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Dr. Datis Kharrazian’s GABA Challenge for a leaky blood brain barrier is a theory and we still have much to learn

By Trudy Scott 16 Comments

gaba challenge theory

I highly respect Dr. Datis Kharrazian and his work and had the pleasure of interviewing him last November on the Anxiety Summit 5: Gut-Brain Axis. During our preparations I asked if we could talk about his GABA challenge for a leaky blood brain barrier and he graciously agreed.

I wanted to address this topic in our interview because two of the most common questions I get asked are these:

  • “How can GABA work if it can’t cross the blood brain barrier?” and
  • “If GABA works does this mean I have a leaky blood brain barrier?”

We had such a great conversation on the topic I’ve decided to pull this part of the transcript into a blog so I can share it here with you and use the blog link to share it more widely as I’m asked these questions on social media and elsewhere.

You will learn how Dr. Kharrazian came up with the GABA Challenge, what his thoughts are today, his reservations with GABA and my excellent results with low doses of sublingual GABA. I also share some links to success stories, some of the research and how to figure out if GABA is for you.

Here it is, word for word.

Trudy: So while we’re talking about the leaky blood brain barrier, I want to just talk briefly about GABA and the GABA challenge that you have proposed as a tool for testing for a leaky blood brain barrier. And as you know, I use GABA extensively with clients with the low GABA physical type of anxiety.

I’ve always been a huge fan of you and your work but we do have a professional difference of opinion in this area. And I’ve never actually been a proponent of using the GABA challenge, and I’ve been pretty vocal about it. So I’m really glad that we had a discussion about this in the Facebook group of your neuroinflammation training, and you shared some insights because I was asking some questions about this.

I’d love you to just share some of what we talked about in that discussion. Because if we don’t talk about it, my community is going to say, “Hey, why didn’t you talk to Dr. Kharrazian about this?”

Dr. Kharrazian: Sure, no problem. I don’t think we have this big a disagreement. I think we just have different ways of looking at what’s out there and what we are observing as people working with people, patients who have anxiety.

So ultimately, we have a bunch of theory right now and a bunch of potential models, but we don’t have any clear studies to show what’s really happening. So, one of the things that I proposed in my book before… you understand, I was working with brain patients for over 20 years now….before we had S100 B readily available for many years, it was only in research; you couldn’t get it from conventional labs, even though research was showing it. And the blood brain permeability test was not available either. These have really become more available the past five years and prior to that, we didn’t really have a great test to evaluate if the blood brain barrier was breached.

In an effort to work with what’s out there, what we could do, one of the things that I was doing was doing a test that we called the GABA challenge test. It was really based on the lactulose mannitol test. So the lactulose mannitol test is a well-established test in gastroenterology where they measure leaky gut. So, in that test what the person does is they consume a monosaccharide and a disaccharide, lactulose and mannitol. Lactulose is a disaccharide, it’s very large, and mannitol is very small. And if mannitol doesn’t get absorbed, then there’s a malabsorption issue. And if lactose, which is very large; that should not get through the tight junctions of the gut, gets absorbed in a post urine test, after they drink it, then it shows they have leaky gut. So the whole premise of when you find particle sizes too large to cross, can be a clue to an indication of permeability.

So the GABA challenge that I write about in my book, Why Isn’t My Brain Working? (my Amazon link) was really a way for us to have patients consume GABA. If you look at the molecular weight of GABA, the Dalton size, it’s several hundred Daltons. Several hundred Daltons cannot cross the blood brain barrier. So the concept was, well if someone is taking GABA and they have an effect, then there’s a potential for it to cross the blood brain barrier. And it was kind of following the theory of the lactulose mannitol test. So there’s patients out there who take GABA and nothing happens and some patients take it and go, “It was amazing. Best thing ever. It finally helped me sleep,” or, “Helped reduce anxiety for me.” So, one of the theories was that maybe for some of these people, their blood brain barrier is breached.

Now I know we talked and there is actually the possibility of other pathways that can impact GABA, maybe directly to the gut itself, through the vagus, so I don’t discount those possibilities because we still don’t know. I mean, ultimately, there’d have to be a study designed where they look at it. And it would have to be an animal study, there’s no way you can get an IRB for human studies to check if it’s crossing the brain. It’s some really advanced isotope tracing techniques and I just don’t think the level of dyes they would have to consume to look at the gut and the brain is peripheral and separate… it wouldn’t be possible. So the real answer is, we don’t know.

For me, I still am always suspicious if someone takes GABA and they have a reaction. I always want to go and check the blood brain barrier. And it’s not 100%, I mean, I can tell you without question, there’s people who take GABA, you do a blood brain barrier test, they feel benefit from it, but their blood brain barrier doesn’t have any markers to show permeability.

So it’s not hard for me to consider the possibility that there’s some exogenous pathways too. But at the same time, it’s also really hard to look at the molecular weight of GABA and look at what can cross a healthy blood brain barrier. This Dalton size, we’re talking nanoparticles to a huge, huge particle. So I don’t know but I think we’ll just have to see what happens. And ultimately, if you feel better with GABA, that’s great. If it’s not harmful to you, and if you feel like taking it, that’s great.

I like to also use things like Valerian root, passion flower, and hops because those compounds cross the blood brain barrier. They cross the blood brain barrier and they bind to GABA receptors.

So, the other thing too with actually using GABA you always have the potential for your neurotransmitter receptor sites to down regulate. And this is seen all the time too, patients take GABA and they feel great and then they have to increase their dose and they don’t get the effect as they first did. And they increase the dose and finally, they just don’t get much of an effect from it. And that’s potentially due to receptor site down regulation, which is not as common if you take agonists like Valerian root or passion flower, or hops. These things bind to GABA receptors. So I did a review in my book, where I went over all the literature of the different GABA compounds, which have been published in the literature.

But I’m not going to deny the possibility that there is a potential exogenous source but I also can’t let go the possibility that the blood brain barrier is permeable. So I’m still waiting.

Trudy: Yes, I think it’s great because the fact that you write about that and you taught about that, and you teach about it. It got me looking into the research further and it got me more curious; and it’s good, it’s good to have a healthy discussion and a healthy debate, and be open to possibilities. I’m very open to having my mind changed if something comes up.

