Archives for July 2023

Gingerbread Coconut Muffins (a gluten-free/low oxalate recipe)

July 28, 2023 By Trudy Scott 12 Comments

If you have gluten sensitivity or celiac disease and/or dietary oxalate issues (pain, anxiety, insomnia, restless legs, hearing loss, eye issues, unresolved thyroid issues, bladder issues and more) and yet really miss the occasional muffin this Gingerbread Coconut Muffins recipe is a delicious gluten-free and low oxalate option. I see way too many so-called healthy gluten-free recipes using almond flour. This is concerning given that almonds are high in oxalates. Keep in mind that wheat is also high oxalate.

I’m finding dietary oxalate issues to be underappreciated especially in menopausal women when symptoms can show up and be more severe. If you’re new to the dietary oxalate issues you can read more below.

I have also found that using almond flour and other nut flours in baking affects your zinc/copper balance, increasing copper and hence causing more anxiety and even panic attacks.

If you don’t have dietary oxalate issues, you can certainly enjoy this recipe too. But watch the overindulging and binge-eating (more on that and using amino acids below).

Gingerbread Coconut Muffins (a low oxalate recipe)

Ingredients

6 eggs
1/3 cup melted butter
1/4 teaspoon salt
1/2 cup molasses
1/2 cup coconut sugar
2-3 teaspoons ginger powder (or liquid ginger extract)
3/4 cup sifted coconut flour
1 tablespoon ground flax seeds

Method

Melt the butter over low heat and add the coconut sugar and molasses. Once it’s cooled add the eggs and mix well. Stir in the coconut flour, salt, ground flax seeds and ginger powder.

Spoon the mixture into two greased mini muffin pans. Bake at 400 degrees F/ 205 degrees C for 12 – 14 minutes. The muffins will rise nicely and will start to turn dark brown. Remove and cool on a cooking rack. Makes 24 mini muffins.

Eat warm or when cooled. Serve with butter and/or cream and/or coconut butter. For a little added sweetness a small amount of raw honey can be spread on a muffin too.

My adaptation from a gingerbread cookies recipe

I adapted this recipe from a Gingerbread Cookies recipe in Cooking with Coconut Flour by Bruce Fife ND. I pretty much always do this when I cook – adapt recipes to my needs and likes – and always reduce the sugar. In this instance, I halved the sugar and used coconut sugar instead.

I also increased the ginger because I love all things ginger. I upped it from 1 teaspoon ground ginger to 2 teaspoons and will actually try 3 teaspoons next time I make them. Ginger can be an issue if you have oxalate issues so you’d want to see how much you can tolerate – so far so good for me. If you do have issues with ground ginger you could always use a liquid ginger extract which is low oxalate.

I omitted the cinnamon and cloves to emphasize the ginger taste. I also added ground flax seeds for added fiber.

I decided to cook them in mini muffin pans instead of making cookies on a baking tray but you could always try this option. Use the same temperature and cooking time per the original recipe.

The blackstrap molasses makes them so flavorful too and takes me back to my childhood. Molasses is nutrient dense too, providing calcium, magnesium, potassium, manganese, iron, vitamin B6, and selenium. Just be sure to use molasses made from sugar cane and not sugar beets (which are high in oxalates).

They were surprisingly soft and moist and eating them with butter and/or cream made them even more delicious. I always like to include some healthy fats. If dairy isn’t tolerated, coconut cream could be substituted. I suspect coconut oil could be substituted for the melted butter but have not tried this yet.

Here is Cooking with Coconut Flour by Bruce Fife ND. You can find it on Amazon here (my link). I’ve baked a number of recipes from this book and I’m impressed. I really appreciate that it’s all coconut flour recipes with no almond flour or other gluten-free flours used.

If you do battle with sugar cravings and binge eating – use amino acids

It’s ideal to keep baked goods – especially the ones shown on the cover of this book – to a minimum. But for an occasional treat this recipe book is excellent.

If you do battle with sugar cravings and binge eating, don’t forget how useful the amino acids are for stopping your cravings with no willpower and no feelings of deprivation. You can learn more about this here: The individual amino acids glutamine, GABA, tryptophan (or 5-HTP), DPA and tyrosine are powerful for eliminating sugar cravings, often within 5 minutes.

I discuss cravings/emotional eating and how to use amino acids in my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood and End Cravings. More here. I also cover how low blood sugar can lead to both anxiety and cravings and how to prevent this by use glutamine and eating for blood sugar stability.

