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benzodiazepine

Intoxicating fragrance: Jasmine as valium substitute? New 2019 research confirms this

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A study from the University of the Ruhr, in Bochum, Germany, resulted in a press-release with a very provocative and enticing title – Intoxicating fragrance: Jasmine as valium substitute and a slew of articles which generated much interest. When I came across this 2010 press release recently, I was of course, intrigued and started digging deeper. Despite the fact that some folks felt it was a long stretch to extrapolate to humans, new research published this year confirms this headline may well have some merit.

Here are some highlights from the 2010 press release:

Instead of a sleeping pill or a mood enhancer, a nose full of jasmine from Gardenia jasminoides could also help, according to researchers in Germany. They have discovered that the two fragrances Vertacetal-coeur (VC) and the chemical variation (PI24513) have the same molecular mechanism of action and are as strong as the commonly prescribed barbiturates or propofol. They soothe, relieve anxiety and promote sleep.

The press release also shares that sedatives, sleeping pills and relaxants which increase the effect of GABA, are the most frequently prescribed psychotropic drugs. Also, “the benzodiazepines, which are now among the world’s most widely prescribed drugs” are “not only potentially addictive, but can also cause serious side effects, e.g. depression, dizziness, hypotension, muscle weakness and impaired coordination.” Valium, Xanax, Ativan and Klonopin are all benzodiazepines and I write more about these medications and why they are so problematic here.

Here are some really interesting facts from the press release/study:

  • The two fragrances vertacetal-coeur (VC) and the chemical variation (PI24513) were … able to increase the GABA effect by more than five times and thus act as strongly as the known drugs.
  • Injected or inhaled, the fragrances generated a calming effect.
  • Applications in sedation, anxiety, excitement and aggression relieving treatment and sleep induction therapy are all imaginable. The results can also be seen as evidence of a scientific basis for aromatherapy.

Here is a link to the 2010 paper: Fragrant dioxane derivatives identify beta1-subunit-containing GABAA receptors. I’ll be honest, it was challenging read for me and when I read the press release and actual paper at first, I wasn’t even sure they were talking about the same thing. You won’t find any mention of jasmine in the study, but instead will find vertacetal-coeur.

As I mentioned above, some organizations felt it was a long stretch to extrapolate to humans. The NHS in the UK was one example, publishing this:

Although some anti-anxiety medications are also known to interact with GABA receptors, it is far too soon to suggest that the effects of jasmine are similar to a recognised treatment for anxiety such as valium. People taking prescribed medication for anxiety should not change their treatment based on this study.

New 2019 research on jasmine for labor anxiety

However, a paper published just this month, A Systematic Review on the Anxiolytic Effect of Aromatherapy during the First Stage of Labor confirms the use of jasmine for reducing anxiety during the first stage of labor (in humans):

It is recommended that aromatherapy could be applied as a complementary therapy for reducing anxiety during the first stage of labor, but methodologically rigorous studies should be conducted in this area.

A total of 14 published papers and 2 unpublished papers were part of the review and other essential oils identified in the review for easing anxiety during labor include: rose, clary sage, geranium and frankincense, chamomile, bitter orange, sweet orange, peppermint, mandarin orange and clove.

Hopefully the NHS in the UK will update their article to include this new review.

Jasmine for other anxiety situations and feedback from real people

I feel very comfortable extrapolating this anxiety-reducing effect of jasmine during labor to other anxiety situations until we have more research.

I also asked folks on Facebook: “Do you use jasmine essential oil and love it? I’m working on a blog post on how jasmine impacts GABA levels and helps ease anxiety and I’d love to include some feedback (good or bad) in the blog. Care to share?” Here is some of the feedback –

Debra: “Never knew there was a Jasmine essential oil… love the smell of fresh Jasmine…will have to look out for it on days when I just need a bit more than what my antidepressant can do…”

Trish: “I use a blend from one of the companies called Joy that has Jasmine in it. It’s awesome, lightens the spirit, makes the day go happier. I use it as a perfume.”

Jessica: “I just started using it.. I really love it! I was using for facial purposes and then read it was good for anxiety and I do feel calm when using and just smelling it really.”

How to get some of the calming benefits of jasmine

There are many ways to enjoy the calming effects of jasmine. Here are some ideas for you:

  • Diffuse the jasmine essential oil alone in combination with other calming essential oils like lavender and one of the citrus oils like neroli or lemon. The Joy blend that Trish mentions above has bergamot, ylang ylang, geranium, lemon, coriander, tangerine, jasmine, roman chamomile, palmarosa and rose. Dr. Mariza, suggests this “Simply Soothing Diffuser Blend” in her new book The Essential Oils Hormone Solution (my review here)– 2 drops neroli, 2 drops jasmine and 2 drops ylang ylang essential oil
  • Use it topically with a carrier oil for a massage, alone or in a blend as above
  • Do what Trish suggests and use it as a perfume (I currently do this with neroli and am now going to try some jasmine)
  • Bring fresh jasmine flowers into your home or get a jasmine pot plant
  • Enjoy it in a tea. Organic India has a lovely tulsi tea that contains chamomile and jasmine. If you recall, tulsi or holy basil is an adaptogenic herb which has anti-stress effects
  • If you can tolerate caffeine, enjoy some Jasmine Oolong tea. Research suggests that the fragrant compounds in the tea “were absorbed by the brain and thereby potentiated the GABAA receptor response…and may therefore have a tranquillizing effect on the brain.”

