The campaign against saturated fats by the American Heart Association has been a tremendous error. The American Heart Association recommends that intake of saturated fats be severely limited. However, with biotin deficiencies and and underactivity of acetyl-CoA carboxylase fatty acids are not synthesized and saturated fatty acids are the first ‘non-essential’ fatty acids to be synthesized. Where there are long term biotin deficiencies, which I think are very prevalent, saturated fats become essential fatty acids. Profound depressions can result from lack of saturated fats in diets.
The supplemented fats must be animal fats. Butter and ghee are the most readily available animal fats. Butter must be eaten 3-4 times a day. Butter works quickly for depression. Purchased beef tallow is apparently not beef tallow. Purchased beef tallow melts at room temperature which beef tallow should not do.
I am leaving the question open as to whether saturated fats are bad for the heart, there is evidence that they are not, but many individuals will face the choice of absolutely crippling depressions and heart disease or more butter in the diet and perhaps statins.
Thyroid hormones have been extensively investigated in major depression but abnormalities in thyroid hormones have not been found. Still in terms of treating depression thyroid hormones have had attractions. Meta-analyses indicate that augmentation of anti-depressants with triiodothyronine (T3) or thyroxine (T4) and can be helpful in the treatment of refractory depression.
There are definite difficulties with thyroid function in major depression but the problem is too little iodine. With dysregulation of the sodium-dependent multivitamin transporter (SMVT) iodine transport is impaired. The SMVT transports iodine. The role of the SMVT in the transport of iodine has not been emphasized to the same extent as the role of the SMVT in the transport of biotin and pantothenic acid. As it turns out the SMVT plays a key role in iodide homeostasis which if upset can result in major depression despite normal levels of thyroid hormones.
As an augmentation strategy to anti-depressants iodine would be taken three times a day. The Tolerable Upper level Limit for iodine for adults is 1100 micrograms per day. Tests on thyroid function would have to be obtained. Abnormal levels of thyroid hormones as shown by tests on thyroid function must be avoided.
If iodine can augment anti-depressants in the treatment of major depression this would point to the SMVT as playing a key role in psychiatric illnesses.
The sodium-dependent multivitamin transporter (SMVT) also transports iodide. How important the SMVT is for iodide transport is not clear. Supplementing with biotin and pantothenic acid, however, could competitively block the transport of iodide by the SMVT. There is another transporter of of iodide, the sodium/iodide cotransporter, (SLC5A5) which is largely expressed in the thyroid. The SMVT is expressed in the digestive tract.
From Interaction of α-Lipoic Acid with the Human Na+/Multivitamin Transporter (hSMVT)
‘Furthermore, the equimolar replacement of NaCl with LiCl or lowering the pH of the uptake assay from pH 7.4 to pH 5.5 (generation of a proton gradient across the oocyte membrane) resulted in R-[3H]LA accumulation in hSMVT-expressing oocytes that was indistinguishable from that observed in control oocytes (Fig. 2E)’ Control oocytes lack the hSMVT. The SMVT is the sodium-dependent multivitamin transporter and LiCl is lithium chloride. The SMVT transports biotin, pantothenic acid and lipoate.
The hSMVT is pH sensitive. Sodium bicarbonate buffers pH. If dysregulation of the SMVT in a key to to bipolar disorder as is argued in the page on bipolar disorder then sodium bicarbonate could be a key to the treatment of bipolar disorder. Sodium bicarbonate would also supply sodium which is required for transport by the SMVT.
The sodium of sodium bicarbonate could raise blood pressure. Each dosage of sodium bicarbonate would have to be taken with a 24 ounce glass of water to prevent dehydration which could raise blood pressure.
Blood pressure would have to be monitored. Individuals with high blood pressure may simply not be able to take sodium bicarbonate.
Sodium bicarbonate would be taken with biotin and pantothenic acid where biotin and pantothenic acid would be taken away from each other. Lipoic acid would not be taken as lipoic acid could competitively block the transport of pantothenic acid and biotin by the SMVT. Lipoic acid is synthesized on residues so there is no need to take lipoic acid.
Acetyl-CoA carboxylase is a biotin-dependent enzyme that is involved in the synthesis of non-essential fatty acids. Supplementation with beef tallow or ghee could be helpful. Taurine would be supplemented to assist with digestion of fatty acids.
If sodium bicarbonate, biotin, pantothenic acid, beef tallow or ghee and taurine are effective in the treatment of bipolar disorder then sodium bicarbonate, biotin, pantothenic beef tallow or ghee and taurine acid would be infinitely preferable for the treatment of bipolar disorder than lithium and/or anti-convulsants.
Supplements on the ‘supplements to be avoided’ list on the Treatment page would also be avoided. See the page on bipolar disorder for more on the SMVT
A ketogenic diet is not advisable as a ketogenic diet would increase beta-oxidation. Low carbohydrate diets could result in weight loss but the side-effects are too great. No one would have weight problems if ketogenic diets improved health. Individuals could live with the bland ketogenic diets. Ketogenic diets, unless used to treat epilepsy, are ill advised. There still could be benefits from avoiding high glycemic foods, especially as long as ketosis is avoided.
Increased beta-oxidation sounds terrific. Rev up metabolism, increase energy, burn fats, loose weight, work hard, play hard, live life to the fullest. However increased beta-oxidation where there is already excessive beta oxidation due to decreases is biotin transport can lead to serious difficulties. See the page on bipolar disorder as to why there could be difficulties in biotin transport.
A warning sign that one should definitely avoid a ketogenic diet is if one is addicted to coffee, tea and/or sodas. Another warning sign that a ketogenic diet should be avoided is if one has any chronic illness.
In medicine ideas that should work but do not work are terrible ideas to put into practice. Ketogenic diets do not work in terms of overall health. Antioxidant supplements still make a lot of scientific sense outside the clinic but do not work and antioxidant supplements that deliver free antioxidants should be avoided. In medicine, a truth which is almost invariably correct, is that when the correct answer is not known then the provided ‘answers’ are usually very far from the truth and can be very dangerous. The best briefs in medicine are always fails in clinics.
Acetyl-CoA carboxylase is a biotin-dependent enzyme that catalyzes the irreversible carboxylation of acetyl-CoA to produce malonyl-CoA. Malonyl-CoA inhibits the rate-limiting step in beta-oxidation of fatty acids. Malonyl-CoA inhibits fatty acids from associating with carnitine by regulating the enzyme carnitine acyltransferase.
Malonyl-CoA also plays a key role in chain elongation in fatty acid biosynthesis
Biotin supplementation would then both inhibit beta-oxidation and assist with chain elongation in fatty acid biosynthesis.
I have been arguing that increases is beta-oxidation that result from increased intakes of polyphenols can lead to difficulties in schizophrenia. Given the dual functions of malonyl-CoA in inhibiting beta-oxidation and assisting with fatty acid elongation if there is excessive beta-oxidation there would have to be difficulties in fatty acid elongation. Supplemental biotin would decrease beta-oxidation and increase fatty acid elongation which would be headed in the right direction. Biotin would not be supplemented at the same time as pantothenic acid as pantothenic acid is a competitive inhibitor of biotin transport.
Biotin is apparently necessary for the treatment of the negative symptoms of schizophrenia. Biotin, however, taken alone is not effective as with biotin there are still difficulties with fatty acid absorption. Negative symptoms of schizophrenia are due to dysregulation of fatty acid metabolism which is dysregulated in multiple ways in schizophrenia.