If you’re new to dietary oxalates as a possible health issue

This blog post is a helpful one to start with if you’re new to dietary oxalates and the issues they can cause: Oxalate crystal disease, dietary oxalates and pain: the research & questions

These are the common medium-oxalate and high-oxalate foods that many folks have problems with: nuts, nut-butters and nut-flour (especially baking with almond flour and something to watch when eating Paleo or GAPS), wheat, chocolate, kiwi fruit (very high – see the raphides image on the above blog), star fruit (also very high), beets, potatoes, sweet potatoes, legumes, raspberries, spinach and soy.

In the above blog post, I share an overview of oxalates, my pain issues with dietary oxalates (severe foot pain and eye pain), and deeper dive into the condition called oxalate crystal disease (with some of my insights and questions).

The big take-aways are that calcium oxalate crystals are sharp and can cause far reaching harm beyond pain – such as unresolved anxiety, thyroid issues, neurological symptoms, eye issues, hearing loss, bladder issues, headaches, fatigue, insomnia, restless legs, autism symptoms and more. You can have issues with dietary oxalates and not have kidney disease/kidney stones, although there is very little research supporting the latter.

You may find these oxalate blogs helpful too:

What dietary oxalates issues have you experienced and has a low oxalate diet helped you?

If you have dietary oxalates issues can you handle ginger?

Do let us know if you make this recipe and enjoy it.

Feel free to share a favorite recipe of something you’ve adapted to be low or even medium oxalate.

If you have questions and feedback please share them here too.

My 12 year old son has ADHD, is impulsive, is a loner, craves carbs, and doesn’t do well or care about school – should he be on GABA?

July 21, 2023 By Trudy Scott 17 Comments

I’ve been reading your blogs and I’m trying to decide if my 12 year old son should be on GABA? He has ADHD, is impulsive, is a loner, craves carbs, and doesn’t do well or care about school.

Can you tell me what supplement he could be deficient and where to purchase? He is currently on ADHD medication (Focalin) during the school year.

Janice asked the above question about her 12 year old son. I wish it was as simple as just using the calming amino acid GABA but it’s seldom one amino acid that is the answer. GABA is often one of many supplements that may help and in this instance I suspect a combination of neurotransmitter imbalances (low GABA, low dopamine and low serotonin), pyroluria, other possible nutritional deficiencies and dietary factors are at play. Read on to hear my approach for working through what may help this young man improve his focus, reduce his carbs, actually care about school and doing well, reduce his impulsivity and help him fit in socially – and ultimately lead to him being a happier, calmer and healthier child.

GABA with preteens who have ADHD and spinning-type symptoms

I always start with one of the amino acids because we get quick results and immediate feedback. Since Janice asked about GABA, this is the GABA feedback I shared with her: I’ve had good results with GABA with preteens who have ADHD and spinning-type symptoms. One clue is when the craving of carbs is driven by stress i.e. stress eating. I always start with the symptoms questionnaire and have the parent rate each low GABA symptom on a scale of 1-10, with 10 being most severe, ideally in conjunction with their child.

I then have the child do a one-off trial of GABA and we observe improvements in the next 5-30 minutes. If the child reports any improvement in any of the symptoms – in this case focus and spinning driven by anxiety – the child continues with GABA and increases over the next few weeks to find the ideal dose for their needs.

Sometimes focus issues are so severe that it’s too challenging to rate symptoms before, doing a one-off trial of GABA and then rating symptoms afterwards. In cases like this, mom makes the decision to have their child use GABA before school, when they get home and possibly early evening too. Mom can observe their focus and spinning: like getting dressed and ready for school, settling down to homework in the afternoon and settling down for bed.

Relying on feedback from school is invaluable too. Stress related carb cravings are also assessed i.e. does he seek out sugar when stressed and anxious.

A mom shares how GABA helps her 11 year old daughter – GABA for children: ADHD, focus issues, irritability, anxiety and tantrums

My daughter hasn’t been diagnosed with ADHD but has a lot of ADHD qualities. We were having a huge amount of behavior problems as she is getting older (she’s 11). She has had amazing behavior at school and at home since giving it to her. She’s almost like a different child. GABA has truly changed our life.

…before the GABA she was irritable, she was fighting with her teacher and schoolmates, she couldn’t focus and was distracted by anything and everything, she was constantly disrupting the class and she was throwing major tantrums over ridiculous stuff (like her hair didn’t do what she wanted), she was mouthy and everything was a fight.

