Alcoholism, Part 2 -- Fixing the Brain ? 1
By David Gersten, M.D.
Alcoholism is an illness of metabolism, or biochemistry, and it is vastly complicated. While there are enormous psychological issues related to alcoholism, these are primarily caused by alcoholism. They are not the cause of alcoholism. I am assuming that you are alcoholic or someone close to you is. This statement is true for 50 percent of you. All the depression, anxiety, shame, guilt, low self-esteem, panic, and fear are caused by disorders of brain chemistry, or neurotransmitter disorders. Alcoholics did not become heavy drinkers ?because? they were depressed. They are depressed ?because? they have the illness of alcoholism. This point is critical to understand so that: 1) you don't blame your illness on your psychological weaknesses or poor will power, and 2) you realize that by healing brain chemistry and much more, you can be cured of most of your mental/emotional problems?or all of them. I do not mean to imply that stress and unresolved conflict have nothing to do with alcoholism. Emotional imbalance can be a contributing cause of any and all illness, but is not specific to alcoholism.
No one likes to throw around the word ?cure? when talking about alcoholism, but that is because few people have dealt with the illness itself, examined the metabolic roots, and treated the root causes. For those of you in doubt, after reading this article, read Seven Weeks to Sobriety: the Proven Program to Fight Alcoholism Through Nutrition,
by Dr. Joan Larson. This is a well-researched book, which has grown out of a very successful treatment model.
Here are the key problems we have to treat:
1. Brain Neurotransmitters
2. Essential Fatty Acid Chemistry
3. Hypoglycemia
4. Candida Overgrowth
5. Adrenal Exhaustion
6. Gastro-Intestinal Dysfunction
7. Nutrient Depletion
8. Allergy and Immune System
9. Oxidative Stress and Detoxification
We need to fix neurotransmitters first. Problems with brain chemistry are why you drink, why you have problems with mood, sleep, cognitive functioning, and why you became addicted to alcohol. All the other key problems (2 ? 9) contribute to bad brain chemistry. Due to the complexity of the metabolic chaos in alcoholism, it is important that we start by helping you deal with the single most important problem, which is healing the central nervous system. In the next article, you will read about how to balance and cure all of the other 9 nutritional and metabolic causes of alcoholism.
Before diving into your brain, a quick look at non-brain issues is in order. Nutrient depletion is an important cause of poor brain function. It is essential that an alcoholic begins to ingest minimal amounts of essential nutrients as well as curative amounts of nutrients to heal serious problems. The alcoholic gets half of his calories from sugar and alcohol, both of which have zero nutritional value. Not only is his nutrition poor, alcohol destroys many key vitamins and minerals.
Most alcoholics suffer from hypoglycemia, which produces quite an emotional roller coaster ride. Hypoglycemia and a host of other factors, lead to adrenal exhaustion, which makes it impossible to deal with mental or physical stress?and which makes hypoglycemia worse. Hypoglycemia deprives the brain of its only nutrient, namely glucose, or blood sugar.
Candida, a systemic yeast infection that is quite common in alcoholics, causes problems from head to toe, creating symptoms that include: exhaustion and fatigue, brain fog, depression, poor concentration, poor memory, hypoglycemia, adrenal exhaustion, intestinal gas and bloating, and muscle weakness.
Each of the core causes of alcoholism interacts with each other. For the purposes of understanding the illness and how to treat it, we need to compartmentalize. At the same time, understand that so many of these causes interact with each other to form one whole metabolic mess. Ultimately, all the primary causes end up creating deficiencies in all important neurotransmitters. The brain is the target organ of alcohol.
If you are an alcoholic who is just starting to get sober, or you have just gotten sober, you are facing these kinds of thoughts, ?Fourteen years of my life are gone. I have screwed up everything. What am I going to do? I am about to return to the real world, return to work, and I am scared to death? Who will help me? Maybe I should kill myself?? This last item, suicidal thoughts, is very important. They are common in alcoholism, as are suicide attempts. You are looking at the stage of Fear and I won't try to talk you out of your fears. It is scary facing the real world after years during which you were lost in a bottle. What you need to know is that you were or are alcoholic because of complicated metabolic problems. Once you understand these problems, and the best way to do so is to seek professional help and have appropriate nutritional testing, you will see the light at the end of the tunnel. Unless drinking has caused severe liver damage, we can repair your chemistry. What that means is,'?We can cure the biochemistry that made you crave alcohol, which made you tolerant and addicted.? So, please keep this in mind as you face the reality of recovery. Without treating the underlying metabolic problems, the alcoholic will have the same metabolic problems in five years. He will still crave sugar. He will still lack normal neurotransmitters. Curing alcoholism is not simply an issue of discontinuing the use of alcohol. It is much more.
