It’s something of a controversial question – some claim that if you just eat a healthy diet you’ll get everything you need. Nutritional therapy starts with the idea that there’s a large gap between rank deficiency and optimal health and well-being. Two further core ideas are that need for any nutrient is very much an individual thing, and that if you’re suffering a functional deficiency, you need relatively large amounts to return to optimal health.

This seems to be particularly the case with vitamin D. Vitamin D is different from most other nutrients in that your body makes vitamin D (when strong sunlight reaches the skin). In fact dietary vitamin D is very much a secondary source. Furthermore it has been said that vitamin D is more a hormone than a nutrient. There are receptors for vitamin D in the nuclei of cells – vitamin D acts as a signalling molecule that affects gene expression. See this lecture by Michael Holick on vitamin D for more information.

Vitamin D deficiency is common in the UK. At our latitude our bodies don’t make any in the winter months. Dark skinned people are especially vulnerable.

Vitamin D deficiency is known to correlate to several major illnesses, including cardiovascular disease, diabetes, cancer, hypertension and depression.

So let’s return to my question – how much do we need and how much should we supplement?

The first thing to say is that undoubtedly the best way to judge dose is to test your blood level. This is because health benefits are associated with achieving a certain blood level. If you’re relatively deficient you need a higher dose. On the other hand vitamin D is toxic in very high levels so you don’t want to overdo it.

(As a qualified nutritional therapist I can arrange the test for you.)

The optimal blood level has been rising over recent years as more evidence comes to light of the health benefits of vitamin D. Currently it’s thought to be at least 50 ng/ml.

This week I came across this study of vitamin D dosage in relation to achieving optimal blood concentrations. I quote: “The supplemental dose ensuring that 97.5% of [the experimental population] achieved a serum 25(OH)D of at least 40 ng/ml was 9,600 IU/d. Conclusion: Universal intake of up to 40,000 IU vitamin D per day is unlikely to result in vitamin D toxicity.” Furthermore they report that no intakes of 10,000 IU per day or lower led to toxic levels of vitamin D.

This is a radical finding because supplementing 10,000 IU of vitamin D per day would once have been considered dangerously high.

It would be extremely difficult to get this much vitamin D from a normal (healthy) diet.

Maybe there are other nutrients which confer health benefits when supplemented way beyond levels achievable from a normal diet?

FMRI based neurofeedback is a powerful form of neurofeedback, albeit rather expensive, because it can target specific regions of the brain, anywhere in the brain. Cheaper forms of neurofeedback such as EEG and HEG generally measure activity only in the outer part of the brain (the cortex).

Hyperactivity in the OFC is known to correlated with contamination anxiety in OCD patients. fMRI neurofeedback is thus a potential therapy for this group – for whom existing therapy options in mainstream medicine are limited. The researchers claim this is the first time fMRI neurofeedback has been used to successfully treat anxiety.

It’s no surprise that neurofeedback affects brain connectivity. Some modern EEG neurofeedback methods are based on connectivity measures and specifically target connectivity changes. But it’s likely that even much simpler forms of neurofeedback affect connectivity without directly training (or measuring) it. The highly interconnected nature of the brain means that there are probably lots of changes happening as a result of neurofeedback training. This impressive study of HEG neurofeedback for Traumatic Brain Injury (TBI) is an example.

However, researcher Jeffrey Schwartz measured changes in brain structure in OCD patients, as a consequence of a much simpler method – mindfulness. (He describes this work in his book ‘The Mind and the Brain’.) What hope for combining mindfulness and neurofeedback?

There is growing evidence that earthing helps reduce inflammation, by allowing the body to take up electrons which work as anti-oxidants. Inflammation creates a greater need for anti-oxidants because it involves the production of damaging pro-oxidant molecules called free radicals. We need our anti-oxidants to mop up these free radicals.

Dr Briffa reports his personal experience of pain reduction after he took up earthing. Pain is usually a sure sign of inflammation.

