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Anxiety case study: a very very slow SSRI taper with tryptophan and other nutritional support

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anxiety case study

Today I’m sharing an update from someone in my community who is tapering from an SSRI (Cipralex/lexapro) in the best way possible – very methodically and doing a very very slow taper, using compounded medication and nutritional support. It is a team approach with a supportive doctor monitoring for serotonin syndrome, her pharmacist compounding her medication and input from me.

She has an excellent diet that contains enough healthy protein and fats, plenty of vegetables, and no sugar or caffeine. She has the basic nutrients covered and is on the pyroluria protocol (these nutrients help make serotonin). She is using the amino acid tryptophan for serotonin support as she tapers. And she is out walking in nature and practicing mindfulness.

All of this sets her up for success and being able to avoid antidepressant discontinuation syndrome.

Here is her story:

I began tapering off 10 mg of Cipralex in November 2017. I have my little “Support Team” that includes a compounding pharmacist and my GP. Feeling very fortunate that I have these people as my taper has not exactly gone as planned (although far better than my last two attempts)

Originally, the plan was to go down by 10% of the dose and stay at that dose for 4 weeks. That didn’t work for me. I was fine when I dropped from 10mg to 9, but after my next 10% drop I experienced that familiar withdrawal hell. I got a little scared, but stuck with it, and decided to stay at that dose for a bit longer. While I leveled out, I did a lot of reading about how SSRIs work. I learned about the 1/2 life of Cipralex (all SSRIs have a different 1/2 life) and what was actually happening physiologically as my body adjusts to the lower dose. It’s a recovery process.

With that new knowledge, I decided to try another approach. I knew I couldn’t handle a drop of 10%. So, I started to taper at a rate of 0.1mg once a week (far less than 10%!). By day three at the new dose, I could feel the withdrawal, but it was far less severe. Small drops=small “withdrawal wave”. I discovered that I am able to manage a 2% drop of the current dose and I have been able to drop that % each week. So, I’m still reducing by 8% a month, which means I am close to the original plan of dropping by 10% a month. At this time I am at 6.24mg.

Yes, it is a very slow process and I have a long way to go, but it’s working. I have read that some people have to reduce by 1% of their current dose and remain at that dose for 4 weeks to allow their body the time to heal and adjust to life on the lower dose. Having the liquid compound has made such a difference! You sure would have difficulty accurately shaving off a pill by 2%!! If anyone is trying to come off of this drug, do your best to find a compounding pharmacist!

I find that I must stick to a very healthy diet. I eat a lot of fresh, raw and cooked vegetables. I mean a LOT of vegetables. I eat good sources of protein and walk for at least 45 min almost every day. I steer clear of sugar and caffeine. Both make my withdrawal much worse.

Every day I take omega 3, vitamin C, vitamin D, vitamin B complex. I take the supplements for pyroluria, vitamin B6, evening primrose oil and zinc. I take magnesium at night. I took Trudy’s amino acids course online and did all of the amino acid trials. I discovered all I really need is tryptophan. It has made a huge difference for me. Yes, I take Lidke tryptophan. For us Canadians, it can be ordered online.

I practice mindfulness. I’ve read a lot about the anxious brain (the reason I took Cipralex in the first place) so I understand what is happening now, what is real and what is just noise in my head.

Antidepressant discontinuation syndrome

This is the best way to taper SSRI medications in order to avoid withdrawal effects, also known as discontinuation syndrome which can be very severe for some folks.

Accordingly to this paper, Antidepressant discontinuation syndrome occurs in about 20% of patients who reduce the dose or abruptly stop an antidepressant that they have been taking for one month. This paper states that “symptoms are usually mild….occur within two to four days after drug cessation and usually last one to two weeks.”

It also states that occasionally symptoms “may persist up to one year…and if the same or a similar drug is started, the symptoms will resolve within one to three days.”

I typically hear from individuals who fall into the category of severe symptoms that are persisting past 2 weeks. It’s not uncommon to see symptoms continue for a year and often longer in some cases.

Also from the above paper, is the mnemonic FINISH which summarizes these symptoms:

  • Flu-like symptoms (lethargy, fatigue, headache, achiness, sweating)
  • Insomnia (with vivid dreams or nightmares)
  • Nausea (sometimes vomiting)
  • Imbalance (dizziness, vertigo, light-headedness)
  • Sensory disturbances (“burning,” “tingling,” “electric-like” or “shock-like” sensations) and
  • Hyperarousal (anxiety, irritability, agitation, aggression, mania, jerkiness).”

