everywomanover29

Food, Mood and Women's Health – Be your healthiest, look and feel great!

PTSD/Trauma

Around my period I definitely feel the need for extra tryptophan if I’ve had some extra heavy emotional stuff come up that I need to process

By 6 Comments

period and extra tryptophan

Many women find that they need additional nutritional support i.e. tryptophan for serotonin support (and often GABA too) around their periods. Today’s case study highlights the hormonal shifts that may lead to a situation where it appears tryptophan doesn’t work, then it does work, and then sometimes it doesn’t work as expected. The variable results and the need to switch between lower and higher doses on an ongoing basis can occur with PMS (premenstrual syndrome) PMDD (premenstrual dysphoric disorder, a severe, sometimes disabling extension of premenstrual syndrome). The variable results can also be more pronounced while recovering from trauma.

This case study is a follow-on from a blog I recently published: Tryptophan doesn’t work, then it does and then it doesn’t: could it be hormonal shifts, dietary factors and/or parasites?

Here is Kimberley’s feedback on the Facebook post that discussed these variable results. She shared how her hormonal shifts led to a need for additional tryptophan and 5-HTP:

Around my period I definitely feel the need for extra tryptophan. My PMDD symptoms have decreased since I started using tryptophan/5-HTP, but sometimes I need a bit more if I’ve had some extra heavy emotional stuff come up that I need to process (since that always happens with my period!).

I thanked her for sharing and said how happy I was for her. I also asked what symptoms have decreased and how much? I also asked how much tryptophan and 5-HTP she uses before her period and then around her period?

I was also curious if she just experimented with different doses until she figured it out or had she heard me talk about the PMDD tryptophan study: A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria. In this study tryptophan was found to reduce symptoms of PMS when used in the luteal phase or second half of the cycle (i.e. after ovulation).

Her low serotonin symptoms have decreased as much as 75-80 percent

Kimberley confirmed that she had read the above study and related blog post – Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability – and more about her symptoms:

I had read the blog you referenced, which is one of the reasons I tried tryptophan in the first place.

I was experiencing a lot of emotional distress, feelings of downright despair that left me miserable both during my period and ovulation (half the month, every month, which was truly awful). Those have definitely decreased, sometimes as much as 75-80 percent, other times they’re worse and I feel like I need more support.

I usually take 1x Lidtke 5-HTP (50mg) mid-afternoon and 1x Lidtke Tryptophan (500mg) at bedtime, but yesterday I increased to 2x Lidtke Tryptophan and do feel an improvement in my mood this morning.

I experimented to get the right dose of both amino acids, initially increasing to the maximum you recommend, and then slowly decreasing to what I’m taking now when I found I didn’t feel well when I took too much.

I just reread the blog you linked above and realized I should be using GABA every day to support progesterone (instead of just as needed for anxiety). Thanks for the reminder!

I love that after reading the blog she was inspired and motivated to experiment with different doses when she is/was feeling so bad. I encouraged her to continue trialing different doses at various times of the month especially in the second half of the month. I also reminded her that some folks do better with tryptophan and some do better with 5-HTP when it comes to low serotonin symptoms. And to continue to look at why serotonin is low and address that. Low GABA (related to low progesterone) can cause increased anxiety at this time and is a common issue with PMS/PMDD.

(You can see the entire list of low serotonin and low GABA symptoms here.)

She plans to continue experimenting with tryptophan and 5-HTP and may also try switching over to just 5-HTP and see if that changes anything. It’s unlikely that she would benefit from much higher doses of either as she shared “I don’t seem to be able to take more than 2 caps of either one without getting uncomfortable symptoms, though.”

Exercise and yoga for her low serotonin and PMDD

She did share how much exercise helps her mood, why she isn’t able to exercise as much:

The biggest thing I know to do to address low serotonin is add more exercise into my life, but this has been hard lately because I’ve had a couple of different viruses recently that left my exercise intolerance worse than it had been. I’m trying to support my mitochondria right now and add light exercise back in slowly.

Exercise is a wonderful way to raise serotonin levels and aerobic exercise has been shown to reduce the symptoms of PMS too. Yoga may be an option while she is recovering. In one study, yoga was found to be beneficial for PMS: “Alpha-brain waves production due to regular yoga practice are directly related with state of peace, creativity, mood elevation, relaxation, and release of serotonin, thus leading yoga practitioners feel more relaxed.”

Trauma: cortisol, serotonin, dopamine and estradiol

Kimberley also shared how how trauma plays into her situation:

I think some of the reasons for my health issues, low neurotransmitters, etc., are trauma related and I’ve been working through Dr. Aimie Apigian’s programs for that. But that’s another story.

I respect Dr. Aimie Apigian’s work in trauma and somatic experiencing and acknowledge this aspect must be addressed too. I love that Dr. Aimie brings this together with a functional medicine approach, looking at biology/biochemistry too. Recent trauma research confirms that there are major biochemical mechanisms involved in PTSD (post-traumatic stress disorder). These can include impacts to cortisol, serotonin and dopamine levels. And women are more vulnerable to these effects.

