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Glymphatic system for brain detox: The Anxiety Summit 6

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Dr. Christine Schaffner is one of my guest experts on The Anxiety Summit 6: Toxins/Meds/Infections!
and our topic is: The Glymphatic System for Brain Detox

  • The astrocyte as the brain pacman for lead and mercury
  • Tonsils, aquaporins, lymph drainage, PANDAS, anxiety and OCD
  • GABA, sleep, anxiety and high-dose neuroprotective melatonin

and much more.

christine schaffner

Here is a snippet from our discussion on the glymphatic system, lead, astrocytes, GABA and aquaporin channels (paraphrased as I don’t yet have transcripts).

In case you’re new to the glymphatic system it is

a recently discovered macroscopic waste clearance system that utilizes a unique system of perivascular tunnels, formed by astroglial cells, to promote efficient elimination of soluble proteins and metabolites from the central nervous system.

Besides waste elimination, the glymphatic system also facilitates brain-wide distribution of several compounds, including glucose, lipids, amino acids, growth factors, and neuromodulators. Intriguingly, the glymphatic system functions mainly during sleep and is largely disengaged during wakefulness.

I’ve been dying to interview Dr. Schaffner since I first heard her present on this topic AND because it’s a relatively new discovery.

During the interview I ask her this question: We know lead (one of the heavy metals) can increase anxiety and cause panic attacks. How does lead adversely impact the glymphatic system?

Dr. Schaffner shares this:

Yes, lead is a neurotoxin and loves fat tissue. Because of this it impacts the health of the astrocytes (a sub-type of glial cells) and the flow of lymph around neurons. Lead can also compromise the blood brain barrier. The astrocytes act like a pacman to take up lead in the brain but they are also impaired by lead. This has an effect on GABA which is calming. GABA also helps the aquaporin channels work better which improves flow of lymph in the brain and helps with detox.

How incredible is this – I share how big a fan I am of GABA:

I’m a big fan of GABA.. .GABA used as a supplement helps to raise GABA levels (of the brain chemical GABA) so it’s calming and helps with sleep. And now we know it helps keep the aquaporin channels open and helps with detoxification of toxins like lead!

This is one of the registration gifts so you can listen to it right away as soon as you register (there will also be a complimentary transcript made available as soon as it’s completed.)

christine schaffner interview

Here is a little about the summit… as you know, anxiety can be related to your daily life experiences BUT it can also be triggered by:

  • foods you eat and what you drink (like wheat, oxalates, alcohol and more)
  • environmental toxins (like lead, plastics, fragrances, insecticides, fluoride and more)
  • many types of medications (like the birth control pill, acne medication, fluoroquinolone antibiotics and more) and/or
  • chronic infections (like Lyme disease, PANDAS, parasites, candida and more).

Once you identify the root causes and understand anxiety’s mechanisms you can support the liver/gallbladder, detox, address infections, implement targeted and supportive solutions, and get relief!

WHY ATTEND?

This is my 6th Anxiety Summit, featuring all new topics and the latest research related to anxiety and toxins, medications and infections.

I’ve also experienced many of these health challenges myself – lead and mercury toxicity, gluten issues and candida – and I’m currently dealing with chronic Lyme disease and dietary oxalate issues. You’ll hear some of my healing journey and my solutions in a few interviews too.

anxiety summit 6

WHAT SETS THIS ONLINE EVENT APART?

What sets this apart from other events on toxins and infections is being able to make the many connections to GABA (the main calming neurotransmitter) and serotonin (a happy and calming neurotransmitter) AND how to use  the amino acids GABA and tryptophan to ease your anxiety right away while you are dealing with the other underlying root causes – which take longer to address.

You will see this woven into each of the expert interviews (just like this one with Dr. Schaffner) and also addressed in detail in my 3 interviews where I do a deep dive into specific applications.

For example, in my toxins interview, I share how GABA reverses fluoride-induced anxiety and hypothyroidism, and how tryptophan and vitamin C ease anxiety symptoms associated with lead toxicity  (I’ll be sharing more about this in the future so stay tuned….)

Over the course of the next 6 weeks you’ll be seeing frequent emails from me with snippets and highlights from various interviews – like this one. I do hope you continue to enjoy them and get excited about the summit! Please do share if you know someone who has anxiety!

It’s been wonderful to get all the emails saying how excited you are and seeing so many of you signing up. These last few months have been full-time on research and interviews and I’ll shortly get to share it all with you!

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 here

 

If you’re already familiar with some of this information and practice some of this already please share how it’s helped you. That way we can all learn.

If you’d like to ask a question, please post in the comments below.

