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Alice in Wonderland Syndrome – is there a pyroluria connection?

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alice in wonderland syndrome

I first learned about Alice in Wonderland Syndrome (AIWS) during one of the Anxiety Summits. I’m surprised at how many queries I get about this syndrome and the fact that everyone who has reached out also has the social anxiety condition called pyroluria or suspects they have it.

This 2017 paper, Alice in Wonderland Syndrome: A real life version of Lewis Carroll’s novel, describes it as follows:

Alice in Wonderland Syndrome was originally coined by Dr. John Todd in 1955. The syndrome is named after the sensations experienced by the character Alice in Lewis Carroll’s novel Alice’s Adventures in Wonderland. Alice in Wonderland Syndrome consists of metamorphopsia (seeing something in a distorted fashion), bizarre distortions of their body image, and bizarre perceptual distortions of form, size, movement or color. Additionally, patients with Alice in Wonderland Syndrome can experience auditory hallucinations and changes in their perception of time. Currently, there is no known specific cause of Alice in Wonderland Syndrome. However, theories point to infections such as the Epstein-Barr virus, medications such as topiramate and associated migraines.

You can read about all the types of visual and non-visual distortions in this paper: Alice in Wonderland syndrome – A systematic review. This paper also includes a list of conditions in which Alice in Wonderland syndrome has been described in the literature, with infections and migraines being very common. The authors also feel that what we see in the published literature may only be the tip of the iceberg:

Since 1955, no more than 169 case descriptions of AIWS have been published. The literature indicates that this may be only the tip of the iceberg, with many individual symptoms of AIWS being experienced (albeit occasionally and only fleetingly) by up to 30% of adolescents in the general population.

The published case numbers have increased slightly (this paper was published in 2016) and it’s reported that many of the 30% of adolescents with AIWS experience non-clinical symptoms i.e. they are not severe enough to need treatment.

I still find “up to 30% of adolescents in the general population” to be very surprising for a syndrome which was once considered very rare and is frequently misdiagnosed.

Read on to hear from some folks in my community who have reached out and described their AIWS episodes. They all have pyroluria and I’d love to know if there is a possible connection.

Everything either looks really far away but massive or really close up but tiny

Sallie, a mom in my community, shared about her son and what he experienced in the comments section of the pyroluria prevalence and associated conditions blog. During his episodes, everything either looks really far away but massive or really close up but tiny:

I believe he has Alice in Wonderland syndrome. I have taken him to GP’s, pediatricians, optometrists, opthamologists and no one knew what was wrong. I spent about 6 months researching the possibilities myself and came across AIWS. When I showed him some of the journal articles, he was so relieved to finally have an answer. Since then, I have had a gut feeling that pyroluria and AIWS may be linked somehow.

She believes his AIWS may have been triggered by an infection when he was around 6 years of age. He developed sudden onset of vomiting, fever and delirium:

Still to this day, he distinctly remembers this night and recalls (like it was yesterday) not being able to stop looking at his hands because they were changing size and how far away/close up they were.

Once he was old enough to articulate what he was experiencing, he was able to tell me he feels weird, like he needs to go to a pitch-black room and lie down. Sometimes it coincides with a headache.

Everything suddenly appears as if far away then everything either looks really far away but massive or really close up but tiny. He feels dizzy while this happens also. Stress definitely increases the number of AIWS episodes.

Infections are reported as one (of possibly many) root causes of AIWS: “Reported causes include infection (especially with Epstein Barr virus), migraine, epilepsy, depression, and toxic and febrile delirium.”

Infections are common mental health triggers. Strep as a trigger for PANDAS/PANS is a classic example. I blog about Bartonella and sudden-onset adolescent schizophrenia here.

He has pyroluria and stress increases the number of episodes he experiences. My question is this: is there a link between the dumping of zinc and vitamin B6 during these times of stress and episodes of AIWS?

The feeling of being extremely small somatically (or physically), like how you feel when in a football stadium

Mike is a 21 year old male and thinks he may very well have pyroluria based on the questions. He also shares this in the blog comments about his AIWS experiences:

I have experienced sensations similar to Alice in Wonderland Syndrome throughout my life, more so during periods of stress. The feeling of being extremely small somatically (or physically), like how you feel when in a football stadium.

Again, he has pyroluria and his symptoms are worse during periods of stress. Keep in mind that stress makes pyroluria symptoms more intense too.

She usually experiences objects/people smaller than what they are but her more pronounced symptoms are sound distortions

Brenda, another mom in the community, shared this about her daughter’s dreams and PMS on the pyroluria questionnaire blog:

I’m quite certain that my 17 year old daughter has pyroluria. I counted 23 symptoms that she definitely exhibits. Her dream recall is so poor that she insists she doesn’t dream at all. I’m going to start her on zinc, B6 and evening primrose oil right away. Her PMS/premenstrual syndrome is so severe that I had decided to see a gyno to discuss birth control pills. Of course I won’t after listening to your interview with Karla Maree (on the Anxiety Summit).