How you will feel if your serotonin is low and how to learn more

With low serotonin you will have the worry-in-your-head and ruminating type of anxiety, panic attacks and phobias, lack of confidence, depression, negativity, imposter syndrome, PMS, irritability, anger issues, insomnia and afternoon/evening cravings.

If you suspect low serotonin symptoms and are new to using the amino acids and do not have my book I highly recommend getting it and reading it before jumping in to taking supplements and navigating this with your prescribing physician: The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings. You may need to lend him/her a copy of my book too.

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

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

Please also read and follow these Amino Acid Precautions.

This lists The Antianxiety Food Solution Amino Acid and Pyroluria Supplements that I use with my individual clients and those in my group programs – you will find the Lidtke Tryptophan here. You can also read more about why I prefer the Lidtke tryptophan on this blog.

I would like to end off by saying how much I appreciate this woman and others sharing their stories like this so we can all learn!

Please also share your taper story and what you did to make it easier.  If you had challenges share those too. Let us know if you can relate to any of the above FINISH symptoms and how long they lasted.

Feel free to post your questions here too.

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: this overstimulation of the nervous system is especially high right now during this 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!

vagus nerve summit

Click here to join me on The Mind, Body & The Vagus Nerve Connection Summit

This event will provide you with all the information you need to:

  • Understand the vagus nerve’s complexity
  • Know the importance of high vagal tone
  • Measure your vagal tone
  • Recognize symptoms and root causes of vagus nerve dysfunction
  • Optimize gut-brain communication
  • Address emotional trauma and chronic stress
  • Improve your relationships to increase vagal tone
  • Strengthen vagus function with physical approaches

And when you register today, you’ll gain INSTANT access to the following free gifts, including my summit interview video and transcript!

vagus nerve summit bonuses

  • Symptoms and Root Causes of Vagus Nerve Dysfunction Navaz Habib, DC, AFMCP
  • Balancing Neurotransmitters to Optimize Vagus Function Trudy Scott, CN
  • EFT, Polyvagal Theory and the Mind-Body Connection Craig Weiner, DC
  • Vagus Nerve 101 eGuide from Eva Detko, PhD, MSc, BA (Hons), mIAHT

To your continued learning and healing – and good vagus nerve function!

Click here to join me on The Mind, Body & The Vagus Nerve Connection Summit

Coronavirus: my immune boosting and antiviral plans (and what to use if you’re anxious)

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coronavirus immunity

 

3/27/20: Updated with a good blog post on elderberry (addressing cytokine storm concerns); an excellent video on “The Coronavirus Explained”; 3 new and promising coronavirus/COVID-19 studies on gut health and melatonin; an excellent hand-washing video I encourage you to watch with your families; a recap on using GABA, tryptophan, DPA, glutamine and tyrosine for emotional support

3/20/20: Updated with webinar information so you can post your questions.

3/12/20: Updated as a result of the situation in Italy and the WHO pandemic declaration – Italy overwhelmed with not enough ICU beds and ventilators; predictions the USA healthcare system (and other countries) will likely not be able to handle a similar situation; stay home and immune-boosting advice from Dr. David Brady; additional resources from Dr. Elisa Song; and more on hand-washing

1/31/20: Originally published – vitamin C and foundational nutrients; my other immune boosting nutrients and first aid kit; GABA or tryptophan if you are worried, overly anxious or fearful

UPDATES 3/27/20:

Coronavirus explained, gut health, elderberry, melatonin and more

So much is changing so quickly and there is so much to learn about the coronavirus. I am spending all my time pouring through the literature, learning from other practitioners, reaching out to researchers and trying to connect some of the dots for you. For this reason I’ve decided to do an update each week to this blog and add new findings and relevant information for you.

I’ve updated this blog again TODAY with a good blog post on elderberry, an excellent video on “The Coronavirus Explained” and 3 new and promising coronavirus/COVID-19 studies on gut health and melatonin. I will be taking a deeper dive into these studies, sharing my perspectives related to the anxiety nutrition work I do. I also share an excellent hand-washing video I encourage you to watch with your families!  And a recap on using GABA, tryptophan, DPA, glutamine and tyrosine for emotional support.

