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OCD

My Kid is Not Crazy and PANS/PANDAS awareness day 2017

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Earlier this week was PANS/PANDAS awareness day 2017 so I’d like to bring some awareness to this condition that causes sudden-onset OCD (obsessive compulsive disorder) type symptoms and anxiety. The PANDAS Network defines PANDAS as follows:

PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) occurs when strep triggers a misdirected immune response results in inflammation on a child’s brain. In turn, the child quickly begins to exhibit life changing symptoms such as OCD, anxiety, tics, personality changes, decline in math and handwriting abilities, sensory sensitivities, restrictive eating, and more.

PANDAS Network estimates that PANDAS/PANS affects as many as 1 in 200 children.

This Huffington Post article: Misdiagnosed: How Children With Treatable Medical Issues Are Mistakenly Labeled as Mentally Ill covers one family’s experience with misdiagnosis with their daughter and the treatment that eventually helped her recover. As you’ll read in the blog, PANS/PANDAS is still very poorly understood in the medical community and misdiagnoses are very common:

the vast majority of pediatricians, child psychiatrists, and neurologists are unapprised of the latest research and continue to misdiagnose children who have PANS/PANDAS with any number of mental health disorders.

The new movie My Kid Is Not Crazy is another great resource for gaining a better understanding of this condition. Here are some snippets from this excellent movie:

Nine-year-old Kathryn was a normal, healthy child. She was a star student, athlete and dancer. In a matter of days, she would become totally dysfunctional. Kathryn had alarming rapid-onset OCD refusing to eat or drink. She had tremendous separation anxiety and would become panicked if her parents were not in sight. She had trouble sleeping and showed signs of age regression in vocabulary and handwriting.

How did this happen?

Kathryn’s family and many families like them— turned to a fractured medical system, where there is fierce disagreement about how to help their daughter. More often than not, a child with these symptoms would be diagnosed as having mental illness. They’d be treated with anti-psychotic medication, behavior therapy, and even hospitalization.

But more than 30 years ago, Susan Swedo—a doctor with the National Institutes of Health—discovered that an undiagnosed strep infection was the cause of one child’s disabling illness. The more Swedo dug, the more evidence she found: Strep was linked to symptoms normally chalked up to psychiatric illness.

She also discovered how non-accepting modern medicine can be of new ideas.

Swedo has put her reputation and career in jeopardy as she fights to cure the condition she named: Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS). Neurologists Jonathan Mink, Roger Kurlan, Harvey Singer and others publically ridicule Swedo and her PANDAS theory, creating controversy over diagnoses and treatment. This group has become known on social media as the “non-believers.” The result: the entire pediatric-care industry is confused and doesn’t know what to do.

And it’s the children who suffer.

“My Kid is Not Crazy,” a film by Tim Sorel, tracks the journey of six children and their families as they become tangled in the nightmare of a medical system heavily influenced by the pharmaceutical industry. Here it’s common for a caregiver to prescribe a young child with a Selective Serotonin Uptake Inhibitor (SSRI) but hesitate to prescribe an antibiotic to counteract a potential infectious-based trigger. For some of these kids, what happens after several years is shocking and sad.

You can watch the trailer here and rent the movie to watch it online or purchase the DVD here.

The movie site also lists many helpful resources for PANS/PANDAS.

Last week’s blog: Anxiety, compulsive thinking, counting behaviors: gluten, tryptophan and inositol covered gluten, tryptophan and inositol for OCD symptoms. I mentioned that I also always keep Lyme disease, heavy metals and PANDAS on the list as possible areas to refer out for if symptoms are not resolving with the above nutritional approaches, so it made sense to share more about PANDAS this week.

Even if the OCD and anxiety is due to PANS/PANDAS, I would still encourage a gluten-free diet and trials of tryptophan, GABA and inositol (and other nutritional approaches) in order to provide some relief while the infection/s are being addressed. Similar results are seen when providing nutrient support like the use of GABA (and/or tryptophan) for relief for Lyme anxiety.

Do you know about PANS/PANDAS and the connection to OCD and anxiety?

