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The benzodiazepine valium blocks DAO and impacts histamine levels: wisdom from Yasmina Ykelenstam and a tribute to her brilliance

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The benzodiazepine valium blocks DAO and impacts histamine levels and may actually increase anxiety via this mechanism. I learned all this in an interview I conducted with my amazing colleague Yasmina Ykelenstam.

Sadly Yasmina lost her battle to a rare and aggressive type of breast cancer this week. She had triple negative breast cancer which has a minimal survival rate of no longer than just a few months. She lived with it for over 2 years, outliving all odds. She had just turned 43.

It is with great sadness and reflection that I write this post as tribute to Yasmina who was as bold as she was brilliant.

Yasmina is well known as the Low Histamine Chef and for an abundance of histamine intolerance resources and recipes on Healing Histamine.

We only met in person on one occasion in 2017 and spent an evening and wonderful lunch together. Her warmth, passion and caring shone through and I felt I already knew this kind and smart woman. I had been following her work online after an interview with Dr. Ben Lynch on season 2 of the Anxiety Summit – Biochemical and genetic predispositions: COMT, GAD & MAOA – where he raved about her work.

I reached out to Yasmina and was so thrilled to have the opportunity to interview her for season 3 of the Anxiety Summit – Histamine-containing Foods: their Role in Anxiety, Depression and Schizophrenia

As a tribute to Yasmina and so her brilliance continues to shine I’m sharing some of the highlights from our interview, where she shared that:

  • Histamine is the gluten of the intolerance world
  • Histamine is a neurotransmitter and plays a role in mood disorders
  • Histamine can cause symptoms of anxiety: Increased heart rate and blood pressure, shortness of breath and gasping for air, pounding heart, dizziness and feeling faint

In case you’re new to histamine intolerance this paper provides a quick overview: Histamine and histamine intolerance

Histamine intolerance results from a disequilibrium of accumulated histamine and the capacity for histamine degradation. Histamine is a biogenic amine that occurs to various degrees in many foods. In healthy persons, dietary histamine can be rapidly detoxified by amine oxidases, whereas persons with low amine oxidase activity are at risk of histamine toxicity. Diamine oxidase (DAO) is the main enzyme for the metabolism of ingested histamine.

This new research shows how a low histamine diet has benefits: Histamine-reduced diet and increase of serum diamine oxidase correlating to diet compliance in histamine intolerance

In our interview we had a lengthy discussion on benzodiazapines and the histamine connection. It was both fascinating and very concerning:

Many people doing a benzodiazepine taper are often switched to Valium which is a DAO [diamine oxidase blocker (or histamine liberator)] and this further prevents histamine from being removed from the body.

Dye are also triggers…the pink Xanax can be problematic 

Here is the transcript from the benzodiazepine section of our interview, with a few tweaks to give it context. I start by asking Yasmina to talk about histamine interactions with psychiatric medications.

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

Yasmina Ykelenstam: Well, I recommend that people go to a wonderful website and it is called histaminintoleranz.ch. It’s German, but it’s translated into English. That’s H‑I‑S‑T‑A‑M‑I‑N‑I‑N‑T‑O‑L‑E‑R‑A‑N‑Z.ch. And they have a very, very long list of medications on there that interact with diamine oxidase or histamine liberators. The one that I just wanted to mention very quickly because it’s relevant to anxiety – and that one is diazepam [you can find this listed on the above site on this page.]

Diazepam (or Valium) is a medicine, as I said, that I used when I was a child – for a couple of days. And it’s a tranquilizer, a benzodiazepine. One of the most commonly prescribed benzodiazepines in the world is Valium.

I don’t know if it still is, but when the UN would send out emergency packs to people, Valium was included in there. That’s how widespread its use is. It’s a diamine oxidase blocker. So it blocks the enzyme responsible for degrading histamine in the body. So people who are dealing with anxiety symptoms that are perhaps caused by histamine issues would not do very well potentially with Valium / diazepam because it would further prevent histamine from being removed from the body.

I was on Valium / diazepam for many, many years after it was first prescribed to me and I did not know that. And it was the medicine, it was the tranquilizer that I chose to use to taper from another benzo. I was on Xanax at the time and I had been told that Xanax is harder to withdraw from than crack. So I should switch to another benzodiazepine that had a longer half-life – how long it stays in the body – so that it would make it easier for me to withdraw. And Valium / diazepam was the one that I chose and I think that’s when my body started giving me the message of “Hurry up; just finish this; just cut, cut, cut; get this out of the body because it’s not doing you any good.”

But there is a very, very long list of medications on that German site and interestingly, there are a number of antihistamines in the list of medications that block diamine oxidase and also the other histamine-degrading enzyme. Cimetidine, C‑I‑M‑E‑T‑I‑D‑I‑N-E – I think it is a second-generation antihistamine. It is still prescribed today. It was being prescribed to many people by a doctor in London.

