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Archives for May 2017

Most children with anxiety relapse, regardless of treatment: Now is the time for Nutritional Psychiatry!

May 12, 2017 By Trudy Scott Leave a Comment

Most children with anxiety relapse, regardless of treatment! This is the title of a recent article on Medscape and is just heart-breaking to read. The article is reporting on a presentation from the 2017 Anxiety and Depression Association/ ADAA conference: Results from the Child Adolescent Anxiety Multi Modal Extended Long term Study CAMELS.

As a nutritionist educating and consulting with individuals with anxiety, using nutritional and biochemical approaches with great success, this is just not acceptable. I know we can do better and now is the time to be incorporating nutritional psychiatry. I’ll go as far to say let us start with nutrition.

Here is the message from the Medscape article (you will need to create a userid and password to be able to view it online)

Children treated for anxiety disorders with psychotherapy, antidepressants, or a combination of the two show no significant differences in outcomes or remission at 5-year follow-up. Furthermore, a majority of children experience relapse and chronic anxiety, new long-term data show.

Scott Compton, PhD, associate professor of psychiatry and behavioral sciences at Duke University School of Medicine, in Durham, North Carolina comments on the study:

For the majority of children with anxiety, the results … suggest that anxiety might be best characterized as a chronic disorder that needs to be managed.

With that in mind, further tailoring is needed to more individually address patients’ needs

As a field, we need to shift our approach away from a ‘one protocol fits all’ to figuring out how best to sequence treatments for the sizeable percentage of children who do not respond to current evidence-based interventions.

I don’t think Dr. Compton was thinking about nutrition when he said this but clearly the current evidence-based interventions are not working for most children and this is where nutrition comes in.

I also feel that anxiety should not be seen as a condition that has to be managed, instead we should be sharing the message that it can be eliminated, and providing long-term solutions to achieve this.

Here is the comment I posted on the article (and I also reached out to the study authors and shared this via email):

Research like this further confirms that we need to be incorporating nutritional interventions and biochemical approaches. We now have the results of the SMILES diet depression trial (published January 2017): the first randomized controlled diet depression study where ONE THIRD of the dietary intervention group saw improvements in their depression symptoms.  This was just diet alone and switching from processed/junk food to real food with no specific dietary restrictions. Participants also reported improvements in anxiety symptoms.  

When we customize diet we see further improvements and examples include the removal of gluten, caffeine, sugar and the addition of quality animal protein (especially at breakfast), organic vegetables and fruit and healthy fats. Addressing specific deficiencies is key too: low zinc, low iron, low serotonin, low GABA, low vitamin B6, low vitamin D etc. And addressing gut health and balancing the microbiome is imperative. There is research supporting all of the above and it’s effective in clinical practice – it simply needs to be part of the treatment of care for all anxious individuals.

A wonderful organization is the International Society for Nutritional Psychiatry Research (ISNPR).  Their first international conference will be held in Bethesda in July this year.  Another excellent conference is IMMH/Integrative Medicine for Mental Health. For practitioners in Australia, the MINDD forum is an excellent resource.

I would love to see more collaboration between practitioners and researchers in the nutritional/functional medicine/nutritional psychiatry space and practitioners and researchers in traditional psychiatry.  I feel we have so much to learn from each other.

My hope is that we can open communication and start to collaborate in order to serve all the anxious children and adults with all the options we have at our disposal!  

As stated in this 2017 paper – Nutritional Psychiatry: Where to Next? nutritional psychiatry is an emerging field and

offers much promise for addressing the large disease burden associated with mental disorders. A consistent evidence base from the observational literature confirms that the quality of individuals’ diets is related to their risk for common mental disorders, such as depression [and anxiety].

This is the case across countries and age groups. Moreover, new intervention studies implementing dietary changes suggest promise for the prevention and treatment of depression [and anxiety].

Concurrently, data point to the utility of selected nutraceuticals as adjunctive treatments for mental disorders and as monotherapies for conditions such as ADHD.

Finally, new studies focused on understanding the biological pathways that mediate the observed relationships between diet, nutrition and mental health are pointing to the immune system, oxidative biology, brain plasticity and the microbiome-gut-brain axis as key targets for nutritional interventions.