Inflammation is a defence response of the body’s immune system – defending against either infectious organisms or toxic substances, for instance. It’s a complex process – the body has many ways to do inflammation, and it can be localised or systemic (meaning widespread in the body). We know about inflammation e.g. when we cut ourselves – it goes red and sore and warm and swollen. But we don’t always feel inflammation. Heart disease is often the end result of years of inflammatory processes affecting the blood vessels. And inflammation can also affect the brain.

The brain is to some extent kept isolated from the rest of the body behind the “blood-brain barrier”. The brain has its own immune system – a function provided by glial cells which in fact out-number neurons by about 10 to 1. There is evidence that brain disorders such as Alzheimer’s, Parkinson’s and depression are brain inflammation disorders. A good place to read more about this is the book ‘The Other Brain’ by Dr Douglas Fields.

In my practice I often see evidence of brain inflammation in my clients (who are usually suffering from anxiety, low mood, fatigue and insomnia) in the form of an organic acids lab test result. An important biochemical pathway in the brain involves the conversion of the amino acid tryptophan to the neurotransmitter serotonin. Inflammation tends to shift this pathway away from serotonin and towards a toxic byproduct.

Can earthing help anxiety, depression and mood disorder patients? I’d say it’s worth a try. Certainly there are case reports of benefits around – see for example this page from the Earthing Institute.

Another mechanism by which earthing may help stress and anxiety is by altering Autonomic Nervous System (ANS) balance. There is some research evidence that it affects Heart Rate Variability (a marker for ANS balance), as this review article makes clear. Furthermore earthing seems to normalise cortisol levels – cortisol being a major stress hormone.

Firstly, the neurofeedback was based on functional magnetic resonance imaging (fMRI) – a rather more expensive modality than the more traditional EEG or HEG which I use in my practice. (In neurofeedback, information about brain activity is fed back to the user and you can in principle use any means of measuring brain activity, as long as you can feed it back in something close to real time.)

Secondly, the neurofeedback trainees were given a meaningful task of generating positive images. Then they used the feedback as a means of judging how well they were doing in that task. More typically in neurofeedback you’re asked just to influence the graph (or game or sound or whatever), or rather let you brain influence it. There’s no task like in the study. In this way, mainstream neurofeedback tends to be about training the brain, rather than training the mind, which I see as something of a disadvantage. It means you go a way having exercised your brain but not having learned a real skill that you can reproduce in the context of your life.

Biofeedback, or peripheral biofeedback (to distinguish it from neurofeedback) is about training the mind. You do learn skills – skills in mind-body self-regulation. You gain insights into the way emotions work, and on the basis of this you can make different choices in the challenging situations you face in your life. In my professional practice I prefer mind-training to brain training (though I do use both).

I should perhaps add that in the UK the Advertising Standards Authority considers it illegitimate for “complementary” health practitioners to claim to treat depression as it is considered a medical condition and apparently there is no evidence that complementary therapy works for medical conditions. So please don’t consider this article a claim that I can treat depression.

Here is the link to the published study of neurofeedback for depression.

First came this Sunday Times article on neurofeedback. Then later this Daily Mail piece on neurofeedback. The common factor is the Brainworks neurofeedback practice in London, so well done to them for their good work (the articles show they’re doing a good job).

It’s great to see a raised profile for neurofeedback – it deserves it. Neurofeedback is reasonably well established in some countries, such as the United States and the Netherlands. There is an abundance of scientific studies supporting its efficacy (albeit no large scale studies). Why not the UK?

My guess is that it’s down to lack of interest from the mainstream mental health professions – psychiatry and clinical psychology etc. I think this lack of interest is in turn attributable to the dominance of the NHS in the UK health sector, where there has been limited scope (and incentive) for innovation. In practice a commitment to evidence based medicine may sink to an unimaginative conservatism.

