everywomanover29

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

5-HTP

GABA, 5-HTP and melatonin isn’t working anymore for my insomnia and tryptophan gives me a migraine – what should I do?

By 3 Comments

Today I’m addressing a great question I received on a recent tryptophan blog about insomnia and the use of the amino acids GABA and 5-HTP in a combination product together with melatonin, and what the next steps should be when you are not getting the expected results. And if continuing with tryptophan is a good idea when it seems to be causing a migraine and isn’t leading to a whole night’s sleep. Here is the question:

I have suffered from insomnia for most of my life. I just got your book and am loving it! Thank you for all that you do. My symptoms seem to be high for both low GABA and low serotonin [here is the questionnaire].

I also believe I have a blood sugar problem, so I’m starting to follow your suggestions for that.

I’ve been taking a supplement for sleep that has both GABA and 5-HTP in it, along with melatonin. It worked for a year, however it just recently stopped working.

I thought maybe I should try tryptophan. After taking only 220 mg per night, along with 5 mg of melatonin, I was able to sleep, but not through the entire night. However, the next day I woke up with a horrible headache/migraine. I know it was the tryptophan because I did a trial and tried a night without it and then again with it and the nights I took it, sure enough, the migraine would return.

I must add that I had bloodwork done and tested low for melatonin, which is why I was adding the melatonin into my protocol.

My question is: do I continue with a higher dose of GABA, 5-HTP and melatonin, since it worked for a year i.e. do I up the dosage of the supplement I’ve been taking? Or do I continue trying different doses of tryptophan?

I shared this response in my comment (with some additions for this blog post).

Always first address the nutritional foundational aspects

Firstly, I was glad to hear she is loving my book The Antianxiety Food Solution (my Amazon link) and implementing dietary changes. This is so foundational to any protocol for both anxiety and insomnia. Too often, someone hears me talking about the amazing amino acids and forgets the nutritional basics of real whole food, quality animal protein (like wild fish, pastured eggs and chicken, grass-fed red meat), organic veggies and fruit, healthy fats (like olive oil, coconut oil and butter), fermented foods and broths, and no gluten, caffeine or sugar.

I don’t ever have clients push through

With regards to her trial of tryptophan I shared that I don’t ever have clients push through on a product that is causing any adverse effects, and especially when it’s a migraine. She was smart and trialed the tryptophan twice to make sure it was the tryptophan that caused the migraine and not something else.

Capitalize on what has worked and increase one at a time

With regards to the GABA, 5-HTP and melatonin I shared that I always like to capitalize on what has worked in the past (or is currently working) and would rather increase the 5-HTP and/or melatonin and/or GABA one at a time.

Notice that I said increase these products one at a time. She is taking a combination product so it’s impossible for her to do this. Maybe her GABA levels are now good (because her progesterone levels have improved due to be on a regular zinc supplement or because she has been doing regular yoga sessions) and maybe she needs more serotonin support (because her estrogen levels are off because of recent exposure to xenoestrogens in plastics).

Even though is research showing that a combination product containing GABA and 5-HTP improved sleep and sleep duration more than the use of either of the two amino acids alone, based on her feedback, if we were working together I would have her do each of the GABA, 5-HTP and melatonin separately. This way it’s easy to mix and match and increase one and possibly lower the other, until the ideal combination is found for her unique needs at this time in her life.

She may even find she only needs GABA or only needs 5-HTP or only melatonin. She may also find she needs sublingual melatonin for helping her fall asleep and timed-release melatonin for helping her stay asleep.

She mentions the amino acid questionnaire so it sounds like she is clear on her symptoms: low GABA physical anxiety affecting her sleep and low serotonin mental worry-type of anxiety affecting her sleep. So as she trials the individual amino acids she can see how she does symptom-wise in order to find the ideal amount.

Other factors to consider with insomnia

It’s often straight-forward with the amino acids and the great thing is that one you have the correct combination you will see results in a few days to a few weeks. But There are other factors we may need to consider with insomnia:

  • Keep in mind that 5-HTP can raise cortisol and low blood sugar can indicate adrenal issues so looking at high cortisol as a factor in the sleep problems would be something to consider. A 4-collection saliva test will measure this and my favorite product for lowering high cortisol is Seriphos. Other nutrients for adrenal support may be needed too.
  • Just addressing low blood sugar can often improve insomnia. Eating to support blood sugar swings, early morning sunlight and no blue light after dark can make a world of difference.
  • Other sleep factors we always want to consider: sex hormone imbalances, parasites (they are more active at night and can keep you awake and play a role in high cortisol), accidental gluten exposure, SIBO (small intestinal bacterial overgrowth), candida, sleep apnea and mouth breathing, EMFs (WiFi in the home, commuting with the iphone on, a new cordless phone etc.) and medication side-effects (benzodiazepines are a common one).

