Trudy Scott Anxiety Nutrition Solutions & Every Woman Over 29

Tryptophan doesn’t work, then it does and then it doesn’t: could it be hormonal shifts, dietary factors and/or parasites?

November 26, 2021 By Trudy Scott 11 Comments

Have you been in a situation where tryptophan doesn’t work, then it does work, and then sometimes it doesn’t work as expected? There is a reasonable explanation as to why it may not work initially – too much or too little was used. The variable results and the need to switch between lower and higher doses on an ongoing basis can happen but it’s not very pronounced unless there is a specific reason. In this blog I cover some of these reasons – hormone shifts, dietary factors and parasites/other digestive issues.

I’m writing this blog in response to a question that was posted on one of my speaker pages on the Anxiety Summit: Gut-Brain Axis. This is the actual question:

I tried to use tryptophan the first time (whole capsule) and got really high. Some time later I tried again, but used 1/4 of a capsule and had a good result. A few weeks later 1/4 of the capsule didn’t work at night. So I went up to half a capsule. And that’s where I am now. But some nights (very rare) I can only get good results from a whole capsule. I use it along with the same amount of GABA. Is that a normal reaction for tryptophan?

I don’t know what brand of tryptophan she was using but assume 500mg was her starting dose and she now shifts between 125 mg (¼ capsule) and 250 mg (½ capsule) with variable results.

It’s not unusual for someone to not feel great on 500 mg if that dose is too much for their unique needs. She did the right thing by lowering her dose. It’s also reasonable that someone may find 500 mg as an initial dose isn’t enough to reduce symptoms.

The variable results and the need to switch between 125 mg and 250 mg can happen but it’s not very pronounced unless there is a specific reason. Some of these reasons include hormone shifts, dietary factors, parasites/other digestive issues, thyroid issues, low lithium, product quality and environmental factors. More on all this below.

Hormone shifts/more serotonin is needed in the luteal phase

I have my clients track when the variability happens, with female clients documenting their cycles. Some women need more serotonin support in the luteal phase i.e. after ovulation and right up to before their periods. Some may even need additional tryptophan for the first few days of their periods too.

Write about tryptophan working well in the luteal phase in this blog – Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability

In a study published in 1999, A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria, tryptophan was found to reduce symptoms of PMS when used in the luteal phase or second half of the cycle (i.e. after ovulation):

37 patients with premenstrual dysphoric disorder were treated with L-tryptophan 6 g per day, and 34 were given placebo. The treatments were administered under double-blind conditions for 17 days, from the time of ovulation to the third day of menstruation, during three consecutive menstrual cycles.

They looked at dysphoria, which is defined as a state of unease or generalized dissatisfaction with life, plus mood swings, tension (and anxiety), and irritability and they found a 34.5% reduction of symptoms with tryptophan compared to 10.4% with placebo.

The paper concludes: “that these results suggest that increasing serotonin synthesis during the late luteal phase of the menstrual cycle has a beneficial effect in patients with premenstrual dysphoric disorder.”

It’s a small study but the results are powerful and it’s something I see clinically with my clients. The one big difference is that I typically have clients using tryptophan throughout the month.

But if you are seeing tryptophan work and then not work at similar times each month this is something to consider and track. And then if need be, increase and decrease tryptophan accordingly (and track again).

Dietary factors – collagen, gluten, sugar, wine and coffee

There are other factors to consider too and dietary impacts is one. For example, collagen leads to a higher need for tryptophan in susceptible individuals (due to it’s serotonin-lowering effects – I blog about this here)

Another dietary factor is accidental gluten exposure in susceptible individuals or a newly discovered gluten issue

High sugar intake, alcohol and/or caffeine consumption may also be a factor – contributing to added stress for the adrenals and depletions in zinc and the B vitamins. This can contribute to lowered serotonin and a need for a higher dose of tryptophan.

Now imagine if it’s just before her period and she adds collagen to her diet and she also eats out and gets zapped by gluten. Triple whammy for this woman!

And she goes to a party and happens to indulge in cocktails or wine, and then goes on a binge at the dessert table, followed by a few cups of coffee (or even one dessert and one cup of coffee).

A food-mood log really helps you figure things out. And then, if need be, increase and decrease tryptophan accordingly. And track again and address the dietary issues.

Parasites and other gut issues

If she has a very pronounced shift in symptoms for 4-5 days around a full moon each month – more severe insomnia, more anxious, more depressed – I would want to check for parasites.

I would also want to check for other digestion issues like dysbiosis, SIBO (small intestinal bacterial overgrowth), candida and liver health as they may all be factors. With SIBO and candida, dietary slip-ups may make symptoms worse right after the slip-up, for example increased bloating making sleep and anxiety worse.

Using tryptophan sublingually/opened on the tongue may bypass some of the digestive/liver issues until they are resolved.

As mentioned above, if need be, increase and decrease tryptophan accordingly. And track again and address the underlying issues.

Other factors to rule out – thyroid, lithium, environmental factors and the product

Two other underlying root causes we always want to rule out when we see variable results using tryptophan (and any of the amino acids) are Hashimoto’s thyroiditis (because we can have variable thyroid results – sometimes hypo/low and sometimes hyper/high) and low levels of lithium (because this can affect the results we see with all the amino acids).

And we always check environmental factors like mold, EMFs and outside stresses. And look for infections like Lyme disease or EBV. If the basics are not unearthing the solution we continue to dig deeper and do a full functional medicine workup. And adjust the tryptophan as needed.

And finally the quality of the product is key. I find Lidtke Tryptophan to be better than many other brands. I’ve also had many clients switch to Lidtke tryptophan and see better results and often need a lower dose.

