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Nutritional testing for figuring out the root cause/s of your anxiety

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test

This blog covers the nutritional or functional testing I use with my clients, and what tests I’d run (and/or have my client’s doctor run) if everyone had unlimited funds.

Often it can be challenging to figure out the root cause/s of your anxiety, but that’s where questionnaires, nutritional/ functional/ testing, and a good practitioner (or team of practitioners like nutritionist, functional medicine doctor, nurse practitioner, therapist etc.) comes in – so you can put all the puzzle pieces together.

The following are what I have most of my clients do:

  • The basic blood work that I like to see is a lipid panel, a CBC (complete blood count), a metabolic panel, an iron panel that includes ferritin, and a thyroid panel that includes TSH, free T3, free T4, reverse T3, thyroid antibodies (antithyroglobulin and antithyroperoxidase), vitamin D, and CRP (C-Reactive Protein). There is much we can determine by looking at functional values: digestive status, possible gut dysbiosis, adrenal function, malabsorption, inflammation, as well as low iron, low vitamin D etc. I’ll share more about the markers on this panel of tests in a later blog post.  
  • I also like to see an adrenal saliva test, which measures four times cortisol. So it’d be a saliva collection first thing in the morning, noontime, 5:00 PM, and 10:00 PM. It also shows DHEA; Secretory IgA; and an anti-gliadin antibody (a marker of gluten sensitivity)
  • I rely on the Pyroluria Questionnaire and response to the supplements. The pyroluria urine test is a possibility. But I seldom have clients do it, because we can often see a false negative.
  • For neurotransmitter imbalances – low serotonin, low GABA, low catecholamines and low endorphins – I rely on the Amino Acid Questionnaire and response to amino acids. Vitamin Diagnostics offer a platelet serotonin/dopamine/norepinephrine and epinephrine panel, which is the most accurate way to measure neurotransmitters, if you really wanted to measure them. I don’t ever recommend urinary neurotransmitter testing. It just doesn’t seem to correlate with symptoms.
  • B12 levels. To determine a B12 deficiency, you would want to measure B12, methylmalonic acid (or MMA), and homocysteine.
  • The 23andme genetic testing. This will measure MTHFR, COMT, MAOA, CBS, GAD and many more polymorphisms.

Here is other testing that may be helpful for certain individuals:

  • A sex hormone saliva test. This will measures progesterone, estriol, estrone, estradiol, and testosterone.   I have a wonderful nurse practitioner that I work with, and, if need be, will refer people out to the nurse practitioner if we need support when it comes to bioidentical hormones.
  • A food intolerance test that measures IgG antibodies to 60+ foods. This shows a delayed reaction to the foods.
  • A fatty acid test. This will measure omega-3s (EPA and DHA), omega-6s and omega-9s. And it’ll also measure trans fats. Doing this test is really helpful if you have pyroluria or think that you may have pyroluria.
  • A RBC (red blood cell) magnesium test. Dr. Carolyn Dean talked about the usefulness of this test season 2 of The Anxiety Summit: Take magnesium and melt your anxiety away
  • A stool test. Metametrix/Genova and Diagnostechs offers functional stool testing. It’ll show good bacteria, yeast, parasites, bad bacteria, and digestive markers.
  • A hydrogen breath test or SIBO test. Genova offers this or you can ask your conventional doctor to order this.
  • The H/pylori antigen test. Genova offers this or a conventional doctor can do this.
  • Intestinal permeability profile. Genova offers this.
  • A celiac panel. Genova offers this, or a conventional doctor can do this.
  • The Cyrex panels, which will show gluten and food cross-reactions, and various autoimmune markers.
  • The histamine whole blood is a useful test to see if you have high histamine/histadelia or low histamine/histapenia. This is offered by Vitamin Diagnostics and must be WHOLE blood.
  • Spectracell shows vitamin and mineral deficiencies.
  • A VAP test. If you have concerns about high cholesterol and heart disease, this is going to measure particle size, fibrinogen, Lp(a) and other cardio markers (since looking at only high total cholesterol is not particularly useful).
  • The OAT/Organic Acid Test. Great Plains offers this and it has markers of digestion, yeast overgrowth, infections, B vitamin status and neurotransmitter function.
  • A hair mineral analysis. This is a great way to look for toxic metals and mineral status. You want to look at ratios, not just levels. This is a good marker for copper toxicity as well. Analytical Research Lab offers this test.
  • If you think your copper is too high, or you’ve got low zinc, you can measure copper or ceruloplasmin. This is in serum.
  • Porphyrin testing. This is a measure of the effect of heavy metals such as lead and mecury. Kris Homme talked about this in Season 2 of the Anxiety Summit: Your hidden mercury burden – A likely root cause of the other root causes of anxiety – part 2
  • An amino acid profile, which is a plasma or blood spot test. It’s not something that I use very often, but I have seen people with this test.
  • You can also test candida antibodies in blood, which is not terribly accurate, but sometimes will show up.