The Government’s health reforms will apparently make innovation a legal duty of health care trusts including mental health trusts. Let’s hope they’ve been reading the papers.

Actually that’s no great surprise. A link between sleep and obesity has also been found in adults. And there are quite a number of studies showing the link, as this article on sleep deprivation and obesity makes clear.

Why should this be the case?

Well, we know that generally sleep deprivation degrades brain performance, as the Wikipedia article on sleep deprivation makes clear. Psychometric testing shows attention and working memory are the worse for sleep deprivation, yet interestingly the brain’s prefrontal cortex (heavily involved in “executive functions” such as attention and planning) is actually more active in sleep deprived people. This is usually interpreted to mean it is working harder to compensate.

Sleep deprivation seems to stimulate stress hormones, in particular cortisol, which is known to produce damaging effects in the brain when chronically high.

Why should insomnia affect weight loss and weight gain in particular?

One principal mechanism could be hormone dysregulation. I’ve already mentioned cortisol, which plays a role in blood sugar regulation which is in turn significant for appetite. The hormones leptin and ghrelin, both of which strongly affect appetite and satiety, have  been shown to be affected. Certainly research shows people report increased feelings of hunger after sleep deprivation.

Another significant factor appears to be the loss of self-control or “will power” that follows sleep deprivation. People are more likely to make poor decisions as to what to eat.

Sleep deprivation also seems to lead to decreased energy expenditure.

The bottom line is that if you’re overweight or struggle to lose weight then at least part of your strategy should be to make sure you get plenty of sleep, and good quality sleep at that. Of course that’s easier said than done. Brain dysregulation is probably both cause and effect of insomnia. Learning to better regulate your brain and nervous system, with neurofeedback and biofeedback, could be part of the answer.

Here’s the link: study of HRV and brain injury

Traumatic Brain Injury (TBI) is a major cause of disablity worldwide. Problems can range from mild to severe, and can last indefinitely, yet strangely, modern brain imaging commonly doesn’t reveal any structural damage.

Long-lasting symptoms include emotional problems such as anxiety and depression, cognitive issues such as attention and memory impairments, and also seemingly physical symptoms such as fatigue and headaches.

Treatment options for chronic TBI cases are limited, at least in terms of mainstream medicine. It’s good to see researchers are looking at new therapy options. I think biofeedback has potentially a lot to offer this group of sufferers.

This study of hemoencephalography (HEG) neurofeedback for TBI is one of the most promising I’ve seen.

HEG neurofeedback directly trains the part of the brain most responsible for executive function – which includes focus and attention, organisation and planning, and emotional self-regulation – namely the prefrontal cortex (PFC).

Heart Rate Variability is also known to correlate with prefrontal brain function, as this study shows: HRV and the prefrontal cortex

So HRV biofeedback makes a lot of sense, not just in TBI cases but for many other variants of prefrontal brain problems such as ADHD and depression. I look forward to hearing more from this team of researchers.

Here’s a link to an article by the US-based Life Extension Foundation that summarises the research:

Supplementation Benefits Mood – Meta-anlaysis

Meta-analysis is the gold standard in research. Essentially a meta analysis compounds the data from a number of studies on a given topic so that you get an averaged picture. Although some studies might be excluded on quality grounds, the point is there is no cherry picking of only the results that support the position you want to take.

If the research had shown the opposite result, I’m sure it would have been headline news. As it is, the mainstream media will I think ignore it.

I’m offering this as information only. Strict rules of the UK Advertising Standards Authority prevent a Nutritional Therapist from claiming to treat just about any disorder. So please don’t take this post to imply I claim to treat mood disorders such as depression, anxiety and stress successfully using nutritional supplementation.

You can of course draw your own conclusions about the worth of nutrition supplements.

Some rather silly explanations surfaced, such as unconscious attention seeking. I think the real explanation is rather more obvious. I come across similar things every day in my therapy practice, particularly in the context of working with biofeedback.