Resources if you are new to using tryptophan and the amino acids as supplements

If you are new to using the amino acids tryptophan/5-HTP and the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low serotonin symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low serotonin or low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acid products that I use with my individual clients and those in my group programs.

I always appreciate good questions like this and hope this feedback has helped her and you too if you’ve experienced something like this (or if you do in the future). In case you’re wondering, this question was posted after someone tuned into my interview, “GABA & Tryptophan: Gut-Anxiety Connections” on the Anxiety Summit 5: Gut-Brain Axis.

Have you had a variable response to tryptophan (or 5-HTP) and can you relate to any of this?

What did you figure out to be the reason?

Feel free to ask your questions here too.

GABA for anxiety, unwanted thoughts, sleep, gut pain, burning mouth (and the blood brain barrier theory and zinc-copper imbalance)

November 5, 2021 By Trudy Scott 10 Comments

In the lead up to The Anxiety Summit 5: Gut-Brain Axis, Nov 8-14, 2021, today I am going to highlight GABA (gamma-aminobutyric acid), so you can really connect the dots and understand how far-reaching an impact this calming neurotransmitter has, and how important GABA is as an amino acid supplement.

Here are a few of the many interviews on the summit that feature GABA. Some of these gems come from the experts and some are from me helping to make the connections.

The GABA challenge for a leaky blood brain barrier: a theory

In my interview with Dr. Datis Kharrazian, Fix the Brain to Fix the Gut, we take a deep dive into his GABA Challenge for a leaky blood brain barrier and he shares how it is a theory and agrees that we still have much to learn about GABA:

The GABA challenge test was based on the lactulose mannitol test which is a well-established test in gastroenterology for measuring leaky gut.
He used GABA because the S100 B and blood brain permeability tests were not readily available at the time.
The theory was that if GABA helped ease anxiety or improved sleep, the person had a leaky blood brain barrier because of the GABA particle size.

He is still always suspicious if someone takes GABA and they have a reaction and does always want to go and check the blood brain barrier too.

But Dr. Kharrazian agrees there may be other mechanisms at play: “there is actually the possibility of other pathways that can impact GABA, maybe directly to the gut itself, through the vagus, so I don’t discount those possibilities. The real answer is, we don’t know.”

I have deep respect for Dr. Kharrazian and appreciate having the opportunity to discuss this with him.

Estrogen dominance, low progesterone, zinc-copper balance, GABA and benzodiazepines

In my interview with Ann Louise Gittleman too, Bile: Key to Anxiety and Hormone Havoc, we talk about high estrogen, low progesterone, zinc-copper balance and GABA:

Part of the whole issue with estrogen dominance is that we don’t have enough zinc in our diet and we need the zinc to make progesterone. We know that when we have a copper/zinc imbalance, with high copper and low zinc, we’re going to feel more anxious.
And we need zinc in order to make GABA and other neurotransmitters like serotonin. We also need it to make progesterone.
Damage to the liver and thyroid that was caused by fluoride was reversed by using the amino acid GABA.

Ann Louise also shares how GABA was a savior for her personally. After suffering from a very bad concussion and a bout with post-traumatic stress she eventually ended up on a benzodiazepine and GABA helped her get off it. The benzo “was very very toxic for my system because I don’t have all the detox pathways functioning the way they should. GABA was my savior. So I’m a big believer in GABA. And to this day, I still take 750 mg at night and in the morning.”

Mimosa pudica seed kills parasites and the whole plant extract modulates GABA

In my interview with Dr. Jay Davidson, Parasites, Anxiety and TUDCA for Your Liver, we take a deep dive into the role of parasites in anxiety and a product he uses for doing a parasite cleanse. Dr. Jay shares these gems about mimosa pudica seed:

It is amazing for overall gut support: “So even if your goal isn’t a parasite cleanse, mimosa pudica seed is awesome to help support the digestive tract.”
It can help break up biofilm.
It’s really good against Candida
It helps to normalize microbial levels within the GI system

And I share a study where the whole plant extract of mimosa pudica was found to help modulate GABA receptors. The study reported the benefits were very similar to one of the common antianxiety medications.

I would love to know if the seed has an impact on GABA levels too and will be digging into the research. I’ll share what I find in a follow-up blog post.

Lactobacillus rhamnosus (a probiotic) increases in GABA levels

In my interview with Dr. Peter Bongiorno, Gut-Brain Axis and Mental Health, he shares a mouse study that found Lactobacillus rhamnosus (a probiotic) led to increases in the calming neurotransmitter GABA:

GABA is typically very low in people who have epilepsy and anxiety.
“This study is showing us that you can actually increase GABA by just getting a good microbiota and getting the right strains of probiotics into your body.”

I love his description of how he thinks about this: “when the brain gets over-excited it’s like a calm blanket that sort of covers the brain and makes everything feel okay.”

Everyone who has benefited from the calming effects of GABA can relate to this.

GABA for gut pain, throat spasms, burning mouth, and anxiety and sleep

And finally, in my interview, GABA & Tryptophan: Gut-Anxiety Connections, I take a deep dive into all things GABA, sharing how low GABA plays a role in poor gut health and digestion:

There is research that shows that low GABA may be a factor with the visceral pain we see with SIBO (small intestinal bacterial overgrowth) i.e. the bowels are very sensitive to the distention or stretch caused by bloating. Using a GABA supplement can help ease the pain very quickly.
GABA supplementation also helps to relax throat spasms that we see with vagus nerve issues (I share my vagus nerve story and how GABA helped me).
GABA supplementation helps with easing burning mouth syndrome which is very common in menopausal women.