Here are just a few additional links with research supporting nutrition for anxiety:

  • Nutritional medicine in modern psychiatry: position statement by ISNPR
  • Nutritional medicine as mainstream in psychiatry
  • Integrative Medicine Approach to Pediatric Obsessive-Compulsive Disorder and Anxiety
  • Oral GABA supplementation allows better prioritizing of planned actions: new research
  • Tryptophan and ascorbic acid for anxiety caused by lead toxicity

And here is some feedback from individuals who have benefited from some of these approaches:

  • Paleo and grain free diets: anxiety and depression success stories
  • GABA helps with Lyme anxiety (while addressing the underlying disease)
  • GABA for children: ADHD, focus issues, irritability, anxiety and tantrums

If you are a practitioner who works with anxious children or adults use these resources to stay at the cutting edge of nutritional psychiatry.

If you have children with anxiety or are someone who suffers from anxiety, use this information to be informed of the latest research and be sure to share this with your practitioner.

And please let me know if you have any questions. As always I love to hear success stories so feel to share those too.

Filed Under: Nutritional Psychiatry Tagged With: anxiety relapse, children

Alzheimer’s disease: address the root cause to reverse symptoms (Microbiome summit)

May 7, 2017 By Trudy Scott 4 Comments

Dr. Jill Carnahan’s interview on the Microbiome Medicine Summit 2 covers cutting edge new information about Alzheimer’s disease, based on the work and research of Dr. Dale Bredesen. They start with the gut-brain connection and Dr. Carnahan shares this:

we used to think of early-onset cognitive decline and dementias and mood disorders as being in their own bucket. And so, we saw psychiatrists or neurological doctors or neurologists to treat those diseases. And now we’re finding as we knew for several years with functional medicine that, obviously, it’s all connected.

And the gut is especially important because this reservoir holds so many of our microbes and possibly pathogens and that speaks to the brain through the vagus nerve and through cytokines and through inflammatory molecules of all types.

And so, this conversation between our gut and our brain is very profound and has a huge impact on things like multiple sclerosis or dementia, Alzheimer’s, or even things like bipolar disorder, schizophrenia, depression, anxiety, and sleep disorders.

So what we’re finding is by addressing the immune system and the gut which are intricately connected, we can often get profound effects on areas in the body that are far from that, like the brain.

Dr. Kellman asks Dr. Carnahan to share a study that will be the slam dunk for really believing in this connection and she mentions a paper titled Microbes and Alzheimer’s Disease. It cites pathogens like herpes simplex virus type 1 (HSV1), Chlamydia pneumoniae, and several types of spirochaete which can affect the brain and play a role in Alzheimer’s disease.

Dr. Carnahan then covers Dr. Dale Bredesen’s subtypes of early-onset dementia which allows you to treat the root cause and actually reverse symptoms. She goes into it in great detail so I’m going to give you the summary version here:

Type #1 is inflammatory

  • This could be from inflammation or infections or other poor dietary habits. And that’s where the microbiome could play into that.
  • You might see elevated CRP, IL-6, TNF-alpha. You might see a low albumin to globulin ratio. You might see high homocysteine, hypothyroid, elevated cortisol

Type #1.5 is glycotoxic

  • The pure pre-diabetic, diabetic
  • That’s kind of the pure elevated insulin, elevated fasting blood sugar, elevated cortisol, low testosterone, high triglycerides, low HDL (and has an element of inflammation)

Type #2 is atrophic: So that’s someone who loses their trophic factor of support like estrogen, testosterone, insulin, and vitamin D3.

And often, these type 1s and type 2s actually have ApoE-4 double mutations which are higher risk for Alzheimer’s.

Type #3 is toxic:

  • Toxic mold exposure, biotoxins from Lyme disease, or heavy metals or other chemicals.
  • Often these chemicals will act on the tight junctions of the gut and increase permeability. And then that permeability leads to massive endotoxemia.
  • Younger onset of symptoms (like 40s and 50s) and reversible once you find and remove the root cause

Type #4 is vascular: inflammation of the blood vessels, high homocysteine

Type #5 is traumatic: wrestlers or boxers or football players that have had multiple head injuries or trauma.

