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Depression

Delayed IgG food sensitivities: depression and anxiety due to inflammation, leaky gut, leaky blood brain barrier and low serotonin

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It’s really encouraging and exciting to see a major study confirming what we’ve known about IgG food sensitivities or IgG food reactivity for years, and also reporting a link to irritable bowel syndrome (IBS) and depression. The paper, published in May this year, The Food-Specific Serum IgG Reactivity in Major Depressive Disorder Patients, Irritable Bowel Syndrome Patients and Healthy Controls states

There is an increasing amount of evidence which links the pathogenesis of irritable bowel syndrome (IBS) with food IgG hyperreactivity. Some authors have suggested that food IgG hyperreactivity could be also involved in the pathophysiology of major depressive disorder (MDD).

The following diagram and excerpt illustrates the gut-immune-inflammatory-brain model for depression that is associated with food IgG hyperreactivity or sensitivity.

The gut-immune-inflammatory-brain model for Major Depressive Disorder associated with food IgG hyperreactivity. According to the hypothesis proposed in our previous work, we present a possible mechanism underlying the MDD [major depressive disorder] development, suggesting that the interplay between genetic and environmental factors may lead to disruption of tight junctions, the loss of their integrity and both gut and BBB [blood brain barrier] permeability. Undigested food compounds, which would normally break down in the gut, translocate into the blood circulation, and trough epitopes combine with food IgG antibodies to form immune complexes. This, in turn, provokes an abnormal response and triggers immune-inflammatory cascade. Uncontrolled release of the proinflammatory mediators may contribute to low-grade systemic inflammation and low-grade neuroinflammation, which, via pathological processes in CNS [central nervous system], i.e., changes in neurotransmitter metabolism, neurogenesis, glutamate excitotoxicity, may in consequence induce and then maintain and prolong depression.

[diagram and excerpt from The Food-Specific Serum IgG Reactivity in Major Depressive Disorder Patients, Irritable Bowel Syndrome Patients and Healthy Controls]

I wrote my book, The Antianxiety Food Solution, in 2011 and there wasn’t research on the gut-immune-inflammatory-brain model, but I do write extensively about delayed IgG food sensitivities (as well as other types of food issues). If you don’t have my book I’m including some of the highlights related to this (and I encourage you to pick up a copy too!). If you do have my book I hope this next section encourages you to go back and read chapter 4 again (and even check out the other books I mention below).

I write about how with delayed food reactions, it may take a few hours to several days before symptoms appear, which can make it difficult to identify the offending food or foods. In these reactions, the body responds by creating a type of antibody known as IgG (immunoglobulin G).

I also write about how food sensitivities can have effects beyond physiological symptoms, including creating imbalances in key chemicals in the brain, which can cause anxiety, phobias, depression, irritability, and mood swings. When food sensitivities have these effects, they are sometimes termed “brain allergies” or “cerebral allergies.” Dr. Carl Pfeiffer wrote extensively about this and used these terms in his wonderful book, Nutrition and Mental Illness, way back in 1987. (This book is a quick read and is one of my favorite older books on the subject of mental health and biochemical imbalances.)

I also reference the work of my colleague and friend, clinical nutritionist Liz Lipski. In her 2004 book, the 3rd edition of Digestive Wellness she shares that

24 percent of American adults claim they have delayed food and environmental reactions.

She feels that these sensitivities are often the result of leaky gut syndrome, a condition characterized by damage to the microvilli lining the intestinal walls. This allows undigested food particles to travel across the intestinal wall and into the blood, where the immune system responds to them as foreign, harmful substances and creates antibodies to neutralize them.

All this sounds very similar to what the new study is reporting doesn’t it? I’d prefer it not to take so long for the knowledge from as far back as 1987 to get into mainstream journals but it’s the world we live in and we can just appreciate that we are moving forward and in the right direction!

The 2018 paper mentioned above concludes the following:

Our findings suggest more common food-specific serum IgG hyperreactivity among patients with IBS and MDD [major depressive disorder], which may be one of the mechanisms leading to the development of immune activation and low-grade inflammation observed in these disorders.

They do support an elimination diet for IBS but not for depression:

There is no causal relationship which could confirm clinical utility of an elimination diet in patients with depression

I do love research, but this really bothers me as it’s just common-sense and we do have some case studies supporting the use of elimination diets. In this case study the patient’s “treatment-resistant” depression improved considerably with an elimination diet, with similar results in another case study where a gluten-free elimination diet improved both anxiety and depression and everyday functioning.

In the meantime, we’ll continue to rely on the wisdom of practitioners like Dr. Pfeiffer and Liz Lipski, and all the clinical evidence showing how an elimination diet does help with both depression and anxiety. Just read some of the success stories on this blog – Paleo and grain free diets: anxiety and depression success stories.

Other mechanisms: nutrient malabsorption and serotonin production

There are other mechanisms that I also cover in my book – nutrient malabsorption and a more direct impact on serotonin production.

One possible mechanism is indirect effects of gastrointestinal damage due to eating problem foods, resulting in nutrient malabsorption. In a 2009 double blind placebo-controlled study:

65 celiac patients aged 45-64 years on a strict gluten-free diet for several years [and showing signs of low folate, low vitamin B12 and low vitamin B6] were randomized to a daily dose of 0.8 mg folic acid,0.5 mg cyanocobalamin and 3 mg pyridoxine or placebo for 6 months

I doubt folic acid or this form of B12 would be used today but even with these forms at these low doses, the study participants showed homocysteine in a good range and reported improvement in general well-being – after just 6 months of supplementation.

Another possible mechanism is the fact that gluten sensitivity and the resulting damage to the gut can limit the availability of tryptophan and therefore lead to decreases in levels of serotonin. Research published in 2005, Gluten-free diet may alleviate depressive and behavioural symptoms in adolescents with coeliac disease: a prospective follow-up case-series study, reports that:

serotonergic dysfunction due to impaired availability of tryptophan may play a role in vulnerability to depressive and behavioral disorders among adolescents with untreated coeliac disease

In addition to removing the foods that are causing the sensitivities, you need to heal the gut and boost serotonin levels with a targeted individual amino acid like tryptophan.

Give the link between anxiety and depression, all of the above could apply if you have anxiety too.

Have you had IgG food sensitivity testing and found that an elimination diet helped reduce your depression or anxiety symptoms?

Kate Spade: suicide, hormonal imbalance, antidepressants as a trigger and the stigma of mental health

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Photo by Paul Keleher (originally posted to Flickr as kate spade) [CC BY 2.0], via Wikimedia Commons
Kate Spade, a well-known American fashion icon and handbag designer, died by suicide last week at the age of 55. I’m always torn in situations like this…just share the news story with my sympathies in order to respect the family or use this as an opportunity to learn from and prevent others from suffering the same fate. This time I’m doing the latter – with the risk of appearing insensitive – because there are red flags here and I feel so strongly that we all need to learn from this in order to move mental health forward. I’m hoping her husband and family would approve.

