Depression is an inflammatory disease; where does inflammation come from? [pdf]

http://www.researchgate.net/publication/256548327_So_depression_is_an_inflammatory_disease_but_where_does_the_inflammation_come_from/file/72e7e52375de6dedea.pdf

by gwern • 12 years ago

163 208 12 years ago

researchgate.net

hmhrex• 12 years ago

Can't wait to read this. As a person who has dealt with severe depression, and has come through it alive, I'm always interested in new research on the subject.

tannerc• 12 years ago

Same. From what I've read so far (only partially through the paper) a lot of this is what we already know, but with more evidence for the claims. Really helpful for those of us who continue to combat depression on a regular basis.

cpncrunch6• 12 years ago

Actually, I think you might be better looking elsewhere for help with depression. In my own experience, and that of other people I know, psychological factors have always been the main cause of depression, and resolving them results in curing the depression. The problem is that it isn't always easy to identify the factors causing the depression.

As for the science: we do know that both psychological stressors and infections both cause inflammation. Stress results in activation of the HPA axis and sympathetic nervous system, which screws up the immune system in various ways (including inflammation). Conversely, having a severe infection can make you feel depressed.

It's really just a theory that inflammation causes depression. I think it's more likely that it's a result of cortisol and/or neurotransmitters (i.e. too much brain activity). Cortisol seems a more likely candidate for being central to depression in my opinion.

The science here seems to be based on a desire to have a physical rather than a psychological cause for depression. Michael Maes has a history of that (see his CFS publications).

jaggederest• 12 years ago

I suspect there may be some posts here dismissing a lot of this as obvious - but it's actually really interesting to hear further evidence that a lot of lifestyle factors really do play a large role as we thought.

The best part about things like this is that, as they say, they're amenable to change - you can affect them, so you can reduce the severity of the feedback loop that makes depression so insidious.

dfc4• 12 years ago

If a lot of depression's hows/whats/whys were "obvious" this article would not be included in the journal's "Current Controversies in Psychiatry."[^1]

[^1]: https://www.biomedcentral.com/bmcmed/series/CCP

lectrick2• 12 years ago

This is actually a fascinating paper. Keep reading until you see the connection between inflammation, exercise and depression... Wow!

pvnick• 12 years ago

  Omega-3 fatty acids, which are important components of
  many healthy foods, such as seafood, nuts, legumes and
  leafy green vegetables, act to reduce inflammation

Score another point for fish oil supplementation, on top of the already enormous pile of scientific research showing it to be a miracle chemical (and I definitely don't say that lightly) [2]. Seriously, if you aren't getting enough omega 3 fatty acids, either from regularly eating lots of fatty fish or through supplementation, you're seriously missing out on some good stuff. Among supplement enthusiasts, it's consistently declared to be one of the only supplements that's actually useful. I prefer the liquid form [1].

[1] http://www.amazon.com/Now-Foods-Omega-Lemon-Flavor/dp/B001B4...

[2] http://examine.com/supplements/Fish+Oil/

Edit: added [2], a well-written examine.com page summarizing fish oil effects

derefr2• 12 years ago

It's not that fish oil is an unalloyed good, mind; just that we get way too much Omega-6 in western diets, and it seems that Omega-3 "cancels it out." In cultures with balanced Omega-3/6 intake, like Japan, fish oil has no benefit.

brational2• 12 years ago

Correct. The alternative to pounding fish oil supplements is simply stop eating so much refined seed and vegetable oils. A ratio can always be fixed in at least 2 ways obviously.

irishjohnnie5• 12 years ago

Plus the Japanese diet tastes better than a fish oil gel cap ... speaking of which, does this mean that the incidence of depression in Japan is low?

WalterSear5• 12 years ago

FWIW, fish oil demand is driving overfishing.

http://www.wired.com/science/planetearth/magazine/15-06/st_i...