We are not seeing 99% of those behaviors at all anymore. She of course is still your typical pre-teen but if I say “no you can’t have that” our “no you can’t go there” her reaction is OK. Before it would have been a major fight or meltdown. Her teacher is reporting to me every day about her wonderful days.

Tyrosine for focus issues, low motivation and low energy type carb cravings

With focus issues I would also consider the role of low dopamine and do a trial of tyrosine. Other clues: are his carb cravings related to low energy and is there also low motivation tied to the fact that he doesn’t care about school? Are there also signs of depression or low mood?

We go back to the symptoms questionnaire and have the parent rate each low dopamine/low catecholamine symptom on a scale of 1-10, with 10 being most severe. Again, do this in conjunction with the child if possible.

We only do a trial of one amino acid at a time so we know what is working. Assuming the GABA has been helping, we’d do a trial of tyrosine next and look for improvements in focus, carb cravings (all neurotransmitter imbalances can lead to carb cravings), motivation and mood.

If the one-off trial approach is not an option, tyrosine is also used before school and right after school but no later than 3pm so as not to affect sleep. Again, the above symptoms are tracked.

In this blog both GABA and tyrosine help this teen: GABA helps 14-year-old with Tourette’s Syndrome (the tics and sleep), and tyrosine makes him happier and his mind sharper

Tryptophan or 5-HTP for ADHD/hyperactivity and afternoon cravings

Hyperactivity can also show up with low serotonin, and so can something like not caring about school i.e. a low mood. A clue here is when his carb cravings are more intense – with low serotonin it’s typically afternoon or evening.

We go back to the symptoms questionnaire and have the parent rate each low serotonin symptom on a scale of 1-10, with 10 being most severe. And again, it’s best to do this in conjunction with the child if possible and do a one-off trial of tryptophan or 5-HTP.

If that’s not possible, tryptophan or 5-HTP is used mid-afternoon and evening and symptoms are tracked. This can be layered in on top of the GABA and tyrosine if they are offering some relief.

Here is a blog post where a mom shares how 5-HTP helps her child – ADHD: 5-HTP melts have been a miracle for one of my adopted kids

5-HTP melts have been a miracle for one of my adopted kids. He had lots of trauma and off the charts ADHD. 5-HTP is better than methylphenidate (Ritalin) and we are now weaning off the non-stimulants.

Just 80 mg 5-HTP in the morning is all he needs. He was super ADHD, he had a para (teacher’s aide) in public school for years to keep him on track and this year at a school for ADHD the teachers were complaining that he was never on task. Now after a week it has changed his life.

Addressing pyroluria, low lithium, low zinc, low blood sugar and diet

Janice mentions her son is a loner so we’d look into pyroluria/social anxiety and add zinc, vitamin B6 and evening primrose oil (and other key nutrients). Keep in mind that zinc deficiency is common and is often low with ADHD.

She also mentions that he is impulsive. Impulsivity and ADHD is common with low levels of lithium. A big clue is a child having a roller-coaster of emotions. I use this low lithium questionnaire to assess for a need for low dose lithium (a nutritional supplement).

I consider low blood sugar with all my clients and with this young man low blood sugar may be contributing to his focus issues, low mood and desire for carbs. The amino acid glutamine helps as does breakfast and meals with quality animal protein and healthy fats.

And it goes without saying that dietary factors must always be addressed. My book is a great resource when are looking for a comprehensive dietary approach, which is needed with ADHD and the symptoms Janice describes – The Antianxiety Food Solution. There is also a chapter on low blood sugar, pyroluria and the amino acids.

If you are an adult and can relate to any of these symptoms and feelings, the same process applies. Just remember this: there is no one-size fits all since we all have unique biochemistry.

Side effects and longer term effects of stimulant medications

I appreciate Janice for reaching out and asking this question. Hopefully, implementing some or all of these changes, will allow her son to stop his stimulant medication, Focalin. This medication is similar to Ritalin (methylphenidate), which can cause the following side-effects: feeling sad or empty, irritability, loss of interest or pleasure, trouble concentrating, trouble sleeping (and many more).

These stimulant medications can also play a role in longer term health effects that include heart disease and the possibility of it being a gateway drug to other stimulants. The research on the latter is hotly debated but it is often seen clinically.

Resources if you are new to using amino acids as supplements

To recap, if you are new to using amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA, low serotonin, low dopamine, low blood sugar and low endorphins).

If you suspect 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 on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

As mentioned, there is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

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 acids that I use with my individual clients and those in my group programs. You can find them all in my online store.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms too). This is a paid online/virtual group program where you get my guidance and community support.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Have any of the above amino acids helped your child or you with the following symptoms: ADHD and poor focus, carb cravings and low mood/low motivation (doesn’t care)?