Elderberry concerns about it triggering a cytokine storm – put to rest

There have been many questions about elderberry and concerns about it possibly triggering a cytokine storm. Suzy Cohen addresses all these concerns here: In Defense of Precious Elderberries

The misinformation you’re getting was based upon a research article that evaluated blood cells in test tubes. It was not a well-designed, placebo-controlled clinical trial. It was not even done on real live people (in vivo).

A number of my respected colleagues agree with her conclusions: “compounds from elderberries can directly inhibit the [flu] virus’s entry and replication in human cells, and can help strengthen a person’s immune response to the virus.” More here.

Understanding the Coronavirus

I found this video very helpful for understanding the coronavirus: The Coronavirus Explained & What You Should Do

 

New and promising coronavirus/COVID-19 studies on gut health

Here are two new coronavirus/COVID-19 gut health studies. I will be taking a deeper dive into these studies in a future blog post, sharing my perspectives related to the anxiety nutrition work I do. For now, here are the links.  It’s very preliminary research but if you tuned in to the recent Anxiety Summit 5: Gut-Brain Axis, you know how promising this is:

Although no specific antiviral treatment has been recommended to date, we speculate that probiotics may modulate the gut microbiota to alter the gastrointestinal symptoms favorably and may also protect the respiratory system

Nutritional and gastrointestinal function should be assessed for all patients. Nutritional support and application of prebiotics or probiotics were suggested to regulate the balance of intestinal microbiota and reduce the risk of secondary infection due to bacterial translocation.

Anxiety and fear were common in patients with COVID-19. Therefore, we established dynamic assessment and warning for psychological crisis.

I address anxiety in all the work I do an agree it needs to be at the forefront for everyone.  I take a deeper dive into GABA and theanine and the anxiety/sleep/immunity connections in this recent blog: GABA and theanine for easing anxiety, improving sleep and supporting immunity.

Melatonin as a potential treatment: new research

This in press and pre-proof paper on melatonin is also very promising: COVID-19: Melatonin as a potential adjuvant treatment:

Melatonin, a well-known anti-inflammatory and anti-oxidative molecule, is protective against ALI/ARDS [acute lung injury/acute respiratory distress syndrome] caused by viral and other pathogens. Melatonin is effective in critical care patients by reducing vessel permeability, anxiety, sedation use, and improving sleeping quality, which might also be beneficial for better clinical outcomes for COVID-19 patients. Notably, melatonin has a high safety profile.

I will also be taking a deeper dive into this study in a future blog post, sharing my perspectives on serotonin, melatonin, anxiety and sleep.

THE best hand-washing video!

This is THE best hand-washing video I’ve come across. It was even retweeted and acknowledged by WHO Director General, Dr Tedros Adhanom Ghebreyesus.

I’m pretty sure I may have been missing my thumbs! What about you?

handwashing

I don’t know how to share a video from twitter other than share the twitter link so I hope you can watch it.

We’re using soap at home and have one designated person in our household of four adults going out to pick up food items. This is the time we use hand-sanitizer (and gloves). Here is another blog on How to Make Your Own Hand Sanitizer in case you’re in a similar situation to us and can’t find ingredients to make more. Suzy mentions vinegar and colloidal silver in this one and shares a number of practical recipes.

IV vitamin C, oxalates, anti-malarial drugs and losss of smell and taste

It’s so encouraging that New York hospitals are treating coronavirus patients with vitamin C.  There are, however, concerns for folks who have dietary oxalate issues (with both oral and IV vitamin C). I’ve been gathering feedback and research on this topic and will hopefully have more to share next week.

I also have some major concerns about the anti-malarial drugs chloroquine and hydroxychloroquine and will share those, together with my perspectives on the loss of smell and taste as a possible marker of infection.

 

bouquet of hope

Until then, here is another little “bouquet of hope” from our garden to you … My darling mom-in-law brought this lovely little arrangement to me in my home office earlier this week! Aren’t I a lucky girl!?

Amino acids for emotional support, good sleep and to prevent comfort-eating

Finally, don’t forget about the amino acids for added emotional and nutritional support (our needs are higher at a time like this):

  • GABA for physical tension and anxiety (more here)
  • tryptophan for excessive worrying and feeling fearful (more here)
  • glutamine if you’re not eating well and getting blood sugar crashes, and for gut healing (more here)
  • tyrosine if you just can’t focus and want to curl up in bed (more here)
  • and DPA if you’re feeling overly emotional and weepy, comfort-eating is your support right now (more here)

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

Please feel free to comment on any of the above new developments and share what you are learning too. And do let me know if this format is helpful for you.

