The Nutritional Supplement

Presentation: Female, aged 60, born and brought up in Switzerland and moved to UK aged 19.

Goals: To lose weight and improve highly disrupted sleep patterns.

Health Summary:

• Family history of depression (father)
• Reliant on anti-histamines and bread to achieve sleep (sleeps at 11pm, wakes at 4am and eats toast in order to sleep again)
• “Needs” to eat bread and butter before bed each night or cannot sleep
• Slight arthritis
• Recurrent tonsillitis as a child (antibiotic treatment) until removal aged 13
• Client developed PND after birth of first child aged 39 which has not resolved (currently on low dose 20 mg daily Citalopram)
• Chronic stress throughout life culminating in highly stressful period throughout 30’s which resulted in onset of sleep disruption and Citalopram prescription
• Energy best late morning and early evening
• Periodic (~every 2 weeks) diarrhoea lasting for 1 day, client thinks stress triggers this
• Craves bread and chocolate

Typical Food Intake (before protocol):

3-4am: Rye toast w/ butter & marmite, tea w/ full fat milk

9am: Cup tea

11am: Greek yogurt, almonds, chopped apple/rye toast cheddar cheese/salad with feta + slice bread

4-5pm: Toast/almonds/dark chocolate (2-3 squares)

8/8.30pm: Beef stew w/ potatoes, veg/pasta w/ seafood pesto salad/roast dinner

After Dinner Snack: Piece bread & butter before sleep

Drinks: 4-5 cups tea (mornings only, redbush in pm), water, 2 glasses wine max

Considerations:

• Likely difficulty in producing and absorbing adequate serotonin, indicated by need to consume carbohydrates (which aid amino acids cross the blood brain barrier for 5HTP and serotonin production
• 5-HTP supplementation not possible due to Citalopram medication
• Adrenal imbalance (cortisol may dysregulate levels of dopamine and serotonin)
• Gut-brain disruption (frequent diarrhoea)

Protocol:

• Focus on supporting neurological pathways, digestive processes and adrenal glands
• Supplementation of zinc ascorbate (Zn 15 ml, vitamin C 200 mg), probiotics (Lactobacillus acidophilus NCFM 30 billion, Bifidobacterium lactis Bi-07 30 billion), broad spectrum digestive enzymes, MegaMag Calmeze, fish oils (1050mg EPA, 750 mg DHA), curcumin (3-5g) and Epsom salt baths

Typical food intake (after protocol):

Morning: Black tea with milk, granola w/ coconut yogurt berries protein powder/eggs avocado fruit.

Snack: Banana & almonds/oatcakes & hummus/cheese & tomatoes or fruit/banana bread/sweet potato bread.

Lunch: Homemade soup & salad olives mozzarella/salad & cheese/feta/omelette & salad/lentil salad with feta

Snack: As above/yogurt & nuts/pineapple/sauerkraut

Dinner: Homemade stock then chicken in tomato sauce sweet potato & greens/roast lots of veg sweet potato/seafood pasta (pea/lentil pasta) & salad.

Occasional glass red wine.

Changes to symptoms (after 6 weeks):

• No longer craving chocolate
• No longer needs bread before bed
• Clothes feel looser
• Occasional waking but only when acute stressful event (i.e. moving house)
• Energy stable and constant throughout day
• Diarrhoea resolved – however stools are generally slightly loose after breakfast (advised to swap cow’s milk for alternative in tea)

Changes to symptoms (after 11 weeks):

• Clothes continue to be looser
• Rarely snacks now
• Includes some starchy carbs with dinner but no other intake throughout day
• Still no need for bread before bed
• Very rarely wakes during night now
• Stable energy
• Loose stools & diarrhoea resolved

Changes to symptoms (after 16 weeks):

• Reducing antihistamines for sleep now
• Sleeping well, very rarely wakes even with antihistamine reduction
• Energy good throughout day
• Stools normal

Summary:

This client’s main focus and issues were her need to eat bread before bed which bothered her hugely and her reliance on antihistamines for adequate sleep. She was thrilled that the need to eat bread resolved completely almost immediately and that she could successfully reduce her antihistamine intake whilst maintaining a healthy sleep pattern. The client saw some setbacks in her sleep pattern after a visit to Switzerland, which we deduced might be a stress response to the travelling. This resolved soon after returning and continuing with the original supplementation.

The latest update was 9 months after the original consultation and the client reported that their sleep was still good, unless there was some acute stress (i.e. building work), which she managed with lifestyle techniques such as evening walks, breathing techniques.