In the announcement about Kate Spade’s suicide in the New York Times, Mr. Spade said:

that though his wife had suffered from anxiety at points during their relationship and marriage, her serious bouts of depression only began about six years ago, at the age of 49.

Kate suffered from depression and anxiety for many years. She was actively seeking help and working closely with her doctors to treat her disease, one that takes far too many lives. We were in touch with her the night before and she sounded happy. There was no indication and no warning that she would do this. It was a complete shock. And it clearly wasn’t her. There were personal demons she was battling.

My heart goes out to Kate Spade’s husband, young daughter and loved ones. Her suicide is just so sad but as I said I have a fair bit to say about this….

 

Hormone imbalance triggering anxiety and depression?

According to the reports, Kate’s “serious bouts of depression only began about six years ago, at the age of 49, but she had suffered “from depression and anxiety for many years”.

Perimenopause and menopause is a classic time for women to experience worsening anxiety and depression and can be driven by fluctuating hormones, especially low estrogen. In this study, Depression and the menopause: why antidepressants are not enough? the authors share that

Postmenopausal depression is more severe, has a more insidious course, is more resistant to conventional antidepressants in comparison with premenopausal women and has better outcomes when antidepressants are combined with HT (hormone therapy).

Addressing hormone imbalance as one possible root cause can eliminate the anxiety and depression. Some of my favorite resources for hormone balance are these books: The Hormone Secret and Cooking for Hormone Balance.

 

Low levels of neurotransmitters like serotonin, catecholamines and GABA?

Directly connected to hormonal imbalance is brain chemistry imbalance. Addressing low levels of neurotransmitters like serotonin, the catecholamines and GABA provide results quickly when they are used in a targeted way based on individual needs:

  • Low serotonin is an issue when estrogen levels are declining and the amino acid tryptophan can have profound benefits if low serotonin is one of the root causes, leading to depression, worry, fear, overwhelm and sleep issues.
  • Low catecholamines can cause the “I just want to say in bed” depression and low motivation, together with fatigue and poor focus. The amino acid tyrosine can help to eliminate some of this and also provides thyroid support.  Poor thyroid health can also be a root cause of depression.
  • We see low GABA levels when progesterone is low and if this is one of the root causes, it can result in increased physical anxiety and insomnia. The amino acid GABA, opened on to the tongue, can provide calming results within minutes.

I can totally relate to the hormonal aspect as I suffered from PMS for years and my anxiety issues and panic attacks started in my late 30s and I had a really low spell as I was going through menopause.  Both GABA and tryptophan turned things around very quickly for me as they do for my clients.

 

The role of diet and nutritional psychiatry?

There is so much new science behind the role of a real foods traditional diet for alleviating both depression and anxiety. The SMILES study, published by Prof Felice Jacka early 2017, was the first randomized controlled diet depression study and ONE THIRD of the dietary intervention group saw improvements in their depression symptoms.  This was just diet alone and switching from processed and junk food to real food with no specific dietary restrictions.

There is also much clinical evidence supporting how diet can have an impact. Holly, suffered from with severe depression and anxiety changed her diet and shared this with me:

Over the course of a year and a half, I was given 10 different psychiatric diagnoses and cycled through 10 different medications. I discovered the healing power of diet completely by accident, and it changed my life. I now live with no diagnoses and no symptoms.

I started with the Whole30 (strict paleo), then went paleo, dabbled with a ketogenic approach, and now I eat a modified paleo diet, with some rice and goat dairy.

This has been termed nutritional psychiatry and you can read more diet-depression and diet-anxiety success stories here.

Keep in mind that your prescribing psychiatrist may not yet be on board with this or up to date on the newest research. Just last week someone told me what happened when they discussed nutritional psychiatry with their doctor and showed them my book The Antianxiety Food Solution (my Amazon link). He said: “Good luck with that!”

 

Could the antidepressant medication have triggered her suicide?

The statement from Kate’s husband says “She was actively seeking help for depression and anxiety over the last 5 years, seeing a doctor on a regular basis and taking medication for both depression and anxiety.”  Could the antidepressant medication have triggered her suicide or played some part?

We will never know with Kate but this is always my first thought when I learn of a suicide and when we hear of homicides in the news. One of my colleagues shared this when her suicide was first announced: “I was wondering if she was under psych care and what role meds might have played in this tragedy.”

This paper is one of many papers reporting similar antidepressant suicide and violence risks, and concludes that:

Antidepressants double the occurrence of events in adult healthy volunteers that can lead to suicide and violence

Kelly Brogan MD – Holistic Psychiatrist​ no longer prescribes psychiatric medications because we don’t know who will experience this side-effect. She writes this about a Swedish study and antidepressants and increased suicides

As antidepressant prescriptions increased 270% over 15 years, suicide rates also increased. Strikingly, more than half of the young women who committed suicide (52%) were prescribed antidepressants within a year of committing suicide. And antidepressants were detected in 41% of the women who committed suicide, showing that they were under the influence of antidepressants at the time of death. 

 

What if you are taking an antidepressant and seeing benefits?

When I posted some of this on Facebook earlier in the week someone who is on an antidepressant and benefiting shared her frustration that we are blaming suicide on medications.

There are many who do benefit but there are two issues I have:

  1. Even if someone is doing well on an antidepressant, benzodiazepine or other psychiatric medication I feel we need informed consent about the side-effects and training for the individual and family on what to look out for as things can change. The can occur when meds are changed, doses are increased or decreased, new meds are added, one or more are stopped abruptly or too quickly (called discontinuation syndrome). Many doctors also need to be educated and to acknowledge that suicide and homicide are very real side-effects of these meds.
  2. We don’t know who will be adversely impacted, which is why consent/knowledge about this is so important.

When we rent ski equipment or go bungee jumping we sign an informed consent form, acknowledging the possible risks of death. Why is this not happening with these medications? I just want individuals to be going into this with eyes wide-open so they don’t say “why didn’t anyone tell us this?”

If someone is currently seeing benefits from antidepressants (or benzodiazepines) I make sure they know ALL the risks and encourage them to continue to look for root the causes and address these (never stopping medications abruptly and never without the prescribing doctor’s permission).

There are many possible biological or biomedical or metabolic causes of depression and anxiety and many of these can play a factor in suicide.  Here is a list of just some of them:

My concern is that none of these – the medications or poor diet and nutritional deficiencies – are ever discussed when someone does commit suicide or goes on a violent or homicidal rampage.

 

The stigma of mental health and the fear of seeking help

There are reports that “Kate Spade felt unable to seek help or discuss her mental health because she feared this might damage the brand she created.”  This is a huge issue and if it was true for her or if anyone with a mental health condition feels like this, this has to change!

As Dr. Mark Hyman MD​ said this when I interviewed him last year before the launch of his Broken Brain docu-series

I began to realize that the body was driving a lot of this brain dysfunction, and that if you fix the body, a lot of the brain disorders would get better, that it wasn’t a primarily a mental problem, but it was a physical problem.