There are environmentally better sources, thought they are, naturally, not as cheap.

corysama• 12 years ago

In terms of $/gram of Omega3, flax oil is much, much cheaper than fish oil.

http://www.amazon.com/Barleans-Organic-Oils-Lignan-16-Ounce/...

http://www.barleans.com/images/supplemental/ot-lignan12oz-su...

It also has a lot of 6&9. I'm assuming that still moves you towards a good balance. Can someone tell me I'm mistaken?

wil421• 12 years ago

I believe that it is certain types of fish oils that are leading over fishing.

For instance if you were to buy salmon oil and the salmon was farmed raised then farmed issues aside you wouldnt be overfishing.

I believe that generic fish oil does lead to overfishing but if you by fish oil from Wild Salmon chances are they arent fishing solely for the oils.

http://www.seafoodwatch.org/cr/SeafoodWatch/web/sfw_factshee...

jmcmichael• 12 years ago

I've switched from using fish oil capsules to eating sardines as they are quite high in Omega 3 (around 1g per 3oz), low in mercury, in no danger of overfishing, and relatively cheap.

eevilspock• 12 years ago

how depressing.

lectrick2• 12 years ago

Instead of killing fish, here is my favorite nut mix (BY FAR!), which also happens to be chock full of Omega-3:

http://smile.amazon.com/Planters-Nutrition-Omega-3-Ounce-Can...

Cannot recommend enough. A handful for a snack is filling, healthy and not too caloric.

chrisgd2• 12 years ago

I can never stop at just a handful though

zwischenzug• 12 years ago

Bit too much sugar there for my liking...

js22• 12 years ago

So you might want to do some research on ALA, EPA, and DHA. Our ability to convert ALA to Omega-3 is apparently fairly limited. This link appears to be fairly well researched:

http://lpi.oregonstate.edu/infocenter/othernuts/omega3fa/

Mz4• 12 years ago

FYI: Ingredients Walnuts, Sweetened Dried Cranberries (Cranberries, Sugar, Sunflower Oil), Candy Coated Dark Chocolate Soynuts (Dark Chocolate {Sugar, Chocolate, Cocoa Butter}, Sugar, Oil Roasted Soybeans {Soybeans, Soybean Oil}, Artificial Color {Includes Caramel Color}, Corn Syrup, Gum Arabic, Confectioner's Glaze {Carnauba Wax, Beeswax}).

Without doing serious research on every ingredient listed above, let me suggest that you (or other interested readers) can just buy Walnuts for the same effect, without being exposed to all this other crap, which may be a problem for some people. Walnuts are unusually high in omega 3. I have a lot of dietary issues and I would be unlikely to eat the above (and I usually do not eat Planter's because most of their nut mixes are made with peanut oil, which is highly inflammatory and tends to make me psychotic and suicidal).

I cannot take fish oil. I am allergic to shellfish and I break out in hives when I take enough fish oil. So I have long eaten walnuts when I want to bump up my Omega 3 intake. But, for my purposes, a) avoiding problem oils does more for me than trying to specifically counteract them by adding other oils and b) eating less acidly also goes a long way to control my inflammatory condition.

matznerd3• 12 years ago

Make sure that the nuts you eat are sprouted. I generally try to eat only raw, sprouted, organic nuts, but they are expensive...

bostonaholic• 12 years ago

Too much sugar and processed seed oils (e.g. sunflower and soybean).

pygy_2• 12 years ago

IIRC, you need a 1/5 (Omega 3 / Omega 6) ratio, but our usual diet is so poor in the former that we end up deprived.

Palm oil, which is everywhere, has Omega 6 aplenty, and (virtually?) no Omega 3. In Europe, it is usually listed as "vegetal oil" in the ingredients lists. When it's not palm, they put the full name.

nazgulnarsil• 12 years ago

palm oil is only 9% polyunsaturated, as opposed to something like canola which is 20%.

esemiss• 12 years ago

Please be aware of the issue of rancidity before taking any fish oil supplements.

http://blog.omega3innovations.com/blog/bid/215649/Is-Your-Fi...

