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Increased sociability improves vagus nerve function: the role of social anxiety, pyroluria and low zinc

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increased sociability and vagus nerve

With the objective of taking a deeper dive into some of the favorite topics of the recent Anxiety Summit: Gut-Brain Axis, today’s blog is about the vagus nerve since Dr. Navaz Habib’s interview, Vagus Nerve Activation to Reduce Anxiety, was voted one of the favorites. I’m focusing on one tool that improves vagus nerve function that we didn’t have time to get into in great detail – and that is how increased sociability helps.  It’s all good and well to recommend getting out and hanging out with more people but if you have the social anxiety condition called pyroluria it’s really challenging, hard work and very stressful. Added stress makes pyroluria worse so it becomes a vicious cycle.

Let’s start with the research that supports the connection between the vagus nerve and increased anxiety and mood problems.  In the interview with Dr Navaz, we discussed this paper: Vagus Nerve as Modulator of the Brain–Gut Axis in Psychiatric and Inflammatory Disorders which states that “vagus nerve stimulation is a promising add-on treatment for treatment-refractory depression, posttraumatic stress disorder, and inflammatory bowel disease” and how stimulation of vagal fibers that go from the gut to the brain (afferent fibers) influences neurotransmitter production and “play crucial roles in major psychiatric conditions, such as mood and anxiety disorders.”  The gut bacteria play a major role too, “partly by affecting the activity of the vagus nerve.”

In our interview we end with very practical ways to activate your vagus nerve

  • Deep breathing exercises (mentioned in the above paper, together with yoga and meditation) and cold showers (which makes you breathe harder)
  • Gargling and using the gag reflex
  • Humming, chanting and singing (I used these approaches for my vagus nerve issue – more here on that)
  • Auricular acupuncture (which is also very effective for addictions)
  • And finally, social interaction or increased sociability, which I want to cover today

The research on the vagus nerve and being more social

Let’s look at the research on the vagus nerve or vagal tone and being more social.  This paper, Upward spirals of the heart: autonomic flexibility, as indexed by vagal tone, reciprocally and prospectively predicts positive emotions and social connectedness, reports that that vagal tone and connectedness or being more social is a two-way street i.e. it’s reciprocal

  • “…increases in connectedness and positive emotions predicted increases in vagal tone” and
  • “Adults who possessed higher initial levels of vagal tone increased in connectedness and positive emotions more rapidly than others”

In summary, the more social and happy you are, the healthier your vagus nerve is and a healthier vagus nerve leads to feeling more connected and happy.

This study was done with adults in a community-dwelling setting over 9 weeks: “adults were asked to monitor and report their positive emotions and the degree to which they felt socially connected each day.”

Address pyroluria in those who have social anxiety

Pyroluria, the social anxiety condition, was not part of the study because it’s under-recognized as a factor in anxiety.  I’d like to propose that we address pyroluria in those who have social anxiety in order to further improve social connectedness and their vagus nerve function.

Many folks with pyroluria put on a brave face in social settings and even “extrovert” which is extremely stressful. The added stress makes pyroluria worse (zinc and vitamin B6 are dumped in much higher amounts) so it becomes a vicious cycle.

Others, who are not willing to even show up because of their severe social anxiety, are not getting that social interaction and connectedness that is so crucial for improved vagus nerve function and better overall health.

Here is the pyroluria questionnaire and the pyroluria/introvert connection.

Connecting the dots further we have

By addressing the social anxiety called pyroluria with a foundation of zinc and vitamin B6, we can increase sociability and thereby improve vagus nerve function.

Have you got pyroluria and has addressing it nutritionally allowed you to be more sociable? Do you find you have better vagus nerve function when you are more sociable?  What other avgus nerve exercises have you found helpful?

Spore-based Probiotics for Serotonin and GABA with Kiran Krishnan: The Anxiety Summit 5

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spore-based probiotics

Kiran Krishnan is one my guest experts on The Anxiety Summit 5: Gut-Brain Axis and our topic is: Spore-based Probiotics for Serotonin and GABA.  What you’ll learn

  • How are spore-based probiotics different
  • Bacillus coagulans for depression with IBS symptoms
  • How they increase carotenoids and serotonin, and reduce inflammation
  • and more

Kiran Krishnan AS5

Kiran starts by explaining what makes spore-based probiotics different from other probiotics:

in terms of what makes them different – to begin with these are organisms that have a unique capability of covering themselves in a thick calcified protein-like coating. So it’s armor, essentially, around the bacterial cell.