Next steps: jasmine and GABA or jasmine alone?

It’s hard to know if jasmine used in any of the above ways will be enough to boost your GABA levels and ease your anxiety completely. The best way to find out is to try and see how you feel. It’s all very promising given that the 2010 study found that the compounds they used were able to increase the GABA effect by more than five times.

Until I’ve had clients use jasmine alone for this purpose, I’m still going to recommend the amino acid GABA (based on the questionnaire and a trial) and will suggest concurrent use of jasmine in some way. Once GABA levels have been boosted and all the other changes have been made (diet, blood sugar control, gut health, adrenals, low zinc, low vitamin B6 etc.), jasmine alone may be enough to keep GABA levels on an even keel.

However, right now I do see jasmine as a viable approach that is worth considering if you’re in the midst of tapering from a benzodiazepine and are not able to tolerate GABA and other oral supplements.

I’d love to get your feedback on jasmine and GABA and how you feel both help you (or have helped) with anxiety, depression, sleep or aggression? And if either has helped you taper off your benzodiazepine?

Please also share your favorite ways to use jasmine.

Feel free to post your questions here too.

Additional Anxiety Resources
Click on each image to learn more

Tulsi or holy basil: adaptogenic herb for adrenal support, anxiety and anti-stress effects

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One very effective approach for supporting the adrenals, reducing anxiety and providing general anti-stress support is using a herbal adaptogen. One of my favorite herbal adaptogens and one that I have found to be very effective and well tolerated by my clients is tulsi, also known as holy basil or the “Elixir of Life” in Ayurveda. I also really like rhodiola. ashwagandha and licorice root but we’ll cover these in another blog.

As stated in this 2017 paper, The Clinical Efficacy and Safety of Tulsi in Humans: A Systematic Review of the Literature

Tulsi, also known as holy basil, is indigenous to the Indian continent and highly revered for its medicinal uses within the Ayurvedic and Siddha medical systems. Many in vitro, animal and human studies attest to tulsi having multiple therapeutic actions including adaptogenic, antimicrobial, anti-inflammatory, cardioprotective, and immunomodulatory effects.

The above paper is a review of the literature and the 24 studies that were included, reported favorable therapeutic effects of tulsi for humans and no significant adverse effects. Only one clinical trial reported mild nausea that lasted a short while.

The authors conclude that the outcome of this review

reinforces traditional uses and suggests tulsi is an effective treatment for lifestyle-related chronic diseases including diabetes, metabolic syndrome, and psychological stress.

With regards to psychological stress, three of the clinical studies reviewed

reported significant reduction in anxiety and stress levels with higher doses of tulsi given over a longer time period.

The positive effect of tulsi on mood was demonstrated … with two studies reporting reductions of 31.6%–39% in overall stress-related symptoms in patients with psychosomatic problems compared to a control group.

In two of these stress studies the dosage ranged from 300mg to 400mg 3 x day and was taken either before or after a meal. In one stress study, 3g (3,000mg) twice a day was used. In all the stress/anxiety studies improvements were observed in 4-12 weeks.

The review also looked at studies on metabolic disorders i.e. type 2 diabetes with “measures of blood glucose, lipids, and blood pressure” and studies on immunity, all showing benefits. In one of the immunity studies, the participants were given 10g (10,000mg) /day for viral hepatitis and symptoms all improved within 2 weeks. I’m sharing this so you can see that the dosage varies depending on the condition and severity of symptoms.

Adrenal support, anxiety, depression and radiation-protection

Here are some additional animal studies that support the use of holy basil or tulsi for adrenal support, for easing anxiety and even depression, and for the anti-stress effect it offers:

found to be effective in the management of stress effects, and anti-stress activity could be due to inhibition of cortisol release

With all the WiFi we are exposed to and the fact that research is now showing that EMFs (electromagnetic frequencies) are likely playing a role in anxiety, depression and ADHD, I’m really pleased to see there are also some animal studies on tulsi being protective against radiation.

Consuming tulsi tea on a daily basis

The review paper above mentions

the Ayurvedic tradition of consuming tulsi on a daily basis

and an easy and delicious way to do this is to drink it as a herbal tea.

Next time you’re ordering your amino acids and pyroluria supplements from my online store with Fullscript, be sure to add a few boxes of Organic India tulsi tea to your shopping cart. This way you can enjoy the healing and anti-stress benefits of tulsi together with the many other herbs included in their teas.

The Lemon Ginger Tulsi has been a long-time favorite of mine and is wonderful when flying to counter motion sickness. Based on the radiation research I uncovered when writing this blog. I’m thrilled I’ll be getting those benefits when flying too. I also enjoy the Peppermint Tulsi early in the day and have recently found a new favorite, the Tumeric Ginger Tulsi (not pictured below). Just so you know, you can also find the herbal teas in most health shops and natural food markets.

The adaptogenic Tulsi-Holy Basil product

Organic India also carries the wonderful adaptogenic Tulsi-Holy Basil product which is taken as a supplement. This is an option if you’re not a herbal tea drinker and/or you need some additional support.

If you’re interested in purchasing the tea or Tulsi-Holy Basil product, you can go to my online store with Fullscript, and simply search for “tulsi”.

