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MDMA-Assisted Psychotherapy for Treating Chronic PTSD: Why I feel we can do better and the role of nutrition and amino acids like GABA

November 2, 2018 By Trudy Scott 5 Comments

You may be familiar with MDMA (3,4-methylenedioxymethamphetamine), also known as “ecstasy”, because of its reputation as a party drug. And you have likely seen some of the media reports on the new research and growing support for MDMA-Assisted psychotherapy for treating chronic PTSD (post-traumatic stress disorder). Due to adverse effects I’d like to share my concerns about this research and treatment and why I feel we can do better – by addressing nutrition and using amino acids like GABA and others.

In a recent press release, Colorado Study Shows Lasting Benefits of MDMA-Assisted Psychotherapy for Treating Chronic PTSD, the non-profit organization, Multidisciplinary Association for Psychedelic Studies (MAPS) reports these study results:

28 participants found that one month after their second day-long experimental session, 42.9% in the active-dose (100 mg and 125 mg) MDMA groups did not qualify for a diagnosis of PTSD, compared to 33.3% in the low-dose MDMA (40 mg active placebo) control group.

The results were even more notable 12 months after the third active-dose experimental session, which found that one year following treatment with MDMA-assisted psychotherapy, 76% of participants no longer had PTSD.

It is the largest U.S. FDA-regulated double-blind, placebo-controlled clinical trial of MDMA-assisted psychotherapy for the treatment of chronic PTSD and the results are impressive: 76% of the study participants no longer had PTSD after a year and 3 treatment sessions. I’m really happy for the participants BUT I believe we can do better because there are adverse reactions to this treatment and there are other safer approaches for recovery.

This comment about an acceptable risk profile and adverse reactions concerns me (and I suspect it concerns you too):

The study replicated previous research showing an acceptable risk profile for MDMA, with the most frequently reported adverse reactions during experimental sessions being anxiety, jaw clenching, headache, muscle tension, dizziness, fatigue, and low mood.

Adverse reactions one week following treatment included insomnia, low mood, irritability, and ruminations. Temporary elevations in pulse, blood pressure, and temperature were also recorded during MDMA sessions, and did not require medical intervention.

A common theme we see in the research on psychedelics is how effective it is for PTSD that doesn’t respond to therapy or medications. This paper states:

There is an immense need for innovative treatment options that improve outcomes, especially for PTSD refractory to psychotherapy and/or pharmacotherapies

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

This paper, The Potential Dangers of Using MDMA for Psychotherapy, the author is concerned about the fact that “acute MDMA can stimulate the release of difficult feelings and memories, which may be distressing” and also the negative moods that occur after MDMA treatment:

This period of negative cognitions may be counter-productive, especially in psychiatrically vulnerable clients, for instance those with predispositions to anxiety, depression, or psychosis. For example, it could increase the likelihood of suicide in those individuals with strong post-recovery feelings of depression.

Because of this, I wholeheartedly agree with the author’s position:

it will always be far safer to undertake psychotherapy without using co-drugs. In selected cases MDMA might provide an initial boost, but it also has far too many potentially damaging effects for safe general usage.

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

  • In this blog post, PTSD from 3 tours in Afghanistan: Can GABA help with the anxiety? how low GABA can lead to physical anxiety, muscle tension and the need to self-medicate with alcohol or sugary foods in order to calm down and relax. We also have research supporting the use of GABA for helping with unwanted obtrusive thoughts which are common with PTSD. When low GABA is suspected we do an amino acid trial with GABA, one of the calming amino acids.
  • A 2016 reports that blueberries boost serotonin and may help with PTSD and anxiety https://www.everywomanover29.com/blog/blueberries-serotonin-ptsd-anxiety/. This was an animal study where the traumatized rats were fed a blueberry-enriched diet. The study authors report an increase in serotonin levels, suggesting that “non-pharmacological approaches might modulate neurotransmitters in PTSD.”
  • A recent meta-analysis, Association between posttraumatic stress disorder and lack of exercise, poor diet, obesity, and co-occuring smoking, confirms the diet and lifestyle connection to being more impacted by trauma when health is not optimal.

I feel it is these above approaches and others like this that we need to be using to address PTSD, rather than subjecting individuals who are already suffering to treatments that have adverse reactions AND are not addressing underlying nutritional deficiencies of low GABA, low serotonin, out of balance endocannabinoid system and overall health, to name a few of many possible underlying biochemical factors.

If this treatment approach is approved, I would hope that all the adverse effects and dangers are clearly explained and I’d also like there to be informed consent before it is used – so individuals know exactly what they are getting into. Hopefully, by the time it is approved, nutritional psychiatry will be more accepted.