This allows the bacteria to, of course. exist indefinitely in the environment. In harsh conditions under UV, radiation and desiccation.These are typically conditions that would kill off a lot of the bacteria that live in your gut. Virtually most of the bacteria, 90% of them cannot exist in that type of environment.

But it also allows these bacteria to come in through the gastric system, through the oral route, and survive the gauntlet that bacteria have to go through just getting through the process of digestion.

He goes on to explain how they can survive the stomach acid, the bile salts and the pancreatic enzymes and how all this is “a very specialized function of these microbes” and how very few bacteria have this capability.

We talk about a number of specific strains of spore-based probiotics and how they directly impact mood, anxiety, your gut health and microbiome:

  • bacillus coagulans is associated with bringing down depression, clinical depression, and at the same time alleviating IBS. And when you look at the correlation there it’s really interesting because IBS is associated with having a high risk for clinical depression.
  • bacillus licheniformis…it tends to increase the growth of other beneficial bacteria. Because one of the characteristics about these spore formers is that they have the ability to do something called quorum sensing. They get into the gut and they breed the microbial environment. They can find the overgrown pathogens or opportunistic bacteria that are causing problems. They’ll sit next to them and they’ll produce up to twenty five different antibiotics in that little micro environment to bring down the growth of those pathogens.

I ask some pressing questions like:

  • what have we seen in the research in terms of seeing changes in the microbiome if you do a stool test?
  • how Megaspore is best used when someone starts out because there is a method of titrating up?
  • why do you say other probiotics aren’t working? We do see some research showing that they are working

I find all of this quite fascinating and we do geek out a fair bit. He shares this: “what’s important to know is that these microbes had been producing these neurotransmitters and compounds before humans ever existed.”

kiran krishnan and trudy scott as5

Be sure to listen to Kiran’s wonderful interview to get a complete understanding of spore-based probiotics and how to use them to improve gut health and help with anxiety and mood issues.

anxiety summit

Please join us and listen to this interview and all the others on The Anxiety Summit 5: Gut-Brain Axis.

When you register now you’ll get access to there 3 interviews right away:

  • Fix the Brain to Fix the Gut – Datis Kharrazian, DHSc, DC, MS, FACN, CNS
  • MTHFR, B12 Genes and Anxiety – Carolyn Ledowsky, ND
  • Why Bile is the Key to Anxiety & Hormone Havoc – Ann Louise Gittleman, PhD, CNS

anxiety summit 5 speakers

If you have already signed up for the summit, I hope you enjoy these interview highlights.

If you have yet to sign up, please do come and join us and learn.

Register for the Anxiety Summit 5

 

If you’re considering purchasing the summit to keep for your learning library, you have a number of options that include:

  • Online only or flash drive or both
  • A PDF or printed transcripts of all the interviews
  • The Best of Anxiety-Gut interviews from previous Anxiety Summits
  • GABA Quickstart Program (a group program with me on how to actually use GABA for your physical anxiety, with a private Facebook group and live Q & A call)
Purchase options

 

If you’re already familiar with spore-based probiotics please share how they have helped you. That way we can all learn.

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

I’d also love to hear from you once you’ve listened in to Kiran’s interview and the others.

 

Psychedelics: is MDMA assisted therapy effective and safe?

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psychedelics

Dr. Dan Engle, MD, did one of the keynote presentations at the recent IMMH conference. The topic was “Psychiatry Meets Psychedelics: Treating Psycho-Emotional Conditions with Ayahuasca, Psilocybin and more.”

psychedelics

This was not about recreational use of psychedelics but rather Psychedelic Assisted Psychotherapy or PAP, which is “professionally supervised use of ketamine, MDMA, psilocybin, LSD and ibogaine as part of elaborated psychotherapy programs.” Dr. Engle also talked about peyote, cannabis, ayahuasca, San Pedro and DMT.

