Archives for December 2016

Oxalates and leaky gut for Anxiety: Webinar replay

December 30, 2016 By Trudy Scott 20 Comments

Just a quick reminder in case you missed this over the New year weekend. You can still listen to the webinar replay from last week: Live Case studies, Q & A, and Special Diet Strategies for Anxiety – with myself and Julie Matthews

Tune in to hear live case studies on how we use special therapeutic diets and bioindividual nutrition strategies with complex clients who have anxiety, other mood issues and various related health problems.

I was my own case study and shared my own oxalate issue in detail (for the very first time) so you can learn in detail about this special diet and how these healthy foods that are high in oxalates caused me excruciating foot pain.

Here is the summary:

In 2013 I was on my feet speaking often 3 full days in a row at conferences
Exhibiting at conferences like American Public Health
Terrible foot pain (+ sharp hip pain in that same year)
- burning pain (like hot coals) and sharp (like shards of glass)
- standing on them and while lying in bed
- one event: had to crawl back to bed from the bathroom
My travel food was all high oxalate foods:
- Smoothies with berries (I took a blender when I travelled)
- Nuts to snack on
- Kale chips

Here is are the high oxalate foods:

And this is how I figured out the issue and what I did about it (with a few dietary changes):

Heard Julie present at WAPF conference
Light bulb: pain and oxalates!
Picked Julie’s brain about my feet pain and oxalates
Consult with Julie – I went salicylate free and oxalate free
It was the oxalates – I knew in 2 weeks!
Pyroluria connection – I have pyroluria and low vitamin B6 is a factor with oxalates
My oxalate results on OAT – nothing showed up
If I am exposed by mistake
- I feel irritable
- A sense of growing pain in my feet (in about 30 minutes)
I always have calcium citrate on hand – sorts me out in a few minutes
Concerns about everyone consuming green smoothies and baking with nut flours (oxalates and copper issues)
Decided to do the Bioindividual Nutrition Program to really learn about these special therapeutic diets
Julie is THE person to teach this!

During the webinar Julie shared her expertise on low oxalate diets and the lab testing, and shared a new powerful case study from her practice – Luka’s story is just heartwarming!

Julie also discusses the science behind these cutting edge therapeutic diet approaches which also include low phenol, low amine, low glutamate and low FODMAPs – and how so much of this can be applied to anxiety, depression and other chronic health conditions.

Here is a slide that covers leaky gut or intestinal permeability and anxiety – and special diets to consider:

The Q&A was excellent (thanks to all of you who attended live and asked questions).

You can register here for access to the replay (this is geared towards practitioners is open for all to listen in and learn + would be great to share with your practitioner if you’re not one)

Julie shared more about the BioIndividual Nutrition Training winter enrollment for practitioners. If you are a practitioner and already know you want to do the BioIndividual Nutrition Training training here is that link to check it out and register.

I highly recommend the training! As I mentioned, it helped me personally and now I use this information with the anxious women I work with and their families. I have also found the connection and sharing amongst the community of practitioners to be an invaluable aspect of joining the program.

PS. Even if you’re not a practitioner, many non-practitioners choose to listen in to these types of calls in order to learn. Feel free to do the same or to pass on to your practitioner so they can learn and then further help you. I also like to share this type of call with my entire community because I know many of you are aspiring health coaches, nutritionists and nutritional psychologists.

PPS. Julie also offers a version of this training to mom’s who want to learn for themselves and their families. Feel free to reach out to them at info [at] bioindividualnutrition.com if you’re interested.

Saffron has both antidepressant and antianxiety effects

December 30, 2016 By Trudy Scott 31 Comments

In a new study published in Pharmacopsychiatry, Crocus sativus L. versus citalopram in the treatment of major depressive disorder with anxious distress: a double-blind, controlled clinical trial, saffron (Crocus sativus L.) has been shown to have both antidepressant and antianxiety effects. It’s also anti-inflammatory and an antioxidant.

In this study patients received either saffron or an SSRI called citalopram/Celexa:

66 patients with major depressive disorder accompanied by anxious distress were randomly assigned to receive either saffron (30 mg/day) or citalopram (40 mg/day) for 6 weeks.

The Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A) were used to assess the effectiveness of the treatment during the study.

60 participants finished the study and they all showed significant improvement in depression and anxiety scores, with no significant difference in effectiveness or side effects from either the saffron or citalopram.

The authors make this conclusion:

The present study indicates saffron as a potential efficacious and tolerable treatment for major depressive disorder with anxious distress.

A 2014 systematic review of clinical studies and examination of underlying antidepressant mechanisms of action of saffron found that:

saffron’s antidepressant effects potentially are due to its serotonergic, antioxidant, anti-inflammatory, neuro-endocrine and neuroprotective effects

This means that saffron could potentially be used in place tryptophan or 5-HTP if you score high on the low serotonin section of the amino acid questionnaire (anxiety, worry-in-the head, obsessiveness, negativity and depression, irritability, PMS, afternoon and evening cravings and insomnia) and yet do not seem to benefit from either of these two amino acids.

And you’ll be getting the added antioxidant, anti-inflammatory, neuro-endocrine and neuroprotective effects.

If you do well with tryptophan and/or 5-HTP, I suspect that using a small amount of saffron together with these amino acids could enhance the effects.

I have yet to use saffron with my clients so I’d love to hear from you (so we all can benefit and learn from each other):

Have you used saffron and found it to be effective for your anxiety and/or depression?
If you’re a practitioner, have you used it with patients or clients?
Have you found 30 mg a day to be the most effective dose and how quickly have you noticed benefits? What symptoms have improved the most?
Have you combined saffron with tryptophan or 5-HTP?

I am on 5-HTP for anxiety and I am wondering about trying tryptophan instead

December 16, 2016 By Trudy Scott 68 Comments

Both 5-HTP and tryptophan help to boost serotonin levels so you can feel happy, calm, sleep well and not crave carbs. I typically have my clients who have low serotonin symptoms start with a trial of tryptophan because it I see such excellent results with this amino acid. That being said, some people simply do better on one versus the other and you may do better with 5-HTP. If you have low serotonin symptoms and are using either of these amino acids and not getting the expected results, it’s worth considering a change.

Here is a question I recently received on the blog. It’s something I’m commonly asked about and something I deal with often when working one-on-one with clients:

I am on 5-HTP (400 mg) [for anxiety]. I am wondering about trying tryptophan instead. What is the best (safest) way to make the switch? What is the starting dose you usually suggest? I am tapering off SSRIs so I know my serotonin reserves are low.

Here are some of the reasons you may want to consider switching and doing a trial of tryptophan

the 5-HTP is not working as you would expect for your anxiety or depression, or other low serotonin symptoms like PMS, insomnia, afternoon and evening carb cravings, negative self-talk, perfectionism, worry in the head and ruminations, and even anger issues or irritability (here is the complete questionnaire)
the 5-HTP is causing digestive issues
you have done an adrenal saliva test and discovered you have high cortisol. If you feel wired-tired I like to use tryptophan because 5-HTP has been shown to raise cortisol levels

Depending on how severe your symptoms are I would have you slowly replace one with the other, keeping in mind that 50mg 5-HTP is roughly equivalent to 500mg tryptophan.

In this particular case she was taking 400 mg 5-HTP and was surprised to hear that she may now need 2000 mg tryptophan, saying “that seems like a lot!”

Here is my feedback:

2000mg tryptophan isn’t too much if you have low serotonin symptoms and need it. If we were working together I would have her start with a trial of 500mg which is the typical starting amount and increase based on her response. If 500mg helps some symptoms but doesn’t give complete resolution of symptoms then I’d have her try 1000mg and monitor symptoms, and then go up to 1500mg and even 2000mg.

She may respond better to tryptophan and may only need 500mg or 1000mg or she may in fact need the full 2000mg.

She is currently taking an SSRI, so I would assume her doctor already knows she has been using 5-HTP and knows her plans to switch, giving approval and monitoring for possible serotonin syndrome. She would also take the tryptophan at least 6 hours from the SSRI.

Here is additional information on SSRI tapering while using amino acids.

Obviously a similar approach could be used to switch from tryptophan to 5-HTP.

I also only ever recommend the Lidtke brand of tryptophan. You can find this and the other amino acids I use with my clients here.

