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Coronavirus and vitamin C for immune support: new pain or more severe pain due to oxalate issues?

By Trudy Scott 113 Comments

coronavirus pain vitamin c

I have concerns regarding the use of high doses of oral vitamin C for boosting immunity – for a subset of susceptible individuals who have dietary oxalate issues. This is directly related to the many recommendations that have been and are being made in relation to the coronavirus pandemic, but it applies beyond the pandemic for anyone who has dietary oxalate issues.  My concerns relate to high doses of vitamin C making existing pain symptoms worse or even causing new pain symptoms in someone who is not aware they may have oxalate problems. This may include joint pain, vulvodynia, bladder pain, painful urination, eye pain, headaches, foot pain, stomach pain, general body pain, deep bone pain etc. All this can manifest as fatigue, irritability, anxiety, low mood and insomnia.

I’ve been promising to blog about this topic for over a month and have gathered enough information for a short book! I figured a good place to start is to share feedback I’ve received so far and ask for your feedback so we can learn and heal, educate and inform others going through this, as well as offer insights to researchers and doctors who are not aware of this issue (and sometimes say “based on biology it’s not possible”).

In the coming weeks, if there is enough interest, I’ll share additional information on mechanisms, what the research says and what the research says is not possible, labs, types of oxalate issues (there are many), the possible causes (there are also many) and long-term impacts beyond pain (for the thyroid, mitochondria, heart and more), the solutions, additional resources and  feedback from experts (of which there are very few – as of now I’ve been reading everything published by Susan Owens, Julie Matthews, Great Plains Labs and research published by kidney specialists).

Until then I’m humbly asking for your feedback. If you have no idea what oxalates are or are taking vitamin C with no issues, then please don’t worry. Things will become clearer as you read this blog and read follow-on blogs. I feel it’s really important to get this initial blog out rather than waiting until I have everything written up perfectly.

I’ve also been hearing feedback from folks who have now recovered from coronavirus or are still recovering, with many reporting lingering pain and fatigue. I am concerned some of that pain may be related to high doses of oral vitamin C or IV (intravenous) vitamin C leading to oxalate issues they may not be aware of.

My request to you – please share your vitamin C oxalate story

This is what I posted on facebook and I’ll simply share it again here: I’m looking for oxalate vitamin C stories to share with folks who don’t believe or are not aware that high dose vitamin C causes issues for those with dietary oxalate issues.

1) What symptoms do you experience?

2) How quickly do you notice symptoms after taking vitamin C?

3) What form of C have you tried? (ascorbic acid or Ester C or whole food sources of C like camu camu/amla/goji berry/acerola cherry/rosehips/kakadu plum/acai berry/ maqui berry or liposomal or something else). Please also share the brand and source of vitamin C if you know

4) How much vitamin C do you use and is this more than you usually take or are you/were you taking this for the first time?

5) How long did it take to get back to normal/no pain/no symptoms once you stopped taking vitamin C?

NOTE – ONLY VITAMIN C: for questions 2) through 5) – in order to be sure the new symptoms are due to vitamin C and not something else – the addition of vitamin C must be the only change made and then stopping vitamin C must also be the only change made. I have clients keep a log too and repeat the “test” if they are not sure. This can be likened to a gluten elimination trial but in reverse. Repeating the “test”also depends on the symptom severity.

6) Does/did anything help to counter the adverse effects (like calcium citrate, vitamin B6, NAC, MSM, biotin, bile support, Epsom salts baths or anything else)?

7) How long have oxalates been an issue for you and are you eating low oxalate? Or is this all new to you?

8) Would you equate the effects of vitamin C to eating high oxalate foods like spinach, raspberries, nuts and seeds, kiwi fruit, figs, turmeric, chocolate, wheat, white potato, soy, beets etc (less severe/same symptoms/more severe)?

I’m also adding these new questions based on some of the research I’ve been doing:

9) Are you aware of any kidney issues and if you get regular blood work done do you track and take note of your estimated Glomerular Filtration Rate (eGFR)?  What have you observed in terms of values? (In case eGFR is new to you it measures how well your kidneys filter the wastes from your blood and is the best overall measure of kidney function. It helps determine if you have any kidney damage.)  Have you ever been told you have kidney issues and have other kidney lab markers out of range?

10) What are your results on the Great Plains Lab organic acids test (OAT) for the following: Oxalic acid, Glycolic acid (glycolate), Glyceric acid (glycerate), Arabinose (a yeast/candida marker) Ascorbic acid (ascorbate, vitamin C), Pyridoxic acid (marker of vitamin B6 status), Furandicarboxylic acid and hydroxy-methylfuroic acid (markers for fungi such as Aspergillus), and markers of bacterial imbalance?