psychedelics

psychedelics

I had the pleasure of meeting Dr. Engle the day before during the speaker panel we were both part of and shared that I was coming to his presentation because I have a curious mind and love to learn but to be honest “I’m not yet sure if I’m on board with pyschedelics because I’m concerned about the adverse effects AND that too many folks will rush into this approach before exhausting all other nutritional and functional medicine options.” He appreciated my honesty, saying the fact that I was going to come to his talk was a great first step.

psychedelics

He highlighted the epidemics of suicide (22-23/day in veterans), anxiety and depression in youth (40% increase in teens and 200% increase in suicide in girls 10-14 years old, and a 50% increase in boys, opioids (115 overdoses/day and a 400% increase from 1999-206) and loneliness (where rates have doubled since the 1980s).

This is all very horrifying and calls for drastic interventions. Is Psychedelic Assisted Psychotherapy the solution and is it safe and effective?

Let’s take MDMA as one example. In case you’re new to the term, MDMA is the abbreviation for 3,4-Methyl​enedioxy​methamphetamine. This 2018 article, Is psychiatry ready for medical MDMA? shares this:

Advocates for MDMA-assisted psychotherapy have been at pains to distinguish the street drug ecstasy from MDMA, the medicine. Ecstasy can contain a range of substances as well as varying doses of MDMA.

psychedelics

Dr. Engle shared some of the psychedelic science, with impressive results for MDMA.

The study by Mithoefer in 2010 reported that 83% of patients with severe treatment-resistant PTSD saw their symptoms resolve after 2-3 sessions of MDMA assisted therapy. These are very encouraging results, however the patients were described as having treatment-resistant PTSD as a result of not seeing resolution of their symptoms with either psychotherapy or psychopharmacology (i.e. medications). They had not been offered a functional medicine/nutritional approach. This is all good and well if there were no adverse reactions with the MDMA assisted therapy.

According to the above paper: There were no drug-related serious adverse events, adverse neurocognitive effects or clinically significant blood pressure increases.

However, what wasn’t mentioned in Dr. Engle’s presentation is that some studies do show adverse effects of MDMA. For me, this is an area of concern as far as psychedelic use goes, and I would have liked to hear more about what kinds of problems we need to be aware of.

This 2014 paper: The potential dangers of using MDMA for psychotherapy lists a number of very concerning potential dangers:

  • Early studies from the 1980s noted that MDMA was an entactogen, engendering feelings of love and warmth. However, negative experiences can also occur with MDMA since it is not selective in the thoughts or emotions it releases. This unpredictability in the psychological material released is similar to another serotonergic drug, LSD.
  • Acute MDMA has powerful neurohormonal effects, increasing cortisol, oxytocin, testosterone, and other hormone levels. The release of oxytocin may facilitate psychotherapy, whereas cortisol may increase stress and be counterproductive.
  • MDMA administration is followed by a period of neurochemical recovery, when low serotonin levels are often accompanied by lethargy and depression.
  • MDMA could increase the likelihood of suicide in those individuals with strong post-recovery feelings of depression.
  • Regular usage can also lead to serotonergic neurotoxicity, memory problems, and other psychobiological problems.
  • Proponents of MDMA-assisted therapy state that it should only be used for reactive disorders (such as PTSD) since it can exacerbate distress in those with a prior psychiatric history.

The author ends by saying: My own position is that it will always be far safer to undertake psychotherapy without using co-drugs. In selected cases MDMA might provide an initial boost, but it also has far too many potentially damaging effects for safe general usage.

There are many practitioners who, like me, are not yet on board with Psychedelic Assisted Psychotherapy, because adverse effects appear to be under-reported and not discussed. A more recent 2018 paper calls for more research about the safety of MDMA assisted therapy: an immediate need for more research directly examining its safe usage in the therapeutic context.

Hopefully the phase 3 MDMA trial Dr. Engle mentioned on this slide will provide further insights about potential safety issues.

psychedelics

Dr. Engle did also share this interesting slide: Active/Lethal Dose Ratio and Dependence Potential of Psychoactive Drugs, Drugs and Society, US Public Policy, 2006. It’s apparently from this paper published by Gable, RS (I’ll confirm once I find out). You can see MDMA on the far right indicating a rather high potential for acute lethality (bottom scale), with a moderate/low risk for dependence (the scale on the left).

