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FOR IMMEDIATE RELEASE
Nutritional Interventions in the Treatment of Schizophrenia: A Case Reportby Aarti Midha, M.D.AbstractSchizophrenia is a psychiatric disorder for which conventional medicine uses antipsychotic medications. This is a case report of a 28-year-old male who arrived at my clinic in 2018 with symptoms of muttering, fearfulness, and withdrawn behavior and was taking antipsychotics and benzodiazepines for many years. We investigated him for metabolic causes, and the investigations revealed raised serum aluminum and high HSCRP. We started with the nutrients N-acetylcysteine, alpha-lipoic acid, and antioxidants to reduce oxidative stress and enhance phase 2 detoxification support, along with other nutrients. He also started an antioxidant-rich, gluten-free diet with probiotics. He started improving after three months. We monitored serum aluminum levels in this process. We started reducing psychotropic medications thereafter and continued antioxidant support to reduce inflammation and oxidative stress. He has been symptom-free for the last four years. He is on a low-dose mood stabilizer along with antioxidant support. He has not taken any antipsychotics in the last four years. Based on the positive outcome, we propose the role of nutritional intervention in reducing inflammation in psychiatric disorders. Keywords: case report, schizophrenia, heavy metal toxins, aluminum IntroductionSchizophrenia is characterized by a variety of symptoms, such as hallucinations, delusions, disordered thinking, and poor social functioning. Research indicates that a variety of genetic, environmental, and neurological factors may play a role in the development of schizophrenia, even though its precise etiology is still unknown. The probable involvement of environmental toxins, in particular heavy metals, in the development of schizophrenia has attracted increasing attention in recent years. These days, the environment is heavily contaminated with heavy metals like lead, cadmium, mercury, aluminum and arsenic. Toxic levels of all of these heavy metals can be found in the air, water, soil, and food, often in locations near industrial and trash disposal sites. Chronic exposure to these heavy metals impairs numerous normal biological functions and results in a series of health problems [1], such as aberrant immunological responses and neuropathological conditions. [2,3] Moreover, it has been reported that toxic heavy metals can cause oxidative stress and subsequently DNA damage, lipid peroxidation, and protein modification, all of which play a role in the pathogenesis of numerous diseases because of chronic inflammation, including cancer, diabetes, and neurological disorders. [4] Toxic heavy metals are an important risk factor for psychiatric diseases since they cause neurobehavioral alterations and disrupt dopamine receptors. [5] Numerous studies have studied the link between exposure to heavy metals and the likelihood of developing schizophrenia. [6] A 28-year-old male who arrived at my clinic in 2018 with symptoms of muttering, fearfulness and withdrawn behavior, with a medication history of many antipsychotics and benzodiazepines over many years with no relief in symptoms. This longitudinal case study is of a medication-resistant schizophrenia patient who had a history of heavy metal exposure and got improved with nutritional interventions and is now asymptomatic for last 4 years. This case study seeks to further explore the potential connection between heavy metal toxicity, chronic inflammation and schizophrenia. This case study makes a significant contribution to the field by highlighting the significance of taking environmental factors into account when managing and treating this crippling disease and by shedding light on the involvement of heavy metal toxins in the etiology and development of schizophrenia. Timeline
DiscussionThis longitudinal case study of the patient leaves us concerned that people diagnosed with schizophrenia may be covert sufferers of undiagnosed environmental toxin exposure, inflammation, hyperpermeable gut, and oxidative stress. The patient has been in follow-up with the treating doctor for the last six years, and both the patient and their family are satisfied with the progress made. The patient continues to follow an anti-inflammatory diet, take antioxidants, and regularly use a low-dose mood stabilizer, oxcabamazeipine 300 mg, with antioxidants such as vitamin C and n-acetylcysteine, and vitamin D and magnesium. These interventions have contributed to the patient's improvement. During this 6 year follow-up period there has been no relapse in schizophrenic symptoms. Recent studies have suggested metabolic syndrome as a risk factor for schizophrenia, attributed to poor dietary habits, unhealthy lifestyles, and physical inactivity of the patient [7] and side effects of second-generation antipsychotics [8]. On the other hand, heavy metal toxins such as As [9] and Pb [10] were found to be associated with metabolic diseases, suggesting a role of abnormal metabolism in linking toxic heavy metal exposure and schizophrenia. The gluten intolerance hypothesis is based on mechanisms linking gluten intake, immune reactions and inflammation with the development of schizophrenia. In this model, it is proposed that within the subgroup of people with schizophrenia and related psychosis with inflammation, consumption of gluten can drive an immune response and is implicated in the pathophysiology of the illness. Elevated anti-gliadin antibodies (AGA) are more frequent in people with schizophrenia than in people without, and AGA has been positively associated with peripheral inflammatory markers. [11] Family PerspectiveWe admitted our brother multiple times to a psychiatric hospital but did not get results with standard medications. We have always been keen to investigate any alternative therapies that could provide