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Don’t Suffer with OCD

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This unique treatment provides much better results than the standard approach…

You wash your hands so often that they’re red and raw. Perhaps you repeatedly rearrange the food in your kitchen cabinets so that all items are facing a certain way.

Or you may check over and over again to make sure that your front door is locked. Perhaps you hoard newspapers and other everyday objects until your house is filled with junk—or count to yourself whenever you drive through a stoplight.

If you or someone you know experiences these or similar symptoms, it could be a red flag for obsessive-compulsive disorder (OCD).

Inside the mind of an OCD sufferer: People with this disorder have disturbing, unwanted thoughts, such as the belief that they are contaminated by germs or are about to be in a horrible car crash. These obsessive thoughts cause intense anxiety that the sufferer attempts to ease with compulsive behaviors (or rituals) such as repeated hand-washing or counting in unusual patterns.

Suffering in silence: For people who have never experienced OCD, the symptoms seem entirely irrational. The irony is, even those who have the disorder know that their thoughts and behaviors are irrational but, for unknown reasons, they just can’t stop them. As a result, people with OCD are usually ashamed of their symptoms and often go to great lengths to hide them from their friends, family or doctor. Unfortunately, more than half of Americans with this disorder never receive treatment.

Even when a person with OCD sees a doctor for it, the condition is very difficult to treat. The conventional approach—usually, an antidepressant and psychological counseling called cognitive behavioral therapy—reduces the severity of symptoms by about 50%, according to research, but achieves complete recovery in only 20% of cases.

New approach: A technique called integrative psychiatry—using conventional treatments and natural therapies such as nutritional supplements—is likely to produce far better results than conventional treatment alone. Best approaches…

SEROTONIN BOOSTERS

Serotonin is a neurotransmitter (brain chemical) that plays a key role in regulating mood, appetite and sleep. Low levels of serotonin are believed to be a contributing cause of OCD. Many factors can reduce serotonin. For example, it’s thought that serotonin levels can be lowered by a diet high in processed foods, sugar and fat…stress…and chronic inflammation.

Selective serotonin reuptake inhibitor (SSRI) antidepressants help OCD by blocking the absorption of serotonin in the brain, which keeps levels in the body higher. Medication is quite helpful for some OCD patients, while others find that it increases their obsessive thinking.

The integrative approach: Several nutritional supplements boost serotonin and thereby help reduce or eliminate OCD symptoms.

Work with your doctor to determine which of the following supplements (one or more may be recommended) would be the most useful for you. To find an integrative doctor near you, go to IntegrativeMedicineforMentalHealth.com.

Helpful supplements…*

  • Vitamin B-12. A deficiency of this serotonin-boosting B vitamin is common in people with OCD. If you have this disorder, your doctor should test your blood levels of vitamin B-12.My advice: Most conventional doctors consider blood levels of 200 pg/mL to 1,100 pg/mL to be “normal,” but I treat any patient with a level below 500 pg/mL with weekly B-12 injections until his/her blood level reaches 900 pg/mL. B-12 is also available in sublingual and liquid forms. Some patients have a dramatic decrease in OCD symptoms with this treatment alone.
  • Folate. This B vitamin is also crucial for serotonin production and can boost the effectiveness of antidepressants. However, some OCD patients can’t absorb folate properly due to a genetic abnormality.My advice: For patients with OCD, I typically recommend having an MTHFR test (methylenetetrahydrofolate reductase mutations) to check for the enzymes that are necessary to process folate. If the test is positive, you may need to take 7.5 mg to 15 mg daily of a medication called L-methylfolate (Deplin) that supplies a high dose of the nutrient.
  • Omega-3s. The brain is nearly 60% fat. To work optimally, it needs healthful fats such as the omega-3 fatty acids EPA and DHA found in fish oil. Omega-3s can be obtained by eating fatty fish two or three times a week, but I have found that OCD patients often have an aversion to fish.My advice: Try a daily supplement containing 3 g of omega-3 fatty acids with an EPA to DHA ratio of 2:1.
  • 5-HTP (5-hydroxytryptophan) is a compound that boosts serotonin levels.My advice: I typically recommend a daily dose of 100 mg to 300 mg of 5-HTP for OCD sufferers.Important: Serotonin syndrome is a potentially dangerous condition (with agitation, rapid heart rate, blood pressure fluctuations and hot flashes) that can develop when patients take 5-HTP in addition to some painkillers and cough medicines. 5-HTP should not be used with an antidepressant unless the patient is under the guidance of a medical professional.
  • Inositol. In some OCD patients, supplementing with inositol (a vitamin-like compound that plays a role in serotonin receptors on cells) improves symptoms of the condition dramatically.My advice: I typically have OCD patients start with 1 g to 3 g a day and increase slowly to 10 g to 12 g daily. The dose should be divided so that it’s taken two to three times a day. (Taking too much inositol too quickly can cause digestive trouble.)

SLOW DOWN THE INFLAMMATION

Inflammation anywhere in the body disrupts serotonin metabolism—and people with OCD are often in a state of chronic, low-grade inflammation.

To reduce chronic inflammation…

  • Get enough vitamin D. Ask your doctor to test you for vitamin D deficiency (which I define as a blood level below 30 ng/mL). If you’re deficient, take 2,000 international units (IU) to 4,000 IU of vitamin D daily to reach the level recommended by your doctor.
  • Take magnesium. This mineral is also thought to reduce inflammation. In addition, it’s required to balance levels of the stress hormone cortisol. If you have OCD, ask your doctor if you should take a magnesium citrate or magnesium glycinate supplement.Important: Don’t take magnesium supplements if you have kidney disease, since you may not be able to excrete excess magnesium.
  • Get better sleep. Treat insomnia with the basics—for example, go to bed at the same time every night and get up at the same time every morning, giving yourself at least seven hours in bed.
  • Reduce stress. Stress not only causes inflammation but also worsens the symptoms of OCD. Reduce stress with mindfulness-based stress-reduction techniques, such as meditation, yoga, playing a musical instrument and/or exercise.

Probiotics for OCD

The toxic gut bacteria Clostridia can generate HPHPA, a compound that disrupts normal brain function. High levels of HPHPA are a feature of many psychiatric diseases, including OCD. If OCD symptoms increase after use of an antifungal or antibiotic (both of which may allow HPHPA growth), ask your doctor about testing for HPHPA.

Your doctor can order a urine test for HPHPA from a lab that specializes in digestive disorders, such as the Great Plains Laboratory, GreatPlainsLaboratory.com, or Genova Diagnostics, GDX.net. If HPHPA is detected, consider trying high-dose probiotics that supply 50 billion to 300 billion CFUs (colony-forming units) daily. Consult your doctor for any additional treatment you may need.

What Is OCD?

Obsessive-compulsive disorder (OCD) is a psychiatric illness that affects more than 2 million Americans.

The condition is characterized by repetitive, upsetting thoughts (obsessions) and an overwhelming urge to perform behaviors or rituals (compulsions) to help alleviate related anxiety. The cause is unknown, but genetics may play a role.

*Check with your doctor before trying these or any other nutritional supplements. Some may interact with prescription medications or affect medical conditions.

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Source: James Greenblatt, MD, an integrative psychiatrist board-certified in child and adult psychiatry. He is founder and medical director of Comprehensive Psychiatric Resources in Waltham, Massachusetts, and a clinical faculty member in the department of psychiatry at Tufts University School of Medicine in Boston. IntegrativePsychMD.com Date: October 1, 2013 Publication: Bottom Line Health
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