Dr. Engle stopped by my booth after his presentation to see if he’d been able to change my mind. I shared my concerns about the potential risks. I also said that it would be helpful to see a study comparing MDMA assisted therapy with a functional medicine/nutritional approach. I also said I’ll keep reading and learning and will keep an open mind but right now I’m still very much on the fence. This approach does seem to be very effective but I have concerns about safety.

I blogged about some of my concerns last year: MDMA-Assisted Psychotherapy for Treating Chronic PTSD: Why I feel we can do better and the role of nutrition and amino acids like GABA

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

One other big reason is that I’m very much on the fence is that I see so much success with the nutritional approach that I use with clients.

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

Here are a few to consider:

I feel it is these kinds of interventions that should be considered for PTSD, rather than subjecting individuals who are already suffering to treatments that have adverse reactions AND are not addressing underlying nutritional deficiencies of low GABA, low serotonin, out of balance endocannabinoid system, dysbiosis and overall health, to name a few of the many possible underlying biochemical factors.

Real whole food, exercise, GABA, tryptophan, zinc, berries, probiotics etc. wouldn’t even feature on a chart such as the one above! They are effective approaches and they are safe!

In case you missed the previous IMMH blogs:

Have you been part of a Psychedelic Assisted Psychotherapy program with MDMA or one of the other psychedelics? What benefits did you experience? Did you have any adverse effects?

Would you consider Psychedelic Assisted Psychotherapy with MDMA or one of the other psychedelics?

Have you see benefits and/or adverse effects with your patients or clients?

As a practitioner, do you want to learn more about how to incorporate GABA and the other targeted individual amino acids, tryptophan/5-HTP, DPA, glutamine and tyrosine, into your work to help your clients/patients with anxiety and PTSD? I invite you to check out my new online practitioner training here: Balancing Neurotransmitters – The Fundamentals. I’m extending the $100 discount offered at IMMH for a few weeks (use coupon code immh2019).

IMMH highlights: mold, oxalates, anxiety, panic attacks and depersonalization

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IMMH highlights

Today I’m sharing some highlights from three different presentations at the recent IMMH/Integrative Medicine for Mental Health Conference – on mold and the connection to oxalate issues, as well as a major trigger of anxiety, panic attacks, depression and depersonalization.

Matthew Pratt-Hyatt, PhD: “The Hidden Threats of Mycotoxins.”

Matthew Pratt-Hyatt, PhD presented on “The Hidden Threats of Mycotoxins.” He shared medically significant mycotoxins and that ochratoxin affects the kidneys and my first thought was: “I wonder if this plays a role in oxalate issues?”

I asked Dr. Pratt-Hyatt after his presentation and he said yes, the mycotoxins produce oxalates and then dietary oxalates can be the tipping point. He wasn’t aware of any research on the mycotoxin-oxalate connection but sees the connection on the Great Plains MycoTOX lab test and Organic Acids test

Matthew Pratt-Hyatt

Matthew Pratt-Hyatt

Matthew Pratt-Hyatt

Matthew Pratt-Hyatt

Dr. Neil Nathan: “Mold Toxicity as an Unrecognized Cause of Mental Health issues.”

One of my favorite presentations was the one delivered by Dr. Neil Nathan on “Mold Toxicity.” He defines mold toxicity and how it can directly trigger anxiety, panic attacks, depression, depersonalization and hallucinations, as well as some of the common complications which can exacerbate mental health symptoms. These include mast cell activation, multiple chemical sensitivities, secondary porphyrias, methylation dysfunction and pyroluria.

I do appreciate the fact that he addressed that there can be PTSD caused by physicians when someone knows they are sick – especially with mold toxicity – and yet they do not feel heard or validated. This can even lead to their families being less supportive.

Dr. Nathan is a brilliant and compassionate practitioner, and the author of the excellent book – Toxic: Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness (my Amazon link)

Neil Nathan

Neil Nathan

Neil Nathan

Neil Nathan

Neil Nathan

Dr. Kurt Woeller: “Metabolic Products in Mental Health – How Fungal, Bacterial, Mitochondrial and Other Compounds Influence the Brain.”

