Chronic infections, such as Lyme disease, can disrupt our neurochemistry, the biochemical activity occurring in our nervous system that regulates our cognition, mood, and mental health. Neurotransmitters, chemical messengers of the body that transmit signals from nerve cells to target cells, control neurochemistry. When the delicate neurochemistry of our bodies is disrupted, symptoms such as anxiety, depression, brain fog, mood swings, irritability, and reduced stress tolerance can occur. These are, unfortunately, common symptoms amongst those with Lyme disease.
Addressing the infection itself is crucial for resolving neurochemical imbalances in Lyme disease. However, our neurochemistry is also profoundly influenced by our nutritional status. Without specific micronutrients, our bodies cannot make the neurotransmitters and other signaling molecules necessary for healthy cognition and mood. Read on to learn about the ten nutrients that can balance your neurochemistry, supporting your mental and emotional wellbeing as you heal from Lyme disease.
In This Article:
Research indicates that up to 50% of the U.S. population is deficient in the mineral magnesium! In addition, a low dietary intake of magnesium, compromised intestinal magnesium absorption, and chronic stress further reduces magnesium availability in the body. (1, 2) Low magnesium is a significant problem for our brains since magnesium is involved in many neurochemical processes.
Magnesium is required for the proper function of COMT (catecholamine O-methyltransferase), an enzyme that inactivates the catecholamine neurotransmitters dopamine, norepinephrine, and epinephrine. When we don’t have enough magnesium on board, our levels of these neurotransmitters remain high, causing us to feel “wired” and anxious.
Magnesium is also a cofactor for tryptophan hydroxylase, an enzyme involved in 5-hydroxytryptophan (5-HT) synthesis. 5-HT is a precursor to the “feel-good” neurotransmitter serotonin that plays a crucial role in regulating our mood. Low magnesium levels may thus reduce serotonin synthesis, contributing to serotonin deficiency symptoms such as depression.
Magnesium indirectly reduces the release of ACTH (adrenocorticotropic hormone), the hormone made in our pituitary glands that tells our adrenal glands to secrete cortisol in response to stressors. (3) A sustained output of ACTH will raise cortisol levels, and sustained high cortisol can cause cognitive symptoms such as brain fog and is associated with low emotional states.
Several modern-day lifestyle factors further reduce our magnesium levels. For example, the consumption of caffeine and the use of certain pharmaceutical drugs, such as proton pump inhibitors (PPIs), reduce magnesium retention in the body, necessitating even greater intakes of magnesium. Therefore, reducing caffeine intake and addressing the underlying factors necessitating PPI use, such as gut imbalances and food sensitivities, is crucial for optimizing magnesium status.
To optimize your magnesium status, you should aim for an intake of 400-800 mg per day. I prefer magnesium glycinate or magnesium threonate due to their superior bioavailability. In addition, magnesium threonate has more specific impacts on the brain because it readily crosses the blood-brain barrier. If you’re dealing with gut issues, you may want to use a topical form of magnesium, such as Ancient Minerals Magnesium Chloride lotion, in addition to optimizing your dietary intake of magnesium.
The best food sources of magnesium include green leafy vegetables, nuts, seeds, fish, and avocado.
I like to routinely measure my clients’ magnesium levels before making specific recommendations for magnesium intake. Red blood cell (RBC) magnesium appears to be the most accurate way to assess magnesium status.
Vitamin B6, Folate, & Vitamin B2
Vitamins B6 (pyridoxine), folate (B7), and B2 (riboflavin) play essential roles in the synthesis of neurotransmitters that regulate cognitive function and mood.
Vitamin B6 is involved in the production of three neurotransmitters: Serotonin, epinephrine, and dopamine. Serotonin, as I mentioned earlier, is our quintessential “feel good” hormone. Dopamine is a “reward” neurotransmitter that regulates positive emotions, motivation, and cognition. Epinephrine is our “fight or flight” hormone and is necessary for the stress response. Insufficient B6 compromises the production of these hormones and may cause symptoms such as depression, anxiety, and low motivation.