By addressing the various root causes, Dr. Bredesen reports a reduction and in some instances reversal of dementia symptoms.

Of course, we know anxiety is common when it comes to Alzheimer’s and dementia. By addressing many of these above root causes we’re also able to reduce anxiety symptoms at the same time.

It was a fascinating interview and I hope you enjoy it as much as I did. I learned a great deal and find it very useful to group the symptoms into types.

There does seem to be one aspect that Dr. Carnahan didn’t address and I haven’t seen it covered in Dr. Bredesen’s papers: the impact of benzodiazepines on dementia and Alzheimer’s disease.  There is conflicting research on this but I feel there is enough research that does show a correlation – enough for us to be concerned.   Here is a recent paper looking at high-dose benzodiazepine use in Chinese patients , supporting an association.

This 2016 paper – Benzodiazepine Use and Risk of Dementia in the Elderly Population: A Systematic Review and Meta-Analysis states:

Our results suggest that benzodiazepine use is significantly associated with dementia risk. However, observational studies cannot clarify whether the observed epidemiologic association is a causal effect or the result of some unmeasured confounding variable. Therefore, more research is needed.

This may likely fall under type #3 (toxic).  I plan to reach out to them as a follow-up.

UPDATE: May 9, 2017.  I did hear back from Dr. Carnahan and she shared that she always discusses history and physical and lab testing, and history of benzodiazepine use or other neuroactive substances. 

And new research shows that it’s more than the benzodiazepines: SSRIs, SRNIs and atypical antipsychotics increase the risk of dementia in veterans with PTSD and even in those who don’t have PTSD. 

I hope you’ll join the host Dr. Raphael Kellman and all the great speakers on the Microbiome Medicine Summit 2, May 8-15, 2017 to learn more.

If you have questions or comments please feel free to share in the comments.

 

Filed Under: Alzheimer's disease, Events Tagged With: Alzheimer’s disease, anxiety, benzodiazepines, dementia, Dr. Dale Bredesen, Dr. Jill Carnahan, Dr. Kellman, gut-brain, microbiome, microbiome medicine summit, SRNI, SSRI

It’s not just you: More women than men have thyroid disorders

May 5, 2017 By Izabella Wentz 1 Comment

Guest post by Izabella Wentz, PharmD, FASCP

If you’ve ever wondered why more women than men seem to have autoimmune disorders, you’re not alone—I repeatedly get asked this question by people (mostly women!) who come to me seeking help with a thyroid disorder.

Even if you have had a hunch that more women than men are affected by autoimmune diseases such as lupus, rheumatoid arthritis, and multiple sclerosis, you’ll be surprised by this statistic: women account for a whopping 78% of all cases of autoimmune disease.

Hashimoto’s thyroiditis, which I was diagnosed with at 27, is five to eight times more common in women. (I’ve since gotten myself into remission and have dedicated my life to helping others heal from this condition.)

These disproportionate figures have perplexed experts for some time. After years of research and time spent working with people with thyroid disorders, I have formed my own theory, which I call the Izabella Wentz Safety Theory. I can’t wait to share it with you—but first, I’ll tell you a little about some of the other influences autoimmunity.

Searching for an Explanation

When we consider why more women than men have Hashimoto’s and other diseases of autoimmunity, we have to consider two key differences between men and women: hormones and a propensity to use more personal care products.

Regarding the first, there’s no denying that hormones could play a major role in autoimmunity developing. Three of the most likely times for the onset of thyroid disease are during and around puberty, pregnancy, and perimenopause.

Sex hormones such as estrogen and prolactin help regulate the immune system and fluctuations in these could contribute to thyroid disorders especially. Estrogen can alter the requirements for thyroid hormone, which could result in an autoimmune condition, especially if nutrient deficiencies are present. Prolactin, a hormone released by the pituitary gland in women after childbirth, can become elevated in women with Hashimoto’s (even in those not postpartum) and has been linked to increased thyroid antibodies and infertility.

