Depression triggered by chronic inflammation

April 17, 2009 by  
Filed under featured, Medical Research & Studies


It’s well known to doctors that patients with chronic inflammation, such as that linked to coronary heart disease or rheumatoid arthritis, are more likely than others to become depressed. Some pro-inflammatory drugs, such as interferon-alpha, which is used to treat Hepatitis C and a cancer known as malignant melanoma, also induce symptoms of depression in a significant number of patients, as does treatment with antibiotics.

What they haven’t known is why, but now researchers at the University of Illinois have discovered that IDO (indoleamine 2,3 dioxygenase), an enzyme found throughout the body and long suspected of playing a role in depression, seems to act as a molecular switch and is in fact essential to the onset of depressive symptoms sparked by chronic inflammation.

The researchers knew that infection causes immune cells to produce cytokines, signaling proteins that help the body fight infection. These proteins also activate IDO in the body and brain. IDO degrades the amino acid tryptophan, which is the precursor of serotonin, a brain chemical known to positively influence mood. The researchers suspect that the metabolites produced when IDO degrades tryptophan are in some way promoting depression and this opens the way to research further into how to inhibit this behaviour and pre-empt depression.

For years, no one considered that an infection somewhere in the body could affect the brain, but we now know that the immune system is a sensory organ and is perfectly adapted to ‘see’ infectious agents. It then communicates that information to the brain so proving that there is a clear link between the immune system and the nervous system.

If you have a tendency towards depression, it can help to know how to combat any potential downward spiral if you have a chronic infecitopn, or are taking antibiotics. St John’s Wort is helpful to many, as is taking additional B complex and vitamin C to both help the immune system and help mood elevation. Keeping the immune system healthy and strong is a priority with a good diet, low sugar intake, regular cupuncture and herbs such as Echinacea to keep on top of any potential down swings.

St John’s Wort – Does it work?

Get ready – this is the rant! As someone who has been writing about health for 20 years, I thought I had become anaesthetised to the ‘false information’ syndrome that seems to accompany most natural medicines. Linus Pauling is a fine example. He was one of the first scientists to work in the fields of quantum chemistry, molecular biology and orthomolecular medicine, was awarded two Nobel Prizes in different fields which you would have thought was enough qualification for anyone. However, his research into the benefits of vitamin C on health were systematically rubbished for years, and now a natural supplement that has been proven to help thousands cope with depression is getting similarly clobbered.

In the best Parliamentary tradition, I have to declare an ‘interest’ in the subject as I have been subject to depression since childhood and have tried virtually every form of treatment, both chemical and natural, over the years. St John’s Wort works for many people – but not for everyone, so I am never surprised to read research that shows it hasn’t been effective within certain parameters.

What I am surprised, and horrified, to discover is that the latest round of ‘St John’ bashing has come from a group of medical men who concluded “that the St.John’s Wort herb is useless in treating ADHD in children”.

That it is true I don’t doubt, because what they didn’t disclose at the time was that all the children used in the study were given inactive forms of the herb, where the active ingredients had been oxidized and rendered useless. Even the Journal of American Medicine admitted that:

“The product used in this trial was tested for hypericin and hyperforin content at the end of the trial and contained only 0.13% hypericin and 0.14% hyperforin.”

That constitutes a sub-clinical dose, barely containing any usable St. John’s Wort at all. It is in fact barely one-tenth of one percent of the active chemical constituents in the herb, and any decent supplement typically contain up to five percent hyperforin, or thirty-five times the amount of active ingredient used in this trial. JAMA felt obliged to point out:

“Hyperforin is a very unstable constituent that quickly oxidizes and then becomes inactive, which is likely what happened to the product used in this clinical trial.”

In other words, they admitted that it was an inactive, ineffective, form that had been used.

Even more worrying is the fact that there were only 54 children used in the results of the trial, with 27 receiving a placebo and 27 receiving St. John’s Wort. This is a very small sample size to justify any declaration that it doesn’t work, especially given the fact that it has been safely and effectively used by tens of millions of people around the world in just the last decade or so.

Incredibly, more than 40 percent of the children used in the study had previously also used psychiatric medications, and we already know that such drugs actually cause behavioural disorders, shown by the fact that so many children commit violent acts against themselves and others after taking psychiatric medications.

This trial was set up to fail on so many levels; for example, six children who displayed a large response to the placebo were supposed to have been dropped from the study to isolate the herb’s effects from placebo effects. However, they were ‘accidentally’ randomized and their results put into the final conclusion, which had the effect of distorting the final results in favour of placebo responders, and reducing the numbers who responded positively to the St John’sWort.

Another example of the study’s bias is that young boys are far more susceptible to the kinds of behaviours that are labelled as “ADHD,” compared to young girls, and yet in this study, the placebo group consisted of only about 50% boys while the herb treatment group consisted of nearly 75% boys. In other words, the placebo group was predisposed to a positive outcome simply due to its composition of girls vs. boys, while the herb treatment group was predisposed to a less-than-favourable response.

To say nothing of the sheer cynicism of this research, and trying not to boil over at them using young children to test something for a serious condition that they absolutely had guaranteed in advance would not work, they then sent numerous press releases out that warned parents not to use the herb. Some of the headlines included:

St. John’s Wort Doesn’t Work for ADHD Washington Post

St. John’s wort no better than placebo for ADHD, Bastyr study finds Seattle Times St. John’s wort doesn’t help ADHD, study finds Reuters That would certainly put most parents off, but it is not really so surprising when you know that one of the study’s authors, Dr. Joseph Biederman, secretly took $1.6 million from drug companies while conducting psychotropic drug experiments on children, and is currently on the payroll of several drug pharmacies selling ADHD medications – a fact he did not disclose when publishing the study in the Journal of the American Medical Association. So he was not likely to want to find that St John’s Wort, or any other natural alternatives, had any effect on treating a condition cheaply and without recourse to drugs. The whole point of the study of course was to make natural medicines look bad. I had thought after Linus Pauling’s hard battle to get his views accredited that it might have got a bit easier – but clearly the agenda is still a commercial, rather than a medical one.

In case you were wondering, St. John’s Wort has been clinically proven to be even more effective than antidepressant drugs for treating mild to moderate depression. That is a much better track record than all the SSRI drugs ever invented, whether it works for ADHD I don’t know, but I would want to see much better research before it is so cavalierly dismissed.