Below are some interesting notes on anorexia nervosa.
These notes are based on research into solid scientific data but they must be considered theoretical.

Perhaps they might help someone suffering from this disease or more likely the family of a sufferer.

Andrew Cavanagh



Anorexia

I had been researching various neurological illnesses for some time when I happened to watch a program interviewing various patients suffering from anorexia nervosa.
I was struck with the similarities between anorexia, schizophrenia (voices in the head) and Depression (which is linked to anorexia).

After some study I believe I have come up with an explanation for the cause of this disease and some possibilities for treatment.
The key to Anorexia would appear to be a lack of serotonin the calming, feel good hormone in the brain.

(It has been shown that in patients with anorexia serotonin 2A receptors have decreased activity. Also drugs which raise activity levels of serotonin like Prozac have been found to be effective in reducing the symptoms of anorexia and particularly in preventing relapse in recovered patients. This lack of serotonin would also explain the very strong link between anorexia and Depression since Depression is almost certainly due to a lack of serotonin in the brain.)

This lack of serotonin seems to be coupled with an excess of dopamine the action or motivation hormone in the brain.
Anorexia is linked to impulsivity. Anorexics also tend to be highly motivated individuals who are often seen as perfectionists - all signs of excess levels of dopamine. The obsessive compulsive disorder that has been found to be linked to anorexia is also almost certainly caused by excess levels of dopamine.

Originally dopamine helped us to survive by increasing pattern recognition.
Basically pattern recognition helps you to fulfil man's three primary urges:
Food, fight or flight and procreation.
When a caveman was hungry the pain from hunger would lead to the release of dopamine.
Dopamine would help him search out and recognize sources of food more effectively (increased pattern recognition).
Dopamine would also help him stay motivated on the task till he caught the food.

When he began to eat that food this would lead to the release of serotonin the feel good hormone helping him to feel more calm and reduce the effects of dopamine.
The anorexic patient almost certainly has a deranged form of pattern recognition.

The anorexic sees the avoidance of food as a desirable outcome.
This condition was probably originally brought about due to a poor balance of eicosanoids, the "master" hormones in the body.
A lower intake of calories would originally result in reduced levels of insulin.

Lower levels of insulin could increase levels of the good eicosanoid PGE1 resulting in more the efficient release of serotonin.
Since serotonin would almost certainly relieve the anxiety related to anorexia the patient could then begin relating avoiding food with the relief from anxiety long after the sense of relief has stopped.

Over time poor nutrition would result in chronically low levels of serotonin because serotonin is made from the amino acid tryptophan.
Tryptophan is obtained from protein in the diet.
It's interesting to note that this deranged form of pattern recognition is the most likely cause of most addictions.
An intial rise of serotonin is related to intitial experiences with the addiction then subsequent experiences result in an absence or very low levels of serotonin increase.
Unfortunately by this time the negative pattern recognition is set and as dopamine levels rise the addict (or anorexic) feels a continually increasing desire to fulfil the addiction.
But the addiction often no longer releases serotonin and often increases dopamine levels.
So the addiction cycle is perpetuated.
Just like the anorexic what is needed is the release of serotonin.

This could explain why drugs like prozac which increase serotonin levels in the brain (by inhibiting their reuptake) can be so effective in treating anorexia and particulary in preventing recovered anorexic patients from relapsing.
This is consistent with the theory that reduced intake of tryptophan in the anorexic patient's diet (tryptophan is the major building block of serotonin) would make it more difficult to treat anorexia with a drug like prozac which simply increases the activity of the existing serotonin in the brain - it does not actually increase production of serotonin.

So the recovered anorexic eating an adequate intake of tryptophan would probably find prozac more effective.
This also suggests that supplementing tryptophan (or it's cousin 5-hydoxyl-tryptophan) may be worth serious consideration for the anorexic patient.

So the avoidance of food most likely makes it even more difficult for the anorexic to produce adequate serotonin leading to a steady downward spiral.
Elevated levels of a bad eicosanoid called interleukin 1beta (IL-1B) are implicated in both anorexia and anxiety or panic disorders.

IL-1B is a controller of your body's immune response to physical stress.
One Swedish study found 74% of women with anorexia or bulimia had developed the antibodies also found in other autoimmune diseases like lupus, Rheumatoid Arthritis and MS.

Again MS is strongly linked to depression and bad eicosanoids (PGE2 in particular which reduces the release of serotonin).
This link to levels of a bad eicosanoid is interesting because high levels of bad eicosanoids lead to lower production and release of the feel good, calming hormone serotonin.

And you can reduce levels of bad eicosanoids and increase levels of good eicosanoids with diet and lifestyle changes (see the book From Depression to glorious health available for free download from www.geocities.com/glorioushealth )

This book describes diet, lifestyle, emotional therapy and supplements all designed to increase the production of serotonin and improve general health.
The possibility that anorexia is linked to schizophrenia seems quite high.

Many anorexics hear voices similar to the schizophrenic patient.
The schizophrenic patient has a genetic problem which leads to the body removing excessive eicosapentaenoic acid (EPA) from the production cycle and creates difficulties in assimilating that EPA into the cell membrane.

This is significant because EPA is the major building block of good eicosanoids.
And good eicosanoids regulate the release of neurotransmitters like serotonin.

Since treatment with large doses of fish oil (preferably pharmaceutical grade fish oil) can be quite effective in the treatment of schizophrenia this therapy would certainly be worth considering in the anorexic patient.
Also supplementation with fish oil should be considered with all related family members since anorexia is genetically related (as is schizophrenia).

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