Have you switched from 5-HTP to tryptophan and seen added benefits?

Have you switched from tryptophan to 5-HTP and seen added benefits?

If you’re a practitioner please share if you’ve used this approach successfully.

Additional Anxiety Resources Click on each image to learn more

Genes, lithium, Kundalini yoga, coffee enemas, GABA, dairy: IMMH highlights part 1

December 12, 2016 By Trudy Scott 17 Comments

Here are some highlights from the recent Integrative Medicine for Mental Health conference. We did it live on Facebook, holding my iphone, as the conference was ending. I’m with my colleague Dr. Josh Friedman and this is the video and transcript of our discussion – we cover the following:

Methygenetic Testing to fine tune your gene results
Low dose lithium for irritability and alcoholism
Kundalini yoga if you have a hard time meditating
Coffee enemas for medication detox
Working as a detective to find your root cause
Simple changes like adding GABA or 5-HTP or removing gluten and/or dairy

Ok we are live… Trudy Scott, certified nutritionist and author of The Antianxiety Food Solution and Dr. Josh Friedman, a psychologist interested in integrative medicine approaches to depression.

Josh: I have a new website integrativedepressionsolutions.com and we are at the IMMH conference and it has just wrapped up – there was a huge amount of information, tons to learn, it was wonderful. What were your take aways Trudy?

Trudy: One of the things that I thought was absolutely fascinating was this booth called Methyl Genetic Testing. You can enter your 23andme data and then what you can also do is – while they are running their analysis on that – enter blood work, enter results of organic acid tests and results of stool. They actually show you if your genes are expressing and causing problems. Because you may have a MTHFR methylation genetic defect showing up on your SNP but maybe it is not causing you a problem. So this way you can actually determine if it is causing you a problem. You had shared with me that you have done the training?

Josh: The training was really amazing. Functional medicine looks at how the biochemical pathways of the body are working. This provides you with another layer – which is how are the genes that are programming those enzymes support those pathways – and it can provide you with an awful lot of information. And then they have a very simple program you plug your genes into and it gives you a guide as to what kind of supplements might help.

Trudy: Amazing! So it is really fine tuning the functional medicine and fine tuning what might actually be going on with each individual.

Josh: It gives you the next amount of information because the functional medicine actually shows you what is happening whereas the genetic testing shows you what potentiality there might be. So you might have a folic acid defect or your folate could be fine – so that was pretty interesting.

Trudy: What else did you like?

Josh: I went to a lecture on the use of low dose lithium for all kinds of things. It is something that I’ve known about – obviously pharmaceutical use [of lithium] for bipolar disorder. Low dose lithium can also be used for bipolar disorder, but the two things new I learnt is that it is incredibly helpful for irritability. So I am dealing with [clients with] depression and it is something that I have often not thought about for irritability. It is also helpful for situations if you have a parent or family history or a past history of substance abuse or alcoholism. So that was something that I’ll take home to my office.

Trudy: And it is something that I currently use in my practice and [I learned it from] Dr. James Greenblatt. He actually presented on a similar topic last year and I heard it then. So low dose lithium is the lithium orotate, we want to be clear about that – 5 to 10 mg twice a day is kind of what we are thinking about. I’ve had great results with women with insomnia. It helps to stabilize the mood and when you are using the amino acids you need a stable mood – you can’t have these ups and downs – so the low dose lithium is really good for that. I would like to hear how it goes when you are using it.

Josh: I have used it with some people with a history of alcoholism and it has provided stability in their mood which is really good. What else have you got?

Trudy: I loved Dr. Kelly Brogan, we always love her, don’t we? She is just really fabulous. She talked about the issues with all the medication and how she does not prescribe anymore. And she talked about a good Paleo diet and getting off gluten and all that good stuff. New things that I heard from her was how she loves Kundalini yoga and how she loves it because she can’t meditate. I find a lot of my clients have a problem with meditating so I always say if that does not work find something that is going to work. And she has found that this Kundalini yoga works for her. So tell me a little about what you know about it?

