environmental toxins

Waking in the night due to environmental toxins: impacts on the liver, gallbladder and fat digestion (making oxalate issues worse)

September 9, 2022 By Trudy Scott 37 Comments

Today I’m sharing how waking in the night may be caused by oxalate issues that are made more severe because of home cleaning products, environmental toxins and fragrances/phthalates. It can happen because of the additional detoxification work required and adverse impacts on your liver and gallbladder. This can impact bile production so fat digestion is impaired. And when you have impaired fat digestion this can contribute to more severe oxalate issues because more oxalates are absorbed in the gut. This can lead to increased pain, worsening sleep and/or waking in the night, increased anxiety, fatigue, depression, more severe bladder symptoms, eye problems etc.

Using extra calcium citrate in the night can help in the short term. But improving fat digestion (with lipase, ox bile, taurine, a lipotropic formula, digestive bitters etc.) and supporting the liver/gallbladder is key because it gets to the root of the problem. And of course, avoid the chemical exposure. Sometimes this can’t be done – which is the case when you are traveling – so you have to do your best to reduce exposure.

This is actually my story. I’m traveling in South Africa at the moment and had a flare of my old oxalate issues, with increased foot pain at night, so much so that it was waking me at 3am in the morning. I’d be awake from 3-5am feeling agitated and restless and waiting for the extra calcium citrate to work. I’m a hot mess when I don’t get a solid 8-9 hours sleep so I had to figure out what the issue was and fix it quickly. It was a somewhat convoluted journey (more on that below) but eventually I landed on taurine as the solution and it’s been wonderful to get my solid sleep with no waking in the night!

I do eat a fair amount of fat – plenty of butter on my steamed veggies, olive oil, coconut oil, avocados, the fat from grass-fed meat, chicken skin, full fat cheese and eggs – and didn’t want to cut back.

So when taurine came to the rescue I was thrilled and still am!

I took 500mg before bed the first day and woke briefly twice but went right back to sleep. The second day I took 500mg taurine mid-morning, 500mg taurine mid-afternoon and 500mg before bed (all away from food). That night I woke briefly once and went right back to sleep. The third day I did the same and slept solidly through the night. My goal had been to increase to 3000mg per day but I’ll stick with 1500mg as long as this continues.

There were a few clues that indicated a need for liver-gallbladder support: the 3am waking is classic for liver issues; and my stool had become pale despite nothing else changing.

Impaired fat digestion leads to an increase in oxalate absorption

As mentioned above, when you have impaired fat digestion this can contribute to more severe oxalate issues because more oxalates are absorbed in the gut. This paper, Fat malabsorption induced by gastrointestinal lipase inhibitor leads to an increase in urinary oxalate excretion, summarizes the mechanism well:

Unabsorbed bile acids and fatty acids may react with calcium in the intestinal lumen, forming “soaps” that limit the amount of free calcium binding with oxalate, with a consequent increase in intestinal oxalate absorption leading to hyperoxaluria

In the above study, it’s orlistat (Xenical®), a gastrointestinal lipase inhibitor rather than environmental toxins and bile issues, that causes the increase in oxalates. I share it because it has a helpful explanation of the mechanism.

I share more about my issues with dietary oxalates here – Oxalate crystal disease, dietary oxalates and pain: the research & questions. My main issues in the past have been foot pain and eye pain, with downstream impacts on sleep. This blog has links to a number of other dietary oxalate blogs if this topic is new to you.

Bile production and detoxification

You may recall my wonderful interview with Ann Louise Gittleman on The Anxiety Summit 5: Gut-Brain Axis. The topic was: Why Bile is the Key to Anxiety & Hormone Havoc. I’ll add sleep to that too.

She covered the role of bile in PMS, estrogen imbalance and thyroid health; and importantly, how it’s involved in the removal of toxins from the body:

Bile is the dumping ground for hormones like estrogen. It’s the dumping ground for heavy metals that create anxiety like mercury, as well as too much aluminum and lead. And it’s the dumping ground, also, for a bunch of chemicals. So you got to keep the bile flowing. You have to keep it decongested. You have to thin it out.

She mentions simple tools to improve bile production: bitters (already part of my routine), lemon and water in the morning (also part of my daily routine), coffee (I can’t drink coffee as it makes me anxious), grapefruit and watercress. She also discusses key nutrients for bile production and quality: choline, inositol, methionine and taurine.

I could not find any lipotropic formula with choline, inositol, methionine (they all had rice flour). And I could not find any products that contained only lipase or ox bile.