I’d also love to hear from you once you’ve listened to this interview. Please do come back and comment about some of the highlights of this interview and what changes you plan to make.

Even if you already receive my newsletters and signed up some time ago to be notified about the upcoming Anxiety Summit 6, you will still need to register at the new link here, because Health Talks Online is doing the production and backend work for me.

If you don’t register you won’t get access to the daily summit emails with all the interviews.

You will however, continue to get these emails from me.

This is my 6th Anxiety Summit and it is all new content!

The content is research-based and practical, and is geared to anxious individuals who are health-savvy and to practitioners who work with anxious individuals.

If you are totally new to functional medicine and nutritional solutions for anxiety, you will still learn so much so just take in what you can and know you’ll get all this eventually.

Anxiety Summit 6: Toxins, Medications and Infections – Products

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This blog is your go-to for the nutrients and products discussed on The Anxiety Summit 6: Toxins/Meds/Infections,  Nov 2-8, 2020 and mentioned in the summit eBooks. 

Top 10 Surprising Nutrients for Toxin Support and Anxiety Relief

These are the nutrients listed in the ebook: Top 10 Surprising Nutrients for Toxin Support and Anxiety Relief  [click here to download the PDF copy and read the research] 

#1 GABA supplementation eases physical anxiety and tension, and alleviates phthalate-induced anxiety

Learn more about GABA for easing anxiety and protection against other toxins in these interviews on The Anxiety Summit 6: Toxins/Meds/Infections  

  • GABA and Tryptophan: Anxiety-Toxin Connections – Trudy Scott
  • Vagus Nerve Infection and Anxiety – Eva Detko
  • SSRIs, Benzodiazepines, Alcohol and Amino Acids – Hyla Cass
  • Fluoride: Neurotoxicity, Anxiety, Acne and Hypothyroidism – Melissa Gallico
  • GABA and Serotonin: Anxiety, PMS, Meds and Infections – Trudy Scott

#2 Tryptophan eases mental anxiety, worry and ruminations, and alleviates lead-induced anxiety/aggression

(Note: Both tryptophan and 5-HTP can be used to support low serotonin levels. Some folks do better with tryptophan and some do better with 5-HTP)

Learn more about tryptophan (and 5-HTP) for easing anxiety and offering protection against lead and other toxins in these interviews on The Anxiety Summit 6: Toxins/Meds/Infections  

  • GABA and Tryptophan: Anxiety-Toxin Connections – Trudy Scott
  • SSRIs, Benzodiazepines, Alcohol and Amino Acids – Hyla Cass
  • 5-HTP: Anxiety, Depression, Insomnia and Liver Protection – Michael Murray
  • GABA and Serotonin: Anxiety, PMS, Meds and Infections – Trudy Scott

#3 Probiotics (psychobiotics) improve mood, reduce anxiety and improve cognition. And a spore-based probiotic reverses the liver-toxic effects of acetaminophen.

Learn more about probiotics for easing anxiety and offering protection against acetaminophen (and other adverse effects of acetaminophen) in these interviews on The Anxiety Summit 6: Toxins/Meds/Infections  

  • 5-HTP: Anxiety, Depression, Insomnia and Liver Protection – Michael Murray
  • Acetaminophen, Spore-based Probiotics and the Liver – Kiran Krishan
  • Drainage in Anxiety and Autism – Luminara Serdar
  • GABA and Serotonin: Anxiety, PMS, Meds and Infections – Trudy Scott
  • Vagus Nerve Infection and Anxiety – Eva Detko

#4 NAC is a precursor of glutathione and promotes detoxification. And NAC also reduces compulsive hair pulling/trichotillomania.

Learn more about NAC for detoxification, helping with compulsions and easing anxiety in these interviews on The Anxiety Summit 6: Toxins/Meds/Infections  

  • Your Brain on Food: Anxiety, OCD and PTSD – Uma Naidoo
  • GABA and Serotonin: Anxiety, PMS, Meds and Infections – Trudy Scott
  • Loss of Chemical Tolerance and Glutathione Recycling – Datis Kharrazian
  • Liver Function and Bile: Anxiety, Detox, the Gut and Hormones – Ameet Aggarwal

#5 Melatonin improves sleep and reduces anxiety after traumatic brain injury. Melatonin also removes toxic proteins via the brain glymphatic system

Learn more about melatonin for sleep, anxiety and the glymphatic system in these interviews on The Anxiety Summit 6: Toxins/Meds/Infections  

  • The Glymphatic System for Brain Detox – Christine Schaffner 
  • GABA and Serotonin: Anxiety, PMS, Meds and Infections – Trudy Scott
  • Fluoride: Neurotoxicity, Anxiety, Acne and Hypothyroidism – Melissa Gallico
  • Red Light Therapy: Anxiety, Toxins and Benzodiazepines – Ari Whitten

#6 Triphala improves gut health and reduces noise-induced stress (and sometimes misophonia). Triphala may also help prevent and reverse radiation-induced DNA and intestinal damage.

