Relief from OCD with personalised nutrition

OCD is an exhausting and debilitating condition both for the person involved and their loved ones. Living with OCD has been described as if these obsessive thoughts and uncontrollable compulsions have hijacked the mind.

Obsessive-compulsive disorder is a mental health condition where a person has unwanted thoughts, fears, or obsessions which can highly affect their day-to-day life and wellbeing. It can be like having a song stuck in your head that never goes away. Instead, intrusive thoughts can include things like fear of food and clothes being contaminated with life-threatening bacteria; that they will die if they don’t carry out daily tasks in a specific order; or they have the need to repeat every action a certain number of times.

Many people have the perception that nutritional therapy and naturopathy has very little influence when it comes to mental health support. However, this could not be further from the truth and the key skill of a nutritional practitioner is to listen to the person’s unique story, run the appropriate laboratory tests to identify any underlying triggers and then work out a health plan of diet changes and supplements that is actionable and not too overwhelming. This all complements the great work that psychiatrists put in.

We have found that genetic testing plays an important role in finding some of the answers, and I have here the heart-warming story of how personalised testing and nutrition made an enormous difference to understanding how someone’s brain is wired, to provide specific individual nutrition which can help.

James’ relief from debilitating OCD, as told by his mother

(all names have been changed for privacy)

‘At the age of 12, James developed severe OCD during his first year at secondary school. He described it as having a frightening bully constantly in his head telling him exactly what to do and what to think and what to say.

Immediately we sought help for him starting with the GP; but James became rapidly worse and with CAMHS unable to help quickly enough, the only route was in private health care.

The child psychiatrist diagnosed James with ADHD and ASD – the OCD a comorbidity to both these diagnoses.

Medication (Sertraline) began and slowly was increased over time. Weekly talking therapy began. James simply got worse. The OCD consumed him and his life, he stopped going to school. He stopped his education. He stopped all his interests. He became entirely isolated in his bedroom.

At 16, the OCD changed to include contamination rituals – a result of the pandemic. This was a new war entirely. James became convinced that he and his environment was contaminated. He would spend hours and hours cleaning himself every single day – his life was nothing other than a cycle of washing himself, to a point of exhaustion. Showers would last for seven hours he would use 7 or 8 bottles of shower gel and not feel clean. He was under hot water for all of that time and unable to get out of the shower. A bath would be for the same amount of time and the water would go cold – but he would be stuck and unable to get out. OCD would prevent him from eating or drinking anything as he was not clean. 24 hours could pass without eating or drinking. James would also be unable to sleep if he felt unclean and he would stay awake for 36 or 48 hours at a time unable to eat, unable to drink, unable to sleep – but also fearing the fact he had to get into the shower or bath in order to make himself clean so that he could eat drink or sleep.

As a family we could barely function. I became his full-time carer day and night. It was absolutely exhausting, and we were utterly desperate. When I wasn’t caring for James or the rest of my family, I was researching online trying to understand why my son was so ill and why medication was not having any effect on him – what possibly could the root cause be? I learned a tremendous amount about how a poor diet, a lack of essential nutrients, an imbalance or depletion of vital vitamins and minerals could have a very big effect on physical and mental health. James had always been a very picky eater and more so recently due to his OCD restricting food intake.

Amongst many possibilities I came across PANS/PANDAS and looked into this as a possible reason, including getting tests done to look at James’s immune system… but nothing showed up.

I was encouraged by an online group of parents linked to PANS/PANDAS to make an appointment with a child and adolescent psychiatrist, based in London. James’s OCD was so severe and debilitating that, at this time, he was unable to wear any clothes. They were all dirty in his mind, despite having been washed at his request, so the first consultation was over Zoom without James appearing. The psychiatrist was incredibly kind and empathetic. He was evidently very experienced and knowledgeable in this area. He suggested a pharmacogenetic test, which revealed that James metabolises medication very fast.

This represented an important discovery as to why, to date, no medication had helped with James’s OCD. The psychiatrist began him on the same medication as before but quite quickly increased it to a higher unlicensed level, so that it might have some effect on James. Sometime later, he brought in another medication, Lamotrigine, which is used now to work in combination with the treatment of OCD. Again, we built up slowly. Over a period of months James started to report very small but significant changes within himself – albeit not evident to us. This was extremely encouraging, and we knew, at last, we were on the right track in treating the symptoms of OCD.

But also, Lucinda has been a huge part of James’s path to regaining a better quality of life. She started working with James about a year after the psychiatrist’s treatment began, aged 18. With her expertise in Functional Medicine and Nutrition, she thoroughly explored James’s illness history, and all previous tests and data collected, with nothing being an obvious cause for his debilitating symptoms. But a clue was how James found alcohol consumption temporarily removed the debilitating OCD and calmed ADHD symptoms. She homed in to investigate the area of neurotransmitters, in the hope it would bring answers – it did! Through the correct test an incredible discovery was made regarding James’s genetics.

