Archives for September 2015

Neuropsychiatric Lyme Disease by Dr. Suruchi Chandra

September 25, 2015 By Trudy Scott 28 Comments

One of my favorite presentations at the recent IMMH/Integrative Medicine for Mental Health conference was Dr. Suruchi Chandra’s Neuropsychiatric Lyme Disease talk.

Here is the description of her presentation:

“Neuropsychiatric Lyme Disease and Associated Co-infections: Clinical Presentations, Diagnostic Challenges, and Treatment Options”

Lyme disease is one of the fastest growing infectious diseases in the United States. It can remain dormant for years and then later mimic a number of psychiatric illnesses, including anxiety disorders, mood disturbances, psychosis, and autism-like behaviors. It can be further complicated by the presence of co-infections. Both the diagnosis and treatment of these infections in the chronic stage can be challenging. We will review both standard treatment recommendations and integrative and holistic approaches, including dietary changes, herbal medicines, and nutritional supplements.

Dr. Chandra started by sharing the late stage neuropsychiatric symptoms of Lyme disease:

Depression
Mood swings
Anxiety, panic attacks, OCD
Psychosis
Violent behaviors and irritability
Chronic fatigue syndrome
Fibromyalgia
ADHD and autism like behaviors
Seizures
Sleep disorders

Here are some of the many very interesting facts she shared:

Lyme disease is one of the fastest growing infectious diseases in the USA (and it doesn’t seem to be only an issue in the USA)
Not everyone recalls a tick bite or bulls-eye rash
Lyme disease is not only isolated to the Northeast – a year ago a Stanford study found the bacterium Borrelia miyamotoi, as well as burgdorferi, the bacterium that causes Lyme disease, in ticks they sampled throughout the San Francisco Bay area
Lyme disease may be due to tick borne complex i.e. it is hypothesized that there are multiple co-infections
Purple rashes that look like stretch marks are common with Bartonella
There can be maternal-fetal transmission of the disease
The involvement of the gut is under-rated with Lyme disease and cognitive decline is a big issue
Lyme and co-infections affects serotonin levels, due to IDO being increased
Low zinc (and high copper) and low manganese levels are often factors

Dr. Chandra is very unique in that she uses no antibiotics, “provokes” before testing and has some very interesting herbal protocols (many that are used with malaria). She stated that Lyme disease is worth treating even if there are no symptoms, simply because of the higher risk of Alzheimer’s disease.

She uses a wonderfully integrative approach with her patients who have chronic tick borne diseases:

integrative-approach-chronic-tick-borne-illnesses

Here is the last slide of her presentation: Consider Lyme disease and the associated co-infections when there is any severe or atypical psychiatric disease, and use a holistic and individualized approach.

Chandra-conclusion

Excellent presentation! This really is the top integrative mental health conference to attend!

Here are a few of my other favorite presentations include:

Julie Matthews’ talk on “Oxalates, Phenols, and FODMAPs: Food Substances and Diets that Impact Mental Health Conditions”
James Greenblatt’s talk “New Information on Nutritional Lithium for ADHD, Mood Disorders and Prevention of Cognitive Decline”
Andrea Gruszecki’s talk on “The Effects of Stress on the Gut-Brain Microbiome”
Dr Kurt Woeller’s talk on “Oxytocin and Cholesterol – Their Interactions and Effects on Mental Health and Autism Spectrum Disorders”

I’ll share some highlights from these in a future blog post.

All the presentations were recorded and I’ll let you know when the recordings are available for purchase. These presentations are not to be missed.

Please share what you know about Lyme disease or if you have been diagnosed with one of the co-infections. Feel free to ask questions too.

Say NO to benzodiazepines for anxiety! (webinar replay)

September 25, 2015 By Trudy Scott 25 Comments

benzo-webinar-replay

Professor Malcolm H. Lader says it well: “It is more difficult to withdraw people from benzodiazepines than it is from heroin.” For this reason we need to say NO to benzodiazepines for anxiety (and other conditions)!

Benzodiazepines are a class of psychoactive drugs that work by enhancing the effect of the calming neurotransmitter GABA, and are used to treat anxiety, insomnia, pain, muscle spasms and a range of other conditions. They are widely prescribed, particularly among elderly patients and may even be used off-label with children with autism.

Use of this medication is very controversial. We know long term use leads to tolerance, dependence, and many adverse psychological effects and even physical effects. Short term use is generally considered safe but even using them for 2 – 4 weeks can lead to problems for certain individuals.

This presentation provided an overview of benzodiazepines; when they are used; who they are prescribed to; details about tolerance, dependence, and the many adverse effects; how to taper, including nutritional support during the taper; what to do instead of saying yes to a benzodiazepine prescription in the first place; and additional resources.