I just see GABA works so well with my clients and we use very, very small amounts. I know with your GABA challenge, it’s… what is the amount, its 1,500 milligrams, I think or 1,500 to 2,000? So I’ll start my clients on 125 milligrams of GABA sublingually and get results. I have not noticed the effect that they need more and more, and more. So that’s interesting that you say that. But yeah, it’s good, I’m glad that we’ve had this discussion.

And the other thing that you did say in the online discussion, you said, if someone has a response to taking oral GABA, in other words, taking a GABA supplement does help them, you would want to test for the blood brain barrier permeability, just to see what’s going on. And I like that you say we can track. I’ve actually been in discussions with Cyrex and said, “Hey, why don’t we monitor people who are doing the Cyrex test and have a response to GABA, either therapeutically for the anxiety or with your challenge?” We may start to see some patterns, which I think would be very interesting.

Dr. Kharrazian: Yes, the best we can do with the data in that scenario is just the correlation statistical analysis. But it still wouldn’t answer it.

Trudy: No, I know. But maybe that will trigger someone to want to do a study. So, the good news is we’re seeing more and more research on GABA in the literature. So, it’s exciting. Well, thank you for discussing that with me.

You can read more from our very enlightening interview here: Fix the Brain to Fix the Gut. Dr Kharrazian covers the impact of brain injury and impaired vagal activity (as well as motility and breakdown of the blood brain barrier), how to activate your neurons, using polyphenols for neuroinflammation and butyrate for leaky gut/brain.

These blogs have additional information on GABA and some of the many possible mechanisms:

Here are some blogs with feedback from folks who have benefited from using sublingual GABA for dental anxiety, ADHD/focus issues and Lyme anxiety:

The best way for you to figure out if you will benefit from GABA is to use the trial method. Do the low GABA questionnaire and do a trial of GABA (used sublingually), starting low and increasing until you find the right amount to ease anxiety and improve sleep. You can find the GABA products I recommend on my supplements blog.

Please do share if you’ve benefited from using GABA or if you use it with success with your clients or patients.

Coronavirus and vitamin C for immune support: new pain or more severe pain due to oxalate issues?

By Trudy Scott 113 Comments

coronavirus pain vitamin c

I have concerns regarding the use of high doses of oral vitamin C for boosting immunity – for a subset of susceptible individuals who have dietary oxalate issues. This is directly related to the many recommendations that have been and are being made in relation to the coronavirus pandemic, but it applies beyond the pandemic for anyone who has dietary oxalate issues.  My concerns relate to high doses of vitamin C making existing pain symptoms worse or even causing new pain symptoms in someone who is not aware they may have oxalate problems. This may include joint pain, vulvodynia, bladder pain, painful urination, eye pain, headaches, foot pain, stomach pain, general body pain, deep bone pain etc. All this can manifest as fatigue, irritability, anxiety, low mood and insomnia.

I’ve been promising to blog about this topic for over a month and have gathered enough information for a short book! I figured a good place to start is to share feedback I’ve received so far and ask for your feedback so we can learn and heal, educate and inform others going through this, as well as offer insights to researchers and doctors who are not aware of this issue (and sometimes say “based on biology it’s not possible”).

In the coming weeks, if there is enough interest, I’ll share additional information on mechanisms, what the research says and what the research says is not possible, labs, types of oxalate issues (there are many), the possible causes (there are also many) and long-term impacts beyond pain (for the thyroid, mitochondria, heart and more), the solutions, additional resources and  feedback from experts (of which there are very few – as of now I’ve been reading everything published by Susan Owens, Julie Matthews, Great Plains Labs and research published by kidney specialists).

Until then I’m humbly asking for your feedback. If you have no idea what oxalates are or are taking vitamin C with no issues, then please don’t worry. Things will become clearer as you read this blog and read follow-on blogs. I feel it’s really important to get this initial blog out rather than waiting until I have everything written up perfectly.

I’ve also been hearing feedback from folks who have now recovered from coronavirus or are still recovering, with many reporting lingering pain and fatigue. I am concerned some of that pain may be related to high doses of oral vitamin C or IV (intravenous) vitamin C leading to oxalate issues they may not be aware of.

My request to you – please share your vitamin C oxalate story

This is what I posted on facebook and I’ll simply share it again here: I’m looking for oxalate vitamin C stories to share with folks who don’t believe or are not aware that high dose vitamin C causes issues for those with dietary oxalate issues.

1) What symptoms do you experience?

2) How quickly do you notice symptoms after taking vitamin C?

3) What form of C have you tried? (ascorbic acid or Ester C or whole food sources of C like camu camu/amla/goji berry/acerola cherry/rosehips/kakadu plum/acai berry/ maqui berry or liposomal or something else). Please also share the brand and source of vitamin C if you know

4) How much vitamin C do you use and is this more than you usually take or are you/were you taking this for the first time?

5) How long did it take to get back to normal/no pain/no symptoms once you stopped taking vitamin C?

NOTE – ONLY VITAMIN C: for questions 2) through 5) – in order to be sure the new symptoms are due to vitamin C and not something else – the addition of vitamin C must be the only change made and then stopping vitamin C must also be the only change made. I have clients keep a log too and repeat the “test” if they are not sure. This can be likened to a gluten elimination trial but in reverse. Repeating the “test”also depends on the symptom severity.

6) Does/did anything help to counter the adverse effects (like calcium citrate, vitamin B6, NAC, MSM, biotin, bile support, Epsom salts baths or anything else)?

7) How long have oxalates been an issue for you and are you eating low oxalate? Or is this all new to you?

8) Would you equate the effects of vitamin C to eating high oxalate foods like spinach, raspberries, nuts and seeds, kiwi fruit, figs, turmeric, chocolate, wheat, white potato, soy, beets etc (less severe/same symptoms/more severe)?

I’m also adding these new questions based on some of the research I’ve been doing:

9) Are you aware of any kidney issues and if you get regular blood work done do you track and take note of your estimated Glomerular Filtration Rate (eGFR)?  What have you observed in terms of values? (In case eGFR is new to you it measures how well your kidneys filter the wastes from your blood and is the best overall measure of kidney function. It helps determine if you have any kidney damage.)  Have you ever been told you have kidney issues and have other kidney lab markers out of range?

