The Walsh Protocol
"Dr. Walsh’s noted accomplishments include: (a) groundbreaking studies reporting reduced violent behavior following nutrient therapy, (b) the 1999 discovery of undermethylation and copper/zinc imbalances in autism, (c) the 2000 finding of metallothionein protein depletion in autism, (d) the 2007 published study linking copper overload and post-partum depression, (e) the identification of five biochemical subtypes of clinical depression, (f) the 2011 development of the Walsh Theory of Schizophrenia, and (g) the direction of the Beethoven Research Project that revealed that the composer suffered from severe lead poisoning." - Walsh Institute
If you are new to the area of brain nutrition, you will want to immerse yourself in the research and recommendations of Dr William Walsh PhD. An area where his expertise demands attention is in the test protocols for determining methylation status, oxidative stress and key nutrient assessments.
Dr Walsh teaches that the most important tests for determining methylation status are not the genetic tests for MTHFR or COMT, etc. Although they are significant, they are not as useful as a whole blood histamine test or a Methylation Panel. The reason is that histamine reflects what is actually going on in the body. The genetic tests, while useful on many levels, help to 'predict' what might influence methylation, but there are over 70 genes involved with methylation. Furthermore, the greater influence on serotonin activity is not so much about serotonin and dopamine production as it is about serotonin and dopamine reuptake at the synaptic space between the transmitting neurons. This is why folic acid, which may help with methylation, is not recommended for undermethylators, and other biotype conditions associated with low serotonin and dopamine activity. Folic acid is a potent reuptake promoter. When in fact, what is most important for these biotypes, is reuptake inhibition.
The Walsh Institute has made it their mission to train physicians in the protocols for diagnosing and supplement therapies for patients experiencing mood and behavior disorders.
The Walsh Biotypes
Biochemical Factors in Behavior Disorders, ADHD and Mental Illness
(from the Walsh Institute Website)
Because of access to a large database of biochemical information from more than 10,000 patients with mental health problems, examination of this data shows that most of these persons have striking abnormalities in specific nutrients required for neurotransmitter production. The most common chemical imbalances we encountered include the following:
Many persons who suffer from anxiety and depression are over-methylated which results in excessive activity at dopamine, norepinephrine and serotonin receptors. Typical symptoms include chemical and food sensitivities, sleep disorders, underachievement, upper body pain, and an adverse reaction to serotonin-enhancing substances such as Prozac, Paxil, Zoloft, St. John's Wort, methionine, and SAMe. They have a genetic tendency to be very depressed in folates and other B vitamins. Biochemical treatment focuses on folates, Vitamins B-3 and B-12 that reduce activity of dopamine and norepinephrine. These persons should strictly avoid supplements containing copper, methionine, and other nutrients that could worsen anxiety and depression..
Many patients with obsessive-compulsive tendencies, oppositional-defiant disorder, or seasonal depression are undermethylated which is associated with low serotonin neurotransmission. They generally exhibit seasonal allergies, perfectionism, competitiveness, and other distinctive symptoms and traits. A high percentage have an inborn tendency to be depressed in calcium, magnesium, methionine, and Vitamin B-6. These undermethylated persons may benefit nicely from Paxil, Zoloft, and other serotonin-enhancing medications, although nasty side effects are common. A more natural approach is to directly correct the underlying problem using SAMe, methionine, calcium, magnesium, amongst others. Although most undermethylated patients thrive on folates, supplements of folates must be avoided for patients whose problems are dominated by low activity at serotonin receptors. Folic acid, folinic acid, and methylfolate all reduce serotonin/dopamine neurotransmission by an epigenetic mechanism, and this effect overwhelms the folate benefits of improved methylation and serotonin synthesis.
A common problem in ADHD, behavior disorders, and hormonal depression is a genetic inability to control copper, zinc, manganese, and other trace-metal levels due to improper functioning of metallothionein proteins. Elevated copper can cause striking changes in the levels of dopamine and norepinephrine in the brain and are also associated with hormonal imbalances and intolerance to estrogen. They must avoid supplements and "enriched" foods containing copper. In addition, we recommend they drink bottled water and limit use of swimming pools and jacuzzis treated with copper sulfate anti-algae agents. Foods to be limited due to high copper content include shellfish, chocolate, and carob. Biochemical treatment focuses on zinc, B-6, and other nutrients that stimulate metallothionein synthesis and functioning.
A common feature of many behavior and emotional disorders is pyroluria, an inborn error of pyrrole chemistry which results in a dramatic deficiency of zinc and Vitamin B-6. Common symptoms include explosive temper, emotional mood swings, poor short-term memory, and frequent infections. These patients are easily identified by their inability to tan, poor dream recall, abnormal fat distribution, and sensitivity to light and sound. The decisive laboratory test is analysis for pyrrole levels in urine. Treatment centers on normalizing blood levels of B-6 and zinc.
Our database indicates a significant number of our patients have chronic low blood glucose levels. This problem generally isn’t the cause of behavior disorders, depression, etc., but instead is an aggravating factor which can trigger striking symptoms. Typical symptoms include drowsiness after meals, irritability, craving for sweets, trembling, anxiety, and intermittent poor concentration and focus. Treatment includes chromium, CoQ-10, and other glucose-stabilizing nutrients, but the primary focus of treatment is on diet. These patients benefit from six or more small meals daily with emphasis on complex carbohydrates and protein. In essence, they cannot tolerate large meals or quick sugars. Complex carbohydrates provide the necessary glucose in a slow, gradual manner and may be thought of as "time-release" sugar.
Occasionally we encounter a patient whose condition has resulted from a heavy-metal overload (lead, cadmium, mercury, etc.) or toxic levels of pesticides or other organic chemicals. Our database indicates that persons with a metallothionein disorder are especially sensitive to toxic metals, and that overmethylation is often associated with severe chemical sensitivities. Effective treatment requires a three-part approach: (1) avoidance of additional exposures, (2) biochemical treatment to hasten the exit of the toxic from the body, and (3) correction of underlying chemical imbalances to minimize future vulnerability to the toxic.
Although only 10% of our database case histories involve serious malabsorption, more than 90% of autistics exhibit this problem. There are three primary classes of absorption problems: (1) stomach problems, including excessive or insufficient HCl levels, (2) incomplete digestion in the small intestine, and (3) problems at the brush-border of the intestine where most nutrients are absorbed into the portal blood stream. The consequences can include nutrient deficiencies, inflammation of the intestinal tract, candida, and mental health problems. Incomplete breakdown of protein and fats can adversely affect brain neurotransmission, and has been associated with impulsivity and academic underachievement. Treatment depends on the type of malabsorption present and may involve probiotics, adjustment of stomach HCl levels, digestive enzymes, and special diets.
The brain is 20% fat (by dry weight) and these fatty substances fulfill very important functions. Glial cells enable brain plasticity, regulate neurotransmission, nourish brain neurons, and form the myelin sheaths, which surround our brain cells. There is strong evidence of the important roles for omega-3 oils (especially EPA and DHA) and omega-6 oils (especially AA and DGLA) in ADHD, depression, and schizophrenia. A famous Harvard study showed EPA and DHA supplements to be more effective than psychiatric medications in combating bipolar depression. Typical American diets usually result in insufficient omega-3 and excessive omega-6, and some nutritionists routinely recommend supplements of omega-3 oils. However, biochemical individuality also exists with oils and certain persons are innately low in omega-6 oils. A review of symptoms and specialized lab tests can identify individual needs.