Our interview and full transcript is here and we cover the gamut in 12 minutes: the gut and microbiome, nutritional deficiencies, food sensitivities, heavy metals, other environmental toxins and medications.

We don’t hide the fact that we have a broken leg so why do we have to hide it when we have a broken brain? If we can start to acknowledge that mental health issues so often have this physical aspect (and often it’s 100% physical) then hopefully we can end this crazy stigma.

And even if there is also trauma or lifestyle factors that make someone depressed or anxious – so be it. Stop the stigma and shame. Why do we have to put on a brave face and pretend all is well. It has to stop so people can ask for help.

Last but not least, I feel we need to offer practical nutritional psychiatry resources to the family who have been traumatized by the loss of a loved one to suicide.  We know the amino acids and B vitamins help individuals recover from psychological stress after a natural disaster and these same nutrients can help the family in the midst of their sorrow.

I am aware it’s a very delicate subject and I’m sure this will rub some people the wrong way but I believe we all need to be talking about this and not tip-toeing around it.

I really feel this all needed to be said today. I hope this helps you or a loved one.

Rest in peace Kate Spade.

I wake in the middle of the night with a jolt of fear, feelings of dread or feeling depressed

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Waking in the night feeling anxious and with a jolt of fear, having a panic attack, experiencing feelings of impending doom, with a pounding heart and even feeling depressed is a common issue I see with clients and it’s a common question that I’m often asked on my blog and on Facebook.

Here is a typical question you may relate to:

I usually wake between 5-6 am and have this overwhelming feeling of dread and start thinking of all the things I have to get done. And then I can’t fall back asleep. What is this?

Or this one:

Does anyone have severe depression when waking up in the middle of the night, but never during the day or before falling asleep. It doesn’t go away until after I’m fully awake and upright in the morning.

Low serotonin?

Serotonin is known to dip later in the day and at night and we know low serotonin can cause depression and insomnia/waking in the night, so my first thought would be to assess for low serotonin and address this if it is the case. I use the questionnaire and trial method.

I always start with tryptophan, but may switch to 5-HTP if that’s not working as expected as some people do better on one versus the other. We add melatonin if the tryptophan or 5-HTP isn’t quite enough to help with the waking.

There are many possible causes of low serotonin so over the course of the next few months these will be addressed too, on a case by case basis. Some of the causes in include: a poor diet, low stomach acid, malabsorption, low zinc, low B6, low iron, low magnesium, dysbiosis and/or parasites and/or candida, the birth control pill, MTHFR defects (with this defect expressing) etc.

Low GABA?

Low GABA levels may be a factor too as this can contribute to insomnia and waking, especially when there is physical tension. New research reports GABA’s involvement in unwanted thoughts and it’s a common factor in my community and clients. Again, I use the questionnaire and trial method to find the ideal amount of GABA for each person.

High cortisol?

High cortisol in the night can also be a factor and I suspect this when someone says they wake with a jolt of fear or feels what they describe as an adrenalin rush. Saliva testing can confirm cortisol levels and Seriphos is the best product I’ve found to lower high cortisol. Addressing low blood sugar and finding the root cause of the adrenal issues are also key. General adrenal support with B vitamins and adaptogenic herbs are often needed too.

Hormone imbalances and/or PMS?

Here is another typical question you may relate to:

I’ve had the worst week regards 3am panic attacks, lurid dreams and wake up aching. It always feels like the end of the world and yet I get up and stagger out to do my morning routines and all is right with the world (apart from physical aches and pains). I have often had bouts of this. It’s a week to go until my period.

If the anxiety or panic attacks are cyclical and tied to your menstrual cycle I will still start with a trial of tryptophan which has been shown to help PMS, tension, depression and mood swings. Serotonin support also helps with fibromyalgia-type aches and pains.

A trial of GABA is often needed too and can help with alleviating the panic attacks, waking and some of the aches. Other factors like a gluten sensitivities, adrenal issues and high oxalates may also play a role in physical aches.

Lurid dreams clues me into the possibility of low vitamin B6, which is an important co-factor for making both GABA and serotonin, as well as being important for alleviating PMS symptoms and the social anxiety condition called pyroluria. The pyroluria protocol, with vitamin B6, zinc and evening primrose oil, helps both the social anxiety as well as PMS symptoms and insomnia.

Address the basics

You may be looking for the perfect supplement to help and while the amino acids come pretty close to being that, it goes without saying that you want to always address the basics. This means making sure you are eating a real whole food diet with quality animal protein and getting that animal protein at breakfast in order to balance blood sugar. The following needs to be eliminated too: caffeine, gluten and sugar. Some individuals do even better on a ketogenic diet.

Looking at sleep hygiene factors fall under the basics too: a dark, cool and quiet room, no PC or iPhone late at night, no iPhone or other EMF sources close by, sunlight exposure in the early morning etc.

And we mustn’t forget stress reduction, exercise and nature.

Address other bigger issues

Medication side-effects must always be considered. Here are a few examples:

Hashimoto’s thyroiditis must also always be considered especially when there are fluctuations in mood, anxiety and sleep. These fluctuations in mood and anxiety can happen at any time of the day and not necessarily in the night.

If the insomnia and middle of the night anxiety and depression persists we continue to dig and look at dietary histamine and oxalate issues, SIBO, parasites and other digestive issues.

If we are still not seeing results then a referral for Lyme disease, mold, sleep apnea and heavy metals may be needed.

My checklist

My checklist when I start when working with someone with issues similar to the above. This will be tweaked based on each person’s own biochemistry and where they are in terms of diet, supplements and lifestyle:

  • Low serotonin? Do a tryptophan or 5-HTP trial
  • Low melatonin? If tryptophan or 5-HTP trial isn’t quite enough then add melatonin
  • Low GABA? Do a GABA trial
  • Low blood sugar? Add quality protein at breakfast, plus glutamine
  • High cortisol? Support the adrenals and use Seriphos or something else to lower the high cortisol
  • PMS/sex hormone imbalances or Hashimoto’s? Address with diet, nutrients and hormone support as needed
  • Low magnesium, low zinc, low B6, low iron? Assess for these deficiencies and address them
  • Gut health issues like leaky gut, dysbiosis, candida, parasites, SIBO? Address these issues
  • Histamine, oxalate or other dietary issues? Address these issues
  • Medication side-effects? Figure out which one is an issue and work with the doctor to taper if needed and address why the medication was initially prescribed.
  • If the issue persists – a referral for Lyme disease, mold, sleep apnea and/or heavy metals

As you can see there are many overlaps with some of the 60+ root causes of anxiety.

Here is additional information on tryptophan for low serotonin, GABA for low GABA and glutamine for low blood sugar, plus the list of supplements I use with clients.