10) What are your results on the Great Plains Lab organic acids test (OAT) for the following: Oxalic acid, Glycolic acid (glycolate), Glyceric acid (glycerate), Arabinose (a yeast/candida marker) Ascorbic acid (ascorbate, vitamin C), Pyridoxic acid (marker of vitamin B6 status), Furandicarboxylic acid and hydroxy-methylfuroic acid (markers for fungi such as Aspergillus), and markers of bacterial imbalance?

11) Do you have pyroluria (based on a urine test) or have more than 15 symptoms from the the pyroluria questionnaire and/or are susceptible to low vitamin B6 (poor dream recall and/or nightmares) and low zinc (and therefore high copper)?

12) How do you score on symptoms of low serotonin, low GABA, low endorphins and low catecholamines? (here is that questionnaire). Is your anxiety, low mood, cravings or sleep worse when you are dealing with your other oxalate symptoms/pain?

13) Do you have any genetic markers that indicate a susceptibility for oxalate issues?

14) Do you have celiac disease, gluten sensitivity, leaky gut, liver issues, gall stones, no gallbladder, poor bile production, fat malabsorption, mold toxicity issues, low pancreatic enzymes, candida, high iron/ferritin?

15) What are your results on a mold toxicity test such as the Great Plains MycoTOX profile? and/or do you live in a moldy home/worked in a moldy environment or have in the recent past?

16) What are you results on a stool test (and which stool test)?

17) Do you have high mercury, high lead or high levels of other metals?

18) What is your vitamin D level (now if you happen to know it and/or typical levels in the past) and did you start to take extra vitamin D during this pandemic too? If you are taking extra vitamin D how much extra? And does your vitamin D supplement also contain vitamin K1 and vitamin K2?

19) Do you have any other out-of-range (functional levels) markers on blood work or other lab tests?

I will come back and add references and the rationale for posing these questions.

Also, feel free to comment with a nickname to keep your health information private.

Josefin’s story: painful “fat tissue” around elbows, knees and hips, and an irritated bladder

I share some of the Facebook feedback below, but first, here are Josefin’s comments on my coronavirus blog. Josefin thanked me for not ignoring the oxalate problems that might come with higher doses of vitamin C, saying she has “experienced them first-hand and it is not something to take lightly.”

I asked her to share what happens when she eats medium and high oxalate foods (like spinach, nuts, kiwi fruit, chocolate etc). She shared this:

I gradually decreased my oxalate content in food as recommended in the TLO-group. During that year I experienced periods with a lot of the typical dumping-signs like sandy stools, pain in body and especially in joints and muscles, sand in eyes, bladder pain, peeing a lot, cravings for oxalate foods and a temporary relief in the dumping symptoms when I ate some higher oxalate foods.

I also realized that the painful “fat tissue” that I had all over the body (but mainly around elbows, knees and hips) for 10 years was really deposited oxalates with mostly fluid around it, since I lost it more and more while I dumped and had more pain there also when I dumped. Now the deposits are all gone.

I did want to know if the adverse symptoms she experienced with vitamin C were the same as when eating foods high in oxalates, and she confirmed they were:

Many of the symptoms of dumping were the same as I had previously experienced a few days to weeks after trying to do bowel flushes with vitamin C.

Josefin has been on a low oxalate diet for 3 years and has found the most vitamin C she can tolerate is 200-250mg of vitamin C per day. More about that in her own words:

Now after being on a low oxalate diet for 3 years (carnivore the last year) I have tried taking vitamin C very many times and come to the conclusion that about 200-250 mg per day is what I can take. If I take more I will get a gradual increase of that painful fat-tissue that will start after a few days to weeks depending on how much vitamin C I take. I will also get more of a flu feeling and irritated bladder.

When I stop taking the vitamin C I will within a day or two get all my typical dumping symptoms and they will continue for days to weeks depending on how much I have taken. Symptoms severity also depends on how much I have been taking.

It turns out she gets similar reactions with various forms of vitamin C: “ascorbic acid, calcium ascorbate, multimineral buffered ascorbate and also liposomal vitamin C from Quicksilver Scientific”.

Syd’s story: cystitis, along with a crashed brain

Syd shared this on the Facebook post:

I get symptoms from taking high dose Vitamin C within about 45 minutes. It shows up as cystitis, mostly, along with a crashed brain.

She did confirm that when taking vitamin C (possibly the ascorbic acid form) the symptoms mimic her symptoms when eating high oxalate foods. She also wants to try liposomal vitamin C and camu camu to figure out if she gets the same reactions:

I have the very same response to high oxalate foods. I used to think it was a bladder infection, but I tested four times and every time the test was negative. I’m having a response at the moment. I (stupidly) started eating protein bars that have nuts in them and after eating about four of them across several days, I have the cystitis symptoms.

I’m staring at some liposomal Vit C in the fridge that I’ve been wanting to try at a low dose. Same with some camu camu. I need the cystitis symptoms to abate first.

Virginia, Cathi and Melissa and their pain stories

Virginia also offered feedback on Facebook on her experiences with vitamin C, and again they are similar to when she eats high oxalate foods:

I took a pack of Vit C 1000mg (ascorbic acid) at night last week, next morning I noticed oxalate dumping. Took calcium citrate and it was gone within a day and yes the reaction is similar to eating high oxalate foods

On another Facebook thread my question got Cathi wondering if vitamin C was a factor in her worsening arthritis:

Hmmmmmm this has me thinking. I started Vitamin C crystals 1000mg a day – small spoonful in water. It is sour and not awful. Then, a couple of months ago the arthritis deposits in my right hand fingers got much worse and my right wrist has given me so much grief I have had to reduce my yoga. And I got a weird cyst or something on the inside of my right wrist. I wonder…. Gonna stop it and see if it makes a difference!!! Thank you as I was totally stumped and I hope this is the answer!!!!