How do I use tulsi with my anxious clients?

Where does recommending the tulsi herbal teas and/or the Tulsi-Holy Basil supplements fit in with the dietary and nutritional protocols of my anxious clients?

  • If you have stress in your life (and who doesn’t?!), drinking the tulsi herbal tea on a daily basis is beneficial. You can mix-and-match with other naturally caffeine-free and healing herbal teas such as rooibos
  • If you have done adrenal testing and cortisol results are outside of the reference ranges (either high or low) drink the herbal tea and use an adaptogenic herbal supplement such as tulsi (or rhodiola, licorice or ashwagandha), together with a B-Complex, extra vitamin C and extra pantothenic acid
  • Assess for low serotonin and low GABA anxiety with the questionnaire and do trials of amino acids for the low GABA physical anxiety and/or tryptophan for the worry-in-the-head anxiety
  • If you are tapering from a benzodiazepine and are not able to initially tolerate high doses of GABA, tulsi is often gentle enough to provide some additional healing support. Research shows the immune modulating effects of tulsi may be mediated by GABAergic pathways).
  • Make all the dietary changes and address gut health, blood sugar control, low levels of various nutrients like low zinc, reduce stress etc.

Organic India’s ethic and mission

I really love that Organic India works “with thousands of small family farmers in India to cultivate tens of thousands of acres of sustainable organic farmland”, the fact that their “farmers and tribal wildcrafters are educated in organic and regenerative agricultural practices”, and that they have global wellness as part of their bigger mission.

I would like to disclose that Organic India has sponsored me on a number of occasions, providing samples of herbal tea for me to share at conferences such as IMMH. I’ve blogged about this in the past thanking Organic India and other companies.

I do also want to mention that the review paper discloses that one of the authors, Professor Marc M. Cohen, “receives remuneration as a consultant and advisor to Organic India Pty. Ltd., which is a company that manufactures and distributes tulsi products. This article is the independent work of the authors and Organic India did not have input into the article’s content or the decision to publish it.” I appreciate this disclosure.

Do you drink tulsi tea on a regular basis and have you seen the anti-stress and calming benefits? If you drink Organic India tea, which one is your favorite one?

Have you used tulsi or holy basil in supplement form as an adaptogenic herb and what benefits have you observed? Have you used it while tapering from a benzodiazepine?

If you’re a practitioner do you use tulsi with clients/patients or recommend tulsi tea?

Feel free to post questions here too.

Fipronil insecticide: GABA/glutamate and anxiety, aggressive behavior, memory and Alzheimer’s disease in humans?

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The insecticide called fipronil has me concerned because there is increasing evidence that it can be toxic to humans and, much to my surprise, I’ve just discovered that the main mechanism of action is by targeting the gamma-aminobutyric acid (GABA) receptor and recent research points to increased anxiety, aggressive behavior, memory problems and even Alzheimer’s disease in animal studies.

Based on a rather surprising conversation I had with someone a few weeks ago (let’s call her Sue), I felt compelled to get more information on fipronil. Before that I was not aware about the specific effects I mention above.

We were in Sue’s front yard and the dog kept sniffing these small white plastic squares in the flower beds. Sue kept pulling the dog away and I asked “why? what are those?” It turns out they were ant-bait devices. Yes, I’m this clueless simply because I’ve never purchased anything like this. I expressed my concerns about toxicity and possible endocrine/hormone effects but didn’t have enough concrete facts, so I went digging through the research. Needless to say I am very concerned with what I found.

What was equally concerning is that Sue had not even considered that it could be harmful. Looking into possible harms was not even on her radar. When pressed, Sue said “it’s only a small amount in each container so I’m sure it’ll be fine” and “the poison is inside the container so none of it will come out – so it’ll be fine.”

This is what went through my mind (which is pretty typical for me – I’m always in questioning mode): What is it and how toxic is it? Does it have impacts on humans and by what mechanism? Could it cause anxiety or increase existing anxiety symptoms? Are there additional concerns about it being in a flower-bed near the front door where you could possibly walk some into the house or breathe it in as you come and go?

Organophosphates and psychological effects

Organophosphates are a commonly used pesticide used on fruits and vegetables and research going as far back as 1994 reports that acute exposure can cause psychological effects because they

act directly on the nervous system by inhibiting the neurotransmitter acetylcholine … [contributing to] … acute psychological and behavioral effects, such as anxiety, depression, and cognitive impairments.

The researchers also suggest that long-term psychological effects of low-level exposure have not been determined satisfactorily.

We hear less about insecticides such as fipronil

We hear less about insecticides such as fipronil and how they work.

According to the National Pesticide Information Center Fipronil is a broad use insecticide that

belongs to the phenylpyrazole chemical family. Fipronil is used to control ants, beetles, cockroaches, fleas, ticks, termites, mole crickets, thrips, rootworms, weevils, and other insects.

Fipronil is used in a wide variety of pesticide products, including granular products for grass, gel baits, spot-on pet care products, liquid termite control products, and products for agriculture.

It can be found in ant-bait and anti-cockroach products as well as Frontline Plus for cats and dogs. You can find a partial list of products here and a fact sheet here.

