Action plan for managing schizophrenia
Improve blood sugar balance
Eat a diet that will stabilise your blood sugar (known as a Low GL diet). This means avoiding sugar and refined carbohydrates, eating at regular intervals, including protein with every meal and snack. Avoid strong stimulants such as coffee, tea and energy drinks and drink mild stimulants such as green tea only occasionally. Keep alcohol to a minimum, for example, one unit per day, three to four times per week.
Up your intake of essential omega-3 and -6 fats
This means eating fish at least twice a week, seeds on most days and supplementing omega-3 oils.
The best fish are for the brain-supportive EPA are: Mackerel (1,400mg per 100g/3oz), Herring/kipper (1,000mg), Sardines (1,000mg), fresh tuna (900mg), Anchovy (900mg), Salmon (800mg) and Trout (500mg). Tuna, being high in mercury is best eaten not more than three times a month.
The best seeds are flax seeds and pumpkin seeds. Flax seeds are so small they are best ground and sprinkled on cereal. Alternatively, use flax seed oil, for example in salad dressings. While technically providing omega-3 only about 5% of the type of omega-3 (alpha linolenic acid) in these seeds is converted in your body into EPA.
When supplementing omega-3 fish oils you are aiming for about 1,000mg of EPA a day for a mood stabilising effect. That means supplementing a concentrated Omega-3 Fish Oil capsule providing 500mg, once or twice a day and eating a serving of any of the above fish three times a week. Alternatively supplement a combination of omega-3 (EPA, DHA) and omega-6 (GLA). These essential fats can be found in combination supplements.
To ensure you are getting the proper types and amounts of antioxidants, eat lots of fresh (or frozen, but not tinned or dried) fruit and vegetables with a variety of colours, and also supplement daily with 2,000 mg of vitamin C, taken in two divided doses, plus 400iu (300mg) of vitamin E, as part of an all-round antioxidant that contains N-acetyl-cysteine and/or reduced glutathione, as well as Co-enzyme Q10.
Reduce your oxidant load by avoiding pollutants including cigarette smoke.
Consider supplementing niacin
Some people feel much better on large amounts of niacin of 1gram and above a day. Very large amounts, ten times this levels, can be liver toxic especially in the sustained release form. In any event, we recommend that anything over 1g is best taken under the supervision of a qualified practitioner. If you become nauseated, that is an indication to stop supplementation and resume three days later, with a lower amount. If you have a history of liver problems or have a high liver load due to medication, drugs or alcohol, you should have your liver enzymes monitored regularly by your doctor.
Niacin comes in different forms. Niacin (formerly known as nicotinic acid) causes a harmless blushing sensation, accompanied with an increase in skin temperature and slight itching. This effect can be quite severe, and lasts for up to 30 minutes. However, if 500mg or 1,000mg of niacin are taken twice a day at regular intervals, the blushing stops.
Some supplement companies produce a ‘no-flush’ niacin by binding niacin with inositol. This works, so it’s probably the best form, but it is more expensive. Niacin also comes in the form of niacinamide, which doesn’t cause blushing either. It has to be said, however, that both of these forms appear to be slightly less effective than niacin. This may be because the blushing effect of niacin improves blood flow, and hence nutrient supply to the brain.
Check your homocysteine level and get enough B vitamins
Your homocysteine level is an indicator of your B vitamin needs. You can test yourself using a home test kit. If your level is above 9µmol/l take a combined ‘homocysteine’ supplement of B2, B6, B12, folic acid, zinc, and TMG, providing at least 400mcg of folic acid, 250mcg of B12 and 20mg of B6. If your homocysteine score is above 15µmol/l double this amount. Also eat B vitamin rich whole foods – whole grains, beans, nuts, seeds, fruits and vegetables. Folic acid is particularly rich in green vegetables, beans, lentils, nuts and seeds, while B12 is only found in animal foods – meat, fish, eggs and dairy produce. A good starting point is also to supplement a multivitamin providing optimal levels of B vitamins, which means 25mg-50mg of B1, B2, B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine or pyridoxal-5-phosphate) and at least 100mcg of folic acid and 10mcg of B12 and biotin. Much higher levels may be beneficial but are best given with the advice and support of your doctor or nutritional therapist.
A simple urine test measures the level of kryptopyrroles in the urine, which should not be above 0.08 units. This can be arranged by a nutritional therapist. People with pyroluria need to eat a healthy diet and supplement relatively large amounts of zinc, perhaps 25mg – 50mg a day, as well as vitamin B6, perhaps 100mg daily. This is best done under the supervision of a suitably qualified nutrition practitioner. Vitamin B6 can be toxic at high doses, the key symptom of which is tingling hands or fingers. If this occurs, stop the B6 immediately and the tingling will stop within 1-3 days. Once it has stopped, you could restart the B6 at half the previous dose.
Investigate food intolerances
You may suspect some foods are contributing to your symptoms. They may be one of the usual suspects – are gluten (wheat, rye, barley), wheat, dairy (all types – cow, sheep, goat, milk, cheese, cream etc), soya, yeast and eggs. If this is the case, you could try an exclusion of the food or foods for a brief trial period. However, its worth noting that it is possible to be intolerant to any foods.
You could undertake an IgG ELISA blood test to determine whether you have raised antibody levels to specific foods in your blood which is a good indication. Either way, don’t make dramatic changes to your diet or cut out whole food groups without professional guidance to ensure your diet remains healthy and balanced.
If you would like further help, you can visit our clinic the Brain Bio Centre which specialises in optimum nutrition for mental health recovery. We have helped many people with schizophrenia, by working with them to create personalised nutritional programmes based upon their health history, symptoms and test results.
Alternatively a register of nutritional therapists in your local area can be found by visiting the British Association for Applied Nutrition and Nutritional Therapy (BANT).
If you would like some extra support through psychotherapy or counselling, the Counselling Directory provides a huge support network of counsellors, enabling visitors to find a counsellor close to them and appropriate for their needs. They have information pages, expert articles and local events information which can help with a variety of topics including schizophrenia.
Optimum Nutrition for the Mind – Patrick Holford, 2010
Optimum Nutrition for the Mind is the classic guide to improving your mood, boosting your memory, sharpening your mind and solving mental health problems through nutrition.
£2 from each book sale is donated to Food for the Brain.