Folate is also involved in the synthesis of serotonin, epinephrine, and dopamine. Variants in the gene that codes for the production of methylenetetrahydrofolate reductase (MTHFR), an enzyme involved in folate metabolism and methylation, can adversely affect brain function. (4) In fact, MTHFR variants (particularly, the C677T variant) are linked to several psychiatric issues, including anxiety, depression, ADHD, schizophrenia, and bipolar disorder. However, just because you have one or more MTHFR variants doesn’t mean you’re doomed to have poor mental health! Optimizing your dietary intake of methylfolate by eating dark leafy greens, legumes, avocado, and liver can bolster your folate status and prevent potential adverse effects of MTHFR variants. I like to screen specific clients for MTHFR genetic variants when cognitive and mental health issues are a concern.
Riboflavin is a cofactor for the MTHFR enzyme. By influencing folate metabolism, MTFHR impacts neurotransmitter synthesis. Riboflavin also supports glutathione synthesis in the brain; glutathione is the body’s premier antioxidant, helping to protect tissues against free radical damage induced by toxins, including bacterial toxins. (5)
The kynurenine pathway is a biochemical pathway in the body involved in Lyme disease that creates an inflammatory environment in the brain. This pathway is also significantly impacted by nutritional status. (6) Vitamin B6, B2, and magnesium insufficiencies dysregulate kynurenine pathway activity, causing brain inflammation and neuropsychiatric issues. Therefore, optimizing B6, B2, and magnesium status may attenuate neuroinflammation in those with Lyme disease.
Vitamin B12 plays a crucial role in synthesizing and maintaining myelin, the cholesterol-rich fatty sheath that insulates our neurons, allowing them to conduct signals properly. (7) B12 is also required for methylation, alongside folate and vitamin B2, impacting gene expression and neurotransmitter synthesis. B12 insufficiency and frank deficiency are associated with severe neurological symptoms, including compromised memory and learning abilities, depression, and peripheral neuropathy. (8, 9, 10) Lyme disease is well known to compromise cognition and trigger depression and neuropathy; we thus want to ensure we have sufficient B12 coming in through our diets to protect our neurological systems.
Vitamin B12 is found almost exclusively in animal foods, such as red meat, poultry, and seafood. Vegetarians and vegans are highly prone to B12 deficiency due to the absence of these foods from their diets. While early studies showed that vegetarians and vegans had slightly higher deficiency rates than omnivores, these studies used relatively insensitive markers, such as serum B12. Conversely, the newer, more sensitive measures of B12 status indicate that the prevalence of B12 deficiency is much higher in vegetarians and vegans than previously believed. (11, 12) If your brain is already struggling cognitively with Lyme disease, the last thing you want is to be low in B12 simultaneously.
I consider B12-rich animal foods, including red meat, poultry, and seafood, functional foods for my clients with Lyme disease, B12 deficiency or insufficiency, and cognitive issues. B12 status can be assessed via a serum B12 measurement, though this is not the most sensitive marker of B12 status. To gather more information on B12 status, I’ll often pair a serum B12 measurement with a methylmalonic acid (MMA) measurement; MMA is a marker of functional B12 status that rises when B12 levels are low.
We need to supply our bodies with plenty of niacin because our bodies will use the amino acid tryptophan to make niacin. Over time, excessive utilization of tryptophan to manufacture niacin will divert tryptophan away from serotonin production, potentially lowering serotonin levels and contributing to depression. (13)
The best food sources of niacin include organ meats, poultry, fish, shellfish, red meat, mushrooms, and leafy green vegetables.
Inositol is a member of the B vitamin family, but we don’t often hear much about it! This is unfortunate because inositol offers great brain health benefits. Through its effects on calcium signaling in the brain, inositol exerts mood-stabilizing and anti-anxiety effects. It may also sensitize serotonin receptors to serotonin, improving “feel-good” serotonin signaling. (14) Inositol is naturally found in citrus fruits, cantaloupe, and bananas; however, you would need to eat a lot of these fruits to consume a therapeutic amount of inositol. In clinical practice, I tend to recommend supplemental inositol for my clients with anxiety and problems with rumination, which is the process of continually thinking the same thoughts. I’ve found inositol to be particularly helpful for my clients with Lyme disease who deal with anxiety.