I have another doctor: Dr. Seneviratne in London. He is an immunologist with mast cell focus. He’s excellent. But there was another doctor who was supposedly a mast cell person who was prescribing cimetidine to people. I had to send a message to him saying please stop doing this because it’s probably not very good for them. Also, we were talking about diphenhydramine and that is an HNMT blocker, which is the other histamine‑degrading enzyme.

Trudy Scott: Okay. So I want to just recap here. So we’ve got these meds that block the DAO enzyme, which in turn prevents you from releasing histamine and preventing histamine from being removed from the body.

Yasmina Ykelenstam: Exactly. Yeah, and what’s odd is diphenhydramine is obviously Benadryl, which is one of the most commonly prescribed antihistamines in the United States.

Trudy Scott: A lot of people are on diphenhydramine. You’re right, yeah.

Yasmina Ykelenstam: There are many different mechanisms of action for degrading histamine and for getting it out of the body. So it might not be the end of the world if you’re taking one medication that affects the DAO enzyme but doesn’t affect the HNMT enzyme. And obviously, there’s the liver and there’s different methods of dealing with things in the body. So it’s not the end of the world, but still it’s something you might not want to do and should definitely discuss with your doctor.

Trudy Scott: Yes, and being aware of this. Now I wanted to just go back to the benzodiazepines because I was not aware of this connection to Valium diazepam, and that being a DAO blocker. So is it only the Valium and the other benzodiazepines are not, or is it all benzodiazepines?

Yasmina Ykelenstam: Okay, let me try to remember. Haloperidol is an antipsychotic, isn’t it? (It’s on the list)

Trudy Scott: Yes, that’s correct.

Yasmina Ykelenstam: I am not aware of any others offhand and I’m just trying to take a quick look at the list now that I have it in front of me. But no, I don’t believe so because I looked them up because having taken all of them, and I mean, really all of them, I have taken every benzodiazepine ever made in the last 30 years. And no, I think it was just the diazepam, but as I said, it is one of the most commonly prescribed.

Trudy Scott: And it’s really important for me to mention this because I am dead against all benzodiazepines because of their addictive/dependent nature and the side effects and when you’re trying to taper off they cause all these problems. I’ve interviewed a number of people on this topic. In Season 1 of the Anxiety Summit, I interviewed Dr. Catherine Pittman who talked about the Benzobuddies.org group and how so many individuals battle getting off benzodiazepines.

Yasmina Ykelenstam: Oh, I was a member.

Trudy Scott: You were?

Yasmina Ykelenstam: I was a member there (at benzobuddies.org) at one point.

Trudy Scott: Oh, you were? Yeah, it’s a very big issue and problematic drug. But why I’m saying this is because Professor Ashton, who’s an expert on tapering, talks about switching to Valium. So this could be problematic.

Yasmina Ykelenstam: Well, if you could reach out to these communities, that would be fantastic because I did spend some time after, figuring out what was going on, trying to contact people and trying to let them know of this link because there were a lot of people that were in these communities that were suffering from protracted withdrawals. And by this point, I had my suspicions that the protracted withdrawals were actually a histamine response and that the reason that they were experiencing this was just that the original issue was never dealt with. And that was that it might be an underlying histamine issue that initially had them diagnosed with the anxiety disorder and then they were taking these meds. And so when you take the medication away, you’re still left with the existing condition but it isn’t being addressed.

Trudy Scott: Yes, and maybe some of them had done the switch to Valium, which was making things worse.

Yasmina Ykelenstam: Exactly.

Trudy Scott: Very interesting.

Yasmina Ykelenstam: The reason I switched to Valium was because I was following Dr. Ashton’s protocol from benzo.org.uk. I was advised against coming off my medication and I was told that there was no safe withdrawal protocol. I brought them a copy of the Ashton protocol and I was laughed out of the office, but I chose to do it on my own anyway and I’m very grateful to her research.

Trudy Scott: Yes, she’s done amazing research. I’m so appreciative to learn of this component and I’m on a mission to educate people about the benzodiazepines and this is just another aspect that we need to be considering. I will certainly reach out to some of these groups and people hearing this on this Summit, is going to bring awareness to this aspect. All of this is fantastic.

Yasmina Ykelenstam: The other brief thing is that, of course, the dyes are also triggers. And this is why a lot of us, when we’re prescribed psychiatric meds, end up with a new set of symptoms because of the coloring that is actually on the tablets. I was unable to take the pink Xanax, but I was able to take the white Xanax, and my doctor never understood it. He said, “I don’t understand how higher doses of Xanax make you feel worse, but the lower ones works for you.” And I kept telling him, “But I’m taking the same dose at the end of the day, so I don’t understand either.”

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

Here is the link to the entire audio so you can get a better understanding of histamine intolerance.

I’d love to hear your benzodiazepine and histamine intolerance experiences – both good and bad

It would remiss of me to omit something that is seldom discussed: the link between benzodiazepine use and increased cancer risk. In our interview Yasmina shared this “I have taken every benzodiazepine ever made in the last 30 years.”