Dr. Kurt Woeller shared more about oxalates and mold in his presentation: “Metabolic Products in Mental Health.” I really like the Oxalate Metabolism diagram that shows the role of low vitamin B6, dietary oxalates including ascorbic acid, collagen and gelatin, mold, yeast and genetics in someone with high oxalates.

On a side note, low serotonin is often a factor with collagen and gelatin but it can be a source of oxalates.

He mentions various health problems associated with high oxalates – pain issues are common and so is fatigue and behavioral issues. Dr. Woeller works primarily with children but I have seen anxiety and depression in adults with oxalate issues too.   If mold is one of the triggers then the mental health issues can be further impacted.

 

In case you missed the previous two IMMH blogs:

What wasn’t discussed were some of the other mechanisms that may be causing the increased anxiety – such as the impacts of toxic mold on neurotransmitters and low levels of zinc.

Have you been exposed to toxic mold and was this a trigger for your anxiety, panic attacks and other mood issues?

Did GABA, tryptophan and zinc (and other nutritional support approaches) help ease some of the anxiety symptoms while you were remediating your home and detoxing from the mold toxicity?

Do you have oxalate issues and have you ruled out the fact that toxic mold may be a trigger? I personally have oxalate issues (I share more about this here) and plan to do the MycoTOX test to learn more. I’ll keep you posted on what I find.

As a practitioner, do you want to learn more about how to incorporate GABA and the other targeted individual amino acids, tryptophan/5-HTP, DPA, glutamine and tyrosine, into your work to help your clients/patients with anxiety triggered by toxic mold? I invite you to check out my new online practitioner training here: Balancing Neurotransmitters – The Fundamentals. I’m extending the $100 discount offered at IMMH for a few weeks (use coupon code immh2019).

Pectus excavatum and pyroluria: is there a connection?

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Pectus excavatum and pyroluria

I recently received a question about the possible connection between pectus excavatum and pyroluria, a social anxiety condition. In layman’s terms, pectus excavatum is a depression or indentation in the chest wall and is related to problems with connective tissue. This Medscape article describes it as follows:

Pectus excavatum, also known as sunken or funnel chest, is a congenital chest wall deformity in which several ribs and the sternum grow abnormally, producing a concave, or caved-in, appearance in the anterior chest wall.

It’s not something I’m familiar with other than seeing someone with this condition at the beach once (I share some pictures below) and when doing the research for this blog.

The question was posed in relation to a blog on Joint hypermobility / Ehlers-Danlos Syndrome, a connective tissue disorder that does seem to be common in those with pyroluria.

In case you’re new to pyroluria, it is a genetic condition that is frequently associated with a type of anxiety characterized by social anxiety, avoidance of crowds, a feeling of inner tension, and bouts of depression. People with this problem experience varying degrees of anxiety or fear, often starting in childhood, but they usually manage to cover it up and push through. They tend to build their life around one person, become more of a loner over time, have difficulty handling stress or change, and have heightened anxiety symptoms when under more stress. You can read more about it here.

There are also connective tissue symptoms with pyroluria with the following commonly a factor: joints popping, cracking, or aching; pain or discomfort between the shoulder blades; and/or cartilage problems. This is often due to low levels of zinc. Here is the entire pyroluria questionnaire.

Addressing low levels of the mineral zinc and vitamin B6, together with some other nutrients and stress management, are key to addressing pyroluria symptoms. The social anxiety can typically be lifted in a week and the joint and pain problems often ease in 1 to 2 months.

So now that I’ve set things up with an overview of pyroluria and EDS and the connective tissue problems, let me share what I uncovered about pectus excavatum and why I feel there is very likely a connection with pyroluria.

Pectus excavatum and low zinc – impacting connective tissue and psychological impairment

According to this 2012 paper, Pectus excavatum: history, hypotheses and treatment options

Pectus excavatum (PE) … is the most common chest wall deformity, representing 90% of all cases. Depending on the severity of PE, deviations of thoracic organs and spine deformities are known. Although PE in most instances has little or no influence on the function of the inner organs, the cosmetic appearance of the patients leads to psychological impairment which requires therapy.