I also go into how low levels of GABA cause physical anxiety and how to do a trial of GABA in order to ease anxiety quickly. I also share the following:

Hippocampal GABA enables inhibitory control over unwanted thoughts
A combination of GABA and theanine helps improve sleep problems

And I also go into the harmful effects of phenibut, which is often used instead of GABA. It can cause physical dependence and withdrawal issues similar to benzodiazepines.

Of course, I also share some of the profound benefits we see with GABA supplementation. One mom shared this about her daughter whose teachers were concerned about her ADHD and anxiety at school: “Since giving her GABA she has had amazing behavior at school and at home. She’s almost like a different child. GABA has truly changed her life.”

This is what we should expect. We want to have this wow effect!

These interviews dove-tail well with this topic and all tie back to and mention GABA, and anxiety and gut health:

Achina P. Stein, DO, DFAPA, ABIHM, IFMCP – SSRI Impact on the Microbiome and Safe SSRI Tapering
Hyla Cass, MD – Endocannabinoid System and Your Gut
Magdalena Wszelaki – Herbs to Improve Digestion and Support GABA
Chandler Marrs, PhD – Thiamine Deficiency in Anxiety and Gut Health (Part 1 & 2)

If this is the first time you’re hearing about the Anxiety Summit 5: Gut-Brain Axis, I encourage you to register and tune in if you have:

Anxiety & feel overwhelmed & stressed by little things
Panic attacks &/or obsessive thoughts or behaviors
Social anxiety/pyroluria
Phobias or fears (flying, spiders or even driving on a highway)

And also if you suffer from…

Food sensitivities, IBS/SIBO, parasites or gallbladder issues
Constipation, diarrhea, bloating, gas, pain & other digestive issues
Leaky gut, a leaky blood-brain barrier or vagus nerve issues

Join us if you are also an emotional eater with intense sugar cravings (and know you suffer from low blood sugar), experience insomnia, low mood, PMS, poor focus and/or low motivation.

This is THE online event to learn about the powerful individual amino acids – GABA, theanine, tryptophan, 5-HTP, glutamine, DPA and tyrosine – to quickly ease anxiety and help with gut symptoms while you are dealing with other root causes which take longer to address. (They also help with cravings as with this example, and sleep and immunity).

With research-based anxiety nutritional solutions and practical steps, you can determine your root causes, ease your anxiety and prevent it from coming back so you can feel on top of the world again!

If you are a practitioner, please join us too and find advanced solutions for your clients or patients too!

You’ve heard me say the Anxiety Summit has been called “a bouquet of hope!” My wish for you is that this summit is your bouquet of hope!

I hope you’ll join me and these incredible speakers, be enlightened and find YOUR solutions!

If you’d like to find all the GABA mentions throughout the summit (or something else like serotonin or zinc etc), using the searchable PDF transcript is the easiest way to do this. This PDF is included when you purchase the series. If you’re thinking of making a purchase I encourage you to do so now before the prices increase.

Purchase now

Here’s to no more anxiety and you feeling on top of the world again!

Trauma: fluctuating between a high anxiety panic state and a low energy freeze response (with low endorphins and a numbing feeling)

October 22, 2021 By Trudy Scott 2 Comments

The freeze response in trauma is not well understood and is a low energy state. When the anxiety has become so high or severe it triggers a low energy or freeze state in order for you to survive. There is also the feeling of numbness and being disconnected when in the freeze state and this eventually becomes the default pattern that the nervous system has been wired into. Healing can start with somatic work and using a functional medicine and nutritional psychiatry approach to address the biological underpinnings of trauma.

Dr. Aimie Apigian, MD, MS, MPH discusses all this and much more in her interview on the Anxiety Summit 5: Gut-Brain Axis, Nov 8-14, 2021.

And then Dr. Aimie interviews me and we discuss how folks with low endorphins are often in the freeze state. These folks are more emotionally sensitive to everything and because of this they experience much more stress. They also experience a feeling of numbness and feel disconnected. The encouraging news is that the amino acid DPA (d-phenylalanine) helps ease the low endorphin symptoms while they are recovering. More on all this below.

The freeze response in trauma is not well understood and is a low energy state

Let’s start with this interview with Dr. Aimie – Biology of Trauma and the Freeze Response. This is what we cover:

Identifying the freeze response and symptoms when anxiety is high
The role of the microbiome, neurotransmitters, oxidative stress, mitochondria and cortisol
Somatic work when in the chronic freeze state: containment hugs and marking your territory

Dr. Aimie explains that the freeze response in trauma is not something that’s been really well understood:

When we talk about just trauma and mood, and stress even, it’s like we still lump everything in that fight, flight, or freeze response. And the fight and flight response could not be more different than the freeze response.
On a biological level, they are completely different biology states, which means that it is humanly impossible to be in both of those states at the same time. So when we look at this freeze response, okay, so what is it? If it’s not fight or flight, what is it?

She shares how the anxiety has been become so high or severe it triggers a low energy or freeze state in order for you to survive:

When we look at what it is, it’s when the anxiety has become so high that the body is not able to sustain that level of both anxiety, but it’s really an energy level.
Because anxiety is a high energy state and it triggers this response in the body where it says, “Ooh, this is unsustainable,” and in order to survive, for our best interests, it would be better for us to go into a low energy state.
And it feels like giving in, giving up. It feels like giving up the fight because the body just goes into this, I kind of call it like, it shifts down into first gear.
You’re no longer zooming along in fifth or sixth gear, you just kind of shift down into first gear and now you’re just going through life.

