Supplements For Mental Health, Let's Talk!

Hi friends 🙂 

The last few weekends I have been on the road (Philly, NYC, Atlanta, Port St Lucie, even my hometown of Kennesaw, GA), so this is my first slow weekend back in Miami since April. It’s one of those weekends where I’m getting caught up on all the things that have been building up (i.e. finally cleaning out our food cabinet with food that expired in 2023 🙃).

Outside of that, I am in my LAST month of my third year of residency and starting July 1st, I enter my FINAL year of medical training. My wife Ari is in her LAST month of residency… ever! I’ll be announcing her new job and plans after residency soon 😁 

Today, I want to talk to you all about a topic that generates a lot of debate online: supplements for mental health.

The discussion around supplements is often polarized. Some claim they’re miracle cures, while others dismiss them entirely. As with most things in life, the truth lies somewhere in between.

What are Supplements?

Dietary supplements are products that are added to your diet to provide specific nutrients. They can be taken as tablets, capsules, powders or even in drinks like teas.

Some Benefits of Supplements

Some supplements have shown strong promise for our mental health and wellbeing, from reducing inflammation, to improving cognition, to helping us sleep. One of their key advantages these days is wide availability. You can find supplements in health stores, pharmacies, and online. BUT… that comes with some downsides and risks too.

Some Downsides of Supplements

Supplements are not without their drawbacks. Most are not regulated by the FDA (Food & Drug Administration in the U.S.) with the same rigor as pharmaceutical medication, which means their quality and efficacy can vary widely. You may THINK you’re getting 450mg of Valerian Root online, but it might actually be 40mg of Valerian Root mixed with an entirely different compound. Additionally, supplements can have side effects and interact negatively with other medications.

The Supplements That I Have Experience With

I have either recommended these to patients or used them myself:

1. Omega-3 Fatty Acids

- Uses: Omega-3s have two main ingredients, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) which help promote blood flow and reduce inflammation. Omega-3’s have been studied for their potential benefits in reducing symptoms of depression and managing symptoms of borderline personality disorder (BPD), such as impulsive behavior.

2. L-methylfolate

- Uses: This is a form of folate (vitamin-B9) that is effective as an augmentation treatment for major depressive disorder (MDD). L-methylfolate is even FDA-approved as a medicinal supplement for antidepressant augmentation (meaning if you are on an antidepressant like Zoloft, and you are still experiencing symptoms of depression, L-methylfolate supplementation may help). L-methylfolate can enhance the effects of antidepressants by facilitating the production of neurotransmitters. It is particularly useful for individuals who have a genetic mutation that affects folate metabolism.

3. L-Theanine

- Uses: Known for its calming effects, L-theanine is commonly used to reduce anxiety and improve sleep quality (fun fact: L-theanine is found naturally in certain teas, like green tea, and specific mushrooms as well). Studies indicate that L-theanine can promote relaxation without drowsiness, making it a popular choice for managing anxiety and insomnia. It increases the levels of calming brain chemicals.

Conclusion

There are a few other supplements that I have recommended for mental health in practice, such as melatonin, and I’m studying others such as Ashwagandha, Magnesium, Vitamin B6, Vitamin B12, and Probiotics which seem to have some fairly strong evidence, and I hope to discuss these more in a future newsletter.

While supplements can be beneficial, they should be used cautiously and ideally under the guidance of a physician. The quality and efficacy of supplements can vary, and they can interact with other medications you may be taking. Always consult with your doctor before starting any new supplement regimen.

Wishing you a week of good health and balance.

5 Things:

Each week, I’ll include a few of my favorite things. Feel free to send me your favorite recipe, gift idea, book, etc and I may even feature it here. Just respond to this email!

Recipe of the week - Roasted Eggplant Parmesan Stacks

These roasted eggplant parmesan stacks are lighter, easier, and faster than traditional eggplant parmesan. A perfect summer dinner idea! Recipe here

Item of the week - Sensitive gums? Same… These are my favorite soft toothbrushes for sensitive gums!

Person to follow this week - Medical School for Kids

I collaborated with Betty and Brandon for Psychiatry for Kids, but they have a ton of other medical books geared towards the next generation! You can follow them here! 

Book to read this week - The Alchemist

This is one of my favorite books! It follows the journey of a young shepherd who dreams of finding a hidden treasure in the Egyptian pyramids. Along his quest, Santiago learns profound life lessons about the importance of listening to one's heart, recognizing opportunities, and following one's dreams despite obstacles. Buy it here.

Dr. Goodman’s Psychiatry tip of the week - Food can be medicine… or poison… If you’re reading the ingredients on the label and it’s full of dozens upon dozens of impossible to pronounce ingredients… this may be a sign that the food is probably not medicinal in nature 🫠 

This Week’s Sources:

1. Appleton KM, Rogers PJ, Ness AR. "Updated systematic review and meta-analysis of the effects of n-3 long-chain polyunsaturated fatty acids on depressed mood." Am J Clin Nutr. 2010.

2. Grosso G, Pajak A, Marventano S, et al. "Role of omega-3 fatty acids in the treatment of depressive disorders: A comprehensive meta-analysis of randomized clinical trials." PLoS One. 2014.

3. Zanarini MC, Frankenburg FR, Reich DB, et al. "Omega-3 Fatty Acid Treatment of Women With Borderline Personality Disorder: A Double-Blind, Placebo-Controlled Pilot Study." Am J Psychiatry. 2003.

4. Papakostas GI, Shelton RC, Zajecka JM, et al. "L-methylfolate as adjunctive therapy for SSRI-resistant major depression: results of two randomized, double-blind, parallel-sequential trials." Am J Psychiatry. 2012.

5. Stahl SM, Lonnen AJ. "The mechanism of action of L-methylfolate: enhancing the synthesis of monoamines by modulating BH4." CNS Spectr. 2011.

6. Nathan PJ, Lu K, Gray M, et al. "The neuropharmacology of L-theanine(N-ethyl-L-glutamine): a possible neuroprotective and cognitive enhancing agent." J Herb Pharmacother. 2006.

7. Kimura K, Ozeki M, Juneja LR, et al. "L-Theanine reduces psychological and physiological stress responses." Biol Psychol. 2007

Disclaimer: These emails do not assume a doctor-patient relationship and my information is not intended to substitute for medical advice. I offer science-backed educational information aimed at empowering you to live your best life. Always consult your personal doctor before starting any treatment. My newsletter will always be free.