I’d love to hear your thoughts on this research and treatment approach. Is it something you have considered or would possibly consider in the future – you personally or with patients?

Or do you have similar concerns that I have?

Have you already tried MDMA recreationally (possibly for therapeutic reasons) and what were your experiences like?

Filed Under: PTSD Tagged With: anxiety, biochemical, blueberries, depression, GABA, insomnia, irritability, low mood, MAPS, MDMA, nutrition, nutritional, PTSD, ruminations

Nutritional and lifestyle support for mercury toxicity and detoxification in general

February 4, 2018 By Trudy Scott 7 Comments

 

I’ve poured through most of the transcripts of the Heavy Metals Summit and there is so much information on nutritional and lifestyle support for mercury toxicity and the detoxification process in general:

  • sweating and using a sauna in order to detox through the skin
  • broccoli sprouts (due to a glutathione boost from sulforaphane, an organosulfur compound – in Julie Matthews’s interview)
  • reducing EMF/ELF and microwave exposure – in Dr. Mercola’s talk! He shares how all this can make matters worse and has some simple approaches like turning off power in the bedroom at night! This was new to me and a brilliant approach!
  • eating organic (to minimize GMO/glyphosate effects on a leaky gut and a leaky blood brain barrier) and never using Roundup
  • addressing low zinc and low selenium
  • supporting methylation so the body can detox on it’s own
  • supporting the liver and increasing bile production which is needed for detoxification
  • addressing low stomach acid which is needed for bile production and absorption of minerals like zinc (which is depleted by heavy metals)
  • avoiding meds like PPIs (which reduce stomach acid) and NSAIDs (which contribute to leaky gut)
  • thyroid support/iodine (as needed)
  • getting the brain’s glymphatic system working with sufficient sleep, melatonin (liposomal) and even liposomal GABA (in Dr. Christine Schaffer’s interview)
  • supporting the vagus nerve in order to improve digestion and detoxification
  • using an air filter and water filters
  • using foods/products like curcumin, ginger, probiotics, apple pectin
  • adding DPP-4 enzyme for gluten issues (mercury depletes this)
  • avoid energy-efficient bulbs (they are high mercury)
  • having Epsom salts baths
  • improving elimination from the bowels and much more

This is the support I offer as a nutritionist and it’s wonderful to hear all these doctors/practitioners discuss about all this with a tie back to mercury, lead and other metals.

Whey is not mentioned on the summit but since someone shared how it’s benefiting her (in the comments of the Boyd Haley blog) I’m sharing here too since it helps with glutathione production. In this paper “a case is made for the use of hydrolyzed whey protein to support metal detoxification and neurological function.” I recommend whey to clients if tolerated.

Many years ago I heard a presentation by a biological dentist who then became a nutritionist – he shared that he used whey with mercury toxic patients (together with other nutrients) and saw metals go up in hair analysis and then come down as their symptoms improved.

As I’ve mentioned in the past, mercury chelation is a controversial topic and you’ll see comments very divided on what the safest approach is. This is not my area of expertise and I’m very cautious with recommendations in this area as I’ve had reports of harm from individuals using all the approaches you’ll hear about on the summit (and even the Andy Cutler protocol which is not covered). My best advice is to follow all the nutritional/lifestyle recommendations and if you do decide to go the chelation root, do your homework, find a practitioner to work with and listen to your gut. If what you’re doing doesn’t feel right then stop doing it.

As with any chronic health condition, mercury detox is a comprehensive approach and very individualized.

There is also a discussion about safe removal of amalgams/mercury fillings. They do need to be done safely so as not to cause further issues. The IOMT also offers excellent guidelines.

The summit also covers other metals like copper (Ann Louise Gittleman covers this and I blog about it here), arsenic (Dr. Joseph Pizzorno covers this – reducing consumption is a big factor; and non-organic chicken is a source) and aluminum.

You can still register here to hear day 7 interviews and the encores: The Heavy Metals Summit.

Have you seen benefits with a nutritional approach?

Filed Under: Events Tagged With: anxiety, broccoli, detox, detoxification, heavy metals summit, liver support, magnesium, mercury, mercury toxicity, minerals, nutritional, nutritional support, sauna, sleep, zinc

60+ Nutritional & Biochemical Causes of Anxiety

May 19, 2015 By Trudy Scott 42 Comments

puzzle pieces

I shared these 60+ Nutritional & Biochemical Causes of Anxiety on my closing call  of the The Anxiety Summit season 3.   I hope they will help you put the puzzle pieces together to resolve your anxiety.

