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Vitamin C, autoimmunity, food sensitivities & visual processing: Chronic Headache & Migraine Summit

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Guest post by Erin Knight, FDN-P

Did you know that nearly 60% of migraineurs report suffering from anxiety as well? I didn’t. That was one of many surprising things I discovered interviewing functional medicine experts and clinicians with decades of experience helping people overcome their headaches and migraines at the root cause (you can listen in to these interviews here on the Chronic Headache and Migraine Summit)

As much as the high correlation between migraines and anxiety surprised me, I could quickly see some reasons for the connection. People with frequent headaches report that managing life around headaches and missing out on things places an incredible strain on relationships and career that is nearly as bad as the physical pain. In other words, the mental agony of being sidelined by severe headaches is worse than the pain itself and contributes to the stress we carry around each day. But I don’t have to tell you that.

Is this meal going to cause a headache today? Am I going to be able to make it to my daughter’s choir concert? Is my boss going to pass me up for that project because I’ve been out with migraines so many days this year? If you are like me, these questions are always top of mind – creating a vicious circle between worrying – headaches – and more stress.

While it may seem quite obvious that there is this worrying and fear that migraineurs carry around with them each day, you may be surprised to learn from the experts speaking at the Chronic Headache and Migraine Summit, that there are many underlying root causes that can lead to both anxiety and headaches at a biological level. Some of these include:

  • Poor absorption of nutrients such as magnesium
  • Leaky gut and inflammation in the digestive tract that impacts the production of neurotransmitters like serotonin and hormones like estrogen
  • Emotional trauma in childhood (which is linked to a staggering increase in chronic conditions such migraines, autoimmune diseases, obesity and chronic fatigue 

The good news is that there are real solutions to improve your health at a foundational level that can drastically improve or even resolve both headaches/migraines and anxiety at the root cause.

The experts in the Chronic Headache and Migraine Summit talk both about what has helped their clients recover their health as well as natural, simple ways to reduce the pain and intensity of headaches quickly and at home so you can go on with your life.

If you know you experience headaches due to weather changes, sinus stuffiness, neck tension, classic migraine or monthly hormonal changes – there are different relief techniques to employ for each. For example, Jay Davidson (featured on Day 4) highlights 3 tricks for clearing pressure out of your head when you feel a thunderstorm headache coming on – and they work in minutes! My favorite is to dab frankincense essential oil with your fingertips along the hairline in your neck. I can feel drainage start immediately with this simple technique!

If you think you’ve tried it all and been through the gamut of herbal and homeopathic remedies – I promise you will learn something that surprises you and makes a difference in your journey.

5 things I learned about hosting the Chronic Headache and Migraine Summit that might surprise you too:

  • There are many superstar supplements that can help people with different types of migraines beyond the typical riboflavin and magnesium citrate – for example, Vitamin C, different forms of magnesium, 5-HTP or tryptophan, and glutathione.
  • Migraines are being reclassified as an autoimmune disease. One autoimmune disease that frequently leads to migraines (and anxiety and miscarriages) is the clotting disease called Antiphospholipid Syndrome (featured on day 7 in Trudy Scott’s interview)
  • Food sensitivities may be more important than avoiding trigger foods
  • There is a visual processing disorder that affects 15% of the population and is simple to correct.
  • Toxicity from air and water pollution causes different types of chronic headaches and can be easily identified and reversed.

We are so thrilled to be able to offer this first-of-its-kind resource for people who want to stop managing their headaches, stop watching life pass them by from the sidelines and find natural relief options that really work. Register and start watching here

Feel free to share something that surprises YOU from the talks in the comments below.

A gut feeling – the gut microbiome in health, diseases and behavior

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Pathways linking the gut microbiota and the CNS/central nervous system

There are a number of pathways linking the gut microbiota and the CNS/central nervous system: the vagus nerve, the circulatory system and the immune system. The gut microbiota have a direct impact on anxiety and depression via these pathways.

The 2015 paper referenced in the above slide is: Control of brain development, function, and behavior by the microbiome

More recently, studies have suggested that gut bacteria can impact neurological outcomes–altering behavior and potentially affecting the onset and/or severity of nervous system disorders. In this review, we highlight emerging evidence that the microbiome extends its influence to the brain via various pathways connecting the gut to the central nervous system. While understanding and appreciation of a gut microbial impact on neurological function is nascent, unraveling gut-microbiome-brain connections holds the promise of transforming the neurosciences and revealing potentially novel etiologies for psychiatric and neurodegenerative disorders.