TheEzEzz• 12 years ago

There's an obvious conflict of interest with that link. They discuss the rancidity of fish oil and then pitch their own fish oil product. I've heard rancidity of fish oil discussed before. It seems like a reasonable thing to be concerned with, but I'd like to see an impartial, scientific discussion.

ericxb• 12 years ago

I like Coromega brand because it can't become rancid. The oil is sealed in an air tight packet until you consume it.

manmal2• 12 years ago

Open a capsule of each new batch and smell it. Then put the package in the fridge, and keep it there. Problem solved.

irishjohnnie5• 12 years ago

Grass fed beef is apparently also a good source of Omega-3

http://www.ncbi.nlm.nih.gov/pubmed/16500874

neves• 12 years ago

Brazilian meat is grass fed. Which countries more export grass fed meat?

tasty_freeze• 12 years ago

There is recent research linking fish oil and prostate cancer, especially more aggressive forms of prostate cancer.

http://www.nlm.nih.gov/medlineplus/podcast/transcript090313....

Jach• 12 years ago

I was going to link that too if someone else didn't. But since the base rate is already about 150/100,000 per year, and 15% over a lifetime, and the survivability for prostate cancer is high, the increase isn't really that much and the benefits outweigh the risks for me.

danparsonson3• 12 years ago

The great majority of effects tested and listed in the 'Human Effect Matrix' at [2] are either minor in magnitude or non-existent. That would seem to contradict your statement that Omega-3 is a miracle chemical.

Am I reading it wrong?

dfc4• 12 years ago

This is reads as "minor or nonexistent?

  Evidence Level  Effect      Change    Magnitude  Consensus
  A               Depression  Decrease  Notable    100%

DanBC2• 12 years ago

There is good evidence that supplementing fish oil does nothing to prevent death, but that eating fish does.

I haven't got cites but it was pretty clear on this BBC Radio Four programme - maybe someone else has got better sources?

http://www.bbc.co.uk/programmes/b019dl1b

(They talk about the dangers of Selenium supplementation in regions with plenty of bioavailable selenium in the soil, especially when combined with Vit E supplementation. These are not heroic doses either.)

dfc4• 12 years ago

Why do you prefer the liquid form?

gtani• 12 years ago

I think Andrew Weil's books are a good common sense source on supplements and he recommends fish oils purified to exclude mercury and PCB's. For counterexamples, I've noticed a few people taking quite large dosages of B complex vitamins. Dr. Weil notes that mega doses of B3 and B6 can cause problems including irreversible nerve damage. He also recommends against resveratrol supplements, another trendy thing.

partoutok• 12 years ago

The Cochrane review on omega-3 fats in 2004[1] didn't find any clear benefit concerning Mortality/Cardiovascular problems/Cancer.

[1] http://summaries.cochrane.org/CD003177/there-is-not-enough-e...

carbocation• 12 years ago

Follow-up studies, such as this 12,000 person RCT [1], have not been any more favorable towards omega-3 fatty acids.

When my patients ask me if they should take omega-3 capsules, I tell them that it depends on whether they enjoy paying for them. (Some do.)

1 = http://www.nejm.org/doi/full/10.1056/NEJMoa1205409

illuminate4• 12 years ago

"on top of the already enormous pile of scientific research showing it to be a miracle chemical (and I definitely don't say that lightly)"

http://www.badscience.net/category/fish-oil/

The research hasn't held up, but the marketing and supplement industry pretends as if it has.

tomgruner• 12 years ago

Also hemp hearts - available from some costco stores and most whole foods are an excellent source of omega 3s. They are good in smoothies too.

Nursie• 12 years ago

Fish oil supplementation is, like most other supplementation, really only applauded by the supplement industry.

There's no proof any of it does much, which is why here in the UK all supplement advertising has to include disclaimers like "May benefit the elderly or those on a restricted diet"

shubb• 12 years ago

There have been some decent clinical trials showing a high does of fish oil (something like 1g a day) improves mood better than placebo in bipolar depresssives. There are some risks to taking really high doses of fish oil every day though - and not just mercury content.