Yasmina was always very open about her healing journey and I suspect she asked herself this question and would be ok with me making this possible connection in the hope it may help someone who is considering a starting a benzodiazepine prescription or someone contemplating doing a benzodiazepine taper.

I hope this has been helpful if you’re currently taking a benzodiazepine, are considering taking one, have taken one in the past, have issues with high histamine foods, are taking one of the other medications on the list, and/or have had issues with the colors in medications.

With much appreciation to Yasmina! We loved her and thank her for sharing so freely and wisely and we love that her wisdom will live on! Rest in peace.  My deepest sympathies to her family and others who were close to her.

Note added later on 9/14/18 after this blog was published:

As soon as I heard the sad news about Yasmina I wrote this blog as a tribute to her. Then a few hours before it was due to be published I heard her family had not yet made the announcement public and hadn’t yet shared the news with her community.  At the last minute I removed the tribute sections out of respect for them. When I woke I saw the announcement on her Facebook page and reinstated my tribute.

I’ll be doing further updates to share some of what was said about continuing her legacy and anything more I learn.

GABA oral rinse reduces burning mouth pain

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Burning Mouth Syndrome (BMS) is a chronic pain condition characterized by persistent burning in the mouth. It affects mostly females, especially postmenopausal women, and conventional approaches are often not very successful. You’ll often see articles and papers with the terms ‘refractory’ and ‘unknown etiology’/unknown causes.

Medications like SRNIs and benzodiazepines

Some studies report limited success with medications like venlafaxine/Effexor, an SRNI and topical and oral use of benzodiazepines such as clonazepam/Klonopin. In this paper, Refractory burning mouth syndrome: clinical and paraclinical evaluation, comorbidities, treatment and outcome, 8 participants saw their pain diminish by half within 3 months.

Another paper, The Effect of Clonazepam Mouthwash on the Symptomatology of Burning Mouth Syndrome: An Open Pilot Study, reports success with a benzodiazepine mouthwash in half the participants.

Other than the poor quality of life and having to continue to live with pain, the bigger concern is the side-effects of medications like these, plus concerns with tolerance and then issues with withdrawal.

New oral GABA research for burning mouth

It’s for this reason that I’m excited about the recent research, γ-Aminobutyric acid (GABA) oral rinse reduces capsaicin-induced burning mouth pain sensation: An experimental quantitative sensory testing study in healthy subjects, that finds that both and men and women experienced immediate benefits when using GABA for burning mouth pain.

The burning mouth pain was caused by the application of capsaicin to the tongues of thirty healthy males and females. Capsaicin is the compound that makes chili peppers hot. (I find it interesting that capsaicin was the compound used to cause the burning mouth sensation because this same compound is used in topical creams and patches to ease pain.)  

The study concludes as follows:

Capsaicin-induced burning tongue pain and decreases in WDT (warm detection) and HPT (heat pain) can be ameliorated by rinsing the mouth with lidocaine and GABA solutions.

Rinsing the mouth with an oral GABA containing solution ameliorated burning pain and increased heat sensitivity produced by application of capsaicin to the tongue. This finding suggests that GABA can act as a local analgesic agent in the oral cavity.

Lidocaine, a numbing medication, was part of the GABA solution in this study, but because it has side-effects that may include anxiety, I recommend a trial of a GABA-only solution to ease the burning mouth pain.

Using a GABA-only oral solution

Using a GABA-only oral solution makes sense given that the likely mechanism of action of topical benzodiazepines in burning mouth pain is via local action on peripheral GABAA receptors found in the nerve fibers of the tongue.

This is also very feasible based on how effective GABA is for other pain such as proctalgia fugax/rectal spasms, and the visceral pain and muscle tension in your gut caused by the bloating symptoms of SIBO (small intestinal bacterial overgrowth) and muscular back pain after a fall.  

How much GABA will help?

As with any use of GABA and the other amino acids, how much will help depends on each person’s unique biochemistry and needs at the time. In the same way I do a trial of GABA with my anxiety clients to determine how much would help, I do the same with burning mouth pain (and other pain situations).

I recommend a trial of a GABA-only product and starting low with 100 to 200mg of GABA swished held in the mouth with some water for a few minutes. This can be used three or four times a day in between meals and with the mg increased slowly based on results.  You can find the GABA supplements I recommend here.

GABA is an amino acid that is recognized for calming physical anxiety and tension and since anxiety (and depression) is very common in those with burning mouth pain, the GABA is going to provide calming benefits too.  

As with any health condition, finding the underlying root causes using a comprehensive functional medicine approach is key. One such root cause may be low GABA and using oral GABA is going to address this one and provide some relief while other root causes are identified and addressed.  