11) Do you have pyroluria (based on a urine test) or have more than 15 symptoms from the the pyroluria questionnaire and/or are susceptible to low vitamin B6 (poor dream recall and/or nightmares) and low zinc (and therefore high copper)?

12) How do you score on symptoms of low serotonin, low GABA, low endorphins and low catecholamines? (here is that questionnaire). Is your anxiety, low mood, cravings or sleep worse when you are dealing with your other oxalate symptoms/pain?

13) Do you have any genetic markers that indicate a susceptibility for oxalate issues?

14) Do you have celiac disease, gluten sensitivity, leaky gut, liver issues, gall stones, no gallbladder, poor bile production, fat malabsorption, mold toxicity issues, low pancreatic enzymes, candida, high iron/ferritin?

15) What are your results on a mold toxicity test such as the Great Plains MycoTOX profile? and/or do you live in a moldy home/worked in a moldy environment or have in the recent past?

16) What are you results on a stool test (and which stool test)?

17) Do you have high mercury, high lead or high levels of other metals?

18) What is your vitamin D level (now if you happen to know it and/or typical levels in the past) and did you start to take extra vitamin D during this pandemic too? If you are taking extra vitamin D how much extra? And does your vitamin D supplement also contain vitamin K1 and vitamin K2?

19) Do you have any other out-of-range (functional levels) markers on blood work or other lab tests?

I will come back and add references and the rationale for posing these questions.

Also, feel free to comment with a nickname to keep your health information private.

Josefin’s story: painful “fat tissue” around elbows, knees and hips, and an irritated bladder

I share some of the Facebook feedback below, but first, here are Josefin’s comments on my coronavirus blog. Josefin thanked me for not ignoring the oxalate problems that might come with higher doses of vitamin C, saying she has “experienced them first-hand and it is not something to take lightly.”

I asked her to share what happens when she eats medium and high oxalate foods (like spinach, nuts, kiwi fruit, chocolate etc). She shared this:

I gradually decreased my oxalate content in food as recommended in the TLO-group. During that year I experienced periods with a lot of the typical dumping-signs like sandy stools, pain in body and especially in joints and muscles, sand in eyes, bladder pain, peeing a lot, cravings for oxalate foods and a temporary relief in the dumping symptoms when I ate some higher oxalate foods.

I also realized that the painful “fat tissue” that I had all over the body (but mainly around elbows, knees and hips) for 10 years was really deposited oxalates with mostly fluid around it, since I lost it more and more while I dumped and had more pain there also when I dumped. Now the deposits are all gone.

I did want to know if the adverse symptoms she experienced with vitamin C were the same as when eating foods high in oxalates, and she confirmed they were:

Many of the symptoms of dumping were the same as I had previously experienced a few days to weeks after trying to do bowel flushes with vitamin C.

Josefin has been on a low oxalate diet for 3 years and has found the most vitamin C she can tolerate is 200-250mg of vitamin C per day. More about that in her own words:

Now after being on a low oxalate diet for 3 years (carnivore the last year) I have tried taking vitamin C very many times and come to the conclusion that about 200-250 mg per day is what I can take. If I take more I will get a gradual increase of that painful fat-tissue that will start after a few days to weeks depending on how much vitamin C I take. I will also get more of a flu feeling and irritated bladder.

When I stop taking the vitamin C I will within a day or two get all my typical dumping symptoms and they will continue for days to weeks depending on how much I have taken. Symptoms severity also depends on how much I have been taking.

It turns out she gets similar reactions with various forms of vitamin C: “ascorbic acid, calcium ascorbate, multimineral buffered ascorbate and also liposomal vitamin C from Quicksilver Scientific”.

Syd’s story: cystitis, along with a crashed brain

Syd shared this on the Facebook post:

I get symptoms from taking high dose Vitamin C within about 45 minutes. It shows up as cystitis, mostly, along with a crashed brain.

She did confirm that when taking vitamin C (possibly the ascorbic acid form) the symptoms mimic her symptoms when eating high oxalate foods. She also wants to try liposomal vitamin C and camu camu to figure out if she gets the same reactions:

I have the very same response to high oxalate foods. I used to think it was a bladder infection, but I tested four times and every time the test was negative. I’m having a response at the moment. I (stupidly) started eating protein bars that have nuts in them and after eating about four of them across several days, I have the cystitis symptoms.

I’m staring at some liposomal Vit C in the fridge that I’ve been wanting to try at a low dose. Same with some camu camu. I need the cystitis symptoms to abate first.