Similar trials for just doing plenty of regular excersise such as walking show a better result. Given that excersise is really good for you, it's probably a better option.

novaleaf• 12 years ago

try flax, not fish.

derefr2• 12 years ago

I'm curious: does this imply that plain-old non-specific anti-inflammatory drugs combat depression? I'm aware that sleep-deprivation, cold-caps, and, oddly-enough, ketamine all have anti-depressant effects, and that these are mostly unexplained—would the link here be that these things have anti-inflammatory effects on the brain?

jmhain• 12 years ago

Except apparently they do the opposite.

http://www.sciencedaily.com/releases/2011/04/110425153602.ht...

meowface2• 12 years ago

Except apparently they do the opposite.

Welcome to every debate on nutrition, supplements, and pharmaceuticals in history.

Regardless, the study you linked says they reduce the effectiveness of SSRIs, not that they exacerbate depression.

Lerc• 12 years ago

I suffer from depression and a grab bag of auto-immune/inflammatory conditions.

The drug that seems to have the biggest impact upon my depression is Etanercept despite it being primarily to treat my arthritis etc,

Ketamine would be cheaper. hell, heroin would be cheaper.

pantalaimon• 12 years ago

Ketamine is actually quite effective

http://ajp.psychiatryonline.org/article.aspx?articleid=17333...

Alex39176• 12 years ago

does this imply that plain-old non-specific anti-inflammatory drugs combat depression?

Yes, but taking them doesn't solve the underlying problem, and they're not safe to take on a daily basis. If you were going to use an anti-inflammatory though then CBD or THCA would probably be better than, say, ibuprofen.

tothelast3• 12 years ago

This would be a very interesting area for future research. Those drugs that you mentioned are not commonly linked with anti-inflammatory activity - feels more likely that it would be linked to more directly psychoactive properties. Anecdotally, I believe that anti-inflammatories such as NSAIDs (non-steroidal anti-inflammatory drugs, i.e. Ibuprofen and Naproxen Sodium) and Minocycline have been cited as having anti-depressant impacts. Minocycline is a very potent anti-inflammatory and has been used off-label in a variety of autoimmune conditions.

Some further reading - http://www.ncbi.nlm.nih.gov/pubmed/18267354 http://www2.kenes.com/wcap/scientific/Documents/Symposia/Tsu...

courtf• 12 years ago

Pretty fascinating, I didn't realize there were any links between depression and inflammation. In addition to suffering from depression starting at a fairly young age, I also have allergic reactions that result in inflammatory responses to seemingly random environmental factors. This is something that appears to run in the family. I wonder if addressing the allergic symptom would suppress some of the depressive ones?

marze• 12 years ago

A diet described in a book titled "Perfect Health Diet" has been reported to help with allergies.

manmal2• 12 years ago

I've suffered quite a lot from inflammatory responses to food (especially gluten and casein) and had mental symptoms similar to depression (not clinical though). Water retention, pain, weakness, the whole lot. It took some years until I made the connection and have since stayed on a gluten- and casein-free diet, adding fish oil and apple cider vinegar. I lost > 30 pounds since (inflammation seems to cancel out weight loss) and feel great mentally (most of the time). Whenever I have a setback, I become irritable and depressive - usually quickly revertable by two fish oil capsules and a glass of diluted ACV (moodiness disappears within 2 hours; water retention takes 1-2 days to disappear again - this seems to be associated with the lymphatic system).

rtre• 12 years ago

Interesting, just the other day I was listening to Joe Rogan's podcast with Dr.Rhonda Patrick (#459). If I recall correctly, they breifly discuss inflammation. She goes on to mention that elevated levels of "C-reactive protein" in the blood is used as a marker for inflammation. The podcast is worth a listen, they go into other topics such as nutrition, vitamins & minerals, etc. http://podcasts.joerogan.net/podcasts/dr-rhonda-patrick

ivan_ah• 12 years ago

direct link: http://www.biomedcentral.com/1741-7015/11/200

abdophoto2• 12 years ago

Inflammation in the body has been correlated with a lot of diseases believe it or not. Gluten is one of the big contributors to inflammation in the body. A lot of people laugh at the whole "Gluten Free" thing, but there's a good bit of evidence that significantly reducing or removing it from your diet can make a serious impact.