I want to look into the following testing:

What functional/nutritional testing have you had done and have found to be helpful? Which of the above tests would you like more detailed information about?

60+ Nutritional & Biochemical Causes of Anxiety

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nutritional causes of anxiety

I shared these 60+ Nutritional & Biochemical Causes of Anxiety on my closing call  of the The Anxiety Summit season 3. Since then I’ve kept this list updated as I find additional research, connections and case studies.  In conjunction with my book “The Antianxiety Food Solution”, interviews and other blogs, I hope this list will help you put the puzzle pieces together to resolve your anxiety. 

Keep in mind it’s not uncommon to have many root causes so if it feels too overwhelming, addressing low serotonin and/or low GABA first, really does help with the overwhelm, fear, anxiety and negativity.

The Foundational Causes from The Antianxiety Food Solution :

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The Anxiety Summit Season 2: All the speakers and topics

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

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

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

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

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

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

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

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

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

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

The Anxiety Summit – How Gluten Elimination Healed Me and Eliminated my Anxiety

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Lebby Salinas, The Fooducator®, certified health & wellness coach, is interviewed  by host of the Anxiety Summit, Trudy Scott, Food Mood Expert and Nutritionist, author of The Antianxiety Food Solution.

How Gluten Elimination Healed Me and Eliminated my Anxiety

  • Lebby’s gluten story and how she nearly died
  • The gluten testing she did and what she learned
  • The C.R.A.P diet
  • Community work and the Fooducation® Movie Series
  • Buying local produce

Lebby Salinas suffered from many food allergies and illnesses that conventional medicine couldn’t diagnose or cure; at one point, becoming very ill and needing to be hospitalized. After many years and many thousands of dollars, she took her health into her own hands.

Lebby took Hippocrates at his word and began to “Let food be thy medicine and medicine be thy food.” She discovered that it was more about what was wrong with the foods she was eating, not what was wrong with her body.

She shared how her healing journey is a continual journey shared this:

When you have anxiety you are told to just think positive and just change your thoughts and I like to say just change your food!

Most of her life she had been eating what is referred to as the S.A.D. diet (Standard American Diet) consisting of a lot of what she calls C.R.A.P. 

C= carbonated and sugared drinks

R= refined sugar

A= artificial flavors and dyes and

P = processed foods

The first time someone suggested a connection between food and mood and anxiety she found the idea so foreign.   It was only later that she figured out how bad gluten was for her health and how it made her so sick and caused anxiety and panic attacks.

Dr. Charles Parker, holistic psychiatrist, was the first doctor who recommended that she eliminate gluten and dairy, rather than prescribe her antidepressants. This was based on IgG food sensitivity testing.

Later the doctors at another hospital said she didn’t have celiac disease, could eat gluten, looked at her like she was “a bit crazy” and prescribed Xanax to calm her down. She was sent home and her husband was told to get her things in order.

Lebby shared how she was then referred to Dr. Tom O’Bryan, he did the Cyrex test and said she needed to do the elimination diet and heal her gut or she would likely die.

