Testing for Mental Health
As more awareness grows around mental health, we’re finding that common conditions associated with depression, anxiety, stress and similar conditions can be attributed to overall physical health. Pathology testing of digestive and immune health can provide great insights into potential causes of mental health conditions.
Mental illness and pathology testing are not often considered concurrently. How can a physical blood test or stool test give any information about a condition that effects the mind? This is a common misconception. There are many pathology tests that can assist in identifying the cause of mental illness so that appropriate treatment can be applied.
The Gastrointestinal Tract
A bidirectional communication between the gut, microbiome and the brain can exert an effect through the central nervous system, endocrine system, immune system and metabolic system. Alterations of the gut environment have been found to be associated with conditions such as obesity, diabetes, inflammatory conditions as well as neuropsychiatric disorders such as depression and anxiety.
Many neurotransmitters and chemicals required for brain and nervous system function are actually produced in the gut. In fact the gut produces more serotonin (responsible for regulation of mood, sleep and appetite) than the brain. Other neurotransmitters such as GABA and Glutamate which are involved in stress management, cognition and memory are also believed to be produced by gut bacteria. An imbalance of gut bacteria and gut function can, in fact, impact overall mental state.
Serotonin is also important for adequate gut function affecting gut secretions and digestion. Dysregulation of the brain-gut axis can cause digestive pain and discomfort, bloating and symptoms like diarrhoea and constipation.
Food Sensitivity is closely related to gut health and immune function. Research shows that food intolerances can be linked to IgG antibodies raised by your immune system when certain foods are eaten. IgG antibodies bind to proteins in certain foods as it enters the blood stream and form circulating antibody-antigen immune complexes. These complexes may be deposited around the body causing inflammation and can result in a wide range of symptoms such as fatigue, IBS, bloating, migraines, arthritis, bronchitis and depression.
Hormones can have an impact on mental health and wellbeing. Fluctuations in hormones such as testosterone, oestrogen, progesterone, cortisol and DHEA can all have a direct effect on mood and mental state. Changes in these hormones can lead to symptoms of irritability, anxiety, depression, lethargy and apathy. Gut health can have a direct effect on hormone levels, whereby an imbalance of the gut microbiome can reduce the effectiveness of enzymes such as, β-glucuronidase, which can increase oestrogen levels.
Sex hormones can be impacted by stress hormones such as DHEA and cortisol. Increased strain on the adrenal glands can upregulate DHEAs levels. Through aromatisation DHEA is converted to oestrogen and testosterone resulting in elevated levels of these hormones which can lead to hormonal symptoms that are in fact stemming from an adrenal condition.
Genetics play a vital role into most of the processes that affect us. One such gene is the MTHFR. A mutation of this gene can potentially effect activation of vitamin B12 and folate causing an increase in homocysteine levels. All of these can have an impact on mental health. Folate is methylated through the MTHFR enzymatic pathway to its active form, folinic acid, which is then required for the remethylation of homocysteine to methionine. A polymorphism in this gene can reduce the efficacy of the MTHFR enzyme, causing reduced conversion of homocysteine to methionine, resulting in elevated levels of homocysteine and reduced activation of folate to its active form. Vitamin B12 and folate are essential for brain development and function. In infancy a deficiency in Vitamin B12 and folate may result in neural tube defect, whereas in adulthood these deficiencies have been linked to risk of depression, reduction in cognitive development and produce symptoms such as memory loss, fatigue, irritability, apathy, personality changes. Furthermore, B12 and folate deficiency have been associated with a reduced response to antidepressant treatment.
Elevated levels of homocysteine also have a direct adverse effect on neurons and blood vessels including those that are in the brain. This may contribute to cognitive decline, dementia and depression. Vitamin B12 and folate are involved in the production of SAMe, which donates methyl groups required for neurological function. Deficiency in these nutrients causes an increase in homocysteine levels which has a direct correlation with depression.
C-reactive protein (CRP) is a protein made by the liver and secreted into the blood. It is a marker for the detection or monitoring of acute inflammation. CRP can increase fairly rapidly, within a few hours from the onset of infection or inflammation.
Studies have identified a direct correlation between increased CRP and other pro-inflammatory markers such as interleukin-6 (IL-6) and alpha-1-acid glycoprotein (AGP), with increased incidence of depression. Furthermore, depression may be characterised as an inflammatory disease as many symptoms of depression may be a result of other on-going inflammatory processes in the body, the gut and the brain.
Vitamin D deficiency has been found to have a strong association with depression. Vitamin D receptors are located on neurons and glia in many areas of the brain including the cingulate cortex and hippocampus, which have been implicated in the pathophysiology of depression. The involvement of vitamin D in brain development as well as neuroimmunomodulation and neuroprotection indicate that this vitamin may be beneficial in treatment of depression.
Many areas and aspects of pathology testing can help to determine imbalances in health and disease, assisting in the identification of the cause of health issues including the complexities surrounding mental health assessment.
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