If you have been unsuccessfully battling depression, you are not alone. At least 40 percent of all alcoholics in the United States are affected. I say 'at least' because our Health Recovery Center study found that almost two-thirds of our clients are depressed at entry. In fact, most alcoholics I have treated suffered from some degree of depression.
It is tempting to pin the blame for hopelessness and despair on the external events that can be triggered by alcoholism, such as the deterioration of a marriage or the loss of employment. To be sure, some of the depression alcoholics report is a result of the negative course life can take when you drink too much. You will be relieved to learn that this type of situational depression is self-limiting and will pass when your life begins to improve. Counseling or group therapy can be of enormous value here. But depression among alcoholics usually runs much deeper than the situational variety I have just described.
Depression often has biochemical roots that stem from the destructive effect of alcohol on the normal chemisty of the brain. Research has verified the relationship between biochemistry and depression. Autopsies of people who have committed suicide have revealed biochemical disruptions that may be unique to suicidal depression. In this chapter you will learn to recognize the warning signs of this tragedy in the making.
No amount of counseling or psychotherapy can help people who suffer from biochemically induced depression. I learned this the hard way: watching my son fight the deep sadness and feelings of hopelessness that descended upon him as his depression worsened. The counseling he received was excellent, but words have no power to reverse the biochemical disruption caused by alcoholism and drugs. In fact, therapy's focus on the unhappy or unsatisfactory external events marring the lives of such seriously depressed people only creates more misery.
My search for an explanation for Rob's suicide led me to studies that confirmed the connections between brain biochemistry and depression and offered methods of repair that succeed far more reliably than any form of talk therapy. I learned that there is no single biochemical glitch that explains all depression. At my clinic, we treat seven different sources of depression affecting alcoholics. In this article, you will learn which of the seven may underlie your depression, (in some cases, two or more may be to blame). You will also learn how to overcome your particular chemical problem or problems. This may mean taking more nutrients. It may require further changes in your diet. Or you may need drug treatment to correct a medical condition that can precipitate depression. First, of course, you'll have to confirm that you are depressed. Then you can evaluate the severity of your case.
Although two-thirds of the clients at my clinic are severely depressed when they enter the program, many do not realize they are affected. Men in particular are inclined to attribute the feelings induced by depression to other causes. Some blame their inability to handle stress well. Others reject being labeled depressed because of the social stigma often unjustly attached to this condition. Some are simply so overwhelmed by alcoholic symptoms that their depression is masked. Even so, depression is not difficult to spot if you know that certain behaviors are red flags to the condition:
Biochemical depression has certain symptoms that distinguish it from the depression stemming from negative life events. You have reason to suspect that you are biochemically depressed if any of the markers listed below describes your depression:
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As important as identifying the cause of your depression is determining the depth of your feelings. If you often have suicidal thoughts, please confide in your physician and a close friend or relative. You will recover, but in your present state you need the support of someone you trust. Share this information and together do the detective work needed to discover what is responsible for your continued depression.
As I noted earlier, at my clinic we have identified seven sources of biochemical depression affecting alcoholics:
[These may not only affect alcoholics but any of us who suffer from depression.] Where do you fit in? Let's begin with the most likely biochemical scenario.
Neurotransmitters are the natural chemicals that facilitate communication between brain cells. These substances govern our emotions, memory, moods, behavior, sleep, and learning abilities. Neurotransmitters are manufactured in the brain from the amino acids we extract from foods, and their supply is entirely dependent on the presence of these precursor amino acids. Alcohol destoys these essential precursor amino acids which is probably why alcoholics seem so emotionally muddled and depressed. Without adequate amino-acid conversion, neurotransmitters are no longer produced in sufficient amounts; this deficiency causes "emotional" symptoms, including depression.
The two major neurotransmitters involved in preventing depression are serotonin (converted from the amino acid L- tryptophan) and norepinephrine (also know as noradrenaline, converted from the amino acids L- phenylalanine and L-tyrosine). You can resupply the vital neurotransmitter precursors and reverse depression by taking daily amino-acid supplements. Your symptoms will determine which amino acid you will take for depression: L-tryptophan if your symptoms are sleeplessness, anxiety, or irritability; L-tyrosine or L-phenylalanine if your symptoms are lethargy, fatigue, sleeping too much, or feelings of immobility.