While I was looking for something to improve my bile production, I did try a milk thistle extract (for overall liver support) and a liver-gallbladder herbal tincture but both made things worse. So I did some reading on taurine, found a nice taurine only 500mg product and haven’t looked back. Read on for some of the mechanisms.

Taurine and bile acid conjugation and detoxification

Metabolic actions of the amino acid taurine include: “bile acid conjugation, detoxification, membrane stabilization, osmoregulation, and modulation of cellular calcium levels.”

This paper, The Continuing Importance of Bile Acids in Liver and Intestinal Disease, explains the significance of bile acid conjugation with taurine:

After biosynthesis from cholesterol and before excretion from the hepatocyte, bile acid molecules are conjugated with glycine or taurine, which converts a weak acid to a strong acid. As a result, conjugated bile acids are fully ionized at the range of pH values present in the small intestine.

Taurine works on GABA receptors and is a GABA alternative

What is really interesting is that taurine works on GABA receptors and has a synergistic effect with GABA. I suspect this played a role for me too.

In this editorial, Taurine and GABA neurotransmitter receptors, a relationship with therapeutic potential?, the authors share the following::

“Taurine exerts its neuronal inhibitory effect through the activation of GABAA receptors (GABAAR) but with less affinity than the specific agonists of each receptor.
GABA and taurine act synergistically in extra-synaptic GABA receptors.
Some experiments suggest that taurine activates GABAB receptors with high affinity”

In countries where over-the-counter GABA is not available (like the UK, Australia and New Zealand), I will recommend taurine as an option. I don’t find it to be as effective as GABA but it is slightly calming.

You may need to course-correct from time to time

I share this story to illustrate that things can be going well in terms of sleep, pain, anxiety, depression and so on, and then something can happen and you have to course-correct.

I also often hear from folks in my community saying: “GABA and/or tryptophan was working perfectly to help me sleep and all of a sudden it’s no longer working. What is going on?” A situation like this shows how something else can change and it has nothing to do with the amino acids no longer working.

I do already use GABA, tryptophan (more on these below), melatonin and magnesium at bedtime and continued taking these supplements but I had to fix the root cause – the fat digestion issue.

I will add this: even if you don’t have dietary oxalate issues, this approach may be worth considering if you have no gallbladder, have fat digestion issues, are exposed to environmental toxins, have liver issues and wake in the night.

Resources if you are new to using amino acids as supplements

If you are new to using any of the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low serotonin and low GABA).

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, self-medicating with alcohol and more.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs. You can find them all in my online store.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms). This is a paid online/virtual group program where you get my guidance and community support.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you experienced any adverse symptoms when exposed to environmental toxins? And has this made your oxalate issues worse or affected your fat digestion?

Have you used taurine with success? How much helps you?

Have other liver or gallbladder approaches also helped?

If you have questions please share them here too.

Read all posts in this series:

Mitochondrial Dysfunction in Anxiety with Tara Hunkin on The Anxiety Summit 5

October 18, 2019 By Trudy Scott 2 Comments

Tara Hunkin, NTP, CGP, RWP is one my guest experts on The Anxiety Summit 5: Gut-Brain Axis and our topic is: Mitochondrial Dysfunction in Anxiety. In this interview you’ll learn:

The role of mitochondria in the gut, brain and anxiety
Causes (such as medications and environmental toxins), testing, and signs and symptoms of mitochondrial dysfunction
Healing nutrients: Carnitine, COQ10, folinic acid, meal timing (as well as antioxidants and many other nutrients such as PQQ)

Tara starts with an overview of mitochondria, the energy powerhouses of our bodies and why they are so important in both physical and mental health.

You can hear some of this background information in this short in-person interview we did in San Diego recently.

(Note: The dates for the 2021 Anxiety Summit 5 is November 8-14, 2021)

You’ll also hear Tara share about this new bidirectional relationship that has been identified between anxiety and mitochondrial dysfunction. One of the papers she is referring to is this 2019 review paper: Anxiety and Brain Mitochondria: A Bidirectional Crosstalk. Here are the highlights:

Despite the established link between mitochondrial dysfunction and various psychiatric disorders, the contribution of mitochondria in anxiety disorders has not been extensively addressed.
Mitochondria are emerging as modulators of anxiety-related behavior, as evidenced both in animal and human studies.
There is a bidirectional link between mitochondria and anxiety. Mitochondrial, energy metabolism, and oxidative stress alterations are observed in high anxiety; conversely, changes in mitochondrial function can lead to heightened anxiety.

