Bipolar Disorder
Overview
Bipolar disorder shares core pathophysiology with other neurocognitive conditions: neurotransmitter imbalance, mitochondrial dysfunction with oxidative stress, and chronic inflammation (see Kato and Kato 2000). Dysregulated mitochondrial signaling, telomere stress, and micronutrient insufficiency can amplify mood cycling, highlighting the need for nutrient strategies that stabilize bioenergetics and stress responses (see Lundberg et al. 2020; Tardy et al. 2020).
Biological Target Matrix
Inflammation
| Substance | Foods | Mechanism of Action |
|---|---|---|
| Genistein | Anti-inflammatory and anti-neuroinflammatory properties; reduces neuroinflammation | |
| DHA (Docosahexaenoic Acid) | Precursor to specialized pro-resolving mediators (SPMs) including protectins and maresins; terminates inflammation without immunosuppression | |
| EPA (Eicosapentaenoic Acid) | Potent anti-inflammatory; precursor to E-series resolvins; specialized pro-resolving mediators (SPMs) terminate inflammation without immunosuppression, downregulate COX-2, inhibit neutrophil infiltration, enhance macrophage clearance | |
| Omega-3 Fatty Acids | Specialized Pro-Resolving Mediators (SPMs) - resolvins, protectins, maresins terminate inflammation without immunosuppression, downregulate COX-2, inhibit neutrophil infiltration, enhance macrophage clearance, limit glutamate-induced excitotoxicity | |
| Berberine | — | Reduces LPS translocation and dampens LPS-driven inflammation through antimicrobial effects on pathobionts |
| EGCG (Green Tea Catechin) | Polyphenol antioxidant and anti-inflammatory effects; reduces inflammatory signaling | |
| Acetate | — | Supports immune regulation and anti-inflammatory processes |
| Butyrate | — | Has anti-inflammatory effects, potentially reducing neuroinflammation; deficiencies linked to many neurological disorders including ADHD |
| Propionate | — | Helps reduce neuroinflammation and protects the blood-brain barrier; enhances cognitive function |
| Short-Chain Fatty Acids (SCFAs) | Amaranth, Asparagus, Bell Peppers, Berries, Black Goji, Cabbage, Capers, Cherries, Chicory, Cranberries, Dairy Products, Dandelion Greens, Ghee, Grapes, Green Bananas, Jerusalem Artichokes, Kimchi, Kombucha, Leeks, Lupins, Miso, Mucuna Beans, Natto, Oats, Oranges, Pickles, Purple Potatoes, Raspberries, Sauerkraut, Seaweed, Sourdough Bread, Strawberries, Tart Cherry, Wheat, Wheat Germ, Whole Grains | Butyrate has anti-inflammatory effects, potentially reducing neuroinflammation; propionate helps reduce neuroinflammation and protects the blood-brain barrier |
| Urolithin A | Powerful antioxidant; supports anti-inflammatory effects | |
| Quercetin (and Isoquercetin) | Anti-inflammatory, anti-neuroinflammatory, and neuroprotective properties; supports gut barrier integrity and TLR4 suppression | |
| Vitamin C (Ascorbate) | Antioxidant properties; supports anti-inflammatory effects | |
| β-Carotene | Anti-inflammatory properties; supports immune regulation | |
| Lutein | Anti-inflammatory properties; supports immune regulation | |
| Lycopene | Anti-inflammatory properties; supports immune regulation | |
| Zeaxanthin | Anti-inflammatory properties; supports immune regulation | |
| Curcumin (Turmeric) | Anti-inflammatory and neuroprotective effects; supports BDNF expression through polyphenol synergy | |
| Hydroxytyrosol (Olive Polyphenol) | Strong anti-inflammatory profile; contributes to neuroprotective effects of extra-virgin olive oil | |
| Oleocanthal | NF-κB inhibition; strong anti-inflammatory effects similar to ibuprofen; contributes to neuroprotective effects of extra-virgin olive oil | |
