In this episode of The Energy Blueprint, we’re highlighting how you can naturally address anxiety, mood disorders, and brain health thanks to the expert work of two past guests—nutritionist Trudy Scott and Uma Naidoo, MD.
Trudy and Dr. Uma’s approaches complement each other to make a robust, actionable episode that I know you’ll love.
Table of Contents
After this podcast, you’ll understand:
- The many hidden and completely draining connections between mood issues and energy and one highly targeted way to address this link
- A quick, easy, and inexpensive solution that helps many people’s anxiety and mood
- Why even someone who eats a balanced diet and lives a healthy lifestyle might still benefit from mood-improving compounds
- A specific list of symptoms that alert you to the unique form of supplemental mood support you need
- The neurotransmitter you might be low in if you experience the winter blues with insatiable cravings for carbohydrates
- A balanced take on serotonin imbalances, depression, the role of the gut-brain axis, SSRIs, and other options for addressing mood disorders
- A fascinating explanation of how food affects brain health, including the fact that the gut and the brain originated from the same cells in our body!
- How our current medical model can actually hinder the long-term relationship between psychiatrist and patient unless medications are prescribed
- 3 key takeaways you should know about the gut-brain axis
- The most under-consumed nutrient that is crucial for gut and brain health, especially for people with depression
- Why some people with anxiety should avoid stevia, even though it’s a natural sweetener!
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Dr. Uma Naidoo - Transcript
How nutrition ties into brain health
Ari: Excellent. I have a big question for you. It’s okay if this requires a very long in-depth answer or certain-
Dr. Naidoo: Like the one I just gave.
Ari: Many layers of an answer. Well, this one’s more sciency, less personal. I’d like to create an overview for listeners of how nutrition actually interacts with brain health. What are some of the key, maybe three, four, five different physiological mechanisms or pathways that nutrition is actually affecting what’s going on in our brain and how that ties into mental health?
Dr. Naidoo: That’s a great question. As research evolves we understand that there are different mechanisms by which the brain is impacted by food. Some of them include things like oxidative stress as well as I think what is the most important in my opinion, but amongst others, the gut-brain connection. This is newer science because it really has evolved in the last one to two decades. Even though Hippocrates nodded to this and [unintelligible] said he made eons ago.
Hippocrates really is considered the father of modern allopathic medicine. It took science a long time to catch up. Now that we understand there is this connection between the gut and brain, we were able to understand further that the gut and brain originate from the exact same cells in the human body, the neural crest cells. These cells then divide up and form two different organs in the body, the gut and the brain, but then they remain connected anatomically by the 10th cranial nerve, the vagus nerve, which I like to call a two-way text messaging system.
These organs are communicating all the time but one of the things that we also need to put together is in the gut, we know that serotonin and other neuro-transmitters are working. We know that they are involved with the brain, but 95% of serotonin is made in the gut and also several receptors, about 90% of the receptors are there. You realize then that the gut has this location for serotonin. Then there’s this communication mechanism, and you realize that as we are eating food and it’s getting digested and it’s going to the gut, the food is going to interact with neurotransmitters. It’s also going to interact with the trillions of microbes that are in the gut microbiome. Those microbes are really there to support our health. We should be taking care of them, and there are trillions of them. When our food is broken down, the good microbes on the days that we are eating a healthy meal, the good microbes are able to help with that process, and the breakdown products, things like short-chain fatty acids, which are great for the gut, help to lower inflammation and now anti-inflammatory foods another great way to explain this mechanism.
[unintelligible] if we are consuming more of a sugar-laden or say a fast food diet, what we need to also understand is the breakdown products of those foods can be very toxic to the gut environment. There are bad microbes that live alongside the good microbes and when they are fed with sugar and fast foods and stuff like that, their breakdown products are toxic to the single-cell lining of the gut. When they damage that lining over time conditions like leaky gut arise and the condition and the gut of inflammation is called dysbiosis.
