Biomedical Tidbits
by Will Block

ntidepressants, including SSRIs - a class of drugs that includes Prozac® and Paxil® - have been found to carry an increased risk of gastrointestinal (GI) bleeding. According to a new study in the British Medical Journal, that risk is three times greater in people taking these antidepressants than in people not taking them.1 It is equivalent to the risk associated with taking the pain relievers aspirin or a nonsteroidal anti-inflammatory drug (NSAID), such as Advil®, on a regular basis. These drugs are known to irritate the lining of the stomach.

This report raises an obvious caution for those taking both an SSRI and aspirin or an NSAID. By contrast with those agents, 5-hydroxytryptophan, or 5-HTP - a natural supplement that is used for its antidepressant effects and that, according to one study, demonstrated equivalent efficacy compared with an SSRI - has not been found to have such a negative effect on the GI tract, although it has been reported in a few instances to cause mild upset stomach. Comparatively, the side effects of 5-HTP are quite low, almost to the point of nonexistence.

  1. de Abajo FJ, Rodríguez LAG, Montero D. Association between selective serotonin reuptake inhibitors and upper gastrointestinal bleeding: population-based case-control study. BMJ 1999; 319: 1106-9.

Cardiac mortality is believed to vary significantly with the seasons. Not surprisingly, a new study homes in on the winter months. As it turns out, January is the worst month for coronary death rates, with December only slightly behind, according to an article published in Circulation.1 Your risk of dying from heart attack is 33% higher in December and January than during the summer months.

Temperature has little to do with the death rates. Instead, behavioral changes, such as increased food and alcohol consumption and psychological stress, rank high as causes of heart attacks. Another possibility might be depression resulting from the shorter daylight hours.2 This syndrome has become known as seasonal affective disorder, or SAD, and it has been proposed that natural antidepressant supplements such as 5-HTP or phenylalanine might be of significant value (see this article in the April 1998 issue of Life Enhancement). 5-HTP is of value because it can naturally increase your supply of serotonin, thus helping to prevent depression, and phenylalanine can help keep your mood up and cheerful, thus preventing the winter blues from setting in. Now is a good time to arm yourself with a 5-HTP nutritional supplement. It might be a good idea as well, to try a phenylalanine supplement. And, of course, some supplements are good for cardiovascular function, which, as we now know, is related to depression.

  1. Kloner RA, Poole WK, Perritt RL. When throughout the year is coronary death most likely to occur?: A 12-year population-based analysis of more than 220,000 cases. Circulation 1999 Oct 12;100(15):1630-4.
  2. Zipes DP. Warning: the short days of winter may be hazardous to your health. Circulation 1999 Oct 12;100(15):1590-2.

If you have heart disease and you're depressed, you're much more likely to suffer from cerebral insufficiency, according to findings published in a recent issue of the American Journal of Psychiatry1 - and vice versa. In other words, cerebral blood-flow problems may lead to depression or cardiovascular disease, or both.

Researchers at Duke University Medical Center in Durham, North Carolina used magnetic resonance imaging (MRI) to view the brains of 19 elderly subjects, five of whom had major depression. When compared with the nondepressed subjects, these five individuals were seen to have significantly reduced cerebral blood flow. The lead author of the study, Dr. Doraiswamy, said that research in this field ". . . suggests a growing link between cardiovascular risk factors, cerebral perfusion, and depression."2 Therefore, it is reasonable to conclude that maintaining (or restoring) proper cerebral blood flow could be a significant key to preventing (or helping to abolish) depression.

Several phytonutrients are known to improve brain blood-flow characteristics, including vinpocetine3 (better glucose and oxygen delivery to the brain) and Ginkgo biloba (better blood-flow characteristics).4 Other nutrients associated with cerebral blood flow are arginine (improves vasodilation),5 citicoline (enhances blood-flow dynamics),6 and acetyl L-carnitine (helps reduce brain hypoxia by improving cellular energy production).7

  1. Doraiswamy PM, MacFall J, Krishnan KR, O'Connor C, Wan X, Benaur M, Lewandowski M, Fortner M. Magnetic resonance assessment of cerebral perfusion in depressed cardiac patients: preliminary findings. Am J Psychiatry 1999 Oct;156(10):1641-3.
  2. Cerebral hypoperfusion linked to depression in elderly patients with CAD. Reuters Online Health. October 19, 1999;
  3. Tamaki N, Matsumoto S. Agents to improve cerebrovascular circulation and cerebral metabolism - vinpocetine. Nippon Rinsho 1985 Feb;43(2):376-8.
  4. Koltringer P, Eber O, Klima G, Rothlauer W, Wakonig P, Langsteger W, Lind P. Microcirculation in parenteral Ginkgo biloba extract therapy. Wien Klin Wochenschr 1989 Mar 17;101(6):198-200.
  5. Noguchi T, Sasaki Y, Seki J, Giddings JC, Yamamoto J. Effects of voluntary exercise and L-arginine on thrombogenesis and microcirculation in stroke-prone spontaneously hypertensive rats. Clin Exp Pharmacol Physiol 1999 Apr;26(4):330-5.
  6. Cacabelos R, Caamano J, Gomez MJ, Fernandez-Novoa L, Franco-Maside A, Alvarez XA. Therapeutic effects of CDP-choline in Alzheimer's disease. Cognition, brain mapping, cerebrovascular hemodynamics, and immune factors. Ann NY Acad Sci 1996 Jan 17;777:399-403.
  7. Corbucci GG, Menichetti A, Cogliatti A, Nicoli P, Arduini A, Damonti W, Marchionni A, Calvani M. Metabolic aspects of acute cerebral hypoxia during extracorporeal circulation and their modification induced by acetyl-carnitine treatment. Int J Clin Pharmacol Res 1992;12(2):89-98.

Helicobacter pylori, with which up to 40% of the entire planet is infected, has now been shown to be strongly linked to non-ulcer-related dyspepsia, according to the results of a meta-analysis of 23 studies published in the British Medical Journal.1 What's more, the analysis shows that getting rid of H. pylori significantly increases the likelihood that you can kiss your dyspeptic symptoms goodbye . . . you are almost twice as likely to meet with success.

If it has been your misfortune to suffer from dyspepsia, you know what it's like, week after week, to bear the upper abdominal pain or discomfort, often with no end in sight. The good news, based on the meta-analysis, is that you can do something about your dyspepsia if you have the prevalent H. pylori infection. In its study, the British Medical Journal found that those who had H. pylori were 60% more apt to have non-ulcer-related dyspepsia than uninfected subjects. Moreover, when the bacterium was eradicated, dyspeptic symptoms were more likely to improve - by 90% as compared with patients in whom the infection persisted.

Nutritional supplements have been shown to be deadly to H. pylori, especially powdered mastic gum. Other active nutrients - thyme, cinnamon, and hyperforin (concentrated from a special variety of St. John's wort) - are mighty antibacterials, able to alter the ability of the enzyme urease to maintain a hospitably acidic environment for H. pylori. These phytonutrients are also able to kill bacteria such as Staphylococcus aureus, some mutant strains of which can now defeat even the antibiotic of last resort, vancomycin.

  1. Jaakkimainen EL, Linton A, Boyle E, Tudiver F. Is Helicobacter pylori associated with non-ulcer dyspepsia and will eradication improve symptoms? A meta-analysis. BMJ 1999;319:1040-4.

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