Learn more about triphala for anxiety, gut health and misophonia in these interviews on The Anxiety Summit 6: Toxins/Meds/Infections  

  • Liver Function and Bile: Anxiety, Detox, the Gut and Hormones – Ameet Aggarwal
  • PANDAS/PANS: The Brain on Fire – Elisa Song
  • Body Burden: Environmental Toxins, Tattoos and Wheat – Tom O’Bryan (noise pollution) 
  • GABA and Serotonin: Anxiety, PMS, Meds and Infections – Trudy Scott

#7 TUDCA improves LPS-induced cognitive impairment and neurotoxicity. TUDCA also eases depression caused by chronic unpredictable stress. 

Learn more about TUDCA and taurine for depression/anxiety and bile production in these interviews on The Anxiety Summit 6: Toxins/Meds/Infections  

  • Impact of Toxins on Lyme Disease and Infections – Jay Davidson (TUDCA) 
  • SSRIs, Benzodiazepines, Alcohol and Amino Acids – Hyla Cass (taurine)
  • GABA and Tryptophan: Anxiety-Toxin Connections – Trudy Scott (taurine)
  • Liver Function and Bile: Anxiety, Detox, the Gut and Hormones – Ameet Aggarwal (taurine)

#8 Rosemary shows benefits for stress, anxiety, depression and pain. It’s also protective when it comes to electromagnetic fields (EMFs).

Learn more about rosemary and EMFs in these interviews on The Anxiety Summit 6: Toxins/Meds/Infections  

  • EMFs: Anxiety, Insomnia, ADHD and Headaches – Lloyd Burrell
  • Lyme: a Herbal Approach for Pain, Anxiety and Brain Fog – Darin Ingels
  • GABA and Tryptophan: Anxiety-Toxin Connections – Trudy Scott 
  • The Glymphatic System for Brain Detox – Christine Schaffner
  • Mold Toxicity: Anxiety, Depression, Panic and Psychosis – Margaret Christensen

#9 Oral lavender (as Silexan) is as effective for anxiety as the benzodiazepine lorazepam.  And lavender essential oil reduces LPS-induced inflammation via HSP70.

Learn more about lavender, benzodiazepines and LPS in these interviews on The Anxiety Summit 6: Toxins/Meds/Infections  

  • Psychiatric Medications in Children and Teens – Nicole Beurkens
  • SSRIs, Benzodiazepines, Alcohol and Amino Acids – Hyla Cass
  • Body Burden: Environmental Toxins, Tattoos and Wheat – Tom O’Bryan (NF-κB and Toll-like receptor 4)
  • Disconnection Syndrome, Immunity and Awe – David Perlmutter
  • GABA and Tryptophan: Anxiety-Toxin Connections – Trudy Scott 
  • Benzodiazepines: Short-Term Benefits, Long-Term Harms – Catherine Pittman

#10 Milk thistle is liver-protective and enhances glutathione production. It is also beneficial as an antidepressant for OCD.

Learn more about milk thistle, glutathione, the liver, alcohol and acetaminophen in these interviews on The Anxiety Summit 6: Toxins/Meds/Infections  

  • SSRIs, Benzodiazepines, Alcohol and Amino Acids – Hyla Cass 
  • GABA and Tryptophan: Anxiety-Toxin Connections – Trudy Scott 
  • Liver Function and Bile: Anxiety, Detox, the Gut and Hormones – Ameet Aggarwal 
  • Acetaminophen, Spore-based Probiotics and the Liver – Kiran Krishan
  • Loss of Chemical Tolerance and Glutathione Recycling – Datis Kharrazian

Stay tuned for additional information, products and resources all the summit interviews.

Let us know which are your favorites or which similar products you have used with success – and how they have helped you.

Feel free to also post your questions in the comments below 

DOWNLOAD THE PDF HERE

 

REGISTER FOR THE ANXIETY SUMMIT 6

 

Willow’s survival story: Easter Lilies cause acute renal failure in cats and Peace Lilies cause oxalate issues

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willow lilies oxalate

Be aware that Easter Lilies (pictured above) can cause acute renal failure in cats and Peace Lilies (pictured below) can cause calcium oxalate issues.

