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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

Additional Anxiety Resources
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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.

Additional Anxiety Resources
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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
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Mindd 2019: The cell danger response and microbiome; and microchimerism and pregnancy

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Today’s blog highlights two interesting and very different topics that can impact both your mental and physical health: The cell danger response: inflammation, the microbiome and digestion; and microchimerism and how pregnancy can change the health of a mother in unintended ways.

I love to share resources after I’ve attended a conference but today I’m switching it up and sharing resources before the conference for three reasons: 1) to get you fired up and excited about attending in person (or on the Livestream) 2) to share in case you can’t attend in person (or via Livestream) and 3) to highlight the amazing work that the Mindd Foundation is doing via the Mindd Forum 2019, which will be in Sydney, Australia, March 23-24, 2019.

There’s also a giveaway of 2 free tickets to the Public stream (in-person or livestream) so read on below to see how to enter.

The cell danger response: inflammation, the microbiome and digestion

The cell danger response can cause increased inflammation and have direct impacts on the microbiome and digestion. The Cell Danger Response (also known as CDR)

is the intracellular response to stressors, viruses, chemicals or toxins and any foreign particles that come into the human system that need to be expelled. If the cell danger response is constantly being activated and is defective, it may cause a heightened prevalence and severity of inflammation.

The above article highlights the effects on the cell danger response on the microbiome, digestion and nutrient absorption, with ramifications for anxiety, depression, ASD (autism spectrum disorder), ADHD (attention deficit hyperactivity disorder) and many other conditions. Here are some highlights of what the CDR can impact the lower part of the colon

  • alter disaccharide metabolism, causing the lower/distal bowel to receive a more significant number of simple sugars and change carbohydrate digestion
  • alter the cells that line the intestines leading to differences in how amino acids are processed, affecting production of neurotransmitters such as GABA, serotonin and dopamine, with consequences for both your brain and gut health

Dr. Robert Naviaux coined the term CDR and will address these links in detail and explain current research with regard to the CDR, cellular healing and how to incorporate these concepts into practice. He will address the role this plays in the healing cycle and treating chronic disease, and specifics on CDR as it applies to understanding Chronic Fatigue Syndrome. His masterclass series is titled: Cellular Pathways for Chronic Disease Recovery.

According to Mindd, three of Dr. Robert Naviaux’s research publications were the most frequently downloaded papers in the journal Mitochondrion in the last 90 days, so this gives you an idea on the relevance of this topic.

Dr Nancy O’Hara also has a helpful explanation of the CDR here cover Clinical Applications of Dr. Naviaux’s research, together with Dr. Elizabeth Mumper.

It’s a pretty complex topic and I’ve been trying to get my head around it for some time. I blogged about some of his early research on CDR and the dramatic effects of a single dose of suramin on “social communication and play, speech and language, calm and focus, repetitive behaviors and coping skills” in 10 boys, ages 5 to 14 years, all diagnosed with autism.

What does all this mean for you?

  • Could the CDR be a factor in your chronic unresolved SIBO (small intestinal bacterial overgrowth)?
  • Could there be applications for anxiety for you if you have tried ALL the nutritional/biochemical approaches and are still not seeing symptom resolution?
  • Could addressing the CDR help you if you’ve been harmed by benzodiazepines, SSRIs and/or fluoroquinolones and can’t take any supplements or can only tolerate very small doses?
  • Could addressing the CDR help when you have a combination of many stresses like past or recent trauma, genetic defects, heavy metals, mold and Lyme, as well as gut issues and nutritional imbalances?

We clearly have much to learn in this area and I’m excited to hear more from these practitioners.

Microchimerism and how pregnancy can change the health of a mother in unintended ways

Pregnancy can change the health of a mother in unintended ways, sometimes causing harm and in other instances saving the mother’s life. Microchimerism is the “two-way implantation of cells between a mother and fetus.”

Approximately 50-75% of women carry immune cells derived from their fetus after giving birth. Not only that, but the offspring can also hold onto maternal cells too. The fetal cells present in a mother can be apparent for years after giving birth, and their role in human health is currently being investigated. Research is also evaluating the likelihood of whether an older sibling/previous pregnancy can pass cells to a current fetus of a different pregnancy.

The majority of research on microchimerism has investigated its potential to cause harm. This is due to a 1996 paper hypothesizing the link between microchimerism and the cause of autoimmune conditions. However, the connection between microchimerism and positive health outcomes has been receiving attention in the last few years. This is partly due to detecting the capability of mammals to save their mother’s lives by providing cells that are repairing tissue, including bone marrow, to replace dysfunctional cells.