She also asked if I was familiar with Alice in Wonderland Syndrome and if so do I think it may be connected to pyroluria?  She shares this about her daughter’s AIWS experiences:

My daughter has experienced occasional Lilliputian (trivial or small) hallucinations since childhood.  She usually experiences objects/people smaller than what they are but her more pronounced symptoms are sound distortions. She hears voices/noises (real, not imagined) much louder than they are in reality.

She does not have migraines, has never had mononucleosis or any of the other conditions listed as possible causes of Alice in Wonderland Syndrome. That’s why I’m thinking it may be caused by nutritional deficiencies.

This was my introduction to this syndrome and I appreciate her for asking the question. I did some reading of the research and the word “hallucination” got me thinking that a pyroluria connection was possible. The original work by Dr. Carl Pfeiffer with pyroluria was with individuals with schizophrenia.

However, the second paper mentioned above does state that “AIWS is characterized by perceptual distortions rather than hallucinations or illusions and therefore needs to be distinguished from schizophrenia spectrum and other psychotic disorders.”

We clearly have much to learn and I’m still curious to find out how often these two conditions do overlap – pyroluria/social anxiety and Alice in Wonderland Syndrome.

Resources if you are new to pyroluria

Pyroluria is a social anxiety condition and the physical and emotional symptoms are caused by deficiencies of vitamin B6 and zinc. When you experience high levels of stress, vitamin B6 and zinc will be further depleted, so you may notice worsening symptoms and more anxiety. Here is the symptoms questionnaire and additional resources if you are new to pyroluria:

Have you (or a family member) had episodes of Alice in Wonderland Syndrome? And do episodes coincide with times of added stress?

Do you also suspect pyroluria and has the pyroluria protocol or other nutritional interventions helped to reduce or stop the episodes?

I’d love to also hear anything else you’re willing to share: age at onset, age AIWS stopped, do you suspect an infection as the trigger (or a medication or toxins or something else?), do others in the family have AIWS episodes and how would you describe your AIWS episodes?

Feel free to post any questions here too.

I was called a vulture for preying on sensitive people in a social anxiety group – because I mentioned pyroluria and a nutritional solution

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I was called a vulture

Earlier this week I was called a vulture for preying on sensitive people in a social anxiety group because I mentioned pyroluria and a nutritional solution in response to someone asking for help. I shared much of this on Facebook and the response has been huge – supportive, understanding and encouraging, and also something many of you have also faced and can relate to. I’m publishing it as a blog post too because I feel there are many takeaways and lessons we can all learn from this.

The person asking for help posted this:

I’m seriously stuck. I’ve been battling social anxiety disorder my whole life. I feel like my social skills have gotten worse during 2020-2021. Is anyone the same way? And If possible can anyone give me some good advice?

I posted this in response to the request for advice:

Look into pyroluria and the nutrient protocol – life-changing for me (and my clients – disclaimer: I’m a nutritionist)

And this is the response from someone else in the group:

So not medicine. I think as a nutritionist you shouldn’t be advising people to avoid actual medical help. Foods can’t help but most depression and anxiety isn’t stress based. It’s a biological chemical imbalance. Food won’t help it in the long run. As someone who’s had bipolar, depression, anxiety, social anxiety, insomnia and possible schizo. I have known people to get seriously ill from people that couldn’t manage to be actual doctors. I’ve lost a friend due to them being advised to stop meds and take some herb. Please unless you are actually here because you have social anxiety and such. Could you please leave and stop acting like a vulture over the sensitive people.

I get that it can be tough to grasp that nutrition and nutrients could be a solution for social anxiety but even with a response like this I will continue to share my message.

This was my response:

Correct, not medicine … nutrition. I had social anxiety and panic attacks and diet (gluten-free, caffeine-free, sugar-free etc) and nutrients like zinc, vitamin B6, GABA, tryptophan and more solved my anxiety. I’m passionate about creating awareness because I’ve seen “nutritional psychiatry” work for 100s of thousands of folks.

Please be open-minded … and google “nutritional psychiatry”, “gut-brain”, “pyroluria social anxiety” and “gluten schizophrenia” … you will be pleasantly surprised. It’s going to take some time for all this to be part of mainstream psychiatry but it’s in the research and awareness and acceptance is growing.

I’m sorry about your loss but I would never advise anyone to stop taking their meds. For folks who want to explore this approach we always work in conjunction with their prescribing doctor.

It’s also not very nice calling someone a vulture but I understand that the idea that food and nutrients could be so powerful when it comes to anxiety and mental health can be tough when you first hear about it.

Why I’m sharing this – it’s not for sympathy or to call this person out

I’m not sharing this here for sympathy.

I’m not sharing this to call out this person who called me a vulture or to judge or shame them.

I’m sharing it to illustrate the challenge we have with getting this message out.

I’m sharing it in case you’ve tried to tell a loved one or friend or colleague about the power of anxiety nutrition solutions and have had push-back.

I’m sharing here so we remember to have empathy for someone who doesn’t yet know or understand what we have learned and experienced (no matter what they say or how they say it or even if they have even been preyed on in the past so a comment like this may be justified in their mind).