Has the pyroluria protocol helped your child or you be less of a loner?

Has low dose lithium helped your child or you with impulsivity and focus issues?

Have dietary changes helped too?

If you are a practitioner, are you using amino acids, the pyroluria protocol, low dose lithium and dietary changes with success in cases like this?

Feel free to post your questions and feedback here in the comments.

Psychiatric Complications of Primary Hyperparathyroidism and Mild Hypercalcemia: anxiety, depression, anger, irritability, delusions and impaired cognition

July 7, 2023 By Trudy Scott 38 Comments

In samples of patients undergoing parathyroidectomy for primary hyperparathyroidism (PHPT), these disturbances have been identified at a rate of 43.1%–53.0% for anxiety, 33.0%–62.1% for depression, 22.0% for thoughts of death or suicide, 51.9% for anger and irritability, 5.0%–20.0% for hallucinations and delusions, and 37.3%–46.5% for impaired cognition.

In fact, it has been noted that there are more neuropsychiatric phenomena in PHPT than is often recognized and that these symptoms are easily missed, particularly in the elderly population.

This excerpt is from, Psychiatric Complications of Primary Hyperparathyroidism and Mild Hypercalcemia, published in Psychiatry Online.

I’ve recently been reading as much as I can about this condition, for personal and professional reasons. As soon as I learn about something new I go digging to see if there is an anxiety connection. And I must say I was very surprised to read these stats. It’s not something I’ve heard discussed or taught at mental health conferences.

The authors also state this about the condition:

The incidence of primary hyperparathyroidism (PHPT) is about 21 cases per 100,000 person-years, and the disorder is usually caused by a solitary parathyroid adenoma. PHPT has traditionally been recognized by its characteristic symptoms, including urolithiasis (“stones”); osteopenia and osteoporosis (“bones”); abdominal cramping, nausea, and peptic ulceration (“moans”); and depression, anxiety, cognitive dysfunction, insomnia, confusion, and personality changes (“psychiatric overtones”).

How do changes in serum calcium levels contribute to mental health and cognitive symptoms?

It’s always helpful to understand the mechanism and it was the first thought that went through my mind – how does hyperparathyroidism and changes in serum calcium levels cause these mental health and cognitive symptoms? The authors share this:

Although the pathogenesis [or cause] of psychiatric symptoms in primary hyperparathyroidism remains unclear, calcium is thought to figure prominently in determining changes in monoamine metabolism in the central nervous system(CNS), thereby modifying neurotransmission and resulting in alterations in mood and cognition.

I went digging and found this paper – Acute psychosis secondary to suspected hyperparathyroidism: A case report and literature review.

The authors also state that the mechanism isn’t known for certain. And although they are referring specifically to psychosis, the explanation could be applied to other symptoms too: “It is thought that the changes in serum calcium level slow down nerve function and neurotransmission rate, inducing psychosis (and other symptoms like anxiety, depression, anger, irritability and suicidal thoughts).

Understanding this possible mechanism helps us find a temporary solution for these symptoms until the hyperparathyroidism is addressed with surgery i.e. using amino acids as supplements.

Using amino acids to ease symptoms while you are seeking the root cause/s

If you’ve been following my work and have read my book The Antianxiety Food Solution, you’ll be familiar with using targeted amino acids as supplements to support low levels of neurotransmitters. These provide quick relief of symptoms (in a day or less) while you are seeking the root cause.

If we look at the above symptoms:

Anxiety can be a sign of low serotonin (worry type of anxiety) and/or low GABA (physical type of anxiety) – and tryptophan/5-HTP and/or GABA help ease symptoms.
Depression can be a sign of low serotonin (negativity), low dopamine (curl-up-in-bed depression) an/or low endorphins (weepy depression) – and tryptophan/5-HTP, tyrosine and/or DPA help ease symptoms.
Irritability and anger are common with low serotonin – and tryptophan/5-HTP helps to ease symptoms.
Low GABA can also be involved with anger and rage
Cognitive issues can be caused by low dopamine and low GABA – and tyrosine and/or GABA help ease symptoms

(You can find the symptoms questionnaire here. As always, amino acids are used based on symptom clusters and dosed according to your unique needs.)

If you find you have been using the amino acids long term and have explored all the possible root causes described in my book and summarized here, it may be worth investigating primary hyperthyroidism especially if you’re menopausal.