Have you seen symptom resolution by addressing the infection/s one of your children, personally or with a patient or client?

Have you seen some symptom relief when also using GABA and/or tryptophan and/or inositol?

Anxiety, compulsive thinking, counting behaviors: gluten, tryptophan and inositol

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Today I’m going to share my feedback on a question I received on how to approach working with a child with anxiety, compulsive thinking and counting behaviors in the hope it can help you or someone you know (or are working with if you’re a practitioner). Here is the question:

Regarding anxiety and compulsive thinking/OCD counting behaviors in a 12 year old, have you experienced (or heard through client sharing) a correlation with certain foods or inflammatory compounds? In a younger person, I am trying figure out the triggers if there is low production of certain neurotransmitters driving the symptoms. This child in particular has had a long history of allergies and terrible asthma (requiring nebulizer treatments) so I’ve long suspected food sensitivities as a driver for systemic inflammation but am trying to connect the dots for her parent. The counting seems to be a distraction of sorts for her – I assume following a triggering thought. This parent is very new to integrative therapies so treating with an amino acid is going to *feel* like she’s not doing enough as parent. Standard talk therapy has not helped.

This is how I responded and it’s how I would start to work with a parent with a child with these types of issues.

After looking at the basics to make sure the child is eating real whole food with no additives, is not consuming any caffeine and is getting quality animal protein at breakfast (to keep blood sugar stable and reduce anxiety), I always consider gluten and even dairy and other food intolerances. I write about the success of a gluten-free diet with a 7 year old boy in this blog: Integrative Medicine Approach to Pediatric Obsessive-Compulsive Disorder and Anxiety. He saw a “marked reduction of OCD symptoms and anxiety along with marked improvement of social behavior and school work.”

OCD and counting behaviors are classic low serotonin symptoms and her anxiety could be the low-serotonin worrying type or the low GABA type which is more physical anxiety. I’d have them do the amino acid questionnaire

I’d start with a trial of tryptophan – using 100mg of Lidtke Chewable Tryptophan – to help with the OCD, counting and worry-type anxiety. If it helps, I’d have her use it twice a day mid-afternoon and evening, increasing it over the course of a few weeks to find the ideal amount for symptom relief (and keeping a food mood log to record doses and symptoms).

Some people do really well with tryptophan, others do better with 5-HTP for low serotonin symptoms, so doing a trial with 25mg of 5-HTP would be an option if the tryptophan doesn’t help as expected.  

I would carefully review the precautions with the mom as tryptophan and 5-HTP can sometimes be an issue with asthma and may need to be lowered or discontinued.

Inositol can be added if additional nutritional support is needed for the OCD and counting behaviors and may even be needed to replace the tryptophan or 5-HTP if either one triggers asthma. The maximum dose in the research is 18g of inositol per day and I start at 2g once a day and increase slowly over a few weeks to find the ideal dose. Here is feedback from one mom on how inositol alone helped her son with migraines, stress, anxiety and OCD

Once we’ve figured out nutritional support for the low serotonin symptoms then we’d address low GABA if needed, using sublingual GABA. [Update Nov 17, 2017: I mentioned GABA as a possibility but with her symptoms and the new GABA research on intrusive thoughts, a GABA trial would definitely be something to pursue]

I found this comment to be rather unusual: “treating with an amino acid is going to *feel* like she’s not doing enough as parent.” The parents I work with are thrilled to discover how powerful the amino acids are and how quickly they provide amazing results.

These other factors would also be addressed: possible high cortisol, gut health and any of the other possible contributing root causes. I also always keep Lyme disease, heavy metals and PANDAS on the list as possible areas to refer out for if symptoms are not resolving with the above approaches.

Here are links to the amino acid questionnaire, the precautions and the supplements:

  • I have my clients complete the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and check off their symptoms in each of the sections. The rating uses scale of 1-10 with 10 being worst.
  • I also have my clients review the Amino Acids Precautions and we figure out which amino acids they can and can’t use
  • These are some of the supplements I use with my clients

Have you used any of the above approaches with your child or for your symptoms or for a client/patient?