Keeping you in my thoughts! And keeping you informed and empowered so anxiety is less of an issue.

UPDATES 3/20/2020:

I’m planning a series of webinars to get your coronavirus questions answered:

  1. I’m planning to interview a health coach/colleague living in Italy/Germany right now and have her share her experiences about living in lock-down and more about the situation in Europe
  2. I’m planning to interview Dr. David Brady to share his patient protocols for immunity,  testing and much more
  3. I’ll be doing one with me talking about best how to deal with the anxiety, worry and laying awake until 3am fearful.  Anxiety and lack of sleep adversely impact immunity so we have to sort that out. I’ll also cover the many nutrients for anxiety that also support immunity
  4. I’m looking for an expert to talk about vitamin C and the risks for those with dietary oxalate issues, and other viable and safe options instead of vitamin C
  5. I’ll be interviewing a doctor on the role of melatonin in counteracting severe inflammatory responses such as pro-inflammatory cytokines. It’s being theorized that older individuals are being more impacted because of low melatonin levels and it’s because children have higher levels of melatonin they are less impacted.

I hope these will be helpful for you? What questions do you have for each webinar (please list the webinar # and the question/s when you comment below. Please don’t send your questions via email – as you can imagine we are receiving a large number of emails!) Let me know what other information you are looking for.

UPDATES 3/12/2020:

The situation in Italy has me concerned

At the time of initial publication of this blog at the end of January, I was in agreement with what the Orthomolecular Medicine News Service were suggesting – we were reading a lot of media hype.

I am not one for fear-mongering, but after reading this very sobering account by two Italian doctors 2 days ago, I am now much more concerned about the coronavirus for the folks who will be most severely impacted – the elderly and the immune-compromised.

In Italy they do not have enough ventilators or ICU beds. Dr. Jason Van Schoor shared warnings from a colleague working in Northern Italy:

I feel the pressure to give you a quick personal update about what is happening in Italy, and also give some quick direct advice about what you should do.

First, Lombardy is the most developed region in Italy and it has a extraordinary good healthcare, I have worked in Italy, UK and Aus and don’t make the mistake to think that what is happening is happening in a 3rd world country.

The current situation is difficult to imagine and numbers do not explain things at all. Our hospitals are overwhelmed by Covid-19, they are running 200% capacity

We’ve stopped all routine, all ORs have been converted to ITUs and they are now diverting or not treating all other emergencies like trauma or strokes. There are hundreds of pts with severe resp failure and many of them do not have access to anything above a reservoir mask.

Patients above 65 or younger with comorbidities are not even assessed by ITU, I am not saying not tubed, I’m saying not assessed and no ITU staff attends when they arrest.

We have seen the same pattern in different areas a week apart, and there is no reason that in a few weeks it won’t be the same everywhere

You can read the entire thread on Twitter here. At first glance there is skepticism and disbelief this could be happening but a trusted colleague in San Francisco has heard similar accounts from doctors she knows in Italy. It’s thanks to her that I started digging deeper into the situation in Italy and had my mind changed.

And this article in the New York Times was also just published confirming much of this: Italy’s Health Care System Groans Under Coronavirus — a Warning to the World. They they do mention doctors being muzzled which is very concerning. We need transparency if we are to learn.

Predictions the USA healthcare system (and other countries) will likely not be able to handle a similar situation

This article supports what is happening in Italy, with serious predictions for the USA (and presumably other countries too) – What does the coronavirus mean for the U.S. healthcare system? Some simple math offers alarming answers

What does an avalanche of uncharacteristically severe respiratory viral illness cases mean for our health care system? How much excess capacity currently exists, and how quickly could Covid-19 cases saturate and overwhelm the number of available hospital beds, face masks, and other resources …

….like in Italy where this is happening right now!

This is why I am now fully behind social distancing and staying home

I’m still of the opinion I need to focus on healthy living/eating and boosting my immunity (and it’s what me and my family are currently doing) but I am now fully behind social distancing, staying home, not attending big events and not traveling – so this virus can be contained as much as possible. Knowing what I now know about Italy makes this an easy decision which is why I’m sharing it here today – even if it is frightening.