Lindsey Warnock shared these pictures and the story of her kitty Willow on Facebook and kindly gave me permission to share this on my blog as a caution for anyone with cats:

On Thursday Willow played with lilies in my office. She didn’t eat anything. She only batted at them and got the pollen all over her before I shooed her away. We laughed initially but thank God something in my head told me to google it.

I read, “All parts of the lily – including the stem, leaves, petals, stamens and pollen – are poisonous to cats. Even minor exposures (cat chewing on a leaf or getting pollen on his or her haircoat or whiskers) can be fatal.”

“Cats typically do not survive, even with aggressive therapy (such as dialysis).” [from this site noliliesforcats.com]

I freaked out. Threw her in the shower (that wasn’t fun) and immediately took her up to Blue Pearl Emergency & Specialty Hospital. Due to covid, they came and took her from my car and after her exam the ER doctor called me. She said her prognosis was very poor because they found the pollen around her mouth and on her tongue. She even said, “in my experience I’ve never seen a cat survive lily poisoning. Most owners only realize there’s an issue when the cat is sick and by that point it’s just too late”

Insert hysterical crying here. She said that her only saving grace may be that we sought treatment quickly but realistically she might not make it through the night. They made her throw up, gave her activated charcoal and aggressively treated her with fluid therapy and other meds.

Thank God after 2 days in the hospital, she pulled through!!! We will go for a recheck soon but her doctors are confident her organs didn’t suffer any long term damage from the poisoning.

I can’t tell you the intense guilt I felt and still feel for buying those stupid flowers. I felt like a murderer, terrible fur mom, terrible person. I’ve had cats my entire life and have never heard of lily poisoning. The vet’s response to that was “most people only find out the hard way” The doctors, technicians and staff at Blue Pearl really are the best! They saved our baby.

Please SHARE this with your friends. I would hate to see anyone go through this!! Thank you all for your support during that gut-wrenching 2 days. We’re thankful our girl is back home! No. More. Flowers. Ever.

This was a few weeks ago and when I checked in I see that Willow is still doing well!

This article, Toxic Plants by Tina A Wismer, DVM, DABVT, DABT, shares the toxic effects of the lily (pictured above) Willow brushed up against:

Lilies of the Lilium and Hemerocallis sp.have been shown to cause acute renal failure in the cat. Some examples include: Easter lilies (L. longiflorum), tiger lilies (L. tigrinum), rubrum or Japanese showy lilies (L. speciosum, L. lancifolium), and day lilies (H. species). The toxic principle is unknown, but is known to be water soluble. Even minor exposures (a few bites on a leaf, ingestion of pollen, etc.) may result in toxicosis, so all feline exposures to true lilies should be considered potentially life-threatening and should merit aggressive clinical intervention.

Peace lilies are also an issue for cats and dogs – due to oxalates

Peace Lilies are also harmful for cats and dogs because they contain calcium oxalate crystals. Fortunately they are not deadly.

peace lilies

This Toxic Plants article also lists common houseplants – including Philodendron spp. and Spathiphyllum spp. or Peace Lily – that contain insoluble calcium oxalate crystals, describing how they are also harmful for cats and dogs:

The calcium oxalate crystals look like needles, and when the plant is damaged these crystals embed themselves in the oral cavity. Clinical signs include hypersalivation, vomiting and possible swelling of the pharynx (obstruction is rare). Treatment includes milk or water to rinse mouth. Clinical signs usually resolve within 24 hours with no lasting effects.

Here is an image of calcium oxalate crystals called raphides. You can see why these needle shaped calcium oxalate crystals found can inflict pain and cause harm. There are many different shapes of calcium oxalate crystals and this is just one example.

Raphides
Raphides purified from kiwifruit. Raphides, needle shaped calcium oxalate crystals, were collected from kiwifruit homogenate through heavy media separation using a dense CsCl solution. (A) The SEM image of purified raphides (x400). Shared from: Synergistic Defensive Function of Raphides and Protease through the Needle Effect via Creative Commons.

This article, Easter Lilies and Cats do not Mix! shares more about the two different groups of lilies, “true” lilies (like Easter Lilies) and “benign” lilies (like Peace Lilies). Author, Karen Christopherson, DVM, CVA says “It is best to skip lilies altogether in households where cats live.”

Be sure to read the entire Toxic Plants article for a list of all plants that are harmful and severely toxic to cats and dogs. I had no idea there were so many!

I am not a vet and am not an expert on any of this so please do check in with your own vet.