Lucinda set about working out a plan to support this genotype through key supplements which were to be introduced very, very gradually over time. Most astonishing was James’s reaction to the first of her recommended antioxidant supplements which I had given to James unannounced, in the hope of preventing any kind of a placebo effect. After 2 days, James excitedly reported “my brain is working better, something has changed!” It was literally like a switch – and the first very significant change in years! Lucinda and I worked slowly in building up tailored supplements and to focus on protein-rich foods at every meal, reducing James’s desire to reach for quick-fix sugary snacks and drinks. It’s taken time but James absolutely sees the effect of what he puts into his body! He chooses water over any sugary drink now, explaining that he doesn’t want to feel tired, as then his brain doesn’t work! He rarely chooses to eat sweets. But most noticeable is that he now eats a wider range of foods including salad leaves!! He directly associates what he eats with how his brain functions.

As a result, James is continuing to make excellent progress – he has made a huge recovery significantly in the past year! Most notably he is able to access life for the first time since aged 12. He made an independent trip to the USA in July, to stay with family – something that was unimaginable just 6 months earlier! James is looking forward to making plans and living his life – at last!”

What did James’s genetic test reveal? As told by Lucinda

What was this connection with James drinking alcohol and feeling calmer? In his genetic testing, James was found to have decreased GABRA2 receptor activity, which means that he has a reduced sensitivity to the neurotransmitter GABA. GABA is a brain chemical that helps us to feel calm and relaxed and enables us to wind down and get to sleep. Without enough GABA we can feel anxious and find it difficult to concentrate and remember things, it can disrupt sleep and leave us irritable, unrelaxed and restless. Think of a GABA receptor as socket in a cell for the GABA to plug into, connect and work its calming magic.

This means that to benefit from GABA in his system James needs to consume extra GABA-rich drinks such as chamomile and green tea. And also increase his intake of GABA-rich foods including fermented and cultured foods like yoghurt, kefir, sauerkraut and kimchi; as well as wholegrains, cruciferous vegetables, berries, pulses, nuts and seeds. It is also beneficial to adopt GABA-inducing lifestyle choices such as breathwork, yoga, meditation and mindfulness as well as vigorous exercise.

GABA should sit in balance with glutamate, the brain chemical which excites the brain. However too much glutamate has been linked to repetitive behaviours, obsessions and compulsions as well as high anxiety and meltdowns that can continue for hours on end. When there is an imbalance of glutamate and GABA it is easier for the brain to get stuck in continuous circle of thoughts that whir away in the head and don’t go away. These persistent thought loops can make the person feel trapped and exhausted.

Ultra-processed foods are often high in free glutamate (look for ingredients such as monosodium glutamate, yeast extract and “natural flavourings”, which are highly concentrated forms of glutamic acid) and eating too many of these foods may well affect this fine balance between GABA and glutamate. Some kids and teens are highly sensitive to even tiny amount of free glutamate, and these children have to follow a diet entirely cooked from scratch to function.

This GABRA2 genotype has been associated with increased risk of alcohol dependence as alcohol activates GABA receptors, promoting relaxation and reducing anxiety. It is also associated with other substance addiction such as narcotics. The GABA effect of alcohol is that calm and content feeling when you first take a sip of wine. However as we all know, this cosy mellow GABA feeling only lasts for a few hours, and then you can start to feel more anxious, nauseous and tired.

Luckily the herb valerian as well as rosemarinic acid found in rosemary, lemon balm, sage, thyme, oregano and peppermint can help to increase this GABRA2 receptor activity and mimic the effect of drinking alcohol in a more consistent and sustained way, without the side effects or dependence. So, this is where we started with James, by introducing these herbs both in his diet and as a food supplement.

James also has other SNP deletions in his genomic profile which means that keeping the seesaw of GABA and Glutamate in balance is always going to be a challenge for him and nutrients such as zinc, magnesium and vitamin B6 should help over time to keep the equilibrium better.

James is doing really well now, and I have been so thrilled to be a small part of his OCD journey. I am so excited about James’s future, and I hope he can do more travel and then he might feel confident restart studying and get some qualifications under his belt so he can find his purpose in life which brings him joy.

Round up

If you or your child live with debilitating OCD, it can be tough, but there often diet changes and natural interventions that can help you manage things better. For practical dietary ideas and recipes to weave more GABA rich foods and herbs into your daily life and other nutrition tips for OCD then look at my book Brain Brilliance. And if you are keen to explore genetic testing for you or your child who is struggling with mental health challenges, then the NatureDoc clinical team are there for you to run some laboratory tests and genomic profiling and find personalised nutrition support.

Lucinda Recommends

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Relief from OCD with personalised nutrition

James’ relief from debilitating OCD, as told by his mother

What did James’s genetic test reveal? As told by Lucinda

Round up

Lucinda Recommends

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