Tryptophan to Serotonin
The amino-acid tryptophan found in large amounts in milk and turkey is the nutrient needed to form serotonin, which controls moods, sleep, sex drive, appetite, and pain threshold. Eating disorders and violent behavior have also been traced to serotonin depletion. Replacing serotonin can lift depression and end insomnia. In one notable study, a medical researcher in Holland demonstrated that a combination of tryptophan (2 grams nightly) and vitamin B6 (125 milligrams three time a day) could restore patients with anxiety type depression to normal in four weeks. Depression accompanied by anxiety and sleep disturbances is most likely to respond to tryptophan.
How to Take Tryptophan
Until the U.S. Food and Drug Administration prohibited the manufacture and sale of tryptophan in the United States in the fall of 1980, we used it for ten years at the clinic without any ill effects. This amino acid has also been widely used in England and Canada. Last year, however, a number of deaths and illnesses in the United States were traced to batches of tryptophan manufactured in Japan. In response, the FDA removed tryptophan from the U.S. market. At the time of this writing, the ban remains in effect. I want to caution you against using any tryptophan purchased before the FDA barred its sale. I am confident that eventually tryptophan will again be freely available in this country. At that point, you can purchase a fresh supply. Here are guidelines for its use:
Of all the amino acids, tryptophan is least able to cross the blood-brain barrier. It must pass this biological hurdle in order to be converted to serotonin. Always take your tryptophan on an empty stomach.
Safety and Side Effects
Orthomolecular physicians have safely used tryptophan in doses of one to six grams daily. Since it is not stored in the body, it cannot accumulate to toxic levels. However, taking high levels of tryptophan can produce some side effects:
Formula for Depression Due to Serotonin Depletion
|L-Tryptophan*||500 mg||2 to 8 capsules per day in divided doses (1 or 2 mid-morning, 1 or 2 mid-afternoon, 2 to 4 at bedtime) on an empty stomach|
|Vitamin B6||50 mg||1 capsule 3 times per day|
|Vitamin C||1000 mg||1 capsule per day|
|Niacin||500 mg||1 capsule per day (non-time released)|
*Use tryptophan only if the FDA lifts the current ban on its sale.
Who Should Not Take Tryptophan
Tyrosine to Norepinephrine
The amino acid tyrosine, found in large amounts in cheeses, has an amazing effect on depression. A number of studies have found that it can succeed where antidepressant drugs fail. In the brain, tyrosine is converted into the neurotransmitter norepinephrine, which has been described as the brain's version of adrenaline. You can appreciate the power of norepinephrine when you realize that the effect produced by cocaine comes from the drug's ability to activate norepinephrine while inhibiting serotonin. This chemical reaction causes the brain to race until the supply of norepinephrine is depleted. The crash leaves addicts exhausted, depressed, extremely irritable, and craving more cocaine. Large doses of tyrosine can reduce withdrawal symptoms and prevent serious depression among cocaine addicts. We have used tyrosine at the Health Recovery Center for the past few years with no adverse effects. The usual dose is three to six grams per day, taken on an empty stomach. You must take vitamins B6 and C to facilitate conversion of tyrosine to norepinephrine (see table below).
L-Phenylalanine to Norepinephrine
As an alternative to tyrosine, you can take the amino acid L- phenylalanine, which also can be converted into norepinephrine. A number of studies have confirmed L-phenylalanine's amazing antidepressant effects. In one, this potent amino acid was found as effective an antidepressant as the drug imipramine (Tofranil). L-phenylalanine has one important advantage over tyrosine in treating depression. It can be converted to a substance called 2-phenylethylamine or 2-PEA. Low brain levels of 2-PEA are responsible for some depression (before it converts to tyrosine, which then converts to norepinephrine). If you are affected, L-phenylalanine will be better for you than tyrosine. The only way to find out is by trial and error. I recommend that you start by taking L-phenylalanine. If you find that it makes your thoughts rush (an effect that is often described as the brain "racing"), you don't need 2-PEA and should switch to tyrosine. The only other disadvantage to taking L-phenylalanine is its slight potential for raising blood pressure.