These other root causes can be very varied as explained in the paper Burning Mouth Syndrome. They can include: age-related reduction in estrogen and progesterone levels, lower cortisol, diabetes mellitus and hypothyroidism, allergic reactions to foods, additives and even metals in the mouth, autoimmune connective tissue disorders, nutritional deficiencies (B1, B2, B6, B12. folate, and/or zinc), smoking and candida, and medication side-effects as mentioned above.

Have you experienced burning mouth pain and seen relief with GABA or other nutritional approaches?

If you’re a practitioner, is burning mouth pain common in your postmenopausal clients or patients and what approaches have you found most successful? Have you found GABA to be helpful?

If you are still suffering with burning mouth please share the following when you comment:

  • Your age (it seems to be more prevalent in women 59 and older)
  • If you have anxiety and/or depression now and have been prone to either in the past
  • How you score on the low GABA questionnaire and which symptoms you relate to? This will provide a clue that low GABA may be an issue and the oral GABA rinse is more likely to help
  • How you score on the low serotonin questionnaire (same link as GABA questionnaire above) and which symptoms you relate to? SSRIs have been shown to help in some cases and we know tryptophan/5-HTP help with pain so serotonin support may help too. Perhaps a tryptophan or 5-HTP rinse is worth a trial too?
  • How long it’s been an issue, what approaches you’ve tried and which approaches have helped (even if they only helped a short while or helped the pain a little)
  • Current and past medications (burning mouth is caused by certain medications)

I’d love to gather a list of all this so we can help you and more women who suffer with these awful symptoms.

Benzodiazepine horror story on The Mental Wellness Summit 2

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The Mental Wellness Summit 2, airs online September 25 – October 2, 2017

Whether challenged by depression, anxiety, stress, addiction or another mental health challenge, every single person is impacted and affected – you, your family, friends, neighbors and coworkers -either directly or indirectly every single day.

This Mental Wellness Summit 2 will provide you with the information you need to:

  • Overcome the silence, isolation and fear of your struggle
  • Transcend outdated, prescription-based healthcare systems
  • Find holistic practitioners and natural solutions for your pain
  • Implement expert practices, tools and tips into your daily routine

My interview covers the dangers of benzodiazepines and why GABA is a more effective option for anxiety.

Here are some snippets from my interview where I discuss benzodiazepines which are

  • a class of psychoactive drugs / tranquillizers with sedative, sleep-inducing, anti-anxiety, anticonvulsant, and muscle relaxant properties
  • they target the GABAA receptor and enhance the effect of the neurotransmitter GABA
  • the common Brand name/drug name are: Xanax/ Alprazolam, Klonopin/Clonazepam, Valium/ Diazepam, Ativan/ Lorazapam

These medications are commonly prescribed for:

  • Anxiety, social anxiety, panic, pain/dental pain, insomnia, fear of flying, Lyme disease, ER visits for back/neck spasms
  • Children with autism
  • IBS
  • pre-surgery anxiety
  • ICU patients needing ventilation
  • during chemotherapy for cancer treatments – for anxiety, nausea and anticipatory nausea

I share this true benzodiazepine horror story:

Been totally disabled by benzos for over 3 years. I have been off meds for 17.5 months and the impact of these meds makes any anxiety I ever felt a cake walk. Please run from the poison.

When I turned 21 I went to the doctor for dizziness and they put me on xanax. I started to feel anxious and they then added Zoloft. That was the start of a long journey. I was shifted from one anti-depressant to another. At 34 I was told I was treatment resistant and they added lamotrigine. Then my world crashed at age 37. I have been on xanax, then klonopin, then Ativan, then back to xanax, then valium to taper. I had also been given ambien to sleep in early 30s.

I tapered off meds over a period of a year. I was on 1.5 mg xanax and tapered off valium as prescribed. I have tried many supplements but I react poorly to all of them. I get very agitated and revved up.

I have locked shoulder muscles, neck, jaw; I have internal vibrations, I get bad headaches, jelly legs, distorted vision like floaters and squiggles and fireworks, my teeth all feel like they will fall out but they are not loose, it feels like adrenaline or cortisol rushes through the body. Sometimes my arms go numb. I am pretty tortured every day. These meds are truly causing chemical warfare on some of us. 

This is one of the many reasons I do this work – so more people don’t end up in this situation and so everyone knows about the dangers of benzodiazepines and that there are nutritional solutions for anxiety. One of them is the amino acid GABA and I discuss this in the latter half of the interview.

I hope you can join us on The Mental Wellness Summit 2 summit!

Registration details are here

World Benzodiazepine Awareness Day 2017: Awareness and Anxiety Nutrition Solutions

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World Benzodiazepine Awareness Day 2017 was celebrated earlier this week on July 11th. The organization recommends that everyone should watch and share this short informative video: The risks of taking benzodiazepines (Klonopin, Xanax, Ativan) as prescribed. It could save your life or the life of someone you know.