Tara shares how important the mitochondria are when it comes to digestion and gut health too:

the liver is heavily mitochondrial-dense and is needed to help eliminate toxins we are exposed to (toxins that affect our mitochondria and increase anxiety)
the mitochondria are also important when it comes to digestion – the lining of digestive tract (the epithelial cells of the microvilli) contain large numbers of mitochondria

The authors also highlight that “Pharmacological manipulation of mitochondria may be a potential therapeutic approach to relieve high anxiety symptoms.” One of the objectives of this summit is to highlight non-pharmacological approaches and Tara does exactly this in our interview.

She covers both lifestyle and nutritional approaches for addressing mitochondrial dysfunction (acetyl-l-carnitine, glutathione, antioxidants, coenzyme Q10, folinic acid and many more).

I also mention two other interviews on the summit where we talk about nutrients that also support mitochondrial function: PQQ (pyrroloquinoline quinone) and TUDCA (tauroursodeoxycholic acid).

Be sure to listen to these interviews for more about these two nutrients:

Jay Davidson, DC, PScD: Parasites, Anxiety and TUDCA for Your Liver
Michael Murray, ND: PQQ for Stress, Sleep, Mitochondria and Gut Health

We also discuss testing and all the environmental factors that impact the mitochondria including medications such as risperidone/risperdal (and antipsychotic medication), valproic acid (used for seizures), fluoroquinolone antibiotics like Cipro (and others) and also benzodiazepines (the commonly prescribed anti-anxiety medications).

You can listen to each of the interviews (and get transcripts) by purchasing The Anxiety Summit 5: Gut-Brain Axis.

If you’d like to give feedback or ask a question, please post in the comments section. I’d love to hear from you once you’ve listened in.

If you’d like to give feedback or ask a question, please post in the comments section at the bottom.

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

Amyotrophic lateral sclerosis/ALS: ketogenic diet, GABA, 5-HTP and environmental toxins

May 25, 2018 By Trudy Scott 31 Comments

(Image from ABC: The Enemy Within – Australian Story)

I recently watched a documentary on the life and work of Justin Yerbury, a basket-ball player turned scientist who has motor neuron disease (also referred to as ALS) and is seeking a cure. It was aired on ABC and called The Enemy Within – Australian Story

When Justin Yerbury’s family members began to die from motor neurone disease he made a life-changing decision.

He turned his back on a professional basketball career and enrolled in a science degree. Almost 20 years later, he is an internationally recognised expert on the disease, leading the way in the search for a treatment.

Recently, however, Justin’s work took on a terrible urgency as he too developed symptoms of MND.

As Australian Story filmed with Justin and his family, his condition deteriorated dramatically, requiring difficult decisions to enable him to continue his search for a cure.

Having met Justin in 2017, Professor Stephen Hawking recorded the introduction to this story shortly before his death from motor neurone disease.

(the Australian spellings are neurone instead of neuron and recognised instead of recognized)

I felt very moved by his story and work and felt compelled to reach out to Dr. Yerbury to share what I have learned about this condition in the last few years. I know of a number of practitioners who work with individuals with this condition and even some colleagues with family members who have been diagnosed with this condition. I have also had enough queries that it’s time for a blog post on the topic so you are informed too.

What is Amyotrophic lateral sclerosis (ALS) and motor neuron disease (MND)?

Let’s start with the fact sheet on Amyotrophic lateral sclerosis from the NIH (National Institute of Neurological Disorders and Stroke). They describe ALS as follows:

Amyotrophic lateral sclerosis (ALS) is a group of rare neurological diseases that mainly involve the nerve cells (neurons) responsible for controlling voluntary muscle movement. Voluntary muscles produce movements like chewing, walking, and talking. The disease is progressive, meaning the symptoms get worse over time. Currently, there is no cure for ALS and no effective treatment to halt, or reverse, the progression of the disease.

ALS belongs to a wider group of disorders known as motor neuron diseases, which are caused by gradual deterioration (degeneration) and death of motor neurons. Motor neurons are nerve cells that extend from the brain to the spinal cord and to muscles throughout the body. These motor neurons initiate and provide vital communication links between the brain and the voluntary muscles.

I encourage you to watch the 30 minute program if you want to learn more about this condition and Dr. Yerbury’s work (they call it MND rather than ALS in the documentary.)

You may also be familiar with the life and story of Professor Stephen Hawking – he had ALS or motor neuron disease.

Ketogenic diet for ALS?