I really appreciate questions like this being posted on the blog so others like you also get to benefit. This question also demonstrates just how our needs for certain nutrients can change over time and how we may to keep adjusting what we are doing.

In case you have questions about specific products that I use with clients, here is my supplements blog and more information on GABA for the physical type of anxiety and 5-HTP/tryptophan for the worry-type of anxiety.

Can you relate to this scenario? Feel free to ask your questions about sleep, GABA, 5-HTP, tryptophan and melatonin and share your experiences with these products and how they have helped you or if you’ve had issues with any of them.

Midday bright light therapy for bipolar depression

By 6 Comments

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

The press release issued by Northwestern University reports as follows

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

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

Images used with permission from Northwestern University

How the 7,000 lux bright light therapy was used

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

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

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

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

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

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

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

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

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

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

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

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

I also received this feedback about increased agitation:

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

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

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

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

Using light therapy and tryptophan (or 5-HTP)

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

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

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

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

Anxiety, compulsive thinking, counting behaviors: gluten, tryptophan and inositol

By 20 Comments

Today I’m going to share my feedback on a question I received on how to approach working with a child with anxiety, compulsive thinking and counting behaviors in the hope it can help you or someone you know (or are working with if you’re a practitioner). Here is the question:

Regarding anxiety and compulsive thinking/OCD counting behaviors in a 12 year old, have you experienced (or heard through client sharing) a correlation with certain foods or inflammatory compounds? In a younger person, I am trying figure out the triggers if there is low production of certain neurotransmitters driving the symptoms. This child in particular has had a long history of allergies and terrible asthma (requiring nebulizer treatments) so I’ve long suspected food sensitivities as a driver for systemic inflammation but am trying to connect the dots for her parent. The counting seems to be a distraction of sorts for her – I assume following a triggering thought. This parent is very new to integrative therapies so treating with an amino acid is going to *feel* like she’s not doing enough as parent. Standard talk therapy has not helped.

This is how I responded and it’s how I would start to work with a parent with a child with these types of issues.

After looking at the basics to make sure the child is eating real whole food with no additives, is not consuming any caffeine and is getting quality animal protein at breakfast (to keep blood sugar stable and reduce anxiety), I always consider gluten and even dairy and other food intolerances. I write about the success of a gluten-free diet with a 7 year old boy in this blog: Integrative Medicine Approach to Pediatric Obsessive-Compulsive Disorder and Anxiety. He saw a “marked reduction of OCD symptoms and anxiety along with marked improvement of social behavior and school work.”

OCD and counting behaviors are classic low serotonin symptoms and her anxiety could be the low-serotonin worrying type or the low GABA type which is more physical anxiety. I’d have them do the amino acid questionnaire

I’d start with a trial of tryptophan – using 100mg of Lidtke Chewable Tryptophan – to help with the OCD, counting and worry-type anxiety. If it helps, I’d have her use it twice a day mid-afternoon and evening, increasing it over the course of a few weeks to find the ideal amount for symptom relief (and keeping a food mood log to record doses and symptoms).

Some people do really well with tryptophan, others do better with 5-HTP for low serotonin symptoms, so doing a trial with 25mg of 5-HTP would be an option if the tryptophan doesn’t help as expected.  

I would carefully review the precautions with the mom as tryptophan and 5-HTP can sometimes be an issue with asthma and may need to be lowered or discontinued.

Inositol can be added if additional nutritional support is needed for the OCD and counting behaviors and may even be needed to replace the tryptophan or 5-HTP if either one triggers asthma. The maximum dose in the research is 18g of inositol per day and I start at 2g once a day and increase slowly over a few weeks to find the ideal dose. Here is feedback from one mom on how inositol alone helped her son with migraines, stress, anxiety and OCD

Once we’ve figured out nutritional support for the low serotonin symptoms then we’d address low GABA if needed, using sublingual GABA. [Update Nov 17, 2017: I mentioned GABA as a possibility but with her symptoms and the new GABA research on intrusive thoughts, a GABA trial would definitely be something to pursue]

I found this comment to be rather unusual: “treating with an amino acid is going to *feel* like she’s not doing enough as parent.” The parents I work with are thrilled to discover how powerful the amino acids are and how quickly they provide amazing results.

These other factors would also be addressed: possible high cortisol, gut health and any of the other possible contributing root causes. I also always keep Lyme disease, heavy metals and PANDAS on the list as possible areas to refer out for if symptoms are not resolving with the above approaches.

Here are links to the amino acid questionnaire, the precautions and the supplements:

  • I have my clients complete the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and check off their symptoms in each of the sections. The rating uses scale of 1-10 with 10 being worst.
  • I also have my clients review the Amino Acids Precautions and we figure out which amino acids they can and can’t use
  • These are some of the supplements I use with my clients

Have you used any of the above approaches with your child or for your symptoms or for a client/patient?

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

By Leave a Comment

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

By 11 Comments

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

By 30 Comments

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?