Toxoplasma gondii: schizophrenia, bipolar disorder, OCD and unresolved anxiety?

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Toxoplasma gondii is a microscopic parasite that infects cats and can be found in the soil – research shows it may be a factor in schizophrenia, bipolar disorder and OCD in susceptible individuals. Could toxoplasma gondii could be one of the root causes of unresolved anxiety? I believe so and feel it’s under-rated.

This is the one of the parasitic infections I cover in an interview I did on The Parasite Summit.

Here are a few snippets from my interview:

A single-celled parasite called Toxoplasma gondii causes a disease known as toxoplasmosis.

Toxoplasma gondii is a microscopic parasite that infects cats and can be found in the soil. The infection can be acquired by ingesting contaminated food or water, by handling contaminated cat litter, or by transmission from mother-to-child.

According to the CDC – as of Mar 1, 2017 – in the United States it is estimated that 11% of the population 6 years and older have been infected with Toxoplasma. In various places throughout the world, it has been shown that up to 95% of some populations have been infected with Toxoplasma.

I love cats and have always been a cat person and pets are wonderful companions helping many of us humans recovering from PTSD and trauma – but we always need to dig deeper:

  • some individuals don’t respond as well to dietary changes, brain chemical balancing and addressing other biochemical/nutritional factors
  • I’m always looking for root possible causes. I’ve identified 70+ causes of anxiety and one of them is parasites
  • any parasite could be a factor – it causes stress and inflammation in the body, and we may see high cortisol leading to increased anxiety, insomnia and inflammation
  • could toxoplasma gondii could be one of the root causes of unresolved anxiety? I believe so and feel it’s under-rated – and believe we’ll be hearing more about it as more research comes out

I discuss this review paper published this year: Is Toxoplasma gondii a Trigger of Bipolar Disorder?

The association between T. gondii and schizophrenia/schizoaffective disorder is one of the most studied links between one pathogen and a psychiatric disorder.

However, growing emerging evidence has also documented an association between latent toxoplasmosis and the risk of [bipolar disorder] and suicidal/aggressive behaviors. T. gondii infection, as previously suggested for schizophrenia, may contribute to the onset and the progressive course of the disease interacting with genetic hereditary predisposing factors, as well as affecting neurotransmitter systems and immune responses, which have recently been shown to be closely linked to the pathogenesis of BD and its medical comorbidities.

The link between this parasite and psychiatric disorders could be also explained by its ability to influence neurotransmitter pathways. Indeed, T. gondii has been shown to increase dopamine levels, as well as to modulate serotonin, gamma-aminobutyric acid (GABA) and glutamate signaling.

With the impacts on neurotransmitters it’s clear how this parasite could directly trigger anxiety, panic attacks, fears, worry and even OCD. I cover this and more (malaria and malaria medications too) in my interview and book.

Parasites may be silently impacting your health and they’re FAR MORE COMMON than you think! Parasites aren’t just found in third-world countries, millions are already infected in industrialized countries and parasites could be silently hampering your health. Fortunately, with awareness and appropriate care, parasites can be prevented and treated, once detected.

If you’re struggling with any of the following, it may be worth looking into parasites:

  • Gastrointestinal: pain/cramps, excess gas, bloating, constipation/diarrhea
  • Infertility and hormone disorders
  • Skin issues: acne, itching, rashes
  • Mental health: depression, bipolar disorder, anxiety, OCD, schizophrenia
  • Challenges with autoimmune disease recovery (Toxoplasma gondii may also be a factor in Hashimoto’s thyroiditis)

Please share feedback and ask questions in the comments below.

OCD, anxiety, PANDAS and PANS: Dr Brandon Brock

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This is a quick reminder that The Autism, ADHD and Sensory Processing Disorder Summit starts tomorrow.