I’m sharing here because I truly believe in the power of planting seeds of knowledge.

I’m sharing here because I believe everyone deserves to feel their absolute best every single day.

I’m sharing here because everyone struggling with anxiety and social anxiety deserves to know about the growing field of “nutritional psychiatry” in mainstream medicine.

This is why I’m sharing here and why I’ll continue to share nutritional solutions in groups where folks are asking for help for social anxiety, anxiety and panic attacks (and other conditions where pyroluria and neurotransmitter imbalances are common, and there is a role for diet and nutrients).

Why the disconnect and the possible role of neurotransmitter imbalances

I’m hoping all this can help you as you reach out and offer support to someone in an online group. And also help you as you share what you have learned or experienced personally when it comes to nutritional solutions for social anxiety/anxiety – with loved ones, community members, friends and colleagues who are sometimes less than receptive.

I suspect one big disconnect is comprehending that lifestyle/diet/nutrients could help with anxiety and mental health challenges. Heart disease, diabetes, high blood pressure and cancer are more recognized as being lifestyle conditions even dietary and lifestyle changes are not always implemented.

I also often hear this: “my anxiety or social anxiety or panic attacks are so severe (or so complex) there is no way nutrients and nutrition could help! I need medications for sure.”

If someone has nutritional deficiencies or neurotransmitter imbalances, that may also be playing a role in how they respond. For example, low serotonin can make you feel hopeless, fearful, negative, overwhelmed and even angry. This is in addition to feeling anxious and not sleeping well, so you’re more likely to be cranky and irritable.

Links to resources for you to share

Here are links if you need some resources to share or in case you’re new to some of this:

Tamara’s wonderful feedback about gluten and vitamin D

This was Tamara Underwood’s response to my vulture post and her powerful feedback about gluten and vitamin D:

That was a thoughtful response Trudy. I think when people have complex health issues, they think the solution needs to be complex. I had no idea how powerful nutrients could be until it solved my own health issues. Often, it is returning to basics and using foundational support in a targeted way.

I’ve had chronic migraines (3-4 a week) since I was a toddler. Tried every medication, label and off label, to manage them for 40+ years. Removing gluten was life changing. I’ve been migraine free for 8 years now.

Also, about 10yrs ago, I experienced a very dark, unexplained depression for nearly a year. Of course drugs and therapy are the first line treatments. Not sure why I was opposed to starting there but thankful. My Vit D was 4.1. I felt so radically better within a week of starting repletion that I went back to school for my MS in Clinical Nutrition.

I think about how different life might be now, 10 yrs later, had I not pushed for testing. Psych meds wouldn’t have improved my Vit D so I would have been prescribed all the variations and combos and told how complex my case was when it didn’t help. [One study supporting an association between low vitamin D and depression]

There are just so many toxicities, deficiencies, and imbalances worth exploring if your mental wellness suffers. I’m passionate about this subject and a big fan of yours Trudy.

I’m thrilled that going gluten free and addressing low vitamin D solved her migraines and depression. It’s so wonderful to hear Tamara was inspired to go back to school to study nutrition. She now does this work helping professionals (firefighters, EMTS etc.) who shoulder a greater burden of stress and trauma. Check out Underwood Functional Wellness. I appreciate her for allowing me to share here.

I plan to update this blog with more of the wonderful insights from my community on Facebook but folks are still actively engaging and I need to get permission to share here. Stay tuned for more.  You can also join the discussion on the Facebook post here.

Until then, feel free to post your insights, thoughts, experiences (and questions if you have them) in the comments below.

Let us know how nutritional approaches have helped your anxiety and/or other health issues?

What made you open to this approach and were you initially skeptical?

And let us know if you continue to share your success and plant seeds even when you get negative feedback – and why? And do you have resources you like to share?

The Antianxiety Food Solution by Trudy Scott

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antianxiety food solution

The Antianxiety Food Solution

– How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood and End Cravings
by Trudy Scott, CN (published by New Harbinger, 2011)

It’s remarkable how much the foods we eat can impact our brain chemistry and emotions. What and when we eat can make the difference between feeling anxious and staying calm and in control. But most of us don’t realize how much our diets influence our moods, thoughts, and feelings until we make a change. In this book, you’ll find four unique antianxiety diets designed to help you address nutritional deficiencies that may be at the root of your anxiety and enjoy the many foods that foster increased emotional balance.

This easy-to-use guide helps you choose the best plan for you and incorporates effective anxiety-busting foods and nutrients. You’ll soon be on the path to freeing yourself from anxiety—and enjoying an improved overall mood, better sleep, fewer cravings, and optimal health—the natural way!