A 2021 paper, Estradiol, stress reactivity, and daily affective experiences in trauma-exposed women discusses high cortisol and more severe symptoms around their periods when estradiol (one of the estrogens) is low. As I mentioned above, estrogen and serotonin are closely related. The authors state this:“For women who are cycling, it may be useful to understand how the menstrual cycle affects their symptoms. When you can explain what’s happening biologically, it often becomes less threatening.”

Yoga may provide added psychological benefits as she works through her past trauma too.

Kimberly gave me permission to share her story and this is always something I appreciate so others in my community can learn from these types of experiences. If needed, I hope this her story gives you confidence to experiment with different doses and combinations around your period.

She also benefits from the comments from others on Facebook and the comments here on the blog, our back and forth, and this blog post.

She promised to keep me posted on how she goes and I’ll be sure to share when I hear back from her.

Resources if you are new to using tryptophan, 5-HTP and GABA and the amino acids as supplements

If you are new to using the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low GABA symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low GABA or low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acid products that I use with my individual clients and those in my group programs.

Have you found you need additional tryptophan/5-HTP or GABA around your period? How have you experimented and how does it help you?

If you’re a practitioner, have you seen this with clients or patients?

Do you also feel better with exercise and/or yoga?

And are/were your variable results more pronounced while recovering from trauma?

Feel free to ask your questions here too.

Trauma: fluctuating between a high anxiety panic state and a low energy freeze response (with low endorphins and a numbing feeling)

By 6 Comments

trauma

The freeze response in trauma is not well understood and is a low energy state. When the anxiety has become so high or severe it triggers a low energy or freeze state in order for you to survive. There is also the feeling of numbness and being disconnected when in the freeze state and this eventually becomes the default pattern that the nervous system has been wired into. Healing can start with somatic work and using a functional medicine and nutritional psychiatry approach to address the biological underpinnings of trauma.

Dr. Aimie Apigian, MD, MS, MPH discusses all this and much more in her interview on the Anxiety Summit 5: Gut-Brain Axis, Nov 8-14, 2021.

And then Dr. Aimie interviews me and we discuss how folks with low endorphins are often in the freeze state. These folks are more emotionally sensitive to everything and because of this they experience much more stress. They also experience a feeling of numbness and feel disconnected. The encouraging news is that the amino acid DPA (d-phenylalanine) helps ease the low endorphin symptoms while they are recovering. More on all this below.

The freeze response in trauma is not well understood and is a low energy state

Let’s start with this interview with Dr. Aimie – Biology of Trauma and the Freeze Response. This is what we cover:

  • Identifying the freeze response and symptoms when anxiety is high
  • The role of the microbiome, neurotransmitters, oxidative stress, mitochondria and cortisol
  • Somatic work when in the chronic freeze state: containment hugs and marking your territory

dr aimie

Dr. Aimie explains that the freeze response in trauma is not something that’s been really well understood:

  • When we talk about just trauma and mood, and stress even, it’s like we still lump everything in that fight, flight, or freeze response. And the fight and flight response could not be more different than the freeze response.
  • On a biological level, they are completely different biology states, which means that it is humanly impossible to be in both of those states at the same time. So when we look at this freeze response, okay, so what is it? If it’s not fight or flight, what is it?

She shares how the anxiety has been become so high or severe it triggers a low energy or freeze state in order for you to survive:

  • When we look at what it is, it’s when the anxiety has become so high that the body is not able to sustain that level of both anxiety, but it’s really an energy level.
  • Because anxiety is a high energy state and it triggers this response in the body where it says, “Ooh, this is unsustainable,” and in order to survive, for our best interests, it would be better for us to go into a low energy state.
  • And it feels like giving in, giving up. It feels like giving up the fight because the body just goes into this, I kind of call it like, it shifts down into first gear.
  • You’re no longer zooming along in fifth or sixth gear, you just kind of shift down into first gear and now you’re just going through life.

The feeling of numbness and being disconnected when in the freeze state

In addition to the low energy state, this is where Dr. Aimie talks about the feeling of numbness and being disconnected when in the freeze state:

  • Now you’re just going through your day, you feel a little numb, you feel a little disconnected.
  • But the trigger for that freeze response originally comes from the anxiety level, which really becomes a level of fear, terror, panic.

Dr. Amie also shares how this becomes the default pattern that the nervous system has been wired into:

  • And people can have what I call a strong pull towards the freeze response so that they no longer are even aware of the fear and the terror.
  • They just feel anxiety and boom, they go straight into the freeze response because it has just become that default pattern that the nervous system has been wired into.

The biology of trauma and somatic work

She goes on to discuss the biology of trauma and the role of the microbiome, neurotransmitters, oxidative stress, mitochondria and cortisol in contributing to the freeze response (i.e. making you more susceptible to trauma) and as factors we can address in order to facilitate recovery and healing.

