lithium

Tryptophan doesn’t work, then it does and then it doesn’t: could it be hormonal shifts, dietary factors and/or parasites?

November 26, 2021 By Trudy Scott 18 Comments

Have you been in a situation where tryptophan doesn’t work, then it does work, and then sometimes it doesn’t work as expected? There is a reasonable explanation as to why it may not work initially – too much or too little was used. The variable results and the need to switch between lower and higher doses on an ongoing basis can happen but it’s not very pronounced unless there is a specific reason. In this blog I cover some of these reasons – hormone shifts, dietary factors and parasites/other digestive issues.

I’m writing this blog in response to a question that was posted on one of my speaker pages on the Anxiety Summit: Gut-Brain Axis. This is the actual question:

I tried to use tryptophan the first time (whole capsule) and got really high. Some time later I tried again, but used 1/4 of a capsule and had a good result. A few weeks later 1/4 of the capsule didn’t work at night. So I went up to half a capsule. And that’s where I am now. But some nights (very rare) I can only get good results from a whole capsule. I use it along with the same amount of GABA. Is that a normal reaction for tryptophan?

I don’t know what brand of tryptophan she was using but assume 500mg was her starting dose and she now shifts between 125 mg (¼ capsule) and 250 mg (½ capsule) with variable results.

It’s not unusual for someone to not feel great on 500 mg if that dose is too much for their unique needs. She did the right thing by lowering her dose. It’s also reasonable that someone may find 500 mg as an initial dose isn’t enough to reduce symptoms.

The variable results and the need to switch between 125 mg and 250 mg can happen but it’s not very pronounced unless there is a specific reason. Some of these reasons include hormone shifts, dietary factors, parasites/other digestive issues, thyroid issues, low lithium, product quality and environmental factors. More on all this below.

Hormone shifts/more serotonin is needed in the luteal phase

I have my clients track when the variability happens, with female clients documenting their cycles. Some women need more serotonin support in the luteal phase i.e. after ovulation and right up to before their periods. Some may even need additional tryptophan for the first few days of their periods too.

Write about tryptophan working well in the luteal phase in this blog – Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability

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):

37 patients with premenstrual dysphoric disorder were treated with L-tryptophan 6 g per day, and 34 were given placebo. The treatments were administered under double-blind conditions for 17 days, from the time of ovulation to the third day of menstruation, during three consecutive menstrual cycles.

They looked at dysphoria, which is defined as a state of unease or generalized dissatisfaction with life, plus mood swings, tension (and anxiety), and irritability and they found a 34.5% reduction of symptoms with tryptophan compared to 10.4% with placebo.

The paper concludes: “that these results suggest that increasing serotonin synthesis during the late luteal phase of the menstrual cycle has a beneficial effect in patients with premenstrual dysphoric disorder.”

It’s a small study but the results are powerful and it’s something I see clinically with my clients. The one big difference is that I typically have clients using tryptophan throughout the month.

But if you are seeing tryptophan work and then not work at similar times each month this is something to consider and track. And then if need be, increase and decrease tryptophan accordingly (and track again).

Dietary factors – collagen, gluten, sugar, wine and coffee

There are other factors to consider too and dietary impacts is one. For example, collagen leads to a higher need for tryptophan in susceptible individuals (due to it’s serotonin-lowering effects – I blog about this here)

Another dietary factor is accidental gluten exposure in susceptible individuals or a newly discovered gluten issue

High sugar intake, alcohol and/or caffeine consumption may also be a factor – contributing to added stress for the adrenals and depletions in zinc and the B vitamins. This can contribute to lowered serotonin and a need for a higher dose of tryptophan.

Now imagine if it’s just before her period and she adds collagen to her diet and she also eats out and gets zapped by gluten. Triple whammy for this woman!

And she goes to a party and happens to indulge in cocktails or wine, and then goes on a binge at the dessert table, followed by a few cups of coffee (or even one dessert and one cup of coffee).

A food-mood log really helps you figure things out. And then, if need be, increase and decrease tryptophan accordingly. And track again and address the dietary issues.

Parasites and other gut issues

If she has a very pronounced shift in symptoms for 4-5 days around a full moon each month – more severe insomnia, more anxious, more depressed – I would want to check for parasites.

I would also want to check for other digestion issues like dysbiosis, SIBO (small intestinal bacterial overgrowth), candida and liver health as they may all be factors. With SIBO and candida, dietary slip-ups may make symptoms worse right after the slip-up, for example increased bloating making sleep and anxiety worse.