The Foundational Causes from The Antianxiety Food Solution :

  1. Food – real whole food, organic (pesticides may be problematic), quality protein (grass-fed, wild, pastured), healthy fats; avoid junk/processed food with additives/colors/trans fats/GMOs
  2. Sugar – depletes zinc and magnesium and fills us up. We should not feel the need for treats/fruit should satisfy our desire for sweet
  3. Low blood sugar – breakfast/protein/healthy snacks/no coffee
  4. Caffeine/Coffee – even decaf coffee may be an issue. Coffee has high-levels of pesticides, affects blood sugar and affects hormones
  5. Tobacco – depletes key nutrients like zinc, vitamin C      
  6. alcohol – depletes key nutrients like zinc, vitamin C
  7. Food sensitivities – gluten (plus glyphosates/roundup affect serotonin/zinc etc), dairy, GAPs, grains
  8. Digestive system – low HCl
  9. Digestive system – Low good bacteria/probiotics
  10. Digestive system – other enzymes are low
  11. Digestive system – candida
  12. Digestive system – parasites
  13. Digestive system – leaky gut
  14. Digestive system – liver/gallbladder issues
  15. Digestive system – SIBO
  16. Brain chemicals/neurotransmitters: low GABA (covered in detail in season 4 of the Anxiety Summit) 
  17. Brain chemicals/neurotransmitters: low serotonin
  18. Brain chemicals/neurotransmitters: low endorphins
  19. Brain chemicals/neurotransmitters: low catecholamines (need for coffee/sugar) or high catecholamines. Gut health, what you eat, coffee, gluten all affect the brain chemicals
  20. Pyroluria/social anxiety – zinc, vitamin B6 and EPO (addressing this improves brain chemical imbalances and hormone imbalances)
  21. A need for zinc
  22. A need for vitamin B6
  23. A need for EPO
  24. Toxins/pesticides/plastics/BPA
  25. Medication side-effects/withdrawal (benzos are the worst)
  26. Sex hormones imbalances (especially low progesterone)
  27. Thyroid problems – hyperthyroid/Hashimoto’s thyroiditis can cause anxiety symptoms; low thyroid symptoms – amino acids are not as effective
  28. Adrenals issues: cortisol imbalance can affect how you handle stress, digestion, inflammation; high cortisol can have direct impact on anxiety levels
  29. Low total cholesterol (<150)
  30. Low levels of vitamin D, magnesium, vitamin C
  31. Low levels of vitamin B12
  32. Low levels of folate
  33. Low levels of iron (test ferritin)
  34. Not getting exercise
  35. Not working on stress-reduction (tai chi, meditation, guided imagery, yoga)
  36. Not getting out in nature
  37. Not getting at least 8 hours of sleep
[the above are all covered in great detail in my book  The Antianxiety Food Solution ]

Other possible nutritional/biochemical/physical causes of anxiety/depression

  1. Drug-induced nutrient deficiencies (for example: the birth control pill depletes vitamin B6, folate, magnesium)
  2. MVP (mitral valve prolapse) – it feel like the “heart is skipping a beat” (magnesium may help)
  3. Infections – strep can cause OCD/PANDAS/PANS. Also consider: H/Pylori, Lyme disease, clostridia
  4. Heavy metals like mercury or lead.  We covered mercury in season 2 – Your hidden mercury burden: A likely root cause of the other root causes of anxiety and mercury/lead detox in season 4 with Dr. John Dempster
  5. Anything that increases inflammation in the body (high CRP is a good clue)
  6. Herbicide/Roundup use in the home/garden
  7. Genetic polymorphisms – MTHFR, COMT, MAOA, GAD – Dr. Ben Lynch is an excellent resource and has shared his expertise on season 2 – Anxiety: Biochemical and genetic predispositionsand season 3 – How Methylfolate can make you Feel Worse and even Cause Anxiety
  8. Apolipoprotein E ?4 (ApoE ?4) gene polymorphism
  9. Other possible hormone issues: high prolactin, low oxytocin
  10. Histamine reaction to certain foods (Yasmina covers this in her interview in season 3: Histamine-containing Foods: their Role in Anxiety, Depression and Schizophrenia )
  11. Oxalates reaction (berries, leafy greens, nuts). A good resource is lowoxalateinfo
  12. SIBO and FODMAPs/fructose malabsorption (affects serotonin levels)
  13. Too much of some nutrients: fish oil, a B complex, tyrosine, folate
  14. Low lithium (impacts GABA levels)
  15. Copper toxicity i.e. high copper and low zinc
  16. EMFs, air pollution, noise pollution, cell phone use, smart meters
  17. Marijuana use – used recreationally or as medical marijuana (Dr. Hyla Cass covers this in season 4 of the Anxiety Summit – cognitive issues, anxiety, psychosis, schizophrenia, social anxiety)
  18. Toxic mold exposure (Dr. Jill Carnahan covers this in season 3)
  19. Fluoride exposure
  20. Poor mouth health
  21. Toxoplasma gondii
  22. Metals/chemicals/drugs in the tap water
  23. Low leptin (signals satiety/fullness) and high ghrelin
  24. Over-the counter drugs, inner ear issues/cochlear damage, light sensitivity (Sharon Heller shared Hidden Causes of Anxiety on season 2) 
  25. Physical pain (from an injury)
  26. Gas leaks
  27. Plastics/BPA
  28. Accutane, the acne drug can lead to psychiatric disorders in some people