| Oleuropein | Anti-inflammatory properties; contributes to neuroprotective effects of extra-virgin olive oil | |
| Saffron (Crocin, Safranal) | Anti-inflammatory effects | |
| ALA (Alpha-Linolenic Acid) | Essential omega-3 precursor; limited conversion to DHA/EPA; contributes to omega-3 pool for anti-inflammatory effects | |
| DPA (Docosapentaenoic Acid) | — | Important in vascular health, repair, and immune modulation; emerging brain-health roles (less studied than EPA and DHA) |
| Arachidonic Acid (AA, n-6) | — | Omega-6 PUFA that gives rise to eicosanoids with predominantly pro-inflammatory actions; overall dietary n-6:n-3 balance affects inflammatory tone |
| Linoleic Acid (LA, n-6) | Essential omega-6 fatty acid; precursor to arachidonic acid and eicosanoids; excessive n-6:n-3 ratios may skew toward pro-inflammatory eicosanoids | |
| Copper | Participates in redox enzymes and antioxidant networks | |
| Zinc | Beef, Black Beans, Broccoli, Cashews, Chicken, Chickpeas, Crab, Dark Chocolate, Eggs, Kale, Lamb, Lentils, Milk, Oats, Oysters, Peanuts, Pork, Pumpkin Seeds, Quinoa, Shrimp, Sourdough Bread, Spinach, Wheat, Whole Grains, Yogurt | Supports immune signaling; gut barrier integrity disrupted by nutrient deficiencies including zinc |
Mitochondrial Support
| Substance | Foods | Mechanism of Action |
|---|---|---|
| Butyrate | — | Supports mitochondrial function, enhancing brain energy metabolism; aids in reducing cholesterol and neuroinflammation |
| Short-Chain Fatty Acids (SCFAs) | Amaranth, Asparagus, Bell Peppers, Berries, Black Goji, Cabbage, Capers, Cherries, Chicory, Cranberries, Dairy Products, Dandelion Greens, Ghee, Grapes, Green Bananas, Jerusalem Artichokes, Kimchi, Kombucha, Leeks, Lupins, Miso, Mucuna Beans, Natto, Oats, Oranges, Pickles, Purple Potatoes, Raspberries, Sauerkraut, Seaweed, Sourdough Bread, Strawberries, Tart Cherry, Wheat, Wheat Germ, Whole Grains | Butyrate supports mitochondrial function, enhancing brain energy metabolism; aids in reducing cholesterol and neuroinflammation |
| Urolithin A | Supports mitochondrial resilience and mitophagy; improves cognitive endurance; may extend to executive function | |
| Quercetin (and Isoquercetin) | Enhances mitochondrial baseline activity and energy production; supports mitochondrial function | |
| Taurine | Protects mitochondrial function under oxidative stress; stabilizes mitochondrial membranes; supports ATP production | |
| Magnesium | Almonds, Amaranth, Barley, Black Beans, Broccoli, Buckwheat, Cashews, Chia Seeds, Chickpeas, Cocoa, Dark Chocolate, Flax Seeds, Kale, Kidney Beans, Lentils, Milk, Oats, Peanuts, Pumpkin Seeds, Quinoa, Salmon, Seaweed, Sourdough Bread, Spinach, Sunflower Seeds, Swiss Chard, Tempeh, Tofu, Walnuts, Wheat, Whole Grains, Yogurt | Supports enzymes involved in glycolysis and the Krebs cycle (processes that generate ATP from glucose); binds to ATP and all triphosphates in cells to activate them |
| Vitamin B5 (Pantothenic Acid) | Forms CoA (coenzyme A), required for β-oxidation and TCA cycle acetyl-CoA flux; deficiency impairs ATP production impacting brain energy | |
| Oleuropein | Oleuropein aglycone (the active form) supports mitophagy, SIRT1 activation, and AMPK activation; enhances mitochondrial function, autophagy, and neuroprotective effects through modulation of mitochondrial dynamics and antioxidant pathways | |
| Vitamin B1 (Thiamine) | Essential for mitochondrial glucose metabolism in the brain leading to ATP production; supports PDH (pyruvate dehydrogenase) and α-KGDH (alpha-ketoglutarate dehydrogenase) function | |
| Vitamin B12 (Cobalamin) | Crucial role in conversion of methylmalonyl-CoA to succinyl-CoA, a key step in mitochondrial energy production; deficiency leads to buildup of methylmalonic acid and odd-chain fatty acids, which are neurotoxic | |