People go into the concert hall thinking to themselves, “try not to cough”. If I say to you, “don’t think about a pink elephant”, what’s the first thing that comes into your mind? Negatives such as “don’t” are nearer the surface – relevant to the logical mind but less so to the unconscious mind.

I think a fundamental feature of the mind is that whatever thought or idea or image comes into your mind, a part of you asks – not necessarily consciously – “what would that feel like?” – and then part of you simulates the answer. This is quite helpful mostly – for example you’re in a restaurant and you ask yourself, “should I order the frogs’ legs?”. But sometimes it’s not so useful. If you have a fear of flying, and a month before your holiday you start thinking about getting on the aeroplane etc., then you don’t have to wait to feel bad – you can have some of the fear there and then.

This simulation is something to do with the body. Emotions play themselves out in our body’s physiology (in part). In anticipatory anxiety your heart speeds up, you have butterflies in your belly, etc.

Put these ideas together and you can start to see why people cough in classical concerts. In brief, the sequence is: 1. don’t think about coughing, 2. (unconsciously) what would it feel like to cough? 3. focus goes to little signs, looking out for a tickley throat, 4. this sort of imaginative attention amplifies whatever signs are there, making a cough more likely, 5. struggle against it and you’re caught in a kind of mental quicksand that makes the cough irresistible.

Biofeedback is really useful in therapy because it really shows up the nature of mind in this way – especially the mind-body connection. The therapist or coach draws attention to the bodily responses to even fleeting thoughts and images, creating awareness (mindfulness), which is the first step on the way to change. Learn to reverse or transform these bodily responses, and you take the heat out of worrisome thoughts.

This post is a guest article by Antonio Martins-Mourao, PhD, who is a practising Clinical Psychologist and a Lecturer in Psychophysiology and Mental Health, at the Open University, where he also runs the QEEG & Brain Research Lab currently researching Anxiety disorders.

www.londonscientificneurotherapy.com/Forthcoming.html

Anxiety disorders are often accompanied by distressing and restricting symptoms that motivate patients to seek primary medical care and regular GP assistance. A prime example of anxiety-related co-morbidities includes acute gastrointestinal complaints such as Irritable Bowel Syndrome (IBS), which presents mechanisms quite similar to anxiety with clear consequences for patients’ everyday life management. IBS, in particular, has significant impact on the quality of life and productivity of sufferers, affecting 10% to 15% of the population in the UK, leading to an average loss of 20 working days per year. Conservative estimates suggest that IBS has a total direct cost of over 220 million pounds to the National Health System, per year.

An obvious question in the minds of many GPs would be: is there an efficient and cost-effective way to help sufferers with Anxiety and IBS to manage their symptoms? As a matter of fact there is. Biofeedback is a simple yet powerful technique that has been shown to stabilize the autonomic nervous system, reducing anxiety levels and tackling IBS symptoms within weeks. HRV biofeedback, in particular, is a painless and non-invasive technique that uses the patient’s heart rate data and patterns of breathing to facilitate “mindful” mental shifts and improved cardiovascular system function to promote Autonomic health and homeostasis. Once the patients learn how to reduce their sympathetic activation, using simple equipment, their symptoms begin to subside, leading to greater autonomy, confidence and increased self-esteem.

HRV biofeedback can be used by GPs, nurses, counsellors and psychotherapists, to promote emotional states that enable significant symptomatic reduction. It is also supported by an impressive number of studies published showing its reliability and effectiveness in the treatment for a range of clinical disorders, including pain, cardiac rehabilitation, anxiety and stress-related disorders. When used in combination with talk therapies such as Cognitive Behavioral Therapy (CBT), Mindfulness-based Cognitive Therapy (MBCT) or Acceptance and Commitment Therapy (ACT) the outcomes can be even more effective, requiring less therapist time.

There is an additional advantage. Biofeedback is medication-free and can be used by patients, at home, after basic training.