Hawthorn University invited me to present this webinar and you can watch the replay here:

You can find a list of the resources/studies/blog posts used in this webinar here.

I’d love questions/feedback/comments/your benzodiazepine experiences/additional resources etc. You can also comment on the other benzodiazepine blogs here and here.

Evolution of Medicine – Heathcare from Scratch

September 21, 2015 By Trudy Scott Leave a Comment

Today, our healthcare system works well when you have an emergency, but to treat chronic illnesses like heart disease, diabetes, obesity, cancer, anxiety and depression we need to reinvent healthcare to help you live a longer, happier, calmer, stress-free and healthier life. The Evolution of Medicine Summit can help you avoid chronic diseases, keep your family healthy and learn about healthcare that actually works!

Plus, the summit will introduce the very first affordable, ACA-compliant alternative to health insurance, Liberty Direct!

I know the host, James Maskell and love that he is tackling this topic and that they are introducing this new health insurance! Exciting!

30+ great speakers will discuss:

Our current health system and its limitations (plus, alternatives you can access!)
How to take advantage of health technology
A vision for an empowered, proactive and participatory healthcare system
Preventing chronic disease and taking control of your health today

It will take all of us, patients and practitioners, to create a medical system that truly combats chronic disease. I invite you to join me in learning at The Evolution of Medicine Summit!

I’m not a speaker on this one – just interested in learning and sharing this information with you!

Here are a few snippets from three of the interviews:

eric-zielinski

Eric Zielinski, DC, MPH (C)

2 million people become infected with bacteria that are resistant to antibiotics every year. And 23,000 people die as a direct result. We’re dealing with an epidemic here, unbelievable epidemic where these super bugs, we’re calling them, are just becoming resistant to every medical approach. As far as we could tell, there is no resistance to essential oils, because that is the natural way that God created the planet which has a natural resistance. Once man gets involved, we see things becoming tainted.

When it comes to rebuilding healthcare from scratch, it has to start with you. It has to start with me. It has to start with every mom and dad to take accountability for their own health. Stop giving their accountability to doctors in the medical system and saying, “I’m really responsible for my own healthcare.” That means do your own research. That means go to trusted websites. And that means you go to seminars as they’re available to you. Get plugged in. There’s a lot of good networks locally. There’s networks globally through the internet. There are a lot of tools. You just need to find them.

suzanne-somers

Suzanne Somers – What is making you TOX-SICK

Remove all the chemical elements that you can whether it’d be what you put on your skin, what you put on your hair, what you put on your face, what you put on your lips, what you clean your house with, and what you put in your stomach really matters in today’s world, because it’s not the same world of our parents or grandparents. We’re under the greatest environmental assault in the history of humanity.

Doctors who have stepped out of the safety of the standard of care box should be called heroic because here is an example where in almost all cases, it’s not about making money. It’s about doing the right thing.

marc-david

Marc David, MA – The Psychology of Eating

Good nutrition is important. And oftentimes it’s only half the story of nutrition, meaning what we eat oftentimes is only half the story of good nutrition. And the other half is who we are as eaters, meaning what we’re thinking, what we’re feeling, what we’re believing, our level of stress or relaxation, our level of pleasure, how much awareness we’re getting from a meal, the story that we’re living out in life, the timing of our meals. All of these are dramatically impacting our nutritional metabolism.

Stress will powerfully deregulate appetite. Many people think that they can’t control or manage their appetite because they’re willpower weaklings. I want to say 8 out of 10 times it has to do with stress. It has to do with anxiety and fear, which will deregulate appetite from a number of mechanisms.

You can register here https://ji177.isrefer.com/go/summitreg/trudyscottcn/

Amino Acids and Neurotransmitters: Trudy Scott’s MINDD interview

September 18, 2015 By Trudy Scott 14 Comments

mindd-interview

This time last year folks from the MINDD Foundation interviewed me at the Integrative Medicine for Mental Health conference. The MINDD Foundation helps practitioners and patients discover and implement effective treatments for Metabolic, Immunologic, Neurologic, Digestive, Developmental conditions that often affect the mind.

In this video I share about the amino acids tryptophan and 5-HTP for raising low serotonin levels, and the amino acid GABA for raising low GABA levels.

Here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution so you can see if low serotonin or low GABA may be a factor. Be sure to check the Amino Acid Precautions and work with your doctor if you are taking an SSRI.