There is also some evidence that excess L-phenylalanine can cause headaches, insomnia, and irritability. For these reasons, it is important to start with a low dose. L-Phenylalanine doses can range from 500 milligrams to 1500 milligrams daily taken on an empty stomach. Overdose symptoms are headaches, insomnia, and irritability.
Formula for Depression Due to Norepinephrine Depletion
|L-Tyrosine||500 mg||4 to 10 capsules per day in 2 or 3 equal doses on an empty stomach|
|OR -- L-Phenylalanine||500 mg||1 to 3 capsules per day in equal doses on an empty stomach|
|Vitamin B6||50 mg||1 capsule 3 times per day|
|Vitamin C||1000 mg||1 capsule per day|
Who Should Not Take Tyrosine or L-Phenylalanine
Another biochemical cause of depression is a genetic inability to manufacture enough prostaglandin E1 (PGE1), an important brain metabolite derived from essential fatty acids (EFAs). The problem is the result of an inborn deficiency in omega-6 essential fatty acid. Alcohol stimulates temporary production of PGE1 and lifts the depression.
If you have been depressed since childhood, your introduction to alcohol was probably an extreme relief. But this relief is short-lived. When you stop drinking, PGE1 levels fall again and depression returns. To banish it, you turn again to alcohol. Thus a deadly spiral begins toward alcoholism.
During the last fifteen years, researchers have learned to restore normal PGE1 levels in alcoholics and eliminate both the depression and the need to drink for relief. A substance called gamma-linolenic acid (GLA) is easily converted to PGE1. I have seen some amazing recoveries from depression within three weeks of GLA treatment. Take the case of Colleen, a high school English teacher:
As her college years passed, Colleen's alcohol consumption escalated. She needed to drink more and more to get the lift she sought. She also began to experience deep depressions in the days following heavy drinking. After college, she began teaching high school English. Controlling her depression with alcohol became a real balancing act. Eventually, her drinking came to the attention of her peers and her students. Colleen was appalled at the idea that she was a problem drinker. She decided to prove she could live without alcohol. The next ten years were some of the most miserable of her life. She joined AA and sought psychiatric help for her severe depression. Sadly, no antidepressant drug relieved her misery. It was hard to keep teaching, hard to keep living.
Her depression had reached the suicidal stage when she reasoned that alcohol could put an end to her despair. Her decision to resume drinking didn't take much reflection. Predictably, her alcohol intake began to escalate rapidly. This time, no one sympathized. Her principal ordered her to treatment. Three weeks after completing an inpatient program, she was back at employment and drinking again to medicate her depression. A second round of treatment left her temporarily dry and depressed. Colleen was on a merry-go-round she couldn't get off. When she called the Health Recovery Center, she was crying, "I have alienated everyone because I won't stay sober, but being drunk feels better than being depressed."
I often think someone up there does watch over people, it seems more than coincidence that Colleen found her way to one of the few treatment centers in the country that would run tests and restore her chemistry to normal. Within three weeks, her depression had vanished. She no longer needed nor craved alcohol.
Colleen's was a classic case of chronic depression caused by too little PGE1. Although alcohol blocks production of additional amounts of this metabolite, its active effect is to enhance what little is available in the brain. Eventually, a no-win situation develops and alcohol becomes the only way to prevent depression. The solution, of course, is to provide the brain with the PGE1 needed to reverse the depression. If your body can't do this normally, you can correct the problem by taking gamma linolenic acid (GLA) in the form of Efamol ( a trade name for oil of evening primrose). The formula for EFA deficient depression (see table below) includes three supportive nutrients in addition to Efamol: zinc, needed for formation of gamma-linolenic acid (GLA); vitamin B6 for metabolism of cis-linolenic acid; and vitamin C, to increase production of PGE1. When you take GLA and its co-factors, depression magically lifts and won't return as long as you continue to take the formula. Colleen now uses this natural substance daily instead of alcohol, and her world has brightened up permanently.
