SMILES diet depression trial: reduced depression and anxiety

March 24, 2017

The SMILES trial, A randomised controlled trial of dietary improvement for adults with major depression was recently published BMC Medicine. It is the first randomized controlled trial to test whether dietary improvement can actually treat depression. Yes, we’re using dietary improvement and treat in the same sentence!

The objective was to determine ifstructured dietary support, focusing on improving diet quality using a modified Mediterranean diet model” would have an impact on mood. The outcome is very exciting:

‘SMILES’ was a 12-week, parallel-group, single blind, randomised controlled trial of an adjunctive dietary intervention in the treatment of moderate to severe depression. The intervention consisted of seven individual nutritional consulting sessions delivered by a clinical dietician. The control condition comprised a social support protocol to the same visit schedule and length.

The results indicate that dietary improvement may provide an efficacious and accessible treatment strategy for the management of this highly prevalent mental disorder, the benefits of which could extend to the management of common co-morbidities.

These encouraging results were seen in participants who switched from a junk food diet to a real foods diet. Of the 67 who were enrolled in the study, the majority were using some form of therapy: psychotherapy and medications combined or psychotherapy only or medication only. There were 31 in the diet support group and 25 in the social support control group. Participants had to have been eating this diet in order to be accepted into the study:

a poor (low) intake of dietary fibre, lean proteins and fruit and vegetables, and a high intake of sweets, processed meats and salty snacks.

The dietary approach followed by participants in the study intervention group was the ‘ModiMedDiet’ which is based on the Australian Dietary guidelines and the Dietary Guidelines for Adults in Greece.

The primary focus was on increasing diet quality by supporting the consumption of the following 12 key food groups (recommended servings in brackets): whole grains (5–8 servings per day); vegetables (6 per day); fruit (3 per day), legumes (3–4 per week); low-fat and unsweetened dairy foods (2–3 per day); raw and unsalted nuts (1 per day); fish (at least 2 per week); lean red meats (3–4 per week), chicken (2–3 per week); eggs (up to 6 per week); and olive oil (3 tablespoons per day), whilst reducing intake of ‘extras’ foods, such as sweets, refined cereals, fried food, fast-food, processed meats and sugary drinks (no more than 3 per week). Red or white wine consumption beyond 2 standard drinks per day and all other alcohol (e.g. spirits, beer) were included within the ‘extras’ food group. Individuals were advised to select red wine preferably and only drink with meals.

The dietary composition of the ModiMedDiet was as follows: protein 18% of total energy; fat 40%; carbohydrates 37%; alcohol 2%; fibre/other 3%.

Here are the reasons I’m excited about this research:

  • It’s the first randomized controlled diet depression study and one third of the dietary intervention group saw improvements in their depression symptoms.
  • Participants also reported improvements in anxiety symptoms.
  • The authors even addressed the cost factor, stating it was more affordable to eat this way ($112 per week vs $138 per week).
  • The authors address the fact that the dietary intervention group was able to make these dietary changes “despite the fatigue and lack of motivation” that we so commonly see with depression.
  • I’m hopeful it’s going to pave the way for making dietary approaches part of the standard of treatment for mental health conditions. The paper suggests the addition of “clinical dieticians to multidisciplinary mental health teams.” This is wonderful but I’d like to add that these dieticians, together with nutritionists and health coaches would need to be well versed in functional medicine approaches.
  • According to an article on ABC, one participant continued the Mediterranean diet after finishing the study and is now doing a diploma in health science. How inspiring is this? When we get results like this we want to share them with everyone!  

These are very encouraging results and we applaud the positive results of this SMILES study which are truly groundbreaking.

Let’s also be aware of where we are headed with future research and how we can improve on the trial diet.  The researchers conclude with this comment about future research:

The scaling up of interventions and identification of the pathways that mediate the impact of dietary improvement on depressive illness are also key imperatives

Professor Jacka recently shared this paper on how personalized dietary interventions successfully lower post-meal glucose i.e. how certain foods can affect two people quite differently because of our unique gut bacteria. She said that she wants to do a similar personalized nutrition study for depression if they are successful in obtaining NHMRC funding.

Here are some questions I’ve been asked about this SMILES trial (and I’m sharing here in case you have similar questions):

  • why did only one-third of the study intervention group see improvements?
  • why was wheat and other grains included?
  • why was low fat dairy and lean meats emphasized?
  • why was there no mention of grass-fed meat, wild fish, healthy fats like butter and coconut oil, pastured eggs or chickens or quality organic fruits and vegetables?

The ideal dietary approach for anxiety, depression and any health condition is always one that high quality, is personalized and takes into account biochemical individuality. With the removal of gluten, grains and the inclusion of the other dietary changes mentioned above, plus addressing all nutritional imbalances I expect we will see more than one-third of the dietary group experiencing improvements in depression in future trials.  

I truly appreciate the work of Professor Felice Jacka and her team and look forward to seeing more studies like the SMILES trial, using a personalized approach and quality foods that include grass-fed red meat and wild fish, plus pastured eggs or chickens, and healthy fats; and organic produce as a baseline.

And then looking at the impacts of these dietary changes on anxiety and depression: gluten and/or grain removal;  removal of high histamine foods and high oxalate foods;  a low FODMAPs diet; the specific carbohydrate diet/SCD; a Paleo diet and so on – all based on biochemical individuality. (Next week, in part 2 of the blog, I’ll share some incredibly inspiring diet-depression and diet-anxiety Paleo success stories).