As always, if the amino acids are new to you, review the precautions and be smart about using them. My book The Antianxiety Food Solution (Amazon affiliate link) has an entire chapter on the amino acids, plus chapters on diet, gut health, caffeine, blood sugar and more.

We’d love to hear which of the above approaches have helped with your insomnia and waking with a jolt of fear or dread or pounding heart.  

The Broken Brain highlights: Trudy Scott interviews Dr. Mark Hyman

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I’m really excited to share my in-person video interview with Dr. Mark Hyman, MD. It’s an interview I arranged because I’m so excited about his Broken Brain docu-series which will start airing on January 17th. You may have seen it when they recently did a test launch but if you haven’t yet seen the series it is well-worth watching and is highly recommended! (Registration link here)

In this interview with Dr. Hyman we talk about root causes of anxiety, depression, dementia, Alzheimer’s disease and ADHD: medication side-effects, diet, the microbiome, nutritional deficiencies, brain chemical imbalances, heavy metal toxicities and more; he shares his personal mercury toxicity story and the why behind the Broken Brain series; we cover off-label medications, trauma, labels and functional medicine.

I love the term he uses to describe body-mind medicine (which is different from mind-body medicine): somatopsychic = mental symptoms caused by bodily illness i.e. all of the above root causes.

One of the big reasons I’m supporting The Broken Brain docu-sersies is that it offers solutions and plenty of hope!

Here is the interview and transcript.

(there are captions on the video – if you don’t see them be sure to click the CC on the bottom right)

Trudy: – Welcome, it’s Trudy Scott here, food mood expert, certified nutritionist, author of The Antianxiety Food Solution, host of The Anxiety Summit, and today I’ve got the pleasure of interviewing Dr. Mark Hyman, who is the creator and host of the new Broken Brain series, and I’m just really excited to be here. I’ve been such a fan of yours for so many years. I know my community knows who you are, and they’re really excited about the Broken Brain series. I wanted to get together with you, and give some highlights, and talk about firstly why you created the Broken Brain series, and you’ve got a story behind your passion about it.

Dr. Mark Hyman: – I do. I do. Thank you for having me. Yeah, so about 20 years ago, I went from being a very healthy young doctor to having a broken brain, and a broken body, and it turned out it was from mercury poisoning that I got when I was in China, and I just developed severe chronic fatigue, where I couldn’t focus, I couldn’t remember, I couldn’t think, I couldn’t pay attention, I was depressed, I couldn’t sleep, I felt just completely not myself, and through that journey, was able to discover this world of functional medicine, which I thought was fairly developed at the time, but was really just in its infancy, and through discovering functional medicine, I was able to repair my own system, and fix my broken brain. I began to apply this with patients, seeing all kinds of things, without really knowing what I was doing, I was just treating people’s physical systems, fixing their gut, helping their immune system, cleaning up their diet, optimizing their nutritional status, balancing their hormones, and all their mental problems would get better. Their anxiety would get better, their depression would get better, and I wasn’t actually treating the depression or anxiety. Autism, ADD, memory issues, dementia, all these things would start to get better, and I began to realize that the body was driving a lot of this brain dysfunction, and that if you fix the body, a lot of the brain disorders would get better, that it wasn’t a primarily a mental problem, but it was a physical problem. Just as there’s a mind body effect, which is real, there’s also a body mind effect and that hadn’t been really talked about, so I wrote a book called The UltraMind Solution 10 years ago, which outlined this model, and then really this has been an incredible 10 years of brain research that I felt needed updating, and so we created a documentary series online looking at the new research, and how this applies, and the things that I noticed 10, 15, 20 years ago are now becoming more and more accepted and understood as real, and so we’re able to actually work with people in a very specific and direct way to help heal their broken brains, and to help people recover from things that we thought were really irreversible, not just anxiety, depression, but ADD, autism, dementia, Parkinson’s, all sort of issues that affect the brain that have a very different approach that can be used to repair and heal.

Trudy: – That’s so powerful, and I love that you talk about this effect that the body has on the brain, because we know about mind body medicine, you talk about that in the series, about how we can use our mind to affect our health, but you use this term. Tell me what the term is that you use that talks about how physical issues in our body, nutritional deficiencies, imbalances, can actually affect the brain.

Dr. Mark Hyman: – You mean the body mind effect?

Trudy: – Yes.

Dr. Mark Hyman – Yeah.

Trudy: – You’ve give it a term, and it was called?

Dr. Mark Hyman: – Oh, somatopsychic.

Trudy: – Somatopsychic, yes.

Dr. Mark Hyman: – We think of psychosomatic, but there’s also a somatopsychic phenomena. I would say if you have mercury poisoning, or you have a thyroid problem, or you have abnormal gut flora, or you’re vitamin D deficient, or B12 deficient, it’s very hard to have a proper functioning brain. You can’t just say someone’s got depression, that’s what’s causing their hopelessness, and helplessness, and sadness, and maybe many other things, it could be psychological, it could be a trauma, but it also could be so many other factors, and they often are overlooked and ignored, and when I start peeling back the layers of what’s happening with these people, and looking underneath the hood, and looking through the functional medicine lens at the body as a system, and correcting the imbalances, it’s shocking to me what happens. I always remember when I start applying this, I was like, wow, you got better? I can’t believe it. You shouldn’t really get better, according to Western medicine.

Trudy: – Amazing, and you mention trauma. Even if someone has experienced trauma, if their nutritional status is good, they’re able to deal with it better.

Dr. Mark Hyman: – Right.

Trudy: – And maybe have less symptoms of post-traumatic stress.

Dr. Mark Hyman: – That’s right.

Trudy: – If they have a good nutritional status, and there’s a lot of good research supporting that.

Dr. Mark Hyman: – Absolutely.

Trudy: – You talk about that in the series as well.

Dr. Mark Hyman: – Yeah, absolutely. Your brain has the ability to be resilient, but if you’re nutritionally depleted, and if you’re having all sorts of inflammatory problems, if you’re eating foods you’re reacting to, or allergic to, your brain can’t work properly, so your baseline is going be much lower, but if you fix all those things, then your capacity to deal with your psychological issues, it’s not that they don’t exist, it’s that your ability to cope with them, to work through them, to heal and repair the more difficult things, which are early life traumas, or abuse, or addiction, these are much easier to deal with once you fix the basic constitution of the person.

Trudy: – Right. Now one thing that you talk about a lot in the Broken Brain series, which I really appreciate, is the fact that there’s so much over-medication.

Dr. Mark Hyman: – Yeah.

Trudy: – Can you talk a little about it today? And I know with your story, you also had anxiety, depression, and you were prescribed medications as well.

Dr. Mark Hyman: – Yeah.

Trudy: – So this is common.

Dr. Mark Hyman: – Yeah.

Trudy: – You talk about antipsychotics. You shared some pretty scary stats on the increase that we see.