| Vitamin B2 (Riboflavin) | Forms FMN/FAD coenzymes, supporting oxidative metabolism and redox balance; facilitates metabolism of B12, B6, and niacin; supports antioxidant enzymes | |
| Coenzyme Q10 (CoQ10) | Electron transport chain cofactor; supports ATP production; antioxidant protection for neurons | |
| Creatine | Supports ATP recycling via phosphocreatine system; buffers high-energy demand in neurons; enhances mitochondrial energy buffering | |
| Capric Triglyceride (Tridecanoin) | Capric triglyceride (C10) is converted to ketones (beta-hydroxybutyrate) in the liver, which serve as an alternative energy substrate for mitochondria; ketones can be used by brain mitochondria when glucose metabolism is impaired, supporting ATP production and mitochondrial function | |
| Caproic Triglyceride (Tricaproin) | Caproic triglyceride (C6) is converted to ketones (beta-hydroxybutyrate) in the liver, which serve as an alternative energy substrate for mitochondria; ketones can be used by brain mitochondria when glucose metabolism is impaired, supporting ATP production and mitochondrial function | |
| Caprylic Triglyceride (Trioctanoin) | Caprylic triglyceride (C8) is converted to ketones (beta-hydroxybutyrate) in the liver, which serve as an alternative energy substrate for mitochondria; ketones can be used by brain mitochondria when glucose metabolism is impaired, supporting ATP production and mitochondrial function | |
| MCT (Medium-Chain Triglycerides) | MCTs are converted to ketones (beta-hydroxybutyrate) in the liver, which serve as an alternative energy substrate for mitochondria; ketones can be used by brain mitochondria when glucose metabolism is impaired, supporting ATP production and mitochondrial function | |
| Iron | Amaranth, Beef, Black Beans, Broccoli, Cashews, Chicken, Chickpeas, Chlorella, Clams, Cocoa, Dark Chocolate, Dark-Meat Poultry, Duckweed (Wolffia globosa), Edamame, Eggs, Heart, Kale, Kidney, Kidney Beans, Lamb, Lentils, Liver, Mankai (Duckweed), Oats, Organ Meats, Oysters, Pumpkin Seeds, Quinoa, Sourdough Bread, Soy, Spinach, Spirulina, Swiss Chard, Tempeh, Tofu, Wheat, Whole Grains | Critical for oxygen delivery to the brain via hemoglobin; supports mitochondrial function and energy production |
| Manganese | Supports mitochondrial antioxidant defense through MnSOD activity | |
| Selenium | Protects mitochondria from oxidative damage through antioxidant enzyme activity | |
| Vitamin B3 (Niacin; Niacinamide) | Replenishes NAD+, supporting oxidative phosphorylation, sirtuin signaling, and mitochondrial biogenesis; key for neuronal energy metabolism |
Neurochemical Balance
| Substance | Foods | Mechanism of Action |
|---|---|---|
| Choline | Essential precursor for acetylcholine synthesis, supporting memory, learning, and neuroplasticity; supports membrane phospholipid biosynthesis (PC) which is critical for membrane fluidity and neurotransmitter receptor function; phospholipid methylation (PLM) alters membrane structure, facilitating faster neuronal recovery and influencing ion channel behavior in gamma oscillations linked to attention and cognition | |
| Genistein | Enhances endocannabinoid activity; modulates dopamine, glutamate, and GABA signaling pathways | |
| DHA (Docosahexaenoic Acid) | Accounts for ~10–15% of total brain fatty acids, but represents 20–30% of fatty acids in neuronal phospholipids such as PE and PS, and more than 90% of the brain's omega-3 PUFA; critical for membrane fluidity, synaptic vesicle fusion, and neurodevelopment; transported across BBB as LPC-DHA via MFSD2A | |