Dr. Aimie also describes the somatic work she does with her patients who are in the chronic freeze state: exercises like containment hugs and marking your territory. She shares that “I want people to experience their nervous system. I want them to know what it feels like, be able to actually recognize which state of the nervous system they are in at any given moment in time, and be able to feel what that feels like in their body, because then that’s how we teach them how to shift that.”

In her work and in this interview, Dr. Amie brings the world of trauma recovery and somatic work to the functional medicine and nutritional psychiatry world. It’s an eye-opening interview you don’t want to miss.

The connection between the trauma freeze response and low endorphins

Also featured in the summit is another interview where Dr. Aimie happens to interview me on this topic: Glutamine, DPA and Tyrosine for Anxiety and Sugar Cravings. We cover the following:

  • Sugar addiction: impacts on the microbiome, tryptophan metabolism, zinc & B vitamins
  • Glutamine for intense sugar cravings, anxiety & support of the microbiome/mucosa
  • DPA for comfort/reward cravings, pain & acute stress; tyrosine for focus & calm energy

It’s during this interview that I make the connection between the trauma freeze response and low endorphins when we are discussing the last bullet above.

As a reminder, these are the mood symptoms of low endorphins:

  • Heightened sensitivity to emotional pain
  • (and also Heightened sensitivity to physical pain)
  • Crying or tearing up easily

And these are the ways sugar cravings often show up when you have low endorphins:

  • Eating to soothe your mood, or comfort eating
  • Really, really loving certain foods, behaviors, drugs, or alcohol
  • Craving a reward or numbing treat

dr aimie

As I share about the endorphins and how I use the amino acids DPA and/or DLPA to boost endorphin levels, I remember how Dr. Aimie discussed the numbing effect when someone is in the freeze state and it made me think about endorphins. So I ask Dr. Amie if she finds that folks with low endorphins are often in the freeze state.

Dr. Amie says most definitely yes and shares that with the low endorphins, people in the freeze state really are more emotionally sensitive to everything and because of this they experience much more stress:

  • From my perspective, working with a lot of the trauma response … they are much closer … to that line of overwhelm.
  • So most definitely, yes. And it’s that comfort, right? It’s that self-soothing, and it’s the numbing effect. The numbing effect of reaching for food when you’re not hungry. It’s just for numbing the emotional sensitivity that you have with low endorphins.
  • Endorphins really affect the stress levels and then mood, and then inflammation? It starts this cascade of changes in their biology because of the low endorphins and the increased amount of stress that they experience with that sensitivity.

This discussion tied in perfectly to the study I had to share: The Role of Beta-endorphin in Stress, Behavior, Neuroinflammation, and Brain Energy Metabolism.

In this 2020 paper, the authors discuss beta-endorphins in the context of reward-centric behaviors, pain, neuroinflammation, immune function and also how endorphins attenuate (or reduce the effects of) the acute stress response. They also share how endorphins exert a regulatory effect on serotonin levels.

I find the latter link to serotonin very interesting and will be digging deeper into this in another blog post.  I’ll also be digging into the low endorphins aspect of the trauma freeze response in the coming months. And I want to learn more about the somatic work that Dr. Aimie uses – to experience some of it myself and to bring to my community i.e you! I do love that I also get to learn so much when I do these interviews.

Use DPA to ease the weepiness and need to numb out with comfort food or behaviors

For now, if you have experienced trauma and recognize being in the freeze state, and you feel numbed out and disconnected, and also relate to the above other low endorphin symptoms, I would do a trial of DPA (the amino acid d-phenylalanine) and see how you do. It will likely help ease some of the low endorphin symptoms while you are recovering.

Keep in mind that you can also have low endorphin symptoms without having experienced trauma. I see this with many of my clients and it’s not uncommon to also have low serotonin worry and low GABA physical anxiety symptoms too..

In both instances, I would do a trial of DPA (I like the Lidtke Endorphigen product) and see how you do. If it is low endorphins you’ll ease the weepiness and need to numb out with comfort food or behaviors (such as endless scrolling on social media). You can expect to see results in 5-10 minutes when the DPA is opened onto the tongue.