In the above paper, they write about one of the hypotheses: weak cartilage through metabolism dysfunction. They report decreased levels of zinc in the pectus excavatum patients, suggesting “the lack of zinc in the diet results in a lower metabolic activity of chondrocytes.” Chondrocytes are cells found in cartilage connective tissue. In summary, one hypothesis is that low dietary zinc affects cartilage connective tissue in some individuals with pectus excavatum.

Observe the mention of psychological impairment. Could the low zinc be playing a role in this too? I address this below.

Pectus excavatum and Ehlers-Danlos, plus dental crowding

This paper, Pectus Excavatum and Heritable Disorders of the Connective Tissue, make the connective tissue and Ehlers-Danlos connection:

It seems clear that several patients affected by pectus excavatum display a typical association with connective tissue disorders, which may span from mild form like simple laxity without morbidity associated, to more severe forms such as MFS and Ehlers-Danlos syndrome

This paper also mentions “Highly arched palate with dental crowding” which is common in pyroluria and seems to be related to low levels of zinc.

The image below illustrates a moderate/severe form of pectus excavatum.

pectus excavatum
Figure 1. from Pectus Excavatum and Heritable Disorders of the Connective Tissue

Chest picture of an adolescent affected by a moderate/severe form of pectus excavatum. Written consent was obtained from the patient and the patient’s parents for publication of this image.

Vitamin B6 and high homocysteine

With regards to vitamin B6, one of the other key nutrients needed for pyroluria, one paper, Pectus carinatum repair in an adolescent with hyperhomocysteinaemia: Anaesthetic implications reports a case of a 14-year-old boy with high homocysteine. his level was 18.5 μmol/l (normal levels are within 7–10 μmol/l). He was treated with folic acid, Vitamin B6 and B12 supplements. Is this common in all cases of chest wall deformities? I don’t know but it would interesting to find out.

Pectus excavatum: social anxiety and depression

There are some older studies that report mental health symptoms, including social anxiety are common. In this 1999 paper, Funnel chest. Psychological and psychosomatic aspects in children, youngsters, and young adults, they report these reactions in children older than 11:

embarassment reactions, social anxiety, feelings of stigma, limited capacity for work, orientation towards failure, reduced tolerance of frustration and temptation, limited capacity for communication and even markedly depressive reactions are observed.

It’s understandable that the physical manifestations of this condition would lead to some of these feelings but I have to question how much of this could also be related to low zinc and low vitamin B6. Both nutrients are needed for easing pyroluria/social anxiety symptoms and making neurotransmitters such as serotonin.

Other than trying to make some connections with the research, when this question was asked on facebook, a number of people said they (or a family member) has both pyroluria and pectus excavatum.

If you do have pectus excavatum and pyroluria, getting on the pyroluria protocol will:

  • ease some of the social anxiety and depressive symptoms
  • very likely lead to less pain and discomfort
  • very possibly prevent further connective tissue issues
  • feasibly prevent pectus excavatum in future children or perhaps reduce the severity in the instance where zinc is a factor (this one is a long shot that I feel is worth further research)

I’d love to gather more information and am looking for feedback so please do share your symptoms and experiences in the comments. Let us know if you or your child or other family member has pectus excavatum and any of the following:

  • A score 15 or more on the pyroluria questionnaire and/or suffer from social anxiety
  • Have low zinc
  • Have low B6 (poor dream recall or nightmares is a clue)
  • Have high homocysteine i.e. above 10 μmol/l
  • Ehlers-Danlos syndrome or joint hypermobility
  • Dental crowding

Resources for you

Sleeping through the night for the first time in many years: a trial and error approach to find the ideal tryptophan product

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If you have trouble sleeping through the night (or even have anxiety or panic attacks), finding the nutritional/biochemical root causes and addressing them is going to provide relief but it’s not always straightforward to find your root cause or causes (there are often more than one). Also, what works for you today may not work for you in 2 years time and may not work for your friend who has similar symptoms. You have to be a detective yourself and/or work with a health professional who can put all the puzzle pieces together.

I recently read a Facebook comment where someone was really frustrated about all the trial and error work that may be involved:

I’m just so tired of all this trial and error work trying to figure out why I’m anxious and depressed can’t sleep more than 4 hours a night. It’s been going on way too long I just want answers and a solution to all this. Enough already!