We start to therefore unfold that the food mood connection evolves based on this connection between the gut and brain. There are several other mechanisms, anti-inflammatory foods, the mechanism, oxidative stress, how we combat that, understanding neuroplasticity, and more. There are many more different ways, but the one that I feel really captures it for people is when you understand how your food is digested and the fact that the actual digestive products impact that environment and impact your gut. It’s a very simple way to think about making that connection come alive for you, and that’s the reason I focus on it and I wrote my book based on that.
The gut-brain axis
Ari: Beautiful. Yes, I definitely want to dig more into the gut-brain axis. I’ve heard this figure many times before about 90%, 95% of the serotonin that’s produced in our body is produced in our gut rather than our brain. Oftentimes this is communicated in a way that implies that therefore all of that serotonin is modulating our happiness. We have this narrative that’s been inculcated into the population for many decades now, that serotonin is what controls our happiness or depression. Serotonin deficiency equals depression, and if we are depressed, what that means is we have a chemical imbalance that we need to correct with these SSRIs, these specific serotonin reuptake inhibitors.
That’s the popular narrative that’s been around a long time. More recently, to add one more layer to this, there was a paper that recent systematic review that just came out by Moncrieff et Al, and showed that the data really does not support the serotonin deficiency imbalance model of depression. What are your thoughts on, I know there’s a lot in there and we can go into this piece by piece, but maybe starting with this piece of what is actually the role of serotonin, whether produced in the gut or the brain? What’s the nature of this relationship of serotonin to happiness and depression in your opinion.
Dr. Naidoo: In my opinion, I think that there are a lot of things that we need to be super careful about because science, and especially nutritional science is ever-evolving. I’m aware of the study and I think it’s great that someone brought this information forward. I want to just be clear though, that anyone listening to this shouldn’t, just stop taking their medications without speaking to their doctor because that can be hugely dangerous and have side effects. That being said, I think in my opinion, the way that we diagnose individuals based on the DSM-5-TR is flawed. There’s a checklist and humans do not fall into checklists, especially the emotional well-being. Someone might have PTSD and a touch of depression, someone might have anxiety and ADHD. People just simply don’t fall into one category. That has been a respected way that all of us have been trained, and I still use it when it’s necessary, and I use it as a framework. We have an issue with diagnostic categories. Then we have an issue, which is something we touched on already, that the system is dedicated towards, yes, therapy is a very important part of treatment, but it’s medication driven. Some of that is actually related to how insurance reimbursement happens. A psychiatrist in hospitals, for the most part in the United States, psychiatrists are expected in a clinical setting to prescribe a medication as part of their visit. They often not called on their therapy training to do that and part of that is related to how reimbursement happens. If you choose not to prescribe a medication, you may not actually at times be able to follow that patient long-term because they get a visit with the psychiatrist. That in itself is flawed because we are trained to do more than just prescribe medication, but that is the system in itself. Nutrition doesn’t even enter the conversation. For the most part. The other piece about it is that serotonin dopamine, [unintelligible 00:16:08] all of these different chemicals are involved. We know that it’s not just one theory, it’s not just one hypothesis, it’s not just one substance. We also know that there are many factors that impact mood, anxiety where serotonin has been implicated. I think that this is super helpful information for us to have. In fact, this year there were two things that were pretty huge in mental health that were unearthed. One was the Moncrieff paper, I believe it was from the British Medical Journal. The other was that some of the findings in the initial core research around Alzheimer’s disorder and how the images were done were found to be fraudulent. Billions of dollars of research were done on what we think was [unintelligible 00:17:02] data and has led us in the direction around the hypothesis of how we are treating, how we are trying to figure out, how we are trying to find a cure. Those are two very big things and-
Ari: I actually don’t know the part about Alzheimer’s, was it that the images were focused on these beta-amyloid plaques or something to that effect?