GABA & glutamate: anxiety, aggressive behavior and neurotoxic effects

Fipronil works to kill insects via the inhibition of glutamate- and GABA-activated chloride channels resulting in uncontrolled neural excitation. It also blocks GABAA receptor function and is typically considered toxic to insects but not humans.

As soon as I read the GABA-glutamate mechanism I started searching for anxiety and neurotoxic connections.

There are no human studies on increased anxiety due to fipronil exposure but research on zebrafish larvae exposed to fipronil at typical environmental levels, finds anxiety-like behavior.   In the paper, A metabolomic study of fipronil for the anxiety-like behavior in zebrafish larvae at environmentally relevant levels, the authors report decreased levels of glycine and serine with higher levels of glutamate saying fipronil may be a potential neurotransmitter disruptor. Here are some of the possible mechanisms they discuss related to this:

  • The decreased metabolite glycine caused by fipronil may contribute to the excitatory swimming performance. Whether the glycinergic reciprocal receptor (GlyR)…inhibitory mechanism is also involved in low level of fipronil [exposure] requires further investigation.
  • Additionally, as one of the most abundant amino acids in microenvironment stress, proline is biosynthetically derived from the amino acid L-glutamine. Low levels of L-proline detected in fipronil-treated group may indicate the accumulation of glutamine. As an excitatory neurotransmitter, high level of glutamine would associate with the excitatory behavior of the fish.

In another study, Prenatal exposure to fipronil disturbs maternal aggressive behavior in rats, the authors suggest fipronil impacts the central nervous system areas that control aggression and increases in maternal aggressive behavior are via impacts on GABA(A) receptors.

This 2016 paper lists a variety of toxic effects to both animals and humans: Fipronil insecticide toxicology: oxidative stress and metabolism:

because of accidental exposure, incorrect use of fipronil or widespread fipronil use leading to the contamination of water and soil, there is increasing evidence that fipronil could cause a variety of toxic effects on animals and humans, such as neurotoxic, hepatotoxic, nephrotoxic, reproductive, and cytotoxic effects

They explore oxidative stress as a possible mechanism as to how fipronil causes these toxic effects.

Does concrete make fipronil more toxic?

One of the questions I asked myself was this: Are there additional concerns about it being in a flower-bed near the front door where you could possibly walk some into the house?

It turns out that this may be a valid concern. In this 2016 paper, Conversion of pesticides to biologically active products on urban hard surfaces, the researchers report that urban landscapes that include concrete can actually convert pesticides to other biologically active and more toxic intermediates, likely caused by the alkalinity and metal oxides in concrete. They report that fipronil:

was quickly transformed to desulfinyl and sulfone derivatives, with the desulfinyl level exceeding that of parent in the runoff water only 1week after treatment. Fipronil derivatives have aquatic toxicity similar or even greater than the parent fipronil.

Impacts on memory and a possible factor in Alzheimer’s disease

This 2016 animal study, Memory impairment due to fipronil pesticide exposure occurs at the GABAA receptor level, in rats concludes that fipronil can

have toxic interactions with the CNS [central nervous system] of mammals and lead to memory impairment by modulating the GABAergic system.

We also have to ask how big a role this insecticide could be playing in Alzheimer’s disease? In a paper published earlier in 2018, Induction of Amyloid-β42 Production by Fipronil and Other Pyrazole Insecticides, they use the term “Alzheimerogens” when writing about insecticides such as fipronil and the metabolite fipronil sulfone:

Focusing on fipronil, we showed that some of its metabolites, in particular the persistent fipronil sulfone, also favor the production of Aβ42/Aβ43 in both cell-based and cell-free systems.

Fipronil administered orally to mice and rats is known to be metabolized rapidly, mostly to fipronil sulfone, which stably accumulates in adipose tissue and brain.

In conclusion several widely used pyrazole insecticides [such as fipronil] enhance the production of toxic, aggregation prone Aβ42/Aβ43 peptides, suggesting the possible existence of environmental “Alzheimerogens” which may contribute to the initiation and propagation of the amyloidogenic process in sporadic AD.

The paper shares that amyloid-β peptides (Aβs), especially increased production of Aβ42/Aβ43 over Aβ40, represent a characteristic feature of Alzheimer’s disease.

Why wait for long-term human studies?

Hopefully you’re like me and don’t buy ant-bait or roach-bait products.

My bigger concern is the wide-spread use of spot-on pet-care products which contain fipronil, exposing our beloved pets to this toxin and all the humans they come into contact with. Pet-groomers are especially cautioned. And I’d also add a caution for children playing with pets where these flea and tick products are used since “the developing brain is particularly vulnerable to the action of insecticides.”

We don’t know for sure how harmful this insecticide is for humans and it’s not clear what the mechanisms are – GABA-glutamate and/or glycine and/or oxidative stress – but why wait for long-term human studies, especially given that chronic and long-term effects are difficult to investigate and based on what we already know about their effects on Parkinson’s disease, amyotrophic lateral sclerosis, and depression.

I have found enough information to be very concerned and to feel justified in continuing to avoid fipronil. I encourage you to avoid fipronil as well.

This is especially the case if you already suffer from long-term anxiety, insomnia or another chronic health condition as it may be one more possible contributory factor.

Given that fipronil blocks GABAA receptor function, I have to wonder if chronic long-term exposure could play a role in difficulties with benzodiazepine tapering.