Oxalate questions I have

With regards to oxalates I have these questions I’d love to know the answers for:

  • Do all cats and dogs have an inborn ability to tolerate calcium oxalate crystals like those found in the Peace Lily?
  • Would cats and dogs also have issues (especially severe pain in their joints, bladder issues and increased anxiety) if they were to ingest high oxalate foods like spinach, beets, sweet potatoes, soy and kiwi fruit?
  • Given that there are some human “antidotes” for helping with acute exposure symptoms after ingestion of high oxalate foods (like spinach, rhubarb, nuts, kiwi fruit etc) in susceptible individuals, I am curious to know if some of these could be used with cats and dogs too: calcium citrate, magnesium citrate, vitamin B6 and/or an epsom salt bath?
  • Do humans with dietary oxalate issues have problems working with some of these indoor plants (like Peace Lilies) when planting them, pruning and even getting pollen on the skin?

Are you aware of these harmful effects of plants for cats and dogs? Let us know if you experienced something similar to what happened to Willow or with a plant like the Peace Lily. What advice did your vet share with you and how is your cat or dog doing now?

If you have answers to any of the above questions please do share too.

Feel free to post your questions here too.

We appreciate Lindsey for letting me share this and say well done for your quick thinking!

Vitamin C causes oxalate formation resulting in pain, anxiety, and insomnia (when there is a defect in ascorbic acid or oxalate metabolism)?

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vitamin c and oxalate

Supplemental vitamin C has many exceptional health benefits and causes no issues for a large majority of individuals. However if you have dietary oxalate issues, doses of vitamin C above 100mg to 250mg per day may be problematic and trigger pain, anxiety, insomnia, bladder issues and more. This blog, Coronavirus and vitamin C for immune support: new pain or more severe pain due to oxalate issues?, is part 1 of the series  which sets the scene and is a fact-finding article. Part 2, Oxalate crystal disease, dietary oxalates and pain: the research & questions (part 2), covers the research behind oxalate crystal disease.

Today we look at some of the research on vitamin C/ascorbic acid being a possible trigger for the formation of oxalates in certain instances. This paper, No contribution of ascorbic acid to renal calcium oxalate stones, has a good summary:

Even though a certain part of oxalate in the urine derives from metabolized ascorbic acid, the intake of high doses of vitamin C does not increase the risk of calcium oxalate kidney stones due to physiological regulatory factor: gastrointestinal absorption as well as renal tubular reabsorption of ascorbic acid are saturable processes, and the metabolic transformation of ascorbic acid to oxalate is limited as well.

But in the large-scale Harvard Prospective Health Professional Follow-Up Study, those groups in the highest quintile of vitamin C intake (> 1,500 mg/day) had a lower risk of kidney stones than the groups in the lowest quintiles.

This paper does however have this precaution:

Recurrent stone formers and patients with renal failure who have a defect in ascorbic acid or oxalate metabolism should restrict daily vitamin C intakes to approximately 100 mg.

My proposed interpretation of this

I’d like to propose an interpretation of this, based on what we know about oxalates. These are the individuals who should restrict daily vitamin C intakes to approximately 100 mg per day (or up to around 250mg per day – more on the range below):

1) If you are someone who is a recurrent stone former or is in renal failure with a defect in ascorbic acid or oxalate metabolism

2) If you are someone with dietary oxalate issues i.e. you have similar symptoms when consuming vitamin C as you do when consuming high oxalate foods. Could we consider that you be classified as having “a defect in ascorbic acid or oxalate metabolism?” I would say yes.

I’ve added #2 above because we need to keep in mind that many individuals who have issues with dietary oxalates are not necessarily stone formers and nor do they have renal failure.

Research is also lacking in this area as you can read in Oxalate crystal disease, dietary oxalates and pain: the research & questions (part 2).

An omission of the 100mg per day restriction

I would like to point out that the study mentioned above was referred to in an article on Dr. Andrew Saul’s site but for some reason the section about the 100mg daily restriction was omitted from the article. It may have something to do with the fact that the author firmly believes that no-one has oxalate issues with any dose of vitamin C. In fact, he even jokingly makes this comment in the article:

Is some clown still trying to tell you that vitamin C is somehow dangerous? Or that you shouldn’t take more than 200 mg/day?

If you are someone who does experience pain when consuming vitamin C (like I do), I’m pretty sure you don’t find this comment amusing.

Vitamin C intake leading to pain, anxiety, insomnia, low mood and bladder issues

Here is some additional feedback from a question I posted on Facebook. This is the question I posted:

I’ve been sharing here about vitamin C being an issue for some folks who have oxalate issues and seeing an increase in pain. I’d love to hear if you upped your vitamin C intake for immune support and saw your mood take a dive or your anxiety increase or your sleep get worse? Vitamin C typically helps because it’s a cofactor for making neurotransmitters like serotonin and GABA and tyrosine but too much of a good thing is not good! Did you also have increased or new pain (as well as anxiety, low mood and insomnia)?