On this same thread, Melissa shared that noticed severe joint and muscle pain within 2 or 3 days of starting vitamin C:

When the COVID stuff started, I started taking vitamin C as a preventative measure to keep my immune system strong. Within two or three days, I had system joint and muscle pain everywhere. I could hardly move! I stopped the vitamin C and it cleared up in 3 or 4 days. I’ve never had kidney stones, but my brother has, so maybe it’s a genetic predisposition? I do have a history of on & off systemic joint pain since my early 20’s.

I never thought I had oxalate issues but now I’m wondering if it might be related to my random systemic joint pain. 

I was taking between 1,000 to 3,000 mg per day. The label says Solaray timed release vitamin c (ascorbic acid), acerola cherry and rose hips.

Thanks to these folks, everyone who has already contributed on other blogs, all the Facebook feedback (and to you if you provide feedback today).

My hesitation – I don’t have all the answers and we are in the midst of a pandemic where vitamin C is so important

I planned to include this in part 2 but I’m adding this section now because a few hours after publication there are already so many comments and questions. I did hesitate about publishing this blog when I don’t have all the answers and because we’re in the midst of a pandemic where vitamin C has been shown to be very important.

There is plenty of research on the benefits of vitamin C and it’s widely used with much success during serious illness and for sepsis. This paper, An Update on Current Therapeutic Drugs Treating COVID-19, published just last month, discusses vitamin C (ascorbic acid) as a supporting agent, playing a role as a potent antioxidant, with benefits for immune health and as an antiviral against flu viruses.

It also discusses an IV vitamin C coronavirus trial and high dosages currently being used in various hospitals for this virus. The authors do also say “no major side effects” which is what we are typically told about vitamin C.

The Orthomolecular Medicine News Service have issued a number of valuable press releases on vitamin C specific to coronavirus but they are steadfast in their conviction that there are no issues with vitamin C, saying it doesn’t cause kidney stones.

For the majority (I think) there will be no major side-effects but for those with oxalate issues high doses of vitamin C are clearly problematic.

One caveat is that there may be a place for short-term high-dose use during a healing crisis, even for someone with dietary oxalate issues. Unfortunately I don’t have an answer for this aspect yet and I’m hoping a vitamin C expert will contribute to the discussion or I’ll discover some research about this.

And let’s not forget this study published in 1994, The clinical effects of vitamin C supplementation in elderly hospitalised patients with acute respiratory infections, where 200mg of supplemental vitamin C per day resulted in an 80% decrease in deaths among severely ill, hospitalized respiratory disease patients.

This topic is near and dear to my heart and folks have oxalate issues now so I decided to go ahead and publish this information. I’m looking for a solution for my community who are already aware they have oxalate issues (many of you have already reached out to me so thank you) and for myself too. I’ll share details of my oxalate story (my pain is in my feet and my eyes) and my vitamin C experiment in a future blog (I used food based vitamin C and 100-200mg/day and it didn’t go well).

As I mentioned above, I’m also concerned there are many people who don’t know they have oxalate issues and may end up with issues because of all the well-meaning vitamin C advice that is being shared during this pandemic.

I may have bitten off more than I can handle with this topic – I’m learning voraciously and it’s like drinking from a fire-hose! But I’m doing what I often do … I learn by teaching and asking for your feedback and questions, and I’m open about the fact that I’m not an expert and don’t have all the answers.

**** Some cautions *****
Please discuss your situation with your doctor and other health practitioners before stopping or reducing vitamin C based on what you’re reading here.

If you are completely new to the topic of oxalates, this is sound advice from Susan Owens on getting started: “work your way gradually into a completely low oxalate diet.” You can learn more on getting started here. Susan runs the Trying Low Oxalate Group (TLO) on facebook and they are extremely helpful.  I will be sharing additional resources/studies/practitioner feedback etc. but this will get you started.

A reminder that pain can have many root causes other than dietary oxalate issues (or in addition to oxalate issues): gluten issues, nightshades, low GABA, low serotonin, low endorphins, Lyme disease (bartonella can cause foot pain), fibromyalgia, low B12, heavy metals, mold toxicity, autoimmune conditions etc.

******************

Feel free to comment below – share your feedback and ask your questions. And do let me know if you’re interested in learning more about this topic and additional blog posts.

If you’re a practitioner who works with individuals with dietary oxalate issues I’d love to hear from you too.

Coronavirus: new research on vitamin D supplementation possibly improving clinical outcomes

By Trudy Scott 57 Comments

coronavirus and vitamin d

It’s very encouraging to see research like this being published in the midst of the coronavirus pandemic: Vitamin D Supplementation Could Possibly Improve Clinical Outcomes of Patients Infected with Coronavirus-2019 (COVID-2019)

Serum 25(OH)D level was lowest in critical cases, but highest in mild cases. Serum 25(OH)D levels were statistically significant among clinical outcomes.

The results suggest that an increase in serum 25(OH)D level in the body could either improve clinical outcomes or mitigate worst (severe to critical) outcomes, while a decrease in serum 25(OH)D level in the body could worsen clinical outcomes of COVID-2019 patients.

In other words,  lower levels of vitamin D were associated with more severe symptoms and higher levels were associated with less severe symptoms. The role of vitamin D in immunity has been long understood and is summarized in the paper as follows:

Vitamin  D has  been  proven  to reduce  risk  of  getting a common  cold. It  also  enhances cellular immunity, modulates adaptive  immunity, and  enhances expression  of  antioxidation-related genes.

There are a few aspects I’d like to highlight: it was not a peer-reviewed randomized controlled trial but rather a retrospective study (looking back on past events) submitted as a research letter; it was a small study of 212 cases and they were all confirmed to have SARS-CoV-2 infection.  Vitamin D status was based on serum 25(OH)D levels of “(1) normal -25(OH)D of >30 ng/ml, (2) insufficient-25(OH)D of 21-29ng/ml, and (3) deficient-25(OH)D of < 20 ng/ml,” with tests done every 7 days.