In The Antianxiety Food Solution, you’ll discover:

  • How to assess your diet for anxiety-causing and anxiety-calming foods and nutrients
  • Foods and nutrients that balance your brain chemistry
  • Which anxiety-triggering foods and drinks you may need to avoid
  • Easy lifestyle changes that reduce anxiety and increase happiness

Buy your copy

 

Buy the book from Amazon
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Endorsements

This book “fills an important gap in the popular literature on anxiety. It provides clear, helpful guidelines for utilizing nutrition to overcome anxiety.Edmund Bourne, PhD, author of The Anxiety and Phobia Workbook
A great book with plenty of practical advice backed by science.Daniel G. Amen, MD, author of Change Your Brain, Change Your Life
Every one of the millions now suffering from anxiety has a new friend in Trudy Scott, whose book offers them a nutritional lifeline.  Replete with specific and practical suggestions, this book is backed up by research and clinical expertise.Julia Ross, MA, MFT, author of The Mood Cure and The Diet Cure
This book is a must-read if you have anxiety and want to treat the underlying causes and heal, rather than having to rely on medications. Adjust your brain chemistry with the right nutrients and you can reclaim your brain and your life!Hyla Cass, MD, author of 8 Weeks to Vibrant Health
This book is a real tour-de-force in complementary mental health literature and should be on the shelves of every anxiety sufferer. It’s a user-friendly and balanced book about foods and nutrients that can reduce anxiety, and it is also refreshingly original.Jonathan Prousky, MSc, ND, professor of clinical nutrition at the Canadian College of Naturopathic Medicine and author of Anxiety: Orthomolecular Diagnosis and Treatment
As a nutrition and fitness expert and the mother of a child with an emotional disorder, I find this book invaluable. It is one I will use myself and recommend to both clients and colleagues.JJ Virgin, CNS, CHFS, nutrition and fitness expert, author of Six Weeks to Sleeveless and Sexy, and cohost of TLC’s Freaky Eaters
A leader in the field of food and mental health, Trudy Scott supplements the core themes of food and gut health with chapters on amino acids, pyroluria, and lifestyle changes. Trudy aptly emphasizes that readers should try to find the root cause of their health problems.Lawrence E. Cormier, MD, holistic psychiatrist in Denver, CO
This book may be the key you’ve been looking for. It does an excellent job of explaining the science behind anxiety and then bringing it to a practical level, providing a nutritional and integrative approach to anxiety.Elizabeth Lipski, PhD, CCN, director of doctoral studies at Hawthorn University in Whitethorn, CA, and author of Digestive Wellness
Trudy Scott’s work communicates something I tell my patients every day: there is a powerful connection between what we eat and how we feel.Mike Dow, PsyD, cohost of TLC’s Freaky Eaters
I recommend this book not only to those who suffer from anxiety, but to their health care providers as well.Karla Maree, certified nutrition consultant, neuronutrient therapist, and director of nutritional therapy at Recovery Systems Clinic
A comprehensive book providing the nation with much-needed formulas for overcoming anxiety and restoring stable emotions!Joan Mathews-Larson, PhD, LADC, founder of the Health Recovery Center in Minneapolis, MN, and author of Depression-Free, Naturally
This book offers a wealth of useful information for those who would like to try dietary and other lifestyle changes in order to improve their mental health. It is also a valuable resource for clinicians interested in broadening their approach to the treatment of anxiety.Felice N. Jacka, PhD, research fellow at the University of Melbourne in Australia
Full of practical tips for restoring balance to your body and mind. I highly recommend it.Mark Atkinson, MD, author of The Mind-Body Bible
The Antianxiety Food Solution is one of the most comprehensive guides to nutritional healing for anxiety.Elizabeth Large, ND
Trudy Scott is an expert on the relationship between food and mood, an often neglected area. This book provides clearly presented practical information, which I believe to be important adjunctive help in the treatment of anxiety, depression, and serious mental illness.Katherine Falk, MD, psychiatrist in New York, NY
An easy-to-read book that should help many people with anxiety.Michael B. Schachter, MD, CNS, board-certified psychiatrist
 

Buy the book from Amazon
Buy the Kindle from Amazon
Buy the book in German

 

Reviews from readers

I can “recommend it for practitioners who have patients/clients who want to improve their affect, increase energy levels (who doesn’t!), suffer from anxiety, poor memory or sleep issues. Pass on this book to them and ask them to read it through cover to cover. It’s got a wealth of tips and resources linking behaviour with nutrition, and does it gracefully and with much self-insight.

I’ve read many books on the subject of psychology and biochemical links, and this is definitely one of the best written. It’s aimed at the intelligent reader who may have a little knowledge of nutrition, as well as practitioners and those who use patient centred approaches within their practice.

Donald Scott, Osteopath & Naturopath, Natural Therapy Centre, Kilmacolm, Inverclyde, United Kingdom

I cried my way thru this book ~ out of JOY~ for finally finding a very helpful book! I have been on a journey for 10 years trying to navigate issues with depression, stress, anxiety, insomnia and other fun things. I’ve been to doctors, psychologists, psychiatrists and counselors. I’ve been put on medication which after many years of that left me suicidal, overweight, depressed and very angry. It is VERY frustrating trying to navigate doctors, testing and information out there that could help you. This summer I read several books that addressed depression from a dietary and nutrition standpoint. This one was the best in my opinion. It’s not too long, easy to read and understand, and well organized. And it agreed with several things I had read in other books ~ such as the use of amino acids, vitamins and issues with gluten and sugar to address depression, etc. There’s many good ‘life stories’ in it too which help you relate. Thanks Trudy Scott!