This is what W-BAD shares about benzodiazepines and Z-drugs that are used as prescribed:

Benzodiazepines (Xanax, Klonopin, Ativan, Valium, Librium, and others) as well as Z-drugs (Ambien, Lunesta and others), which are similar, have the most debilitating withdrawal reactions in all of medicine.

This happens in regular, everyday people who are taking the medications exactly as their doctor prescribed. It also happens to people on what they think are “low doses” and is not just a “high dose” problem. This happens because the prescribing guidelines for this class of drug recommend short-term use only (less than 2-4 weeks), yet doctors are prescribing them for much longer. Even worse, these unsuspecting patients are given no warning (or informed consent) by their doctor about these risks and dangers before taking the prescription past the recommended timeline. The patients think the drugs are “safe” because they are prescribed when they are actually quite dangerous medications that are capable of inflicting sometimes severe and life-threatening withdrawal syndromes which are known, for some people, to persist for many years.

W-BAD shares these stats about how common it is to see physical dependence, adverse effects, and withdrawal:

Experts and studies estimate that as many as 60% of people taking benzodiazepines for more than the recommended 2-4 week time period will develop physical dependence, adverse effects, and withdrawal

60% is actually a conservative percentage, as some other sources indicate that “50-80% of people regularly taking benzodiazepines (even in ‘low dose’) for longer than a few months will develop a physical tolerance to the drug and become dependent, resulting in difficulty stopping benzodiazepines because of withdrawal symptoms”.

30% of long-term users will experience severe withdrawal or adverse effects which may include seizures, hallucinations, psychosis, akathisia, and sometimes suicide or death (people are especially at risk for severe withdrawal if they over-rapidly taper or cold-turkey their benzodiazepine/Z-drug).

The tapers to discontinue these medications, once you’ve taken them past 2-4 weeks and depending on dose, can last many months or years. I see this all the time in my practice.

About 10-15% of people who withdraw will develop a protracted withdrawal syndrome which can potentially persist for many years (there are anecdotal reports of it persisting up to five, seven, and even ten years post-cessation.). Others, even after a slow, gradual reduction of the benzodiazepine or Z-drug will experience withdrawal that lasts for up to 18 months post-cessation.

Physical dependence is a physical condition, a state of adaptation in the body caused by chronic use of a tolerance forming drug, in which abrupt or gradual drug withdrawal causes withdrawal.

When someone becomes physically dependent to benzodiazepines (or Z-drugs), they are also at risk for developing tolerance. With benzodiazepines/Z-drugs, specifically, when the receptors in the brain become adapted or accustomed to the action of the original dose of BZ, more of the drug is needed in order for the desired therapeutic effect (or the original effect at the original dose) to be achieved. This means that the drug loses its effectiveness and the person taking it can begin to experience withdrawal symptoms while still taking the prescribed dose of the drug.

It’s very unfortunate that some of the very same symptoms that are trying to be addressed by these medications are now amplified or seen for the first time:

Some common symptoms of tolerance include increasing anxiety, panic attacks, development of agoraphobia for the first time, interdose withdrawal (withdrawal symptoms emerging in between doses), as well as a plethora of other physical/neurological/psychological symptoms.

Visit the website World Benzodiazepine Awareness Day to learn more and to get involved:

By spreading the word about taken-as-prescribed benzodiazepine risks, harms, and dangers, W-BAD (World Benzodiazepine Awareness Day) hopes to bring awareness to the general public and the medical community about this problem before more people are needlessly harmed. Please help share this video with everyone you know and, together, we can prevent more victims of iatrogenic (caused by medicine) dependence, withdrawal, and injury from prescribed benzodiazepines and Z-drugs.

There are some heartbreaking stories on the Facebook page (an excellent resource) :

W-BAD acknowledges Professor Malcolm H. Lader for guiding them in providing information that appears throughout the website and in handout materials. Prof. Lader first described benzodiazepine withdrawal syndrome as a potential brain injury in the scientific literature, and also campaigned around the world to get everyone from politicians to royalty to listen.

Here is some guidance with slow tapering protocols from W-BAD (and never stop cold-turkey).

For additional resources this is the blog post I published last year: World Benzodiazepine Awareness Day – say NO to Benzodiazepines for anxiety!

Awareness and nutrition solutions

I do love that this awareness is being created. It is so needed for those who are prescribed these medications and currently taking them, for anyone who may consider a future prescription, and for everyone in the medical profession, as well as all integrative and functional medicine practitioners and nutritionists.

All this awareness creates the perfect opportunity to offers nutrition solutions too, so we can address:

  • the initial root cause/s of your anxiety which led to your prescription of this medication to start with
  • the anxiety you now experience even through you were prescribed these medications for something else (such as pain)
  • your current biochemistry and nutritional status to facilitate an easier taper from the benzodiazepine with the least withdrawal effects
  • your current biochemistry and nutritional status so you don’t get anxiety in the future, once you have completed the taper

And if you are considering a benzodiazepine prescription in the future you are now informed about the dangers and have nutritional resources too.