Women do have a higher risk of developing diseases of the thyroid after they’ve given birth. But theories, such as “fetal microchimerism” which suggests that the presence of fetal cells in a woman’s thyroid gland after childbirth could be the spark of an immune system response, haven’t proven to be true.  

All this is to say that at present, there isn’t enough information to support the idea that hormones alone are to blame for the higher rates of autoimmunity in women.

It’s also been considered that because women generally use a greater number of personal care products—makeup, lotions, perfumes, etc.—they are more exposed to a greater number of chemicals, which could alter the immune system.

I haven’t seen enough evidence to convince me of this explanation either.

In truth, I think the answer is much more complicated and requires us to consider some of the underlying vulnerabilities that often occur in people with Hashimoto’s.

Unsafe Conditions Ahead: Go Back to Bed!

After working with thousands of people with Hashimoto’s, I’ve found that there are some common co-occurring factors. Many have nutrient depletions, intestinal permeability, food sensitivities, an impaired stress response, an impaired ability to get rid of toxins, and infections.

The more I thought about these factors, the more I realized that they have something in common: they all send a message to our bodies that the environment isn’t entirely safe and maybe self-preservation mode is what’s best for now. This provided the basis for my Safety Theory.

Let me explain.

Women are responsible for bringing new life into the world. And with this job comes a more finely tuned ability to sense the safety of the environment. We may be more inclined to sense that it’s not be the best time to reproduce—this could be because resources are scarce and we need to focus on our own survival, or for some other protective reason.

In either case, it’s a result of an evolutionary adaptation, or what’s known as adaptive physiology.

When we were cavewomen, one of the main sources of stress was food scarcity—we didn’t always know when we were getting our next meal. When we didn’t eat, consumed things that we weren’t intended to digest, or developed nutrient deficiencies, our bodies would conserve resources and reduce calorie burning.

Strangely enough, even though these scenarios first occurred hundreds of thousands of years ago, there are aspects of modern living that are replicating these signals: we go on calorie-restricted diets (signals food scarcity), eat a highly processed diet (creates nutrient deficiencies), and try to eat foods we’re not intended to digest, such as gluten (leads to digestive difficulties/intestinal permeability).

And when these vulnerabilities are present, they set the stage for an attack on the thyroid to take place and for some of the symptoms of self-preservation to develop. As thyroid function is disrupted, metabolism is slowed and you are sent into a quasi-hibernation mode.

Your body is signaling to you to conserve energy, hold onto weight, making you feel cold and tired all the time so you stay in your cave (or your bed), and lowering your interest in reproduction (low libido) until the environment is safe and fertile once again.

Other Environmental Threats Women Face and How the Thyroid Responds

Did you know that your thyroid gland can sense danger and initiate the autoimmune response? I think in this ability lies another possible clue as to why more women than men develop thyroid disorders.

It’s no secret that the world we live in is not as safe for a woman as it is for a man. Women are more likely to be abused, physically, emotionally, and sexually. And abuse is one of the most undeniable messages to our bodies that we are not safe. The function of the perceptive and sensitive thyroid is put at risk when this is the case.

This is part of my Safety Theory, but it’s not just a theory—multiple studies have confirmed that thyroid hormone imbalances occur in people who have been abused:

  • Research shows that there are alterations in thyroid hormones in women who have been sexually abused. These women also had co-occurring menstrual-related mood disorders.
  • Another study, published in 2005, found that women with PTSD due to childhood sexual abuse experienced thyroid hormone alterations
  • Fluctuating or modified thyroid hormone patterns have also been reported in people who have undergone traumatic stress events.

The abuse doesn’t have to be physical to trigger a red alert in the body. Many girls and women today experience emotional abuse or trauma that can make us feel isolated and cue up a flight response. This can happen at school or in adult social circles, where if we can’t keep up the appearance of being a Superwoman, we might get edged out of the tribe.

The Key to Healing—Showing (and Telling) Your Body It’s Safe

In working with so many women with Hashimoto’s over the years, I’ve learned so much about the condition and the vulnerabilities that can lead to its development. And I’ve also learned about some of the most effective strategies and approaches to healing.

One of the most moving revelations was that a message of safety is so important to helping women through recovery. I’m referring to comprehensive self-care, which can include internal mantras and the right kind of exercise and pampering that help create a restorative environment.