Virginia, Cathi and Melissa and their pain stories

Virginia also offered feedback on Facebook on her experiences with vitamin C, and again they are similar to when she eats high oxalate foods:

I took a pack of Vit C 1000mg (ascorbic acid) at night last week, next morning I noticed oxalate dumping. Took calcium citrate and it was gone within a day and yes the reaction is similar to eating high oxalate foods

On another Facebook thread my question got Cathi wondering if vitamin C was a factor in her worsening arthritis:

Hmmmmmm this has me thinking. I started Vitamin C crystals 1000mg a day – small spoonful in water. It is sour and not awful. Then, a couple of months ago the arthritis deposits in my right hand fingers got much worse and my right wrist has given me so much grief I have had to reduce my yoga. And I got a weird cyst or something on the inside of my right wrist. I wonder…. Gonna stop it and see if it makes a difference!!! Thank you as I was totally stumped and I hope this is the answer!!!!

On this same thread, Melissa shared that noticed severe joint and muscle pain within 2 or 3 days of starting vitamin C:

When the COVID stuff started, I started taking vitamin C as a preventative measure to keep my immune system strong. Within two or three days, I had system joint and muscle pain everywhere. I could hardly move! I stopped the vitamin C and it cleared up in 3 or 4 days. I’ve never had kidney stones, but my brother has, so maybe it’s a genetic predisposition? I do have a history of on & off systemic joint pain since my early 20’s.

I never thought I had oxalate issues but now I’m wondering if it might be related to my random systemic joint pain. 

I was taking between 1,000 to 3,000 mg per day. The label says Solaray timed release vitamin c (ascorbic acid), acerola cherry and rose hips.

Thanks to these folks, everyone who has already contributed on other blogs, all the Facebook feedback (and to you if you provide feedback today).

My hesitation – I don’t have all the answers and we are in the midst of a pandemic where vitamin C is so important

I planned to include this in part 2 but I’m adding this section now because a few hours after publication there are already so many comments and questions. I did hesitate about publishing this blog when I don’t have all the answers and because we’re in the midst of a pandemic where vitamin C has been shown to be very important.

There is plenty of research on the benefits of vitamin C and it’s widely used with much success during serious illness and for sepsis. This paper, An Update on Current Therapeutic Drugs Treating COVID-19, published just last month, discusses vitamin C (ascorbic acid) as a supporting agent, playing a role as a potent antioxidant, with benefits for immune health and as an antiviral against flu viruses.

It also discusses an IV vitamin C coronavirus trial and high dosages currently being used in various hospitals for this virus. The authors do also say “no major side effects” which is what we are typically told about vitamin C.

The Orthomolecular Medicine News Service have issued a number of valuable press releases on vitamin C specific to coronavirus but they are steadfast in their conviction that there are no issues with vitamin C, saying it doesn’t cause kidney stones.

For the majority (I think) there will be no major side-effects but for those with oxalate issues high doses of vitamin C are clearly problematic.

One caveat is that there may be a place for short-term high-dose use during a healing crisis, even for someone with dietary oxalate issues. Unfortunately I don’t have an answer for this aspect yet and I’m hoping a vitamin C expert will contribute to the discussion or I’ll discover some research about this.

And let’s not forget this study published in 1994, The clinical effects of vitamin C supplementation in elderly hospitalised patients with acute respiratory infections, where 200mg of supplemental vitamin C per day resulted in an 80% decrease in deaths among severely ill, hospitalized respiratory disease patients.

This topic is near and dear to my heart and folks have oxalate issues now so I decided to go ahead and publish this information. I’m looking for a solution for my community who are already aware they have oxalate issues (many of you have already reached out to me so thank you) and for myself too. I’ll share details of my oxalate story (my pain is in my feet and my eyes) and my vitamin C experiment in a future blog (I used food based vitamin C and 100-200mg/day and it didn’t go well).

As I mentioned above, I’m also concerned there are many people who don’t know they have oxalate issues and may end up with issues because of all the well-meaning vitamin C advice that is being shared during this pandemic.

I may have bitten off more than I can handle with this topic – I’m learning voraciously and it’s like drinking from a fire-hose! But I’m doing what I often do … I learn by teaching and asking for your feedback and questions, and I’m open about the fact that I’m not an expert and don’t have all the answers.

**** Some cautions *****
Please discuss your situation with your doctor and other health practitioners before stopping or reducing vitamin C based on what you’re reading here.

If you are completely new to the topic of oxalates, this is sound advice from Susan Owens on getting started: “work your way gradually into a completely low oxalate diet.” You can learn more on getting started here. Susan runs the Trying Low Oxalate Group (TLO) on facebook and they are extremely helpful.  I will be sharing additional resources/studies/practitioner feedback etc. but this will get you started.

A reminder that pain can have many root causes other than dietary oxalate issues (or in addition to oxalate issues): gluten issues, nightshades, low GABA, low serotonin, low endorphins, Lyme disease (bartonella can cause foot pain), fibromyalgia, low B12, heavy metals, mold toxicity, autoimmune conditions etc.