Josh: I think Kundalini yoga is quick movements with very quick breathing so it easily occupies the mind. So for someone who would have a hard time sitting and meditating that kind of movement would be helpful. Other kinds of movements and other types of yoga are Tai Chi or qigong. Movement or walking meditation can be easier practices for stress management if sitting completely still is hard.

Trudy: So we are doing Facebook live here for those of you who are just joining now. We are at Integrative Medicine for Mental Health conference and it is Trudy Scott and Josh Friedman.

And I want to pass the phone to Josh to hold because my arm is sore and killing me. Maybe he will do a better job than me.

The other thing that I heard from Kelly Brogan that I really enjoyed is that she is using coffee enemas. I have quite a lot of experience with them because the first practitioner that I worked with when I was an intern used coffee enemas for detox for cancer and had really good results. Dr. Brogan was saying how effective it is for phase 1 and phase 2 detox. It also helps with bile production and the part that I really like is that it helps with medication detox. So this is something that I’m going to be looking into a little bit more and I’ll come back and share more as I learn more.

Josh: That’s pretty cool. One take away I had is that functional medicine can often be like a very complex process of delving into the root underlying cause of symptoms – so things like detox pathways or different kinds of infections. Trudy here gave a talk – and her talk was on amino acids and dietary change and blood sugar stabilization and stress management. One of the things I heard running through the entire workshop was sometimes it is simple things that can make a huge difference. And so with using amino acids for mood issues it can be incredibly quick.

I don’t remember what her name was, but there was a psychiatrist who presented at the end, she talked about how she got into functional medicine and she was talking about the radical changes she had in her health status from simple dietary changes. So stopping gluten and dairy was a huge change for her.

Trudy: That’s important. We want to realize that these dietary changes and nutrients can have profound effects. I was talking to Dr. Nicole Beurkens earlier [about zinc and GABA for anxiety] and saying a lot of my clients will say “my anxiety and my depression is so severe I have to have medication, there is no way that diet and nutrients can make a difference”. But they really can. It can completely transform your life. I remember you shared a story of someone who got off gluten?

Josh: Yes, I see those powerful changes every day – where someone with a dietary change or a supplement like 5-HTP or GABA just changes everything. It is the one change that might move things along. It is quite amazing.

Trudy: And it is just a matter of finding what that root cause is for your anxiety and your depression – it may be low serotonin, and it may be gluten or you might need lithium support, it may be that you have an infection. We have heard about Clostridia this weekend, we’ve heard about Toxoplasma gondii, we’ve heard about Lyme disease – they can manifest in many different ways, [including anxiety and depression] – so finding that root cause is important.

Josh: So what people were talking about was being a clinical detective. So working collaboratively with your clients and just saying “it is going to be a process, we will find a solution, but it is going to take some time to figure it out.” Then there is a lot of detective work that can be done with pencil and paper: measures, asking questions, a clinical interview and it is putting the person’s story together to get to the bottom of what is going on. And so sometimes we can do that without testing. There are a lot of clinicians here, there are doctors here but neither of us are physicians and a lot of the work we both do is working with clients to try to figure out what that missing piece is.

And so, sometimes the missing piece can be quite small. I had a patient who had debilitating depression, had been hospitalized three or four times and we did one test, and the test was an IgG food allergy test. He was a weight lifter and he was doing 5 whey protein shakes a day, and it came up that he was severely allergic to dairy. He stopped dairy and within two days his mood was back to normal. I spoke to him recently and he has been stable and happy since his mood lifted.

What a wonderful outcome for his client!

And what an excellent conference! This is part 1 of our discussion. Stay tuned for part 2.

Feel free to post questions or comments below. And let us know if any of the above resonate with you?

Gut healing bone broth and SIBO on the Better Belly Project

December 11, 2016 By Trudy Scott Leave a Comment

A quick reminder that The Better Belly Project: Crushing the Critters, Plugging the Leaks, and Balancing the Biome for Your Best Body Ever, hosted by fermentationist, Summer Bock started on December 9th!

Here are some snippets from some of the many excellent interviews.