May 14, 2016 updates after Season 4 of the Anxiety Summit:

   66. Leptin resistance, obesity, skinny-fat and high body fat % (Mike Mutzel covers this in season 4 – anxiety, inflammation, microbiome, PTSD, cortisol and HPA axis)

   67. Fluoroquinolone antibiotics (Lisa Bloomquist covers this in season 4 – anxiety, psychosis, connective tissue damage, mitochondrial impacts)

   68. Low histamine/histapenia/overmethylation or high histamine/histadelia/undermethylation – read more here and the season 4 interview with Dr. William Walsh

   69. Lack of community and social connection (James Maskell covers this in season 4)

Note: these causes do not include psychological or physical trauma or abuse (both past and current).

If the idea of 60+ causes feels too overwhelming and scary for you start with the basic food changes and look at the Amino Acids Mood Questionnaire from The Antianxiety Food Solution. GABA and serotonin support benefits most of my clients.  You can see how to do a trial here  and find the products I use with my clients here – such as tryptophan and GABA.

If you are not already registered for the Anxiety Summit you can get live access to the speakers of the day here: www.theAnxietySummit.com

Missed this interview or can’t listen live? Or want this and the other great interviews for your learning library? Purchase the MP3s or MP3s + transcripts and listen when it suits you.

You can find your purchasing options here: Anxiety Summit Season 1, Anxiety Summit Season 2, and Anxiety Summit Season 3.

Filed Under: Amino Acids, Antianxiety, Food and mood, Gluten, Real whole food, The Anxiety Summit 3 Tagged With: amino acid questionnaire, anxiety, biochemical, nutritional, real whole food, the anxiety summit, Trudy Scott

The Anxiety Summit – 60+ Nutritional & Biochemical Causes of Anxiety and Recommended Supplements

May 19, 2015 By Trudy Scott 88 Comments

 

Trudy Scott, host of The Anxiety Summit, Food Mood Expert and Nutritionist, author of The Antianxiety Food Solution presents:

Closing call: 60+ Nutritional & Biochemical Causes of Anxiety and Recommended Supplements

  • 60+ Nutritional/biochemical causes of anxiety and associated solutions
  • 4 degrees/levels of anxiety I see and response to the 60+ causes
  • The unique ability of the body to heal
  • Testing I use with my clients and what tests I’d run if everyone had unlimited funds
  • My recommendations:  supplements
  • My message of hope

I mentioned the speaker blog posts.  You can access them all here: The Anxiety Summit Season 3: All the speakers and topics

I also referred back to speakers and topics from season 1 and 2 so here are those links:

The Anxiety Summit Season 2: All the speakers and topics

The Anxiety Summit: All the speakers and topics (this is summit 1)

If the idea of 60+ causes feels too overwhelming and scary for you here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution. Serotonin support in the form of tryptophan or 5-HTP may help

As Dr. Peter Bongiorno said in his interview: Serotonin and Anxiety, Happiness, Digestion and our Hormones

There can be multiple factors involved as to why someone has anxiety. How you’re going to work through these factors successfully is going to be very different for each person.

Here is the list of the 60+ Nutritional/biochemical causes of anxiety.  (Just click on this link to see all of them)

Here is the list of supplements: The Antianxiety Food Solution Amino Acid and Pyroluria Supplements (Just click on this link to see all of them)

Here is the: Nutritional testing for figuring out the root cause/s of your anxiety (Just click on this link to see all of them)

If you are not already registered for the Anxiety Summit you can get live access to the speakers of the day here: www.theAnxietySummit.com

Missed this interview or can’t listen live? Or want this and the other great interviews for your learning library? Purchase the MP3s or MP3s + transcripts and listen when it suits you.

You can find your purchasing options here: Anxiety Summit Season 1, Anxiety Summit Season 2, and Anxiety Summit Season 3.