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

Feel free to comment below – share your feedback and ask your questions. And do let me know if you’re interested in learning more about this topic and additional blog posts.

If you’re a practitioner who works with individuals with dietary oxalate issues I’d love to hear from you too.

The vagus nerve impacts mood, anxiety, immune response, digestion and heart rate

By Trudy Scott 12 Comments

vagus nerve impacts

The vagus nerve forms a bi-directional “super-highway” between your brain and the majority of your internal organs. Unless your vagus nerve is in good shape and activates readily when it is supposed to, the communication between your brain and the body will be disrupted.

This modern world can lead to overstimulation of the nervous system and you can become desensitized to chronic stress. Over time, this can lead to low vagal tone, which has been linked to a variety of mental and physical health issues, including chronic inflammation, poor gut function, neurodegeneration, autoimmunity and cancer.

And we know this to be true: you cannot FULLY heal leaky gut, microbiome function or brain issues WITHOUT optimizing your vagus function.

Host of the Mind, Body & The Vagus Nerve Connection Summit, Eva Detko, PhD, MSc, BA (Hons), mIAHT, shares the above wisdom about the vagus nerve. I’ll add this: overstimulation of the nervous system is especially high right now during the coronavirus pandemic.

In my interview, Balancing Neurotransmitters to Optimize Vagus Function, we start with a review paper that reports how the vagus nerve is intricately connected with anxiety and mood (and immunity).

I share from Vagus Nerve as Modulator of the Brain–Gut Axis in Psychiatric and Inflammatory Disorders:

  • The vagus nerve represents the main component of the parasympathetic nervous system, which oversees a vast array of crucial bodily functions, including control of mood, immune response, digestion, and heart rate.
  • It establishes one of the connections between the brain and the gastrointestinal tract and sends information about the state of the inner organs to the brain via afferent fibers.

The review article goes on to state how the vagus nerve is an attractive tool for treating psychiatric and gastrointestinal disorders: “There is preliminary evidence that vagus nerve stimulation is a promising add-on treatment for treatment-refractory depression, posttraumatic stress disorder, and inflammatory bowel disease.”

And as we all know when we hear the term treatment-refractory depression, it means we haven’t got to the root cause of it. It just means that medications haven’t worked for it.

So this allows us to extrapolate and say, well, there’s other lifestyle and dietary, and nutritional approaches that we could use. But they’re saying that stimulating the vagus nerve, activating it, can actually help in this area. And with my work in anxiety, whenever I see depression, I feel like I can replace that with anxiety (because of similar underlying causes). The other thing that they say is that there’s this impact on inflammation: “Treatments that target the vagus nerve increase the vagal tone and inhibit cytokine production.”

And we know that when we’ve got inflammation going on in the body, that’s going to contribute to mood disorders: “Stimulation of vagal efferent fibers in the gut influences neurotransmitters (like serotonin and dopamine, and GABA) that play a crucial role in major psychiatric disorders.”

So the conclusion is that vagal tone is correlated with the capacity to regulate stress responses and can be influenced by breathing. Its increase through meditation and yoga is likely to contribute to resilience, and the mitigation of mood and anxiety symptoms. And we know from other research, and we know from just doing it, that using meditation and yoga is going to affect anxiety levels. We’ve seen research showing that yoga and meditation raises GABA levels, which is one of the neurotransmitters that helps us feel calm.  But now we’re also seeing from the research that good vagal tone has an impact as well.

So it’s really exciting to see that there’s many different ways that we can use to approach someone who does have anxiety issues.

I also talk about a very interesting study that brings the connections between GABA and the vagus nerve together very nicely. As I’m talking I see Eva nodding in agreement as I cover this. I wanted to share this study to add another mechanism as to how GABA may work, given so many people don’t believe it can because of the blood brain barrier.

This was an animal study done in 2011 and it’s titled: Ingestion of Lactobacillus Strain Regulates Emotional Behavior and Central GABA Receptor Expression in a Mouse via the Vagus Nerve. You may have had other people in the summit talking about this. I can see you nodding there. Let me just bring it back to this discussion because I’ve got something to add about this. But what they found is this – Lactobacillus rhamnosus increased GABA in the hippocampus. It reduced cortisol levels, which was caused by the increased stress, and it reduced anxiety and the depression in the animals.

When they severed the vagus nerve in some of the mice in the study they found that these neurochemical and behavioral effects were not found. So as soon as the vagus nerve was severed, the effects of the Lactobacillus rhamnosus, which was increasing GABA levels, was not reducing the anxiety and it was not reducing those cortisone levels.