I really enjoyed Dr. Brandon Brock’s interview, Understanding PANS and PANDAS role in ASD, ADHD and SPD, and it is particularly relevant for anxiety and OCD. During the interview he describes what he often finds with these children with PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections):

A lot of times the child may come in having nightmares or they just start bed wetting or they’re having fears or a little bit of irritability and they get blamed on all kinds of things. You know they get blamed on maybe a sketchy home environment that’s really not that sketchy, or maybe they just say it’s normal for a child to go through this, or maybe they’re just starting to hit puberty so they’re getting more aggressive. In other words there’s always a reason other than looking at the brain physiology. Why is it changing? Is the brain physiology changing because maybe there is an environmental factor? You know maybe there is some abuse or something. And that does happen.

But on a bigger scale maybe they had some sort of infectious disease, or maybe they had a toxin that got into their body, and it made their immune system react, and it started giving them symptoms like abnormal movements, ticks, especially in the face, lip smacking, hair twirling.

He talks about how these immune reactions to the brain and basal ganglia cause symptoms:

So when you have an immune response against the basal ganglia it’s kind of like pushing the play button over and over and over again. So now we see things like obsessive compulsive disorder, we see tics, we see choreiform movements [repetitive and rapid, jerky, involuntary movement that appears to be well-coordinated], we see nightmares and bizarre thoughts, or the kid does something that we call a perseveration. It is the repetition of a particular response (such as a word, phrase, or gesture), so they say something over and over and over. So there’s a fine line between a kid being a kid and then a kid having something like PANDAS. And really what we call that is auto-immune encephalitis, which just means inflammation of the brain. So the kid’s brain really is kind of like, if you want to say it metaphorically, on fire.

Dr. Brock talks about the 2 strep tests or anti-streptococcal antibody titers that are commercially available and determines whether the child has had a previous strep infection:

  • Antistrepolysin O (ASO) titer,* which rises 3-6 weeks after a strep infection, and
  • Antistreptococcal DNAse B (AntiDNAse-B) titer, which rises 6-8 weeks after a strep infection.]

In addition to the many other labs tests they do, he goes on to discuss another whole set of antibodies that can become positive down the road:

Dopamine antibodies, calcium calmodulin mechanisms, and then all of the intra-cellular structures, like the tubulin structures, the alpha and beta tubulin structures, the micro-tubulin structures, and even the cell wall. So we have an antibody panel that really says it’s either the structure, it’s either the receptor, or it’s the actual pumping mechanism that makes dopamine.

He didn’t mention this but it’s the Cunningham Panel done by Moleculera Labs

Dr. Brock goes on to talk about functional neurology, diet, how to find a good practitioner and much more. It’s a great interview!

The Autism, ADHD and Sensory Processing Disorder Summit, hosted by Tara Hunkin, NTP, runs from June 19-28, 2017.

It will be 10 days of eye opening information into the root causes of your child’s neurological dysfunction. Imagine learning about what may have caused their symptoms and how to address them with nutrition and biomedical approaches and leverage the power of positive neuroplasticity to improve function, health and their lives.

As I mentioned in the prior summit announcement many of the interviews on this summit may be applicable for you even if you don’t have a child with a sensory processing disorder, ADHD and/or autism – many of my clients with anxiety often benefit from the biomedical support that many of these speakers are addressing. Simply replace sensory processing disorder, ADHD and/or autism with anxiety and listen and learn.

And if you’re new to my work, do also tune into my interview: Anxiety’s Role in ASD, ADHD and SPD and how nutrient therapy can help.

Here are a few other speakers and their interesting topics (and I can’t wait to hear them all):

  • David Perlmutter, MD: The role of the microbiome in neurological health.
  • Alex Doman: Using music to heal your child’s brain
  • Derrick MacFabe, MD: The role of propionic acid in the multi-system challenges found in ASD.
  • Sonia McGowin, DC: How to know if biomedical intervention is right for your child.

You can register for The Autism, ADHD and Sensory Processing Disorder Summit here

Mental Health Month: anxiety, nutrition, gluten, GABA, leptin and fluoroquinolones

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egg-asparagus-salad

Since 1949, Mental Health America and affiliates across the country have led the observance of May is Mental Health Month by reaching millions of people both online and locally. They share this:

This year’s theme for Mental Health Month is – Life with a Mental Illness – and calls on individuals to share what life with a mental illness feels like for them in words, pictures and video by tagging their social media posts with #mentalillnessfeelslike (or submitting to MHA anonymously). Posts are being collected and displayed at mentalhealthamerica.net/feelslike.