To recap, be sure to tune in to these 2 interviews to see how it’s all connected and to hear more about trauma, the biology of trauma and how to use amino acids to balance neurotransmitters:

  • Aimie Apigian, MD, MS, MPH – Biology of Trauma and the Freeze Response
  • Trudy Scott, CN – Glutamine, DPA and Tyrosine for Anxiety and Sugar Cravings

These interviews dove-tail well with this topic of trauma, the freeze response and neurotransmitters:

  • Navaz Habib, DC, AFMCP – Vagus Nerve Activation to Reduce Anxiety (because vagus nerve activation habits speed trauma recovery)
  • My other amino acid interview, Cravings and GABA & Tryptophan: Gut-Anxiety Connections (because the amino acids help to support low serotonin and low GABA which is common with trauma)
  • Evan Brand, CFMP, NTP – Floatation Therapy for Anxiety and PTSD (because floatation therapy is gentle and yet effective)
  • Eric Zielinski, DC – Essential Oils for Anxiety and Digestion (because essential oils are well tolerated and effective)
  • David Jockers, DNM, DC, MS – Fasting for Anxiety and Gut Health (he talks about the effects of fasting on endorphins and serotonin)

I encourage you to register and tune in if you have:

  • Anxiety & feel overwhelmed & stressed by little things
  • Panic attacks &/or obsessive thoughts or behaviors
  • Social anxiety/pyroluria
  • Phobias or fears (flying, spiders or even driving on a highway)

And also if you suffer from…

  • Food sensitivities, IBS/SIBO, parasites or gallbladder issues
  • Constipation, diarrhea, bloating, gas, pain & other digestive issues
  • Leaky gut, a leaky blood-brain barrier or vagus nerve issues

Join us if you are also an emotional eater with intense sugar cravings (and know you suffer from low blood sugar), experience insomnia, low mood, PMS, poor focus and/or low motivation.

This is THE online event to learn about the powerful individual amino acids – GABA, theanine, tryptophan, 5-HTP, glutamine, DPA and tyrosine – to quickly ease anxiety and help with gut symptoms while you are dealing with other root causes which take longer to address. (They also help with cravings as with this example, and sleep and immunity).

anxiety summit 5

With research-based anxiety nutritional solutions and practical steps, you can determine your root causes, ease your anxiety and prevent it from coming back so you can feel on top of the world again!

If you are a practitioner, please join us too and find advanced solutions for your clients or patients too!

You’ve heard me say the Anxiety Summit has been called “a bouquet of hope!”  My wish for you is that this summit is your bouquet of hope!

I hope you’ll join me and these incredible speakers, be enlightened and find YOUR solutions!

Here’s to no more anxiety and you feeling on top of the world again!

Register now

 

Can you relate to the freeze state and fluctuating from a high energy anxiety/panic state?

When you’re in the freeze state do you feel numb and disconnected?

Have you had success with somatic work? And also using a functional medicine approach to healing?

Also let us know if you’ve benefited from using DPA to help ease the low endorphin symptoms?

Feel free to post your questions here too.

Rage, anxiety, cravings & insomnia in 11-year old girl with RAD/reactive attachment disorder: chewable tryptophan turns things around

By 16 Comments

rad and tryptophan

Today I’m sharing the case of an 11-year-old girl who had huge rage issues, was angry much of the time, suffered from terrible anxiety, had crazy sugar cravings (for bread and colored candies) and had dreadful insomnia. Because of the insomnia she was also very fatigued and this likely drove some of her cravings and irritability too. She was adopted and had been diagnosed with RAD (reactive attachment disorder). During our first session, chewable tryptophan turns things around quickly – she smiles and is willing to make changes and quit the sugar and gluten. We also address low iron levels and with these 4 nutritional interventions this child’s behavior improves dramatically.

This book chapter, Reactive Attachment Disorder, states how The Diagnostic and Statistical Manual 5th Edition (DSM-5) classifies reactive attachment disorder as follows:

a trauma- and stressor-related condition of early childhood caused by social neglect or maltreatment. Affected children have difficulty forming emotional attachments to others, show a decreased ability to experience positive emotion, cannot seek or accept physical or emotional closeness, and may react violently when held, cuddled, or comforted. Behaviorally, affected children are unpredictable, difficult to console, and difficult to discipline. Moods fluctuate erratically, and children may seem to live in a “flight, fight, or freeze” mode. Most have a strong desire to control their environment and make their own decisions. Spontaneous changes in the child’s routine, attempts to discipline the child, or even unsolicited invitations of comfort may elicit rage, violence, or self-injurious behavior.

Reactive attachment disorder/RAD and low serotonin

There is no research on tryptophan helping to address RAD symptoms or trauma, but based on her low serotonin symptoms, a trial of tryptophan was the first thing I considered.

There is, however, evidence to indicate the role of low serotonin in RAD, as indicated by a study where antidepressants were successfully used. The authors mention how:

The absence of responsive and consistent caretaking can subject the developing brain to an inordinate amount of physiological stress, leading to increased cortisol production and consequential inefficiencies in the serotonin and the growth-hormone releasing systems.

Although not specific to RAD, another paper looking at trauma states that:

Serotonin and dopamine levels were found to be abnormal in the presence of PTSD.

As the field of nutritional psychiatry grows, I expect to see more and more research supporting the use of tryptophan and other amino acids for those suffering from symptoms like this. Symptoms that are caused by imbalances that are triggered by the trauma in their lives.

We know that therapy, EFT, EMDR and other approaches are crucial for trauma recovery (this family had already done some of this work) but we must start to incorporate nutritional support too.