If this is old news to you feel free to share with family and friends who may not be as informed as you.

If this is news to you, I hoping this gets you thinking and questioning. I’d love to hear your thoughts, concerns and questions.

The benzodiazepine valium blocks DAO and impacts histamine levels: wisdom from Yasmina Ykelenstam and a tribute to her brilliance

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The benzodiazepine valium blocks DAO and impacts histamine levels and may actually increase anxiety via this mechanism. I learned all this in an interview I conducted with my amazing colleague Yasmina Ykelenstam.

Sadly Yasmina lost her battle to a rare and aggressive type of breast cancer this week. She had triple negative breast cancer which has a minimal survival rate of no longer than just a few months. She lived with it for over 2 years, outliving all odds. She had just turned 43.

It is with great sadness and reflection that I write this post as tribute to Yasmina who was as bold as she was brilliant.

Yasmina is well known as the Low Histamine Chef and for an abundance of histamine intolerance resources and recipes on Healing Histamine.

We only met in person on one occasion in 2017 and spent an evening and wonderful lunch together. Her warmth, passion and caring shone through and I felt I already knew this kind and smart woman. I had been following her work online after an interview with Dr. Ben Lynch on season 2 of the Anxiety Summit – Biochemical and genetic predispositions: COMT, GAD & MAOA – where he raved about her work.

I reached out to Yasmina and was so thrilled to have the opportunity to interview her for season 3 of the Anxiety Summit – Histamine-containing Foods: their Role in Anxiety, Depression and Schizophrenia

As a tribute to Yasmina and so her brilliance continues to shine I’m sharing some of the highlights from our interview, where she shared that:

  • Histamine is the gluten of the intolerance world
  • Histamine is a neurotransmitter and plays a role in mood disorders
  • Histamine can cause symptoms of anxiety: Increased heart rate and blood pressure, shortness of breath and gasping for air, pounding heart, dizziness and feeling faint

In case you’re new to histamine intolerance this paper provides a quick overview: Histamine and histamine intolerance

Histamine intolerance results from a disequilibrium of accumulated histamine and the capacity for histamine degradation. Histamine is a biogenic amine that occurs to various degrees in many foods. In healthy persons, dietary histamine can be rapidly detoxified by amine oxidases, whereas persons with low amine oxidase activity are at risk of histamine toxicity. Diamine oxidase (DAO) is the main enzyme for the metabolism of ingested histamine.

This new research shows how a low histamine diet has benefits: Histamine-reduced diet and increase of serum diamine oxidase correlating to diet compliance in histamine intolerance

In our interview we had a lengthy discussion on benzodiazapines and the histamine connection. It was both fascinating and very concerning:

Many people doing a benzodiazepine taper are often switched to Valium which is a DAO [diamine oxidase blocker (or histamine liberator)] and this further prevents histamine from being removed from the body.

Dye are also triggers…the pink Xanax can be problematic 

Here is the transcript from the benzodiazepine section of our interview, with a few tweaks to give it context. I start by asking Yasmina to talk about histamine interactions with psychiatric medications.

* * * * * * * * * * * * * * * * * * *

Yasmina Ykelenstam: Well, I recommend that people go to a wonderful website and it is called histaminintoleranz.ch. It’s German, but it’s translated into English. That’s H‑I‑S‑T‑A‑M‑I‑N‑I‑N‑T‑O‑L‑E‑R‑A‑N‑Z.ch. And they have a very, very long list of medications on there that interact with diamine oxidase or histamine liberators. The one that I just wanted to mention very quickly because it’s relevant to anxiety – and that one is diazepam [you can find this listed on the above site on this page.]

Diazepam (or Valium) is a medicine, as I said, that I used when I was a child – for a couple of days. And it’s a tranquilizer, a benzodiazepine. One of the most commonly prescribed benzodiazepines in the world is Valium.

I don’t know if it still is, but when the UN would send out emergency packs to people, Valium was included in there. That’s how widespread its use is. It’s a diamine oxidase blocker. So it blocks the enzyme responsible for degrading histamine in the body. So people who are dealing with anxiety symptoms that are perhaps caused by histamine issues would not do very well potentially with Valium / diazepam because it would further prevent histamine from being removed from the body.

I was on Valium / diazepam for many, many years after it was first prescribed to me and I did not know that. And it was the medicine, it was the tranquilizer that I chose to use to taper from another benzo. I was on Xanax at the time and I had been told that Xanax is harder to withdraw from than crack. So I should switch to another benzodiazepine that had a longer half-life – how long it stays in the body – so that it would make it easier for me to withdraw. And Valium / diazepam was the one that I chose and I think that’s when my body started giving me the message of “Hurry up; just finish this; just cut, cut, cut; get this out of the body because it’s not doing you any good.”

But there is a very, very long list of medications on that German site and interestingly, there are a number of antihistamines in the list of medications that block diamine oxidase and also the other histamine-degrading enzyme. Cimetidine, C‑I‑M‑E‑T‑I‑D‑I‑N-E – I think it is a second-generation antihistamine. It is still prescribed today. It was being prescribed to many people by a doctor in London.

I have another doctor: Dr. Seneviratne in London. He is an immunologist with mast cell focus. He’s excellent. But there was another doctor who was supposedly a mast cell person who was prescribing cimetidine to people. I had to send a message to him saying please stop doing this because it’s probably not very good for them. Also, we were talking about diphenhydramine and that is an HNMT blocker, which is the other histamine‑degrading enzyme.