Dr. Naidoo: Correct. They were focused on proving a set of this hypothesis and the paper was, I believe, more than 15 years ago. I forget the details, Ari, of how it came to light, but it’s written about all over in the popular press, and it’s been published in a journal that someone re-examines– An expert reexamined these images and these images were tainted and found to be tweaked in a way that seemed to imply a certain outcome. Then that outcome was what everyone based their research grants on because it was now a proven hypothesis, let’s call it.
I feel that just taking those two things and the work that I do into account, I realize in a very humble way, we really don’t know the answers. When you ask me about serotonin, what I can say is it’s involved. I have seen people improve their symptoms, like the patient I mentioned on a small dose of Prozac can feel better. How much of that was the therapeutic relationship, his changes to his lifestyle and nutrition the actual medication? It’s really not clear. I’m not trying to avoid answering the question.
I’m saying that it’s multifactorial and that this is where an integration of research and clinical skills and being able to actually talk to a patient is hugely important. A lot of really brilliant people put out tons of data on nutritional psychiatry or nutrition or mental health and never see a patient, and I think there’s an issue with that. In integrating it, I will tell you that people have done well on good nutritional and lifestyle measures because I practice a method that is really holistic, integrated, and functional. It’s not just one thing, but nutrition is a pillar.
I can also say that the integration of actually speaking to someone and tracking symptoms is hugely important. When you realize that someone can be depressed due to a life event, a huge loss. It may not be the loss of a loved one. It could actually be the loss of a job. It could be the loss of an identity. It could be so many different things. You also realize that someone with a head injury can suffer from depression or anxiety or other symptoms in mental health. There’s a whole subspecialty of psychiatry that deals with that. When you put this together, I think the best we can do is assess someone clinically, do the best we can to offer them a really thorough evaluation of what’s going on, and then test to see what could work for them. I don’t always use medication and someone who is able to function, I might use lifestyle measures first but I’m a trained psychiatrist and I therefore feel comfortable at least being able to assess someone’s safety. That is one of the most important things in mental health is if someone is safe, they’re not suicidal, they are not so severely depressed. You can use other methods alongside that, but sometimes in the emergency room or the clinic or the acute care clinic, you see someone who’s actively either manic, psychotic has lost touch with reality, or depressed. Very long answer, but I’m open to conversation about it, but I’m hoping you see what I’m trying to say about the breadth of the number of things going on.
Mental health issues and neurotransmitters
Ari: Yes, absolutely. A couple more questions related to neurotransmitters. This might be hard to answer, but to what extent do you think mental health issues can be explained by neurotransmitter imbalances in the brain versus other mechanisms?
Dr. Naidoo: I think it’s one of many different things, and I don’t think that all of it is actually fully known. I think they play a role. Do I think they’re the only thing? No. I think that they do impact mood, they do impact symptoms and we need to include them in the conversation but we may not need to rely on them as much as we did. Now, with that being said, that’s where speaking to a trained psychiatrist or a clinician who can evaluate your symptoms and decide if you need a medication becomes important. Medications are not always needed. Here’s the other thing, there are probably mechanism we don’t know yet that we are still researching. One of the exciting areas of research is really finding solutions through food, psychobiotics, and or through nutrients.
Can these actually be taken by individuals to feel emotionally better and to offset symptoms, but be in the form of a food or nutrient, and by manipulation of the gut microbiome, the gut microbes? I think that as those types of solutions are added to say the buffet of solutions that we have, I think that becomes important too so that we don’t just have what I feel like mental health relies on, which is pulling out a prescription pad and giving you a medication when you leave your doctor’s office because it doesn’t always work. I think we also know from research that, for example, in anxiety, it’s been shown that only 7% of people actually get better. For the large part, most individuals may not have a full treatment of their symptoms, may still be suffering and some are not touched by the medication at all.
Ari: Got you. As far as the gut-brain access is concerned and I know you’ve mentioned some of these in passing, but what would you say are the two or three key pathways to understand about that relationship between what’s going on in the gut and the brain to understand how the gut health affects brain health?