The feeling of numbness and being disconnected when in the freeze state

In addition to the low energy state, this is where Dr. Aimie talks about the feeling of numbness and being disconnected when in the freeze state:

Now you’re just going through your day, you feel a little numb, you feel a little disconnected.
But the trigger for that freeze response originally comes from the anxiety level, which really becomes a level of fear, terror, panic.

Dr. Amie also shares how this becomes the default pattern that the nervous system has been wired into:

And people can have what I call a strong pull towards the freeze response so that they no longer are even aware of the fear and the terror.
They just feel anxiety and boom, they go straight into the freeze response because it has just become that default pattern that the nervous system has been wired into.

The biology of trauma and somatic work

She goes on to discuss the biology of trauma and the role of the microbiome, neurotransmitters, oxidative stress, mitochondria and cortisol in contributing to the freeze response (i.e. making you more susceptible to trauma) and as factors we can address in order to facilitate recovery and healing.

Dr. Aimie also describes the somatic work she does with her patients who are in the chronic freeze state: exercises like containment hugs and marking your territory. She shares that “I want people to experience their nervous system. I want them to know what it feels like, be able to actually recognize which state of the nervous system they are in at any given moment in time, and be able to feel what that feels like in their body, because then that’s how we teach them how to shift that.”

In her work and in this interview, Dr. Amie brings the world of trauma recovery and somatic work to the functional medicine and nutritional psychiatry world. It’s an eye-opening interview you don’t want to miss.

The connection between the trauma freeze response and low endorphins

Also featured in the summit is another interview where Dr. Aimie happens to interview me on this topic: Glutamine, DPA and Tyrosine for Anxiety and Sugar Cravings. We cover the following:

Sugar addiction: impacts on the microbiome, tryptophan metabolism, zinc & B vitamins
Glutamine for intense sugar cravings, anxiety & support of the microbiome/mucosa
DPA for comfort/reward cravings, pain & acute stress; tyrosine for focus & calm energy

It’s during this interview that I make the connection between the trauma freeze response and low endorphins when we are discussing the last bullet above.

As a reminder, these are the mood symptoms of low endorphins:

Heightened sensitivity to emotional pain
(and also Heightened sensitivity to physical pain)
Crying or tearing up easily

And these are the ways sugar cravings often show up when you have low endorphins:

Eating to soothe your mood, or comfort eating
Really, really loving certain foods, behaviors, drugs, or alcohol
Craving a reward or numbing treat

As I share about the endorphins and how I use the amino acids DPA and/or DLPA to boost endorphin levels, I remember how Dr. Aimie discussed the numbing effect when someone is in the freeze state and it made me think about endorphins. So I ask Dr. Amie if she finds that folks with low endorphins are often in the freeze state.

Dr. Amie says most definitely yes and shares that with the low endorphins, people in the freeze state really are more emotionally sensitive to everything and because of this they experience much more stress:

From my perspective, working with a lot of the trauma response … they are much closer … to that line of overwhelm.
So most definitely, yes. And it’s that comfort, right? It’s that self-soothing, and it’s the numbing effect. The numbing effect of reaching for food when you’re not hungry. It’s just for numbing the emotional sensitivity that you have with low endorphins.
Endorphins really affect the stress levels and then mood, and then inflammation? It starts this cascade of changes in their biology because of the low endorphins and the increased amount of stress that they experience with that sensitivity.

This discussion tied in perfectly to the study I had to share: The Role of Beta-endorphin in Stress, Behavior, Neuroinflammation, and Brain Energy Metabolism.

In this 2020 paper, the authors discuss beta-endorphins in the context of reward-centric behaviors, pain, neuroinflammation, immune function and also how endorphins attenuate (or reduce the effects of) the acute stress response. They also share how endorphins exert a regulatory effect on serotonin levels.

I find the latter link to serotonin very interesting and will be digging deeper into this in another blog post. I’ll also be digging into the low endorphins aspect of the trauma freeze response in the coming months. And I want to learn more about the somatic work that Dr. Aimie uses – to experience some of it myself and to bring to my community i.e you! I do love that I also get to learn so much when I do these interviews.

Use DPA to ease the weepiness and need to numb out with comfort food or behaviors

For now, if you have experienced trauma and recognize being in the freeze state, and you feel numbed out and disconnected, and also relate to the above other low endorphin symptoms, I would do a trial of DPA (the amino acid d-phenylalanine) and see how you do. It will likely help ease some of the low endorphin symptoms while you are recovering.

Keep in mind that you can also have low endorphin symptoms without having experienced trauma. I see this with many of my clients and it’s not uncommon to also have low serotonin worry and low GABA physical anxiety symptoms too..

In both instances, I would do a trial of DPA (I like the Lidtke Endorphigen product) and see how you do. If it is low endorphins you’ll ease the weepiness and need to numb out with comfort food or behaviors (such as endless scrolling on social media). You can expect to see results in 5-10 minutes when the DPA is opened onto the tongue.