When I am working with someone who has been prescribed a benzodiazepine, I get them nutritionally stable BEFORE they even consider a benzodiazepine taper.

I use amino acids like GABA and tryptophan, melatonin and niacinamide to make the taper easier and so we can balance brain chemistry before tapering and then during the taper (all under the supervision of the prescribing doctor and using the Ashton taper protocol).

Dr. Jonathan Prousky, talks about his success with benzodiazepine tapers on a prior Anxiety Summit interview – using melatonin, niacinamide, Neurapas Balance, rhodiola and GABA.

There is also a big focus on diet (real food/often a Paleo diet, no additives, organic, healthy fats, no gluten, no sugar, no caffeine, quality grass-fed/wild protein), addressing high cortisol if needed, addressing low zinc, low iron, low vitamin B6, low B12 and looking at gut health. Lifestyle and stress reduction is important and we look at and address all possible 60+ underlying factors/causes.

This is all covered in detail in my book “The Antianxiety Food Solution” (on amazon here) The basics plus advanced topics (like fluoroquinolone antibiotic issues when on benzodiazepines and more) are also addressed on the Anxiety Summits.

I feel very strongly about providing this nutritional support and sharing how helpful it is because organizations like W-BAD and Benzobuddies.org (as much as love them) advocate for no nutrient support suggesting it won’t help or could make symptoms worse. I will admit that some people who are tapering are very sensitive and in these situations very very tiny amounts (as small as a pinch in some instances) of some of the nutrients may be a better option, always only doing one thing at a time to make sure it’s helping and not making symptoms worse, and doing functional medicine tests. Using essential oils, light therapy, gentle detox, Heartmath and yoga are wonderful to start with, in conjunction with all the diet changes.

Please share your benzodiazepine story and what has helped you taper more easily and recover.

If you’re a practitioner please share what approaches you have used to help your clients or patients taper more easily.

Prozac Nation Is Now the United States of Xanax in New York Times Magazine: my response

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This is the title of a new article recently published in the New York Times Magazine: Prozac Nation Is Now the United States of Xanax. In other words, depression has been replaced by anxiety and the respective medications.

It’s an excellent read for creating awareness about anxiety and benzodiazepines but also sad because there is so much we can do and no solutions are offered. Here are some startling stats shared in the article:

According to data from the National Institute of Mental Health, some 38 percent of girls ages 13 through 17, and 26 percent of boys, have an anxiety disorder. [Note: this was quoted in the article. I’m trying to track down the source because an article in Time Magazine last year says this: ‘About 30% of girls and 20% of boys–totaling 6.3 million teens–have had an anxiety disorder, according to data from the National Institute of Mental Health’ as of 2015.]

On college campuses, anxiety is running well ahead of depression as the most common mental health concern, according to a 2016 national study of more than 150,000 students by the Center for Collegiate Mental Health at Pennsylvania State University. [Both anxiety and depression have shown slight but persistent increases each year for the past six years]

Meanwhile, the number of web searches involving the term [anxiety] has nearly doubled over the last five years, according to Google Trends. (The trendline for “depression” was relatively flat.)

I’m the optimistic type, I’m proactive and I like to give hope as well as solutions – and I have quite a bit to say about this article so here goes.

#1 Too many people are prescribed benzodiazepines without knowing what they are getting into

The article does not address the issues with benzodiazepines: how too many people are prescribed benzodiazepines without knowing what they are getting into, with many suffering dreadfully and never offered nutritional solutions. When I shared the article on my facebook page, someone in my community shared this (and gave me permission to share it further in the hope someone else will be spared her suffering)  

Been totally disabled by benzo for 3.5 years. I have been off meds for 17.5 months and the impact of these meds makes any anxiety I ever felt a cake walk. Please run from the poison. Find healthy foods, nutrition and take the break your body is begging you for. We need to listen to our bodies! If it is screaming with anxiety maybe you need to make some life changes. I wish I did instead of taking a med that has almost destroyed me.

I asked her what symptoms she was experiencing, and as well as suffering from severe motion sickness (so badly she can’t even leave her home) she also shared this:

I have locked shoulder muscles, neck, jaw; I have internal vibrations, I get bad headaches, jelly legs, distorted vision like floaters and squiggles and fireworks, my teeth all feel like they will fall out but they are not lose, it feels like adrenaline or cortisol rushes through the body. Sometimes arms go numb. I am pretty tortured every day. These meds are truly causing chemical warfare on some of us.

I believe this will be the next big epidemic and I hope I heal somehow to help others

She had been on a variety of benzodiazepines, SSRIs and other medications for over 17 years and you may think this is an isolated incidence. I assure you it is not – just read the list of the most common psychological and physical symptoms of benzodiazepine withdrawal.

5mg diazepam / Valium, a benzodiazepine

Here is some useful information about the risks and dangers of benzodiazepines:

#2 Let’s help anxious individuals like you find solutions

Scott Stossel, journalist and author of My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind was quoted as saying this in the article:

The silver lining for those with nervous disorders is that we can welcome our previously non-neurotic fellow citizens into the anxious fold.