Trudy Scott: Okay. So I want to just recap here. So we’ve got these meds that block the DAO enzyme, which in turn prevents you from releasing histamine and preventing histamine from being removed from the body.

Yasmina Ykelenstam: Exactly. Yeah, and what’s odd is diphenhydramine is obviously Benadryl, which is one of the most commonly prescribed antihistamines in the United States.

Trudy Scott: A lot of people are on diphenhydramine. You’re right, yeah.

Yasmina Ykelenstam: There are many different mechanisms of action for degrading histamine and for getting it out of the body. So it might not be the end of the world if you’re taking one medication that affects the DAO enzyme but doesn’t affect the HNMT enzyme. And obviously, there’s the liver and there’s different methods of dealing with things in the body. So it’s not the end of the world, but still it’s something you might not want to do and should definitely discuss with your doctor.

Trudy Scott: Yes, and being aware of this. Now I wanted to just go back to the benzodiazepines because I was not aware of this connection to Valium diazepam, and that being a DAO blocker. So is it only the Valium and the other benzodiazepines are not, or is it all benzodiazepines?

Yasmina Ykelenstam: Okay, let me try to remember. Haloperidol is an antipsychotic, isn’t it? (It’s on the list)

Trudy Scott: Yes, that’s correct.

Yasmina Ykelenstam: I am not aware of any others offhand and I’m just trying to take a quick look at the list now that I have it in front of me. But no, I don’t believe so because I looked them up because having taken all of them, and I mean, really all of them, I have taken every benzodiazepine ever made in the last 30 years. And no, I think it was just the diazepam, but as I said, it is one of the most commonly prescribed.

Trudy Scott: And it’s really important for me to mention this because I am dead against all benzodiazepines because of their addictive/dependent nature and the side effects and when you’re trying to taper off they cause all these problems. I’ve interviewed a number of people on this topic. In Season 1 of the Anxiety Summit, I interviewed Dr. Catherine Pittman who talked about the Benzobuddies.org group and how so many individuals battle getting off benzodiazepines.

Yasmina Ykelenstam: Oh, I was a member.

Trudy Scott: You were?

Yasmina Ykelenstam: I was a member there (at benzobuddies.org) at one point.

Trudy Scott: Oh, you were? Yeah, it’s a very big issue and problematic drug. But why I’m saying this is because Professor Ashton, who’s an expert on tapering, talks about switching to Valium. So this could be problematic.

Yasmina Ykelenstam: Well, if you could reach out to these communities, that would be fantastic because I did spend some time after, figuring out what was going on, trying to contact people and trying to let them know of this link because there were a lot of people that were in these communities that were suffering from protracted withdrawals. And by this point, I had my suspicions that the protracted withdrawals were actually a histamine response and that the reason that they were experiencing this was just that the original issue was never dealt with. And that was that it might be an underlying histamine issue that initially had them diagnosed with the anxiety disorder and then they were taking these meds. And so when you take the medication away, you’re still left with the existing condition but it isn’t being addressed.

Trudy Scott: Yes, and maybe some of them had done the switch to Valium, which was making things worse.

Yasmina Ykelenstam: Exactly.

Trudy Scott: Very interesting.

Yasmina Ykelenstam: The reason I switched to Valium was because I was following Dr. Ashton’s protocol from benzo.org.uk. I was advised against coming off my medication and I was told that there was no safe withdrawal protocol. I brought them a copy of the Ashton protocol and I was laughed out of the office, but I chose to do it on my own anyway and I’m very grateful to her research.

Trudy Scott: Yes, she’s done amazing research. I’m so appreciative to learn of this component and I’m on a mission to educate people about the benzodiazepines and this is just another aspect that we need to be considering. I will certainly reach out to some of these groups and people hearing this on this Summit, is going to bring awareness to this aspect. All of this is fantastic.

Yasmina Ykelenstam: The other brief thing is that, of course, the dyes are also triggers. And this is why a lot of us, when we’re prescribed psychiatric meds, end up with a new set of symptoms because of the coloring that is actually on the tablets. I was unable to take the pink Xanax, but I was able to take the white Xanax, and my doctor never understood it. He said, “I don’t understand how higher doses of Xanax make you feel worse, but the lower ones works for you.” And I kept telling him, “But I’m taking the same dose at the end of the day, so I don’t understand either.”

* * * * * * * * * * * * * * * * * * *

Here is the link to the entire audio so you can get a better understanding of histamine intolerance.

I’d love to hear your benzodiazepine and histamine intolerance experiences – both good and bad

It would remiss of me to omit something that is seldom discussed: the link between benzodiazepine use and increased cancer risk. In our interview Yasmina shared this “I have taken every benzodiazepine ever made in the last 30 years.”

Yasmina was always very open about her healing journey and I suspect she asked herself this question and would be ok with me making this possible connection in the hope it may help someone who is considering a starting a benzodiazepine prescription or someone contemplating doing a benzodiazepine taper.

I hope this has been helpful if you’re currently taking a benzodiazepine, are considering taking one, have taken one in the past, have issues with high histamine foods, are taking one of the other medications on the list, and/or have had issues with the colors in medications.