I love that they say that spreading the word that mental health issues like anxiety, depression, bipolar and other disorders is something everyone should care about.

I’d love to educate and inspire many of those individuals who have already posted on social media using #mentalillnessfeelslike and have yet to find a solution. There are so many of them and it’s heart-breaking. You can go to mentalhealthamerica.net/feelslike now and see what is being said.

Here are a few examples:

Severe anxiety feels like you are lost in a big city where no one else can speak your language and you are trying to get home.. #mentalillnessfeelslike

#anxietyfeelslike #mentalillnessfeelslike a never ending battle to keep worry from creeping in to your every thought. Trying to be present

Anxiety Attack #mentalillnessfeelslike: I’m swirling in a cyclone while also being constructed by a Boa

#MentalIllnessFeelsLike Worrying About Passing This Semester Causing Your Anxiety To Mess Up More Although Your Anxiety Put You Here

And this profound quote by MentallyAbnormallyNormal (you can find her here on Facebook)

mentally-abnormally-normal-meme

I encourage you to participate if it feels ok to you. I’d especially love you to share how nutrition and nutrients like GABA, tryptophan, zinc, vitamin B12, and/or vitamin D have helped you. You can also respond directly to the posts others have made.

Here are some links to my prior blog posts on some of the many nutritional (and biomedical) approaches so feel free to also share some of this information and use it if you’re still on your healing journey to overcome anxiety, panic attacks, OCD, insomnia and other mood problems:

I’ll be adding to this last blog during season 4 of The Anxiety Summit which runs June 6th – 16th. As I continue to interview experts I learn more about the myriad of possible underlying causes of anxiety:

For some of my clients, eliminating anxiety (and other mood disorders) can be as simple as switching to a real whole foods diet, eating to balance blood sugar, quitting sugar/gluten/caffeine and adding some key nutrients like zinc and vitamin D. Many benefit immensely when using targeted individual amino acids like GABA and tryptophan. And some need to dig deeper to find the root cause of the anxiety.

But let’s always keep looking for that root cause or causes – find YOUR root cause/s – and address it/them.

My heart goes out to you if you are still suffering and still seeking a solution (and to everyone tagging themselves with #mentalillnessfeelslike and #anxietyfeelslike).

I say let’s aims to change this to the past tense so instead of #mentalillnessfeelslike let’s get to #mentalillnessfeltlike. Or how about #anxietyfeltlike or even #nutritionfixedmyanxiety ?

It truly is possible with food and nutrients! Do you agree? What has worked for you? Feel free to share in the comments and tag yourself on social media.

And do join us on The Anxiety Summit next month and share this during the Mental Health Month of May.

 

Anxiety and OCD: Inositol instead of tryptophan or 5-HTP?

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inositol for anxiety and OCD
DFH Inositol powder – it’s pleasant-tasting and 1 teaspoon is about 3g

Have you used inositol for anxiety and OCD (obsessive compulsive disorder) or even obsessive thinking or behaviors? Have you used it alone or with tryptophan or 5-HTP? I’d like to share an interesting discussion on a recent blog I wrote: Amino acids for anxiety – which ones and for how long? to illustrate how we are all unique and how some nutrients work well and some not so well.

I received this question on the blog regarding the use of amino acids tryptophan or 5-HTP and OCD/anxiety:

I was wondering if this will help with OCD? I did not see any mention of OCD in your articles. Do you feel it can be treated the same way you would treat other anxieties? I was told that since I take serotonin medication that I should not take 5-HTP because it may cause too much serotonin. What are your thoughts?