What is astounding to me is that such a small difference in vitamin D levels could have such a dramatic impact on severity of symptoms i.e. from a median of 31.2 ng/ml to 17.1 ng/ml:

  1. mild – mild clinical features without pneumonia diagnosis: serum 25(OH)D level was 31.2 ng/ml
  2. ordinary – confirmed pneumonia with fever and other respiratory symptoms: serum 25(OH)D level was 27.4 ng/ml
  3. severe – hypoxia (at most 93% oxygen saturation) and respiratory distress: serum 25(OH)D level was 21.2 ng/ml
  4. critical – respiratory failure requiring intensive case monitoring: serum 25(OH)D level was 17.1 ng/ml.

The author concludes as follows, recommending randomized controlled trials and large population studies:

… this study provides substantial information to clinicians and health policy-makers. Vitamin D supplementation could possibly improve clinical outcomes of patients infected with COVID-2019. Further research should conduct randomized controlled trials and large population studies to evaluate this recommendation.

I would really like to acknowledge the author, Dr. Mark Apilio, for taking the time to gather this information and submit this research in the midst of the pandemic, so we can all learn and further our knowledge.

I reached out to him to find out more about his interest in vitamin D. I was also curious to find out if vitamin D levels are routinely checked in the Philippines and if vitamin D supplementation recommendations are common practice. I received this feedback:

I am a clinical professor with experience in handling patients with infection. In times like this, academicians in the Philippines are driven to finding therapeutic drugs for Covid-19 or palliative drugs, at least. Also with other experts’ advice, Vit D could be a good topic to research using clinical outcomes of the Covid-19 patients.

Vitamin D supplementation in the Philippines is uncommon since most of the Filipinos believe that they could get Vit D easily because of the sun (country near the equator). However, Vit D test is common for patients with severe respiratory infections for monitoring of status. Based on the table [in the review letter], mean ± SD was used to report serum 25(OH)D level of the cases. I am happy with the results of the study and the support of Vit D advocates like you. I do hope this shall serve as a call for health officials to at least focus on something like this which could impact clinical outcomes of Covid-19 patients.

Keep in mind that low vitamin D is also a factor when it comes to mental health and anxiety. You can read more about this aspect here – Vitamin D: anxiety, depression, sun exposure, supplements and optimal levels. This blog also has additional information about testing and optimal ranges from the Vitamin D Council.

I really like these two Designs for Health products: Vitamin D Synergy which provides Vitamin D3 2000 IU and vitamin K1; and Vitamin D Supreme which provides Vitamin D3 5000 IU and vitamin K1/K2. Both can be purchased via my online supplement store (details on setting up an account here).

Vitamin D is such a simple and yet powerful intervention for immune support and I look forward to randomized controlled trials for coronavirus. In the meantime, it’s one of the many immune-supportive nutrients I plan to continue using and recommending to my clients.

UPDATES 5/1/2020:

I’m sharing some updates to last week’s blog on vitamin D and coronavirus because there is a brand new study with astounding results and some other supporting vitamin D papers.  There is also new research on vitamin K and coronavirus and I’ve added this one too. I did hear back from the author in the Philippines and added his feedback above.

This is the new paper with astounding results. It was a retrospective cohort study: Patterns of COVID-19 Mortality and Vitamin D: An Indonesian Study (and just posted April 26). It had 780 cases with laboratory-confirmed infection of SARS-CoV-2 in Indonesia:

Age, sex, co-morbidity, Vitamin D status, and disease outcome (mortality) were extracted from electronic medical records. The aim was to determine patterns of mortality and associated factors, with a special focus on Vitamin D status. Results revealed that the majority of the death cases were male and older and had pre-existing conditions and below normal Vitamin D serum level.

These are the astounding results:

  • Vitamin D deficient cases (serum 25(OH)D of < 20 ng/ml) were approximately 19.12 times more likely to die from the disease
  • Vitamin D insufficient cases (serum 25(OH)D of 21 – 29 ng/ml) were approximately 12.55 times more likely to die from the disease

This review paper, Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths published earlier in April makes these recommendations about dosages and vitamin D levels to aim for (pending additional research):

To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40-60 ng/mL (100-150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.

In this paper (not yet peer-reviewed), Reduced Vitamin K Status as A Potentially Modifiable Prognostic Risk Factor in COVID19, the authors report that vitamin K status – according to Dp-ucMGP levels – was reduced in patients with COVID-19 and related to poor prognosis.”

They state this is due to the fact that “Coagulation is an intricate balance between clot promoting and dissolving processes in which vitamin K plays a well-known role.” They also propose an intervention trial with vitamin K for patients with COVID-19.

Do share if you routinely get your vitamin D levels checked and supplement regularly with vitamin D.  And let us know if you’ve noticed an improved immune system when your vitamin D levels are optimal. If you did get the virus please also let us know how you’ve fared and recovered.

The psychological trauma of coronavirus – nutritional support for doctors, nurses and their loved ones

By Trudy Scott 13 Comments

psychological trauma coronavirus

If you are a nurse or doctor or providing support in any capacity in hospitals and other essential services during this coronavirus pandemic you need nutritional support.  You may be feeling on edge and anxious, worried about the future, concerned and angry about the lack of personal protective equipment (PPE), fearful for your safety and terrified about bringing the virus back to your family, exhausted and yet not able to sleep, feeling overly emotional and weepy about your patients (and decisions you are making or you anticipate having to make), and starting to have nightmares.

I’m not downplaying the enormity of the stress and trauma you are already facing and will continue to face, but we must not forget that nutrients (and nature and exercise) have a role to play in PTSD and trauma. They help to make you more resilient and mitigate some of the effects of trauma, and they also support healing and recovery.

When you feel calmer and you sleep better, you indirectly support your immune function too. There is also research that directly supports the role that GABA plays in improving immune function (more on this below).

B-complex and a multi-vitamin for everyone

If this is all that can be managed, a B-complex and a good multi-vitamin would be my first choice for everyone. I wrote this blog during Hurricane Harvey: Nutrition solutions for psychological stress after a natural disaster. It’s equally applicable now. Simply replace “after a natural disaster” with “during the coronavirus pandemic.”

My colleagues Bonnie Kaplin and Julia Rucklidge published this paper in 2015: A randomised trial of nutrient supplements to minimise psychological stress after a natural disaster. They found that folks traumatised after New Zealand earthquakes and floods in southern Alberta, Canada, showed significantly greater improvement in stress and anxiety when consuming a B-Complex and/or broad-spectrum mineral/vitamin formula.