With much appreciation to Yasmina! We loved her and thank her for sharing so freely and wisely and we love that her wisdom will live on! Rest in peace.  My deepest sympathies to her family and others who were close to her.

Note added later on 9/14/18 after this blog was published:

As soon as I heard the sad news about Yasmina I wrote this blog as a tribute to her. Then a few hours before it was due to be published I heard her family had not yet made the announcement public and hadn’t yet shared the news with her community.  At the last minute I removed the tribute sections out of respect for them. When I woke I saw the announcement on her Facebook page and reinstated my tribute.

I’ll be doing further updates to share some of what was said about continuing her legacy and anything more I learn.

Thailand cave rescue: yes to calming meditation and GABA, no to antianxiety medication

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The cave rescue of 12 teens and their soccer coach in Thailand is such a beautiful story of hope, courage, resilience, volunteerism and the whole world coming together! I’ve been following the news about this from day 1 (as I’m sure you were) and felt such relief and joy on hearing they had all been safely rescued and appear to be physically and mentally fine.

I’m weighing in on the fact that meditation seems to have played a major role in keeping them calm, using GABA or theanine instead of antianxiety medications and B vitamins for ongoing psychological support.

Meditation seems to have played a role in keeping them calm

Meditation seems to have played a role in keeping them calm, according to this report from the UK

The 12 Thai boys and their football coach who were trapped in a cave in Thailand got through the ordeal by practicing meditation, family members have said.

According to a mother of one of the boys, the team were meditating in the widely shared video of their discovery by two British divers.

Look at how calm they were sitting there waiting. No one was crying or anything. It was astonishing.

The coach who was rescued from the cave on Tuesday, trained as a Buddhist monk for 12 years before he decided to coach the Wild Boars soccer team.

‘He could meditate up to an hour,’ said his aunt, Tham Chanthawong. ‘It has definitely helped him and probably helps the boys to stay calm.’

Here is the video of their lovely smiling calm faces when they were first found.

 

In this paper, Meditation Programs for Psychological Stress and Well-Being, they report that

Meditation programs, in particular mindfulness programs, reduce multiple negative dimensions of psychological stress [such as anxiety, depression, stress, distress, well-being, positive mood, attention]

Meditation has also been shown to improve dopamine and serotonin transporter binding, which appears to have reduced fatigue and improved mood in this study, likely because there are higher levels of these neurotransmitters available.

In a study done with young adults, Effects of mindfulness meditation on serum cortisol of medical students, meditation lowered cortisol levels, suggesting reduced feelings of stress.

Meditation and GABA/theanine instead of antianxiety medications

It was clearly an extremely difficult rescue and the Australian doctor, Adelaide anaesthetist Dr Richard Harris, risked his life to go into the cave and stayed with the boys and their coach for several days. He assessed their health and made sure they were ready for the rescue.

He used his medical expertise and rescue diving experience to decide to have each of them use antianxiety medication for the arduous 8-hour plus rescue (I suspect it was Dr. Harris’ decision). It was confirmed by Thai Prime Minister Prayuth Chan-ocha – to help calm their nerves – and it’s likely they were given a benzodiazepine, hopefully only the one time.

Even though very short term acute situations like this, is actually the intended use of benzodiazepines, it concerns me that these young boys were medicated, especially since adverse paradoxical reactions can be caused by benzodiazepines and are difficult to predict and diagnose.

The following adverse reactions can occur: “unanticipated restlessness and agitated episode,” sometimes aggression, hostility, and rage, as well as “an increased state of anxiety.” An adverse reaction during the actual rescue would have been very serious.

There were also reports of elevated white blood cells (WBC) and signs of a lung infection in some of the boys, and one boy had low blood pressure. These are all be side-effects of benzodiazepines. It’s difficult to know what caused any of this – was the medication, the rescue itself and the fact that were under water or spending all that time in the cave?

My intention is not to be critical of the medical decisions that were made in these very dire circumstances. I’ve done caving or spelunking as it was called in England and it’s pretty scary being underground and in the dark, wading through running water – and we were safely in control of things!

I’m sharing about benzodiazepines simply to raise awareness about other options and some of the many risks. And we haven’t even explored the fact that long-term use of benzodiazepines do more harm than good. More than a week to 2 weeks is considered too long, and for some this is even too long.

I really do look forward to the day when benzodiazepines are not the first approach but rather that:

  • meditation is recognized as being as effective, if not a more effective calming approach (I suspect the mediation benefits these boys had been experiencing would likely have carried them through the rescue)
  • the amino acids GABA or theanine are recognized for the calming benefits they offer (especially since the “mechanism of benzodiazepine action is through the gamma-aminobutyric acid [or GABA] receptors.”

B vitamins and other nutrition solutions after psychological stress

Thailand’s Department of Mental Health shared that

People who endure such an intense and dangerous event can go on to suffer lasting anxiety, depression and other symptoms of post-traumatic stress disorder.

I was so pleased to hear that the boys and their coach are being given B vitamins. There is evidence-based research on the psychological benefits of B vitamins after a trauma (like an earthquake or flood), thanks to my colleagues Julia Rucklidge, PhD and Bonnie Kaplan PhD​.

I do hope the B vitamins are continued and is offered to worried family members and all the wonderful rescuers who must be exhausted and stressed too.