josephpmay• 12 years ago

Could you point me to the "good bit of evidence" that shows this?

abdophoto2• 12 years ago

Less than 2 years ago, my wife was diagnosed with MS (Multiple sclerosis). As soon as we found out, I started digging like crazy to learn more about why this happened and what we could do to prevent it from progressing. I'm a big believer in that the body has the ability to heal itself by avoiding certain foods and intaking others. I mean, food is fuel we put in our body.

After digging for a while, I came upon some staggering discoveries. First, there are people who have reversed their MS almost completely on diet alone. The diets consist of A LOT of high-nutrition fruits and vegetables along with Omega 3's, organic meats, etc. These Paleo-like diets also forbid gluten with the main reason being that it causes serious inflammation in some folks. This TEDx video by Dr. Terry Wahl was very helpful (http://www.youtube.com/watch?v=KLjgBLwH3Wc). I read her book and it literally laid the foundation for which changed our eating habits entirely.

A month or so after, we flew out to Massachusetts to a well-known wellness center where they performed various blood and stool tests. The Dr's (including a Nutritionist) sat down with us for the entire day and asked about daily habits from what our work days were like to what we ate. Without mentioning my own research, they also said that gluten is something we should completely remove from our diet.

There's a ton of other stuff out there, but since removing gluten entirely, my wife has felt great. We just did an MRI and she has no new lesions. She no longer experiences blurriness or weakness which is great. It may not be completely because of Gluten, but removing seems to have seriously made a impact.

jcutrell• 12 years ago

http://www.celiaccentral.org/research-news/

My wife has celiac disease, which is basically a gluten allergy. Her grandfather had sprue, which was renamed to celiac more commonly[1].

As much as I hate anecdotal evidence, I personally do feel significantly better on a day to day basis when I eliminate the most hefty forms of gluten (bread, for instance). Could have absolutely nothing to do with it, but it seems to hold even when I eat gluten free substitutes. Again, an anecdote, but look into celiac for more solid research on the subject.

[1]http://www.nlm.nih.gov/medlineplus/ency/article/000233.htm

Alex39176• 12 years ago

http://www.ncbi.nlm.nih.gov/pubmed/18404144

kingkawn2• 12 years ago

Why is there an assumption that the inflammation comes from anything other than the mind state of depression itself?

jonsen2• 12 years ago

http://www.sciencebasedmedicine.org/depression-re-examined-a...

cpncrunch6• 12 years ago

That study is interesting, but doesn't mention inflammation. It basically says that depression is a result of stress.

mattgreenrocks3• 12 years ago

The link between depression and inflammation is news to me. Is it fully accepted, or still being worked on? I've had bad run-ins with both, sometimes, at the same time. A particular case was a bad burnout incident I endured a few years ago. I saw many doctors trying to figure out why my hands and wrists had enormous amounts of tension. MRIs, x-rays, and conduction tests showed no issues. I had to leave my job and rest for several months entirely to be able to use them again.

Because of this, I've always suspected a stronger mind-body link than traditional Western medicine currently admits to (obvious caveat of n = 1). It seems that whatever state my mind is in, my body follows soon after. Mental anxiety begets physical tension. It's like my whole body downclocks itself to deal with things.

The mind will get it's way, no matter how much you resist.

aestra2• 12 years ago

Because of this, I've always suspected a stronger mind-body link than traditional Western medicine currently admits to (obvious caveat of n = 1). It seems that whatever state my mind is in, my body follows soon after. Mental anxiety begets physical tension. It's like my whole body downclocks itself to deal with things.