But it should be more than that.

What I’ve found is vital is addressing the vulnerabilities head-on—the signals your body is sending to conserve need to be shut off. You must repair your internal ability to respond to stress and restore detoxifying and digestive functions, eliminate food sensitivities and infections, and replenish nutrients that are lacking.

I’ve spent years creating and refining protocols that help women (and men) accomplish these goals. And I’ve finally been able to collect and present them together in one place in one program in my new book Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back.

When you follow the protocols I outline there, you send safety signals to your body by reducing your toxic burden, supporting your stress response, and supporting your gut with nutrition and targeted supplements. You communicate in a concrete way that the environment is stable and safe, and your thyroid can get back to its important work of helping you feel energized and warm, calm and clear headed.

I have dedicated my life’s work to helping women heal from Hashimoto’s so that they might feel safe, supported, and active in their lives again. I hope you’ll check out Hashimoto’s Protocol to see if might help you or a loved one recover from a thyroid disorder.

Until then, I encourage you to start sending safety signals today. Start by being nice to your body—feed it nutritious foods when it’s hungry and don’t skip meals. Don’t subject it to excessive or unnecessary stress, which means make time for play and rest. Stop forcing it to push through exhaustion by piling on the caffeine—rest! Listen to your digestion; if there are signs that a food is not working for you, don’t double up on antacids, but instead adjust.

Listen to your body and care for it like a child, or any other loved one who you would treat with absolute care. Like someone you’d want to make sure feels safe.

Filed Under: Thyroid, Thyroid health, Uncategorized Tagged With: hashimoto's, hashimoto's protocol, izabella wentz

Laughter, self-compassion and appreciation: Global Stress Summit

May 1, 2017 By Trudy Scott 1 Comment

Laughter, self-compassion and appreciation: 3 wonderful tips for reducing stress and anxiety in your life – from experts in the Global Stress Summit, hosted by Heidi Hanna.

#1: Laughter and mirth

Heidi Hanna’s wise words:

I have three things I do every morning to prime my brain. One is movement. One is meditation. And one is mirth

Heidi and neurohumorist Karen Buxman talk about the many benefits of humor and laughter during Karen’s interview What’s so Funny About Stress? It’s one of my favorites in the summit!

Laughter and humor boost resilience, affect gene expression and generate gamma brain waves in a similar way that meditation does, acting as a brain tonic. People who experience this gamma wave pattern find that

Food tastes better, things look more appealing and colors look brighter

I’m with them and HAVE to laugh every day – what about you?

#2 Self-care and self-compassion in times of loss

Ken Druck, PhD shares this in his interview on Courageous Living: Turning Adversity into Opportunity

There is no time at which we are more brutal, bullying, unforgiving, impatient, judgmental and critical of ourselves than in times of loss

This could be the loss of someone we love or a living loss like a divorce or break-up. He goes on to say:

It’s a teachable moment in our life to learn self-care and self-compassion. The practice of self-compassion is the basis for surviving through these hard and rough stretches in our lives

#3 Appreciation for your loved one every day

Arielle Ford shares this in her interview with her husband Brian on Positively Resilient Relationships

I try to give him 5 appreciations every day, just things that he’s doing and acknowledging them

She shares how research shows that doing it in public in front of other people wins millions more brownie points!

Arielle and Brian also share how they lighten up stressful situations with laughter and humor. I love their “Sheila” and “Wayne” tip when either of them are being too bossy (Sheila is Arielle’s mom and Wayne is Brian’s dad).

Arielle also offers these wise words: instead of being annoyed with something Brian is doing she changes the way she perceives the behavior.

It’s encore day of the Global Stress Summit so you can watch these and all the speakers today. If you haven’t already signed up you can still do so – just register here)

If you’re considering purchasing the series for your learning library be sure to do so today before the price increase. Here is the link to learn more and purchase.

I hope you enjoy them as much as I have!

Filed Under: Events, Stress Tagged With: anxiety, appreciation, Arielle Ford, global stress summit, Heidi Hanna, Karen Buxman, Ken Druck, laughter, Mirth, Self-care, stress

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