In summary:

  • a simple change like switching from junk to real food can have a major impact on your depression and anxiety
  • you may need to make additional dietary changes (gluten-free, grain-free, adding healthy fats and focus on quality, plus avoiding or adding certain foods based on your biochemical individuality)
  • you may also need to address brain chemical imbalances with amino acids supplements, address gut health, adrenal issues, low zinc, low vitamin B6, low vitamin D etc. too

Are you encouraged by this research?

And have you made similar dietary changes to those done in the SMILES trial and seen a reduction in your anxiety and depression?

Have you removed gluten or grains and made additional dietary changes, and added supplements and seen even more benefits?

Note: to avoid confusion I’ve used the Australia spelling of “randomised” and “fibre” in the quoted sections and the US spelling “randomized” elsewhere in the blog.


Trudy Scott (CN), Certified Nutritionist is the founder of, a thriving nutrition practice with a focus on food, mood and women’s health. Trudy educates women about the amazing healing powers of food and nutrients and helps them find natural solutions for anxiety and other mood problems. Trudy’s goal for all her clients (and all women): “You can be your healthiest, look your best and feel on-top-of-the-world emotionally!”

Low serotonin anxiety and sugar addiction: my interview on the Sweet Freedom Summit

March 20, 2017

It’s not common knowledge that brain chemical or neurotransmitter imbalances can cause sugar cravings as well as anxiety and depression. But there certainly is a big connection between stress eating, comfort eating, emotional eating and low levels of the brain chemicals serotonin, GABA and endorphins. There is a growing body of research supporting this connection.

Sharing this sugar craving-brain chemical connection and bringing it back to my expertise in anxiety and stress is something I don’t get to do often enough. So when I heard about the Sweet Freedom Summit that Sherry Strong was hosting, I immediately reached out to her and shared this brain chemical imbalance/addiction/mood topic in the hope she’d invite me to speak.

I was thrilled when she said she’d love to interview me and then doubly thrilled when she said our interview was SO good (I really enjoyed it too!) she’s decided to offer it as a gift to EVERYONE who signs up for the summit! Wow!

The Sweet Freedom Summit runs April 10-17 and I’m giving you a sneak peek to some of my interview today.

Sherry starts the sugar cravings/emotional eating/addiction discussion by asking what the connection is to brain chemistry imbalances and what evidence do we have that this is happening? Here are a few snippets from my response:

Say we’ve got a brain chemical deficiency of low serotonin, we are going to crave sugar and carbs in the afternoon and evening. And we will also have the low serotonin symptoms which are depression, the worry type of anxiety, the ruminating thoughts, the worry, the fear (these are the symptoms I experienced in my late 30s – I was also a chocoholic)

So you have this emotional aspect and the sugar cravings aspect when you’ve got these brain chemical imbalances.

And I just want to share something with you. This is a study done in 2002. And I’m going to just read a quote from this. The title is Evidence that Intermittent, Excessive Sugar Intake Causes Endogenous Opioid Dependence.

They’re saying that sugar can be as addicting as opioids and drugs. The goal of the study was to determine whether withdrawal from sugar can cause symptoms similar to opioid dependence. We’ve been hearing in the news how opioid drugs like OxyContin can cause dependence and we can have severe withdrawal symptoms.  

What they’re saying is palatable food stimulates systems in the body that are implicated in drug addiction. And they felt that intermittent, excessive sugar intake might create a dependency and you get these withdrawal signs.

So they are saying that withdrawal from sugar is very similar to withdrawal from something like morphine or nicotine. And this is interesting because we know how addicting drugs can be. And we don’t realize that sugar can be as addicting.

Sherry had me repeat this statement to really bring the message home: 

Brain chemical imbalances, such as low serotonin, can cause mood problems, depression or anxiety or obsessive tendencies. And they can cause addictions, be it to street drugs, be it prescription drugs, or be it to sugar or some kind of carbohydrate. And we need to take them all as seriously as each other.

Do you resonate with any of the above? Maybe the example I shared will be closer to reality for you:

Just think about the obsessive nature we have when we’re craving something. We’ll binge eat a box of cookies. And then we may even rush out and buy a second box to replace the box that we binge-ate to replace it before someone sees that we’ve eaten the first box. That sounds like the behavior of a drug addict to me!

We also cover the low GABA type of stress eating that we see with anxiety and low endorphins comfort/reward eating where you really LOVE certain foods (think a big bowl of ice-cream) – and which targeted individual amino acids to use for each brain chemical imbalance. This all means NO willpower is required and zero feelings of deprivation! Really! (and you get a mood boost too)

I hope you can join us at the online no-cost event – simply click here to register today. It runs April 10-17 and when you register you’ll get immediate access to my interview and some other cool sign up gifs. Please share with family and friends who you know can benefit from this information!

Two decades ago, your host, Sherry Strong, was completely addicted to sugar. She was obese, sick and depressed to the point of wanting to die. All of that changed when she removed sugar from her diet.

If you are struggling to give up sugar, are an emotional eater or stress-eater or even if you simply indulge periodically – whether a health professional, busy mom, athlete or career-driven person – this event can help you, finally, improve your health, your life, your mood and end those sugar cravings and addictions!

Got questions or feedback? Please share them in the blog comments below.


Trudy Scott (CN), Certified Nutritionist is the founder of, a thriving nutrition practice with a focus on food, mood and women’s health. Trudy educates women about the amazing healing powers of food and nutrients and helps them find natural solutions for anxiety and other mood problems. Trudy’s goal for all her clients (and all women): “You can be your healthiest, look your best and feel on-top-of-the-world emotionally!”


Anxiety, phenibut, toxins and cold showers for detoxification

March 19, 2017

Anxiety, phenibut, toxins, cold showers for detox and more. All of this and more is being covered on the upcoming online Diabetes Summit.

