Nutritional Therapies

In bipolar disorder, a good diet can often make the difference between stable control and erratic symptoms. Furthermore, weight gain and managing heart disease risk are a frequent challenges that nutrition addresses. While taking a Holistic approach Dr. Janikula always uses diet and nutritional therapies. There are several important nutrition concepts to keep in mind listed separately below.

Dr. Janikula has developed the “Janikula Bipolar Diet” and a free download of his patient pamphlet will be available soon.

Concept #1: Eat Whole foods.

Eating whole, unprocessed food is the most important concept in all of nutrition. When these foods are eaten more nutrients are available, there are fewer chemicals, and there are no refined products like sugar. Much is learned about whole foods from Weston A. Price, one of the first researches in whole food nutrition. Dr. Price was a dentist in the early 1900's who heard of the excellent health in traditional cultures who lived off the land. He travel across the globe studying people eating whole, traditional food and reported in detail about the foods they consumed. His reports are amazing and Dr. Janikula believes his concepts are central to all good diets. The Weston A. Price foundation publishes many good articles on nutrition and lists the the basic characteristics of traditional diets. The Janikula Bipolar Diet is completely whold foods and uses many concepts from Weston Price.

Concept #2: Blood Sugar balancing/ Metabolic Syndrome.


A recent review estimated that metabolic syndrome occurs in up to 50% of patients with bipolar disorder. Metabolic syndrome is a blood sugar problem presenting with; weight gain around the abdomen, blood sugar is slightly high (>100), there is low HDL cholesterol(<40 in men and <50 in woman), blood pressure is slightly high (>130/>85), and triglycerides are slighly elevated (>150).

In addition, many patients with bipolar have a condition called reactive hypoglycemia. Reactive hypoglycemia is where the body overreacts to sugary foods leading to a crash in blood sugar and many symptoms.

If you have excess weight around your waist and crave carbohydrates/sugar you most likely have blood sugar balance problems. Furthermore, antipsychotics and mood stabilizers alter metabolism to create a blood sugar problem or make existing blood sugar problems worse. If you are taking any of these medications and noticed weight gain, a blood sugar balancing diet is essential to weight management, mood management, and long term risk of heart disease and diabetes.

The best way to manage blood sugar problems is to control the amount and type of carbohydrate you consume. In general low carbohydrate diets work well as long as they are based on whole foods. High sugar foods are the worst offenders and should be avoided. When patients limit carbohydrates and avoid simple sugars they notice improved mood, weight loss, and increased energy. Slipping back into a high carbohydrate diet often leads to a mood episode, especially depression. Dr. Janikula considers this diet both a mood stabilizer and an antidepressant. Hopefully, in the next 10 year studies will back up his personal findings.

Finally, if the blood sugar imbalance is large enough, a blood sugar balancing supplement should be used to gain control. (see supplements section).

The Janikula Bipolar Diet is a complete blood sugar balancing diet.

Concept #3: Food Allergies

Clinical ecologists have found the connection between food sensitivities and brain reactivity. Past physicians such as Brent Cambell, William Crook, and J.C. Breneman found connections between foods and mood problems. It is hypothesized that when a sensitive food is eaten an immune reaction can happen in the brain and cause mood problems. The foods people are sensitive to are the foods they eat the most. These include: wheat and wheat products, Dairy, Eggs, Corn, Chocolate, and pork. There is no data on how often these occurs, but Dr. Janikula estimates that food allergies trigger mood episodes in a small percentage of patients with bipolar and cause unwanted physical symptoms such as digestive disturbances, sinus infections, and migraines.

There are several ways to detect food allergies. The best (gold-standard) method is to perform and allergy elimination diet. During this diet all possible food allergens are avoided for 1-2 weeks. If symptoms improve you have food sensitivity. Then to ascertain which foods are problematic, one food is added in at a time for three consecutive days. If the food is a problem the body reacts more vigorously after and absence. Typically there is no question that the food is problematic. This is done for each food reintroduced and if no reaction occurs the food can continue to be eaten.

Food Allergy reduction is part of the first phase of the Janikula Bipolar Diet.

Concept #4: Eat Essential fatty acids.

Healthy brain function depends on adequate supply of essential fatty acids, namely DHA and EPA. Patients with bipolar respond well to Fish Oil supplementation. One Harvard based studied on 30 unstable bipolar patients showed fish oil helped patients remain stable and improved depression. From this study, it showed that about 65% of the patients respond well to Fish oil supplementation.

Dr. Janikula uses fish oil with ALL of his patients to help stabilize mood. He finds it works especially well if the patient has dry skin, dry hair, and has excessive thirst. He tries to ensure patients are getting at least 6 grams of EPA and 4 grams of DHA. This is a large amount of fish oil and finds most patients are not taking enough to get a good response.

Vital Nutrients makes a product called “Fish oil liquid Ultra pure” that contains about 2 grams EPA and 0.5 grams DHA. Dr. Mark has patient take 2 teaspoons a day.

Concept #5: Eat Organic foods.

It is unknown how much chemicals, pesticides, and heavy metals affect the course of bipolar disorder but avoiding them is a good idea. One easy way to avoid pesticides is to avoid the “dirty dozen.” These are the 12 most pesticide laden foods that you would buy at the supermarket. The list was put together by the Environmental Working Group (www.ewg.org) where you can download a pocket list. Purchasing these 12 foods organic is a good way to decrease you pesticide consumption by 90%.

Dirty Dozen

Peaches
Apples
Sweet bell peppers
Celery
Nectarines
Strawberries
Cherries
Lettuce
Imported Grapes
Pears
Spinich
Potatoes

Concept #6: Take Supplements

Multivitamin.

Dr. Janikula prescribes all his patients a high dose multivitamin/mineral. Not only does a high dose multivitamin ensure adequate nutrients, the extra nutrients help offset any genetic metabolic deficits. There are two promising open trials that show mood stabilization using a multivitamin/mineral supplement. One by Kaplan showed a 55%-66% symptom reduction in 80% of 14 adolescents. Another trial by Charles Popper showed that 19/22 patients responded. As multivitamins have no negative side effects this option should always be used.

Dr. Janikula uses Thorne basic nutrients III and is in the process of formulating a new supplement.

Metabolic nutrients

Recent, research shows many metabolic blocks frequently occur in the brain of bipolar disorder patients. These metabolic blocks may be part genetic susceptibly, or party of the mood episode itself. Many nutrients help offset these metabolic blocks and trials have begun to evaluate there effectiveness. Dr. Janikula often uses 300 plus mg of CoQ10 and 500 mg of R-Lipoic Acid. He has a hard time assessing the success of the treatment but believes it might help with cognitive functioning.

Blood Sugar support

If blood sugar problems are large enough a blood sugar support supplement is helpful. More will added soon.

Neurotranmitter precursors.

Rarely Dr. Janikula will supplement depressed patients with neurotransmitter precursors 5-HTP, L-Tryptophan, and L-Tyrosine if depression or sleep remain uncontrolled. He feels these are safe and rarely cause a switch to mania.