Kathy Masterson, Amazon review

Book reviews

Table of contents

Introduction

My Story
Anxiety Statistics and Facts
Causes of Anxiety
What Is a Natural Approach and Why Use It?
Overview of the Book

Chapter 1: Figure Out Your Optimum Antianxiety Diet

The Antianxiety Food Solution Diets

Antianxiety Food Solution Diet 1: Gluten Free
Antianxiety Food Solution Diet 2: Gluten Free and Dairy Free
Antianxiety Food Solution Diet 3: Grain Free and Dairy Free
Antianxiety Food Solution Diet 4: Traditional Foods

Foods to Include

Eat Real, Whole, Good-Quality Foods
Eat Frequently Enough
Eat Quality Animal Protein

Red Meat
Poultry and Eggs
Fish and Other Seafood

Eat Nonstarchy Fresh Vegetables
Eat Fresh Fruit
Eat Good Fats
Keep Hydrated
Eat Legumes
Eat Starchy Fresh Vegetables
Eat Gluten-Free Whole Grains
Consume Dairy
Eat Whole Grains That Contain Gluten

Foods to Avoid

Avoid Empty Foods
Other Foods You May Need to Avoid

Eat Bonus Foods
Recipe and Food Resources
Wrapping Up

Chapter 2: Avoid Sugar and Control Blood Sugar Swings

The Harmful Effects of Sugar and Sweeteners
Sugars and Sweeteners Defined
Where Sugar Is Found
Artificial Sweeteners
What to Use Instead of Unhealthy Sugars and Artificial Sweeteners
Control Blood Sugar Swings

Benefits of Controlling Blood Sugar Swings
Simple Dietary Changes to Help Control Blood Sugar Swings
Supplements

How Quickly You Can Expect Improvements
If You Have a Sugar or Carb Addiction and Can’t Quit

Chapter 3. Avoid Caffeine, Alcohol, and Nicotine

Coffee and Caffeine

Caffeine and Anxiety
Other Reasons to Consider Giving Up Caffeine
How to Quit Caffeine and What to Drink Instead
If You Do Want to Drink Coffee

Alcohol

Nutritional Deficiencies Due to Alcohol Consumption
Alcohol and Low Blood Sugar
Alcohol Sensitivity
How to Quit Alcohol

Nicotine

Nicotine and Anxiety
How to Quit Smoking

How Quickly You Can Expect Improvements

Chapter 4. Address Problems with Gluten and Other Foods

Why Food May Be Affecting Your Mood
True Food Allergies
Food Sensitivities or Delayed Food Reactions
Problems with Gluten

Gluten, Anxiety, and Other Mood Problems
Gluten and the Digestive System

Testing for Gluten Sensitivities

Two-Week Gluten Elimination-Challenge Trial
Lab Tests for Gluten Sensitivity

Salivary Antigliadin Antibodies
IgG Antibodies for Gluten-Containing Grains
Elevated Thyroid Antibodies

Testing for Celiac Disease

Alternatives to Grains That Contain Gluten
If Gluten Isn’t a Problem
Problems with Dairy Consumption
Problems with Other Foods
Problems with All Grains and Starchy Vegetables
Using Amino Acids to Reduce Cravings
Allergies and Anxiety Due to Low Blood Histamine
How Quickly You Can Expect Improvements

Chapter 5. Improve Your Digestion

The Digestive Process

Why Good Digestion and Absorption Are Important
Using Your Stool as a Clue to Your Digestive Function

Eating Guidelines for Good Digestion

Eat Foods That Promote Good Digestion and Skip Poor-Quality Food
Change Your Eating Habits

Causes of Poor Digestion and How to Improve Your Digestion

Low Levels of Stomach Acid or Pancreatic Enzymes

Testing for Low Stomach Acid and Pancreatic Enzymes
How to Correct Low Stomach Acid or Low Pancreatic Enzymes

Large Intestine Issues
Bacterial Imbalance or Parasites
Candida Overgrowth

Testing for Bacterial Imbalance, Parasites, and Candida
Controlling Candida and Increasing Beneficial Bacteria

Foods and Nutrients for Healing a Damaged Digestive System
Liver or Gallbladder Problems
How Quickly You Can Expect Improvements

Chapter 6. Balance Brain Chemistry with Amino Acids

GABA

Steps to Raise GABA Levels

Serotonin

Steps to Raise Serotonin Levels

Catecholamines

Steps to Raise Catecholamine Levels

Endorphins

Steps to Raise Endorphin Levels

Testing for Levels of Amino Acids
Drug of Choice
Guidelines for Supplementing with Amino Acids
Amino Acid Precautions
How Quickly You Can Expect Improvements