Starting Monday March 20th

I’m really pleased to be a speaker on this summit this year. I cover the anxiety diabetes connection. Anxiety is very common in diabetes – some research shows it’s as high as 25%, and women with diabetes are twice as likely to be affected with anxiety and depression. I also cover how and how GABA helps reduce physical anxiety AND how new research shows GABA is also a promising treatment for diabetes!

Dr. Mowll asked me about using phenibut instead of GABA:

I’ve seen a number of papers that talk about tolerance. I’ve talked to practitioners who’ve said they’ll rotate. They’ll have people be on Phenibut for five days, two days off. And I’ve seen some really scary drug forums where people are using Phenibut as a sort of mood enhancing and performance enhancing drug. They are using very high doses and there are protocols on how to safely taper off Phenibut.

So when I see things like that it concerns me. I’ve had a handful of people, who’ve had some pretty bad side effects from Phenibut. So with someone who’s going through anxiety I just don’t want to add anything else into the mix that may cause problems.

The concern is it does seem to work really well for anxiety and sleep, so that’s why I think a lot of practitioners are drawn to using it. And it may be that they’re not recommending the GABA/ Gamma Amino Butyric Acid sublingually. And they may not be doing a trial to find the optimal dose [so that’s why they are not seeing the results they’d hope to see]. So I would steer clear of phenibut.

We also cover the following (all relevant if you have diabetes AND if you don’t have diabetes):

  • doing a GABA trial and the blood brain barrier controversy
  • benzodiazepine tapers and nutritional support during a taper
  • rooibos tea for metabolic support and adrenal health

On day 2 of the summit, Razi Berry shares this about the toxins in our environment and the impacts they have on our health:

Out of the 80,000 chemicals that we have in our world, we have barely studied any of them. A couple presidents ago, the Environment Protection Agency was supposed to study the first 300 of these 80,000 chemicals. And so far they’ve only studied one, which is BPA. And BPA is all around us

She had to get rid of the toxins in her environment to help her fibromyalgia and chronic fatigue.

I had to stop using the body sprays that I love from Bath and Body, and the perfumes

I got rid of everything fragrant. And I didn’t use essential oils at first either because you still want to use them judiciously and in the right way. So I switched to everything unscented. And I found a lot about beeswax candles. Beeswax candles are so not only beautiful, and they have this honey like scent to them, but they actually neutralize odors and toxins in the air. They don’t just cover it up. So you actually can clean the air by burning beeswax candles. For centuries churches could not burn tallow or paraffin. They could only burn beeswax.

She covers tons of other everyday toxins we are exposed to and how we can safely avoid them. And then importantly, how we can detoxify from these toxins. One approach she covers is hot and cold showers or hydrotherapy (very powerful and very easy to do at home):

Hydrotherapy is a really old technique. It became really popular in the last turn of the century, the late 1800s, early 1900s. And it’s this use of water and/or temperature to help prime your body to get rid of toxins.

So one of the ways that you can do hydrotherapy at home is through what’s called a constitutional hydrotherapy shower. And it’s basically taking a hot and cold shower where you alternate. You start with the water as hot as you possibly can handle it. And you do that for like 12 seconds. Then you turn it to as cold as you can take it.

And the first switch from hot to cold is the most important because it really creates this pump in your lymphatic system, the hot, cold, hot, cold, and really helps to move toxins through your body so it can be eliminated by your kidneys, by your liver, through your respiration.

As you can see there’s plenty to learn from these experts!

Here are just a few of the topics being covered (general topics and applicable if you have diabetes):

  • How food allergens can trigger blood sugar problems, and how to detoxify the body safely
  • Understanding the stress continuum and how children trauma, adverse life events, and daily stressors can lead to diabetes (all of this is applicable to any health condition)
  • Natural strategies to balance blood sugar including new supplement recommendations, essential oils, and using food as medicine
  • Breaking down various eating strategies including the ketogenic diet (vegan diets and raw food diets are also addressed but I must add that I don’t endorse this way of eating if you do have anxiety)
  • Menopause and blood sugar issues (insulin, cortisol and oxytocin)
  • How to get your sleep right to balance insulin and blood sugar

And some topics taking a deeper diver into very specific diabetes areas (if you have type 1 or type 2 diabetes):

  • Developing a deeper understanding of peripheral neuropathy – how to test for it and how to treat it, naturally and effectively
  • Important strategies for those dealing with type 1 diabetes in themselves or a child 
  • Autoimmunity and diabetes

I hope you’ll join us to learn from these experts on the online Diabetes Summit.  My friend and diabetes expert, Dr. Brian Mowll, is hosting this life-changing event for the fourth year, and this year’s event looks amazing.

You can register for this online event here.

Feel free to ask questions in the comments below.


Trudy Scott (CN), Certified Nutritionist is the founder of, a thriving nutrition practice with a focus on food, mood and women’s health. Trudy educates women about the amazing healing powers of food and nutrients and helps them find natural solutions for anxiety and other mood problems. Trudy’s goal for all her clients (and all women): “You can be your healthiest, look your best and feel on-top-of-the-world emotionally!”


Anxiety: when to use GABA and tryptophan and how much to use

March 17, 2017

When you have anxiety it can be confusing trying to figure out the root cause. I like to start by assessing for low GABA and low serotonin because when you address these with targeted individual amino acids you typically see results right away and feel hopeful (and now have time to look for other root causes like gluten issues, high cortisol, gut issues, dietary changes etc).

But there may still be some confusion about when to use GABA and when to use tryptophan and how much of each of these amino acids to use.