Using tryptophan sublingually/opened on the tongue may bypass some of the digestive/liver issues until they are resolved.

As mentioned above, if need be, increase and decrease tryptophan accordingly. And track again and address the underlying issues.

Other factors to rule out – thyroid, lithium, environmental factors and the product

Two other underlying root causes we always want to rule out when we see variable results using tryptophan (and any of the amino acids) are Hashimoto’s thyroiditis (because we can have variable thyroid results – sometimes hypo/low and sometimes hyper/high) and low levels of lithium (because this can affect the results we see with all the amino acids).

And we always check environmental factors like mold, EMFs and outside stresses. And look for infections like Lyme disease or EBV. If the basics are not unearthing the solution we continue to dig deeper and do a full functional medicine workup. And adjust the tryptophan as needed.

And finally the quality of the product is key. I find Lidtke Tryptophan to be better than many other brands. I’ve also had many clients switch to Lidtke tryptophan and see better results and often need a lower dose.

Resources if you are new to using tryptophan and the amino acids as supplements

If you are new to using the amino acids tryptophan/5-HTP and the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low serotonin symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low serotonin or 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 so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

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 acid products that I use with my individual clients and those in my group programs.

I always appreciate good questions like this and hope this feedback has helped her and you too if you’ve experienced something like this (or if you do in the future). In case you’re wondering, this question was posted after someone tuned into my interview, “GABA & Tryptophan: Gut-Anxiety Connections” on the Anxiety Summit 5: Gut-Brain Axis.

Have you had a variable response to tryptophan (or 5-HTP) and can you relate to any of this?

What did you figure out to be the reason?

Feel free to ask your questions here too.

Microdose lithium formulation is capable of halting signs of advanced Alzheimer’s and improving cognition

February 7, 2020 By Trudy Scott 45 Comments

In a new study, a team of researchers has shown that, when given in a formulation that facilitates passage to the brain, lithium in doses up to 400 times lower than what is currently being prescribed for mood disorders is capable of both halting signs of advanced Alzheimer’s pathology and of recovering lost cognitive abilities.

The above snippet is from a press release published last month on Science Daily: Can lithium halt progression of Alzheimer’s disease? Keep in mind that this is an animal study but the results are so promising. I’m also very intrigued by the delivery method (more on that below).

In order to give this microdosing context, a typical adult prescription for is 900-1800mg lithium carbonate/day. I reached out to the lead author for clarification about the dosing of this new formulation and lead researcher Dr. Cuello shared this with me:

I calculate that our lithium dosage is 285 times lower concentration than the 900 mg dose (based on 70 kg of body weight) and 570 times lower than the 1800 mg dose.

This translates to around 3.2 mg to 6.4 mg NP03 based on 70kg of body weight (which is around 154.3 lbs).

NP03 is a disease-modifying nano dose formulation of lithium citrate which is used sublingually. I assume it’s not yet commercially available.

Also from the press release: “our findings show that microdoses of lithium in formulations such as the one we used, which facilitates passage to the brain through the brain-blood barrier while minimizing levels of lithium in the blood, sparing individuals from adverse effects, should find immediate therapeutic applications.”

Here is a link to the actual paper: NP03, a Microdose Lithium Formulation, Blunts Early Amyloid Post-Plaque Neuropathology in McGill-R-Thy1-APP Alzheimer-Like Transgenic Rats

Can we compare NP03 to low dose lithium orotate?

What is really interesting is that low dose lithium in the form of lithium orotate is commonly recommended by integrative practitioners for anxiety, mild mood swings, brain fog, ADHD and insomnia. I have found it to be extremely beneficial for many of my clients and have used it personally with success (for brain fog and insomnia).

Just how much lithium orotate is low dose? Typical doses are 5-10 mg per day, increasing to 20mg per day.

Can we compare NP03 to low dose lithium orotate? It’s too early to know for sure but we I believe we can start to make extrapolations, especially given that both are very low doses.

Integrative psychiatrist, Dr. James Greenblatt, MD has written extensively about low dose lithium orotate for the above purposes and for Alzheimer’s too. In this article, Lithium: The Cinderella Story About a Mineral That May Prevent Alzheimer’s Disease, he shares that

Scientists first became interested in the use of lithium for treating neurodegenerative disorders when they observed that bipolar patients using lithium therapy seemed to have lower rates of cognitive decline than peers on other medications.