Case: “I had to have a parathyroid gland removed a few years ago… I literally felt better from the moment I came round from the surgery”

We always want to find the root cause when we have various symptoms. With this condition, it’s common to observe very quick resolution of symptoms after parathyroid surgery to remove the adenoma/s. Someone in our community shared this:

I had to have a parathyroid gland removed a few years ago … I literally felt better from the moment I came round from the surgery. It’s a miserable disease. I thought I was going to die! Lots of people get so low that they don’t feel like they can go on.

Bone pain was awful. Fatigue, depression etc.

I had had some dental issues around that time. One of my teeth crumbled. My Vitamin D went down to 9 so I am sure that was a large part of the puzzle.

I was actually diagnosed fairly quickly but was retested many times. I self-referred to a surgeon that was in-network in the end as my insurance wouldn’t cover various surgeons that my doctor wanted me to go too.

I had had breast cancer a few years ago and so had had weekly blood tests and, when I went back and looked, my calcium had been high for years. So important to read our own results.

The surgery was so easy.

What an amazing outcome for this woman and I appreciate her for sharing so we all get to learn and benefit from her journey. And yes, I agree, we need to advocate for ourselves and ask for and keep copies of all our labs. And get educated and ask questions. It’s really unfortunate that high calcium and hyperparathyroidism is so often missed.

Not everyone has all the listed symptoms of primary hyperparathyroidism. This woman did experience fatigue, depression and bone pain. She did not experience anxiety and didn’t have kidney stones. I do suspect dietary oxalate issues (without kidney stones) can be an issue for some folks because of the calcium disruption.

Some reasons why hyperparathyroidism is underdiagnosed

In the last few months I have learned that primary hyperparathyroidism is underdiagnosed. PTH (parathyroid hormone) is not routinely tested and I believe that it should be. Also, as you read above, elevated calcium levels are often ignored or brushed off as being a non-issue. And to complicate things further calcium is not always elevated. Hyperparathyroidism is also underdiagnosed and undertreated in the elderly.

For many women (and men) the discovery happens after they are diagnosed with osteoporosis and then calcium and PTH are tested, and/or past elevated calcium levels are “discovered.” If the hyperparathyroidism diagnosis happens first then osteoporosis screening is not always done and I believe it should be. And don’t get me started on when I believe osteoporosis screening should start (at 45 and not 65 or 70 years old) and issues with DEXA screening (more to come on this).

The good news is that primary hyperparathyroidism is a well-established cause of secondary osteoporosis which starts to resolve after the surgery too.

I’m still very much in learning mode

Primary hyperparathyroidism only recently appeared on my radar as a result of the 2023 osteoporosis summit, hosted by my friend and colleague, Margie Bissinger, Physical Therapist and osteoporosis coach. Dr. Deva Boone was a speaker on this condition on the summit and her site is a wealth of information. I appreciate them both.

As I mentioned above, I am also amazed it’s not something I’ve heard about at mental health or integrative health conferences and when doing continuing education.

I will admit I’m no expert and I’m still very much in learning mode – for myself and for you and this community. But, as you know, I like to share what I learn. As I continue to learn, I plan to share additional perspectives and the osteoporosis/menopause and oxalate links.

I am also in the process of creating a hyperparathyroidism questionnaire to use with my clients. Not everyone has all the above symptoms and not all the papers and resources list all the symptoms covered here today. For example, fatigue is listed on many sites but not in the above two papers and very few sites emphasize the mental health symptoms.

I’m also learning there are clues to look for – like forearm results on the DEXA scan and a good TBS/trabecular bone score has some significance. Stay tuned.

Resources if you are new to using amino acids as supplements

If you are new to using amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA, low serotonin, low dopamine and low endorphins).

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

If you’ve been diagnosed with hyperparathyroidism (or a family member has been) you can likely relate to much of this. Please share your/their journey. I’d love to hear how long it took for a diagnosis and treatment and what symptoms resolved after surgery, and how quickly.

Did you find the amino acids helped anxiety, mood and cognition symptoms in the short term, and then were no longer needed after surgery?

If you’re new to hyperparathyroidism, feel free to ask your questions and share what you’d like to hear more about in the follow-up blog.

If you are a practitioner, is primary hyperparathyroidism on your radar and do you recommend PTH testing in addition to calcium testing? Have you found the amino acids to be a good short-term solution for your clients/patients?

And if hyperparathyroidism is your area of expertise, feel free to add to the discussion.

Feel free to post your feedback here in the comments.