Here are some of the responses from folks who shared about pain, anxiety, insomnia, low mood and bladder issues:

  • Fay shared this: “Yes increased pain, insomnia and anxiety with increased C and mouth sores to boot. Taking liposomal C and Ester C to boost antioxidants for health reasons and pain in elbows and knees. Not sleeping well at all either.”
  • Lica shared this: “Yes increased anxiety…never thought of it before…felt a bug coming on and took c for a few days…yup anxiety.”
  • Nicola shared this: “Increase in body pain, burning bladder, sleep affected and low mood ( not something I usually suffer with). I was taking liposomal C then increased the dose and also added Ester C as I had symptoms of covid. I was taking 1-2g a day of liposomal previously as a preventative and increased to 4g plus 4g of Ester. Only did it for a couple of days. Stopped three days ago and pain is starting to subside but no sleep last night. So I will continue with a break for now and add a very low dose again perhaps of Ester C and see how I go.”

I really appreciate these women sharing their experiences so we can all learn!

What is the upper limit of vitamin C for individuals with dietary oxalate issues?

I’m sure you’re wondering about the various dosages mentioned: the study mentions 100mg per day,  Dr. Andrew Saul’s clown comment says 200mg per day and Susan Owen’s TLO Facebook group recommends no more than 250mg per day. You’ll need to figure out what the upper dose of vitamin C you can tolerate – by trial and error.

The big disconnect is always the mention of kidney stones

This is one of many similar studies on the topic of ascorbic acid/vitamin C and oxalates. There are also many studies and articles stating that vitamin C does NOT play a role in the formation of oxalates and cause kidney stones. The big disconnect is always the mention of kidney stones. The missing piece – in the research and in many articles – is that you can have issues with dietary oxalates AND vitamin C when there is no kidney disease/no kidney stones.

I have a number of additional oxalate blog posts planned so please let me know what else you want to hear about.

Here are the 2 previous blog posts on this topic of oxalates, vitamin C and pain:

Please also share your vitamin C oxalate story and how you figured it out (and if you react in a similar way to dietary oxalates).

Let us know what your ideal dose is (and which dose caused issues) and what form of vitamin C and product name you use/used. Feel free to share if you also have a history of kidney stones.

Feel free to post your questions here too.

Anxiety case study: a very very slow SSRI taper with tryptophan and other nutritional support

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anxiety case study

Today I’m sharing an update from someone in my community who is tapering from an SSRI (Cipralex/lexapro) in the best way possible – very methodically and doing a very very slow taper, using compounded medication and nutritional support. It is a team approach with a supportive doctor monitoring for serotonin syndrome, her pharmacist compounding her medication and input from me.

She has an excellent diet that contains enough healthy protein and fats, plenty of vegetables, and no sugar or caffeine. She has the basic nutrients covered and is on the pyroluria protocol (these nutrients help make serotonin). She is using the amino acid tryptophan for serotonin support as she tapers. And she is out walking in nature and practicing mindfulness.

All of this sets her up for success and being able to avoid antidepressant discontinuation syndrome.

Here is her story:

I began tapering off 10 mg of Cipralex in November 2017. I have my little “Support Team” that includes a compounding pharmacist and my GP. Feeling very fortunate that I have these people as my taper has not exactly gone as planned (although far better than my last two attempts)

Originally, the plan was to go down by 10% of the dose and stay at that dose for 4 weeks. That didn’t work for me. I was fine when I dropped from 10mg to 9, but after my next 10% drop I experienced that familiar withdrawal hell. I got a little scared, but stuck with it, and decided to stay at that dose for a bit longer. While I leveled out, I did a lot of reading about how SSRIs work. I learned about the 1/2 life of Cipralex (all SSRIs have a different 1/2 life) and what was actually happening physiologically as my body adjusts to the lower dose. It’s a recovery process.

With that new knowledge, I decided to try another approach. I knew I couldn’t handle a drop of 10%. So, I started to taper at a rate of 0.1mg once a week (far less than 10%!). By day three at the new dose, I could feel the withdrawal, but it was far less severe. Small drops=small “withdrawal wave”. I discovered that I am able to manage a 2% drop of the current dose and I have been able to drop that % each week. So, I’m still reducing by 8% a month, which means I am close to the original plan of dropping by 10% a month. At this time I am at 6.24mg.