Dr. David Brady, ND, author of The Fibro Fix, provides some basic advice on staying as healthy as possible in this recent video posted on Facebook. His is the calm voice of reason, sharing precautions to take during the COVID-19 pandemic and also fully supporting the social isolation and stay home message.  He does mention andrographis for antiviral support, garlic, elderberry, vitamin C, lauric acid (monolaurin), vitamin D, preformed vitamin A (as opposed to beta-carotene), zinc and echinacea as all good nutrients to consider for his patients and family.

Unfortunately, many of my colleagues are still saying it’s media hype, out of control fear-mongering, is not as bad as the flu and there is no way this could happen in a country like the USA, Australia, UK and elsewhere.  I know they’ll get on board with all this once they have this information too.

I sincerely hope I am wrong about this and things don’t get as bad as Italy. For now I’m playing it safe.

My hand-washing research

I got called out for not mentioning hand-washing when I first published this blog. My focus was to share my first-aid kit i.e. nutraceuticals I use but KT was is absolutely right

Hand hygiene is the single most important intervention for reducing healthcare associated infections and preventing the spread of antimicrobial resistance.

My assumption was that this is common knowledge but based on this statement in the same paper, perhaps this isn’t the case?

while tremendous progress has certainly been made in this field, a significant amount of work is yet to be done in both strengthening the evidence regarding the impact of hand hygiene and maximizing its implementation

With regard to what to use: antibacterial soap showed little added benefit compared with regular soap

Interestingly this paper also states “Hand hygiene is clearly effective against gastrointestinal and, to a lesser extent, respiratory infections. Studies examining hygiene practices during respiratory illness and interventions targeting aerosol transmission are needed.” I’m not sure of the implications of this for the coronavirus. For now I’m following the guidelines outlined in Dr. Song’s blog (below).

This 2017 Time article, Washing Hands In Cold Water Works As Well As Hot Against Germs, clears up what they say is often conflicting data and has some good guidelines from a study published the same year (it was looking at E. coli bacteria and not viruses): wash hands in cold water, at least 10 secs of lathering and use regular soap. Hand lotion afterwards seems to help too.

Additional resources

I’ve also got some blogs from colleagues to share with you so you have additional resources:

It’s an approach the physicians of the Orthomolecular Medicine News Service are recommending and it’s gives me a higher level of comfort in these days ahead.

As I mentioned above I do have some questions and concerns about this vitamin C IV approach (and high doses of oral vitamin C) for folks with oxalate issues (myself included) and for folks with G6PD deficiencies and hemochromatosis. I’ll share more as I learn more.

  • And this one from Dr. Song too – Handwashing and Coronavirus: Are you doing it the right way? I encourage you to watch the hand-washing demo videos she links to and show them to your children! This fact is astounding: “If 60% rather than 20% of air travelers maintained clean hands, it could slow down the spread of infections by almost 70%“
  • Dr. Song also shares How to Make a 60% Alcohol-Based Hand Sanitizer. “Washing hands with soap and water is the #1 recommended way to prevent the spread of Coronavirus. But if you don’t have access to soap and water, what can you do? The CDC recommends using a hand sanitizer with at least 60% alcohol.“
  • A blog from Paleohacks: Thieves Oil What It Is, Benefits & How to Make It. Use Thieves oil as a natural disinfectant around your home. “It’s great for wiping down counters, cleaning toys, disinfecting cutting boards, removing stale odors, freshening trash cans and gym bags, and even cleaning veggies.”

Originally published 1/31/20:

How are you handling all the coronavirus news? Worried? Anxious? Fearful? Or are calmly watching and listening and making sure your immune system is in good shape and you have natural antivirals on hand if necessary? (and updated 3/12/20 – are you taking the stay at home message seriously? much more on that below)

There are still many unknowns but I’ve been gathering some articles and resources for my own personal use. I’m not an expert in infections but since folks in my community are asking I promised to share my first-aid kit and rationale in a blog post.

I can help with the anxiety and fear aspect if all this doesn’t put your mind at ease. I cover how I use individual amino acids with my clients at the end of this blog post.

Vitamin C and other foundational nutrients

This newly published blog by Andrew Saul PhD, Vitamin C Protects Against Coronavirus, offers sage foundational advice that resonates with what I already know:

The physicians of the Orthomolecular Medicine News Service and the International Society for Orthomolecular Medicine urge a nutrient-based method to prevent or minimize symptoms for future viral infection. The following inexpensive supplemental levels are recommended for adults; for children reduce these in proportion to body weight:

Vitamin C: 3,000 milligrams (or more) daily, in divided doses.