Here is some of the information I sent to Dr. Yerbury, explaining my work as a nutritionist working with women with anxiety using nutritional psychiatry approaches. Many of these nutritional psychiatry approaches – such as the SMILES study – have been spear-headed in Australia by Professor Felice Jacka.

I’ve recently being looking at the growing research base on the ketogenic diet and mental health and when I saw his story on ABC my first thought was – I wonder if there is research on ketogenic diets and ALS/MND? After a very quick search I found these papers:

High-Fat and Ketogenic Diets in Amyotrophic Lateral Sclerosis

there are strong epidemiologic data showing that malnutrition is a common symptom of amyotrophic lateral sclerosis both in humans and in mice and may contribute to disease progression. There is also epidemiologic evidence that increased dietary fat and cholesterol intake might reduce the risk of amyotrophic lateral sclerosis and the rate disease progression. Finally, data from animal studies strongly suggest that increasing dietary intake of fat ameliorates disease progression. However, determining whether amyotrophic lateral sclerosis patients should be treated with a high-fat or ketogenic diet can be based only on randomized double-blind placebo-controlled interventional trials.

Neuroprotection in Metabolism-Based Therapy

Metabolism-based therapy [which includes the ketogenic diet] has been used successfully in the treatment of seizures but study of its use in other neurodegenerative disorders [such as Alzheimer’s disease, Parkinson’s disease and ALS] is growing.

A gluten-free diet?

We must always consider gluten with every chronic health condition. There is a case report of celiac disease with neurologic manifestations misdiagnosed as amyotrophic lateral sclerosis:

he was diagnosed as having CD, and a gluten-free diet was immediately begun. At a 4-month follow-up, his weight and the quality of his stool had improved gradually, and the neurological manifestations had not progressed.

Another study reports that in certain cases, ALS may be associated with autoimmunity and gluten sensitivity, with elevated transglutaminase 6 antibodies in the serum of 23 patients.

GABA and 5-HTP: the Deanna Protocol

Awhile back I was contacted by someone in my community about the Deanna Protocol for ALS because it uses amino acids GABA and 5-HTP and other nutrients like niacin and CoQ10:

It is determined that the substances in the DP™ Plan provide energy to cells that are dying and in doing so keeps them alive. This is very important because when nerve cells die, they release glutamate which kills the contiguous cells. If too many cells are dying then we cannot supply enough energy to keep up with the rate of death of the cells. When the DP™ Plan is taken in sufficient quantities, it will support the nerves that are challenged by glutamate.

As you may already know I use targeted individual amino acids such as GABA and tryptophan/5-HTP with clients so I am very familiar with their therapeutic benefits for anxiety and I am fascinated they also ease symptoms in ALS.

There is an animal study supporting this approach: Metabolic therapy with Deanna Protocol supplementation delays disease progression and extends survival in amyotrophic lateral sclerosis (ALS) mouse model.

Anxiety and depression

There is also research indicating that psychiatric symptoms often precede an ALS diagnosis:

neuropsychiatric conditions are overrepresented in amyotrophic lateral sclerosis (ALS) patient kindreds and psychiatric symptoms may precede the onset of motor symptoms…. A diagnosis of depression was significantly associated with a first record of ALS ≥5 years later, in keeping with growing evidence for major depressive disorder as an early marker of cerebral neurodegeneration.

This doesn’t mean if you have anxiety or depression that ALS or another neurodegenerative disorder is in your future, because we can address so many of the root causes before we get to that diagnosis. Many of the nutrients in the Deanna Protocol will help both the person with ALS and the caregivers who also suffer psychological distress.

Environmental toxins and ALS

We recently spent 3 days at Shell Harbour just south of the Wollongong area and we loved it!

As beautiful as it was I couldn’t help but be concerned about the toxins being released into the air from the steel production plants. Dr. Yerbury lives in the area and is conducting his research at the University of Wollongong. I know toxins play a role in many diseases and wondered about an ALS connection. I found this paper: Association of Environmental Toxins With Amyotrophic Lateral Sclerosis

I also shared that I’m a total research geek and pretty passionate about the power of nutrition, lifestyle and environmental factors because this was how I was able to eliminate my own anxiety and panic attacks.

You can learn more about Dr. Yerbury and his publications here. We appreciate the work him and his research team are doing and thank him for sharing his story.

It would be wonderful if some of this information can help Dr. Yerbury and even be considered for future research by his very passionate research team. I also hope this information will be helpful for you or a loved one suffering with ALS or MND.