Kellyann Petrucci, M.S., N.D., is the author of the New York Times bestselling book Dr. Kellyann’s Bone Broth Diet and she shares this about the gut healing bone broth:

I call this my liquid gold, and this is my gold standard, this is my go-to, this is the love of my life, I have to say, is bone broth. Here’s why I love bone broth so much. We talked about your intestines, the long tubing. Well we talked about it being red and inflamed. Think about it like this. If you’ve got a sunburn, it’s inflamed, it’s red, you want to heal it, you want to get it to feel better, so the two things you’re looking for is you want to get out of pain, you want it to feel better, and you want it to heal. You put some aloe vera on there, it calms it, it soothes it, it heals it. But guess what? That’s what bone broth actually does to your gut. That’s what it does to your intestines. It goes in there and it heals it. It seals it. It provides nutrition.

To me it’s one of the most premier and best foods that you can possibly put in your body, and there’s nothing trendy about it. There’s nothing trendy about bone broth. It’s simply putting some healthy bones in a pot with some water. Celery, onions, and carrots for some flavoring, if you want. Throw them in there. Any spices that you want. You want to take that and simmer it for anywhere from 18 to 24 to 48 hours depending on what your goal is and what you’re doing. Just simmer it for a long period of time.

You want to get it gelatinous, because one of the big hitches, one of the beautiful things about bone broth is it really helps your body mainline it’s own collagen. We know that collagen, that’s the glue that holds us together, it’s super important. We lose that as we get older. Cooked collagen is gelatin. Gelatin is a big, big word, because that word means so much to gut health and gut healing. Gelatin, it heals everything so beautifully, particularly the gut. That’s why for me, that’s what I’ve used with patients, with readers, with celebrities, with everybody I work with, my go-to is bone broth. I love it because, again, I’m into the trifecta effect. I want something that I give my patients to work on so many levels so they get a lot done with a little bit of effort, and that’s why I love bone broth.

Dr. Vincent M. Pedre is author of Happy Gut and he shares about Small Intestinal Bacterial Overgrowth (SIBO)

I’m excited to talk about SIBO because I feel that it is one of the most misunderstood diagnoses. In Western medicine, so regular MD’s, they don’t know how to treat it. They don’t understand the length that it has to be treated in order to resolve the SIBO. SIBO doesn’t resolve overnight. It didn’t happen overnight. It’s not going to resolve overnight.

What happens in SIBO is that you get too many of the good guys in the small intestine, so an imbalance occurs.

If you have methane-predominant SIBO, often these people have constipation because the methane causes the migrating motor complex that controls peristalsis. It causes it to malfunction. These people will develop constipation.

He covers the SIBO breath test and how it measures hydrogen and methane, and the effects of fermented foods:

What we’re looking for and measuring in those samples is hydrogen and methane. Now, this is key because we’ve been talking about bacteria up to now. The methane producers are a genus of bacteria or species that is more archaic. It’s called archaea. They’re not even sure that they’re actually bacteria. They’re very fastidious. They’re a little bit harder to treat.

If it is a methane-predominant and it is probably more Archaea, they will, more likely, do well with fermented foods. It’s not going to worsen their symptoms. It actually will help them get better. We need the lactobacillus to out-compete the archaean to keep it in control.

He covers pros and cons of antibiotics and other medications, herbal approaches and probiotics, pro-kinetics, can you treat it through diet, with fermented foods and changing the diet into a low-FODMAP diet, avoiding the foods with the short-chain carbohydrate, plus tips to improve digestion like reducing stress, having fun, tips for stimulating the vagus nerve and much more. It’s a wonderful interview!

My anxiety-gut interview airs on December 14^th and I address the following in my interview:

IBS and anxiety
psychobiotics
serotonin and the second brain
GABA and GABA-eating bacteria
the vagus nerve and the gut-brain connection
how to use tryptophan and GABA to ease anxiety (and cravings)
melatonin for gut motility and sleep
glutamine for gut healing, calming and intense sugar cravings
prebiotics to lower high cortisol
and probiotic-rich foods too of course!

Why attend?

From the bacteria and flora, to your digestion and your elimination, the way your belly is operating has a lot to do with how you are operating.
You’ll be able to customize your experience so that whether you’re a full-fledged nutrition geek, or simply interested in maximizing your belly’s efforts you’ll find the knowledge and information that is perfect for you.
With all the toxins we’re exposed to, with processed foods and the stress in our lives, it’s more important than ever that your digestion is dialed in.