To recap, be sure to tune in to these 2 interviews to see how it’s all connected and to hear more about trauma, the biology of trauma and how to use amino acids to balance neurotransmitters:

Aimie Apigian, MD, MS, MPH – Biology of Trauma and the Freeze Response
Trudy Scott, CN – Glutamine, DPA and Tyrosine for Anxiety and Sugar Cravings

These interviews dove-tail well with this topic of trauma, the freeze response and neurotransmitters:

Navaz Habib, DC, AFMCP – Vagus Nerve Activation to Reduce Anxiety (because vagus nerve activation habits speed trauma recovery)
My other amino acid interview, Cravings and GABA & Tryptophan: Gut-Anxiety Connections (because the amino acids help to support low serotonin and low GABA which is common with trauma)
Evan Brand, CFMP, NTP – Floatation Therapy for Anxiety and PTSD (because floatation therapy is gentle and yet effective)
Eric Zielinski, DC – Essential Oils for Anxiety and Digestion (because essential oils are well tolerated and effective)
David Jockers, DNM, DC, MS – Fasting for Anxiety and Gut Health (he talks about the effects of fasting on endorphins and serotonin)

I encourage you to register and tune in if you have:

Anxiety & feel overwhelmed & stressed by little things
Panic attacks &/or obsessive thoughts or behaviors
Social anxiety/pyroluria
Phobias or fears (flying, spiders or even driving on a highway)

And also if you suffer from…

Food sensitivities, IBS/SIBO, parasites or gallbladder issues
Constipation, diarrhea, bloating, gas, pain & other digestive issues
Leaky gut, a leaky blood-brain barrier or vagus nerve issues

Join us if you are also an emotional eater with intense sugar cravings (and know you suffer from low blood sugar), experience insomnia, low mood, PMS, poor focus and/or low motivation.

With research-based anxiety nutritional solutions and practical steps, you can determine your root causes, ease your anxiety and prevent it from coming back so you can feel on top of the world again!

If you are a practitioner, please join us too and find advanced solutions for your clients or patients too!

You’ve heard me say the Anxiety Summit has been called “a bouquet of hope!” My wish for you is that this summit is your bouquet of hope!

I hope you’ll join me and these incredible speakers, be enlightened and find YOUR solutions!

Here’s to no more anxiety and you feeling on top of the world again!

Can you relate to the freeze state and fluctuating from a high energy anxiety/panic state?

When you’re in the freeze state do you feel numb and disconnected?

Have you had success with somatic work? And also using a functional medicine approach to healing?

Also let us know if you’ve benefited from using DPA to help ease the low endorphin symptoms?

Feel free to post your questions here too.

SSRI/antidepressant impact on the microbiome, discontinuation syndrome and safe tapering

October 16, 2021 By Trudy Scott 2 Comments

Antidepressants can have an antibiotic effect, causing dysbiosis and impacting serotonin, GABA and dopamine production. This can cause psychiatric symptoms and even suicidal thoughts or behaviors. Various SSRI (selective serotonin reuptake inhibitors) and SNRI (serotonin norepinephrine reuptake inhibitors) have more of an effect than others. And the top known side effects for SSRIs are gut symptoms: nausea, diarrhea and vomiting.

These medications are seldom prescribed with informed consent and can cause severe psychological, cognitive, physical and neurological withdrawal side effects (also known as discontinuation syndrome). A functional medicine and nutritional approach using 5-HTP, GABA, theanine and glycine can often be used to smooth the taper process.

Dr. Achina Stein addresses all this in her interview, SSRI Impact on the Microbiome and Safe SSRI Tapering, on The Anxiety Summit 5: Gut-Brain Axis, which will be airing online Nov 8-14, 2021.

We cover the following:

Antibiotic effect of antidepressants: dysbiosis and impacts on serotonin/GABA/dopamine
Withdrawal/discontinuation syndrome symptoms of SSRIs and benzodiazepines
5-HTP, GABA, theanine and glycine to smooth the taper process

Here are a few snippets from our interview.

We start with a discussion on the antibiotic effect of antidepressants and a review of this paper – Serotonin Reuptake Inhibitors and the Gut Microbiome: Significance of the Gut Microbiome in Relation to Mechanism of Action, Treatment Response, Side Effects, and Tachyphylaxis.

Dr. Stein comments on this study sharing how SSRIs affect the gut and microbiome in many different ways:

“This paper is important. It’s one of several papers that talk about how the SSRIs or serotonin reuptake inhibitors affect the gastrointestinal tract. And as you know, the gastrointestinal tract is really full of serotonin.
SSRIs, as well as other psychotropic medications, actually exert an antibiotic effect, which can have a direct consequence in disrupting the integrity and stability of the gut microbiome.
And the ones that are most likely to do that are Sertraline, fluoxetine, and paroxetine in that order. And it’s followed by fluvoxamine, escitalopram, and citalopram, having the least impact.
What they’re noticing is that this antibiotic effect actually results in dysbiosis.
The top known side effects for SSRIs are gut symptoms: nausea, diarrhea, vomiting.
We know that the gut microbiome has a significant effect on emotions, behaviors, and metabolic changes.
And it’s involved in the metabolism of drugs, and this combination is what really causes psychiatric symptoms and even suicidal thoughts or behaviors.”

She also talks about the bidirectional gut-brain connection/communication, the microbiome and short-chain fatty acids (which are a common theme you’ll hear throughout the summit):

“There is this huge connection between the gut microbiome and the brain.
And there’s also other indirect communication pathways because we’ve always wondered, well, how does this happen that the gut is connected to the brain?
So the other pathways which are more indirect are the hypothalamic-pituitary-adrenal axis.
And there’s also an immune-mediated connection where there’s a communication between short-chain fatty acids and microglia in the brain.
So short-chain fatty acids are the main metabolites produced by the microbiota in the large intestine through bacterial fermentation of indigestible polysaccharides, which are dietary fiber and resistant starch. And they possess neuroactive properties. So they influence the communication between these short-chain fatty acids between the gut and the microglia of the brain.
And it’s a bidirectional communication too.”

And we talk about tachyphylaxis or the poop-out effect of antidepressants.

The discussion on the SSRI (selective serotonin reuptake inhibitors) and SNRI (serotonin norepinephrine reuptake inhibitors) discontinuation syndrome (or withdrawal symptoms) is eye-opening and sobering, Here are just a few of the many psychological symptoms that she says patients may experience when tapering:

I’m just going to read them off because I think it’s important for people to know: mood swings, unstable moods, hypomania, hyperarousal, anxiety, medication-induced agitation – which is described as being caffeinated – impulsive behavior, aggression, irritability, crying spells, lowered mood or depression.