Um every western medical practitioner "admits" to this kind of mind body connection.

dllthomas3• 12 years ago

I think western medicine is pretty on board with the notion that significant stress causes (or exacerbates) other issues.

As just one random example:

http://www.webmd.com/mental-health/effects-of-stress-on-your...

mattgreenrocks3• 12 years ago

Yeah, but no doctors asked about my stress, or emotional health, or anything that could have started me down the line of investigation. I treated it as an isolated physical problem, not a symptom of stress/mental issues. The response was always the same: "we don't know...sorry."

Maybe I should've realized that stress was killing me, but I was severely depressed. It's not like I could see myself objectively.

stan_rogers• 12 years ago

There are quite a few physical conditions that are commonly accepted to be largely psychosomatic in origin, including things like osteoarthritis. While it's probably true that the term translates to "it's all in your head" to most folks, a better translation is probably "it's mostly from your head". Stress and tension aren't just metaphorical; they're usually accompanied by actual physical/mechanical manifestations that can sometimes have a devastating and irreversible effect on joints, tendons and other assorted bits of framing, machinery and plumbing. (It shouldn't be surprising to find that the discomfort and dysfunction feed back into the emotional state, compounding the problem.) And that's just from long-term, low-level stuff that people tend to try to ignore. I can't recall running across a physician with any real experience (interns are another matter) who hasn't had a solid grasp of that concept.

bunderbunder• 12 years ago

You can practically set your watch by the timing of the latest meme that purports to identify the One True Panacea for Clinical Depression™. Looking like it'll be time to pull the crown on mine pretty soon.

yogi123• 12 years ago

Recent articles have tied omega 3 intake to increased risk of prostate cancer. Got a lot of press last year. I took Omega 3 for the last 14 years. Spent thousands buying Nordic Naturals from Whole Foods at $25/bottle. Whenever I'd stop taking it, I felt a decline in mood so thought it had good systemic benefits. When I went off it this time, I felt zero change before or after (haven't taken since last summer).

This study was the last straw. I'd already given up supplements and even a daily multivitamin as studies indicate no positive effect and possible harm. Now I take no supplements. The more I read the more I'm convinced it's faulty science and marketing. A healthy, varied diet of mainly plant based foods should provide all that most people need. If you look at links to omega 3 studies on Wikipedia I don't recall there being conclusive positive evidence, but maybe I'm wrong. Couple of links on prostate cancer study and whether it's accurate or not:

http://www.cancer.org/cancer/news/omega-3-fatty-acids-linked...

http://health.heraldtribune.com/2013/08/26/dr-oz-omega-3-can...

http://articles.mercola.com/sites/articles/archive/2013/07/3...

js22• 12 years ago

Still, some vitamins may be worth supplementing depending upon your diet, exposure to sun, and activity level. For example:

http://examine.com/supplements/Vitamin+D/

http://examine.com/supplements/Magnesium/

http://examine.com/supplements/Vitamin+K/

meowface2• 12 years ago

Is there an effective way to know which vitamins you're missing? Can full blood tests help tell you which vitamins you should be taking daily?

tothelast3• 12 years ago

Examine.com is a great website. In general, I would consider Vitamin D and Magnesium to be the most beneficial for a layperson without any specific health issues.

pessimizer• 12 years ago

There are problems with taking high doses of Vitamin D3 that may be an allergic reaction or genetic, and controversy that the amount of non-supplement D3 consumed by people on average may be a lot higher than we think.

http://www.mgwater.com/vitamin_d.shtml http://www.livestrong.com/article/302715-risks-of-too-much-v...

(result of random refference googling)

f1nch3r• 12 years ago

There were some well-reported flaws in that multivitamin study. One I remember off the top of my head from the study done with cardiovascular patients was that the "high levels" of vitamin D3 given to the participants was 100 IU.