relief and enhance the quality of life for our brother as we watch him suffer from incapacitating symptoms. Initially we were unaware of nutritional interventions for treatment of schizophrenia. The idea of adding particular foods and supplements to our loved one's diet felt strange to us because we had mainly relied on conventional medical treatments. Patience, empathy, and a willingness to make big dietary modifications for our family were necessary to support our loved one during this journey. Together, we discovered the significance of including anti-inflammatory and antioxidant-rich foods in our diets, as well as the need to stay away from items that contain aluminum. This required alterations to our grocery shopping, meal preparation, and cooking techniques. Even if it wasn't always simple, seeing how these treatments might improve the mental health of our brother made it all worthwhile. We eventually began to see improvements in our brother's health. The symptoms lessened in intensity and frequency, enabling him to participate more actively in their everyday lives and interpersonal interactions. His mood, cognitive capacity, and behavior all improved. These developments offered us reason for optimism and strengthened our faith in the effectiveness of dietary therapies as an additional strategy for treating schizophrenia. In conclusion, we have seen firsthand as family members how nutritional therapies can significantly reduce inflammation brought on by aluminum in the treatment of schizophrenia. We urge other families to learn more about these therapies, educate themselves on the possible advantages, and work cooperatively with medical professionals to include them in the care of their loved ones. ConclusionTreatment of schizophrenia with medication is limited and often comes with severe side effects. This case report explores potential mechanisms and nutritional interventions for improving the condition. Nutritional interventions that aim to reduce oxidative stress and inflammation can be a safe and effective addition to treatment. Author contact: Dr Aarti Midha, gawriaarti@yahoo.com Further readingOrthomolecular nutrition has been shown to help prevent and reverse schizophrenia. A low-carb ketogenic diet can contribute to recovery. [12-14] High-dose supplementation with vitamins and micronudtrients, importantly niacin (vitamin B3), has been successful in reversing schizophrenia. [14-16] References1. Sun HJ, Xiang P, Luo J, et al. (2016) Mechanisms of arsenic disruption on gonadal, adrenal and thyroid endocrine systems in humans: A review. Environ Int. 95:61-68. https://pubmed.ncbi.nlm.nih.gov/27502899 2. Schultz SK, Andreasen NC (1999) Schizophrenia. Lancet, 353:1425-1430. https://pubmed.ncbi.nlm.nih.gov/10227239 3. Suzuki Y, Inoue T, Ra C (2011) Autoimmunity-inducing metals (Hg, Au and Ag) modulate mast cell signaling, function and survival. Curr Pharm Des. 17:3805-3814. https://pubmed.ncbi.nlm.nih.gov/22103852 4. Jomova K, Valko M (2011) Advances in metal-induced oxidative stress and human disease. Toxicology, 283:65-87. https://pubmed.ncbi.nlm.nih.gov/21414382 5. Finefrock AE, Bush AI, Doraiswamy PM (2003) Current status of metals as therapeutic targets in Alzheimer's disease. J Am Geriatr Soc. 51:1143-1148. https://pubmed.ncbi.nlm.nih.gov/12890080 6. Ma J, Yan L, Guo T, et al. (2019) Association of Typical Toxic Heavy Metals with Schizophrenia. Int J Environ Res Public Health. 16:4200. https://pubmed.ncbi.nlm.nih.gov/31671526 7. Saha S, Chant D, McGrath J (2007) A systematic review of mortality in schizophrenia: Is the differential mortality gap worsening over time? Arch Gen Psychiatry, 64:1123-1131. https://pubmed.ncbi.nlm.nih.gov/17909124 8. Henderson DC, Vincenzi B, Andrea NV, et al. (2015) Pathophysiological mechanisms of increased cardiometabolic risk in people with schizophrenia and other severe mental illnesses. Lancet Psychiatry, 2:452-464. https://pubmed.ncbi.nlm.nih.gov/26360288 9. Spratlen MJ, Grau-Perez M, Best LG, et al. (2018) The Association of Arsenic Exposure and Arsenic Metabolism With the Metabolic Syndrome and Its Individual Components: Prospective Evidence from the Strong Heart Family Study. Am J Epidemiol. 187:1598-1612. https://pubmed.ncbi.nlm.nih.gov/29554222 10. Xia J, Jin C, Pan Z, et al. (2018) Chronic exposure to low concentrations of lead induces metabolic disorder and dysbiosis of the gut microbiota in mice. Sci. Total Environ. 631-632:439-448. https://pubmed.ncbi.nlm.nih.gov/29529432 11. DL, Kelly HK, Demyanovich WW, et al. (2018) Anti-gliadin antibodies (AGA IgG) related to peripheral inflammation in schizophrenia, Brain Behav Immun. 69:57-59. https://pubmed.ncbi.nlm.nih.gov/29074356 12. Sarnyai Z, Kraeuter AK, Palmer CM (2019) Ketogenic diet for schizophrenia: clinical implication. Curr Opin Psychiatry. 32:394-401. https://pubmed.ncbi.nlm.nih.gov/31192814 13. Choi J, Kang J, Kim T, Nehs CJ (2024) Sleep, mood disorders, and the ketogenic diet: potential therapeutic targets for bipolar disorder and schizophrenia. Front Psychiatry. 15:1358578. https://pubmed.ncbi.nlm.nih.gov/38419903 14. ISOM (2006) Sister Theresa Feist. Orthomolecular Medicine Hall of Fame. https://isom.ca/profile/theresa-feist 15. Smith RG (2017) Niacin Treatment of Schizophrenia. Orthomolecular Medicine News Service. https://orthomolecular.org/resources/omns/v13n23.shtml 16. Levy TE (2023) Schizophrenia is Chronic Encephalitis ... and Niacin Cures It. Orthomolecular Medicine News Service. https://orthomolecular.org/resources/omns/v19n40.shtml Orthomolecular MedicineOrthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: http://www.orthomolecular.org Find a DoctorTo locate an orthomolecular physician near you: http://orthomolecular.org/resources/omns/v06n09.shtml The peer-reviewed Orthomolecular Medicine News Service is a non-profit and non-commercial informational resource. Editorial Review Board:
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