The biggest question that I get about GABA is: “How could GABA possibly work if it can’t cross the blood brain barrier?”  Maybe this is one way that is having an impact on anxiety. We know that we’ve got a lot of GABA receptors in our peripheral tissue. We’ve got GABA receptors in our muscles, which probably is the reason why we feel it when we’ve got this physical tension, or we’ve got the spasms. We’ve got GABA receptors in our pancreas. We’ve got GABA receptors in our endocrine system.

But maybe this vagus nerve connection and the fact that when it’s severed we’re not getting those effects, maybe this is another way that GABA is having an impact on anxiety.

Making the vagus nerve connection to serotonin, I share some interesting new research on SSRIs/antidepressants and the vagus nerve: Oral Selective Serotonin Reuptake Inhibitors Activate Vagus Nerve Dependent Gut-brain Signalling.

SSRIs like Zoloft or Paxil or Prozac are often prescribed for anxiety, depression, autism and dementia. And there’s a whole host of issues that we have with SSRIs where you’ll have serious withdrawal symptoms in some people.

In the study, the researchers proposed that SSRIs were having an effect on serotonin and it was the vagus nerve that was now communicating to the brain leading to increased serotonin levels. Similar to the GABA study, when they severed the vagus nerve of the mice, they did not see the same benefits from the SSRI.

My thinking is this: could we possibly extrapolate and say the amino acid tryptophan may have similar effects?

We won’t hold our breath for a similar tryptophan study but we can learn from this paper and possible mechanisms.

I also share how I use GABA and tryptophan with clients so if you’re new to using targeted individual amino acids you’ll learn more about this too.

As you know, my work is primarily using the neurotransmitters precursors (such as the amino acids) and using dietary changes, but we don’t want to forget about other approaches like vagus nerve support.

If we can improve vagus function, then we’re going to get even better benefits.

I share some of my favorite vagus nerve exercises. One of them – social interaction – has been challenging lately but cold showers are very do-able.

Let me share some aspects on the importance of social interaction for improving vagal tone.

Research shows that the more social interactions you have, the more it improves vagal tone. And then that improved vagal tone, improves your mood and makes you more social (and has ramifications for so many other areas as you’ll learn on the summit).

However if you have a condition called pyroluria (social anxiety, preferring one-to-one connections rather than being in large groups, not liking small talk, early morning nausea, not really big on animal protein – I go into it in depth during the interview if it’s new to you), getting out and being social can be very challenging when you are forcing yourself and putting on a brave face:

It’s a very stressful situation in doing that, and then it makes your pyroluria worse so your social anxiety gets worse. So when you have pyroluria and you have a stressful situation, you end up dumping high levels of zinc and B6. So it makes things worse.

If you do go out, it’s either very stressful or you just don’t even do it. So my contribution to the discussion is: let’s address pyroluria and that’s going to in turn allow people to get out and socialize without feeling uncomfortable, without feeling awkward, without having to stress, without feeling absolutely exhausted afterwards, and it’s going to help improve vagal tone.

Eva sums up with this important aspect:

What people need to know is that social connection is good for your vagus nerve only if it’s perceived positively by you internally. So if you’re in a situation where you’re forcing yourself to interact with other people, you’re actually not going to have a positive knock-on effect on your vagus nerve because it’s going to be the opposite. You’re going to stimulate the sympathetic nervous system response because you’re there, as you described, completely uncomfortable and basically stress out. So those social connections need to be positive.

Here are some interviews I look forward to tuning into:

  • Niki Gratrix, BA, Dip ION: Connecting the Vagus Nerve, Emotions and Gut Function
  • Ben Lynch, ND: Epigenetics of Chronic Stress
  • Bridgit Danner, LAc, FDNP: How Mold Toxicity Damages Your Nervous System
  • Jay Davidson, DC, PScD: Impact of Infections on Mitochondrial and Vagus Function
  • Kimm Sun, CNM: Impact of Birth Trauma Across Lifetime
  • Eva Detko, PhD, MSc, BA (Hons): Impact of Perfectionism on Heart Rate Variability
  • Misa Hopkins: Vagus Nerve Session of the Day – Vagus Nerve Sound Healing

I don’t go into the immune connection in my interview because it was recorded before the coronavirus pandemic started but keep this in mind as you tune in: you cannot have a well-functioning immune system without a healthy nervous system, and vice-versa!

Coronavirus: new research on vitamin D supplementation possibly improving clinical outcomes

By Trudy Scott 57 Comments

coronavirus and vitamin d

It’s very encouraging to see research like this being published in the midst of the coronavirus pandemic: Vitamin D Supplementation Could Possibly Improve Clinical Outcomes of Patients Infected with Coronavirus-2019 (COVID-2019)

Serum 25(OH)D level was lowest in critical cases, but highest in mild cases. Serum 25(OH)D levels were statistically significant among clinical outcomes.