In a newly published article in the Calgary Herald, Dr. Kaplan explains how these nutrients act as co-factors for making serotonin, GABA and dopamine and that “we should all consider a B-complex and/or a broad-spectrum nutrient formula on a daily basis to strengthen our mental resilience.”

My second recommendation is GABA and/or theanine

Supporting low levels of GABA, the calming neurotransmitter, eases your anxiety, improves your sleep and supports your immunity. When you feel calmer and you sleep better, you indirectly support your immune function too:

the physiological response to psychological stressors can dramatically impact the functioning of the immune system (from this paper)

We also have research that directly supports the role that GABA plays when it comes to improving immune function.

We want you to stay emotionally and physically strong and so does your family!

I write more about this here: GABA and theanine for easing anxiety, improving sleep and supporting immunity.  I share advice if you’re currently using GABA/theanine or have used it in the past, and a summary if you’re new to low GABA anxiety symptoms and using GABA/theanine.

Melatonin and serotonin support

I have my clients use a sublingual melatonin for going to sleep and a timed-release melatonin for staying asleep, and it’s another recommendation I’m making.

Melatonin improves sleep, helps ease anxiety and fear and may help with PTSD:

  • A double-blind, placebo-controlled crossover trial concludes that “melatonin may be an effective treatment for shift work nurses with difficulty falling asleep.”
  • Low levels of melatonin are common in military-related PTSD.
  • Melatonin modulates fear and “may serve as an agent for the treatment of PTSD”.

This in press and pre-proof paper reports on melatonin: COVID-19: Melatonin as a potential adjuvant treatment:

Melatonin, a well-known anti-inflammatory and anti-oxidative molecule, is protective against ALI/ARDS [acute lung injury/acute respiratory distress syndrome] caused by viral and other pathogens. Melatonin is effective in critical care patients by reducing vessel permeability, anxiety, sedation use, and improving sleeping quality, which might also be beneficial for better clinical outcomes for COVID-19 patients. Notably, melatonin has a high safety profile.

This is very promising for offering added protection if you are working on the front-line and for  your patients too.

Serotonin is the precursor to melatonin and the amino acid tryptophan is one of the raw materials for making serotonin. I would also include tryptophan or 5-HTP for supporting serotonin levels to help with the worry and anxiety in the head, lying awake ruminating, feelings of fear, anger, depression, worry and negative thinking.

Try to get into nature for the pure joy of it and to lower your cortisol

Do your absolute best to try and get some nature. I share some simple options in this blog:

  • Get out into nature at least one day a week i.e. do some “forest bathing”
  • Take a short detour and drive to work via a tree-lined street
  • Look at some images of nature: sit and stare at a giant poster or even watch a show on National Geographic

Beyond the pure joy of spending time in nature, there is research supporting all of the above in playing a role in reducing anxiety, feeling more positive and calm, reducing cortisol levels and helping with recovery from stressful situations.

tree-lined street

Do this workout a few times a week for mood support

Here is a great workout from Dr. Zach Bush, MD. He recommends doing it 3 x day and starting with 10 reps of each of the 4 exercises and building up to 20 reps of each one:

The Four Minute Workout is a new concept of exercise that revolves around the body’s ability to use Nitric Oxide for muscle growth. This is an efficient anaerobic workout that can be done multiple times per day. The more frequently you do it, the better your results.

In this blog, I write how signals from our large leg muscles alter our brain and nervous system and improve mood.

If it’s your loved-one on the front-lines be sure to take care of yourself too

All of this nutritional support is also important if you are the mother or husband or wife or sister or brother etc. who is anxious and worrying about your loved one. You need to be strong for them so be sure to take care of you too.

Even if you are not working on the front-line or don’t know anyone doing so, if you are experiencing any of the above emotions, you need nutritional support too.

The New York Times article

It was reading this very somber and eye-opening article in the New York Times that promoted me to write this blog: The Psychological Trauma That Awaits Our Doctors and Nurses

The angst that clinicians may experience when asked to withdraw ventilators for reasons not related to the welfare of their patients should not be underestimated,” warn the authors of the article in The New England Journal of Medicine.“It may lead to debilitating and disabling distress.

We look at veterans and thank them for their service, never being able to fully comprehend what they’ve been through. The same may soon be true of some of our health care professionals. We may think we know. But we don’t.

No-one should have to make these choices and our hearts break for you and the families who are being impacted.

Louisiana article conveys the gravity of the situation like no other

Unfortunately it is happening already. This article conveys the gravity of the situation like no other and I’ve been pouring through everything – an account from a respiratory therapist in a Louisiana hospital (published two weeks ago.) We have been hearing similar stories from Italy for over a month now. Be warned – it’s horrifying!

It does include this statement… “The medical details in this story were vetted by an infectious disease doctor, a cardiologist and an internist at three different hospitals. All of the information about ARDS, the condition that the respiratory therapist describes, was fact-checked against peer-reviewed articles and UpToDate, a resource for physicians to check current standards in care, clinical features, and expected complications and outcomes.”

Because but I’m not familiar with this publication, I also checked with colleagues who are doctors and this is medically accurate.

While we don’t want to create panic I want to understand what doctors and nurses are facing so I can help. I do also believe we all deserve to know the facts, so we can truly support our doctors and nurses, and so we take this very seriously and stay home!

My biggest wish

It is my biggest wish that we can prevent much of this heart-ache and trauma going forwards, by preventing the spread of this virus and preventing the need for ventilators by helping sick individuals recover more quickly or prevent folks getting sick in the first place.

I do know of many incredible functional medicine practitioners who are creating task forces and working behind the scenes putting together proposals to present to governors, governments and mainstream medicine.

The products I mention and eating real whole food

The products I recommend to my clients are Designs for Health B Supreme and Designs for Health Twice Daily Multi.

You can find the GABA, theanine, tryptophan and 5-HTP on the supplements blog here.