Edit with one quick link.

http://oregonstate.edu/ua/ncs/archives/2013/dec/review-most-...

matznerd3• 12 years ago

Your link to the Herald Tribune and Mercola both recommend DHA (and omega-3). It is seriously one of the greatest things you can take, hands down. Nordic Natural is an expensive brand, and buying at Whole Foods is even more expensive (try Amazon, and a cheaper, but quality brand is Carlson's). It is hard to tell sometimes when you go off a supplement the true effects because your high DHA levels can take a while to be used up, and even then the body has processes to try and scavenge or breakdown molecules in other areas to make up for it. It is much more efficient and beneficial to provide the needed stuff in a useable form.

a_c_s• 12 years ago

Mercola is certainly not a credible source

adammil• 12 years ago

Can anyone acquainted with the hard sciences comment on whether this paper passes even a basic sniff test? The title of the paper and so many references to other psychiatry journals seem like potential red flags.

stared2• 12 years ago

I saw some red flags as well (see my comment), so I asked a question:

http://cogsci.stackexchange.com/questions/5841/is-it-univers...

LyndsySimon• 12 years ago

Are you saying you find it... fishy?

cpncrunch6• 12 years ago

It seems to be mostly wishful thinking...see my other comment here.

stared2• 12 years ago

Some premises of this article are at least sound, at least, fishy. Easy language, lot of promises, and a lot of plausible things but not necessarily with causal relation.

It starts with "We now know that depression is associated with [...]", where AFAIK we are far from pinning down etiology of depression (there may be multiple mechanisms, etc). And it is one of reasons why antidepressant have relatively low effectiveness. The abstract ends with a longer list of things that make it flashy.

Moreover, things like smoking are sometimes considered actually having mildly anti-depressive effect (though it is disputed).

I don't say that the paper is wrong. Just a paper not listing doubts and promising a lot should be less believed that one making very humble observations (but the later one would not make HN frontpage, hence the bias).

lutusp• 12 years ago

I'll bet this new empirical scientific result will make psychiatrists and psychologists abandon talk therapy and their questionable anti-depression drugs, right away, in the public interest. Let's all hold our breath for that outcome.

http://www.planet-science.com/media/24009/holding%20breath_9...

benched• 12 years ago

Look I'll just say it. This strongly matches the pattern of all the other hiding-in-plain-sight, simplistic explanations for complex bio-existential problems, that turn out to be bullshit.

marcosdumay2• 12 years ago

Yet, nearly all breakthroughs in medicine seem to follow that same pattern, at least for me, an outsider.

I can't throw it away that easily, and by the way you phrase your comment, I think you can't either. Yes, the fact that it is in the oppinion column isn't a good indicator... I'm in the "waitting further results" mode.

illuminate4• 12 years ago

"Yet, nearly all breakthroughs in medicine seem to follow that same pattern, at least for me, an outsider."

Yes, the pattern of selection bias.

Harj4• 12 years ago

You can check your inflammation levels via a blood test called hs-CRP (http://en.wikipedia.org/wiki/C-reactive_protein).

I took it and was surprised to learn I was in the high risk range. I tried a vegetarian diet for just under a month, re-tested and I'd dropped into the low risk range (this was the only lifestyle change I made that month). I found that a full vegetarian diet isn't sustainable for me so now I'm trying out only having meat once a day (usually for dinner) and will re-test to see what result that has. I suspect that the absence of meat may have been less important than the increase in vegetables.

The caveat is that hs-CRP isn't a perfect test because your result can be spiked temporarily if e.g. your body is recovering from intense exercise or a cold. That's why I think it's a good test to do more regularly and have longitudinal data for.

I've been spending a bunch of time getting more comprehensive blood tests recently. If you've any questions feel free to ping me (harjeet [dot] taggar [at] gmail).

mattgreenrocks3• 12 years ago

Very interesting; where do you get your blood tested? AFAIK, you have to be willing to pay the lab expense, which is tailored for insurance.

Harj4• 12 years ago

Yes unfortunately most insurance won't cover any tests beyond the basic ones in your yearly medical. There are a few options:

- WellnessFX (http://wellnessfx.com) offers the nicest experience and display of your results, but it's pricey and the tests all come bundled together so you can't pick just one or two you're interested in.