Chapter 7. Address Pyroluria or Low Levels of Zinc and Vitamin B6

Prevalence of Pyroluria and Co-occurring Disorders
Testing for Pyroluria

Pyroluria Urine Test
Zinc Taste Test
Vitamin B6 Testing
Fatty Acid Testing
Comprehensive Metabolic Profile

Zinc, Vitamin B6, and Fatty Acids for Pyroluria

Zinc Supplementation
Food Sources of Zinc
Vitamin B6 Supplementation
Food Sources of Vitamin B6
Fatty Acids for Pyroluria
Other Nutrients for Pyroluria

How Quickly You Can Expect Improvements

Chapter 8. Other Nutrients, Hormone Imbalances, Toxins, Medications, and Lifestyle Changes

Basic Supplements

Multivitamin and Multimineral with B Vitamins
Iron
Vitamin C

Individual Nutrients for Anxiety

Extra B Vitamins
Magnesium and Calcium
Vitamin D
Omega-3s and Omega-6s
Theanine and Lactium

Hormone Imbalances

Adrenal Dysfunction
Thyroid Dysfunction
Sex Hormone Imbalances in Women

Reduce Your Exposure to Toxins

Toxins in the Home
Heavy Metals

Understand the Effects of Medications

Make Important Lifestyle Changes

Do Some Exercise, Preferably Outdoors
Get Enough Sleep
Consider Therapy and Support Groups
Set Aside Time for Relaxation

Take Up Yoga, Tai Chi, Qigong, or Meditation
Take a Real Vacation Every Year
Try Guided Imagery
Other Techniques That May Help

Parting Words

Appendices

  1. Sue’s Story
  2. Food, Mood, Energy, Cravings, and Sleep Log

Resources

Internet Resources for Healthy Eating and Living
Lab Tests
Recommended Reading

Nutritional Healing
Food, Cooking, and Cookbooks

References

A selection of quotes and facts from each chapter

Here are a selection of quotes and facts from each chapter of the book:

Introduction

“There’s a reason why I’m so passionate about working with people with anxiety and why I’m writing this book. I’ve had my own personal journey with anxiety…”

Chapter 1: Figure Out Your Optimum Antianxiety Diet

There are 4 antianxiety diets but “Eating real, whole, good-quality food is the foundation of this book and any program to prevent and alleviate mental health issues such as anxiety….”

Chapter 2: Avoid Sugar and Control Blood Sugar Swings

“Sugar and alcohol may contribute to elevated levels of lactate in the blood, which can cause anxiety and panic attacks”

Chapter 3: Avoid Caffeine, Alcohol, and Nicotine

In a study, “…those with panic disorders experienced increases in symptoms such as nervousness, fear, nausea, heart palpitations, and tremors after consuming caffeine and said the effects were similar to how they felt during a panic attack…”

Chapter 4: Address Problems with Gluten and Other Foods

“Clinical experience and specific studies support the connection between gluten and anxiety, social phobia, depression, and even schizophrenia”

Chapter 5: Improve Your Digestion

“…people with digestive complaints such IBS, food allergies and sensitivities, small intestinal bacterial overgrowth and ulcerative colitis frequently suffer from anxiety and…depression.”

Chapter 6: Balance Brain Chemistry with Amino Acids

“GABA plays a major role in anxiety, and serotonin plays a role in at least some types of anxiety…. The great thing about supplementing with amino acids is that you’ll get immediate feedback: positive effects, adverse effects, or no changes at all.”

Chapter 7: Address Pyroluria or Low Levels of Zinc and Vitamin B6

“Low levels of zinc and vitamin B6 are frequently associated with a type of anxiety characterized by social anxiety, avoidance of crowds, a feeling of inner tension, and bouts of depression”

Chapter 8: Other Nutrients, Hormone Imbalances, Toxins, Medications, & Lifestyle Changes

“Mild to moderate deficiency of vitamin C may be associated with increased nervousness and anxiety… Supplemental magnesium together with vitamin B6 was shown to alleviate anxiety-related premenstrual symptoms, as well as breast tenderness and menstrual weight gain…”

As you can see, there are many factors that can affect how anxious you feel and since we are all biochemically unique it’s important to figure out and address what may be triggering your anxiety, mood issues and associated cravings.
 

Buy the book from Amazon
Buy the Kindle from Amazon
Buy the book in German

 

Once you’ve read your copy (or listened to the audio version) I would love to hear back from you on how my book has helped you and/or family members – either here in the comments below or via an Amazon review or a review on another platform.

Feel free to post your questions too.

Tryptophan calms comfort eating, eases self-doubt, reduces uncontrollable late night snacking and results in a lot more peace around food.

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tryptophan calms

Zoe shares her life long story about comfort eating, her insecurities and self-doubt in her teens, the comfort-foods that allowed her to “escape” and how addressing low serotonin at 41 years of age led to her feeling a lot more peace around food. The effects of one chewable tryptophan were instant! Here is her story in her own words, some insights from me and possible next steps for Zoe to consider.