He writes how an enzyme called Glycogen Synthase Kinase-3 (GSK-3) – a serine/threonine protein kinase – normally plays a major role in neural growth and development and how lithium

works as a direct GSK-3 inhibitor… halting inappropriate amyloid production and the hyper-phosphoryation of tau proteins before they become problematic.

If all this fascinates you as much as it does me, Dr. Greenblatt writes more about lithium orotate in his excellent book: “Nutritional Lithium: A Cinderella Story: The Untold Tale of a Mineral That Transforms Lives and Heals the Brain” (my Amazon link).

Alzheimer’s and cognitive decline have many root causes

Keep in mind that Alzheimer’s and cognitive decline have many root causes that must be considered. This may include inflammation, stress and candida, and even insecticide exposure.

Benzodiazepines have also been linked to increased Alzheimer’s risk which is why a nutritional approach for anxiety is the best approach. Let’s use the amino acids like GABA (for physical anxiety), and tryptophan (for worry and fears), as well as dietary changes and improving gut health instead of anti-anxiety medications.

The best Alzheimer’s book

The best Alzheimer’s book is “The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline” by Dr. Dale Bredeson (my Amazon link). He doesn’t mention lithium orotate so I look forward to hearing his thoughts on this new research. [I’ll come and update the blog when I do]

You can read about some of Dr. Bredesen’s work here: Alzheimer’s disease, mercury and mycotoxins

I look forward to human clinical trials of NP03. Dr. Cuello “ believes that there is an excellent opportunity to launch initial clinical trials of this formulation with populations with detectable preclinical Alzheimer’s pathology or with populations genetically predisposed to Alzheimer’s, such as adult individuals with Down Syndrome.”

I would also love to see lithium orotate compared to NP03 in future research.

In the meantime I feel this early research is exciting because it supports some of what is being seen clinically with lithium orotate.

Have you used lithium orotate with success? How much has helped you and have you seen cognitive benefits? What about a more even mood, better sleep and less anxiety?

And have you or a family member seen improvements with the Bredesen protocol?

Genes, lithium, Kundalini yoga, coffee enemas, GABA, dairy: IMMH highlights part 1

December 12, 2016 By Trudy Scott 17 Comments

Here are some highlights from the recent Integrative Medicine for Mental Health conference. We did it live on Facebook, holding my iphone, as the conference was ending. I’m with my colleague Dr. Josh Friedman and this is the video and transcript of our discussion – we cover the following:

Methygenetic Testing to fine tune your gene results
Low dose lithium for irritability and alcoholism
Kundalini yoga if you have a hard time meditating
Coffee enemas for medication detox
Working as a detective to find your root cause
Simple changes like adding GABA or 5-HTP or removing gluten and/or dairy

Ok we are live… Trudy Scott, certified nutritionist and author of The Antianxiety Food Solution and Dr. Josh Friedman, a psychologist interested in integrative medicine approaches to depression.

Josh: I have a new website integrativedepressionsolutions.com and we are at the IMMH conference and it has just wrapped up – there was a huge amount of information, tons to learn, it was wonderful. What were your take aways Trudy?

Trudy: One of the things that I thought was absolutely fascinating was this booth called Methyl Genetic Testing. You can enter your 23andme data and then what you can also do is – while they are running their analysis on that – enter blood work, enter results of organic acid tests and results of stool. They actually show you if your genes are expressing and causing problems. Because you may have a MTHFR methylation genetic defect showing up on your SNP but maybe it is not causing you a problem. So this way you can actually determine if it is causing you a problem. You had shared with me that you have done the training?

Josh: The training was really amazing. Functional medicine looks at how the biochemical pathways of the body are working. This provides you with another layer – which is how are the genes that are programming those enzymes support those pathways – and it can provide you with an awful lot of information. And then they have a very simple program you plug your genes into and it gives you a guide as to what kind of supplements might help.

Trudy: Amazing! So it is really fine tuning the functional medicine and fine tuning what might actually be going on with each individual.

Josh: It gives you the next amount of information because the functional medicine actually shows you what is happening whereas the genetic testing shows you what potentiality there might be. So you might have a folic acid defect or your folate could be fine – so that was pretty interesting.

Trudy: What else did you like?