Dr. Naidoo: Sure. I think understanding firstly that connection and how food is broken down and a healthy food versus a less healthy food and what that impact is. The second is the actual gut environment. Now, those gut microbes perform many functions for us. They are helping with hormone production, vitamins, sleep, and circadian rhythm, which is our internal body clock. They’re helping with our immunity. 70% of the immune system is in the gut. Super important at a time like now and beyond. They’re doing lots of things plus impacting mental health. As they’re acting one of the ways that they act is they interact with food. We need to understand that they are producing byproducts, they’re interacting that gut environment. They are impacting inflammation or fighting off inflammation. They are functioning as well.
Then the third component to realize is in this environment there’s a very delicate single-cell layer that is the lining of the gut. That lining is easily damaged. When you are producing more toxic substances, that lining gets damaged and these cells have something called tight junctions. When those are pretty easily damaged, there’s leakage and you get conditions like leaky gut or intestinal permeability, and where these toxic substances then enter the circulatory system. You start to realize the gut and brain are connected. Then if there’s leakage this is all going to reach and go back to other parts of the body. It’s also going to go back to the brain.
This is where neuroinflammation gets set up and neuroinflammation one of the other mechanisms by which we are considering in this whole emerging field becomes important. There’s some really top researchers in cognitive health and Alzheimer’s, like my colleague Dr. Rudy Tanzi at Mass General. One of the things he really firmly believes is that neuroinflammation can be reduced in its early stages by how you eat, your lifestyle measures, a plant-rich diet, anti-inflammatory foods, fiber-rich foods. One of the ways that you can actually lower that inflammation in your brain simply by how you eat.
Neurotransmitter production in the gut and mental health
Ari: Excellent. What about production of vitamins and neurotransmitters in the gut? We mentioned serotonin already, but I know GABA is another neurotransmitter that’s produced in the gut. Last I looked into this maybe a year or two ago, it seemed that there was some controversy around the role of GABA in the gut, and some theories were suggesting maybe it travels through the vagus up into the brain. Other theories were saying that maybe it just signals the vagus detects the presence of GABA in the gut and then signals something to the brain. It modulates brain expression just via nerve signals. What would you say overall about the importance of vitamin and neurotransmitter production in the gut related to mental health?
Dr. Naidoo: I think it’s hugely important. I think that there’s always updates through research and how we are thinking. In my more than 20 years experience of doing this work, one of the things that I feel is that, say we know that they’re different ways that GABA interacts. We know that GABA is important. We know that serotonin is important. We now know that the gut microbiome is important and we know that these gut microbes are effective. I want to use the example of omega-3 fatty acids here. Just take a second to do this. As someone practicing mental health, we often will lean on omega-3 fatty acids as a supplement, or in my case, I prefer to suggest food sources for individuals.
For the most part, this is one supplement that many psychiatrists actually do lean on. They will often include that in a treatment plan. We know that there’s a lot of good data on improvement of mood, help with cognition, help with anxiety, and others. It was a very big study published in December of last year by colleagues of mine who looked at a geriatric population of individuals and found that omega-3 did not help geriatric depression. Again, this was a well-done study well researched, and should it mean that I would never give that supplement or suggest that food to an elderly patient? No, because more and more we’re also moving towards highly personalized medicine, and the gut microbiome in each person is like a thumbprint. More and more we have theories, we have scientific theories, we have ongoing research, thank goodness we are learning all the time, but we also have the individual.
I think that’s what becomes important to integrate, that there’s ongoing research like you shared about GABA, but it’s usually important to understand that GABA plays a role environment production and hormone production and neurotransmitters. It may be different for each person. Now take vitamin D for example. We get 80% of our vitamin D by spending 10 minutes of time outdoors in actual daylight, not through window because of how vitamin D is produced. I think that understanding these little nuances knowing that vitamin B9 folate, you get a ton of it from leafy greens, low folate is associated with low mood. As you put together the facts that we’ve known or we learn from research with what is going on in the person’s body in a personalized way, and you understand that the gut is hugely important and integral to these different mechanisms, it becomes important. I also think the other thing is food impacts all of this, and that’s where I think food is a powerful tool to help all of us.