Dr. Mark Hyman: – When you look at it, it kind of goes up and down, but psychiatric medication as a whole, is the number two or three most prescribed category of drugs in America, and increasing across the globe, and it’s being used instead of dealing with the real issues, and they don’t really even work that well. I mean, anxiety medications can work, but antidepressants have been shown really not to work that well for mild to moderate depression. For severe depression, they can be helpful, and they can be life saving for some people, but they’re not a panacea, and when I was a kid, there was that one kid in the class, Patty Ainsworth, who was a troublemaker. Now it’s like 10% of the class is on ADD medication. That’s a problem.

Trudy: – It is.

Dr. Mark Hyman: – And when we see one in four people have depression in their lifetime, and if the knee jerk reaction is medication, it just sort of gives people a sense of numbness, but it doesn’t really deal with the issue. So I think we are way over-medicated, and on top of that, there’s pushing of medications for off-label use, which means that they’re not approved for those indications. So they’re doing this for kids with antipsychotics, and they’re actually been sued. So the pharma companies have been held liable for promoting these drugs for off-label uses, which they’re not allowed to do, for kids. They get fined billions of dollars, but they don’t care because they’ve made umpteen more billions, and they just see it as a marketing expense. So it’s really discouraging to see what happens to the pharmaceutical use in this space, because even for example, ADD is so fixable by dealing with the root causes, and most of us not are not even trained how to think that way.

Trudy: – That’s why I love the Broken Brian series, because it offers a message of hope, offers some practical solutions, and it empowers the person who’s suffering from the brain disorder, whatever it is, anxiety, depression, dementia, you name it, empowers them with solutions, and I think the other thing is it’s going to give curious practitioners who are not on board with this functional medicine approach some insights into what the future may hold, which I think is very promising.

Dr. Mark Hyman: – Yeah. It’s very powerful. I remember this guy who read my book, The UltraMind Solution, which is really what the Broken Brain series is based on, and he was a doctor, and he had a kid with autism, and he said, “We’re so desperate. Our kids was five, he wasn’t talking. We just started with the diet. We just got him off gluten, casein, and a few days later, all of a sudden, he started talking in full sentences,” and this is a skeptical physician who witnessed this, and I see this all the time. Patients, for example, have Alzheimer’s, or dementia, or diagnosed with dementia, and it turns out they have other issues. They have heavy metal poisoning, or they might have Lyme disease in the brain, or they might have severe nutritional deficiencies, or they might be insulin resistant with high levels of sugar in their diet that are affecting their brain, and you can fix those things. There may still be issues left over, but it’s going to be much easier to deal with those after.

Trudy: – Get to the root cause, and address those root causes.

Dr. Mark Hyman: – That’s right. That’s the purpose of functional medicine, which is a medicine of why, not what, and we have all these labels, but you know, if someone comes into my office, and they’re hopeless, and helpless, have no interest in life, can’t focus, can’t sleep, don’t want to have sex, I know what’s wrong with you. Depression, but depression isn’t the cause of those symptoms, it’s the name of the symptoms. It doesn’t tell you what’s really wrong with that person. It’s could be a host of things, from low thyroid, to gluten, to mercury poisoning, to vitamin D deficiency, to B12 deficiency, to insulin resistance. All these factors can lead to depression. Same syndrome, but different causes. So I’m much more interested in addressing the causes, then you don’t have to use the medication.

Trudy: – And some people have an issue with gluten, and have autism symptoms, and someone else can have depression or anxiety or dementia.

Dr. Mark Hyman: – That’s right.

Trudy: – So it can affect different people in a different way.

Dr. Mark Hyman: – That’s a very good point. So in functional medicine, we see that one disease can have many causes, but on the other hand, one causative factor can create many diseases. For example, heavy metals may cause dementia, or autism, or depression, or anxiety, or insomnia, or gut issues can cause all these various things that are not one disease, or for example gluten, like you mentioned, can cause autoimmune disease, can cause cancer, can cause diabetes, can cause osteoporosis, can cause anemia, can cause depression, can cause even dementia. So how do you begin to think about it? Our current naming of diseases doesn’t make any sense. So all the labeling, if you look at the diagnostic criteria, we have something called the DSM-5, which is the diagnostic and statistical manual that categorizes and catalogs all the psychiatric disorders, and they’re all categorized by symptoms. So it’s all descriptive. It’s says if you have these five symptoms, you have this, but it doesn’t tell you why, and it doesn’t really help you, other than giving you a label, which doesn’t mean anything about helping you understand what’s really going on.

Trudy: – And then you’re on a medication that’s going to give you side effects, and not actually get to the root cause of the problem.

Dr. Mark Hyman: – Right.

Trudy: – And yeah, just make some nutritional changes, addressing the thyroid, getting off gluten, addressing the gut – big session in the Broken Brain series.

Dr. Mark Hyman: – Yeah, it’s huge.

Trudy: – The gut brain connection.

Dr. Mark Hyman: – I mean, we’re just learning about this. For example, for years one of the main ways I treated the brain was fixing the gut, and that means optimizing the flora, getting rid of bad bugs, helping heal leaky gut, and we just did it, we didn’t really have a deep understanding other than we knew the microbiome was important, but now we know, for example, that there are more bacterial molecules in your blood than your own molecules, that you have 10 times as many bacterial cells in you as your own cells, 100 times as much bacterial DNA, and that DNA is all producing proteins, and all those proteins, you have 20,000 genes, there’s two million genes of bacteria in you, and they’re all producing molecules that are entering your blood stream, and driving all sorts of biological reactions, that aren’t even human molecules. So we have to begin to sort of how do those affect the brain and what’s going on? And it’s very powerful.

Trudy: – And so much research in this area, it’s just growing and growing.

Dr. Mark Hyman: – Yeah.

Trudy: – So you mentioned earlier that you wanted to do this because of all the new research. There is so much research on the gut brain connection, nutritional psychiatry. Dr. Drew Ramsey talks about this recent study on depression, and just getting people onto a real whole foods diet, and how 30% saw remission of symptoms, just changing their diet.

Dr. Mark Hyman: – Of course.

Trudy: – Not even going gluten free. So it’s powerful. These small changes can have powerful effects.

Dr. Mark Hyman: – Profound, profound effects

Trudy: – Well, thank you so much.

Dr. Mark Hyman – Thank you.

Trudy: – For your wonderful work that you do. And for making time today. I highly recommend the Broken Brain series with Dr. Mark Hyman, all the wonderful experts.

Dr. Mark Hyman: – Oh, so many. We’ve got 57 experts.

Trudy: – Amazing, some of our favorite functional medicine practitioners.

Dr. Mark Hyman: – Yeah.

Trudy: – Thank you.

Dr. Mark Hyman: – Thank you.

(I’m a tad disappointed that there is the background noise of people talking – and apologize – but I am hoping the great content overrides this and it’s not too distracting.)

Save the date for the 8 -part Broken Brain docusersies, hosted by Dr. Mark Hyman – and register here. It airs January 17-25th

Here’s a list of ALL the episodes, to showcase just some of what you will have access to. Each episode will be available for 24 hours, at no-cost!