Do You Have an EFA Deficiency? In his book "Essential Fatty Acids and Immunity in Mental Health, Charles Bates, Ph.D., provides a list of factors that suggest an essential fatty acid deficiency:
Formula for Depression due to EFA Deficiency
|Efamol||500 mg||3 capsules, 3 times per day with meals (9 per day); can be reduced to 6 per day after 1 month|
|Zinc picolinate||20 mg||1 capsule with food|
|Vitamin B6||50 mg||1 capsule 3 times per day|
|Vitamin C||1000 mg||1 capsule per day|
|Niacin||100 mg||1 capsule with food daily|
The effect of nutritional deficiencies on brain chemisty can cause depression, anger, listlessness, and paranoia. Unfortunately, the connection between depression and vitamin and mineral deficiencies is often missed. At Johns Hopkins University, sixty-nine cases of scurvy (total vitamin C depletion) were discovered at autopsy, and yet the disease had not been diagnosed before death in 91 percent of these patients.
One of the most dramatic cases of vitamin and mineral deficiencies I have seen involved a man I'll name Paul. He had been arrested four times for drunken driving but continued to drink daily. His probation officer brought him to the Health Recovery Center. The three of us had to decide if an outpatient program would be proper for someone as depressed as Paul. The court had just ordered him back to treatment; judging by the miserable look on his face,it was the last place he wanted to be. Paul was thirty, divorced and living alone. He rarely ate more than one meal a day, usually fast food or junk food. He lived on coffee, cigarettes, and beer. Paul confided that he was probably going to lose his sales job because he could no longer motivate himself. He blamed all of his troubles on depression. There were so many aspects of his life-style that suggested a real depletion of the natural chemicals he needed to recover from alcoholism and depression that I urged Paul to let us work with him. Two days later, after receiving his B-complex shots, Paul remarked that we must have injected him with an amphetamine. The effect of restoring these life-giving substances was dramatic. He also made many life-style changes that contributed to his recovery, but one of the most important was the replacement of certain key natural substances that helped relieve his depression.
The 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--the very substances that most alcoholics consume almost to the exclusion of everything else. Small wonder that deficiencies develop.
Here's a rundown of recent finding about the relationship of B-complex vitamins to depression:
Continued vitamin C deficiency causes chronic depression, fatigue, and vague ill health.
Deficiencies in a number of minerals can also cause depression. I would like you to familiarize yourself with the minerals that can underlie depression so you can better understand the rationale for taking supplementary doses:
The Safety of Supplements
Vitamin C and the B-complex vitamins discussed above are all water soluble. This means that they can't accumulate in your body or he stored for future use. Amounts above and beyond your current nutritional needs are dumped into your urine. As a result, there is no danger of overdose. Unlike water soluble vitamins, minerals can be stored in your tissues. [Refer to the Optimum Nutrition Formula for the RDAs and suggested optimum levels.] For therapeutic doses you will need the advice of a qualified nutrition consultant. Do not exceed the recommended therapeutic doses, since accumulation of minerals in the body can be dangerous.
The stress showed on Mary's face as she described how weary and depressed she felt. Her husband and children demanded too much of her and she drank to escape the pressures and responsibilities. Mary had been in our program for two weeks. She was now alcohol free and making life-style changes. Still, she had very little energy and didn't seem to be recovering very fast. As we talked, she inadvertently offered several clues to the source of her problem. She complained that even on her restricted diet she simply couldn't lose weight. Exercise was out of the question. She was just too tired, even though she slept up to ten hours a night. She was wearing a heavy sweater even though it was a warm spring day. She said she had a hard time keeping warm and was very susceptible to catching colds. By the end of our session, I had heard enough to refer her to our physician for a thyroid test. Symptoms of hypothyroidism (low thyroid function) include:
Researchers speculate that hypothyroidism causes depression because there is an insufficient supply of oxygen to the brain, since people with low thyroid function do not use oxygen efficiently. Linus Pauling contends that all depression could be eliminated if brain cells received sufficient oxygen.
If you have any of the symptoms listed above, you can test yourself for hypothyroidism with a procedure first described in the Journal of the American Medical Association by thyroid expert Broda Barnes, M.D. The test could not be simpler. People with low thyroid function have lower than normal temperature because they are not burning up as much food as they should. All you have to do for this test is determine whether your body temperature is lower than normal. Use a digital or basal thermometer, not a fever thermometer. The basal type is commonly used by women trying to get pregnant--or trying to avoid pregnancy--to determine when ovulation occurs on the basis of an increase in body temperature. Basal thermometers are available in most drugstores. Place the thermometer snugly under your armpit for ten minutes. If it registers below 97.8 degrees and if you have symptoms of hypothyroidism, you probably need thyroid hormone. This home test can give you a fix on your thyroid status. If you haven't yet been tested, you can ask your doctor to check further. The usual laboratory tests for thyroid (T3, T4, and TSH) do not always tell the whole story. But a new test, the fluorescence activated microsphere assay (available from ImmunoDiagnostic Laboratories in San Leandro, California) will often reveal abnormalitites less sophisticated tests miss.