Josh: I went to a lecture on the use of low dose lithium for all kinds of things. It is something that I’ve known about – obviously pharmaceutical use [of lithium] for bipolar disorder. Low dose lithium can also be used for bipolar disorder, but the two things new I learnt is that it is incredibly helpful for irritability. So I am dealing with [clients with] depression and it is something that I have often not thought about for irritability. It is also helpful for situations if you have a parent or family history or a past history of substance abuse or alcoholism. So that was something that I’ll take home to my office.

Trudy: And it is something that I currently use in my practice and [I learned it from] Dr. James Greenblatt. He actually presented on a similar topic last year and I heard it then. So low dose lithium is the lithium orotate, we want to be clear about that – 5 to 10 mg twice a day is kind of what we are thinking about. I’ve had great results with women with insomnia. It helps to stabilize the mood and when you are using the amino acids you need a stable mood – you can’t have these ups and downs – so the low dose lithium is really good for that. I would like to hear how it goes when you are using it.

Josh: I have used it with some people with a history of alcoholism and it has provided stability in their mood which is really good. What else have you got?

Trudy: I loved Dr. Kelly Brogan, we always love her, don’t we? She is just really fabulous. She talked about the issues with all the medication and how she does not prescribe anymore. And she talked about a good Paleo diet and getting off gluten and all that good stuff. New things that I heard from her was how she loves Kundalini yoga and how she loves it because she can’t meditate. I find a lot of my clients have a problem with meditating so I always say if that does not work find something that is going to work. And she has found that this Kundalini yoga works for her. So tell me a little about what you know about it?

Josh: I think Kundalini yoga is quick movements with very quick breathing so it easily occupies the mind. So for someone who would have a hard time sitting and meditating that kind of movement would be helpful. Other kinds of movements and other types of yoga are Tai Chi or qigong. Movement or walking meditation can be easier practices for stress management if sitting completely still is hard.

Trudy: So we are doing Facebook live here for those of you who are just joining now. We are at Integrative Medicine for Mental Health conference and it is Trudy Scott and Josh Friedman.

And I want to pass the phone to Josh to hold because my arm is sore and killing me. Maybe he will do a better job than me.

The other thing that I heard from Kelly Brogan that I really enjoyed is that she is using coffee enemas. I have quite a lot of experience with them because the first practitioner that I worked with when I was an intern used coffee enemas for detox for cancer and had really good results. Dr. Brogan was saying how effective it is for phase 1 and phase 2 detox. It also helps with bile production and the part that I really like is that it helps with medication detox. So this is something that I’m going to be looking into a little bit more and I’ll come back and share more as I learn more.

Josh: That’s pretty cool. One take away I had is that functional medicine can often be like a very complex process of delving into the root underlying cause of symptoms – so things like detox pathways or different kinds of infections. Trudy here gave a talk – and her talk was on amino acids and dietary change and blood sugar stabilization and stress management. One of the things I heard running through the entire workshop was sometimes it is simple things that can make a huge difference. And so with using amino acids for mood issues it can be incredibly quick.

I don’t remember what her name was, but there was a psychiatrist who presented at the end, she talked about how she got into functional medicine and she was talking about the radical changes she had in her health status from simple dietary changes. So stopping gluten and dairy was a huge change for her.

Trudy: That’s important. We want to realize that these dietary changes and nutrients can have profound effects. I was talking to Dr. Nicole Beurkens earlier [about zinc and GABA for anxiety] and saying a lot of my clients will say “my anxiety and my depression is so severe I have to have medication, there is no way that diet and nutrients can make a difference”. But they really can. It can completely transform your life. I remember you shared a story of someone who got off gluten?

Josh: Yes, I see those powerful changes every day – where someone with a dietary change or a supplement like 5-HTP or GABA just changes everything. It is the one change that might move things along. It is quite amazing.

Trudy: And it is just a matter of finding what that root cause is for your anxiety and your depression – it may be low serotonin, and it may be gluten or you might need lithium support, it may be that you have an infection. We have heard about Clostridia this weekend, we’ve heard about Toxoplasma gondii, we’ve heard about Lyme disease – they can manifest in many different ways, [including anxiety and depression] – so finding that root cause is important.