  1. The Broken Brain Epidemic / My Story (January 17)
  2. Gut Brain Connection: Getting to The Root of a Broken Brain (January 18)
  3. Losing Your Mind (Alzheimer’s, Dementia, MS, and More) (January 19)
  4. ADHD and Autism (January 20)
  5. Depression & Anxiety (January 21)
  6. Traumatic Brain Injury: Accidents, Sports, and More (January 22)
  7. 7 Steps to An UltraMind (Part 1) (January 23)
  8. 7 Steps to An UltraMind (Part 2) (January 24)

I hope you enjoy it and get as much out of it as I did!

I actually flew from Sydney to LA for this opportunity to meet and interview him, and share more about the Broken Brain series, and I’m so glad I did! It was the first time I’d met Dr. Hyman in person and it truly was an honor to be in the company of this great man who is doing so much in the functional medicine world! Again, here is that link to register

Please share if any of this resonates with you – what solutions you have found have helped you and/or what you are working on addressing now?

AN UPDATE: there has been some feedback on the term “broken brain” being too negative and even scary so I gathered some feedback and share it in this blog: Is the term ‘broken brain’ hopeful and real or too negative and scary? I really want to hear your thoughts if you are offended by the term broken brain.  I also want to share Dr. Hyman’s apology.

Midday bright light therapy for bipolar depression

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A recent study from Northwestern University and published in The American Journal of Psychiatry: Adjunctive Bright Light Therapy for Bipolar Depression: A Randomized Double-Blind Placebo-Controlled Trial has found that midday daily exposure to 7,000 lux bright white light for 6 weeks, significantly decreased symptoms of depression and increased functioning in people with bipolar disorder.

The press release issued by Northwestern University reports as follows

Previous studies found morning bright light therapy reduced symptoms of depression in patients with Seasonal Affective Disorder (SAD.). But patients with bipolar disorder can experience side effects such as mania or mixed symptoms from this type of depression treatment. This study implemented a novel midday light therapy intervention in an effort to provide relief for bipolar depression and avoid those side effects.

Compared to dim placebo light, study participants assigned to bright white light between noon and 2:30 p.m. for six weeks experienced a significantly higher remission rate (minimal depression and return to normal functioning). More than 68 percent of patients who received midday bright light achieved a normal level of mood, compared to 22.2 percent of patients who received the placebo light.

Images used with permission from Northwestern University

How the 7,000 lux bright light therapy was used

Here are the details of how the 7,000 lux bright light therapy was used in the study:

The light therapy patients were instructed to place the light box about one foot from their face for 15-minute sessions to start.

Every week, they increased their exposure to the light therapy by 15-minute increments until they reached a dose of 60 minutes per day or experienced a significant change in their mood.

Study lead author Dr. Dorothy Sit shares that starting low and slowly increasing the treatment made it more tolerable. None of the study participants experienced side effects, likely because the treatment was customized for each patient:

No one experienced mania or hypomania, a condition that includes a period of elation, euphoria, irritability, agitation, rapid speech, racing thoughts, a lack of focus and risk-taking behaviors.

A noticeable mood improvement with bright light therapy was also noticed as quickly as four weeks, which is similar to other light therapy research for non-seasonal depression and depression during pregnancy.

How do you do this in the middle of a work day?

You may have concerns about doing this at midday as this facebook follower voiced:

I guess if your bipolar depression is so debilitating that you cannot hold a job, then this is worth trying.

But 60 minutes!! What working person has 60 minutes in the middle of their workday?

It’s very doable because there are very nice desk versions that could easily be used at work (without anyone knowing – if privacy is a concern) or at a home-office desk for your convenience. I share some examples in this blog – Winter blues or SAD: light therapy.

I have tried lights in the morning but found that it caused agitation

I also received this feedback about increased agitation:

I have tried lights in the morning but found that it caused agitation. Over time my tolerance went down so that I could only use for less than 5 minutes. I haven’t ever tried midday light though. I’m not bipolar but I have depression which is generally worse in the winter. Exercise helps.

It may be worth trying midday light therapy if morning light therapy causes agitation or other adverse effects.

The press release mentions that light therapy is typically used in the morning to help reset circadian rhythms and the authors are unclear why midday light therapy worked for these patients with bipolar disorder. They plan to investigate further. If it is working via the same mechanism i.e. by resetting circadian rhythms, then it may well work at this time for other individuals too.

It may also be that your depression (and/or anxiety) is not caused by low serotonin but by something else instead – such as low catecholamines, poor thyroid health, gluten issues, poor diet and so on.

Using light therapy and tryptophan (or 5-HTP)

I have also found that some people do well on a combination of light therapy and tryptophan (or 5-HTP). One of my clients had many low serotonin symptoms and did better mood-wise and with reduced anxiety, on a small amount of tryptophan but still needed additional serotonin support. Additional tryptophan was too much for him and increased his day-time sleepiness, but using a small amount of tryptophan together with light therapy was the ideal balance for him.

Have you used light therapy with success – for the winter blues or depression or bipolar disorder? Or even for anxiety?

Have you ever used it at midday or at other times?

And have you used light therapy in conjunction with tryptophan or 5-HTP?

Collagen and gelatin lower serotonin: does this increase your anxiety and depression?

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I see everyone raving about gelatin and collagen – and rightly so – they have amazing health benefits. However, no-one is addressing the fact that gelatin is actually used in tryptophan-depletion studies to lower serotonin (gelatin is derived from collagen: when collagen breaks down, it becomes gelatin). When I first discovered this fact it really concerned me that this very important aspect is ignored so I added it to my long list of topics to investigate.

I posted the above on Facebook last month as part of a fact-finding exercise and appreciate all the feedback and questions. Today I share some of the feedback and research and I’d love to hear from you what your experiences have been.

The health benefits of collagen

In case you’re new to collagen, Dr. Josh Axe provides an excellent overview of the health benefits of collagen

  1. Improves Health of Skin and Hair
  2. Reduces Joint Pains and Degeneration
  3. Helps Heal Leaky Gut
  4. Boosts Metabolism, Muscle Mass and Energy Output
  5. Strengthens Nails, Hair and Teeth
  6. Improves Liver Health
  7. Protects Cardiovascular Health

Gelatin is used in tryptophan depletion studies

Tryptophan-depletion studies have been done for years, as a way to study the relationship between low serotonin and depression.  Often a tryptophan-deficient amino acid mixture is used for this purpose.  More recently, collagen and gelatin are being used.

Collagen and gelatin are an excellent source of these amino acids: proline, glycine, glutamine and arginine, but they do not contain the amino acid tryptophan.

