hi lizzy if you did want to try a nutritional approach it would depend if you're already taking any vitamins/minerals and if so how much and what timing.
b vitamins, vitamin D, minerals, and essential fatty acids are key players.
B COMPLEX VITAMINS
The B-complex vitamins are essential to mental and emotional well-being. They cannot be stored in our bodies, so we depend entirely on our daily diet to supply them. B vitamins are destroyed by alcohol, refined sugars, nicotine, and caffeine so it is no surprise that many people may be deficient in these.
a daily b-50 or b-100 complex is a good starting point. people who take high doses of b12 (as in 2000mcg) in the morning may experience trouble sleeping. best to take higher doses of b12 in the afternoon or evening.
low vitamin D3 levels can affect mood. ms patients tend to be low in vit D3. aim for serum levels of at least 100 nmol/L. up to around 150 nmol/L
. no higher than 250 nmol/L. the appropriate test is 25(OH)D3. a daily maintenance dose is 4000IU.
MINERALS: CALCIUM, MAGNESIUM, ZINC
it is important to balance D3 intake with minerals like calcium, magnesium, and zinc.
calcium intakes around 1000mg per day are adequate.
magnesium - try for intakes in the neighbourhood of at least 400mg elemental magnesium per day. a good source would be from albion chelated magnesium glycinate. other forms are hard to absorb and may give you unwanted GI side effects. ms patients tend to be lower in mg, not to mention that anxiety and depression are associated with low magnesium levels. magnesium serum levels should be at least 0.91 mmol/L
. in order to achieve that serum level you will have to take some magnesium at the same time as vit D3, but also another dose at a different time of day.
zinc intake requirements depend on your current status. 25-50mg per day would be good but make sure levels don't go too high. target serum values are 18.2-18.4 umol/L
. i don't have good research on the top end of the safe range, but to be on the safe side i'd say don't go over 20??
POLYUNSATURATED FATTY ACIDS
essential fatty acids are also important. ms patients have more omega-6 in their systems than healthy controls. improve omega-3 / omega 6 balance.
fatty acids are also key in depression..
Arachidonic acid to eicosapentaenoic acid ratio in blood correlates positively with clinical symptoms of depression
fatty fish like albacore tuna or salmon can be very effective at improving O3 status.
ergo baked chinook salmon twice per week could help sort out your essential fatty acid balance:
Comparison of the effects of fish and fish-oil capsules on the n–3 fatty acid content of blood cells and plasma phospholipids
from a supplement perspective, it appears that EPA is more important the DHA for treating depression. my fish oil supplement contains 400mg EPA and 200mg DHA per softgel.
finally, if you do not have an exercise regimen in place, getting moving in some personally EDSS-appropriate way, may help lift depression and improve sleep.
hope that helps. if you have any questions fire away
my approach: no meds so far - just nutrient-dense anti-inflammatory whole foods, and supplements where needed
info: www.whfoods.com, www.nutritiondata.com