This slide and study was part of Professor Karsten Kristiansen’s  keynote presentation at The Society for Mental Health Research conference in Sydney last month: “A gut feeling – the gut microbiome in health, diseases and behavior.”   I had the pleasure of attending and meeting Professor Kristiansen. He gave me permission to share some of the highlights which you can watch in the video below.

Professor Felice Jacka, nutritional psychiatry researcher and founder of ISNPR introduced him and his presentation on the gut-brain connection.

Here I am with Professor Karsten Kristiansen and Professor Felice Jacka

It was really wonderful to finally Professor Felice Jacka in person. I have been following her research work since her first food mood study in 2010: Association of Western and traditional diets with depression and anxiety in women. You may recall our wonderful interview on The Anxiety Summit: The Research – Food to prevent and treat anxiety and depression?

Here are 2 position statements on nutritional psychiatry from ISNPR:

It was also wonderful to see Felice’s name on so many of the microbiome and mood-diet posters that were presented at the conference!

We appreciate Professor Kristiansen, Professor Felice Jacka and all the research work they and their teams of researchers do!

Saffron has both antidepressant and antianxiety effects

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In a new study published in Pharmacopsychiatry, Crocus sativus L. versus citalopram in the treatment of major depressive disorder with anxious distress: a double-blind, controlled clinical trial, saffron (Crocus sativus L.) has been shown to have both antidepressant and antianxiety effects. It’s also anti-inflammatory and an antioxidant.

In this study patients received either saffron or an SSRI called citalopram/Celexa:

66 patients with major depressive disorder accompanied by anxious distress were randomly assigned to receive either saffron (30 mg/day) or citalopram (40 mg/day) for 6 weeks.

The Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A) were used to assess the effectiveness of the treatment during the study.

60 participants finished the study and they all showed significant improvement in depression and anxiety scores, with no significant difference in effectiveness or side effects from either the saffron or citalopram.

The authors make this conclusion:

The present study indicates saffron as a potential efficacious and tolerable treatment for major depressive disorder with anxious distress.

A 2014 systematic review of clinical studies and examination of underlying antidepressant mechanisms of action of saffron found that:

saffron’s antidepressant effects potentially are due to its serotonergic, antioxidant, anti-inflammatory, neuro-endocrine and neuroprotective effects

This means that saffron could potentially be used in place tryptophan or 5-HTP if you score high on the low serotonin section of the amino acid questionnaire (anxiety, worry-in-the head, obsessiveness, negativity and depression, irritability, PMS, afternoon and evening cravings and insomnia) and yet do not seem to benefit from either of these two amino acids.

And you’ll be getting the added antioxidant, anti-inflammatory, neuro-endocrine and neuroprotective effects.

If you do well with tryptophan and/or 5-HTP, I suspect that using a small amount of saffron together with these amino acids could enhance the effects.  

I have yet to use saffron with my clients so I’d love to hear from you (so we all can benefit and learn from each other):

  • Have you used saffron and found it to be effective for your anxiety and/or depression?
  • If you’re a practitioner, have you used it with patients or clients?
  • Have you found 30 mg a day to be the most effective dose and how quickly have you noticed benefits? What symptoms have improved the most?
  • Have you combined saffron with tryptophan or 5-HTP? 

I am on 5-HTP for anxiety and I am wondering about trying tryptophan instead

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Both 5-HTP and tryptophan help to boost serotonin levels so you can feel happy, calm, sleep well and not crave carbs. I typically have my clients who have low serotonin symptoms start with a trial of tryptophan because it I see such excellent results with this amino acid. That being said, some people simply do better on one versus the other and you may do better with 5-HTP. If you have low serotonin symptoms and are using either of these amino acids and not getting the expected results, it’s worth considering a change.

Here is a question I recently received on the blog. It’s something I’m commonly asked about and something I deal with often when working one-on-one with clients:

I am on 5-HTP (400 mg) [for anxiety]. I am wondering about trying tryptophan instead. What is the best (safest) way to make the switch? What is the starting dose you usually suggest? I am tapering off SSRIs so I know my serotonin reserves are low.

Here are some of the reasons you may want to consider switching and doing a trial of tryptophan

  • the 5-HTP is not working as you would expect for your anxiety or depression, or other low serotonin symptoms like PMS, insomnia, afternoon and evening carb cravings, negative self-talk, perfectionism, worry in the head and ruminations, and even anger issues or irritability (here is the complete questionnaire)
  • the 5-HTP is causing digestive issues
  • you have done an adrenal saliva test and discovered you have high cortisol. If you feel wired-tired I like to use tryptophan because 5-HTP has been shown to raise cortisol levels

Depending on how severe your symptoms are I would have you slowly replace one with the other, keeping in mind that 50mg 5-HTP is roughly equivalent to 500mg tryptophan.