Hopefully the boys will also continue to meditate with their soccer coach and share some of the benefits they experienced with family and friends.

How did you feel when you heard the rescue was over? Good news gives us such feel-good warm emotions doesn’t it!?

Do you meditate and have you used calming GABA or theanine?

Let us know if you have questions too.

Melatonin improves sleep quality and reduces anxiety after a TBI (traumatic brain injury)

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New research shows that melatonin improves sleep quality and reduces anxiety after a TBI (traumatic brain injury). The study, Efficacy of melatonin for sleep disturbance following traumatic brain injury: a randomised controlled trial was completed in Australia and used a prolonged-release (also called timed-release) melatonin product.

The study participants, 67% of whom were male, had mild to severe TBI and sleep disturbances as a result of their injuries (most of which were from car accidents). There were 2 study groups, with one group given 2mg of prolonged-release melatonin for 4 weeks and then switched to a placebo for 4 weeks (with a 48-hour window in between). The other group did the opposite.

The prolonged-release melatonin was made by Sigma Pharmaceuticals Australia and called Circadin. Each night 2 hours before bedtime, 2mg of Circadin was taken by study participants. They received a reminder text message each night.

These are the study results for sleep:

Melatonin was associated with a significant and moderate reduction in PSQI [Pittsburgh Sleep Quality Index] global scores, indicating improved sleep quality.

There was no significant reduction in sleep onset latency with melatonin compared to placebo.

What this means is that overall quality of sleep improved but there was no change in the time it takes to fall asleep (sleep onset latency). The latter is to be expected with prolonged-release or timed-release melatonin.

The study concluded that:

The present results, therefore, suggest that melatonin may be useful in treating sleep disturbances in patients with TBI.

With better sleep quality you would expect reduced fatigue and improved vitality – both were reported by study participants.

Melatonin associated with a small decrease in self-reported anxiety

What is interesting is that melatonin was also associated with a small decrease in self-reported anxiety (no differences in depression were reported.) The authors suggest that one possible mechanism of this may be that melatonin acts a muscle relaxant. In this commentary: Potential action of melatonin in insomnia, the authors equate the beneficial effects of melatonin to benzodiazepines:

many of the actions of melatonin on sleep propensity, anxiety, thermoregulation, and convulsions resemble those reported following administration of benzodiazepines. It is possible that some of these actions of melatonin may be mediated via peripheral benzodiazepine receptors

They are suggesting that with melatonin we get the sleep improvement (sleep propensity is the readiness to transit from wakefulness to sleep, or the ability to stay asleep if already sleeping), relaxation effects and antianxiety benefits of benzodiazepines.

But you get none of the side-effects, tolerance issues and withdrawal nightmares with a benzodiazepine which do more harm than good. On a side notes: this month World Benzodiazepine Day is celebrated to create awareness and offer support for benzo sufferers.

I would have picked something more inert for the placebo ingredients

I would have picked something more inert for the placebo ingredients: mannitol (106mg), acacia (11 mg) and pure icing sugar (106 mg). Mannitol, a sugar alcohol, can cause bloating and diarrhea in some individuals and although the amount is tiny (5g of sugar equals 1 teaspoon), sugar consumption is not ideal before bed. As I would expect adverse symptoms:

were more frequently reported during placebo treatment. The most commonly reported symptoms were neurological, followed by bodily pain, gastrointestinal and dermatologic.

In Australia, melatonin cannot be purchased over the counter (OTC) at health stores or via online retailers, unlike in the USA, and is only available by prescription. I’m all for melatonin being available OTC but the silver lining to this is that companies that make melatonin, such as Circadin, have a vested interest in the research. Research is expensive and time-consuming and we get to benefit too.

Keep in mind that this research is applicable to anyone with low melatonin, whether or not a prior TBI has occurred.

There are many root causes of insomnia – how I work with clients

In those with TBI, sleep disturbances are common, and the authors do report reduced evening and overnight melatonin production in this population. However, there are many root causes of insomnia, with low melatonin being one possible root cause – in TBI and in those who have not had a TBI.

One study limitation is that they didn’t measure melatonin levels or circadian rhythm (salivary cortisol) in all of the study participants so we can’t be sure everyone did have low melatonin.

And melatonin isn’t going to work in all instances of insomnia. It’s one root cause I look at.

This is how I work with clients who have insomnia:

  • I start with low serotonin and address this with tryptophan observing improvements in sleep and easing of worry and anxiety (on a side note, low serotonin is common after a TBI so this makes total sense)
  • Then I have my client use sublingual melatonin if they have issues falling asleep AND timed-release melatonin if they have issues staying asleep (you can see some of the melatonin products I recommend here)
  • When saliva results come back, we address the adrenals as needed, often adding Seriphos when cortisol is high
  • Other factors are addressed based on each person’s need: gluten issues, SIBO, parasites, candida, EMFs, sex hormone imbalances, medication side-effects, sleep habits

We’d love to hear if timed-release melatonin has helped you improve your sleep quality? And if it also helped with easing anxiety?

What about tryptophan or sublingual melatonin for helping you fall asleep? And the other root causes?

If you’re a practitioner, do you use tryptophan or sublingual or timed-release melatonin with your clients? And address the other root causes of insomnia?

Feel free to post your questions too.