The results suggest that an increase in serum 25(OH)D level in the body could either improve clinical outcomes or mitigate worst (severe to critical) outcomes, while a decrease in serum 25(OH)D level in the body could worsen clinical outcomes of COVID-2019 patients.

In other words,  lower levels of vitamin D were associated with more severe symptoms and higher levels were associated with less severe symptoms. The role of vitamin D in immunity has been long understood and is summarized in the paper as follows:

Vitamin  D has  been  proven  to reduce  risk  of  getting a common  cold. It  also  enhances cellular immunity, modulates adaptive  immunity, and  enhances expression  of  antioxidation-related genes.

There are a few aspects I’d like to highlight: it was not a peer-reviewed randomized controlled trial but rather a retrospective study (looking back on past events) submitted as a research letter; it was a small study of 212 cases and they were all confirmed to have SARS-CoV-2 infection.  Vitamin D status was based on serum 25(OH)D levels of “(1) normal -25(OH)D of >30 ng/ml, (2) insufficient-25(OH)D of 21-29ng/ml, and (3) deficient-25(OH)D of < 20 ng/ml,” with tests done every 7 days.

What is astounding to me is that such a small difference in vitamin D levels could have such a dramatic impact on severity of symptoms i.e. from a median of 31.2 ng/ml to 17.1 ng/ml:

  1. mild – mild clinical features without pneumonia diagnosis: serum 25(OH)D level was 31.2 ng/ml
  2. ordinary – confirmed pneumonia with fever and other respiratory symptoms: serum 25(OH)D level was 27.4 ng/ml
  3. severe – hypoxia (at most 93% oxygen saturation) and respiratory distress: serum 25(OH)D level was 21.2 ng/ml
  4. critical – respiratory failure requiring intensive case monitoring: serum 25(OH)D level was 17.1 ng/ml.

The author concludes as follows, recommending randomized controlled trials and large population studies:

… this study provides substantial information to clinicians and health policy-makers. Vitamin D supplementation could possibly improve clinical outcomes of patients infected with COVID-2019. Further research should conduct randomized controlled trials and large population studies to evaluate this recommendation.

I would really like to acknowledge the author, Dr. Mark Apilio, for taking the time to gather this information and submit this research in the midst of the pandemic, so we can all learn and further our knowledge.

I reached out to him to find out more about his interest in vitamin D. I was also curious to find out if vitamin D levels are routinely checked in the Philippines and if vitamin D supplementation recommendations are common practice. I received this feedback:

I am a clinical professor with experience in handling patients with infection. In times like this, academicians in the Philippines are driven to finding therapeutic drugs for Covid-19 or palliative drugs, at least. Also with other experts’ advice, Vit D could be a good topic to research using clinical outcomes of the Covid-19 patients.

Vitamin D supplementation in the Philippines is uncommon since most of the Filipinos believe that they could get Vit D easily because of the sun (country near the equator). However, Vit D test is common for patients with severe respiratory infections for monitoring of status. Based on the table [in the review letter], mean ± SD was used to report serum 25(OH)D level of the cases. I am happy with the results of the study and the support of Vit D advocates like you. I do hope this shall serve as a call for health officials to at least focus on something like this which could impact clinical outcomes of Covid-19 patients.

Keep in mind that low vitamin D is also a factor when it comes to mental health and anxiety. You can read more about this aspect here – Vitamin D: anxiety, depression, sun exposure, supplements and optimal levels. This blog also has additional information about testing and optimal ranges from the Vitamin D Council.

I really like these two Designs for Health products: Vitamin D Synergy which provides Vitamin D3 2000 IU and vitamin K1; and Vitamin D Supreme which provides Vitamin D3 5000 IU and vitamin K1/K2. Both can be purchased via my online supplement store (details on setting up an account here).

Vitamin D is such a simple and yet powerful intervention for immune support and I look forward to randomized controlled trials for coronavirus. In the meantime, it’s one of the many immune-supportive nutrients I plan to continue using and recommending to my clients.

UPDATES 5/1/2020:

I’m sharing some updates to last week’s blog on vitamin D and coronavirus because there is a brand new study with astounding results and some other supporting vitamin D papers.  There is also new research on vitamin K and coronavirus and I’ve added this one too. I did hear back from the author in the Philippines and added his feedback above.

This is the new paper with astounding results. It was a retrospective cohort study: Patterns of COVID-19 Mortality and Vitamin D: An Indonesian Study (and just posted April 26). It had 780 cases with laboratory-confirmed infection of SARS-CoV-2 in Indonesia:

Age, sex, co-morbidity, Vitamin D status, and disease outcome (mortality) were extracted from electronic medical records. The aim was to determine patterns of mortality and associated factors, with a special focus on Vitamin D status. Results revealed that the majority of the death cases were male and older and had pre-existing conditions and below normal Vitamin D serum level.