Dr. Stein also shares the many cognitive, physical and neurological side effects, and how she works with her patients with a functional medicine and nutritional approach to try and mitigate the side effects. She likes to use 5-HTP, GABA, theanine and glycine to smooth the taper process.

We also have a lengthy discussion about informed consent and the fact that it’s not happening and should be.

We do a deep dive into all this and much more.

The interviews that dove-tail well with this topic are as follows:

My interviews, GABA & Tryptophan: Gut-Anxiety Connections and Glutamine, DPA and Tyrosine for Anxiety and Sugar Cravings. The amino acids help during the tapering process and help you make the dietary changes.
Thiamine Deficiency in Anxiety and Gut Health (Part 1 and 2) with Chandler Marrs. She talks about how medications can deplete thiamine. Could this contribute to some of the severe discontinuation syndrome symptoms we see?
Anxiety, Gut-Brain Communication and Diet with David Perlmutter, MD, FACN, ABIHM. This one gives you an excellent overview of the gut-brain communication and fermented foods, short-chain fatty acids and histone deacetylases (HDACs).
Gut-Brain Axis and Mental Health with Peter Bongiorno, ND, LAc. This is also a great overview on the mental health impacts of the microbiome. He goes deep into serotonin and GABA production mechanisms.

I encourage you to register and tune in if you have:

Anxiety & feel overwhelmed & stressed by little things
Panic attacks &/or obsessive thoughts or behaviors
Social anxiety/pyroluria
Phobias or fears (flying, spiders or even driving on a highway)

And also if you suffer from…

Food sensitivities, IBS/SIBO, parasites or gallbladder issues
Constipation, diarrhea, bloating, gas, pain & other digestive issues
Leaky gut, a leaky blood-brain barrier or vagus nerve issues

Join us if you are also an emotional eater with intense sugar cravings (and know you suffer from low blood sugar), experience insomnia, low mood, PMS, poor focus and/or low motivation.

With research-based anxiety nutritional solutions and practical steps, you can determine your root causes, ease your anxiety and prevent it from coming back so you can feel on top of the world again!

If you are a practitioner, please join us too and find advanced solutions for your clients or patients too!

You’ve heard me say the Anxiety Summit has been called “a bouquet of hope!” My wish for you is that this summit is your bouquet of hope!

I hope you’ll join me and these incredible speakers, be enlightened and find YOUR solutions!

Here’s to no more anxiety and you feeling on top of the world again!

How have antidepressants impacted your gut and digestion?

Have you experienced discontinuation syndrome when tapering from an SSRI or SNRI or benzodiazepines? And have diet and the amino acids helped smooth the taper process?

Feel free to post your questions here too.

Fatigue, sleep disorders, depression, anxiety, fibromyalgia and cardiac troubles as the expression of a classic mild thiamine deficiency

October 8, 2021 By Trudy Scott 6 Comments

Fatigue, sleep disorders, depression, anxiety, fibromyalgia and cardiac troubles are some of the symptoms we see as the expression of a classic mild thiamine deficiency. Thiamine deficiency is very under-rated and under-recognized, and can have far reaching ramifications. And a magnesium deficiency and high dose magnesium can actually cause a thiamine deficiency. There are also many other causes of thiamine deficiency that may not be on your radar: a high carb/processed food/sugar diet, coffee, tea, alcohol, genetics, environmental toxins, medications, celiac disease, leaky gut, bariatric surgery and malabsorption.

It’s for this reason that I invited Chandler Marrs, PhD to speak on the Anxiety Summit 5: Gut-Brain Axis. We had so much to cover and it ended up being so long, that we split it into part 1 and part 2.

This is what we cover in Thiamine Deficiency in Anxiety and Gut Health (Part 1)

Excessive carbs, alcohol, medications and genetics as causes of low B1/thiamine
Dysbiosis, dysmotility, constipation, anxiety, depression, panic attacks, low energy
Psychiatric and digestive effects: research, history and other symptoms

This is what we cover in Thiamine Deficiency in Anxiety and Gut Health (Part 2)

The mitochondria, dysautonomia and POTS
Other symptoms: hyperemesis, exercise intolerance, muscle pain, neuropathy
Thiamine supplementation – forms, dosing and paradoxical reactions

Thiamine deficiency is under-rated and under-recognized

We start with why it’s an under-rated and under-recognized deficiency and Dr. Marrs shares that the assumption is that deficiency is not common and even when you test it looks like you are not deficient:

“The assumption is that there is no such thing [as a thiamine deficiency] and that it’s rare unless you are a chronic alcoholic. And even then, it’s missed 80% of the time. Or you have a severe injury or illness that depletes thiamine rapidly.
The presumption is that we’ve solved it, and it’s rare, and it only happens in countries where food availability is problematic.
The reality is that the chemistry of our foods, the chemistry of our environment, the medications that we take all combine and accrue to not only deplete the available thiamine on the basis of intake but to increase the need and to damage a lot of the enzymes involved in the processing of thiamine.
So a lot of folks are functionally deficient in that even though by definition they meet the daily requirement and they may, based upon lab testing, show up as being sufficient and not frankly deficient.
And so, I think that we just have taken our eye off of the ball with regard to this particular nutrient.”