Historically I had comfort eaten and felt insecure and had lots of self-doubt. This led to trying alcohol and cocaine in my early 20s, plus I’m a vegetarian so I think I blew through all my natural serotonin by the time I tried tryptophan at 41!

I think [low] serotonin was huge for me and tryptophan helped calm my comfort eating.

My comfort eating started at secondary school, around 14, an escape from my feelings when I got home from school. I would eat mashed potatoes with loads of butter or a Sara Lee Chocolate gateau.

Thinking about it now, I realize I was craving carbohydrates and I would eat till I felt sick. I craved feeling really full and sadly was bulimic for a few years there as a teenager. I think my feelings of not feeling good enough/unloved drove me to comfort eating and not feeling understood. I would eat, be sick then do an exercise video before my parents even got home! It may also have been hormonal as I get PMS. I also have PCOS (polycystic ovarian syndrome).

Good news is I tried tryptophan last summer and the effects were instant.

I hadn’t read the instructions properly so ate a Lidtke chewable tryptophan tablet with my meal and instantly felt the effect. I stopped eating and feeling hungry instantly. I took the chewables for a couple of months then went onto Lidtke 500mg for another few months.

I do still have a tendency to snack late at night but it’s gone from totally uncontrollable 8 or 9 out of 10 to a 3 or 4 out of 10. I don’t crave food anywhere near as much as I used to and I have a lot more peace around food now.

Thank you for being the one to introduce me to them, you are a super star.

A few thoughts from me

This is a wonderful outcome and I’m thrilled for her transformation! I also appreciate Zoe giving me permission to share here so you can be inspired and have hope!

A few thoughts from me:

  • PMS/dysphoria is common with low serotonin levels and research shows that tryptophan can help ease symptoms in a few cycles
  • Low levels of serotonin and endorphins can lead to alcohol consumption and experimenting with drugs as a means of self-medication. This can often be replaced with sugar addiction and cravings which are also a way to self-medicate.
  • Low serotonin is a factor with bulimia, although it’s typically an under-recognized factor when it comes to eating disorders.

I share where I’d start if we were working together and possible next steps below.

How did she use tryptophan and which products did she use?

Zoe initially used the Lidtke chewable (each one is 100mg) for a few months: ”I used the Lidtke chewable as I don’t need much to feel the effects of aminos!”

Then she switched to the Lidtke 500mg: “I was taking 500mg mixed with banana on an empty stomach every day for about 6 months.”

This amount of tryptophan would be considered low for most folks. 500mg is a typical starting dose often used 1-2 mid-afternoon and 1-2 in the evening.

You may see all her low serotonin symptoms and think she has a lot going on and will likely need large doses of tryptophan for serotonin support. But you never know how much tryptophan will work until you do a trial.

Low endorphins and DPA for eliminating comfort eating

Zoe actually posted much of the above in response to a question I posted on Facebook about eliminating comfort eating and the amino acid called DPA (d-phenylalanine). DPA typically helps the kind of eating where you feel “I deserve this or this is my reward or this is my treat.” Until you address low endorphins with DPA, you may also feel eating these foods are numbing – as in numbing or blocking emotional pain.

She shared “Yes I’ve tried DPLA and it had a very nice effect.” But as you’ve read above, low serotonin was a bigger issue for Zoe and it was the tryptophan that really helped calm her comfort eating.

DLPA or DPA?

I reminded her that DPLA (dl-phenylalanine) is quite different from DPA (d-phenylalanine). DLPA works on boosting low catecholamines (improving low motivation, poor focus and fatigue and stay-in-bed kind of depression) and to a small extent also low endorphins. DPA works purely on boosting low endorphins.

But Zoe did see benefits from DLPA:

DPLA made me feel very content with my life. I felt very happy where I was all of a sudden, instead of feeling the need to chase something better all the time. I’ve never had just straight DPA, I’ve found it hard to find.

It’s not uncommon to see low serotonin and low endorphins in situations like this.

Tryptophan is no longer helping: my feedback and other ideas

Zoe did also share this about the 500mg tryptophan no longer helping like it used to:

The tryptophan doesn’t seem to have the same effect on me anymore sadly but that maybe because I’m ‘topped up’ but I did wonder if I had ruined the quality of my tryptophan by storing it on top of my microwave (so they were heating up).

I’ll try the [Lidtke] Tryptophan Complete this time and hope they work as I do still get a bit of PMS which seemed to go away for a while.

I did hear about mixing it with inositol being a possible solution too?