If you are working in a hospital or medical setting or essential services

  • Please reach out if you need help with any of this – how to implement these recommendation or where to get the products
  • If you’re already doing this please share so we can encourage others to support themselves

And if your loved ones or friends in healthcare need support

  • Please share this blog with them and help them get access to these nutrients
  • I also encourage you to read my book – The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings – and give them the highlights about eating real whole food, quality animal protein, organic veggies and fruits, fermented foods, healthy fats, avoiding caffeine and sugar, eating for blood sugar control etc.
  • Please share if you know ways we can get this information (and nutrients) into the hands of more of our front-line workers
  • My focus is nutrition and nutrients but they also need someone to talk to so give them a call and be a listening ear. Also, help them find an online therapy service if they feel they need it. It’s encouraging to see more and more of this being made available.

One final comment – these are the bare essentials. In an ideal world, with more time, it would be best to work with a functional medicine practitioner and nutritionist and figure out your exact nutritional needs.

GABA and theanine for easing anxiety, improving sleep and supporting immunity

By Trudy Scott 86 Comments

gaba theanine

Stress and anxiety suppresses immunity and so does poor sleep. One root cause of anxiety and poor sleep can be low GABA (gamma-aminobutyric acid) levels.  When you boost low levels of GABA (the neurotransmitter) with the amino acid GABA (it has the same name as the neurotransmitter) or theanine (another amino acid), you feel calmer and you sleep better, and you indirectly support your immune function too. We also have research that directly supports the role that GABA and theanine may play when it comes to improving immune function.

This paper, Psychological Stress, Immunity, and the Effects on Indigenous Microflora, describes the field of PsychoNeuroImmunology which

has clearly demonstrated that the physiological response to psychological stressors can dramatically impact the functioning of the immune system, thus identifying one way in which susceptibility to or severity of diseases are exacerbated during stressful periods.

It’s important that we keep all this in mind as we deal with the coronavirus pandemic and during other times when we may be exposed to infections.

The authors also share that psychological stressors impact the microbiome contributing to increases in markers of inflammation even when there is no infection. As you may recall from the recent Anxiety Summit 5: Gut-Brain Axis there is a bidirectional communication between the gut and the brain, with poor gut health having a direct impact on anxiety levels.

The sleep-immunity connection

Here is some of the research supporting the sleep and immunity connection:

Sleep is considered an important modulator of the immune response. Thus, a lack of sleep can weaken immunity, increasing organism susceptibility to infection.

Sleep abnormalities affect immune function in a reciprocal manner, leading to changes in proinflammatory cytokines, such as tumor necrosis factor, interleukins 1 and 6, and C-reactive protein. The multitude of systems that react to sleep loss suggest effects beyond the central nervous system and include total body functioning.

The GABA and theanine anxiety-immunity connection

Here is some of the research supporting the more direct role GABA and theanine may play when it comes to immune function (and act as a relaxant and anti-stress nutrient at the same time):

GABA could work effectively as a natural relaxant and its effects could be seen within 1 hour of its administration to induce relaxation and diminish anxiety. Moreover, GABA administration could enhance immunity under stress conditions.

A number of recent studies have suggested that theanine administration can improve the body’s immune system….one particular study highlighted the use of theanine as an intervention to decrease the incidence of upper respiratory tract infection symptoms via enhancing gamma and delta T-lymphocyte function.

The authors cite one study where “administration of 200 mg theanine was found to have an “anti-stress” effect on pharmacy students” and “regulate dopamine and serotonin levels in the brain through the release of the inhibitory neurotransmitter GABA.”

The  low GABA type of anxiety

When you have the  low GABA type of anxiety you’ll feel physically tense and overwhelmed, fearful and not be sleeping well. You may lie in bed stiff and tense and may also have unwanted thoughts and experience monkey-mind. It’s common to self-medicate with alcohol to stay calm or you may also use carbs to relax. When you use the amino acid supplement GABA, you get quick and very effective relief – when it’s used sublingually.

Already using GABA/theanine or have used it in the past?

If you are already using GABA or theanine you may find you need extra during this time of added stress.  You don’t want to make the mistake of thinking “This is serious, I need to double-up.” The best approach is to monitor your low GABA symptoms and consider using an extra dose during the day or possibly more at night or possibly more at each dose. Use the trial method to monitor your response.

Someone in my facebook community said she was conserving her GABA and noticed her anxiety was creeping back up. Now is not the time to cut back on GABA.

If you’ve found benefit from GABA or theanine in the past but are not currently using it you may very likely feel the need for the additional support right now.

New to low GABA anxiety symptoms and using GABA/theanine?

If you suspect low GABA symptoms and are new to using the amino acids and do not have my book I highly recommend getting it and reading it before jumping in to taking supplements: The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings. (get it out of the library if you’re watching your expenses.)

There is a complete chapter on the amino acids and one for pyroluria, plus information on real whole food, sugar and blood sugar, gluten, digestion and much more.  If you’re not a reader there is now also an audible version.

Here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and additional information on Anxiety and targeted individual amino acid supplements: a summary

Please also read and follow these Amino Acid Precautions.

This lists The Antianxiety Food Solution Amino Acid and Pyroluria Supplements that I use with my individual clients and those in my group programs.

In summary, anxiety and sleep deprivation are not good for your immunity, and theanine and GABA can ease anxiety, improve sleep AND enhance immunity.

Please share your experiences with GABA and theanine and feel free to ask questions. Let us know if you were aware of the connections to immune function and if you’ve noticed your immune system is stronger when using GABA or theanine?

Botox injections (cosmetic or non-cosmetic): are they a root cause of anxiety and panic attacks?

By Trudy Scott 71 Comments

botox injections

New research shows Botox injections are being considered for severe depression and bipolar disorder because it stops frowning and this lack of frowning has a positive impact on neurotransmitters and mood. I recently posted this on Facebook and asked this question:

I’m curious if you have had Botox injections or would consider it (for cosmetic reasons) or perhaps for migraines, dystonia, proctalgia fugax or depression/bipolar?

If you have had Botox injections are you happy with the result or did you have any adverse effects like increased anxiety, panic attacks or anything else?

The response was varied with most folks saying they would never consider using Botox for cosmetic reasons, some folks saying they used Botox for cosmetic reasons and had issues and some folks saying they’ve used Botox for cosmetic reasons and love it, and others who have used Botox for non-cosmetic reasons.