Nutrition and depression
Ari: Excellent. Getting into more practical stuff around specific mental health conditions and specific foods, what would you say are some of the biggest specific foods or nutritional factors that relate to one’s risk of depression?
Dr. Naidoo: The foods that you want to be careful about are very important because many people consume foods and they worry about their waistline or their weight gain. They don’t realize that these foods are actually impacting their mental health. The typical Western diet call the standard maken diet, a sad diet for a reason. It’s rich in sugar, hyper fructose corn syrup, processed ultra-processed foods, lots of stabilizers, food coloring, et cetera. They do cause weight gain, but they also have very devastating effect on our brain. A lot of foods that we consider so-called comfort foods are discomfort for the brain. A lot of foods that are treats, call treats by individuals actually mistreat the brain.
A lot of the things like artificial sweetness that disrupt many of the artificial sweetness that disrupted to the gut microbiome. The unhealthy fats, the hydrogenated fats, and the processed vegetable oils are just not great for us because they disrupted for the gut. They’re pro-inflammatory. They upset the omega-3 to omega-six ratio on the body.
Gut inflammation ultimately leads to brain inflammation and then become problematic because inflammation is seen as one of the underlying mechanisms for things like cognition, cognitive disorders, depression, anxiety, and more. When we break it down that way, we realize that there are foods that we want to cut back on and be careful about, but the foods that you can lean into one of the biggest foods is fiber.
It’s one of the nutrients that most Americans don’t consume. We tend to be worried about the grams of protein we are consuming, but we don’t consume nearly enough fiber. A big database study showed that I think one or two out of every 10 Americans eats enough fiber, yet fiber, which we get from plants, fruit, beans, not seeds, legumes, and whole grains actually nurture those gut microbes and feed them.
They need fiber in order to function. Any fiber-rich food is something that you can lean on. Prebiotics, probiotics, and fermented foods another huge group that actually can help offset mood symptoms. A study that looked at the use of a probiotic supplement versus Prozac showed that the supplement did better. Even eating a probiotic rich diet can help you. Fermented foods, a huge study from a research group out of Stanford, a highly respected group, looked at fermented foods and was published in summer of 2021. This showed that actually eating fermented foods and adding this to your diet can reduce the amount of inflammation. Hugely helpful, that group of foods. Omega-3 fatty acids, like we mentioned which you can get from fatty fish, wild-caught salmon, and other types of fatty fish.
You also can get plant-based sources from things like flax seeds, sea algae, and more. The plant-based sources do have the short-chain. Omega-3 is less efficiently transmitted to the brain, let’s say, but still worth including in your diet. Those are just some of the foods to think about. Then one of the ones I always like to mention, which I think are the hidden gems in our kitchen cabinet are spices.
Saffron and turmeric have been shown to be extremely helpful in terms of mood. Depression, definitely something to consider, and for turmeric is add a pinch of black pepper?
Artificial sweeteners' impact on health
Ari: What are your thoughts on artificial sweeteners? Do you feel they’re safe? Are they safe in general? Are they a risk for mental health or brain health in particular?
Dr. Naidoo: They, unfortunately, don’t do well in mental health for the most part, the older sweetness. There’s some newer ones that are showing some- I would say some better signs in the research. We don’t have all the mental health data on them yet. For the most part, if you had drinking a diet soda and you have anxiety that could be very problematic for you.
Artificial sweetness can offset symptoms and I’ve seen that happen. One clinical example is someone who was trying to actually give up soda, move to diet soda, and became more anxious. Even though the sugar-laden soda, the 20 grams of sugar in a– I think it was a 12 to 16-ounce bottle or maybe a 20-ounce bottle of soda wasn’t great for the brain either.
