July 16, 2018


Perhaps the worst illness we could suffer from is depression. It is overwhelming in its devastation. The guilt, shame, and paralysis are unseen and unable to be adequately explained or understood. It has plagued us since creation. Job, in the Bible, was a well documented sufferer.


What are the causes? Difficult and frustrating circumstances are well understood causes. Other than the obvious reasons, why do we get depressed? In medicine we feel that the main problem is low neurotransmitter levels, such as serotonin, dopamine and norepinephrine. Levels of these mood-regulating neuro-hormones may drop in



some people and not in others. Why? Genetics is certainly a reason: neurotransmitter imbalance is observed to run in families. As a result of this insight into brain chemical imbalance, doctors have developed a “reflexive response” to any issue or complaint that could be depression related. The patient says “ depression” and the doctor says “Prozac” (or some other anti-depressant). Since our days in medical school and residency, where we were taught to look for depression as a background problem in many doctor-patient encounters, we would whip out our prescription pad and hope the “magic” antidepressant would be the solution. We understood some biochemistry and the “solution” was quickly provided in our 10-minute office visit.

A detailed comprehensive analysis of a patient’s problems can provide great insight. It is critical to look for the keys in depression, since treatment with pharmaceutical drugs is not always effective or may have dozens of side effects like sexual problems, headache, fatigue, insomnia, anxiety, diarrhea, weight gain, tremor, and nausea.

One of the worst side effects could be death. There was a recent study of 921 Duke University hospital patients who were undergoing cardiac angiography to determine the amount of heart blockage. Twenty percent were on antidepressants. After following the antidepressant and the non-antidepressant cardiac patients for three years, the antidepressant group had a 55 percent higher risk of dying. We don’t know why yet.

Today, holistic medical doctors rigorously search for the origins of depression in their patients. Over the course of a two-hour comprehensive life history and physical examination, every detail of a patient’s story is evaluated. Every physical, emotional and chemical stressor is noted, and when mapped out, the doctor can discern patterns and trends that often reveal underlying reasons for depression.

Integrative or holistic medical doctors utilize many available urine and blood tests. A physician may test for the following, as indicated by a patient’s history:

  • B Vitamins are required in the manufacture of brain neurotransmitters, and if levels are low despite multivitamin intake, this deficit would indicate an area of potential problems. Vitamin B6 is used to make serotonin. Another B vitamin, folic acid, is needed for catecholamine synthesis. Vitamin B12 is also crucial for nerve integrity and function.
  • The amino acids tyrosine, phenylalanine and tryptophan are key players in building enough of the “happy” brain neurotransmitters. Vitamin D is important as well. All of these can be low due to mal-absorption, something routinely seen in many patients, but malabsorption can also be tested for and measured.
  • Hypoglycemia is often hidden unless a specialized 5-hour glucose tolerance test with insulin levels is performed. Frequent hypoglycemia can cause a cyclic depression, resulting in alternating waves of depression and normal moods.
  • Systemic Candida yeast infections, often caused by antibiotic and/or steroid use or from a high sugar diet, are well known brain triggers and can be tested with an organic acid urine analysis. Brain fog and bloating often accompany the mood problem.
  • Adrenal Fatigue from chronic stress leaves people depressed, often with dizziness upon standing, a craving for salt, and fatigue from the minute they wake up. Sleep is never refreshing and they struggle through the day, “crash” about 2-3:30 PM and revive for an hour in the evening. A hormone saliva or urine test is best to detect this.
  • Estrogen, Progesterone, Testosterone and DHEA are critical hormones for mood stability and low levels or imbalances are frequently responsible for numerous problems including depression and anxiety. These hormones are best evaluated with saliva or hormone testing. Dr. John Lee, M.D. treated thousands of women successfully with bio-identical progesterone.
  • Low thyroid imbalance is often undetected. Many patients have depression and a multitude of low thyroid symptoms like fatigue, hair loss or coarse lifeless hair, low body temperature, constipation, insomnia and dry skin. A doctor may do a “standard” thyroid test and say it’s not an issue, but a special blood panel would reveal the imbalance.
  • Since the 1970’s environmental physicians have known that “hidden” food, chemical and inhalant allergies can alter the brain chemistry. They have developed a unique, highly sophisticated and precise method of detecting and neutralizing these allergies with a combination of IgG/IgE Elisa blood testing along with intra dermal provocative neutralization testing.
  • New in the field of acupuncture is Electronic Meridian Analysis. The doctor uses a special computerized probe to measure the 12 acupuncture meridians on each half of the body. The computer evaluates the information and even prints out a specific formula of acupuncture points to treat in order to correct imbalances, some of which may be a cause for mood disorders.

In summary, if your depression has continued despite the usual medications, consider getting an integrative-holistic medical work-up. After studying a detailed medical history, the physician may recommend testing for some of the following:

  • Amino acids
  • Fatty acids
  • Vitamin/ Mineral levels
  • Hidden thyroid imbalance
  • Hormone tests
  • Allergy testing
  • Candida tests
  • Hypoglycemia testing
  • Acupuncture testing

Note: A two hour comprehensive history, physical examination, and laboratory or allergy testing are all part of our approach at the Center for Occupational and Environmental Medicine in North Charleston, South Carolina. For more information, call (843) 572-1600.