While I feel for this woman, I do acknowledge that it can sometimes be challenging to put all the puzzle pieces together. Other times we are able to figure things out very quickly. I’d like to share some feedback from Lorraine on the tryptophan-PMS-anxiety blog to illustrate how one small change made a big difference for her and it was a matter of trial and error.

Lorraine shares her great results with this Tryptophan Complete tweak for her insomnia:

Trudy, after listening to your talks about Lidtke Tryptophan I decided to give the Tryptophan Complete a try. I’ve taken one capsule each on the last two nights instead of two of the Tryptophan 500mg caps. Both nights I slept straight through all night and had a hard time waking up in the morning. I’ve struggled with insomnia for many, many years. The 500mg Lidtke Tryptophan supplements were helping but I was still waking up during the night. For me to sleep all night is almost miraculous.

I’ve been also taking Progesterone (low on testing), Magnesium, L-Theanine and Melatonin.

I recently added phosphatidylserine, and Holy Basil because saliva testing showed high cortisol at bedtime and off the charts high in the morning. I’m hoping to start eliminating some of those other supplements now that I’m sleeping so well.

I want to thank you for the Anxiety Summits and your book and updates on Facebook and newsletters. I have learned so much from you!

I’ve blogged about which product to use for boosting serotonin: Tryptophan 500mg or Tryptophan Complete (by Lidtke)?. I share this

  • I like to have my clients do a trial of the amino acidsso they can find the ideal dose for their needs and right now I still feel this would still be the best approach to take – using 500mg tryptophan. Once you have figured out you do well with tryptophan-only product and have your dose, then consider reducing it slightly after about 2-3 weeks and adding in additional Tryptophan Complete.
  • The other option is this: if you don’t get the expected results with Tryptophan 500mg, then try the Tryptophan Complete. You may need the other ingredients for it to work well for you.

Lorraine chose to do the latter – switching to Tryptophan Complete – since she didn’t get ideal results with Tryptophan 500mg and it worked for her. I will add that even though she slept straight through all night, I don’t like that she had a hard time waking up in the morning and when that happens, I recommend less tryptophan. It’s very possible that the ideal combination would be 1 x Tryptophan 500mg and 1 x Tryptophan Complete (my first suggestion).

Here is my quick commentary on the other products she’s using for her insomnia:

  • Progesterone and theanine: Testing progesterone levels are important before using progesterone. Both theanine and GABA support GABA production and when GABA is low, we often see low progesterone. With both low GABA and low progesterone, sleep and anxiety can be worse.
  • Magnesium: This mineral is commonly low and is needed to make both serotonin and GABA.
  • Melatonin: This is made in the body when there is sufficient serotonin and may not be needed long-term once she has good levels of serotonin (which the tryptophan product/s are helping her make).
  • Phosphatidylserine and holy basil: High cortisol is a common root cause of both insomnia and anxiety and saliva testing is an excellent way to confirm this. Phosphatidylserine can be used to lower high cortisol although I have found even better results with a phosphorylated serine product called Seriphos. Holy basil or tulsi is an adaptogenic herbal product that provides adrenal support helping with sleep problems and easing anxiety and stress.

In Lorraine’s case, her insomnia was caused by low serotonin (hence the need for tryptophan, melatonin and magnesium), low GABA/low progesterone (hence the need for progesterone, theanine and magnesium) and high cortisol (hence the need for phosphatidylserine and holy basil).

She shares she’s hoping to start eliminating some of these other supplements now that she’s sleeping so well. So, this would be another trial and error approach, stopping and/or reducing one at a time and seeing how she does. Or she may well find she needs to continue with everything for some time.

As you can see, for Lorraine it was a matter of trial and error to find her solution, but it was well worth it to get the “miraculous results” she experienced: sleeping though the night for the first time in many years!

Some of these products may work for you but it’s going to be a matter of trial and error to find your root cause/s and solution.

In case they are relevant for you, these products mentioned in this blog can all be found in my online Fullscript store:

I’d love to hear how you’ve used a trial and error approach either on your own or with the help of your practitioner to find the nutritional solution for your insomnia and/or anxiety?

If you’re a practitioner, please do share an example of how you’ve used this approach with a client or patient.

If you’ve had frustrations with this trial and error approach, please share them too.

Feel free to post your questions here too.