The artificial sweetener unfortunately set up the anxiety. Some of the newer sweeteners, one of them is [unintelligible] have a better relationship with insulin. If my patients come in and they just have to have something sweet and anything in moderation, little bit of stevia, a little bit of [unintelligible] little bit of maybe allulose they even newer ones coming out on the market that I’ve heard about through my work with the World Economic Forum.
What I can say is be careful with sweetners, use them in moderation. Really try to move away from things like diet sodas, read to see what sweeteners’s in them. One caveat is Stevia can set off anxiety in people and studies have shown this. If you do suffer from anxiety, be are a little bit careful with Stevia, because although it’s natural for some reason, it doesn’t always do well in people with anxiety.
Ari: Interesting. What about anxiety? Is it the same as far as and you just mentioned one thing with sweeteners there, but is it the same as the list with depression as far as the foods and the nutritional factors that affect that or are there some key differences?
Dr. Naidoo: There are some key differences because there are slight nuances with every one of the mental health conditions. With anxiety, one of the foods that you can lean into is tryptophan which is a precursor of serotonin but tryptophan actually has been shown to help anxiety. In some countries, like Canada, it’s a supplement that needs to be prescribed.
You can get tryptophan from things like chickpeas. You can get it from certainly certain types of poultry. Then there are vitamins that have been shown to be helpful and minerals. The reason I mentioned the minerals is magnesium is often overlooked, but magnesium can be significantly helpful for anxiety, as well as potassium and selenium, you get enough selenium from one or two Brazil nuts a day that you can eat.
That’s always a good one to lean into. Then there are some herbs that people often brush aside as unimportant, that lavender, passion plant and camomile can act actually help people with anxiety. Then vitamins that can lean into are vitamin D. We mentioned sunlight, tendons of outdoor time, vitamins B one, B six A, C, and E. The foods and what I did in my book, Aria, is in the final chapter share recipes, but for these different foods and these different vitamins, I list the vitamin in the type of foods. People have a checklist that they can go to because it’s hard to remember everything.
Trudy Scott - Transcript
How amino acids can be used to treat anxiety
Ari: So mood and energy are extremely interrelated, and things that optimize mood generally also optimize energy, and things that destroy the mood, especially things like anxiety and stress and fear, are absolute energy destroyers. And it’s the major cause of fatigue for a segment of people with chronic fatigue. So I think this information is extremely important and has the capacity to be very powerful for a sizeable segment of people dealing with fatigue. So first of all, give us a quick overview on amino acids and how they can be used in the context of dealing with anxiety, sleep, energy, and mood optimization?
Trudy: So, this is just one area to focus on, and it’s an area that I focus on with my clients. And it’s using amino acid as a supplement to boost your own levels of neurotransmitters. And in the context of this summit, which is energy, we want to have good energy, and there’s a specific amino acid — there’s one specific amino acid — that can actually boost energy. But there’s also two that I use that can help with the mood aspect, the anxiety aspect, the low mood, which will help with sleep as well. So if you’re not sleeping well, that’s going to drain your energy as well. So other than the aspect of what you just mentioned, when you have a terrible fear, you have terrible anxiety, you’re worrying all the time, which is energy-draining, if you’re not sleeping well, that’s also going to impact your energy levels.
And I got into this because of my own anxiety, and my own panic attacks. And I remember that first panic attack coming out of what seemed like the blue, I had no idea what it was. I’ve never experienced anxiety before. I was an adventurer, traveled around the world. I was a rock climber. I met my husband on a cliff face. We got married in the mountains after climbing. I wouldn’t have considered myself an anxious, timid kind of person, but because of biochemistry, because of food sensitivities, because of toxins, because of some dietary changes that I made, I messed up my biochemistry, and it caused the anxiety and panic attacks. And that first panic attack hit me. And I couldn’t breathe. I was hyperventilating. I got to get some air. I’ve got to get some oxygen, help. What’s going on?