While the mechanism of action is currently unclear, it is understood that microchimeric fetal cells can provide repair processes within maternal tissue, via cellular differentiation.

Leah Hechtman will be speaking at the Mindd Forum 2019 on Microchimerism, mRNA and Parental Wisdom. She will review the understanding of how pregnancy can change the health of a mother in unintended ways and “how we can influence unique genetic pathways to improve the health of future generations.” Read about Leah and more about this fascinating topic in the MINDD article on microchimerism.

Ideally, attend the conference in person. These topics will all be presented as part of both the Public stream and the Practitioner stream, and will also be available via Livestream – at the Mindd Forum 2019 (links below).

Other topics of interest being presented at the Mindd forum

Alexx Stuart from Low Tox Life is presenting in the Food Is Medicine program – Foods that Support Detoxification: Brilliant Brassicas!

Are you looking for clever ways to bring delicious inspiration to your plate? Learn how to incorporate brassica vegetables (Broccoli, Cauliflower, Brussels sprouts, Cabbage, Kale and more) – this vital family of veggies – to inspire detoxification and disease-fighting, every single day. From breakfast to snacks to family meals and even dessert!

Naturopath, Nutritionist and Mindd Ambassador Helen Padarin is presenting – Nutrition & Lifestyle that Supports Mitochondria

Many symptoms can be due to your mitochondria needing support. These can include waking tired, energy slumps, fatigue, trouble concentrating, poor muscle tone, speech difficulties, learning disabilities, Autism Spectrum Disorder, vision or hearing problems, exercise intolerance or heart, liver or kidney disease. If you haven’t yet heard about your mitochondria – it’s time to get to know them and learn how to treat them well! Mitochondria are highly intelligent energy producing engines in every cell in your body.

Gillian Koziciki of Cultured Artisans is presenting – Fermenting the Rainbow for Health & Vitality

Bidirectional communication between your gut microbiota and cellular mitochondria show a link to your health and energy levels. Feeding your gut healthy, probiotic foods increases the good bacteria of your microbiome which assists your mitochondrial health. The full colour spectrum of foods can be fermented to provide guerilla nourishment.

Both Dr. Mumper and Dr. O’Hara are presenting – A Functional Approach to Conditions On-the-Rise

Clinical pearls and case histories, testing and treatment on Lyme disease, ADHD, PANDAS & PANS, Alopecia, Vitiligo and Cutaneous Mastocytosis, migraines, rhinitis, asthma, eczema, Cerebral folate deficiency, Chronic inflammatory response syndrome (i.e. toxic mold issues), POTS & Dysautonomia, Autism, Celiac & non-celiac gluten sensitivity, and ADHD without drugs.

Here are all the links

The cell danger response and the microbiome – what’s the link?

What is the Cell Danger Response? with Dr. Nancy O’Hara

A new outlook on Microchimerism

Practitioner stream link

Public stream link

You can find the Mindd Foundation on facebook here.

Drawing to win a ticket to the Public sessions (2 tickets to be won) and 10% discount

If you’d like to be entered into a drawing to enter a ticket to the Public Stream (in-person or livestream):

  1. Comment below and share why you’d like to attend/listen in and what interests you about any or all of these topics
  2. AND share this blog with a friend, colleague and/or on social media. Be sure to mention where you shared it when you comment.
  3. AND let me know if you’d like to attend the Public track in person or do the livestream Public track

I have 2 tickets to give away and I’ll announce the winners on the blog Monday March 18 at 10pm PDT (USA) which is Tuesday March 19 at 4pm AEDT (Australia), and will email you directly if you’re a winner.

As a Mindd Ambassador, I am also thrilled to be able to offer a 10% discount to my community. Use the promotional code TRUDY10 at checkout to receive this discount (this is for both the practitioner and public tracks and the livestream).

Can you see any applications of the above for your health personally or for someone in your family, or a client/patient?

Feel free to post your questions here too and I’ll do my best to try and address them.

And don’t forget to comment and share the blog for a chance to win a ticket to the Public stream!

I have issues with perimenopausal anxiety a couple of weeks per month and don’t want to turn to SSRIs.

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My challenges with anxiety have been hormonal. I’ve had issues with both postpartum anxiety and now perimenopausal anxiety a couple of weeks per month as I’m approaching menopause. I don’t want to turn to SSRIs but some days are pretty miserable and most other days I feel fine. Any info you have to share regarding this topic or any natural solutions would be of great interest.