The case study

Here are the details of this case study and the nutritional interventions. As I mentioned above, because of her severe rage episodes, a trial of tryptophan was the first thing I considered:

She was referred to me by a friend. The family didn’t have much money. And so, we had to really try and figure out a few simple interventions that we could use that were going to be effective.

This young girl had been adopted. She was diagnosed with reactive attachment disorder and her anger issues were just phenomenal. The mom had to physically put her body around her and hold her down when she was having one of her fits because she was worried that she was going to hurt herself and hurt other people.

She also had anxiety, huge cravings for colored candies and insomnia. She was so fatigued because she wasn’t sleeping well.

So sitting in my office with this young girl and her mom, we started to talk about the sweets and the candies and the need to give up the candies. She was fuming with me. She was sitting in a swivel chair. She turned her back on me and didn’t want to talk about having to give up candy at all.

I said, “Look, let’s not even talk about that, but would you take this chewable tryptophan here? And we’ll talk about it in a second.” I gave her 100 mg of the chewable tryptophan and continued discussing things with her mom.  She had no idea what it was going to do or how it would make her feel.

Within five minutes she turned her chair back, looked at me and she said, smilingly, “Yes, let’s do it. I can give up the candy.” She was smiling and she was happy.

So long story short, with this young girl, we started her on [chewable] tryptophan [and it turned things around quickly].

Chewable tryptophan – when I use it and when I don’t

I typically use 500mg Lidtke tryptophan for the adult clients I work with and prefer this company’s product because it is really high quality. It really does work better than many other tryptophan products on the market.

Lidtke also makes a chewable 100mg tryptophan which is also high quality, and the product I used with this young girl. Here are some benefits of this 100mg product:

  • It’s useful for doing the initial trial in order to figure out if tryptophan is going to help with low serotonin symptoms in children – because it’s a lower dose.
  • It’s especially useful for children for ongoing use (typically midafternoon and evening) because it’s a lower dose.
  • It’s also useful for adults who are “pixie dust” folks and do better with a lower dose of supplements in general or respond more severely to medications/alcohol/chemicals. We may start with a trial of the 100mg chewable and increase from there, also typically midafternoon and evening.

I don’t use the chewable 100mg tryptophan under these circumstances:

  • When the child (or adult) finds that 5 x100mg works for them at each time they need it. In this instance it’s best to switch to a 500mg tryptophan. Using it swallowed may work or it may need to be opened onto the tongue.
  • When the child (or adult) starts to consume the chewables like candy. They are sweet and do taste good and I’ve seen this happen. Because you are continually consuming something sweet you may end up over-consuming them if sugar addiction is one of your issues. You may also end up taking too much tryptophan.

If the chewable tryptophan is not available where you live, using a small amount of a powdered tryptophan or opening a capsule of the 500mg tryptophan is an option. Since it tastes bitter it can be mixed with mashed banana or inositol. (You can find all the Lidtke products in my online supplement store. The link is in the resources section below.)

Gluten and candies were also a huge issue, and she had low iron

There was more to her issues than only low serotonin:

Gluten was also a huge issue, so we got her off gluten and the candies. The tryptophan helped with this” (i.e. it made it easy to break the addiction and not feel deprived).

Tryptophan also helped her sleep. And it helped with the severe rage issues.

Obviously the gluten was contributing to the rage issues as well.

Her iron and ferritin levels were really low (possibly as a result of her gluten issues). So we added an iron supplement, and animal protein/red meat.

So with just four interventions – the gluten, the animal protein, getting her iron levels up and the tryptophan – this kid was just a new kid.

Here are some articles that are related to the above:

Keep in mind there is not a one-size-fits-all and these 4 simple nutritional interventions – tryptophan, gluten removal, adding red meat and addressing low iron – happened to be the combination that worked for this young girl.

Resources if you are new to using tryptophan as a supplement

If you are new to using the amino acid tryptophan as a supplement, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low serotonin symptoms and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists Lidtke chewable tryptophan 100mg, Lidtke tryptophan 500mg and other products that I use with my individual clients and those in my group programs.

We use an amino acid like tryptophan for quick relief of symptoms, like I did in this instance. Then we focus on the foundations like diet – like no gluten and red meat in this instance – and address all other imbalances, like her low iron. If cortisol was high we would have addressed that.

This case deserves it’s own blog post

In case you’re wondering, I first shared this case study in my interview, “Calming Anxiety, Aggression and OCD with Amino Acids and Food”, on The Unlocking ADHD and Autism Summit (it starts next week and airs online May 31 – June 6, 2021.) Due to the interest in this case and the use of chewable tryptophan, I felt it deserved a deeper dive and its own blog post with links to some of the research and some practical information about the chewable tryptophan.

Have you used this chewable tryptophan product with success – personally, with your child or with a patient/client?

Have you found that addressing serotonin with tryptophan (or 5-HTP) helps resolve symptoms in a child diagnosed with RAD or a child with rage issues? What about helping with sleep problems, easing anxiety and stopping cravings too?