Here are some useful related blog posts on the topic of amino acids:

It’s very timely to be sharing this information. In the recent webinar I shared that we know benzodiazepines do patients more harm than good and a brand new study shows that the psychiatric drug called Paxil, claimed to be a safe and effective treatment for depression in adolescents, is actually ineffective and associated with serious side effects. It is a reanalysis of an influential study originally published in 2001.

While the amino acids and other nutrients are powerful, we must always remember to get the foundations in place – real whole traditional food, no sugar, no caffeine and no gluten. This paper published earlier this year says it perfectly: Nutritional medicine as mainstream in psychiatry

Evidence is steadily growing for the relation between dietary quality (and potential nutritional deficiencies) and mental health, and for the select use of nutrient-based supplements to address deficiencies, or as monotherapies or augmentation therapies.

We advocate recognition of diet and nutrition as central determinants of both physical and mental health.

I will add that many of the recent “real whole traditional food” papers are not yet mentioning the mental health effects of gluten. Many say to include “whole grains.” So I’d like to share this wonderful testimonial recently posted on this blog: Bipolar, disruptive mood or gluten and junk food?

Ever since childhood I could not concentrate and focus at school. This seriously affected my grades. This continued into my working career and caused me to loose several jobs. Whilst I had periods of wellness this condition always returned to plague me. In one job as a retail manager I became driven for a six month period and then I crashed into deep depression sleeping for 18 hours a day. Prior to this crash I was stuffing my face with bread and fats. I was stressed and anxious. Ten years later this happened again.

I was diagnosed with bipolar 2. Only now at the age of 58 I discovered that I have an intolerance to wheat (gluten) after an elimination diet I feel so much better – all my symptoms are gone. It is like a MIRACLE! MY diagnosis is nonsense.

If the information in this video and article sounds intriguing and you’d like guidance with using targeted individual amino acids like tryptophan, 5-HTP and GABA (as well as glutamine and DPA/endorphigen), together with making diet and lifestyle changes, stay tuned for the launch of The Amazing Aminos for Anxiety homestudy group program.

You can add your name in the comments if you’d like to be notified when it launches. You’re also welcome to sign up here to be notified when we have more details about the start date.

Feel free to ask additional questions in the comments.

Benzodiazepines do patients more harm than good

September 15, 2015 By Trudy Scott 81 Comments

Dr. Nicole Beurkens recently shared her experiences about benzodiazepines on the blog: Say NO to Benzodiazepines for anxiety!

In my experience as a clinical psychologist benzodiazepines do patients more harm than good. While it is appealing to think that a pill can quickly and effectively remove symptoms of anxiety, panic, and/or insomnia, the reality is that there are significant negative long-term consequences for most people who use these medications.

It is not uncommon for me to have patients on multiple psychotropic medications, including benzos, due to symptoms of anxiety, insomnia, or other mental health issues.

Patients can quickly become dependent on these medications, and they are often prescribed higher doses over time with diminishing returns.

Some patients reach a point where they are not having symptom relief with the benzos, but they cannot function at all without them.

This issue is fresh in my mind because I have a 24-year-old male patient who is entering a rehab program next week due to addiction and substance use issues. The gateway drugs that led to these addiction issues for him were Ativan and Adderall prescribed to him since he was 14 years old. He now sees that these drugs have done a significant amount of damage, but we are having to admit him to a long-term treatment program to get off of these medications (and other substances) safely.

I maintain that if prescribers fully informed patients of the risks involved with these medications most people would never start taking them. We need to do more to educate patients and practitioners about the realities of these medications, as well as safer alternatives.

I am now devoting a significant amount of time and attention to this issue not just for benzodiazepines, but psychiatric medications in general. Especially where children are concerned, parents and professionals needs to have appropriate facts about these drugs and understand the many non-medication options that are available. I’m writing about this and providing resources at my site http://www.DrBeurkens.com for anyone who is interested. Thanks, Trudy, for getting this information out to more people!

As she says, it’s so important that we need to do more to educate patients and practitioners about the realities of these medications, as well as safer alternatives. Here is a recent blog post where she does just that: Beware the Rush to Prescribe

I appreciate that Dr. Beurkens is now devoting a significant amount of time and attention to this issue not just for benzodiazepines, but psychiatric medications in general. Her motto is to provide “Solutions to End Overmedication of Children with Developmental or Mental Health Concerns.”

Anxiety and OCD: Inositol instead of tryptophan or 5-HTP?

September 11, 2015 By Trudy Scott 150 Comments

Have you used inositol for anxiety and OCD (obsessive compulsive disorder) or even obsessive thinking or behaviors? Have you used it alone or with tryptophan or 5-HTP? I’d like to share an interesting discussion on a recent blog I wrote: Amino acids for anxiety – which ones and for how long? to illustrate how we are all unique and how some nutrients work well and some not so well.