Filed Under: Amino Acids, Antianxiety, Food and mood, Gluten, Real whole food, The Anxiety Summit 3 Tagged With: amino acid questionnaire, anxiety, biochemical, nutritional, real whole food, supplements, the anxiety summit, Trudy Scott

Nutritional medicine as mainstream in psychiatry

January 30, 2015 By Trudy Scott 31 Comments

Home-made grass-fed burger, greens/basil, avocado, sprouts and cheese
Home-made grass-fed burger, greens/basil, avocado, sprouts and cheese

Psychiatry is at an important juncture, with the current pharmacologically focused model having achieved modest benefits in addressing the burden of poor mental health worldwide. Although the determinants of mental health are complex, the emerging and compelling evidence for nutrition as a crucial factor in the high prevalence and incidence of mental disorders suggests that diet is as important to psychiatry as it is to cardiology, endocrinology, and gastroenterology. Evidence is steadily growing for the relation between dietary quality (and potential nutritional deficiencies) and mental health, and for the select use of nutrient-based supplements to address deficiencies, or as monotherapies or augmentation therapies.

I’m excited to share this groundbreaking publication, “Nutritional medicine as mainstream in psychiatry” which was published just last week in the mainstream journal Lancet. We have members of The International Society for Nutritional Psychiatry Research, also known as ISNPR to thank: Jerome Sarris, PhD, Alan C Logan, BA, Tasnime N Akbaraly, PhD, G Paul Amminger, MD, Vicent Balanzá-Martínez, MD, Marlene P Freeman, MD, Joseph Hibbeln, MD, Yutaka Matsuoka, MD, David Mischoulon, MD, Tetsuya Mizoue, MD, Akiko Nanri, MD, Daisuke Nishi, MD, Drew Ramsey, MD, Julia J Rucklidge, PhD, Almudena Sanchez-Villegas, PhD, Andrew Scholey, PhD, Kuan-Pin Su, MD, Felice N Jacka, PhD.

The abstract concludes as follows:

We present a viewpoint from an international collaboration of academics (members of the International Society for Nutritional Psychiatry Research), in which we provide a context and overview of the current evidence in this emerging field of research, and discuss the future direction. We advocate recognition of diet and nutrition as central determinants of both physical and mental health.

You may recognize some of these people from my prior writings and interviews.

  • Felice Jacka was interviewed in season 1 of the Anxiety Summit. Our topic was The Research: Food to prevent and treat anxiety and depression? She has been and still is very active in the nutrition/mental health/anxiety/depression research community
  • Julia Rucklidge recently did a fabulous TEDx talk called The surprisingly dramatic role of nutrition in mental health. She is also a very prolific researcher.

Dr. Marlene Freeman is also the author of an editorial, Nutrition and Psychiatry, published in the American Journal of Psychiatry in 2010.

It is both compelling and daunting to consider that dietary intervention at an individual or population level could reduce rates of psychiatric disorders. There are exciting implications for clinical care, public health, and research.

This is one of my favorite quotes! If you’ve ever heard me present I’m sure you’ll recognize it! This was in 2010 so we are making progress with getting nutrition recognized in the mainstream mental health world and I couldn’t be happier.

Here are a few select quotes from the new paper (which will shortly be released as an open-source document).

Mental disorders in general, and major depression and anxiety disorders in particular, account for a large burden of disability worldwide. Rapid urbanisation, and an overall transition from traditional lifestyles (concerning diet, physical activity, and social structures), which are some of the most pressing global and environmental issues of our time, have both been linked to increases in depression and other mental disorders

The mechanisms by which nutrition might affect mental health are, at least superficially, quite obvious: the human brain operates at a very high metabolic rate, and uses a substantial proportion of total energy and nutrient intake; in both structure and function (including intracellular and intercellular communication), it is reliant on amino acids, fats, vitamins, and minerals or trace elements.

The purpose of this Personal View is to provide a platform for robust debate in the specialty, particularly regarding the need to move towards a new integrated framework in psychiatry, whereby consideration of nutritional factors should be standard practice.

Diet and nutrition offer key modifiable targets for the prevention of mental disorders, having a fundamental role in the promotion of mental health. Now is time for the recognition of the importance of nutrition and nutrient supplementation in psychiatry. Nutritional medicine should now be considered as a mainstream element of psychiatric practice, with research, education, policy, and health promotion supporting this new framework.

This is so powerful! I commend the efforts of these authors and thank the researchers for all the groundwork which has led to where were are today…recognizing the very powerful connection between what we eat and how we feel. It’s exciting to be part of this movement!

 

Filed Under: Mental health Tagged With: anxiety, depression, diet, Jacka, Lancet, nutrition, nutritional, psychiatry

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