In Mary's case, standard lab tests indicated low-normal thyroid function, but her morning temperature never rose above 96.9 degrees. We treated her with armor Thyroid, a prescription drug. It relieved her depression and eliminated her mental sluggishness and fatigue. She also lost weight. If your home thyroid test shows that your temperature is consistently below 97.8 degrees, see your physician to discuss treatment. If the doctor wants more information on your testing method, refer him or her to Dr. Barnes's book "Hypothyroidism: The Unsuspected Illness". Another useful book is "Solving the Puzzle of Illness" by Steven Langer, M.D. Dr. Barnes has published more than a hundred papers and several books on the role of the thyroid gland in human health. He treats thyroid disorders with natural desiccated thyroid rather than synthetic thyroid preparations. The advantage of natural thyroid over synthetic is that all thyroid hormones are replaced with the natural product, whereas synthetics have not yet been able to duplicate nature completely and do not affect two troublesome symptoms of hypothyroidism, dry skin and water retention.
In his studies of twelve hundred hypoglycemic patients, Stephen Gyland, M.D., found that 86 percent were depressed. More recently, positron emission tomography (PET) scans have verified that glucose metabolism is often reduced in the brains of patients suffering from depression. The table below, which is based on Dr. Gyland's studies, compares the symptoms of hypoglycemia and depression. It is no accident that both conditions are so common among alcoholics. If hypoglycemia underlies your depression, you should begin to notice an improvement soon after you adopt a better diet that no longer supports the hypoglycemia.
Faintness, cold sweats
The connection between food allergies and depression was a revelation to me. I was treating a young woman who was both alcoholic and depressed. I expected to find some food or chemical sensitivities because she had a terrible withdrawal hangover when she stopped drinking, indicating an allergic/addicted response to alcohol. But I was not prepared for the Jekyll and Hyde changes that I witnessed.
By the end of the week-long modified fast, Carol was feeling much better. Her depression was gone and her energy had returned. Then she tested wheat. Within two hours she crashed. Crying over the telephone, she told me she was too depressed to continue the program. The next day she apologized. We were both grateful to find a major trigger to her depression. After her severe reaction, I expected Carol to avoid wheat religiously. At the time, I didn't understand the addiction aspect of the allergic/addicted response. Carol had enormous cravings for breads and pasta, so her resolve lasted only a few days. Then she succumbed to temptation and ate pizza for lunch. An hour later, she arrived at her treatment group sobbing inconsolably while the others groped for emotional explanations for her behavior. After her wheat reaction wore off, her depression again lifted.
Wheat is not the only substance capable of triggering a maladaptive reaction within the brains and nervous systems of sensitive people. Alcohol, certain foods (particularly the grains from which alcohol is made), and many chemicals (particularly hydrocarbon-based products like gasoline and paints) can also cause reactions. Food addiction keeps us coming back for more of certain foods. We love the initial mild energy they provide as they bring us out of our withdrawal state. We don't understand that the downside of this addiction is depression, anxiety, and mental confusion, the result of the inevitable withdrawal in the nervous system and the brain. So be suspect of foods that you feel you cannot do without.
During the last five years, we have seen a steady parade of clients who are fighting an internal war with an overgrowth of a common intestinal yeast called Candida albicans. I can usually tell on the basis of a first interview who is a probable candidate for treatment of candida-related complex (CRC). People suffering from this problem appear depressed, tired, anxious, and so spacey that they can't follow what I'm saying. They tell me they continually crave sugar as well as alcohol, and they have telltale signs of yeast invasion throughout their bodies. Their immune systems are so depressed that most foods cause bloating and produce allergic/addictive responses. If you suffer from CRC, your depression won't lift until these yeast colonizers are brought under control. [Visit your nutrition consultant for a full program to handle this all-too-common condition.]
