Integrative Medicine

Question 1

A middle aged patient with Barrett’s esophagitis, hypertension, and mild anxiety/depression expresses a wish to stop her Prozac treatment. In addition to lifestyle interventions including diet and exercise, she takes a proton pump inhibitor and an angiotensin converting enzyme inhibitor. You decide to start her on S-adenosylmethionine (SAMe). What following nutrient is important for maximizing the efficacy of SAMe?

Answer 1

B12, particularly because the patient is currently receiving acid suppressive therapy, which inhibits the absorption of B vitamins. B12 works with SAMe to support the production of neurochemicals associated with mood regulation.

Question 2

A Cochrane review of St. John’s wort suggests that it is:

Answer 2

As effective and better tolerated than serotonin specific reuptake inhibitors (SSRI)

Question 3

Which of the following supplements could be considered as addition to conventional treatment for depression?

Answer 3

vit D and B complex
Rationale: Epidemiological evidence shows that Vitamin D deficiency is associated with an 8%–14% increase in depression and Vitamin B6 is essential in the manufacture of serotonin, and vitamin B6 levels have been found to be low in many depressed patients.

Question 4

The best way to diagnose ADHD is by:

Answer 4

Vanderbilt parent and teacher rating scales

Question 5

Which dietary supplements are most likely to be helpful for children with ADHD?

Answer 5

Omega-3 fatty acids, iron, magnesium