My answer was as follows (I’ve added a few links because I like to share the research):

OCD can often be related to low serotonin so yes tryptophan and/or 5-HTP can help and is often very effective. If you take an SSRI then tryptophan and/or 5-HTP should only be taken under a doctor’s supervision and at least 6 hours from the SSRI. I would suggest working with a practitioner who knows the amino acids too. And talk to your doctor about doing a taper if that’s what you’d like to do

The other nutrient that helps with OCD is inositol and this is fine to take with an SSRI. I start my clients on 2g/day and go up to 18g/day. Here is one of the older papers on inositol, showing benefits for depression, panic attacks and OCD and a more recent paper discussing OCD and inositol and other nutrients such as NAC and glycine.

With OCD I’d always also look into past strep infections and PANDAs as this could be a factor too.

One of my blog readers, Tracy, responded to the question with some encouragement (how lovely!) and gave us a great example of how we are all different and there is no one size fits all:  

Chiming in with a bit of encouragement here – a bit late perhaps, but wanted to let you know that my teenage son suffers from OCD and anxiety. A number of years ago I found Trudy’s website while trying to find some natural ways to help him. We tried 5-HTP with good success (it also helped lessen the frequency and intensity of his migraines) but it caused stomach upset with him, even when taken with food, so be aware that it may have this effect on you if you try it. After about 9 months of 5-HTP we kind of “forgot” to give it to him and he continued to feel good.

Once my son started high school he started having more stress in his life and his OCD, anxiety and migraines returned. I started him on inositol about 8 months ago. It has had an even greater effect on the OCD than the 5-HTP (remember everyone is different tho!).

I’d highly recommend you try the inositol since 5HTP/tryptophan is not an option for you at this time. My son has had no side effects from inositol at all. Good luck!!

I was pleased to hear that the 5-HTP helped when Tracy’s son was younger. Some people do have digestive issues with 5-HTP. It’s usually in the first week and then typically resolves. This was obviously not the case with this young man.

I was also thrilled to hear that the inositol is helping so much now and wanted to know how much helps so I asked her. Tracy shared how much her son needs (not much at all) and the symptoms it helps with:

My son takes 500mg (NOW brand) daily in the mornings, usually with breakfast. That amount works well for him most days.

When stress is higher and he starts experiencing “breakthrough anxiety” or obsessions, I have him take another 500mg in the evenings as well, just for a couple days or until the stress has diminished.

I should mention that his OCD tends to be primarily obsessive in nature with very little compulsion. His father was actually diagnosed with mild OCD before I met him and he learned to deal with his through counseling and behavior modification. I read about tryptophan (Julia Ross) and asked him to try it. It works well for him when his anxiety acts up (which interestingly tends to have a seasonal component!) It has been an education living with these two!

You can take up to 18g a day of inositol but I suggest starting with 2g a day and building up as needed.  But as you can see above, even 500mg to 1000mg (which is 1 g – I grew up in South Africa and love the metric system!) may be enough.

I happen to use the DFH Inositol powder (pictured above). It has a pleasant slightly sweet taste and is easy to increase the amount based on how much you find helpful. You can find this on the supplements blog here.

As I mentioned above, tryptophan or 5-HTP can help with anxiety, OCD, obsessive thoughts and behaviors (and panic disorders and depression). Adding inositol is an option when the tryptophan/5-HTP isn’t quite enough, or simply use inositol alone.

I also think inositol makes a great addition for mixing into the nasty tasting tryptophan if you find you get better benefits with the tryptophan capsules opened. I suggest starting with 2g inositol per 500mg tryptophan.

I appreciate Tracy giving me permission to share her son’s success with these nutrients. We can all learn so much from stories like this. If you’ve been using any of the amino acids and/or inositol, I hope this has been helpful for you.

Please share how you’re doing in the comments and feel free to ask additional questions.

If this sounds intriguing and you’d like guidance with using the amino acids and other nutrients like inositol, stay tuned for the launch of The Amazing Aminos for Anxiety homestudy group program. This homestudy group program will provide guidance with using each of the targeted individual amino acids, including nutrients like inositol. You can also add your name in the comments if you’d like to be notified when it launches. You’re also welcome to sign up here to be notified when we have more details about the start date.