In this particular case she was taking 400 mg 5-HTP and was surprised to hear that she may now need 2000 mg tryptophan, saying “that seems like a lot!”

Here is my feedback:

2000mg tryptophan isn’t too much if you have low serotonin symptoms and need it. If we were working together I would have her start with a trial of 500mg which is the typical starting amount and increase based on her response. If 500mg helps some symptoms but doesn’t give complete resolution of symptoms then I’d have her try 1000mg and monitor symptoms, and then go up to 1500mg and even 2000mg.

She may respond better to tryptophan and may only need 500mg or 1000mg or she may in fact need the full 2000mg.

She is currently taking an SSRI, so I would assume her doctor already knows she has been using 5-HTP and knows her plans to switch, giving approval and monitoring for possible serotonin syndrome. She would also take the tryptophan at least 6 hours from the SSRI.

Here is additional information on SSRI tapering while using amino acids.

Obviously a similar approach could be used to switch from tryptophan to 5-HTP.

I also only ever recommend the Lidtke brand of tryptophan. You can find this and the other amino acids I use with my clients here.  

Have you switched from 5-HTP to tryptophan and seen added benefits?

Have you switched from tryptophan to 5-HTP and seen added benefits?

If you’re a practitioner please share if you’ve used this approach successfully.

How do I taper from my antidepressant with tryptophan and can I safely use the other amino acids?

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antidepressant-tapering

Today’s article is based on a question I am seeing more and more on the blog: How do I taper from my antidepressant with tryptophan and can I safely use the other amino acids?

I find my clients do better when tapering off an antidepressant (which is often prescribed for anxiety and panic attacks) when their nutritional status is solid. Incorporating diet changes and adding amino acids and other nutrients first can result in a more successful taper with less side-effects. This would mean starting with the basics – eating real whole food, incorporating quality animal protein, eating to balance blood sugar, and removing gluten, caffeine and sugar.

If needed and based on testing results, it’s important to address any other nutritional deficiencies such as low iron, low vitamin D, low stomach acid, low total cholesterol, low B12 (and whatever else is an issue), plus support the adrenals/sex hormones/thyroid if needed and addressing gut health like leaky gut and dysbiosis.

Adding a good copper free multivitamin and often the addition of zinc and vitamin B6, evening primrose oil and possibly fish oil – the latter based on each person’s unique needs.

With antidepressants such as selective serotonin-reuptake inhibitors (SSRIs), I have my clients work with their prescribing doctor and get the approval to add tryptophan (or 5-HTP) 6 hours apart from the SSRI. If they are taking the medication at night they get the approval from their doctor to switch it to the morning, and will take tryptophan (or 5-HTP) at least 6 hours later, mid-afternoon and evening.

If they decide to do both the medication and tryptophan (or 5-HTP), they get a protocol for the SSRI taper for the future. This is important. If you are in too big a rush to start right away, it often causes more issues. It’s also important to make sure you get a very slow taper protocol from your doctor. Some antidepressants are harder to taper (Paxil is notoriously difficult) and they all should be tapered really slowly.

The plan is to start to taper the SSRI once you have been using the tryptophan (or 5-HTP) for at least 4 to 8 weeks and are seeing real benefits by using it. This translates to much much less or none of the following symptoms: anxiety, depression, insomnia, rumination, worry, negative-self-talk, perfectionism, afternoon and evening carbohydrate cravings, PMS, rage or anger.

For some of my clients it’s 3 months before they feel they are ready to taper. This may be because of feedback they have provided based on prior taper attempts and how they are feeling this time. It may also be based on what else is going on in their lives like a stressful work situation. It may also be based on the time of the year: winter is generally not a good time to taper and definitely not if you suffer from increased depression or anxiety in winter.  

The tryptophan (or 5-HTP) is adjusted up as needed while continuing to taper the SSRI.  

The doctor is always kept informed and monitors for the possibility of serotonin syndrome. I learned about the potential concerns about serotonin syndrome when using tryptophan or 5-HTP with an SSRI from Julia Ross, author of The Mood Cure, and so I continue to caution my clients about this.

When I interviewed Dr. Peter Bongiorno in season 4 of the Anxiety Summit (Serotonin and anxiety: tryptophan, 5-HTP, serotonin syndrome and medication tapers), he shared that he is not concerned about serotonin syndrome being an issue with tryptophan or 5-HTP dosed with an SSRI, even if taken at the same time. He cited research that found the combination of tryptophan and SSRI did not result in serotonin syndrome in any of the participants.      