- http://health-tests-direct.com and http://directlabs.com are other options that have more a la carte options.

- If you're in the Bay Area, the cheapest (by some distance) option is to use a new blood testing lab called Theranos, which has a location in the back of the Walgreens on University Ave in Palo Alto. If you download their lab order form (http://theranos.com/Content/pdf/theranos_lab_form.pdf), tick the tests you'd like and have an MD sign it (doesn't have to be your doctor, could be a friend). You can take it into the Walgreens and they'll draw your blood there and email you the results a few days later.

cwal372• 12 years ago

I'm very curious that eating meat only once a day is a compromise for you. How much did you eat before you started thinking about this?

Harj4• 12 years ago

At a minimum twice a day, which I don't think is that unusual for most people e.g a chicken sandwich for lunch and chicken with some kind of side for dinner.

Cutting down to once a day i.e. having a vegetarian lunch, might not sound like much but it's harder than you'd expect. Most restaurant versions of a vegetarian option is a meat dish minus the meat e.g. a sandwich with just lettuce and perhaps one tomato slice. Finding a vegetarian option that's tasty and filling can be challenging (though comes with a good consequence of forcing you to discover new places to eat).

I'm sure this is much easier if you work someplace with a good catered lunch option.

awolf3• 12 years ago

For a counter-point, I eat an extremely meat heavy diet and have a superb CRP number (.23).

It's more likely about avoiding low quality meats, which unfortunately is what 95% of the meat produced in the US is.

Harj4• 12 years ago

That's a very good point. Quality of meat isn't something that seems to be accounted for in studies linking meat consumption to various diseases/health issues.

Out of curiousity, do you eat a lot of vegetables?

Alex39176• 12 years ago

By low quality meat, do you just mean corn fed?

650REDHAIR• 12 years ago

For anyone else that was wondering how much this test will run you-

"Cost is just $40 – $70 and it’s covered by most insurers, including Medicare..."[0]

[0]http://www.forbes.com/sites/melaniehaiken/2011/06/17/3-lifes...

tokenadult• 12 years ago

It took me a while to slog through that whole long list of references at the end of the end of the article, but correlational study designs don't impress more by being numerous, especially when most of them are published in middling-to-lousy journals. That's what isn't fun about reading about medical issues here on Hacker News: too many of the articles kindly submitted here are of much too low quality to be worthy of our attention. There are some intriguing ideas in this opinion piece, but basically hardly anything there is backed up by experimental studies, not in a human study and not even in an animal study. The title of the article reflects an attempt to come up with a One True Cause of depression that surely is not the one true cause (most doctors who are experts in depression, or in inflammation, do NOT characterize depression as an "inflammatory disease") and then the article goes off the rails from there.

Check back when there is better established evidence about treatment. A better read about depression by a more informed physician would be a book review submitted recently to HN[1] that was hardly noticed when it was submitted.

[1] http://www.sciencebasedmedicine.org/depression-re-examined-a...

jmnicolas• 12 years ago

I suffer from depression for more than 20 years. Here is what should be done to fight it effectively :

- take anti-depressants - wake up every day early and at the same time (6 AM from Monday to Sunday) - when there is not enough sun outside, sit 30 minutes in front of a full specter lamp - eat healthy (vegetables & fish oil) - have some physical activity (walking, standing desk) - socialize

If I was able to effectively do the last 3 things I think depression would have no impact in my life.

josh-wrale• 12 years ago

I have a conjecture about depression. I believe that autoimmune conditions (e.g. hypothyroidism, MS, vitamin D deficiency) are sometimes a result of the self-hate associated with severe bouts of depression. The individual feels adversely about their existence, and so the body sets about deconstructing itself. I would be very happy to learn this is never the case, but I suspect that it sometimes is the case. (see: https://en.wikipedia.org/wiki/Nocebo )

Depression is an inflammatory disease; where does inflammation come from? [pdf]

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