I received this question on the blog regarding the use of amino acids tryptophan or 5-HTP and OCD/anxiety:

I was wondering if this will help with OCD? I did not see any mention of OCD in your articles. Do you feel it can be treated the same way you would treat other anxieties? I was told that since I take serotonin medication that I should not take 5-HTP because it may cause too much serotonin. What are your thoughts?

My answer was as follows (I’ve added a few links because I like to share the research):

OCD can often be related to low serotonin so yes tryptophan and/or 5-HTP can help and is often very effective. If you take an SSRI then tryptophan and/or 5-HTP should only be taken under a doctor’s supervision and at least 6 hours from the SSRI. I would suggest working with a practitioner who knows the amino acids too. And talk to your doctor about doing a taper if that’s what you’d like to do

The other nutrient that helps with OCD is inositol and this is fine to take with an SSRI. I start my clients on 2g/day and go up to 18g/day. Here is one of the older papers on inositol, showing benefits for depression, panic attacks and OCD and a more recent paper discussing OCD and inositol and other nutrients such as NAC and glycine.

With OCD I’d always also look into past strep infections and PANDAs as this could be a factor too.

One of my blog readers, Tracy, responded to the question with some encouragement (how lovely!) and gave us a great example of how we are all different and there is no one size fits all:

Chiming in with a bit of encouragement here – a bit late perhaps, but wanted to let you know that my teenage son suffers from OCD and anxiety. A number of years ago I found Trudy’s website while trying to find some natural ways to help him. We tried 5-HTP with good success (it also helped lessen the frequency and intensity of his migraines) but it caused stomach upset with him, even when taken with food, so be aware that it may have this effect on you if you try it. After about 9 months of 5-HTP we kind of “forgot” to give it to him and he continued to feel good.

Once my son started high school he started having more stress in his life and his OCD, anxiety and migraines returned. I started him on inositol about 8 months ago. It has had an even greater effect on the OCD than the 5-HTP (remember everyone is different tho!).

I’d highly recommend you try the inositol since 5HTP/tryptophan is not an option for you at this time. My son has had no side effects from inositol at all. Good luck!!

I was pleased to hear that the 5-HTP helped when Tracy’s son was younger. Some people do have digestive issues with 5-HTP. It’s usually in the first week and then typically resolves. This was obviously not the case with this young man.

I was also thrilled to hear that the inositol is helping so much now and wanted to know how much helps so I asked her. Tracy shared how much her son needs (not much at all) and the symptoms it helps with:

My son takes 500mg (NOW brand) daily in the mornings, usually with breakfast. That amount works well for him most days.

When stress is higher and he starts experiencing “breakthrough anxiety” or obsessions, I have him take another 500mg in the evenings as well, just for a couple days or until the stress has diminished.

I should mention that his OCD tends to be primarily obsessive in nature with very little compulsion. His father was actually diagnosed with mild OCD before I met him and he learned to deal with his through counseling and behavior modification. I read about tryptophan (Julia Ross) and asked him to try it. It works well for him when his anxiety acts up (which interestingly tends to have a seasonal component!) It has been an education living with these two!

You can take up to 18g a day of inositol but I suggest starting with 2g a day and building up as needed. But as you can see above, even 500mg to 1000mg (which is 1 g – I grew up in South Africa and love the metric system!) may be enough.

I happen to use the DFH Inositol powder (pictured above). It has a pleasant slightly sweet taste and is easy to increase the amount based on how much you find helpful. You can find this on the supplements blog here.

As I mentioned above, tryptophan or 5-HTP can help with anxiety, OCD, obsessive thoughts and behaviors (and panic disorders and depression). Adding inositol is an option when the tryptophan/5-HTP isn’t quite enough, or simply use inositol alone.

I also think inositol makes a great addition for mixing into the nasty tasting tryptophan if you find you get better benefits with the tryptophan capsules opened. I suggest starting with 2g inositol per 500mg tryptophan.

I appreciate Tracy giving me permission to share her son’s success with these nutrients. We can all learn so much from stories like this. If you’ve been using any of the amino acids and/or inositol, I hope this has been helpful for you.

Please share how you’re doing in the comments and feel free to ask additional questions.

If this sounds intriguing and you’d like guidance with using the amino acids and other nutrients like inositol, stay tuned for the launch of The Amazing Aminos for Anxiety homestudy group program. This homestudy group program will provide guidance with using each of the targeted individual amino acids, including nutrients like inositol. You can also add your name in the comments if you’d like to be notified when it launches. You’re also welcome to sign up here to be notified when we have more details about the start date.