306-9).

Although not all experiments agree, and there is much we don’t understand about “brain allergy”, some studies in which wheat has been eliminated from the diet have shown improvement. In one, milk and cereal grains were eliminated from the diet of 14 patients, after which they were alternately given soy and wheat. The reintroduction of gluten arrested or reversed the improvement in 10 of them, particularly those with paranoia (Science, 1976; 191: 401-2).

Besides food allergies, a number of nutritional deficiencies can produce schizophrenic like psychoses or exacerbate the symptoms of the disorder.

The most common vitamin deficiency in schizophrenia may well be folic acid. It may even be a major cause of the schizophrenic syndrome. In a 1990 study in the Lancet (336: 392-95), more than a third of patients with schizophrenia had borderline or definite folate deficiency.

Supplementing with folic acid has also produced good results. In the above double blind study, 17 patients received either 15mg of methylfolate (a synthetic form of folic acid) or a placebo in addition to the standard antipsychotic drugs. After six months, there were significant behavioural improvements in the folic acid group.

Another survey of 36 patients with schizophrenia or depression found that almost all of the folate treated patients made a full recovery, compared with three quarters of controls (M I Botez and E N Reynolds, eds, Folic Acid in Neurology, Psychiatry and Internal Medicine, New York, Raven Press, 1979)

Although supplementation may be beneficial, bear in mind that excessively high blood levels of folic acid can exacerbate psychotic behaviour or even react with antipsychotic drugs.

Princeton’s Dr Pfeiffer maintained that folic acid deficiency is more pronounced in patients with low histamine and high copper levels, compared with “pyroluric” schizophrenics those normal in copper but low in vitamin B6 and zinc (Botez and Reynolds, as above).

Dr Pfeiffer was possibly the first to discover the role of histamine in mental illness. In his investigations, half of his patients had high levels of histamine (histadelia), and tended to display phobic behaviour, with suicidal depression. In Pfeiffer’s view, “histapenics” those with low levels of histamine demonstrated what we consider the classic symptoms of schizophrenia: delusions, paranoia and hallucinations. He believed this group would respond to high doses of niacin, niacinamide, B12, zinc and manganese, folic acid and a high protein diet.

Many of Pfeiffer’s ideas were simply observational, based on his own good results. However, his theories have been borne out in some scientific tests. In their review book of folic acid, Botez and Reynolds include an experimental study of Pfeiffer’s, which found that in addition to folic acid, vitamin B12, niacin (B3), vitamin C and zinc were effective in treating histapenic schizophrenics. After five to six months on this supplement regime, this group of schizophrenics had reduced blood copper and raised blood histamine, as well as general improvement in symptoms.

In the same study, folic acid made histadelic schizophrenics worse. This group improved with antifolate drugs such as phenytoin and supplements which decrease histamine, such as daily doses of 1-2 grams per day of calcium salt and methionine, an essential amino acid, and a low protein, high carbohydrate diet.

In another study, of the various supplements tested to increase copper excretion in patients, zinc 50mg, manganese 3mg and B6 50mg were by far the most successful (J Orthomol Psychiatry (1983; 12: 215-34).

A number of researchers have found that schizophrenics are often deficient in omega-6 essential fatty acids. Some have theorized that people with this form of mental illness abnormally metabolize essential fatty acids, and thus have an elevated level of omega-3 fatty acids (those found in fish oils and linseed) and low levels of omega-6 fatty acids (those found in evening primrose oil) (Med. Hypotheses, 1983; 10: 329-36). Indeed, a review article by the Annual of the New York Academy of Science (1989; 559: 411-23) found that the symptoms of schizophrenia are similar to those that occur with disturbances in polyunsaturated fatty acid and prostaglandin metabolism. And a number of studies show beneficial effects of taking evening primrose oil or the equivalent. In one experimental double blind study of 38 patients with established movement disorders (that is, tardive dyskinesia, see box, p 2) exposed to antipsychotic drugs for a long period of time, those given evening primrose oil (rather than placebo) showed “highly significant improvements” in total psychopathology scores and a significant improvement in memory (Psychiatry Res, 1989; 27(3): 313-23).

As for other nutrients, some research has concluded that a low intake of vitamin C is associated with a risk of schizophrenia (Bibl Nutr Dieta, 1986; 38: 173-81), or that schizophrenics have low blood levels of vitamin C, even when their intake is what would ordinarily be considered normal. One study showed that the blood vitamin C level in nearly a thousand hospitalized psychiatric patients was a third lower than in the healthy controls; nearly a third of the patients had levels below the threshold associated with detrimental effects on immune responses and behaviour (Hum Nutr Clin Nutr (1983; 37C: 447-52).

Other studies have shown that manganese and zinc may be depressed in schizophrenics (J Orthomol Psychiatry, 1974; 3 (4): 259-64 and IRCS J Med Sci, 1973; 2:1010). And phenothiazines can cause a deficiency in riboflavin (vitamin B2) (J Orthomol Psychiatry 1983; 12(2): 113-5.

Adapted from Nutritional Influences on Mental Illness: A sourcebook of Clinical Research, by Melvyn R Werbach, M D (Third Line Press, Inc, 4751 Viviana Drive, Tarzana, California 91356, $44. FAX: (818)-774-1575).

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