All the practitioners who commented have concerns about Botox saying results are mixed with some of their clients having severe reactions and some doing fine. As I looked further into this topic I’ve gained additional insights and my biggest concern for you, and my community, is that Botox can lead to very severe anxiety and panic attacks.

I encourage you to keep an open mind about my Botox concerns if you have chronic anxiety that is not resolving and it started (or got worse) after receiving Botox injections, or if  you’re considering Botox injections.

Anxiety, panic attacks, inability to handle stress, body shaking

I gained my biggest insights from the Botox Dysport (Side Effects) Support group. Someone suggested I look into this group and I requested an invite to join so I could learn more. So many of the members of this support group  report anxiety, panic attacks, inability to handle stress, body shaking and problems connecting socially.  This is what one member shared:

…just joining the dots, I’ve been unwell for a few years since getting Botox but didn’t put it together until having it last week and going into panic attacks / ER.

Since then extreme anxiety and I’ve ended up in a mental health facility on benzodiazepines (ativan/valium). Reactions / withdrawal has been severe, have started to put it all together whilst reading through this page.

I’m realising that my decline, immune system failure (chronic epstein barr) fatigue, loss of motivation, loss of appetite, shaking in my body, muscle atrophy, anxiety, no motivation to connect socially, can’t handle any stress, can’t relax, tinnitus, breathing trouble and the list goes on is from botox…. scared to say the least as doesn’t seem to be a solution, I was worried to get Botox originally and obviously am eating myself up with regret, thought I would share if anyone has a similar story.

There are many similar posts to this one and it’s heart-breaking, especially because they say they are not being heard by their doctors.

I had a short online conversation with one of the moderators and she shared they suspect Botox is impacting the hypothalamic-pituitary-adrenal (HPA) axis leading to high cortisol and causing their anxiety symptoms. Many of the members find relief with Seriphos, which is a phosphorylated serine product I’ve had great success with. Here is my blog post on Seriphos for anxiety and insomnia related to high cortisol.

I asked if any of the members find GABA or serotonin support helpful and for some GABA helps ease the physical tension and for other members tryptophan or 5-HTP helps ease the worry type of anxiety. However for others, the amino acids seem to have a paradoxical effect and make symptoms worse.

I’ve never been in favor of Botox for cosmetic reasons simply because I’m not a fan of putting foreign objects/toxins into the body and because I believe in aging gracefully with confidence. I do find that many women feel the need for cosmetic Botox injections and other ways to try and look younger (such as breast implants and hair dye) because of low self-esteem and lack of confidence caused by low serotonin.

Botox for non-cosmetic purposes

Botox is also used for non-cosmetic purposes. Some of my neurologist colleagues also have concerns about cosmetic use and will only use Botox injections for the following:

  • severe cases of dystonia
  • migraines (to relax forehead muscles)
  • proctalgia fugax /rectal spasms

Botox may also be used for multiple sclerosis (MS) symptoms, pelvic pain and bladder issues, for TMJ, after a stroke and for chronic anal fissures in colitis (sphincter spasms can prevent anal fissures from healing).

I would love to see safer approaches for non-cosmetic Botox injections being researched and explored by practitioners. For example:

Botox for mental health – we can do better with nutritional psychiatry

At the beginning of this blog I mentioned the new research that shows Botox injections are being considered for severe depression and bipolar disorder because it stops frowning. This lack of frowning has a positive impact on neurotransmitters and mood.

A study published in 2018, Clinical analysis of 86 botulism cases caused by cosmetic injection of botulinum toxin (BoNT), reports that botulism is a severe side effect of Botox injections with symptoms including: “headache, dizziness, insomnia, fatigue, blurred vision, eye opening difficulty, slurred speech, dysphagia [difficulty swallowing], constipation, and anxiety.”

The authors report these symptoms occur in the first 36 days after the Botox injections and that all symptoms resolved after botulinum antitoxin serum injections.

This conclusion clearly doesn’t address why there are so many folks in the Botox Dysport (Side Effects) Support group continue to experience long-term severe symptoms.

We also have research reporting a possible connection between Botox injections and thyroid autoimmunity.

I feel we can do better especially with what we know about nutritional psychiatry, the use of targeted individual amino acids, nutrients like lithium orotate, the gut-brain connections and everything covered in my book The Antianxiety Food Solution (my Amazon link) and on this blog.

A note of appreciation

I’d like to end with a note of appreciation to everyone who commented on my Facebook post, to the members of Botox Dysport (Side Effects) Support group on facebook (with over 5700 members as of this writing).

I’d also like to thank Diane Kazer for asking bold questions about Botox injections as part of her Non-Toxic Beauty Revolution Summit which addresses Botox, breast implant illness, toxins in your cosmetics and so much more. In my interview we talked extensively about the low serotonin/low self-esteem connections which I feel is a big missing piece for helping women who feel the desire or need to use cosmetic Botox in order to feel good and love themselves.

Diane writes about Botox here: Is Botox Safe? Top 3 Concerns & What to do if you’ve had it, sharing a brief history of botox, what she has uncovered about toxicity issues and possible detox solutions.

She also created this list of 58 Botox Illness Symptoms which she gave me permission to share here. She compiled this list from 1000+ people who have had Botox injections.

58 botox illness symptoms

Because of Diane asking questions and this initial research I’ve done, I’m adding a question about past history of Botox injections to my client intake form and will be gathering more information from my community of anxious women to see if there are patterns as to why some folks have such bad reactions.

I do feel we need to be asking if Botox injections (cosmetic or non-cosmetic) are a possible root cause of anxiety and panic attacks because they are adding to the toxic burden in susceptible folks.

But I do acknowledge it’s challenging to unwind all the contributing factors because it depends on what is going on with each person, such as their gut health, other medications (benzodiazepines themselves can be problematic), past trauma, infections, poor adrenal health, low GABA, low serotonin, poor detox capacity, low bile production, genetics etc. Unfortunately there is no way to know in advance who will be harmed and if Botox is the tipping point.

Please comment below if you’ve had Botox injections and had adverse reactions or have benefited from them with no adverse reactions. And if you have not had Botox would you ever consider it? Feel free to post your questions too.