Have you addressed low iron levels and seen improvements with the removal of gluten too.

Feel free to post your questions here too.

 

[The above statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.]

Depression, anxiety and intergenerational trauma due to racism in the Black community

By 12 Comments

anxiety in black community

I feel sickened by George Floyd’s death and the police brutality we all witnessed. I stand by Black Lives Matter and an end to racism, social injustice and inequalities. In the light of current events in the USA and around the world, today’s article highlights the prevalence of mental health in the Black community, the biological impacts of trauma, racism and intergenerational trauma, some reasons why mental health services are not being used, the impacts of racism on physical health and some resources geared to Black mental health.

In this recent article by Columbia University Department of Psychiatry, Addressing Mental Health in the Black Community, we learn the following:

Research suggests that the adult Black community is 20% more likely to experience serious mental health problems, such as Major Depressive Disorder or Generalized Anxiety Disorder.

Additionally, Black emerging adults (ages 18-25) also experience higher rates of mental health problems and lower rates of mental health service utilization compared to White emerging adults, and older Black adults.

What shocked me was reading this statistic: “the Black community comprises approximately 40% of the homeless population, 50% of the prison population, and 45% of children in the foster care system.” All of this puts the Black community is at more risk for mental health issues.

The article also highlights the biological impacts of trauma“through enslavement, oppression, colonialism, racism, and segregation” and shares that “intergenerational trauma may be passed down biologically from one generation to the next.”

Some of the factors that may lead to mental health services not being used amongst the Black community are lack of trust, lack of finances and fear:

Lack of trust in the medical system due to historical abuses of Black people in the guise of health care, less access to adequate insurance, culturally responsive mental health providers, financial burden, and past history with discrimination in the mental health system.

I encourage you to read the entire article at this link.

This paper, Transgenerational Consequences of Racial Discrimination for African American Health goes further into the intergenerational effects of racism on both psychological and physical health: immune health, heart health, obesity, diabetes and so on. The paper concludes as follows:

without addressing the harmful consequences of racial discrimination, improving the health of African Americans as well as other marginalized groups, will remain inadequately addressed.

This inspiring quote is from Nelson Mandela from his autobiography, Long Walk to Freedom  (1994) and no-one says it better than him. It is a message of hope!

Nelson Mandela Quote
from the Nelson Mandela facebook page

Here are some resources geared specifically to Black mental health

With regards to nutritional support for anxiety, depression and PTSD, everything that I write about in terms of nutritional psychiatry applies. My book, The Antianxiety Food Solution, covers the foundations of diet and how to use amino acids. This recent blog, The psychological trauma of coronavirus – nutritional support for doctors, nurses and their loved ones could easily be adapted to be: The psychological trauma of racism – nutritional support for the Black Community.

I am very aware that when it comes to working with a functional medicine practitioner or a nutritionist, and purchasing supplements/doing special diets may be a major stumbling block for many Blacks with financial hardships. This needs to become the standard of care so everyone has access to resources like these.

Until then finding access to real whole foods is a powerful first step.  In the SMILES diet depression trial,  the first randomized controlled diet depression study, ONE THIRD of the dietary intervention group saw improvements in their depression and anxiety symptoms. This was simply by switching from processed/junk food to real food with no specific dietary restrictions.

This is the power of nutritional psychiatry:

Although the growth in scientific research related to nutrition in psychiatry may be recent, it is now at a stage where it can no longer be ignored. In light of this, we aim to provide a platform to move towards a new integrated paradigm in psychiatry whereby nutritional considerations (both educational and prescriptive) can be considered “mainstream”.

The International Society for Nutritional Psychiatry Research/ISNPR made the above statement via a letter published in 2015 in World Psychiatry, the official journal of the World Psychiatric Association –   “International Society for Nutritional Psychiatry Research consensus position statement: nutritional medicine in modern psychiatry.” You can read more about this here.

This recent paper, Nutritional Psychiatry: Towards Improving Mental Health by What You Eat, further adds to the discussion, providing an “overview of the emerging field of nutritional psychiatry, exploring the scientific evidence exemplifying the importance of a well-balanced diet for mental health.”

I recently heard integrative psychiatrist Dr. Kelly Brogan, share this on The Trauma and MindBody Super Conference:“it’s best to address trauma when your nervous system has physiologically improved.” She always starts with addressing physiology: diet, gluten issues, the gut and microbiome, blood sugar stability, micronutrient deficiencies such as low B12, low thyroid and other contributing physiological root causes.

By incorporating nutritional psychiatry and functional medicine approaches we can provide additional healing support for the depression, anxiety, current trauma and intergenerational trauma caused by racism and inequalities.

Updates 7/7/20:

The above SMILES Diet Depression study doesn’t mention race. There are, however, many studies that didn’t make it into the blog because I felt compelled to publish something quickly.