Without sufficient iron, your brain can’t work well! Heme iron is the most bioavailable form of iron and is found only in animal foods, including red meat, poultry, and shellfish. The plant-based form of iron, non-heme iron, is significantly less bioavailable, meaning it is not as well absorbed in the gut and utilized by the body. Iron deficiency is known to adversely affect mood and cognition through its effects on neurotransmitter synthesis, myelination, and synaptic plasticity, which is how the brain remodels itself in response to new inputs. (15) Low iron levels can contribute to anxiety, depression, and poor sleep quality, creating a vicious cycle of mood issues.
If you are dealing with mood and cognitive issues and have Lyme disease, it would be wise to get your iron status tested with an iron panel. If you have an iron insufficiency or deficiency, you can address it by increasing your intake of iron-rich foods, such as red meat, poultry, and shellfish.
Zinc is a mineral required for over 300 enzymatic reactions in the body, including many involved in neurochemistry and brain function. Zinc regulates neuronal growth and signaling, and a lack of zinc compromises neuronal repair and increases neuronal death. (16, 17) Zinc deficiency is associated with depression and suicidal tendencies, whereas zinc repletion improves mood, memory, and attention. (18, 19, 20) In my clinical practice, I prefer to optimize zinc levels with a “food first” approach; once we’ve optimized dietary zinc intake, I may recommend supplemental zinc as well, depending on my client’s individual needs.
Red blood cell zinc is an ideal way to assess zinc status. The enzyme ALP (alkaline phosphatase), which is measured with a comprehensive metabolic panel (CMP), tends to be low in zinc deficiency and can thus be used as a potential indirect marker of zinc status. (21)
Omega-3 Fatty Acids: EPA and DHA
Omega-3 fatty acids are essential fatty acids that our bodies cannot manufacture, meaning we must consume them in our diets. The omega-3s eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are particularly important for healthy brain function. They are abundant in the cell membranes of neurons, where they facilitate neurotransmission between brain cells. In addition, EPA and DHA regulate mood, learning and behavior, and healthy brain aging. The omega-3 fatty acid found in plants, alpha-linolenic acid, must be converted into EPA and DHA inside the body; unfortunately, this conversion is not efficient in many people, necessitating seafood consumption to sustain optimal levels of these vital fatty acids.
A large body of scientific research demonstrates the importance of seafood-based DHA and EPA for brain function. High intakes of seafood are associated with a reduced risk of depression and improved cognition with age. (22, 23) If you are working to heal from Lyme disease, it is crucial that you optimize your omega-3 status. Aim for 2-3 servings of low-mercury seafood per week. A helpful way to remember which types of fish are lowest in mercury and highest in omega-3’s is to use the “SMASH” acronym, which stands for “salmon, mackerel, anchovies, sardines, and herring.”
As you can see, we need to have our nutritional “ducks in a row” for our brains to function properly! In my experience, optimizing one’s status of these nutrients is crucial for improving cognition, mental clarity, and mood in Lyme disease.
A nutrient-dense, anti-inflammatory, whole foods-based diet is the best place to start for optimizing one’s nutritional status. However, strategic supplementation with these nutrients may also be warranted depending on one’s dietary restrictions, gut health, stress level, and genetic variants. A clinical nutritionist can help you identify nutrient deficiencies and replete your nutrient levels, supporting balanced neurochemistry and healing from Lyme disease.
Sleep, Physical Activity, and Stress Management
Last but not least, it goes without saying that sleep, physical activity, and stress management are vital “nutrients” for optimizing cognition, mental clarity, and mood. These topics each warrant articles of their own, so I won’t go into detail here. However, if your sleep, physical activity, and stress management practices are not dialed in, the nutritional interventions I’ve discussed here may fall short of conferring their full potential benefits. I always discuss lifestyle changes alongside nutrition in my one-on-one work with my clients because a healthy lifestyle is so crucial for realizing the full benefits of an optimized nutrition plan.
Do you have Lyme disease and struggle with your cognitive function and mood? Consider working with me! I am currently accepting new clients in my clinical nutrition practice. If you’re interested in diving deep into improving your nutrition and health by working one-on-one with me, reach out to me here to schedule your discovery call. The discovery call will allow us to meet and talk together to decide if my nutrition services are the right fit for your needs. I look forward to connecting with you!