Here is my feedback on some of this, where I’d start if we were working together and possible next steps:

  • My favorite DPA product is also made by Lidtke and it’s called Endorphigen. It may help with the last remaining snacking
  • However, timing wise late-night snacks for carbs tends to be low serotonin. I would try again with Lidtke 500mg (the microwave heat may have been an issue), considering a trial of 1000mg, trialing the Lidtke Tryptophan Complete (as she may be missing the cofactors to make serotonin) and even consider going back to the chewable Lidtke tryptophan which worked so well initially.
  • I would also look at other factors that may be lowering serotonin levels: has gluten snuck back in or is there any accidental exposure? Has she started consuming collagen and/or gelatin which can lower serotonin in susceptible folks?
  • I would consider trialing inositol if there is an obsessive tendency to the snacking. It does help with PCOS too.
  • She had said “I thought GABA would be amazing for me but it wasn’t.” Since GABA helps with PCOS and PMS, I would revisit GABA trials using different forms, higher doses and making sure trials are sublingual. Progesterone or herbs that support progesterone is another option.
  • I agree with Zoe’s comments about being a vegetarian. Low levels of neurotransmitters are common and we cover the benefits of grass-fed red meat for women in my interview with Dr. Felice Jacka on the first Anxiety Summit. I’d encourage adding some quality animal protein if she’s open to it.
  • For vegetarians, we often also add a free form amino acid blend with tryptophan, especially if adding animal protein is a no-no.
  • I would also consider pyroluria (the social anxiety condition) too as PMS is common, pyrolurics are often vegetarians, and the pyroluria protocol provides necessary cofactors for making serotonin. Zinc is often low in vegetarians too.
  • I would also assess for low iron and low B12 (also often low in vegetarians) and needed for serotonin production; and look into the BCP (birth control pill) or other meds that may be lowering serotonin.
  • I would have her doctor check thyroid health as low thyroid can reduce the effectiveness of the amino acids

As with everyone, a full functional workup looking at diet, nutritional deficiencies, digestion, all hormones, toxins and infections (and so on) is key to address all possible root causes.

Have you found that tryptophan calmed your comfort eating, reduced your self-doubt and late night carb snacking and led to feelings of peace around food? Did it also reduce PMS and other low serotonin symptoms?

If you’re a practitioner working with women who comfort-eat and have typical low serotonin symptoms, have you found tryptophan to help?

Feel free to post your questions and feedback in the comments below.

Social anxiety caused by pyroluria: oxytocin, the vagus nerve, pectus excavatum and Ehlers-Danlos Syndrome

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social anxiety pyroluria

Pyroluria is associated with a type of anxiety characterized by social anxiety, avoidance of crowds, a feeling of inner tension, and bouts of depression. If you have pyroluria you may experience varying degrees of anxiety or fear, often starting in childhood, and you usually manage to cover it up and push through. You may build your life around one person, become more of a loner over time, have difficulty handling stress or change, and have heightened anxiety symptoms when under more stress.

It’s not well-recognized in the medical profession and has long been considered a genetic condition. More recently some practitioners have been proposing that it may be triggered by environmental toxins and that it’s not only genetic. Either way, symptoms can start to resolve within a week when low levels of zinc and vitamin B6, together with some other nutrients are addressed. Stress management is key. This can be emotional stress and the stress of toxin exposure, infections like Lyme disease, mold toxicity and even low blood sugar and gluten issues.

We would typically not connect social anxiety/pyroluria with low oxytocin, vagus nerve function or connective tissue disorders but if you read on you’ll see there are some interesting connections.

Oxytocin, social anxiety and zinc

Research has found that oxytocin levels correlate strongly with levels of social anxiety. A paper published in the Journal of Psychiatric Research looked at how variations in the oxytocin receptor (OXTR) gene is associated with an increased risk of anxiety, stress and depression in individuals with a history of exposure to early life stress. Supporting low levels of oxytocin can ease the threats of social interactions.

What is interesting is that zinc, a key nutrient for pyroluria, is needed for binding oxytocin to its receptor. You can read more about all this here: Oxytocin, social anxiety, pyroluria and autism

Sociability improves vagus nerve function and thriving at home alone

Increased sociability helps improve vagus nerve function. It’s all good and well to recommend getting out and hanging out with more people but if you have pyroluria it’s really challenging. It’s also hard work, very stressful and the added stress makes your pyroluria symptoms worse so it becomes a vicious cycle.

You can read all about this here: Increased sociability improves vagus nerve function: the role of social anxiety, pyroluria and low zinc. There is an updated section on social isolation during coronavirus and how some people are thriving being home alone.

Pectus excavatum and Ehlers-Danlos Syndrome

Pectus excavatum is an indentation in the chest wall and is related to problems with connective tissue. When it comes to pyroluria and pectus excavatum, this is what we see in common: social anxiety and depression, low zinc and low vitamin B6, dental crowding and sometimes Ehlers-Danlos Syndrome (EDS). I write more about this here: Pectus excavatum and pyroluria: is there a connection?.

I’ve written an entire blog on Joint hypermobility / Ehlers-Danlos Syndrome and pyroluria. Anxiety, depression, attention deficit (and hyperactivity) disorder, autism spectrum disorders, and obsessive-compulsive personality disorders are all common with EDS. Many folks with EDS report better less social anxiety, improved mood and often improved physical symptoms/reduced pain on the pyroluria protocol of zinc, vitamin B6, evening primrose oil and a good copper-free multi.

Resources for you

Please do share if you have pyroluria or score high on the questionnaire and have seen improvements in your social anxiety and any physical symptoms.

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

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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!