Yes, it is a very slow process and I have a long way to go, but it’s working. I have read that some people have to reduce by 1% of their current dose and remain at that dose for 4 weeks to allow their body the time to heal and adjust to life on the lower dose. Having the liquid compound has made such a difference! You sure would have difficulty accurately shaving off a pill by 2%!! If anyone is trying to come off of this drug, do your best to find a compounding pharmacist!

I find that I must stick to a very healthy diet. I eat a lot of fresh, raw and cooked vegetables. I mean a LOT of vegetables. I eat good sources of protein and walk for at least 45 min almost every day. I steer clear of sugar and caffeine. Both make my withdrawal much worse.

Every day I take omega 3, vitamin C, vitamin D, vitamin B complex. I take the supplements for pyroluria, vitamin B6, evening primrose oil and zinc. I take magnesium at night. I took Trudy’s amino acids course online and did all of the amino acid trials. I discovered all I really need is tryptophan. It has made a huge difference for me. Yes, I take Lidke tryptophan. For us Canadians, it can be ordered online.

I practice mindfulness. I’ve read a lot about the anxious brain (the reason I took Cipralex in the first place) so I understand what is happening now, what is real and what is just noise in my head.

Antidepressant discontinuation syndrome

This is the best way to taper SSRI medications in order to avoid withdrawal effects, also known as discontinuation syndrome which can be very severe for some folks.

Accordingly to this paper, Antidepressant discontinuation syndrome occurs in about 20% of patients who reduce the dose or abruptly stop an antidepressant that they have been taking for one month. This paper states that “symptoms are usually mild….occur within two to four days after drug cessation and usually last one to two weeks.”

It also states that occasionally symptoms “may persist up to one year…and if the same or a similar drug is started, the symptoms will resolve within one to three days.”

I typically hear from individuals who fall into the category of severe symptoms that are persisting past 2 weeks. It’s not uncommon to see symptoms continue for a year and often longer in some cases.

Also from the above paper, is the mnemonic FINISH which summarizes these symptoms:

  • Flu-like symptoms (lethargy, fatigue, headache, achiness, sweating)
  • Insomnia (with vivid dreams or nightmares)
  • Nausea (sometimes vomiting)
  • Imbalance (dizziness, vertigo, light-headedness)
  • Sensory disturbances (“burning,” “tingling,” “electric-like” or “shock-like” sensations) and
  • Hyperarousal (anxiety, irritability, agitation, aggression, mania, jerkiness).”

How you will feel if your serotonin is low and how to learn more

With low serotonin you will have the worry-in-your-head and ruminating type of anxiety, panic attacks and phobias, lack of confidence, depression, negativity, imposter syndrome, PMS, irritability, anger issues, insomnia and afternoon/evening cravings.

If you suspect low serotonin symptoms and are new to using the amino acids and do not have my book I highly recommend getting it and reading it before jumping in to taking supplements and navigating this with your prescribing physician: The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings. You may need to lend him/her a copy of my book too.

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

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

Please also read and follow these Amino Acid Precautions.

This lists The Antianxiety Food Solution Amino Acid and Pyroluria Supplements that I use with my individual clients and those in my group programs – you will find the Lidtke Tryptophan here. You can also read more about why I prefer the Lidtke tryptophan on this blog.

I would like to end off by saying how much I appreciate this woman and others sharing their stories like this so we can all learn!

Please also share your taper story and what you did to make it easier.  If you had challenges share those too. Let us know if you can relate to any of the above FINISH symptoms and how long they lasted.

Feel free to post your questions here too.

This Is Your Brain on Food by Uma Naidoo, MD (video interview and review)

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brain on food

Dr. Uma Naidoo has a wonderful new book called This Is Your Brain on Food: An Indispensable Guide to the Surprising Foods that Fight Depression, Anxiety, PTSD, OCD, ADHD, and More (my Amazon link)

Her big bold message is this “Until we solve nutritional problems, no amount of medication and psychotherapy is going to be able to stem the tide of mental issues in our society.”  This is something I wholeheartedly agree with!

I had the wonderful opportunity to interview Dr. Naidoo and we talked about the benefits of fermented foods and social anxiety, vitamin D and anxiety, dietary sources of polyphenols for ADHD and much more:

51 women with type 2 diabetes and vitamin D deficiency were randomly allocated to receive one oral pearl of 50,000 IU vitamin D3 (26 women) or a placebo (25 women) fortnightly for 16 weeks

Anxiety score changes were significantly lower in vitamin D group than the controls

Dietary polyphenols… have antioxidant capacities as well as immunoregulatory effects and, therefore, appear appropriate in ADHD therapy.