She shared that doing the Cyrex testing and working with Dr. Tom “literally saved my life!” And that he is going to write up a paper on her illness and great results.

You may recall my great interview with Dr. Tom on season 2 of the Anxiety Summit: Gluten’s impact on the inflamed brain: reducing anxiety and depression

Here is one of the great statements Dr. Tom made during our interview:

No human on the planet can digest gluten! Whether or not it causes symptoms like anxiety or depression or arthritis why eat anything that would cause inflammation!

Dr. Tom also talked about his new product during our interview: 

Glutenza™ is a gluten pulverizing formula uniquely designed with powerful enzymes, prebiotics and probiotics to break down gluten proteins by targeting both internal and external peptide bonds. Glutenza™ goes beyond the traditional DPPIV enzyme, offering superior degradation of gluten proteins by breaking down unhydrolyzed gluten peptides.

Dr. Tom is host of the well-known summit called ‘The Gluten Summit – A Grain of Truth’  (the interviews are excellent and are highly recommended if you want to learn more about gluten issues).

The training that Lebby did once she had recovered was through Dr. Tom’s office and is called the Certified Gluten-free Practitioner training.

I love that Lebby has taken what she learned and now helps others in their healing journeys, as The Fooducator®,  and a certified health & wellness coach. The more she studied health, food, and nutrition, the more passionate she became about sharing with others the power of holistic health and the power that “real food” has in nourishing and healing our bodies, minds and spirits.

One thing she has started is community effort to help improve the health and wellness of communities via the Fooducation® Movie Series that works towards “Changing lives one movie at a time.”™ 

Here are some of her “Fooducator approved movies you absolutely have to watch”: Fat Sick and Nearly Dead, The Future of Food and Ingredients.   You can watch some trailers on her site GetFooducated

lebby salinas getfooducated

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

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

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

The Anxiety Summit – Grainflammation – How Grain Consumption Contributes to Anxiety and other Mood Disorders

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Dr. Peter Osborne DC, author of Glutenology, was interviewed on the Anxiety Summit by host of the Anxiety Summit, Trudy Scott, Food Mood Expert and Nutritionist, author of The Antianxiety Food Solution.

Grainflammation – How Grain Consumption Contributes to Anxiety and other Mood Disorders

  • Gluten and autoimmunity
  • Schizophrenia and “bread madness”
  • How gluten and all grain consumption can lead to chemical changes in the brain
  • How the gluten in corn can impact the mind and mood
  • Concerns with seeds and grains
  • DNA testing for celiac and non-celiac gluten sensitivity

Here are some snippets from our interview:

Gluten is notorious for damaging the gastrointestinal tract.  I know iron, in the literature,  has always been reported as the most common most deficiency in gluten sensitivity. In my 15 years of practice, measuring both ferritin as well as iron panels and vitamin B12 levels, I see B12 being much, much more common as a deficiency in those with gluten sensitivity. The most common side effect of B12 deficiency, beyond fatigue, is actually anxiety.

We discussed the work of Dr Alessio Fasano, world-renowned pediatric gastroenterologist, research scientist and entreprenuer,  chief of Pediatric Gastroenterology and Nutrition at MassGeneral Hospital for Children (MGHfC).

The second barrier is called the right junction, which we know gluten can cause a disruption in tight junctions. This was discovered by Alessio Fasano at Harvard. He actually discovered it while he was at University of Maryland Celiac Research Facility. He discovered these tight junctions were disrupted and dismantled as a result of gluten exposure.

We also know bacterial infections can disrupt these barriers. We also have some evidence that show that glyphosate in Roundup and other chemical artificial pesticides and herbicides can disrupt this gastrointestinal barrier.