I’d like to share a question I received on this blog: I am on 5-HTP for anxiety and I am wondering about trying tryptophan instead and my response so you have a clearer understanding of this:

I have started with Source Naturals GABA Calm 125 mg, 2 on awakening and two in mid-afternoon, and 2 GABA Relaxer at bedtime. It has taken some anxiety edge away from me, but I still feel some anxiety on and off, not so severe as before. I used to feel very anxious on awakening. I want to improve more.

Today, I ordered Lidtke L-trytophan 500mg and am expecting to receive it in a week. I plan to take 2 Gaba Calm on awakening and 2 in mid-afternoon, then add one 500mg Trytophan mid-afternoon and one 500 mg trytophan at bed time.

Is this a good plan? Or shall I have 2 GABA Calm on awakening, 2 trytophan mid-afternoon and 2 trytophan at bedtime.

It’s an excellent question and this is my feedback (with some additional information here for this blog post)

Firstly I’m so pleased to hear the GABA products has taken some of the anxiety edge away.

I would expect this when someone has the low GABA type of anxiety and hear this all the time despite the fact I continue to be asked the blood brain barrier question and does GABA really work as a supplement.

There is also no specific formula to be followed because each person is different and when I’m working with someone we’re figuring out what is working and why and adjusting accordingly. If something is working we continue with that until no additional benefits are seen.

Ask yourself what low GABA anxiety symptoms (this is the physical anxiety) have improved with the GABA and how much (rate each one before – out of 10; and what are they now – out of 10).

From your question it sounds like they could improve more – so if we were working together I’d continue to increase GABA before adding something new. I’d do this until the low GABA symptoms are resolved or until no additional benefits are observed.

Remember when it comes to brain chemical imbalances and anxiety we have 3 anxiety types

  1. Low GABA anxiety type (physical anxiety, more stiff and tense muscles)
  2. Low serotonin anxiety type (mental anxiety, ruminations, negative self-talk, worry)
  3. Low blood sugar anxiety type (physical anxiety, but more shaky)

You need to figure out which type of anxiety you are experiencing and address that. It can be different for each person but it’s not uncommon to experience all of the above.

Once that has been done and we have the ideal amount of GABA and no more low GABA anxiety symptoms I’d then check what low serotonin symptoms my client has (these are the busy mind, ruminations type or worry anxiety).

If she does have some of these symptoms, we pick one or two symptoms and do a trial with 1 x 500mg tryptophan opened on to the tongue (or less if she’s super sensitive). She rates the symptoms out of 10 before the tryptophan trial and then after the trial. Depending on how she responds on the trial, we’ll decide if she needs 1 or 2 x 500mg mid-afternoon and evening. The bedtime dose also depends on how bad the insomnia is. We continue to increase as needed based on symptoms until she has no more low serotonin type symptoms or until no additional benefits are observed.

All the while we are starting to make other changes – like diet, eating for blood sugar balance (this and using glutamine helps with the low blood sugar anxiety type), no caffeine, no sugar, looking for high cortisol, no gluten, looking at gut health and for other nutritional deficiencies.

Here are some links to additional resources related to the above:

I’d love to hear your feedback – do you/did you have the low GABA type of anxiety or the low serotonin type of anxiety or the low blood sugar type of anxiety or all three?

And feel free to share the before rating (from 1 to 10) and the after rating (from 1 to 10) once you’re taking the corresponding amino acid.


Trudy Scott (CN), Certified Nutritionist is the founder of, a thriving nutrition practice with a focus on food, mood and women’s health. Trudy educates women about the amazing healing powers of food and nutrients and helps them find natural solutions for anxiety and other mood problems. Trudy’s goal for all her clients (and all women): “You can be your healthiest, look your best and feel on-top-of-the-world emotionally!”


Menopause: insulin, cortisol, and oxytocin (an interview with Dr. Anna Cabeca)

March 13, 2017

What should a healthy menopause look like and what does an unhealthy hormonal imbalance leads? And what is the significance of insulin, cortisol, and oxytocin?

Dr. Brian Mowll, host of the upcoming Diabetes Summit, interviews Dr. Anna Cabeca on the topic of menopause and metabolic health. Dr. Anna is a board certified gynecologist and obstetrician as well as board certified in anti-aging and regenerative medicine. She is an expert in functional medicine and an expert in women’s health.

She starts with an overview of what menopause should look like and what an unhealthy hormonal imbalance leads to:

Hormonally, what does menopause look like? Yes, we’re going to age. And we’re going to have wrinkles and laugh lines and smile lines and things like that. But that’s awesome. We should be waking up rested, going to sleep on schedule without difficulty and have the sense of peace within us that we’ve become able to enjoy the life that we’ve worked so hard to create and also be able to educate, inspire, and instruct those around us and the generations that follow us. So those are the ideals in menopause.

However, with our environment and toxicities and unhealthy aging and unhealthy hormonal imbalance, what happens is we tend to get overweight, difficulty with weight loss. We tend to have increases in our blood sugar, increases of heart disease. What that feels like, too, is hot flashes, mood swings, itchy skin, night sweats and irritability. The monster within us can come out!

The next part of their discussion is fascinating and rather unexpected. Dr. Brian asks Dr. Anna about the main hormonal players in menopause and this is what she shares:  

As a gynecologist, you would think the major players would be estrogen, progesterone, and even testosterone. However, the major players when it comes to a healthy menopause are insulin, cortisol, and oxytocin. I run menopause programs specifically to get these major hormones in balance. And then we can fine tune the minor hormones.

But unless we’re getting the concepts that relate to increasing our body’s ability to have insulin sensitivity and, regarding cortisol, to have reset our cortisol, our natural circadian rhythm, we’re not going to get hormonal balance at all. And we’ll continue to struggle with the inflammation, the weight gain, the mood swings, [the anxiety and insomnia], the night sweats….  