Dr. Bongiorno also uses the same approach to address the basics:

the most important thing is that we really establish all the basics and that they’re in the healthiest place possible.  Because if those aren’t there, if a patient just gets off the medication and we haven’t really done anything to change the underlying reasons why they got to the place where they had the mood issue, in most cases they’re going to go back there again.

Some people need amino acid support in more than just the low serotonin area so we review the amino acid questionnaire and consider trials of GABA and other amino acids too. All this only applies for SSRIs and tryptophan or 5-HTP. The other amino acids can safely be used with SSRIs, and it’s not uncommon to also have low GABA, low endorphins, low catecholamines and low blood sugar and need them all, but it’s still best to discuss them with the prescribing doctor.

We also review all the amino acid precautions.

Some people choose to work with their doctor to taper the SSRI and then add the tryptophan (or 5-HTP) once they have quit the medication. I have found that this makes it much harder to do and more side-effects are seen. With the amino acids you start to get some relief right away and have hope on the first day! They also make it so much easier to quit the sugar, gluten and caffeine without having to use will-power.

In summary, these are my recommendations for doing an SSRI taper with amino acids:

  • doctor’s approval to taper the SSRI and use amino acids
  • address diet and nutritional deficiencies first – before starting to taper
  • work with someone knowledgeable in amino acid use
  • OR educate yourself by

                   (please don’t simply read one or two blogs and jump in to this)

  • use the amino acids from day one to start addressing low levels of all the brain chemicals
  • use the tryptophan or 5-HTP at least 6 hours away from the SSRI

I would like to add that Dr. Brogan shares that coffee enemas help her patients who are doing medication tapers and this is something I plan to start implementing going forward.

Have you used a similar SSRI taper protocol? And how did it work for you? What would you have done differently? And what advice would you give someone contemplating an SSRI taper?

Have you found that coffee enemas have helped?

DPA to end comfort-eating, end weepiness and boost endorphins

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medicinal-supplements-summit-speakers

The Medicinal Supplements Summit runs September 12 -19 and is dedicated to helping you learn the latest in supplement customization to boost energy, lose weight, beat stress, improve brain function and heal your body! 

My interview addresses amino acids for both anxiety and depression – I talk about GABA, tryptophan, 5-HTP (and when not to use it), DPA, glutamine and tyrosine.

medicinal-supplements-summit-day6

Wendy asks me to share more about DPA for the low endorphins kind of depression, comfort eating, emotional pain, weepiness and physical pain. Here are some snippets on this topic from my interview:

DPA is D-phenylalanine. It’s an amino acid that actually destroys the enzyme that breaks down endorphins. Endorphins are feel-good chemicals that we may relate to when you hear about getting an endorphin rush, when you go for a run or when someone gives you a big hug or when you do something nice for someone or someone does something nice for you, you get that nice sort of feel good feeling, like you’ve got this big hug kind of feeling. So taking this amino acid, DPA, helps, in essence, to raise your endorphins.

There are different kinds of depression. I mentioned the low serotonin depression, which is more the anxiety kind of depression. With the low endorphin kind of depression, you’re very weepy. You may be overly emotional. So if you watched a TV ad or you watched a really sad movie, you may be more prone to crying than the average person. As well as being sensitive to emotional pain, which is the crying and the weepiness, you also tend to be sensitive to physical pain.

So we know that doing acupuncture raises your endorphin levels. And in that way it helps with pain. So taking this amino acid will help with that emotional sadness that you often feel when you’ve got low endorphins. And it is very, very helpful for physical pain as well. I find a number of clients with physical pain that is related to low endorphins. Pain can be related to low oxalates or nightshades, something physical, or even osteoarthritis. So you’ve got some kind of physical issue. But if it’s related to low endorphins you’ll actually see a really nice pain reduction effect from it.

Now, the big thing with low endorphins is this comfort eating. So I mentioned earlier with low serotonin you have the anxiety and the depression and the afternoon and the evening cravings. With low endorphins, as well as this emotional aspect and the pain aspect, the cravings part is very much a comfort kind of craving.

It’s like, “This is my reward. This is my treat. I deserve it.” And when you consume those carbohydrates, that bowl of ice cream, that bowl of cereal, that chocolate chip cookie, you feel like this is my reward. I deserve it. So a lot of people will resonate with the low endorphins kind of emotional eating. And when they get on DPA their mood improves, and this comfort eating goes away.

Tune in to hear my entire interview and all the other great speakers!

You can use this link to register for access: https://qt247.isrefer.com/go/SUPP16reg/trudyscottcn/

And use this link to purchase at pre-summit special prices:
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