Vitamin D3: 2,000 International Units daily. (Start with 5,000 IU/day for two weeks, then reduce to 2,000)

Magnesium: 400 mg daily (in citrate, malate, chelate, or chloride form)

Zinc: 20 mg daily

Selenium: 100 mcg (micrograms) daily

Vitamin C, Vitamin D, magnesium, zinc, and selenium have been shown to strengthen the immune system against viruses.

Additional rationale for vitamin C

In another blog by Andrew Saul PhD, Nutritional Treatment of Coronavirus, offers additional rationale for vitamin C: “Abundant clinical evidence confirms vitamin C’s powerful antiviral effect when used in sufficient quantity” and states that the “physicians on the Orthomolecular Medicine News Service review board specifically recommend at least 3,000 milligrams (or more) of vitamin C daily, in divided doses. Vitamin C empowers the immune system and can directly denature many viruses.”

It’s very encouraging to read that just 200mg a day“given to the elderly resulted in improvement in respiratory symptoms in the most severely ill, hospitalized patients.”

This statement from the above blog puts much of what is considered to be media hype and fear-mongering into perspective: (see below why I no longer feel this is media hype)

“The common cold is a coronavirus, and SARS is a coronavirus, so they are the same viral type” ~ David Jenkins, MD, Professor of Medicine and Nutritional Science, University of Toronto.

I do have some questions and concerns about using high doses of oral vitamin C and vitamin C IV for folks with oxalate issues (myself included). I’m actively seeking answers.

Vitamin D, olive leaf extract, oregano oil, elderberry, NAC and diet

Here are some additional links that I have found or were shared with me (thank you if you shared one of these with me!):

  • Vitamin D and the anti-viral state “These results support the hypothesis that vitamin D … may play a major role in the inhibition of viruses.” I’m very aware of the immune-boosting properties of vitamin D.
  • Olive leaf extract “decreased the duration of upper respiratory illness in high school athletes.” We always have this on hand and it appears to work well for me and my family so I’ll make sure to keep this in mind.
  • Oregano oil – per this article on Holistic Primary care “A number of preliminary in vitro or animal studies have shown that compounds in oregano oil are virustatic and virucidal against several viral pathogens.” I always have oregano oil on hand (and especially when flying) and it always works well for me at the first sign of any bug. I was pleased to come across this research even though we don’t yet have a human study.
  • Black elderberry liquid extract “displays an inhibitory effect on the propagation of human pathogenic influenza viruses” and has antimicrobial effects against bacteria responsible for infections of the upper respiratory tract. This is also a firm favorite in our household in the winter months and I seldom need more than one or two doses at the first sign of the sniffles.
  • N-acetyl-L-cysteine (NAC) “antioxidants like NAC represent a potential additional treatment option that could be considered in the case of an influenza A virus pandemic.” I’ll be giving NAC more consideration.
  • Here are some well-balanced perspectives from Peter D’Adamo on Facebook mentions drinking plenty of water, stocks, garlic (freshly crushed), onions, leeks, elderberry and Andrographis paniculata. He does say “Keep in mind these are just my opinions and observations over a thin veneer of facts.”

Consider lomatium?

Lomatium is not my first choice but I’m listing it here out of interest. Lomatium by Barlow Herbals “During the flu pandemic of 1917-1918, the root came into extensive use by the two Washoe Indian tribes near Carson City, Nevada.” I have yet to try this one but have heard Jane from Barlow Herbals talk about lomatium on a number of summits and I’m intrigued.

My first-aid kit

In summary, here is my first-aid kit: Vitamin C, zinc, extra selenium, vitamin D, magnesium, oil of oregano, olive leaf extract, black elderberry and Biocidin Throat Spray and Xlear Nasal Spray (the latter two are always on hand and I always also travel with them).

I also always have essential oils on hand: tea tree oil, eucalyptus, peppermint, rosemary, lavender and others. I’ll be adding sage per Dr. Elisa Song’s blog (see below).

This is pretty much what I always use other than adding in extra selenium, so it was very affirming to gather all this research.

trudy first aid kit
Here are just a few products from my first-aid kit.

GABA or tryptophan: if worried or overly anxious or fearful

If you’re feeling worried or overly anxious or fearful, the best way is to be informed and prepared. Interestingly, some of the very same nutrients mentioned above also help ease anxiety – vitamin C, zinc, vitamin D, magnesium and selenium and B vitamins – because they are co-factors for making neurotransmitters like serotonin, GABA and dopamine.