Actually, insulin and cortisol have a bigger role than estrogen, progesterone, and testosterone although those are important and DHEA as well which I will replace very frequently. But insulin and cortisol are key to healthy menopause.  

And so cortisol is our natural anti-inflammatory. But also, we know that when we excrete high spikes of cortisol, that’s going to affect glucose production. So whether cortisol is too high or too low, we’re going to have an issue with glucose production and metabolism and increasing hemoglobin A1c and inflammation. So from both those areas, we’re going affect our inflammatory pathways.

Dr. Anna also covers some of the following in the interview:

  • Issues she sees with ketogenic diets and eating low carbohydrate diets (this one is for women in particular – she feels it throws off our neurotransmitters)
  • Why to test for pH and how to do it
  • Simple ways to boost oxytocin
  • Nutritional support for the adrenals

As I mentioned above, these are a few snippets from the upcoming Diabetes Summit.

In case you’re thinking “I don’t have diabetes, I don’t need to tune in to this one”, or “I’m not menopausal” or “I’m a guy” here are few points to consider:

  • If you’re a woman and experience stress this would be applicable whether or not you have diabetes or are in menopause (addressing this could help prevent diabetes and make menopause a breeze)
  • If you’re a man and experience stress this topic is also relevant, whether or not you have diabetes – just remove the words “menopause” and “women” and focus on the information about insulin, cortisol and oxytocin

So do consider tuning in to this one and other interviews in the summit!

If you do have diabetes or pre-diabetes then tuning in to the summit is a must! According to a 2015 study, nearly half the US population had diabetes or pre-diabetes.  Add to that all the Americans who are overweight, obese, or have insulin resistance and other blood sugar imbalances, that number likely climbs above 75%! Unfortunately it’s not just in the US.  Diabetes has become a global epidemic, predicted to get much worse in the next 20 years.

Clearly we need to do something different.  Change often starts with information and inspiration.  Learning the root causes of the problem and real solutions to correct those causes can motivate action.

That’s why I’m excited about this upcoming online Diabetes Summit.  My friend and diabetes expert, Dr. Brian Mowll, is hosting this life-changing event for the fourth year, and this year’s event looks amazing.

I’m really pleased to be a speaker on this summit too. I cover the anxiety diabetes connection and how GABA helps reduce anxiety and how research shows it’s a promising treatment for diabetes. Read more here.

You can register for this online event here.


Trudy Scott (CN), Certified Nutritionist is the founder of, a thriving nutrition practice with a focus on food, mood and women’s health. Trudy educates women about the amazing healing powers of food and nutrients and helps them find natural solutions for anxiety and other mood problems. Trudy’s goal for all her clients (and all women): “You can be your healthiest, look your best and feel on-top-of-the-world emotionally!”


Shame is inflammatory: the thyroid, autoimmunity and serotonin

March 11, 2017

A quick reminder that The Thyroid Secret online documentary replays air this weekend – all 9 episodes will be available to watch! It comes highly recommended! (You can still register here)

In Episode 5, The Stress Sickness, Michelle Corey, Functional Medical Practitioner, Nutritionist and author of the groundbreaking book The Thyroid Cure, The Functional Mind-Body Approach to Reversing Your Autoimmune Condition and Reclaiming Your Health, talks about the connection between shame and inflammation:

We know that shame is inflammatory. In fact, there was a study done where they had students sit for 20 minutes and think about some experience in their life that was shameful. They measured their blood afterwards, and they found spikes in inflammatory cytokines. We know that, from that study that induced shame cause a lot of inflammation. Unfortunately, we live in a global culture of shaming.

…shame is not something people really wanted to talk about, even psychologists or psychotherapists. Because shame is shameful. When you think about something shameful, it’s like the worst thing…

It’s very uncomfortable to speak about. I think just getting into the conversations about it. Just even journaling is one of the ways, because it is inflammatory. I have found, because I work with the autoimmunity [community], and there has been a big connection between abuse and autoimmunity in my practice that there is a lot of shame there. Just having someone be there to truly share your experience in a nonjudgmental way. Not in the way that I’m going to fix you, but just hear your story and have empathy for you. That’s one of the ways that shame dissolves. Because empathy is the antidote to shame. If we can have empathy for ourselves, if others can have empathy for us.”

She is talking about autoimmunity but this topic of shame and empathy is very relevant for my community – that means you of course – simply because of the shame and stigma around anxiety and mental health in general.

In case you’re interested here is the study Michelle is referring to: Immunological effects of induced shame and guilt, published in Psychosomatic Medicine in 2004.

I so appreciate everyone in the series, including Dr. Izabella Wentz, for sharing their powerful stories without shame so we can all be inspired and learn from them and have hope!

It’s not easy. I know because I used to have anxiety and panic attacks myself and made the choice to talk openly about the struggles I had. I was cautioned by a well-meaning mentor not to talk about it. She warned me that it was not professional and just not done in the field. I chose to be open and share anyway and I’m really glad I made this decision. It’s so important for healing on so many levels – for me and especially for those of you who hear my story and have hope!

In this same episode the topic of negative thoughts, the fears that we’re holding and the [negative] beliefs that we have about the body are discussed by Marc David and Emily Joy Rosen, founders of The Institute for the Psychology of Eating.

Marc shares this about these impacts on autoimmunity and the body attacking itself:

Autoimmune disease. That’s an autoimmune disease literally of our thinking, it’s self attacking self. It makes perfect sense to me because we know mind and body track one another. If I’m attacking self with negative thoughts, physiology can often follow where all of a sudden the body starts to attack itself. Or the body can attack its own thyroid gland. Which is, wow, how does that happen?