 Here are some of them:

China, Ghana, India, Mexico, the Russian Federation, and South Africa…examine the relationship between demographic and lifestyle characteristics and depression….. Increased fruit and vegetable intake appeared to co-occur with significantly lower rates of depression, suggesting diet as a modifiable factor for addressing depression burden.

Among overweight/obese women, improvement in health-related quality of life related to physical health, a significant decrease in depressive score, and a reduction in waist circumference were noted.

I am not an authority on Black mental health, racism or intergenerational trauma. As I look into the research, read articles and listen to podcasts, I acknowledge that I’ve been learning a great deal. And I know I still have much to learn.

I am, however, an authority on food and using a nutritional approach for anxiety. Real whole nutrient-dense food is the foundation and always will be – for every single human regardless of race.  We do, however, need more programs and studies that are specific for people of color. 

This needs to be a public health initiative where we also address the food security issues. According to this paper, Food Insecurity and Maternal Mental Health Among African American Single Mothers Living With HIV/AIDS in the Alabama Black Belt, “Food insecurity places low-income African American women at risk of depression.”  This is one of many similar such studies.  

Together with this we need to address racism. This paper, Experiences of Racial and Ethnic Discrimination Are Associated with Food Insecurity and Poor Health, sums up with this:

Public health interventions intended to improve food security and health may be only partially effective without simultaneously addressing racism and discrimination

If you have information on non-profit organizations, community gardens, community kitchens and other resources for supporting Black communities when it comes to nutritional supplements, food insecurity and food deserts, and eating real foods please share in the comments.

For now check out and be inspired by Ron Finley, the Gangsta Gardener – and his amazing community garden and gardening masterclasses: 

Ron envisions a world where gardening is gangsta, where cool kids know their nutrition and where communities embrace the act of growing, knowing and sharing the best of the earth’s fresh-grown food. 

Determined to change South Central Los Angeles from food desert to food forest, he wants his actions to be educational, inspiring, and nutritious. He wants kids to grow up with the option of healthy food, instead of fried, fattening staples. He wants to sweep up and transform his street, his hood, the city of LA and communities everywhere.

Please also share your experiences supporting mental health in Black communities. And if you’ve been subject to racism and felt the mental and physical effects please share too. We’re here to support you and learn how we can do better.

MDMA-Assisted Psychotherapy for Treating Chronic PTSD: Why I feel we can do better and the role of nutrition and amino acids like GABA

By 5 Comments

You may be familiar with MDMA (3,4-methylenedioxymethamphetamine), also known as “ecstasy”, because of its reputation as a party drug. And you have likely seen some of the media reports on the new research and growing support for MDMA-Assisted psychotherapy for treating chronic PTSD (post-traumatic stress disorder). Due to adverse effects I’d like to share my concerns about this research and treatment and why I feel we can do better – by addressing nutrition and using amino acids like GABA and others.

In a recent press release, Colorado Study Shows Lasting Benefits of MDMA-Assisted Psychotherapy for Treating Chronic PTSD, the non-profit organization, Multidisciplinary Association for Psychedelic Studies (MAPS) reports these study results:

28 participants found that one month after their second day-long experimental session, 42.9% in the active-dose (100 mg and 125 mg) MDMA groups did not qualify for a diagnosis of PTSD, compared to 33.3% in the low-dose MDMA (40 mg active placebo) control group.

The results were even more notable 12 months after the third active-dose experimental session, which found that one year following treatment with MDMA-assisted psychotherapy, 76% of participants no longer had PTSD.

It is the largest U.S. FDA-regulated double-blind, placebo-controlled clinical trial of MDMA-assisted psychotherapy for the treatment of chronic PTSD and the results are impressive: 76% of the study participants no longer had PTSD after a year and 3 treatment sessions. I’m really happy for the participants BUT I believe we can do better because there are adverse reactions to this treatment and there are other safer approaches for recovery.

This comment about an acceptable risk profile and adverse reactions concerns me (and I suspect it concerns you too):

The study replicated previous research showing an acceptable risk profile for MDMA, with the most frequently reported adverse reactions during experimental sessions being anxiety, jaw clenching, headache, muscle tension, dizziness, fatigue, and low mood.

Adverse reactions one week following treatment included insomnia, low mood, irritability, and ruminations. Temporary elevations in pulse, blood pressure, and temperature were also recorded during MDMA sessions, and did not require medical intervention.

A common theme we see in the research on psychedelics is how effective it is for PTSD that doesn’t respond to therapy or medications. This paper states:

There is an immense need for innovative treatment options that improve outcomes, especially for PTSD refractory to psychotherapy and/or pharmacotherapies

I agree there is an immense need for successful treatment approaches, but jumping to MDMA from psychotherapy and/or psychiatric medications is skipping out the entire nutritional and biochemical step which is SO powerful and doesn’t have the above adverse effects. I’m concerned too many who have not seen benefits from therapy or medications are seeing MDMA as THE solution and are going to be harmed even further.