Brain Neurotransmitters
The alcoholic's brain suffers due to the actions of three toxins: alcohol, acetaldehyde (a primary breakdown product of alcohol), and tetrahydroisoquinolines (THIQs). Acetaldehyde combines with neurotransmitters to make THIQs, which are addictive, morphine-like compounds. These three toxins affect every important neurotransmitter, and do so in a variety of ways. The main way they cause problems is by acting as pseudo-neurotransmitters and by binding to neurotransmitter receptor sites. As we will shortly see, it appears that the most important neurotransmitter system involved in alcoholism is GABA (gamma-amino butyric acid).
These toxins also wreak havoc with serotonin, norepinephrine, and endorphins, causing depletion in these critical neurotransmitters. Alcohol and its two evil twin toxins fool your brain into thinking it is getting the right nutrients to make neurotransmitters. So, alcohol will temporarily increase endorphins, norepinephrine, serotonin, and GABA. When the alcoholic stops drinking, the action of these neurotransmitters disappears. He goes into withdrawal and begins to drink again, because his brain is crying out for a substitute for these neurotransmitters. Of course, neurotransmitters are only manufactured by a diet rich in the precursors to neurotransmitters. The alcoholic diet is largely devoid of nutrition. It is really enough for you to know just this much, but I will provide a bit more detail.
As the endorphins and serotonin dissipate, and the symptoms of the upregulated brain receptors surpass the person's ability to tolerate them, the upregulated system will again seek their complimenting neurotransmitters, causing the person to seek out and indulge in drinking.
THIQs mimic good neurotransmitters (endorphins and serotonin), responsible for the natural sense of peace, joy and happiness, which most of us are capable of, by binding to their respective receptor sites. The brain is'?upregulated? and the pseudo-neurotransmitters create a euphoric experience. This is the genesis of dependency, as the person begins to need the external substance to feel okay.
Scientists at The Scripps Research Institute have described the mechanisms underlying the brain's response to alcohol and published their findings in the journal Science. Alcohol produces many of its intoxicating actions through facilitation of GABA receptor site activity. Preclinical studies of alcohol dependence have shown that GABA activity decreases during alcohol withdrawal and protracted abstinence. GABA changes are probably a major cause of relapse.
GABA is the major inhibitory neurotransmitter in the brain, and GABA-like drugs are used to suppress spasms. Alcohol is believed to mimic GABA's effect in the brain, binding to GABA receptors and inhibiting neuronal signaling. Drugs like Xanax, Valium, and Ativan work at the GABA receptor site. That should give many of you an idea what GABA feels like.
So, the alcoholic has greatly diminished amounts of GABA in his brain. Alcohol and THIQs make him feel as if he has enough GABA, but he does not, so when he stops drinking, he goes into severe withdrawal?mainly GABA withdrawal.
GABA is one of the most difficult neurotransmitters to restore, but here are the nutrients you can use to help restore GABA. Amino acids will be the key to restoring GABA.
With any amino acids, make sure you purchase nutraceutical grade, which you cannot find in healthfood stores. For some people, GABA, from 1 gram to 3 grams a day will bring peace and serenity and will dramatically alleviate anxiety. The problem is that GABA is erratic in terms of its ability to cross the blood-brain barrier and get into your central nervous system. For some people there is no problem and for others, there is problem. Two words of caution. 1) With GABA, more is not better. Don't play with this. At doses greater than 7 grams per day, GABA does the opposite of what you want, producing severe anxiety and panic. 2) Metabolism of all amino acids requires a healthy liver. If you have seriously compromised liver function due to alcohol toxicity, you should not use amino acids, or should do so only while being closely monitored by a doctor with expertise in this area.
It is very interesting to note that every cell in your body, not just in your brain, is loaded with GABA-receptor sites. This is according to a personal conversation I had with Dr. Candace Pert, who discovered the endorphin receptor site. What is odd about her finding is that there is generally very little GABA in the blood. So, why is the body loaded with GABA receptors? I suspect that spiritual adepts, yogis, rishis, and the like have attained states of consciousness associated with very high brain levels of GABA, levels so high that it spills over into the blood, essentially leaving each cell in a state of ?cellular bliss? and perfect cellular health. For the non-rishis among us, my theory is that, when we ingest GABA, even if it does not all get into the brain, it is binding to GABA receptor sites all over the body, which would produce a calming effect on every cell.