| EPA (Eicosapentaenoic Acid) | Modulates dopamine and serotonin signalling; synergises with DHA but has independent mechanisms; membrane fluidity and neurotransmitter receptor function | |
| Omega-3 Fatty Acids | Membrane fluidity and neurotransmitter receptor function, ion channel behavior and gamma oscillations, support neurotransmission and phospholipid methylation | |
| Propionate | — | Stimulates secretion of norepinephrine and may influence dopamine regulation; promotes synthesis of key neurotransmitters |
| Short-Chain Fatty Acids (SCFAs) | Amaranth, Asparagus, Bell Peppers, Berries, Black Goji, Cabbage, Capers, Cherries, Chicory, Cranberries, Dairy Products, Dandelion Greens, Ghee, Grapes, Green Bananas, Jerusalem Artichokes, Kimchi, Kombucha, Leeks, Lupins, Miso, Mucuna Beans, Natto, Oats, Oranges, Pickles, Purple Potatoes, Raspberries, Sauerkraut, Seaweed, Sourdough Bread, Strawberries, Tart Cherry, Wheat, Wheat Germ, Whole Grains | Propionate stimulates secretion of norepinephrine and may influence dopamine regulation; SCFAs promote synthesis of dopamine and serotonin |
| Glycine | Acts as an inhibitory neurotransmitter; improves sleep latency and quality; supports GABA pathways and neurotransmitter balance | |
| L-Theanine | Supports GABAergic tone and neurotransmitter balance | |
| Taurine | Modulates calcium handling; influences GABAergic tone; supports neurotransmitter balance | |
| Phosphatidylserine (PS) | — | Supports neuronal membrane dynamics and signaling |
| Calcium | Essential for nerve impulse transmission and neurotransmission | |
| Magnesium | Almonds, Amaranth, Barley, Black Beans, Broccoli, Buckwheat, Cashews, Chia Seeds, Chickpeas, Cocoa, Dark Chocolate, Flax Seeds, Kale, Kidney Beans, Lentils, Milk, Oats, Peanuts, Pumpkin Seeds, Quinoa, Salmon, Seaweed, Sourdough Bread, Spinach, Sunflower Seeds, Swiss Chard, Tempeh, Tofu, Walnuts, Wheat, Whole Grains, Yogurt | Broad cofactor for neurotransmitter synthesis and receptor modulation (e.g., NMDA, GABA); functions as an NMDA receptor antagonist and GABA receptor modulator; assists enzymes involved in synthesis of dopamine and serotonin |
| Iodine | Thyroid hormones regulate synthesis and regulation of key neurotransmitters (dopamine and serotonin), supporting cognitive function and development | |
| Vitamin C (Ascorbate) | Supports norepinephrine synthesis; transported in brain via SVCT2 | |
| Saffron (Crocin, Safranal) | Thought to boost serotonin; supports mood regulation and cognitive function | |
| Copper | Cofactor in dopamine β-hydroxylase, supporting catecholamine synthesis; supports norepinephrine synthesis | |
| Zinc | Beef, Black Beans, Broccoli, Cashews, Chicken, Chickpeas, Crab, Dark Chocolate, Eggs, Kale, Lamb, Lentils, Milk, Oats, Oysters, Peanuts, Pork, Pumpkin Seeds, Quinoa, Shrimp, Sourdough Bread, Spinach, Wheat, Whole Grains, Yogurt | Important for DNA synthesis, cell division, and neurotransmitter regulation, particularly in modulating dopamine—a key neurotransmitter implicated in ADHD; acts as an allosteric modulator of the GABA receptor; supports glutamate regulation |
| Vitamin B12 (Cobalamin) | Supports neurotransmitter production through methylation; essential for myelin synthesis | |
| Vitamin B6 (Pyridoxine → PLP) | Cofactor for synthesis of dopamine, serotonin, GABA, and glutamate; supports rate-limiting steps in catecholamine synthesis; requires PDXK activation with magnesium and ATP support | |
| Vitamin B9 (Folate; 5-MTHF) | Supports neurotransmitter synthesis through methylation; cofactor for dopamine synthesis alongside iron, B6, and omega-3s | |