These are the astounding results:

  • Vitamin D deficient cases (serum 25(OH)D of < 20 ng/ml) were approximately 19.12 times more likely to die from the disease
  • Vitamin D insufficient cases (serum 25(OH)D of 21 – 29 ng/ml) were approximately 12.55 times more likely to die from the disease

This review paper, Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths published earlier in April makes these recommendations about dosages and vitamin D levels to aim for (pending additional research):

To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40-60 ng/mL (100-150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.

In this paper (not yet peer-reviewed), Reduced Vitamin K Status as A Potentially Modifiable Prognostic Risk Factor in COVID19, the authors report that vitamin K status – according to Dp-ucMGP levels – was reduced in patients with COVID-19 and related to poor prognosis.”

They state this is due to the fact that “Coagulation is an intricate balance between clot promoting and dissolving processes in which vitamin K plays a well-known role.” They also propose an intervention trial with vitamin K for patients with COVID-19.

Do share if you routinely get your vitamin D levels checked and supplement regularly with vitamin D.  And let us know if you’ve noticed an improved immune system when your vitamin D levels are optimal. If you did get the virus please also let us know how you’ve fared and recovered.

GABA and theanine for easing anxiety, improving sleep and supporting immunity

By Trudy Scott 86 Comments

gaba theanine

Stress and anxiety suppresses immunity and so does poor sleep. One root cause of anxiety and poor sleep can be low GABA (gamma-aminobutyric acid) levels.  When you boost low levels of GABA (the neurotransmitter) with the amino acid GABA (it has the same name as the neurotransmitter) or theanine (another amino acid), you feel calmer and you sleep better, and you indirectly support your immune function too. We also have research that directly supports the role that GABA and theanine may play when it comes to improving immune function.

This paper, Psychological Stress, Immunity, and the Effects on Indigenous Microflora, describes the field of PsychoNeuroImmunology which

has clearly demonstrated that the physiological response to psychological stressors can dramatically impact the functioning of the immune system, thus identifying one way in which susceptibility to or severity of diseases are exacerbated during stressful periods.

It’s important that we keep all this in mind as we deal with the coronavirus pandemic and during other times when we may be exposed to infections.

The authors also share that psychological stressors impact the microbiome contributing to increases in markers of inflammation even when there is no infection. As you may recall from the recent Anxiety Summit 5: Gut-Brain Axis there is a bidirectional communication between the gut and the brain, with poor gut health having a direct impact on anxiety levels.

The sleep-immunity connection

Here is some of the research supporting the sleep and immunity connection:

Sleep is considered an important modulator of the immune response. Thus, a lack of sleep can weaken immunity, increasing organism susceptibility to infection.

Sleep abnormalities affect immune function in a reciprocal manner, leading to changes in proinflammatory cytokines, such as tumor necrosis factor, interleukins 1 and 6, and C-reactive protein. The multitude of systems that react to sleep loss suggest effects beyond the central nervous system and include total body functioning.

The GABA and theanine anxiety-immunity connection

Here is some of the research supporting the more direct role GABA and theanine may play when it comes to immune function (and act as a relaxant and anti-stress nutrient at the same time):

GABA could work effectively as a natural relaxant and its effects could be seen within 1 hour of its administration to induce relaxation and diminish anxiety. Moreover, GABA administration could enhance immunity under stress conditions.

A number of recent studies have suggested that theanine administration can improve the body’s immune system….one particular study highlighted the use of theanine as an intervention to decrease the incidence of upper respiratory tract infection symptoms via enhancing gamma and delta T-lymphocyte function.

The authors cite one study where “administration of 200 mg theanine was found to have an “anti-stress” effect on pharmacy students” and “regulate dopamine and serotonin levels in the brain through the release of the inhibitory neurotransmitter GABA.”

The  low GABA type of anxiety

When you have the  low GABA type of anxiety you’ll feel physically tense and overwhelmed, fearful and not be sleeping well. You may lie in bed stiff and tense and may also have unwanted thoughts and experience monkey-mind. It’s common to self-medicate with alcohol to stay calm or you may also use carbs to relax. When you use the amino acid supplement GABA, you get quick and very effective relief – when it’s used sublingually.

Already using GABA/theanine or have used it in the past?

If you are already using GABA or theanine you may find you need extra during this time of added stress.  You don’t want to make the mistake of thinking “This is serious, I need to double-up.” The best approach is to monitor your low GABA symptoms and consider using an extra dose during the day or possibly more at night or possibly more at each dose. Use the trial method to monitor your response.

Someone in my facebook community said she was conserving her GABA and noticed her anxiety was creeping back up. Now is not the time to cut back on GABA.

If you’ve found benefit from GABA or theanine in the past but are not currently using it you may very likely feel the need for the additional support right now.