This paper, Pharmacokinetics of acute tryptophan depletion using a gelatin-based protein in male and female Wistar rats summarizes what we find in a number of studies that use gelatin for the purpose of lowering serotonin levels, in order to study the relationship between serotonin and behavior:

The essential amino acid tryptophan is the precursor of the neurotransmitter serotonin. By depleting the body of tryptophan, brain tryptophan and serotonin levels are temporarily reduced. In this paper, several experiments are described in which dose and treatment effects of acute tryptophan depletion (ATD) using a gelatin-based protein-carbohydrate mixture were studied in male and female Wistar rats.

My experience with collagen – flat and worried until I added tryptophan

When I recently injured my back and sprained my ankle, I decided to add collagen to speed up the healing and very quickly had to take a deeper dive into the topic because I noticed it affected my mood right away! I was using just one big scoop of collagen in a protein shake (pea protein) and yet I felt flat and slightly anxious within a day. It was the worried low-serotonin kind of anxiety in the early hours – something I haven’t felt in quite some time.

I wondered if it was due to the injury and inflammation my body was dealing with or if it was related to the effects of tryptophan depletion. I stopped the collagen and then added it back and had the same experience. I did this a few times and experienced similar feelings each time.

When I used tryptophan mid-afternoon and at bedtime I felt fine and was able to continue taking the collagen with no problems. I am prone to low serotonin – it was one of the root causes of my big anxiety issues in my late 30s – so I may be more affected than the average person.

Wondering if collagen causing mood issues and an increase in anxiety?

Here is feedback from someone who is wondering if collagen is causing her mood to dive:

I have wondered if it affects my mood so I haven’t been using it lately. Interested to see what other people say. I was using about a table spoon in a drink that I would sip on throughout the morning. My moods just take dives now and then. I have isolated gluten as a HUGE factor. I am forever wondering what else causes the dives and I began to wonder if collagen was causing problems so I haven’t used it in several months.

Stephanie feels moody when using collagen:

I have found that the days I take collagen that I’m moody. I’ve kept trying, but am always surprised by the reaction. I even mentioned it to my naturopath recently. Curious to see if there’s a connection.

Here is feedback from someone also reporting mood dives and feeling on edge (although as I pointed out to her the feeling on edge is very likely due to or partly due to the coffee):

I take collagen (grass-fed and grass-finished) in my coffee every morning. I’ve also had some mood dives consistently the last few months and feel more on edge. I’ve honestly never made the connection and actually thought it was hormones. Something to think about!

Melissa shared it affected her sleep:

As soon as I started taking gelatin daily I have had difficult falling asleep.

Katinka began having strange night time anxiety:

I did [Vital Proteins grass fed beef gelatin] for 2 weeks in bone broth. My nails grew like crazy, but at the same time I begun having strange night time anxiety: worry, obsessive, but not any of the other symptoms like depression and cravings. It is interesting to me because this was the only time I had anxiety at night since going gluten free.

Collagen caused a racing heart for Beverly:

Used to take Vital Proteins products. Was woken up several times in the night with racing heartbeat and out of breath. This went away when I stopped the collagen. I have symptoms of low serotonin but have not tried tryptophan

No noticeable problems

Many people shared that they didn’t notice any obvious mood issues so it’s clearly not a problem for everyone:

  • Jaime: Interesting, I use it almost daily for protein at breakfast. I will pay attention better. No obvious problems now (used for 9 months).
  • Angela: …I don’t think I have any side effects and I do have serotonin issues. I think I will have to do more research
  • Courtney: I just started using collagen peptides but not every day. Maybe once or twice a week. I haven’t noticed any difference in mood but I also just started taking it a few weeks ago.
  • Debra: I take 1bsp of Great Lakes Collagen Hydrosylate every day and take it to help heal my leaky gut….haven’t noticed any particular side-effects. I alternate it with the normal gelatin. I suffer from complex PTSD, anxiety and depression…I haven’t noticed any difference in that either

Jessica Drummond, nutritionist and physical therapist, and an expert on female pelvic pain and women’s health shared:

I use collagen regularly and I also eat quite a lot of meat and fish. For me both help me to feel very grounded and less anxious. I think of collagen as balancing for all of the muscle meat that we eat. I eat anywhere from 10-20 grams 4-5 days per week.

 

Feels anxious using gelatin, stop using it and anxiety is gone/less

Laura’s anxiety got worse within a few months of adding daily gelatin:  

Wow, I never heard that gelatin can lower serotonin. I started using [Puritan’s Pride brand], 650mg, daily about 6 months ago to strengthen my nails. It’s worked very well for that. About a couple months ago my anxiety started to get worse again. My anxiety shows up as fear and worry mostly and not being able to quiet my mind. I had gotten it under control for almost 2 years now. I wonder if there is a connection. I’m going to stop taking the gelatin and see if my anxiety improves. I have not tried tryptophan, but I have found GABA helped quiet my mind and let me sleep better.

She decided to stop taking it to see if her anxiety symptoms would reduce and when I checked back with her she shared this:

I was surprised to find after about 2 weeks of stopping the gelatin, I began to feel more calm again and it’s been a lasting change. I still take zinc, vitamin b6 and lysine in the morning and GABA in the evening. This combination works well for me. I’m so grateful for all the information you share! Thank you!

Toni experienced something similar:

I’ve been using Organic collagen for about 8 months now… love the hair and skin results. My tummy felt better at first but not currently. My anxiety and panic attacks are off the charts: panic attacks, heart racing, sweating, brain fog. I want to escape -like fight or flight. Definately obsessing and fears. Memory difficulty. I have an upcoming GI appointment to check for Candida /SIBO… but I had no idea this could add to my anxiety. I’ll be looking forward to more information, Seriously.

And a few weeks after stopping the collagen she shared this:

I stopped using the collagen. Since then, my anxiety and panic are decreased by less than half. Mild in comparison. I’m definately taking a long break.

Keep in mind I’m not suggesting we should not be using collagen – just that if it seems to lower serotonin and increase anxiety/depression doing a trial with tryptophan may be the solution (more on that and some other possible causes of anxiety below).

When used with tryptophan – no mood issues

Karen uses collagen and tryptophan at night:

I use collagen every day. But hey, I also take L-tryptophan every night for anxiety. It runs in the family and a small amount of Tyrptophan at night helps resolve mine. No clue there was a connection

Maxine uses it every morning and takes 1 tryptophan before bed and reports no mood issues

I take it [Great Lakes gelatin and Vital Choice collagen] every morning in my tea and at night in my bone broth for my skin and joints and I take one tryptophan before bed. The tryptophan with GABA before bed is for better sleep. No mood issues.

 

Used ‘therapeutically’ to lower serotonin

Misty reports using it ‘therapeutically’ to lower her high serotonin levels. This application is new to me and I find it quite fascinating:

I use it to reduce tryptophan because I have a tendency toward high serotonin. I have suffered my entire life with ADD, tics as a child, grinding teeth, general anxiety, lack of motivation and later, IBS. In my quest to maximize my health, I finally came to these web pages for help. In my 53 years I’ve never been as calm as I am now. If I’m not careful, I can get a bout of IBS (not food related and trust me, from GAPS to AIP, nothing really affects me). I reduce tryptophan and I’m balanced. It seems contrary but it works for me and so many others

She links to these articles Tryptophan, Sleep, and Depression and The Sadder Side of Serotonin which both refer to the work of Ray Peat who I recently discovered is very much against the use of tryptophan.