  • Dr. Naidoo recommends these sources of polyphenols: berries and other fruit, vegetables, extra virgin olive oil.
  • I’m fascinated by the fact that polyphenols “act as a low-dose toxin that trains the body to mount an immune response in a process called hormesis” (there are many geeky gems like this in the book)
  • Dr. Naidoo shares the story of her 36 year old patient with severe anxiety. He was a binge eater and also had a history of alcohol abuse. Vitamin B1 (250mg) was every effective for him…“In animal studies, thiamine appears to reduce stress-like responses because it protects the hippocampus”
  • We talk about chamomile tea and how it helps with sleep. There are some cautions if you’re on a blood thinner prescription or going to have surgery. Pregnant women should also avoid it.
  • Dr. Naidoo shares a delicious Golden Milk recipe with tips on how to use turmeric (one her favorite spices and inspired by her grandmother’s cooking) with black pepper. You’ll find this in the recipes section.
  • Dr Naidoo also shares one of her favorite comfort foods – a yummy lentil soup recipe called dal in south Indian cuisines. It’s a great source of fiber, plant-based protein and is very affordable. And really healthy when cooked with vegetables and spices like mustard seeds, ginger, garlic and turmeric. She shares a tip to improve the flavors – making tadka (listen to the interview below, enjoy and be inspired!)

 

It’s a wonderful book that I highly recommend if:

  • you are new to nutritional psychiatry and the power of food
  • you are a seasoned foodie and want to geek out on mechanisms and the science
  • you want to learn about foods and nutrients (all science-based) specifically for depression, anxiety, PTSD, OCD, ADHD and insomnia
  • you are a practitioner and want to learn and share a wonderful book with your patients or clients

I read it cover to cover and picked up so many gems. I also loved reading about her memories of cooking with her Pinetown granny (Pinetown is just outside Durban where we both happened to grow up)!

We do have a few professional differences of opinion that I feel I should mention:

  • I am not in favor of canola oil and I’d switch out the recipes that call for canola oil with olive oil
  • I have a difficult time extrapolating high-fat diets in rat studies to concerns about saturated fat consumption in humans (given the nature of the rat chow in many of these studies)
  • I’m more concerned with portion-size of carbs than I am with portion-size of healthy fats (and typically recommend full-fat coconut milk, and chicken and turkey with skin-on)
  • I find grass-red meat to be beneficial for my clients with anxiety and mood issues
  • Many of my anxious clients cannot tolerate any caffeine and I consider 14 alcoholic drinks a week for men and 7 alcoholic drinks a week for women to be excessive
  • I prefer stove-top and oven cooking to using a microwave.

This is the official book blurb:

Did you know that blueberries can help you cope with the aftereffects of trauma? That salami can cause depression, or that boosting Vitamin D intake can help treat anxiety?

When it comes to diet, most people’s concerns involve weight loss, fitness, cardiac health, and longevity. But what we eat affects more than our bodies; it also affects our brains. And recent studies have shown that diet can have a profound impact on mental health conditions ranging from ADHD to depression, anxiety, sleep disorders, OCD, dementia and beyond.

A triple threat in the food space, Dr. Uma Naidoo is a board-certified psychiatrist, nutrition specialist, and professionally trained chef. In This Is Your Brain on Food, she draws on cutting-edge research to explain the many ways in which food contributes to our mental health, and shows how a sound diet can help treat and prevent a wide range of psychological and cognitive health issues.

Packed with fascinating science, actionable nutritional recommendations, and delicious, brain-healthy recipes, This Is Your Brain on Food is the go-to guide to optimizing your mental health with food.

Uma Naidoo, MD is board-certified psychiatrist (Harvard Medical School), professional chef (Cambridge School of Culinary Arts), and nutrition specialist (Cornell University). She is currently the Director of Nutritional and Lifestyle Psychiatry at Massachusetts General Hospital (MGH), where she consults on nutritional interventions for the psychiatrically and medically ill; Director of Nutritional Psychiatry at the Massachusetts General Hospital Academy; and has a private practice in Newton, MA. She also teaches at The Cambridge School of Culinary Arts.

Dr. Naidoo speaks frequently at conferences at Harvard, for Goop audiences, the New York City Jewish Community Center (JCC), and Ivy Boston. She blogs for Harvard Health and Psychology Today and completed a unique video cooking series for the MGH Academy which teaches Nutritional Psychiatry using culinary techniques in the kitchen.

You can get your copy of This Is Your Brain on Food here (my Amazon link) and find additional information about Dr. Naidoo here and the book here.

Let us know what you think in the comments below and be sure to leave Dr. Naidoo a review once you read your copy!

Feel free to post your questions here too.