And Emily talks about how these thoughts impact treatment protocols:

I’m not saying that’s the only factor whatsoever. I think it is really important to look at the [negative] thoughts that we’re thinking. The fears that we’re holding, and the beliefs that we have about the body. Because they will impact the efficacy of any treatment protocol.

I wholeheartedly agree with both Marc and Emily and would like to add that these are all classic signs of low serotonin (that we can easily address):

  • negative thoughts (or negative self-talk)
  • fears and phobias and
  • the [negative] beliefs that we have about the body (often seen as low self-esteem or lack of confidence)

We could even connect the shame Michelle Corey talks about to low serotonin. The definition of ashamed is “reluctant to do or say something through fear of embarrassment or humiliation” or “hesitant or afraid to do or say something.” It sounds like low serotonin doesn’t it?

The wonderful thing is that these signs of low serotonin can be eliminated with some key nutrients.

The quickest and most effective way to boost serotonin is with the amino acids tryptophan and 5-HTP. I discuss the amino acids in the documentary: I touch on them in episode 2 and you hear me go into more detail in the FULL interview (which is part of the Deluxe GOLD package if you’re considering purchasing the series). Other ways include assessing and addressing low zinc, low vitamin B6, a need for inositol or curcumin or saffron, leaky gut and an out of balance microbiome. Eating GMOs, trans fats and gluten is detrimental. Exercising, eating grass-fed red meat and wild fish and supporting the adrenals is beneficial.

I hope you enjoyed this snippet and enjoy the replays!

And a quick reminder: did you know you can own the entire Thyroid Secret documentary series for yourself?

  • The Premium Silver Package, includes all 9 video episodes of The Thyroid Secret documentary series, complete easy to read transcriptions and MP3 audio recordings of each episode
  • The Deluxe Gold Package includes over 100+ amazing expert video interviews and 64 patient stories in over 76 hours of videos, transcriptions and MP3 audio recordings of each full length interview.

I’d love to hear some of the highlights you found useful and practical? Please share below in the comments.

PS. Feel free to share The Thyroid Secret online documentary with friends and family – all 9 replays air this weekend.


Trudy Scott (CN), Certified Nutritionist is the founder of, a thriving nutrition practice with a focus on food, mood and women’s health. Trudy educates women about the amazing healing powers of food and nutrients and helps them find natural solutions for anxiety and other mood problems. Trudy’s goal for all her clients (and all women): “You can be your healthiest, look your best and feel on-top-of-the-world emotionally!”

Titanium dioxide: gut damage, anxiety and cancer

March 10, 2017

Titanium dioxide, a common food additive found in candy, gum, bread, sunscreens, cosmetics and medications, has been shown in new research to alter digestive cell structure and function due to the damage it causes to the gut lining:

The ability of small intestine cells to absorb nutrients and act as a barrier to pathogens is ‘significantly decreased’ after chronic exposure to nanoparticles of titanium dioxide, a common food additive found in everything from chewing gum to bread.

Acute exposures did not have much effect, but chronic exposure diminished the absorptive projections on the surface of intestinal cells called microvilli. With fewer microvilli, the intestinal barrier was weakened, metabolism slowed and some nutrients — iron, zinc, and fatty acids, specifically — were more difficult to absorb. Enzyme functions were negatively affected, while inflammation signals increased.

The study was done using an in vitro (i.e. “in glass” or test-tube) cell culture model of the small intestinal epithelium. You can read the actual January 2017 study here.

Since this was not a human study this could be some of the extrapolations we could possibly make because of how chronic exposure led to fewer microvilli:

  • The intestinal barrier was weakened and metabolism slowed. If you suspect you may have damage to the gut lining (as in leaky gut and malabsorption), glutamine is an amino acid that when taken as a supplement is very healing of the gut.
  • Malabsorption of iron, zinc, and fatty acids was a factor so it would be important to assess for low levels and address deficiencies if necessary, especially since low levels of all three can have a direct impact on increasing anxiety.
  • Enzyme functions were negatively affected so this would need to be addressed with a broad spectrum enzyme and possibly HCl.
  • Inflammation signals also increased so using something like curcumin and omega-3 fatty acids may be a good choice to reduce likely inflammation.
  • And it goes without saying, eating a nutrient-dense anti-inflammatory diet is key

As soon as I read this paper I thought of my good friend and colleague Mira Dessy, NE, known as The Ingredient Guru, and author of The Pantry Principle: how to read the label and understand what’s really in your food. She is an expert in all things ingredient and food labels related so I reached out to her and she shared that the titanium dioxide powder itself appears to be somewhat harmless (although there are reports of the dust causing causing respiratory irritation). Even this concerns me but it gets even more concerning. Mira goes on to say:  

The challenge, however, is that there is an increasing amount of titanium dioxide nanoparticles being used.  The microscopic size and their ability to penetrate into the blood stream and from there circulate throughout the body is very worrisome.  These titanium dioxide nanoparticles represent a significant challenge to nerve tissue and also impact brain health through oxidative stress.

Given the ability of the nanoparticles to go through the skin and into the blood stream I’m not surprised that there is growing evidence for gut disruption in addition to the nerve and brain health issues.  The damage to epithelial cells and impairment of micronutrient absorption is highly concerning.  