I agree with the premise of too much serotonin causing issues (often the same symptoms we see with serotonin that is too low) but not the general message that tryptophan supplements and foods high in tryptophan are harmful and should be avoided by everyone. Based on the clinical results myself and other practitioners see boosting low serotonin with tryptophan and/or 5-HTP -and the wonderful results they experience – in my opinion, this is really all about biochemical individuality.

I decided to share this story here, even with the controversial tryptophan articles, because it illustrates that it is highly likely that the collagen is lowering her serotonin levels and making her feel better. I’ll tackle the above negative articles about serotonin and tryptophan in a separate blog post.

Why are some people adversely impacted by acute tryptophan depletion/ATD while others are not?

UPDATE: Dec 22, 2017. This section adds additional evidence or possibly some theories for why some people are adversely impacted when consuming collagen, while others are not impacted mood-wise – all related to the lowering of serotonin levels. These are called ATD or acute tryptophan depletion studies.

This paper: The effect of raising and lowering tryptophan levels on human mood and social behavior explains that effects of ATD can vary based on susceptibility of the study participants to clinical depression:

Acute tryptophan depletion (ATD) studies indicate that low serotonin can lower mood and also increase aggression, although results vary somewhat between studies with similar participants. Lowering of mood after ATD is related to the susceptibility of the study participants to clinical depression, and some participants show no effect on mood.

In healthy individuals, there is little or no lowering of mood, although results can be quite variable between studies, with some lowering of mood seen more often in women than in men.

The author reports the following variable responses:

In healthy participants with a family history of depression, there is a lowering of mood although mood remains within the normal range of mood.

In newly recovered depressed patients on antidepressants that act on the serotonergic system, 50 per cent or more of the patients show a temporary reappearance of the depressed mood they experienced before recovery.

In recovered depressed patients off antidepressants, only a small percentage of the patients show a marked lowering of mood.

In recovered depressed on noradrenergic antidepressants, there is no lowering of mood.

The results of the ATD studies suggest that lowering serotonin synthesis can lower mood in some circumstances, and that the magnitude of the effect tends to be greater in people with a greater susceptibility for depression.

Other studies report on these groups of people that were adversely affected with a lowered mood after ATD:

OCD / obsessive compulsive disorder: Patients with OCD experienced a decrease in control and an increase in interfering thoughts after acute tryptophan depletion. There was no effect on anxiety in this group.

Genetic polymorphisms: A number of papers show some genetic polymorphisms make some individuals vulnerable to increased depression after acute tryptophan depletion, such as MAOA and 5-HTTLPR (the serotonin transporter gene). In one 5-HTTLPR polymorphism study differences were seen between men and women: healthy men became more impulsive, whereas healthy women showed a mood reduction after ATD. Keep in mind that having a polymorphism doesn’t mean there will always be an issue, instead, it means there may be a predisposition.

Smokers: The moderating influence of nicotine and smoking on resting-state mood and EEG changes in remitted depressed patients during tryptophan depletion.

Comorbidity between depression and tobacco use may reflect self-medication of serotonergically mediated mood dysregulation [and acute tryptophan depletion or ATD] increased self-ratings of depressed mood [in certain smokers].

Although this study was looking at the role of nicotinic receptors in disordered mood and the self-medication of mood by smoking, we may be able to extrapolate this for our purposes because it was this one subset of smokers who were more depressed after tryptophan depletion. Could it be that smokers or even former smokers are more likely see increased depression after consuming collagen because it contains no tryptophan? Or is it that smokers tend to be drawn to smoking because they are prone to low serotonin?

Women ecstasy users: The effect of acute tryptophan depletion on mood and impulsivity in polydrug ecstasy users.

Women polydrug ecstasy users appear to be more susceptible than men to the effects of lowered serotonin levels [when they] received a tryptophan-deficient amino acid mixture and a control amino acid mixture containing tryptophan, at least 1 week apart.

The women who were impacted – with a lowering of their mood – used a tryptophan-deficient amino acid mixture and not collagen. The authors suggest this could be due to the drug-use causing progressive damage of serotonin neurons. Could this also happen with collagen consumption in current and possibly prior drug users? What about users of other street drugs or even medications that may also damage serotonin neurons?

Interestingly, in a study looking at five chronic fatigue/CFS patients, none of them showed any significant differences in fatigue, depression and concentration when subjected to acute tryptophan depletion /ATD. Was this group of patients too small or were none of them susceptible to low serotonin?

This is just a small selection of studies looking at the effects of acute tryptophan depletion or ATD but they give us much to think about when it comes to considering the varied effects we are seeing when individuals consume collagen.

If collagen affects you adversely and makes you feel more depressed, more anxious and experience worse sleep, can you relate to any of the above scenarios?  

More questions and looking for your feedback

As you can see we have very different experiences but there are enough unanswered questions we need to be asking:

  • Are the negative effects because of low serotonin? If yes, are some of us more susceptible to the serotonin-lowering effects than others and should we stop using collagen despite all the health benefits?
  • And should we be assessing for low serotonin levels before using collagen or gelatin, and supplementing with tryptophan when it is low (more on this below)? There is one company that has added tryptophan to their collagen – is this a good idea?
  • Or are the negative effects some people experience due to glutamates, arginine, histamine, because of quality issues and glyphosate levels, an increase in oxalates or something else such as not eating enough animal protein?

I’ll address the above questions and share some additional research and feedback from collagen experts in part 2 of this article.

Until then, if you have observed a mood dip or increase in anxiety since using collagen or gelatin, I would suggest you stop using collagen/gelatin and see how you feel, then add it back and see how you feel. If you do see a correlation, do the low serotonin questionnaire and a trial of tryptophan (after checking the precautions) to see if this improves your mood when using collagen/gelatin. I recently blogged about tryptophan here (brand is important).

I would love your feedback. Do you use gelatin or collagen regularly i.e. daily or weekly? And why do you use it? How do you use it and what benefits do you notice?

Have you noticed any worsening of mood or an increase in anxiety or any of the other low serotonin symptoms? Do you take tryptophan to offset the fact that gelatin or collagen doesn’t contain any tryptophan?

Have you done the off/on test with collagen/gelatin and what was the outcome?

I’d love your feedback in the comments. Be sure to share what you’re using (collagen or gelatin and the brand), how much, how often you consume it, what you take it with, how much caffeine you consume, how much protein you consume on a daily basis and what kind of protein, and how you react to home made bone broth. If you’re comfortable with sharing how you score on the low serotonin questionnaire (now or in the past i.e. are you prone to low serotonin) and if you’re using a SSRI (or have in the recent past), this may help us piece the puzzle together.