When I’m working with a client who reports symptoms like this we start with serotonin and GABA support; determine if they have low zinc, low vitamin B6 and low iron. I also always ask the question: are you on the birth control pill (now or in even in the past).

I’ve blogged about much of this in the past so I’m going to share snippets and blogs for further reading.

Serotonin support with tryptophan for immediate worry-type anxiety relief

In a study published in 1999, A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria, tryptophan was found to reduce symptoms of PMS when used in the luteal phase or second half of the cycle (i.e. after ovulation).

This is very typical when I’m working with someone with both PMS (premenstrual syndrome) and perimenopausal anxiety, depression, irritability and mood swings. It typically takes 2 to 3 cycles for an amino acid like tryptophan to have an impact on the cyclical nature of your perimenopausal symptoms.

However, tryptophan does typically start to work right away on the less severe anxiety and mood symptoms assuming you find the ideal dose for your needs. I use the trial method to help my clients figure this out.

When you boost serotonin you also reduce the worry-in-your-head and ruminating type of anxiety, and end to panic attacks and phobias, a boost of confidence, no more depression and negativity, imposter syndrome that is no more, an end to your anger issues and irritability, an improvement in sleep and no more afternoon/evening cravings for something sweet.

You can read more about tryptophan here: Tryptophan for the worry-in-your-head and ruminating type of anxiety

GABA support for relief from tension-type anxiety

During perimenopause progesterone is often low and when it is low, we can expect GABA to be low too. Research confirms low GABA and high glutamate-glutamine in premenstrual dysphoric disorder (PMDD) and that shifting hormones may lead to dysregulation of GABA which contributes to HPA axis dysfunction. The HPA (hypothalamic pituitary adrenal) axis is your stress response system and when it’s not functioning well you are more susceptible to the effects of stress and more likely to feel depressed and anxious.

If your GABA levels are low you will feel increased physical tension and insomnia. The amino acid GABA, opened on to the tongue, can provide calming results within minutes.

Dee likes the instant calm and compares how it worked as well as Xanax had worked for her in the past:

I have taken Xanax in the past for panic attacks. My functional medicine doctor suggested this product as I wanted a natural product. I was amazed how it works just like the Xanax did – instant calm feeling within 10 mins of taking 2 capsules. I use them as needed when I am having heightened stress and anxiety.

Low zinc, low vitamin B6 and/or low iron?

Low iron/ferritin is common if you’re still having a period and it’s one of the important -cofactors for making serotonin, thyroid hormones and the sex hormones. Low iron, together with low vitamin B6 plays a role in anxiety and panic attacks. In one study premenopausal women who had been admitted to the emergency room with panic attacks were found to have both low iron and low vitamin B6. I have an entire blog post on this topic here

The other key co-factor for making serotonin is zinc. You’ll want to look into and address pyroluria if you feel more anxious in social situations like family gatherings, going to church events or community picnics, or even while doing business networking or in work meetings. The key nutrients for pyroluria are zinc and vitamin B6 and both help with PMS and perimenopausal anxiety, and hormone balance.

Are you on the birth control pill?

I recently reviewed Beyond the Pill A 30-Day Program to Balance Your Hormones, Reclaim Your Body, and Reverse the Dangerous Side Effects of the Birth Control Pill by Dr. Jolene Brighten.

If you currently on the pill or have been in the recent past read the above review and get the book to give you an excellent understanding of what may be going on with your body.

Dr. Jolene shares that mood disruption is common and mentions a study in the Journal of the American Medical Association which reports the following:

women who began the pill were more likely to be prescribed an antidepressant – which means it contributes to a bit more than moodiness

She writes in great detail about Post–birth control syndrome (PBCS) which is “is a constellation of symptoms women experience when they discontinue hormonal birth control.” She has found the symptoms of PBCS typically occur in the first 4-6 months after stopping the pill. As well as mood swings and anxiety, you may also experience heavy bleeding or no period, acne, headaches, infertility, pill-induced PCOS (polycystic ovarian syndrome), hypothyroidism, gut issues and even autoimmune symptoms.

You also want to reduce your stress levels. Here are some ideas for you:

All the above is a great starting point. You also want to consider adrenal support if needed; and support liver health, together with dietary changes, addressing gut health and thyroid health, getting toxins out of your life and figuring out whatever your own root causes may be.

Here is the link to the amino acids and pyroluria supplements I use with my clients.

Have you found that any of the above has helped you with your PMS or perimenopausal anxiety?

Do you have any stress-relief tips to share with other women who find themselves so stressed out at this age?

Feel free to post questions here too.

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.