| Capric Triglyceride (Tridecanoin) | Ketones produced from capric triglyceride provide ATP through mitochondrial metabolism; ATP is essential for neurotransmitter synthesis, release, and reuptake, indirectly supporting neurochemical balance by ensuring adequate energy for neuronal function | |
| Caproic Triglyceride (Tricaproin) | Ketones produced from caproic triglyceride provide ATP through mitochondrial metabolism; ATP is essential for neurotransmitter synthesis, release, and reuptake, indirectly supporting neurochemical balance by ensuring adequate energy for neuronal function | |
| Caprylic Triglyceride (Trioctanoin) | Ketones produced from caprylic triglyceride provide ATP through mitochondrial metabolism; ATP is essential for neurotransmitter synthesis, release, and reuptake, indirectly supporting neurochemical balance by ensuring adequate energy for neuronal function | |
| MCT (Medium-Chain Triglycerides) | Ketones produced from MCTs provide ATP through mitochondrial metabolism; ATP is essential for neurotransmitter synthesis, release, and reuptake, indirectly supporting neurochemical balance by ensuring adequate energy for neuronal function | |
| Iron | Amaranth, Beef, Black Beans, Broccoli, Cashews, Chicken, Chickpeas, Chlorella, Clams, Cocoa, Dark Chocolate, Dark-Meat Poultry, Duckweed (Wolffia globosa), Edamame, Eggs, Heart, Kale, Kidney, Kidney Beans, Lamb, Lentils, Liver, Mankai (Duckweed), Oats, Organ Meats, Oysters, Pumpkin Seeds, Quinoa, Sourdough Bread, Soy, Spinach, Spirulina, Swiss Chard, Tempeh, Tofu, Wheat, Whole Grains | Essential cofactor for tyrosine hydroxylase, the rate-limiting enzyme in the conversion of tyrosine to dopamine; critical for catecholamine synthesis |
| Tyrosol | Neuroprotective effects; contributes to brain health benefits of extra-virgin olive oil | |
| Tyrosine | Catecholamine precursor (dopamine, norepinephrine); brain transport via LAT1 competes with other LNAAs; iron is an essential cofactor for tyrosine hydroxylase, the rate-limiting enzyme in conversion of tyrosine to dopamine; cofactors include iron, B6, folate, omega-3s, and BH₄ (tetrahydrobiopterin) to support rate-limiting steps in catecholamine synthesis | |
| Phenylalanine | Almonds, Beef, Black Beans, Cashews, Chia Seeds, Chicken, Chickpeas, Eggs, Flax Seeds, Lentils, Milk, Oats, Peanuts, Quinoa, Salmon, Sunflower Seeds, Tempeh, Tofu, Walnuts, Yogurt | Essential amino acid that converts to tyrosine and supports catecholamine synthesis (dopamine, norepinephrine); participates in LAT1 competition at the blood-brain barrier |
| Tryptophan | Precursor for serotonin and melatonin; brain entry competes at LAT1 with other large neutral amino acids (LNAAs); carbohydrate-rich, low-protein meals raise the plasma tryptophan:LNAA ratio because insulin pushes competing LNAAs out to muscles; can feed NAD+ synthesis via the kynurenine pathway | |
| Phosphatidylcholine (PC) | Major neuronal membrane phospholipid central to membrane fluidity, receptor function, and acetylcholine synthesis; DHA/EPA incorporated into PC are converted to lysophosphatidylcholine (LPC), a key transport form across the BBB | |
| Potassium | Critical for membrane potential, nerve signaling, and neuronal excitability; adequate intake balances sodium effects | |
| Sodium | Supports fluid balance, nerve impulse transmission, and muscle function; balance with potassium is relevant for blood pressure and neuronal excitability |
Oxidative Stress
| Substance | Foods | Mechanism of Action |
|---|---|---|
| Genistein | Prevents neuronal death; increases hippocampal glutathione (GSH) and superoxide dismutase (SOD); lowers lipid peroxidation, ROS, and nitric oxide production | |
| Omega-3 Fatty Acids | — | |
| EGCG (Green Tea Catechin) | Supports antioxidant defenses; part of antioxidant network | |