My first response to the article is this: I say NO to Scott Stossel and instead I say let’s think bigger and instead let’s invite the anxious citizens into the calm and no-more-anxiety fold!

Scott’s book is well-written book, offers an excellent understanding of what it feels like to experience anxiety and panic attacks, and has many compelling stories. But as a number of his Amazon reviewer’s say the big question is this: what is the answer or solution? Unfortunately it’s not provided in his book (or the New York Times Magazine article).

The New York Times Magazine article provides another anxiety resource that has helped “bring anxiety into the open, and allowed its clinical sufferers to band together in a virtual group-therapy setting”: The Sarah Fader on twitter, creator of the hashtag #ThisIsWhatAnxietyFeelsLike and a mental-health advocacy organization called Stigma Fighters.

Again, these are wonderful resources for support, awareness and advocacy but they don’t offer solutions if you suffer from anxiety. With nutritional solutions we can change this to #ThisIsWhatCalmFeelsLike.

#3 Too few people know about nutritional solutions

Too few people know about nutritional solutions and that has to change. Clinically we know it works and there is now SO much research supporting this approach.

Here are a few of many blog posts on my site that share powerful anxiety nutrition solutions:

Here is one of the latest food and mental health studies – A modified Mediterranean dietary intervention for adults with major depression: Dietary protocol and feasibility data from the SMILES trial

This and other dietary and nutritional approaches for both depression and anxiety will be presented at the upcoming International Society of Nutritional Psychiatry Research conference in Bethesda, MD next month)

Here are two book resources too: my book The Antianxiety Food Solution and integrative psychiatrist Kelly Brogan’s book A Mind of Your Own.

I’d love your feedback

  • Which nutritional solutions topics do you have questions about and in what areas do you still need help?
  • What ideas do you have for getting this nutritional solution message out in a bigger way?
  • What do you wish you’d known when you were first diagnosed with anxiety and prescribed medication (such as a benzodiazepine or SSRI)?
  • How do we convince the naysayers that this does work and is worth implementing?
  • How do we get the mainstream mental health community on board?
  • What anxiety resources do you have to share

CBD from organic hemp: for anxiety and benzodiazepine tapering

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organic hemp
Organic industrial hemp and the CBD oil by Elixinol (image from www.Elixinol.com)

Cannabidiol (CBD) from industrial organic hemp works on the endocannabiod system which Dr. Blair calls the master controller. I heard Dr. Blair speak on the recent Detox project and he shares the myriad of health benefits he sees in his patients: reduced anxiety and pain, healing of the gut, detoxification support, improved absorption of nutrients (via effects on tight junctions), improved contractions in the gut, improved sleep, reduced inflammation, reduced IBS symptoms (less constipation or diarrhea) and it even modulates cortisol (high or low).

Dr. Blair and connected by phone after his interview and I’ll be interviewing him as soon as I get settled in Australia (so please post your questions in the comments section below).

Since the interview and because my previous blog generated so much interest, I’m here to share some additional information that I have learned since his interview. Because of the work I do with clients with anxiety I am always looking for new resources and I must say I am very excited to learn about CBD from organic hemp.

I posed some questions for Dr. Blair because he briefly mentioned medication tapering and he kindly addressed them for me. These were actually some questions I asked on the Detox Summit blog but for ease of reading I’ll share them in interview style here:

Trudy: Dr. Blair, I’d love to hear if you’ve had success using the Elixinol with individuals tapering from benzodiazepines? And do you find that those that have a really difficult time tapering i.e. many withdrawal symptoms, need much lower amounts?

I currently use GABA, tryptophan, niacinamide and other nutrients with much success but I am always looking for additional options to make it even easier for my clients.

Dr. Blair: Trudy, I have. The taper has been much faster without the typical agitation and systemic symptoms. With CBD as protection I encourage a more rapid decrease in dose. It seems that some typical withdrawal symptoms may be mediated by specific neurotransmitters. CBD “turns down the volume” in some of these cases with it’s homeostatic effects.

Trudy: When doing a benzo taper do you have your patient use the CBD for a certain time period before starting the taper (like a month)?

Dr. Blair: Two weeks should be sufficient.

Trudy: You say “Now, it doesn’t work in everybody, but the rate of positive responses is on the order of 75 percent.” In general, who have you found it not to work for, or is it very variable?

Dr. Blair: I have not found any consistency in the failures. But, in some cases I don’t think the CBD has failed but the patient will not recognize the improvements they have had. Recently, I dosed a gentleman with arthritis of his hands. After 5 minutes he said his pain was almost gone. Then he said, the relief could have been from anything. It’s almost as if these people do not want to have improvement or relief. Or, the withdrawal of pain is so subtle they don’t recognize the CBD as the active agent.

