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Malabsorption of the amino acid tryptophan may be a cause of depression in
celiacs as well as in cases of hypochlorhydria (low stomach acid) and
fructose malabsorption.  Here are some interesting abstracts:

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http://journals.elsevierhealth.com/periodicals/PSR/article/PIIS0022399903005
476

Journal of Psychosomatic Research. 2003 Dec;55(6):573-574

Recurrent brief depression in celiac disease

Mauro Giovanni Carta, Maria Carolina Hardoy, Paolo Usai, Bernardo
Carpiniello, Jules Angst

"A study of 36 adult celiac patients from the Internal Medicine Department
of the University of Cagliari (Sardinia, Italy) and 144 healthy controls
from the community celiac patients showed significantly elevated risks for
major depressive disorders (OR=2.7), dysthymic disorders (OR=6.2),
adjustment disorders (OR=5.3) and panic disorders (OR=7.3). We hypothesised
that the association may be due to malabsorption of tryptophan leading to a
decreased central serotonin synthesis."

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Scand J Gastroenterol. 2001 Apr;36(4):367-71

Fructose malabsorption is associated with decreased plasma tryptophan.

Ledochowski M, Widner B, Murr C, Sperner-Unterweger B, Fuchs D.

Dept. of Clinical Nutrition, Institute for Medical Chemistry and
Biochemistry, University of Innsbruck, Austria.
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BACKGROUND: Fructose malabsorption is characterized by the inability to
absorb fructose efficiently. As a consequence fructose reaches the colon
where it is broken down by bacteria to short fatty acids, CO2, H2, CH4 and
lactic acid. Bloating, cramps, osmotic diarrhea and other symptoms of
irritable bowel syndrome are the consequence and can be seen in about 50%
of fructose malabsorbers. Recently it was found that fructose malabsorption
was associated with early signs of depressive disorders. Therefore, it was
investigated whether fructose malabsorption is associated with abnormal
tryptophan metabolism. METHODS: Fifty adults (16 men, 34 women) with
gastrointestinal discomfort were analyzed by measuring breath hydrogen
concentrations after an oral dose of 50 g fructose after an overnight fast.
They were classified as normals or fructose malabsorbers according to their
breath H2 concentrations. All patients filled out a Beck depression
inventory questionnaire. Blood samples were taken for plasma tryptophan and
kynurenine measurements. RESULTS: Fructose malabsorption (breath deltaH2
production >20 ppm) was detected in 35 of 50 individuals (70%). Subjects
with fructose malabsorption showed significantly lower plasma tryptophan
concentrations and significantly higher scores in the Beck depression
inventory compared to those with normal fructose absorption. CONCLUSIONS:
Fructose malabsorption is associated with lower tryptophan levels that may
play a role in the development of depressive disorders. High intestinal
fructose concentration seems to interfere with L-tryptophan metabolism, and
it may reduce availability of tryptophan for the biosynthesis of serotonin
(5-hydroxytryptamine). Fructose malabsorption should be considered in
patients with symptoms of depression and disturbances of tryptophan
metabolism.

PMID: 11336160 [PubMed - indexed for MEDLINE]

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Med Hypotheses. 1992 Dec;39(4):375-83

The clinical importance of hypochlorhydria (a consequence of chronic
Helicobacter infection): its possible etiological role in mineral and amino
acid malabsorption, depression, and other syndromes.

Cater RE 2nd.

In a previous paper evidence was presented to show that Helicobacter-
induced chronic gastritis is the probable cause of most chronic
hypochlorhydria. In this article evidence is presented for the clinical
relevance of reduced stomach acid secretion. Reduced mineral absorption is
fairly well documented and has sound theoretical support from basic
chemistry. Impaired digestion of protein has been suggested by a few
studies. Small intestinal bacterial overgrowth in hypochlorhydria probably
leads to putrefactive breakdown of the metobolically useful products of
protein digestion, thereby reducing their availability for certain
essential pathways. The possible lowering of tryptophan, tyrosine, and
phenylalanine in the blood may be a precipitating factor in depression in
hypochlorhydric patients. In reduced or absent stomach acid secretion a
constellation of gastrointestinal symptoms has been consistently observed
and reported by clinicians in the past, and treatment of the
hypochlorhydria with hydrochloric acid or its substitutes has often been
observed to be effective in reducing these symptoms.

PMID: 1494327 [PubMed - indexed for MEDLINE]

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