Magnesium deficiency (and high dose magnesium) can actually cause a thiamine deficiency

Dr. Marrs also shares how a magnesium deficiency (which is very common) can actually cause a thiamine deficiency:

“One of the things that’s interesting is it requires magnesium to activate thiamine into its active form.
If someone is thiamine sufficient and magnesium deficient, then they are actually functionally deficient in thiamine because you cannot take the free thiamine and activate it into thiamine pyrophosphate.
So magnesium deficiency itself can cause thiamine deficiency. And there’s a good percentage of the population that doesn’t get enough magnesium.”

And she also shares how when taking high dose magnesium it’s so crucial to also be addressing low thiamine in order to prevent them becoming more thiamine deficient:

“Now, the flip side of that is really interesting. And I think this is important for your audience, in particular, is that magnesium supplementation, when someone has a problem with thiamine, will actually shut down thiamine processing and mitochondrial processing at one of the enzymes. Because if you don’t have thiamine with magnesium, then the enzyme α-ketoglutarate dehydrogenase kind of shuts the whole sequence down.
So if you are giving someone high dose magnesium, which is common to supplement, and not tackling the thiamine as well, you risk them becoming more thiamine deficient and reducing ATP output, energy output even further. So everything has to be in balance to some extent or another.”

I can think of one situation where this could be common. You use high dose magnesium due to constipation. Low thiamine may be one of the underlying causes of your constipation and now high dose magnesium is going to make the low thiamine situation worse.

Up to 30% of psychiatric patients have a thiamine deficiency

We talk about how up to 30% of psychiatric patients have a thiamine deficiency but that there hasn’t been enough work on psychiatric disorders which Dr. Marrs says “is strange given the fact that some of the strongest symptoms involve brain function and the most dangerous or some of the more dangerous damage is relative to areas of the brain.”

I share some quotes from a 2019 paper that does actually look at the psychiatric aspects – Neurological, Psychiatric, and Biochemical Aspects of Thiamine Deficiency in Children and Adults:

“The brain is highly vulnerable to thiamine deficiency due to its heavy reliance on mitochondrial ATP production. This is more evident during rapid growth, i.e., perinatal and children.
Thiamine deficiency contributes to a number of conditions spanning from mild neurological and psychiatric symptoms, confusion, reduced memory, sleep disturbances, and severe encephalopathy, ataxia, congestive heart failure, muscle atrophy, and even death.”

This paper also looks at the beneficial effect of thiamine supplementation in autism spectrum disorder (ASD) and other neurological conditions.

Below, I share some additional studies that we didn’t talk about in the interview but add value to the topic.

Fatigue, sleep disorders, depression, anxiety, fibromyalgia and cardiac troubles as the expression of a classic mild thiamine deficiency

This paper, High-dose thiamine improves the symptoms of fibromyalgia, states that “It is our opinion that fatigue, sleep disorders, depression, anxiety and cardiac troubles are the expressions of a classic mild thiamine deficiency.”

The authors share 3 cases where thiamine/vitamin B1 improved symptoms in all areas for all these women:

Patient 1: Female, 58 years old, weight 59 kg. From 1998, the patient began to have widespread pain accompanied by severe fatigue, depression, anxiety, irritability, sleep disorders, trouble concentrating, dry skin, general sickness, continuous headache, intolerance to low temperatures and, more recently, episodes of tachycardia and extrasystolia [alteration in heart rhythm].
Patient 2: Female, 37 years old, weight 74 kg. From 1999, the patient has had widespread pain and all the symptoms described for patient 1, with the only exception being that of cardiac symptoms.
Patient 3: Female, 60 years old, weight 65 kg. From 2006, the patient began to have widespread pain, fatigue, depression, anxiety, sleep disorders. Trouble concentrating.

As you can see the symptoms can be very varied and this is what makes it challenging to identify low thiamine as being the issue.

Thiamine deficiency after bariatric surgery

Here one case study where thiamine deficiency occurred after bariatric surgery: Wernicke’s encephalopathy mimicking multiple sclerosis in a young female patient post-bariatric gastric sleeve surgery:

We describe a case of Wernicke’s encephalopathy secondary to thiamine (B1) deficiency in a patient status post-bariatric sleeve gastrectomy.

The presenting symptoms of new-onset weakness, diplopia [double-vision], and confusion in a young female patient raised suspicion for multiple sclerosis (MS), but given a history of bariatric surgery, thiamine levels were checked, revealing significant Vitamin B1 (thiamine) deficiency.

This case highlights the importance of thorough history taking, as a misdiagnosis of MS in this case could have resulted in irreversible neurological deterioration and hematological and infectious consequences associated with the inappropriate administration of disease-modifying therapies.

Bariatric surgery is one of many causes of thiamine deficiency.

Some of the other many causes of thiamine deficiency

Other causes of thiamine deficiency include factors that may not be on your radar: a high carb/processed food/sugar diet (and even consistent smaller amounts of “healthy” sweeteners), coffee and tea consumption, alcohol consumption (excessive consumption and even moderate consumption i.e. social drinking), genetics (we talk about specific genes in the interview), environmental toxins, certain medications, celiac disease, leaky gut and malabsorption etc.

We do a deep dive into all this in the two interviews (and much more).

chandler marrs interview — (As you can see, when I do interviews I take notes throughout for a few reasons: writing consolidates the information into my brain and it allows me to make notes for follow-up questions. It also helps the video editing process later.)