If all this information and being prepared isn’t enough to calm you down, then don’t forget the individual amino acids for quick relief. I use GABA for clients who are feeling physically tense and tryptophan or 5-HTP for worry-type of anxiety and if they are imagining the worst and can’t switch off their busy mind off.

We use the trial method to find the ideal amount for each person, starting low and titrating up based on symptoms and then down if not added benefits are seen.

You can find my most popular amino acid products on the supplements blog here (and with details for how to set up an account for my online store). You can find everything else I write about in the store too. Just be sure to work with your practitioner.

My thoughts are with you and all of those currently ill and those who will get ill. We will get through this together.

My hope is that you are less anxious and fearful as you become more informed.

Please share your immune-boosting remedies and your thoughts and plans.

As I mentioned above, these are resources and information I’ve gathered for my own personal use, and are in no way intended to be recommendations.

 

Essential tremor, dystonia, anxiety and cravings – diet, GABA, tryptophan, zinc and vitamin B6

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Essential tremor, dystonia, anxiety and cravings

Today I’m sharing how diet, GABA, tryptophan, zinc, vitamin B6 and other B vitamins can resolve essential tremor and sugar cravings in 2 months, and also resolve musician’s dystonia and social anxiety within 4 months.

According to Medical News Today essential tremor is a movement disorder that can cause hand tremors and “is among the most common movement disorders.” … “The tremor usually affects both sides of the body, but it may be more noticeable in the dominant hand. It tends to occur when the person is moving as well as when standing still. Genetics may be responsible for around half of the cases of essential tremor.”

Essential tremor – diet, GABA, tryptophan and B vitamins

This Croatian paper, Treatment of Essential Tremor with Multi-Modal Nutritional Therapy in a Teenage Patient, reports the “case of a 13-year-old boy with [essential tremor] causing severe functional impairment” over the previous 2 years.

“A multi-modal nutritional therapy approach” was used to target three possible areas that could be contributing to the tremors: a poor diet that was high in sugar, low GABA levels and low serotonin. These changes were implemented:

(i) diet (specifically adopting a Mediterranean diet)

(ii) GABA (through oral supplementation) and

(iii) L-tryptophan/vitamin B pathways (Triptobel oral supplement).

The papers states: “After two months of therapy, his tremor decreased significantly and he regained normal function.”

Once the essential tremor resolved, this teen was able to resume his plans to pursue a musical career as a guitar player (which had been put on hold due to the tremor and his inability to play). What wonderful results!

I’m thrilled to see tryptophan and GABA being used for this condition and am really pleased to read this case report.  Here is my commentary on the supplements and doses he used for anyone wishing to try and replicate this nutritional approach (keeping in mind there is no one-size-fits-all).

  • He used 150 mg of the Triptobel supplement three times daily at 8 am, 1 pm, and 6 pm. One capsule of  the Triptobel contains 150mg L-tryptophan and a B vitamin complex of thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pantothenic acid (vitamin B5), vitamin B6, folic acid (vitamin B9), and cyanocobalamin (vitamin B12).  The total tryptophan dose was 450mg per day. A typical starting dose for someone with anxiety is 500mg 2 x day so his dose was on the low-end.  The Triptobel was also used at mealtimes and according to the label “on a full stomach after a light meal, preferably without protein.” I like to use tryptophan between meals (away from protein) and a B complex with meals so I’m intrigued by this application (but wonder when protein was consumed).
  • He also used 750mg GABA twice daily at 10 am and 4 pm. This is considered a high starting dose for the majority of my clients with anxiety and I start low and build up to this amount.

Anxiety and low mood was not mentioned so I don’t know if they were factors.

It appears sugar and carb cravings were very likely a factor given that his normal daily diet contained “large amounts of refined sugars (chocolate, cake, biscuits, ice cream, etc).” The amino acids would have helped him with those cravings.

With regards to his diet, given how common movement disorders are with gluten issues, I would also consider I gluten-free diet which has been shown to have an adverse impact on neurotransmitter levels and B vitamins. Could gluten have triggered these nutritional deficiencies and the tremors?

And now to share a very similar case in an adult male … with a different and yet related approach.

Dystonia and hand tremors – and the pyroluria connection

This same Medical News Today article also describes dystonic tremor/dystonia as a movement disorder that can also cause hand tremors, stating that “the brain sends incorrect messages, resulting in overactive muscles, abnormal postures, and sustained undesired movements. Young adults and those in middle age are most likely to develop dystonic tremors, which can occur in any muscle.”