I hope you’ll join me and the other experts on The Better Belly Project: Crushing the Critters, Plugging the Leaks, & Balancing the Biome for your Best Body Ever

It’s going to be a great online event and I’m so pleased to be part of it. I can’t wait for you to hear the expert speakers: other authors, nutrition professionals, physicians, fermentation specialists and cutting edge experts that are going to be teaching everything belly.

When: December 9th-14th (Put it in your calendar now!)
How much: Nothing!
Where: Here! /online

See you there!

Psychobiotics: a novel class of psychotropic for anxiety (Better Belly Project)

December 5, 2016 By Trudy Scott 7 Comments

psychobiotics

Are you familiar with the term psychobiotics and the role they play in anxiety and depression? In 2013 Dr. Ted Dinan and Dr. John Cryan published a paper titled Psychobiotics: a novel class of psychotropic and in this paper they define a psychobiotic as:

a live organism that, when ingested in adequate amounts, produces a health benefit in patients suffering from psychiatric illness.

They go on to share how these good bacteria or probiotics can impact our mood and anxiety via neurotransmitter production, sharing that they are:

capable of producing and delivering neuroactive substances such as gamma-aminobutyric acid [GABA] and serotonin, which act on the brain-gut axis. Preclinical evaluation in rodents suggests that certain psychobiotics possess antidepressant or anxiolytic activity.

We often incorrectly hear that GABA taken orally is not effective because it can’t cross the blood brain barrier and if it does work it means you have a leaky brain. This is a myth I am working hard to dispel. The authors contribute to this discussion saying the following:

Effects may be mediated [or effects may occur] via the vagus nerve, spinal cord, or neuroendocrine systems.

The authors conclude with information about how these psychobiotics benefit IBS which we now know is often associated with both anxiety and depression. They share that these psychobiotics or good bacteria:

have been most extensively studied in a liaison psychiatric setting in patients with irritable bowel syndrome, where positive benefits have been reported for a number of organisms including Bifidobacterium infantis.

They also report benefits for alleviating symptoms of depression and chronic fatigue syndrome, likely related to:

the anti-inflammatory actions of certain psychobiotics and a capacity to reduce hypothalamic-pituitary-adrenal axis activity.

The impact these psychobiotics have on inflammation and the adrenals is wonderful since we know about both are closely tied to anxiety and depression, as well as digestive health.

This is older research but Dr. Ted Dinan and his colleagues continue to expand the research and our knowledge on this exciting topic, and we appreciate them for this.

The above is just one topic I cover in my interview on the upcoming online summit: The Better Belly Project: Crushing the Critters, Plugging the Leaks, and Balancing the Biome for Your Best Body Ever, hosted by fermentationist, Summer Bock!

We also cover the following in my interview:

IBS and anxiety
serotonin and the second brain
GABA and GABA-eating bacteria
the vagus nerve and the gut-brain connection
how to use tryptophan and GABA to ease anxiety (and cravings)
melatonin for gut motility and sleep
glutamine for gut healing, calming and intense sugar cravings
prebiotics to lower high cortisol
and probiotic-rich foods too of course!

Here we are during the interview, with me in my new temporary location in Australia.

And we ONLY had one plane fly over! ha ha! Ask me about this – it was hilarious and I plan to share the video…

Here are some additional reasons to attend

From the bacteria and flora, to your digestion and your elimination, the way your belly is operating has a lot to do with how you are operating.
You’ll be able to customize your experience so that whether you’re a full-fledged nutrition geek, or simply interested in maximizing your belly’s efforts you’ll find the knowledge and information that is perfect for you.
With all the toxins we’re exposed to, with processed foods and the stress in our lives, it’s more important than ever that your digestion is dialed in.

I hope you’ll join me and the other experts on The Better Belly Project: Crushing the Critters, Plugging the Leaks, & Balancing the Biome for your Best Body Ever

When: December 9th-14th (Put it in your calendar now!)
How much: Nothing!
Where: Here! /online

Please post your gut, microbiome, IBS and other related questions in the comments. We’ll see you on the summit!