where there ' s an uptake of serotonin , and in an adjunctive good quality fish oil , whose DHA component will help . It ' s a synergistic effect which you ' ll see once we satisfy the need for some of these nutrients .
Adrian : Okay . And you mentioned there ’ s more of a DHEA effect when you use omega-3 , a higher DHEA version ?
Sanjeev : Yes .
Adrian : Is that what you use ?
Sanjeev : Yes .
Adrian : Okay . Is there a dosage that you would use for omega-3s ?
Sanjeev : Yes . Omega-3s are used , so you can use the omega-3 index , as some clinicians do . It costs about $ 120 . And it ’ s particularly important for those who are autoimmune , who want to make sure they maintain the best levels of their omega-3s , because the omega-3 : omega-6 ratio is very important , especially when there is a risk of inflammation . But these types of DHA will not only offer a D series of resolvins , but also they contain protectins , which are particularly required for neurons .
Adrian : Okay .
Sanjeev : So , you want to downregulate that inflammation , and it helps to improve the outer layer of mitochondria and the health of that phospholipid layer . That ' s why we want healthy DHA levels .
Adrian : And how much do you generally give , from a dose point of view ?
Sanjeev : My target is around 2.5 to 3 grams of EPA , DHA in combination . And then I see how they are going . Now , usually , if it is taken in a concentrated oil form , then usually you require about 5 mls to 10 mils . But if taste is an issue then capsules are the only choice . So , between 2.5 to 3 grams is a reasonable dose . And then you can start seeing a response in few months . But I ' m aware that , if people have autoimmune and cardiac issues , then you can even go up higher , to 5 to 6 grams .
Adrian : So if , let ' s say a naturopath sees someone who ' s on stimulant medication and that client is seeing a mainstream psychiatrist , are they able to be prescribed these nutrients ? Are they safe to prescribe in conjunction with stimulant medication ?
Sanjeev : Yes . Good question . And I think most naturopaths have got their interaction software . So , one thing which they can always look for is that I would recommend that if you are prescribing certain supplements , then you should look for any potential interactions . For example , if somebody ' s on warfarin or blood thinners , you have to be careful that their INR doesn ' t derange . And the reason is not that fish oil is bad , but the main thing is that the dose of the anticoagulants has to be adjusted , you know . That is important . If you ' re giving some , for example , garlic , that also affects coagulation .
Another thing that comes up is the matter of certain herbal nutraceuticals , like for example , St . John ’ s Wort . Now , St . John ’ s Wort is an MAO inhibitor . What this means is that if you ' re going to give someone who is taking a stimulant St . John ’ s Wort , for example , then it ' s not a good cocktail . Because you are blocking the breakdown of that neurotransmitter , then you can have serotonergic symptoms . And if the individual has a genetic vulnerability on top of that , perhaps a MAO ( monoamine oxidase ), SNP ( simple nucleotide polymorphism ), or a COMT ( catechol-O-methyltransferase ) SNP , which they cannot break down , it is very vital that when the supplements are given , first , they should be aware of their potential interaction . And there are methods available for checking this . If I ' m not mistaken , there is a platform that you can actually check for potential interactions . And again , when you are prescribing a neutraceutical always start low and slow . Do not be aggressive , because you never know .
Now , a possible barrier could be that the treating psychiatrist at the other end may not like it , because it ’ s something that is not part of their training . This is where I think a collaborative approach will be helpful , rather than taking a defensive view that naturopaths may hold over stimulant use . And what I would say on the other end to the psychiatrist , is that you can resolve possible differences by sharing the literature . One of the researchers from our part of the world is Professor Julia Rucklidge , who has done a lifetime of work in this area and a lot of work in the area of ADHD . Felice Jaka , as you know , from Melbourne has also done a lot of work in this area .
So there are very eminent researchers in these areas and they have published their work in mainstream journals , including psychiatry journals . And if you start creating a library of some of these papers , and in case there ' s any doubt , you share those research papers with them . Because , rather than a defensive view , you should have a collaborative view . And there is a book which I would recommend to all of my listeners , Finally Focused , by Dr James Greenblatt , who ' s a child psychiatrist who has been practising integrated approaches in mental health , particularly ADHD and ASD . The book is a masterpiece , one written by a psychiatrist , a practising mental health clinician who has also presented a lot of strategies for adjunctive nutrient approaches . Some of which I ' ve already highlighted in our discussion .
Adrian : Sounds like a great resource . So to recap . From all you ’ ve said during this podcast it sounds like that in assessment certainly it ' s really important , from your perspective , not just to ask about symptoms but also to do some good blood analysis . And a lot of the blood analysis that you referred to is rebatable on Medicare , which is great . And you start off there and then , basically , if there ' s low vitamin D , and / or low iron , you treat accordingly , And an interesting thing that you said was , “ If there ' s low iron , you can pretty much assume there ' s low zinc ."
94 | vol29 | no2 | JATMS