If you’ve been reading my recent articles on pyroluria (the pyroluria-vagus nerve connection and the introversion-pyroluria-loneliness connection) I’m sure you’ll be be interested to learn that there appears to be a strong link between pyroluria and focal musician’s dystonia (or musician’s cramp) in some individuals.

As you read in the blog above, Jay, also a guitar player, had to put his professional music career on hold due to musician’s dystonia. He also happened to have social anxiety and he started to notice improvements in his anxiety and tremors within the first 2 weeks. At the end of 4 months of being on the pyroluria protocol, he shared this:

I think it is, at this point, safe to say that the pyroluria treatment [120mg vitamin B6 and  60mg zinc) is, at least in my case, the cure for pyroluria and dystonia. 90%+ of my symptoms have disappeared, I am working extensively on repertoire and I am thinking about getting back into performing.

He says his experience was “akin to rebirth as a musician and also as a person.” How wonderful is that to read. Jay’s musician’s dystonia resolved and so did his social anxiety.

The outcome for the teen and Jay were similar and yet the approaches used were seemingly very different. This isn’t actually the case since zinc and vitamin B6 are co-factors that are needed to make GABA and serotonin.

Do you experience tremors, or have you been diagnosed with essential tremor or dystonia (or know someone who has)? And have you considered a nutritional approach?

Do share if you’ve seen success with either of the above approaches, and also experienced reduced anxiety or felt more social?

Why social anxiety, introversion and loneliness can be lethal and a simple nutritional solution

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trudy scott mindshare

It was an honor to be selected as one of fifteen participants for The Future of Health presentations at Mindshare in August 2019. I presented this to my peers in the integrative health and nutrition space but it’s applicable to everyone and I’d like to share it with you today.

Here is my video presentation: Why social anxiety, introversion and loneliness can be lethal and a simple nutritional solution  (click below to watch the video)

Here are some additional reading resources on much of what I cover in my 5 minute presentation:

This is the the amazing and inspiring group of speakers who I shared the stage with:

  • Amie Apigan – Why Attachment is the New Field of Medicine
  • Lauryn Lax – Eating Healthy is Killing You
  • Jess Sherman – Raising Resilient Kids in a Complex World: Will we Rise to the Challenge
  • Terry Wahls – Creating an Epidemic of Health – My Radical Path
  • Susanne Bennett – The Kimchi Revolution: How an Ancient Food Can Transform the Future of Health
  • Razi Berry – Love is Medicine
  • Kaylea Boutwell – I’ve Got Your Back: Novel Pain Therapies Transforming Spinal Care Outcomes
  • Dana Cohen – Hydration: 8 Glasses a Day is not the Way!
  • Elisa Song – Breathing Life into Your Kids
  • Joel Sprechman – Creating 1M Super Poopers & Evolving Crohn’s Colitis
  • Katy Kimball – My Plan to Empty Your Waiting Rooms (the Real Root Cause of Poor Health)
  • Heather Paulson – Why Choose? Using the Best of Both Worlds to Experience Health with Cancer
  • James Maskell – Group Visits: How Functional Medicine Reaches the Vulnerable
  • Mehgan Walker – Life, Liberty and the Pursuit of Chronic Disease: Why Chasing Happiness is Making us Sick

(do let me know if you’d like me to share any of these presentations in the follow-up blog)

mindshare speakers
Mindshare 2019 green room
Here are some of us in the backstage “green room” and getting ready to go on stage!

We each had a maximum of 5 minutes to present and were not allowed slides or notes. The last time I had memorized my talks and had them timed was 15 years ago when I was in Toastmasters. Before that it was when I was in school. I wasn’t even sure if I could do it when I entered my proposal to speak. When practicing the day before I was still unsure I could manage. Because of my Lyme disease, my memory and word recall isn’t as great as it used to be.

If you pay close attention and you’ll notice the spot where I almost freeze – everything just went out of my head! I simply breathed in calmly, made an attempt to look like I had paused and was fortunate that most of the ending came back to me! Whew!

trudy scott mindshare 2019

 

I’d love to hear what you think of my message and if it resonates with you or a loved one. Feel free to share your pyroluria score and how you score on the introvert questionnaire.

Please also share if you’ve seen the benefits of no social anxiety, introversion and/or loneliness (or much less) when on the pyroluria protocol.