| Butyrate | — | Enhances mitochondrial function during oxidative stress; supports antioxidant activity |
| Short-Chain Fatty Acids (SCFAs) | Amaranth, Asparagus, Bell Peppers, Berries, Black Goji, Cabbage, Capers, Cherries, Chicory, Cranberries, Dairy Products, Dandelion Greens, Ghee, Grapes, Green Bananas, Jerusalem Artichokes, Kimchi, Kombucha, Leeks, Lupins, Miso, Mucuna Beans, Natto, Oats, Oranges, Pickles, Purple Potatoes, Raspberries, Sauerkraut, Seaweed, Sourdough Bread, Strawberries, Tart Cherry, Wheat, Wheat Germ, Whole Grains | Support antioxidant activity; butyrate enhances mitochondrial function during oxidative stress |
| Urolithin A | Powerful antioxidant; supports antioxidant defenses | |
| Quercetin (and Isoquercetin) | Effective antioxidant agent that scavenges reactive oxygen species; supports antioxidant defenses | |
| Vitamin C (Ascorbate) | Key water-soluble antioxidant; works within antioxidant network with vitamin E, CoQ10, and polyphenols | |
| β-Carotene | Antioxidant properties; scavenges reactive oxygen species and stabilizes cell membranes | |
| Lutein | Antioxidant properties; scavenges reactive oxygen species and stabilizes cell membranes | |
| Lycopene | Antioxidant properties; scavenges reactive oxygen species and stabilizes cell membranes | |
| Zeaxanthin | Antioxidant properties; scavenges reactive oxygen species and stabilizes cell membranes | |
| Curcumin (Turmeric) | Antioxidant properties; supports antioxidant defenses | |
| Hydroxytyrosol (Olive Polyphenol) | Potent antioxidant polyphenol; supports antioxidant defenses | |
| Oleuropein | Antioxidant polyphenol; works within the polyphenol network in olive oil | |
| Saffron (Crocin, Safranal) | Contains antioxidant crocin; supports antioxidant defenses | |
| ALA (Alpha-Linolenic Acid) | Essential omega-3 fatty acid; contributes to antioxidant and membrane support | |
| Arachidonic Acid (AA, n-6) | — | Contributes to inflammatory and oxidative stress pathways when in excess relative to omega-3s |
| Linoleic Acid (LA, n-6) | Essential fatty acid; balance with omega-3s is emphasized for optimal inflammatory tone | |
| Copper | Included in antioxidant enzyme networks; interacts with iron metabolism affecting oxidative stress | |
| Zinc | Beef, Black Beans, Broccoli, Cashews, Chicken, Chickpeas, Crab, Dark Chocolate, Eggs, Kale, Lamb, Lentils, Milk, Oats, Oysters, Peanuts, Pork, Pumpkin Seeds, Quinoa, Shrimp, Sourdough Bread, Spinach, Wheat, Whole Grains, Yogurt | Essential mineral that serves as a cofactor for antioxidant enzymes; works synergistically with other antioxidants; heavy metals are detoxified by metallothionein (MT) metal carrier proteins that must bind with zinc and copper |
| Coenzyme Q10 (CoQ10) | Part of antioxidant network; works synergistically with vitamin E, vitamin C, lipoic acid, and glutathione | |
| Manganese | Essential cofactor for MnSOD (SOD2), supporting detoxification of superoxide within the mitochondrial matrix | |
| Selenium | Supports glutathione peroxidase (GPx) and other antioxidant systems, protecting membranes and mitochondria from oxidative damage | |
| Tyrosol | Antioxidant properties; supports antioxidant defenses | |
| Oleacein | Antioxidant properties; activates NRF2 pathway; supports antioxidant defenses and neuroprotection | |
| Vitamin A (Retinoids; β-Carotene precursor) | Provitamin A carotenoids (β-carotene) act as antioxidants in neural tissue; contribute to antioxidant network | |
| Vitamin E (Tocopherols/Tocotrienols) | Lipid-phase antioxidant; protects polyunsaturated fatty acids in membranes from peroxidation; works within antioxidant network with vitamin C, CoQ10, and polyphenols |