We discussed lipopolysaccharides (LPS) and how they

can create a lot of inflammatory reaction, and they can contribute to a breakdown in the blood brain barrier

Here is a recent paper on LPS and anxiety and depression: Early prenatal exposure to LPS results in anxiety- and depression-related behaviors in adulthood

We found that mice exposed to LPS show anxiety- and depression-related behaviors

In addition, LPS mice had reduced serotonin and noradrenaline levels in the hippocampus

Here is the blood brain barrier paper discussed – The blood-brain barrier in neuroimmunology: Tales of separation and assimilation

The corn zein discussion was fascinating and concerning because so many people are eating gluten-free products that contain corn (another reason to pass on the processed gluten-free products and just eat real whole food!)

Here are two papers that discuss this (corn is called maize in South Africa)

Here is Dr. Osborne’s gift: 7 Habits of the Highly Effective Gluten-Free Warrior (3 videos)

Here is the information about Genetic Testing For Gluten Sensitivity and Celiac Disease

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

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

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

Should I use 5-HTP for a 5 year old boy who has been “glutened”?

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boy-eating-sandwich

This is a great question that was posted on my blog by Margaret Floyd, author of Eat Naked, a great book on clean eating. Here is a review I did awhile back.

The question (which she gave me permission to share on a blog):

A close friend of mine has a little 5yr old boy who is celiac. Since his Dx, he’s doing much better but they’re struggling to get it out of his diet 100% – he keeps getting “glutened” as she calls it by well-meaning but uneducated parents of his friends, his chess coach, etc. and he’s VERY sensitive to even the slightest exposure. He takes a good 3-4 weeks to recover psychologically every time he’s exposed.

She recently started supplementing him with the supplement SeroPlus (maybe you know it?) which has 5HTP in it. She gave it to him last week when he got “glutened” and noticed his temperament was SO much better than usual. So she’s kept him on it But she’s worried about him developing a dependence on supplemental serotonin in this way.

My instinct is that he won’t develop a dependence because she’s giving him the precursor, and this is so important while his body and specifically, gut, heals. But I wanted to ask you since you’re the pro in these matters. What’s your experience been?

This is a really great question so I decided it was worth sharing with a bigger audience via a blog and my ezine. Here is my response:

I’ve not used Seroplus but it looks good and the positive result is always a good thing! You’re right and I agree, I don’t see dependence as being an issue – we know gluten issues can lead to low serotonin so his continued consumption of gluten may be continually depleting his levels, plus his gut needs to heal.

One issue longer term may be that his gluten exposure may very likely have impacted his adrenals and 5-HTP can raise cortisol which won’t be good if his cortisol is high. This is why in adults I use tryptophan unless I know cortisol results. In kids I always only use tryptophan since it’s closer to food. And I do like to use an individual amino acid versus a combo product as it’s easier to increase and/or decrease just the amino acid. And mom may need to reduce the amount as his gut heals and his serotonin levels come up so you don’t get a reverse effect (too much of any amino can do this).

One more thing to consider is methylation and SNPs – detox is compromised with the MTHFR polymorphisms and this product has 500mcg of folate (the good form!) which may be contributing to his good temperament too. Also if he does have either of the MTHFR mutations it may end up being too much folate if he is given more capsules (hence the benefit of individual amino acids and even individual folate).

I’m sure they are doing all they can to prevent this but would like to suggest this in case…I’d also suggest a card with information on how deadly gluten is to this little guy and really making a point to educate everyone he’s going to be in contact with. I’m sure he’s also old enough to ask smart questions as I’m sure he’s well aware of the effects. It just breaks my heart to hear he keeps getting “glutened”!

Keeping a supply of dipeptidyl peptidase IV (DPP-IV) on hand is also recommended.  DPP-IV specifically breaks down gluten.

I hope this helps you when thinking about whether to use 5-HTP or tryptophan and to understand more about gluten and methylation.

Here is the original blog post which was from my interview on The Anxiety Summit: Targeted individual amino acids for eliminating anxiety: practical applications

And here is the Amino Acids Mood Questionnaire from my book The Antianxiety Food Solution.

Do check out all the fantastic questions on these blogs AND all my answers. I respond to every single question posted on my blog so feel free to post one at any time.