Trudy: Many of the research papers on the benefits of CBD refer to cannabis sativa/marijuana – do we know that CBD has similar benefits whether it’s from hemp or marijuana? How much actual hemp CBD research is there?

Dr. Blair: There are 1570+ papers in pubmed on CBD. Hemp vs marijuana – there is no question that whole plant extracts are the most effective therapeutic sources but there are impediments in that THC is generally illegal or highly controlled. Secondly, it’s difficult to know how much CBD is actually in any marijuana product, and what other chemicals are present. Each crop has different content.

CBD from industrial hemp is cleanly extracted and pooled in large batches for some consistency in concentrations of key active CBD. In my experience CBD alone, or with very, very low THC (<0.3%=industrial hemp) has been very effective for 75% of individuals with major conditions.

Trudy: Just to confirm, how much THC is there in CBD oil from organic hemp?

Dr. Blair: THC in industrial hemp/cannabis is <0.3% but that is the plant and not necessarily the product. Only a batch analysis can tell. Any supplier worth their salt will provide a batch analysis for you to review. But, some CBD products contain much less THC. For example, in Elixinol Liposomes the THC is so low as to be considered undetectable.

THC helps in some cases of epilepsy and probably in cancer but in my experience adverse effects from CBD products come from the small amounts of THC.

Trudy: May I ask what adverse effects you’ve seen? I have concerns about being a factor in the onset of schizophrenia and psychosis, especially in boys under 18 who use marijuana. There are a number of papers published about this. Here is a recent one – Traditional marijuana, high-potency cannabis and synthetic cannabinoids: increasing risk for psychosis. I’ve worked with a few mom moms who say their son’s mental health issues started after they started using marijuana.

Dr. Blair: Adverse effects can include headaches, anxiety, dreams, and lowered blood pressure. Regarding schizophrenia, a close review of the reports indicate many were using skunk product and some were self-medicating for their behavior conditions with the cannabis.

This is the end of the “interview” with Dr. Blair.

I also participated on a panel with other speakers at the recent Integrative Medicine for Mental Health/IMMH conference and when an audience member asked about a patient self-medicating with marijuana, Dr. Bill Code, MS expert, shared much of his expertise, also supporting my new-found knowledge of CBD from hemp.

I do have concerns about CBD from medical marijuana due to the psychoactive THC component and I shared some of my concerns during the panel discussion. We covered some of this in my Anxiety Summit interview with Dr. Hyla Cass: Marijuana and anxiety: Panacea or Pandora’s Box?.

Dr. Code feels some of the psychosis concerns are unwarranted. However, right after the panel ended an ER psychiatric nurse shared how she sees a large number of teenage boys in the ER with symptoms of psychosis whenever they have music festivals in town.

Is it susceptible individuals or the butane or pesticides or mold or a high amount of THC or skunk that is the cause? I don’t know if we have the answer yet and this is why I can endorse CBD from hemp but not marijuana.

I learned even more about CBD from hemp via a company exhibiting at the IMMH conference – CV Sciences, makers of +CBDoil. We spent a good hour talking to Dr. Michael Lewis, advisor to CV Sciences and President and founder of the Brain Health Education and Research Institute, and others from the company, asking a ton of questions. All the answers confirm what I have recently learned from Dr. Blair.

For now, I do feel comfortable sharing what I am learning about CBD from industrial hemp. But I don’t yet have much experience using it with clients. So far this is my experience:

  • I used some of the +CBDoil cream on my aching feet at the IMMH conference and it helped the pain and gave me a solid night’s sleep (which can be challenging when in a hotel). I did also use 2 sprays (equivalent to 1 mg of CBD) earlier in the afternoon too.
  • A colleague who tried some at the IMMH conference felt a little spacey
  • Another colleague at IMMH reported that she felt it was very calming
  • Feedback from my community on the original CBD blog

I also just heard from a mom that she has had incredible benefits using medical marijuana (with both CBD and THC) with her autistic son so I’ll share more as I learn more.

I’m still looking for an answer to this question: How much actual hemp CBD research is there and I am having a hard timing teasing out if the marijuana CBD research applies to all this, but will get answers. Until I learn more, here is some of the research that pertains to anxiety, panic attacks and depression:

Here are some links for you:

  • Dr. Blair offers phone consulting via Prohealthadvisor
  • The Elixinol website and products (these are the products Dr. Blair uses and he is an advisor for the company – use this code for a 10% discount: 10off208)
  • The +CBDoil product (this is the one I tried at the recent IMMH conference)
  • The Realm of Caring (a non-profit site that Dr. Blair recommends as a resource for additional information)

With appreciation to Dr. Jay Davidson for inviting Dr. Blair to speak on the Detox Summit and for both of them enlightening us!

And again, thanks to Dr. Blair for an excellent interview and answering so many of our questions!

Please share other questions you have and we’ll get them addressed when we do our interview.

Please also share both positive and negative results with both CBD from hemp and marijuana.