Josh: So what people were talking about was being a clinical detective. So working collaboratively with your clients and just saying “it is going to be a process, we will find a solution, but it is going to take some time to figure it out.” Then there is a lot of detective work that can be done with pencil and paper: measures, asking questions, a clinical interview and it is putting the person’s story together to get to the bottom of what is going on. And so sometimes we can do that without testing. There are a lot of clinicians here, there are doctors here but neither of us are physicians and a lot of the work we both do is working with clients to try to figure out what that missing piece is.

And so, sometimes the missing piece can be quite small. I had a patient who had debilitating depression, had been hospitalized three or four times and we did one test, and the test was an IgG food allergy test. He was a weight lifter and he was doing 5 whey protein shakes a day, and it came up that he was severely allergic to dairy. He stopped dairy and within two days his mood was back to normal. I spoke to him recently and he has been stable and happy since his mood lifted.

What a wonderful outcome for his client!

And what an excellent conference! This is part 1 of our discussion. Stay tuned for part 2.

Feel free to post questions or comments below. And let us know if any of the above resonate with you?

Nutrients for dementia: could they help during benzodiazepine withdrawal?

September 19, 2014 By Trudy Scott 29 Comments

Half Coconut and Flower on Bamboo Mat

Could certain nutrients help with memory and cognitive issues, and the “pseudo-dementia” symptoms so many people experience when withdrawing from benzodiazapines?

In a recent article I shared the new research on benzodiazepines being linked to increased Alzheimer’s risk and other serious concerns.

Alison, who was featured in the Boston Globe story, commented on the above blog post:

I am only 29 years old, and I developed what I refer to as pseudo-dementia once I developed a tolerance to benzodiazepines and it got worse once the drug was stopped. From what I have seen from others recovering from and in tolerance to benzodiazepines, cognitive functioning and memory can get hit hard and actually mimic dementia. I wonder if the symptoms these elders are experiencing are true Alzheimer’s, or a side effect/withdrawal effect.

This really got me thinking. She makes an excellent point. It may well be that the symptoms they are seeing in the study are a side effect/withdrawal effect, rather than true Alzheimer’s disease and may be reversible. It surprises me that the study authors have not commented on this since cognitive effects are well documented in the literature.

Here are a few examples I found:

“Benzodiazepines revisited—will we ever learn?” Published in Addiction in 2011

“The review noted a series of adverse effects that continued to cause concern, such as cognitive and psychomotor impairment. In addition, dependence and abuse remain as serious problems. Despite warnings and guidelines, usage of these drugs remains at a high level.”

“Benzodiazepine harm: how can it be reduced?” Published in British Journal of Clinical Pharmacology in January this year (2014)

“Adverse effects comprise sedation subjectively and cognitive and psychomotor impairment objectively. Complex skills such as driving can be compromised… Withdrawal and dependence have excited particular concern, and even polemic. Perhaps a third of long term (beyond 6 months) users experience symptoms and signs on attempting to withdraw – anxiety, insomnia, muscle spasms and tension and perceptual hypersensitivity.”

I was not able to find much in the literature on pseudo-dementia. I did see it listed on the benzo.org.uk site but not elsewhere in relation to benzodiazapines.

I did find this paper “Pseudo-dementia: A neuropsychological review” which is presumably something different (as it refers to depression/dementia). This part may be applicable: “ ‘The pseudo component’ which denotes the actual lack of the neurodegenerative dementia” and the fact that it can be reversed.

This all inspired me to do some digging on dementia. If what they are seeing in participants of the British Medical Journal is not true dementia, it’s very encouraging to think that recovery is possible.

There are some very powerful foods and nutrients that help certain people with dementia and I wonder if they would also help with the benzodiazepine-induced pseudo-dementia:

Not all of the above would work for everyone because of biochemical individuality, and there are mixed results in the literature, but it’s worth assessing for possible deficiencies and addressing overall nutrient status.

It would be wonderful to think that benzo recovery can be improved in the areas of cognition, memory and “pseudo-dementia.”

Interestingly, many of these above nutrients are also factors in anxiety and/or depression and may be related to why someone sought help and was prescribed benzos initially.

P.S. There nutrients are great for overall brain function so anyone could benefit from one or more of them. I actually take 20mg of lithium orotate a day and it helps keep my post-menopausal brain sharp and focused.

P.P.S. I have recently learned that many people in benzo withdrawal do not tolerate supplements so please USE CAUTION and work with your health practitioner. I will do a part 2 follow up to this blog listing foods high in these nutrients in case you feel more comfortable and do better with a food based approach.