Now, back to getting more GABA into your brain. The amino acid L-glutamine easily enters the brain, where it is converted into GABA and L-glutamic acid (an excitatory neurotransmitter). Glutamic acid converts into glutamate and GABA. You DO NOT want excessive amounts of glutamate in your brain. It can be highly toxic. However, as a backup plan to ingesting L-glutamine, you can take L-glutamic acid, but you must take a healthy amount of a B-Complex as well as P-5-P, which is the active form of Vitamin B-6. If you are affected by alcoholism, imprint the letters G-A-B-A into your brain and do your own Internet research. Keep your eyes and ears open over the coming years to see what is happening regarding GABA, because it may be the single most important key to understanding alcohol addiction.
What else can you do to increase your GABA levels? Practice some form of meditation on a regular basis. By so doing, you will assist your brain in making GABA, but don't forget to feed your brain what it requires to make GABA.
Starting to Eat Right
While you will understand the Alcohol Recovery Diet much better after reading part III and IV in this series, let's get you started today with a diet that will help heal your brain, your blood sugar, your candida, and more.
1. Eliminate simple sugar.
2. Increase complex carbohydrates.
3.Consume adequate amounts of healthy, unprocessed protein.
4.Increase essential fatty acids in your diet. There are a number of good products on the market, but I like UDO's blend of essential fatty acids that you can get at any local health store. Udo Erasmus is the nation's authority on fatty acids, so I trust his blend. Take 1 tablespoon twice a day. Put it on your salads or steamed vegetables if you like.
5. Decrease saturated fats and fried foods.
6. Increase your intake of water. It will help begin the detoxification process. If you are not a water drinker, try VitaminWater, which comes in multiple flavors. Your local health food store carries it. It tastes great and is not sweet or syrupy. In other words, it will not worsen your hypoglycemia. I love it, and have no ties to any products I have listed here.
7. Avoid wheat and dairy. There is an allergic component to alcoholism, which relates to these two food groups.
8. Avoid caffeine. This may be a tall order. Start where you can start.
Here is a short list of nutritional supplements you can start using that addresses neurotransmitter activity, as well as some biochemistry related to total body health, and that will begin your journey to a cure. Start these supplements this month. In the next article, the supplementation recommendations will address many more issues. These will get you started.
Nutritional Supplementation
1. B Complex.
2. GABA 1,000 mg 2 to 3 times a day.
3. Multivitamin.
4. Multimineral.
5. L-Glutamine 1,000 mg 3 times a day.
6. Pyridoxal-5-Phosphate (active form of Vitamin B-6) 40 mg twice a day.
7. L-Tyrosine 500 mg 3 times a day to increase norepinephrine brain levels. (Make sure you have had blood tests for thyroid function before starting).
8. 5-HTP (5-hydroxy-tryptophan). 50 mg 3 times a day. You still need a prescription for L-tryptophan, but 5-HTP will help increase serotonin levels and is non-prescription.
9. Blend of Essential Fatty Acids. Try UDO's Perfect Blend. Take 1 tablespoon twice a day. Drink it out of the spoon or put it on your veggies.
10. GLA (gamma-linolenic acid) 250 mg 3 times a day.
11. VitaminWater?or just lots of water.
By understanding the principles I've outlined and beginning to follow some of the suggestions for restoring normal neurotransmitter function, you WILL begin to feel better. You will begin to restore, not only GABA, but also norepinephrine and serotonin, two vital neurotransmitters. You will need to understand the totality of alcoholism's metabolic chaos to see the complete picture. For now, remember that alcohol is mainly a disease of brain chemistry. In this article, we have focused on one important neurotransmitter, GABA. In the next issue, we will take an in-depth look at serotonin and norepinephrine.
You can now stop blaming yourself, your parents, or anyone else. Understand that alcohol, acetaldehyde and THIQs destroy neurotransmitters, trick neurotransmitter sites, and create a huge craving for alcohol because alcohol mimics the neurotransmitters that it destroys and displaces from receptor sites. When you begin to rebuild and restore neurotransmitters in a healthy way, much will change in your life for the better.
David Gersten, M.D. practices nutritional medicine and psychiatry out of his Encinitas office and can be reached at 760-633-3063. Please feel free to access 1,000 on-line pages about holistic health, amino acids, and nutritional therapy at