Interviews that dove-tail well with this topic are these ones:

Michael Collins – Sugar/Fructose Addiction: Anxiety, ADHD and Aggression (because sugar and carbs lead to low thiamine)
My interviews, Glutamine, DPA and Tyrosine for Anxiety and Sugar Cravings and GABA & Tryptophan: Gut-Anxiety Connections (because the amino acids help you quit sugar/carbs, coffee and alcohol easily)
Tara Hunkin, NTP, CGP, RWP – Mitochondrial Dysfunction in Anxiety (because low thiamine adversely affects the mitochondria)

I encourage you to register and tune in if you have:

Anxiety & feel overwhelmed & stressed by little things
Panic attacks &/or obsessive thoughts or behaviors
Social anxiety/pyroluria
Phobias or fears (flying, spiders or even driving on a highway)

And also if you suffer from…

Food sensitivities, IBS/SIBO, parasites or gallbladder issues
Constipation, diarrhea, bloating, gas, pain & other digestive issues
Leaky gut, a leaky blood-brain barrier or vagus nerve issues

Join us if you are also an emotional eater with intense sugar cravings (and know you suffer from low blood sugar), experience insomnia, low mood, PMS, poor focus and/or low motivation.

With research-based anxiety nutritional solutions and practical steps, you can determine your root causes, ease your anxiety and prevent it from coming back so you can feel on top of the world again!

If you are a practitioner, please join us too and find advanced solutions for your clients or patients too!

You’ve heard me say the Anxiety Summit has been called “a bouquet of hope!” My wish for you is that this summit is your bouquet of hope!

I hope you’ll join me and these incredible speakers, be enlightened and find YOUR solutions!

Here’s to no more anxiety and you feeling on top of the world again!

Please share if these thiamine deficiency symptoms are new to you.

Also let us know if you’ve benefited from thiamine in the past or are currently using some form of thiamine – and how helped/is helping.

Have you seen this correlation between low magnesium and low thiamine OR taking high doses of magnesium and low thiamine symptoms?

Feel free to post your questions here too.

“A demonic urge to eat sugar and all things sweet”: glutamine opened onto the tongue stops the urge every time!

October 1, 2021 By Trudy Scott 9 Comments

In my interview, Glutamine, DPA & Tyrosine for Anxiety & Sugar Cravings, on the Anxiety Summit 5: Gut-Brain Axis, I share the story of a client of mine who described her sugar cravings as an “almost demonic urge to eat sugar and all things sweet.”

Before working with me she had been trying to control her blood sugar levels by eating the right foods at the right times i.e. healthy fats and quality protein (especially at breakfast). But this wasn’t enough to eliminate her sweet cravings. She would make and eat sweet treats all day long, using “healthier” sweeteners like monk fruit and maple syrup.

The solution was using 500mg of glutamine opened onto her tongue. I had the same conversation that I have with all my clients who would obviously rather eat something sweet than open a glutamine capsule onto their tongue: “If you have an intense craving for something sweet, tell yourself that you’re going to indulge, but also humor your nutritionist and take the glutamine anyway. You may be surprised to find your urge completely disappears.”

She did that and it worked – it stopped her demonic urge to eat something sweet every time and very quickly!

As a reminder here are the signs of low blood sugar –

Anxiety and mood:

Nervous, anxious, panic attacks
Irritable, shaky, headachey – especially if you go too long between meals
Lightheaded if meals are missed
Agitated, easily upset
Eating relieves fatigue

Sugar cravings:

Crave sugar, starch or alcohol any time during the day
Very intense cravings for sweets/sugar

I also share an excerpt from this March 2021 paper, The role of glutamine in supporting gut health and neuropsychiatric factors, highlighting the role of glutamine in gut health and depression/anxiety, and the gut-brain connection:

Glutamine can positively affect gut health by supporting the gut microbiome, gut mucosal wall integrity, and by modulating inflammatory responses.

As modulated by the vagus nerve, via the enteric nervous system, the gut-brain connection can impact the brain’s neurochemical environment.

Poor gut health can disrupt the balance of neurotransmitters, which can result in neuropsychiatric based conditions such as depression [and anxiety].

Glutamine supplementation may provide significant adjunctive nutritional support in cases of depression [and anxiety] by promoting proper gut health.

Here are all the topics I cover in my interview:

Sugar addiction: impacts on the microbiome, tryptophan metabolism, zinc & B vitamins
Glutamine for intense sugar cravings, anxiety & support of the microbiome/mucosa
DPA for comfort/reward cravings, pain & acute stress
Tyrosine for focus & calm energy

Dr. Aimie Apigian, MD, kindly interviewed me. She is also a guest expert on the summit so be sure to tune into her excellent interview too: The Biology of Trauma and the Freeze Response.

I encourage you to register and tune in if you have:

Anxiety & feel overwhelmed & stressed by little things
Panic attacks &/or obsessive thoughts or behaviors
Social anxiety/pyroluria
Phobias or fears (flying, spiders or even driving on a highway)

And also if you suffer from…

Food sensitivities, IBS/SIBO, parasites or gallbladder issues
Constipation, diarrhea, bloating, gas, pain & other digestive issues
Leaky gut, a leaky blood-brain barrier or vagus nerve issues

Join us if you are also an emotional eater with intense sugar cravings (and know you suffer from low blood sugar), experience insomnia, low mood, PMS, poor focus and/or low motivation.

With research-based anxiety nutritional solutions and practical steps, you can determine your root causes, ease your anxiety and prevent it from coming back so you can feel on top of the world again!

If you are a practitioner, please join us too and find advanced solutions for your clients or patients too!

You’ve heard me say the Anxiety Summit has been called “a bouquet of hope!” My wish for you is that this summit is your bouquet of hope!

I hope you’ll join me and these incredible speakers, be enlightened and find YOUR solutions!

Here’s to no more anxiety and you feeling on top of the world again!

Please share if glutamine has helped you with low blood sugar symptoms such as an intense desire for something sweet.

Feel free to post your questions here too.