I love Mira’s book The Pantry Principle (and learned so much from it) and I asked her this week when I reached out for a quote from her why it didn’t make it into her book published just a few years ago in 2013. She shared that it did not really come up on her radar at the time:  

Sadly it turns out that this is because food producers can use up to 1% titanium dioxide (food grade) without declaring it on the label.  Unfortunately when I wrote the book I did not know that.   At the time it appeared to be primarily used in personal care products. Approved for use in cosmetics back in 1973 it is often found in bath powders, cosmetics, antiperspirants, nail polish, sunscreen, and lotions.  It seems to be growing in food usage, appearing in candies, gums, dairy products, condiments, processed meats, and snack foods.  

I’m sharing this because I want you to be aware how quickly things can change and how we really need to keep up with labeling! (be sure to check out Mira’s other work on additives and labeling and my review of her book The Pantry Principle for additional information.)

I was also shocked to find out that food producers can use up to 1% titanium dioxide (food grade) without declaring it on the label – what!? I suspect (and hope) this will be changing in the near future.

I would expect some radical changes from governments and companies using it especially with this IARC (International Agency for Research on Cancer) monograph (another resource Mira provided): 

Titanium dioxide is possible carcinogenic to humans (Group 2B) based on sufficient evidence in experimental animals and inadequate evidence from epidemiological studies.

and this conclusion they reach:

Given the increasing applications of nano titanium dioxide in consumer products (e.g., food or food packaging and skin care products), there is a need to develop better techniques to detect titanium dioxide in tissues and to examine possible carcinogenicity of nano titanium dioxide by other routes of exposure (oral, dermal).

Another recent study found that injected titanium dioxide nanoparticles increased anxiety in rats, increased inflammation and there was increased accumulation in the liver, lungs and brain:

The results suggest that TiO2 NPs [titanium dioxide nanoparticles] could alter the neurobehavioral performance of adult Wistar rats and promote alterations in hepatic [liver] tissues.

I plan to avoid this additive. The best way you can avoid it too is to do the following:

  • eat real food and avoid food that has been processed
  • if you do eat something processed make sure it’s organic because titanium dioxide is not approved for use in organic foods (also make sure it’s not organic “junk food” – there is plenty of that around these days!)
  • read cosmetic labels and avoid toothpastes, makeup, lotions and sunscreens that contain the titanium, especially when in nanoparticle form  

Just to be clear, not all titanium dioxide used in food products are nanoparticles (which are defined as smaller than 100 nanometers in diameter). However up to 36 percent of the titanium dioxide found in nearly 90 food products were nanoparticles, according to this 2012 article: Titanium Dioxide Nanoparticles in Food and Personal Care Products.

I also reached out to my friend and colleague Lara Adler, Environmental Toxins Expert & Educator for her expert opinion:

The issue of nanoparticles in consumer products, whether it’s food, or personal care products like makeup or sunscreen can be confusing. The first issue is that there are no current labelling or disclosure requirements regarding nanoparticles, at least here in the US. Companies that are more keen to appeal to health-minded consumers will often disclose that they are not using nanoparticle sized ingredients, but there’s no legal requirement for anyone to do so, which means it’s totally possible for a product to contain nanoparticles of titanium dioxide and we won’t know. In the European Union, companies are required to disclose and fully label nano-ingredients.

When it comes to topical use in say, sunscreen, research is showing that non-nano titanium dioxide is unlikely to penetrate the skin and enter the body, and is therefore a low risk. The bigger health risk, for nano, or non-nano are products that are aerosolized, like the spray sunscreens as these products are easily inhaled. Most of the research into the negative health effects of titanium dioxide are inhalation studies.

Her feedback supports what Mira and I have discovered from the research: there’s a growing body of research that’s indicating potential negative health effects of nanoparticles, including their ability to migrate throughout the body. She shared these papers with me (both about nanoparticles in general):

A rodent study found that inhaled nanoparticles ended up in the central nervous system, and another study found them ending up in the liver.

But most shocking is this study Lara shared with me about maternal exposure to nanoparticles of titanium dioxide:

It caused the changes in the expression of genes associated with brain development, cell death, response to oxidative stress, and mitochondria in the brain during the perinatal period.

Changes of the expression of genes associated with neurotransmitters and psychiatric diseases were found.

Here are some examples of what you may see on labels:

Titanium dioxide in Devitar sunscreen – this is the sunscreen I have been using and recommended by an integrative cancer doctor. This is a common ingredient in sunscreen since it reflects the sun. I’m on the look-out for a new sunscreen that is free from titanium dioxide because we just don’t know what research is going to find. Right now a product like this is better than some of the other sunscreens that contain endocrine-disrupting oxybenzone and should definitely be avoided at all costs.

A bag of Smarties (yes, I was prowling the candy aisle here in Australia looking for ingredients!). You’ll see it on this label as 171. Titanium dioxide or E171 is used by the food industry to whiten and brighten food. Children have been identified as having the highest exposures because titanium dioxide content of sweets is higher than other food products.


It’s very commonly found in toothpaste for it’s whitening and brightening properties. This is from a tube of Sensodyne toothpaste here in Australia.  

Have you got products in your home with titanium dioxide on the label? I’d love to hear where you see it labelled and if you’ll be avoiding it in the future?


Trudy Scott (CN), Certified Nutritionist is the founder of, a thriving nutrition practice with a focus on food, mood and women’s health. Trudy educates women about the amazing healing powers of food and nutrients and helps them find natural solutions for anxiety and other mood problems. Trudy’s goal for all her clients (and all women): “You can be your healthiest, look your best and feel on-top-of-the-world emotionally!”

Stress, aging and turning off your bad genes: with Dr. Sara Gottfried

March 6, 2017

At age 44, my friend and colleague Dr. Sara Gottfried, M.D., got a research opportunity few people would want. She performed a simple blood test of how fast she was aging, and she failed.