New to low GABA anxiety symptoms and using GABA/theanine?

If you suspect low GABA symptoms and are new to using the amino acids and do not have my book I highly recommend getting it and reading it before jumping in to taking supplements: The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings. (get it out of the library if you’re watching your expenses.)

There is a complete chapter on the amino acids and one for pyroluria, plus information on real whole food, sugar and blood sugar, gluten, digestion and much more.  If you’re not a reader there is now also an audible version.

Here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and additional information on Anxiety and targeted individual amino acid supplements: a summary

Please also read and follow these Amino Acid Precautions.

This lists The Antianxiety Food Solution Amino Acid and Pyroluria Supplements that I use with my individual clients and those in my group programs.

In summary, anxiety and sleep deprivation are not good for your immunity, and theanine and GABA can ease anxiety, improve sleep AND enhance immunity.

Please share your experiences with GABA and theanine and feel free to ask questions. Let us know if you were aware of the connections to immune function and if you’ve noticed your immune system is stronger when using GABA or theanine?

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

By Trudy Scott 16 Comments

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.

Pharma-GABA: study participants with an irrational fear of heights are relaxed and less anxious when crossing a swaying suspension bridge

By Trudy Scott 7 Comments

Based on clinical evidence, we know that gamma-aminobutyric acid (GABA), a calming amino supplement, reduces anxiety. There isn’t as much research on GABA or Pharma-GABA as we’d like to see, so we’ll take small studies that are done on humans.

In a 2006 study, Relaxation and immunity enhancement effects of gamma-aminobutyric acid (GABA) administration in humans, Pharma-GABA was used to determine if it would increase relaxation and reduce anxiety during the stressful event of crossing a suspension bridge:

Eight healthy volunteers, with no clinical evidence of any illness, (5 males and 3 females) aged 25 to 30 years who had a history of acrophobia [extreme or irrational fear of heights], were recruited.

Subjects crossed … a pedestrian suspended bridge at Nara Prefecture, Japan (Totsu River Bridge) with 54 m height, 300 m length, and 2 m width.

I believe it’s also called the Tanize Suspension bridge and is one of the longest suspension bridges in Japan. You can see pictures of the bridge here and here. They say this: “though quite safe, the swaying motion can be disconcerting, or fun, depending on your perspective.”

If we convert that to feet, it’s 177 feet high, almost 1000 feet long (about 3 times the length of a football field) and 6 feet wide.

There were 2 groups: placebo and Pharma-GABA. Salivary immunoglobulin A (IgA) levels (also known as secretary IgA or sIgA) was measured in both groups and used as a marker of relaxation and stress, as well as immunity. Saliva was collected before crossing the bridge, half way across and at the end. The study found that the

placebo group showed marked decrease of their IgA levels, while GABA group showed significantly higher levels.

And concludes as follows:

GABA could work effectively as a natural relaxant and its effects could be seen within 1 hour of its administration to induce relaxation and diminish anxiety. Moreover, GABA administration could enhance immunity under stress conditions.

The paper is reporting about 2 studies and it’s not clear how much Pharma-GABA was used in this bridge study – it was either 100mg or 200mg. Results were observed within 60-90 minutes. Also, this study was conducted by the company who makes the Pharma-GABA product, and they do say that this bridge study includes unpublished data.  Notice that they use the term GABA in the paper – I prefer to differentiate since Pharma-GABA and GABA are actually different.

Other than this and the very small number of participants, I’m always encouraged by any research we have. Clinically, we see very similar results with GABA or Pharma-GABA when someone has a fear of something – heights, flying, spiders etc. – and it typically addresses the physical fear and anxiety symptoms.

Here are some of my thoughts as to why results were only observed after 60 minutes:

  • Pharma-GABA was used in the study and for some folks this is not as effective as using GABA. I typically start my clients on GABA.
  • Using GABA sublingually often has calming results in under 10 minutes, so a chewable Pharma-GABA may have been a better option and would be something I’d recommend
  • Low serotonin is commonly a factor with fears and phobias and I’d recommend a trial of tryptophan

The resources in this blog and my other articles are intended to be used in conjunction with my book: The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings (Amazon link). If you do not have my book I highly recommend getting it and reading it before jumping in and trialing/taking amino acid supplements: There is a complete chapter on the amino acids and one for pyroluria, plus information on real whole food, sugar and blood sugar, gluten, digestion and much more.

You can find the GABA and tryptophan products I recommend on this blog: The Antianxiety Food Solution Amino Acid and Pyroluria Supplements

How would you feel walking across a swaying suspension bridge like this?

Have you used Pharma-GABA, GABA and/or tryptophan to help you with the stress and anxiety caused by a phobia like this or another phobia?