Before we leave the subject of depression, I want to discuss a painful subject: suicide, the final solution to depression. If your life, like mine, has been seared by the suicide of a family member, you may find the answers you have been seeking. And if you have been trying to cope with overwhelming depression and are plagued with thoughts of suicide, you will find a welcome warning that can help you avert tragedy. Over the years, I've learned that alcoholics often conceal the fact that family members have taken their own lives. But if I tell them about my son's suicide, the truth comes rushing out: "My father shot himself" or "Several times, my mother took a deliberate overdose of pills" or "My son hung himself." The pain of these tragic deaths is often compounded by a family code of silence.
Often, those touched by the tragedy are tormented by guilt. They can't stop wondering whether they could have done something to prevent the suicide, whether they missed warning signs that tragedy was approaching. Recent scientific findings provide some of the answers to these agonizing questions and offer comfort and insight.
Most people experience some major disappointment or stress in the course of life, but suicide is rarely the outcome. And, there is no good evidence suggesting that most depression predates alcoholism or that any personality traits underlie alcoholism. Indeed, researchers have so far failed to find genetically transmitted depression among most alcoholics. Instead, studies suggest that the prolonged use of alcohol causes biochemical changes in the brain associated with depression and suicide. The most striking of these findings (from the National Institute of Mental Health) shows that the neurotransmitter serotonin is almost depleted in all the brains of suicides examined during autopsies. Since alcoholism causes the destruction of tryptophan and other precursor amino acids needed for production of the antidepressant neurotransmitters, it's not surprising that many alcoholics are prone to depression and even suicide. As I have explained earlier in this chapter, alcohol can also precipitate depression by destoying a number of other natural chemicals, including
A cerebral allergic reaction to alcohol or other substances can cause suicidal depression. High levels of toxins from Candida albicans overgrowth can also affect the brain and central nervous system and induce suicidal depression. Alcoholism promotes both proliferation of candida and escalation of cerebral allergies. Since alcohol can inflict so much biochemical damage on the brain and nervous system, it should not be surprising that many alcoholics attempt suicide. One recent study found that up to 40 percent of all alcoholics try to take their own lives at east once; another study found that 26 percent of the deaths of treated alcoholics were suicides. If you feel that you or someone close to you is a suicide risk, please re-read this chapter carefully and encourage the changes recommended to restore normal balance and banish depression once and for all.
Now that you are familiar with the various problems that can underlie depression, it's time to determine what to do about the one(s) that may be responsible for your own state of mind. Here are the options:
Don't be surprised if you fit several of these seven categories. Heavy alcohol use wreaks havoc on your biochemical balance. But with a repair program you can restore your health. In some cases you'll need a physician's help or the help of a nutrition consultant. I can't overemphasize the importance of expert medical advice when you are dealing with depression, especially if it is severe. It is equally important to choose a professional attuned to your special needs. Orthomolecular MDs are experts in both allopathic and nutritional science who treat disorders at the cellular level with biological weapons--nutrients that nature has provided in its own system of defense for millions of years. An orthomolecular psychiatrist or physician can help you address the following problems:
For a list of such physicians in your area, contact the American Academy of Environmental Medicine, P.O.Box 16106, Denver, CO 80216, (303) 622-9755.
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This article (extracted from "Alcoholism--The Biochemical Connection" by Joan Larson) was written especially to help alcoholics, who are particularly prone to suffer from depression, but the information it contains will be valuable for every person who frequently feels depressed or unable to sleep through anxiety. Until these nutritional factors are handled no amount of positive thinking or psychotherapy can make much headway. This is the reason that I, as a psychologist, initially became interested in the subject of nutrition.
CFS or Low Level Mercury Poisoning?
We would like to draw your attention to an individual case of Chronic Fatigue Syndrome (CFS, also known as ME) which was not resolvable by nutritional means alone. This was because the real cause was Mercury poisoning, a form of toxicity which has very similar symptoms to CFS. If you have had a lot of dental fillings with silver/mercury amalgam, and you suffer from chronic fatigue, you may have the answer right there in your mouth!
The Dangers of Glyphosate Farming
Eliminating genetically modified foods from your diet and glyphosate from your garden or farm operations, may be the most important decisions you will ever make. You will never know the lives you’ll touch with it. It is not an economic decision at all, it is a moral one.