She was aging 20 years faster than her chronological years, as measured by her telomeres. Those are the protective caps on your chromosomes that determine how your cells age. You want telomeres that are long and lovely. Dr. Sara’s were short and stubby.

Despite what we’ve been told, it’s not normal to age fast, gain weight, feel anxious, and become disease-ridden. Just as the number on the bathroom scale isn’t always a simple reflection of calories consumed vs. calories burned, the number of years you’ve lived isn’t always a reflection of your biological age (meaning the age of your cells).

Dr. Sara’s telomeres and body needed rescuing, so she dove into the science and created a breakthrough protocol to slow down aging.

Dr. Sara also had adrenal fatigue, a slow thyroid, estrogen dominance, disrupted sleep, and insulin resistance. Because her cells were numb to insulin, her blood sugar was climbing. Not in the diabetes range, but prediabetes. These hormone problems added up to faster aging.

During the past five years of research, Dr. Sara discovered crucial truths locked in our genes—truths about how you age, how you gain weight, how your body handles stress, and so much more. In her new book, Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years, she reveals important yet little-known truths to slow down aging and reverse anxiety. She helps you create hormonal harmony and turn on and off the appropriate longevity genes. Here are just a few highlights:

  • Breast cancer runs in her family, so she learned how to turn off her cancer-promoting genes using her fork and wine glass.
  • Sara doesn’t detox well—neither do half of Americans—so she needed to add a specific B vitamin to her daily regimen. Hint: we talk about the MTHFR gene and detox in our interview below).
  • Her grandmother died of Alzheimer’s disease, so Dr. Sara was thrilled to learn about the functional medicine protocol that preserves cognitive function regardless of age. Hint: it involves a specific way of eating, exercising, practicing yoga or meditation, flossing, brushing teeth, and sleeping.

In her new book, you’ll learn what happened to Dr. Sara’s telomeres over the past 5 years as she tested and refined her protocol, first on herself, and then on 1,000 other women.

I was fortunate to receive an advance copy of Younger and loved it so much that I wrote the following endorsement:

The brilliant book, Younger, by Dr. Sara Gottfried MD is mesmerizing, cutting-edge and a must-read! It teaches how you can turn your good genes on and your bad genes off via a healthy mix of science and gene information, together with simple assessment tools and powerful lifestyle changes. You’ll feel happier and calmer, look and feel younger, and actually reverse age-related diseases – even if you have anxiety, depression, Alzheimer’s disease, breast cancer, heart disease or obesity in your family. Why wouldn’t you want to influence your genes for the better? I know I do and so do my community of anxious women. We will all benefit immensely from Dr. Gottfried’s wisdom!

~ Trudy Scott, nutritionist and author of The Antianxiety Food Solution

I also had the opportunity to interview Dr. Sara about this topic and you can watch and listen below as we discuss some of the following:

  • Telomeres and aging (at 44 Dr. Sara had the telomeres of a 64 year old woman)
  • Healthspan and feeling fantastic
  • Walking on the beach for the adrenals, earthing and vagal toning
  • Forest bathing and the effects on cortisol levels [this isn’t in the book]
  • Ikaria “the island where they forgot to die” – herbal teas, tight social community, long lunches, no watches, 7.5 hours of sleep
  • Date night and chanting in the infrared sauna
  • Finnish study: saunas, longevity and the FOXO3 gene (a panacea? and even a form of exercise for those with heart failure)
  • MTHFR “detox” or methylation gene (depression and alcohol detox)
  • We can impact how our genes talk to our bodies in such profound ways
  • The FKBP5 Gene is turned on by severe trauma (studied in Holocaust victims) and affects how we handle stress
  • The TH gene is turned on by the cold
  • rs6330 – NGF/nerve growth factor gene and vagal tone (CC form = more anxious females; TT form = more anxious males) [this isn’t in the book]
  • Genetic testing is optional but can be done with 23andme, Pathway and SmartDNA (in Australia)
  • Testing telomeres with Lifelength and SpectraCell
  • Vagus nerve and parasympathetic system – affects anxiety levels, the gut, voice and brain – improved with meditation, prayer, chanting, social connection, singing, call girlfriends, sleeping on your right side
  • 7 day Younger challenge (most powerful levers from the book)
  • 7 week Younger challenge
  • Thing about your 75 year old self: “I want to make decisions that are kind to her” and “How can you kind be to your future self”

If this resonates with you, I encourage you to join Dr. Sara’s slow aging revolution by ordering your copy of Younger.

I hope you’ll join Dr. Sara and me in our quest to continue resetting genes and reversing aging in 2017. The science is yours for the taking!

If you are like Dr. Sara and have issues with your adrenals, thyroid, insulin, or sleep, you could be aging too fast, as she was. And while the genetic hand you’ve been dealt may seem like a fait accompli, the greatest truth Dr. Sara discovered is that you can “turn on” good genes and “turn off” bad ones using the seven-week protocol she developed based on the latest research. Thankfully, she’s done all the research so you don’t have to!

When you order the new book, feel free to click here to submit your receipt and get several bonuses for a limited time, including Dr. Sara’s Younger Quick Start Guide. This guide includes an overview of the Younger Protocol, Dr. Sara’s Anti-Aging Prerequisites, and a sample menu so that you’re ready when the book arrives.


Trudy Scott (CN), Certified Nutritionist is the founder of, a thriving nutrition practice with a focus on food, mood and women’s health. Trudy educates women about the amazing healing powers of food and nutrients and helps them find natural solutions for anxiety and other mood problems. Trudy’s goal for all her clients (and all women): “You can be your healthiest, look your best and feel on-top-of-the-world emotionally!”