This paper, The Potential Dangers of Using MDMA for Psychotherapy, the author is concerned about the fact that “acute MDMA can stimulate the release of difficult feelings and memories, which may be distressing” and also the negative moods that occur after MDMA treatment:

This period of negative cognitions may be counter-productive, especially in psychiatrically vulnerable clients, for instance those with predispositions to anxiety, depression, or psychosis. For example, it could increase the likelihood of suicide in those individuals with strong post-recovery feelings of depression.

Because of this, I wholeheartedly agree with the author’s position:

it will always be far safer to undertake psychotherapy without using co-drugs. In selected cases MDMA might provide an initial boost, but it also has far too many potentially damaging effects for safe general usage.

In addition to psychotherapy, there are also so many nutritional and biochemical factors we can consider when it comes to PTSD. These don’t have any of the above damaging effects seen with MDMA. Here are a few to consider:

I feel it is these above approaches and others like this that we need to be using to address PTSD, rather than subjecting individuals who are already suffering to treatments that have adverse reactions AND are not addressing underlying nutritional deficiencies of low GABA, low serotonin, out of balance endocannabinoid system and overall health, to name a few of many possible underlying biochemical factors.

If this treatment approach is approved, I would hope that all the adverse effects and dangers are clearly explained and I’d also like there to be informed consent before it is used – so individuals know exactly what they are getting into. Hopefully, by the time it is approved, nutritional psychiatry will be more accepted.

I’d love to hear your thoughts on this research and treatment approach. Is it something you have considered or would possibly consider in the future – you personally or with patients?

Or do you have similar concerns that I have?

Have you already tried MDMA recreationally (possibly for therapeutic reasons) and what were your experiences like?

PTSD from 3 tours in Afghanistan: Can GABA help with the anxiety?

By 23 Comments

My husband is suffering from PTSD [post-traumatic stress disorder] from 3 tours in Afghanistan. Can [GABA] help with the anxiety he is experiencing. Your thoughts?

I received the above question in response to one of my blogs addressing GABA for the physical, stiff-and-tense muscle type of anxiety.

It’s very likely that GABA will help ease some of the anxiety he is experiencing. Anxiety can have many root causes and with PTSD I would look into neurotransmitter imbalances first and use three key amino acids to address these three possible root causes, before digging deeper to address other nutrient deficiencies and root causes that may take longer to address.

Amino acids to provide some anxiety relief quickly

In order to provide some anxiety relief as quickly as possible I would assess for low GABA, low serotonin and low blood sugar using the amino acid questionnaire:

  • With low GABA he could be experiencing physical anxiety, muscle tension and the need to self-medicate with alcohol or sugary foods in order to calm down and relax. We would do an amino acid trial with calming GABA. Research also now shows that GABA helps with unwanted obtrusive thoughts which are common with PTSD.
  • With low serotonin he could be experiencing mental anxiety, ruminations, fears, phobias, anger and irritability and probably insomnia. We would do an amino acid trial with tryptophan first and then 5-HTP if the tryptophan isn’t helping and we know cortisol is not high.
  • With low blood sugar he could experience anxiety and feel extra stressed when he goes too long without eating. It’s likely he could also have an intense desire to eat candies and sweet treats. We would do a trial with glutamine and make sure he’s eating a breakfast that contains quality animal protein such eggs and bacon, or a protein smoothie.

High cortisol?

We would also want to determine if high cortisol is a driving factor of the anxiety. I’d want to see the results from a 4-collection cortisol saliva test (on waking, noon, around 5pm and around 10pm).

We would address adrenal issues (either high or low) with adrenal support of a good 50mg B-complex, extra pantothenic acid, vitamin C, and adaptogen such as rhodiola. If cortisol is high this can trigger anxiety and adrenaline-type surges and the phosphorylated serine product Seriphos used a few hours before the high cortisol is the best for lowering the high cortisol.

Recent research finds evidence that orange essential oil reduces fear and anxiety, diminishes immune system markers of stress in mice and may help alleviate PTSD and a blend of lavender, ylang-ylang, marjoram, and neroli (also a citrus oil) reduces stress and lowers cortisol too.

Other factors: gut health, diet, low vitamin D

When it comes to anxiety and PTSD, there are other factors to be considered:

Possible effects from malaria drugs and other toxic exposures  

If symptoms persist other factors like the effects of medications (or other toxic exposures) must be considered. In one case study, Malaria drug causes brain damage that mimics PTSD, a service member was diagnosed with anxiety, PTSD and a thiamine deficiency. Various treatments, including medication, behavioral therapy and vitamins didn’t help. It was determined that his symptoms were due to the anti-malaria medication mefloquine, which is now known to contribute to neuropsychiatric symptoms in susceptible individuals.

As with any anxiety condition, the root causes and solutions are unique to each individual and the above approach would be adapted based on each person’s unique needs and biochemistry. Additional approaches over and above these listed here may well need to be considered.