And I just remember being absolutely drained afterward, and not knowing what was going on. And then I had a few more panic attacks, and every time it’s draining, and it’s exhausting. And then it took me a number of years to find all the solutions, but just that ongoing anxiety is terribly draining. The feeling of waking in the early hours with this feeling of doom and not being able to put your finger on it. Why am I feeling this feeling of doom? There’s nothing out there. There’s no trauma. There’s no reason for feeling like this. And you just have this feeling of impending doom. And that in itself is very draining. And then for some folks, if it’s low serotonin, and we will go into all of these different categories as we go through this, but for some folks, itching and replaying a discussion they’ve had with someone or replaying some article that they’ve read that they worried about and all of that is very draining.
So there’s many different aspects, and you’re right. It’s very subjective. Some people won’t even use the word anxiety. They’ll just say I just don’t feel normal. And then a lot of people will say, I’ve been like this my whole life. I didn’t know I could feel any different. So it is very subjective, but we want to feel our absolute best. So going back to the question, we use these targeted individual amino acids. So we’re using one at a time. They’re targeted. They’re used for your own unique biochemistry, and they are used — you don’t just say take 500 milligrams of tryptophan, and then you’re fine. You need to find out what are your unique needs because each person may have different needs. Someone may need more; someone may need it more frequently. And then we titrate.
So we’ll start low. And I’ll talk about dosing and everything as we go through this, but you start low based on your symptoms. And then you increase based on your needs. And then if you get to a point where you don’t need that, then you back down. Now, for me, I call myself a GABA girl. GABA was my amino acid that really helped me. I also use tryptophan. And we’ll talk about those in a second, but the main thing is the amino acids give results very quickly. So you will get relief pretty quickly. If you have low GABA, if you have low serotonin, if you have low catecholamines, which is the energy, the one that’s really to tied to energy, you will get relief from those symptoms. And then you can address some of these other underlying root causes that may have caused the low neurotransmitters in the first place, maybe gluten sensitivity, parasites, heavy metals, you name it.
So it gives people hope. It gives them results right away. The other thing which is really nice, Ari, is that it helps stop that addiction. It helps stop those cravings. And if someone’s feeling really bad, they’ve got no energy, they can’t sleep, they’ve got anxiety, and now you’re telling them to take away foods that they love, that they self-medicated with, that they use to feel good, that can be difficult. So the other great benefit of the amino acids is it helps break that addiction. It helps remove that comfort, that need for reward, that need for comfort eating. So it makes it easier to quit the sugar. It makes it easier to quit the gluten or whatever else needs to be changed in terms of dietary changes.
Ari: Got you. So I have a question. This is something that I’ve tried to look into. I have not gotten a clear answer to it, and there seems to be, as far as I can tell, somewhat divergent opinions among experts. And that is the use of these individual amino acids. If somebody is eating an otherwise amino acid sufficient diet and protein sufficient diet and say has adequate amounts of tryptophan and taurine, and many of the other amino acids that are often precursors of neurotransmitters, in those cases, is there a unique benefit or a different mode of action of using these amino acids in isolation?
Trudy: That’s a good question. And it comes down to each person’s needs. So someone may be eating beautiful grass-fed red meat and wild salmon, but maybe they don’t have enough hydrochloric acid. So they’re not breaking down the protein. So they’re not getting the benefits of those amino acids, or maybe someone has some kind of a genetic polymorphism like MTHFR, and it’s expressing, and therefore, they’re not able to make their serotonin.
And we know that hormones play a huge role. They are very intertwined with the neurotransmitters. So maybe you’ve got low progesterone, and that’s going to affect your GABA levels. Or you’ve got low estrogen, and that’s going to affect your serotonin levels. We know women make less serotonin than men. So there’s that aspect as well. If someone’s on the birth control pill, for example, that’s going to deplete your B6. It’s going to deplete zinc levels, which has a direct impact on serotonin levels.
So even if someone is eating a perfect diet, there are all of these other factors that could lower the neurotransmitter levels. Now, the ideal is to get someone to use the neurotransmitter precursors, the amino acids to start boosting their levels. But then we want to address all of these underlying factors. We can’t just say, well, just supplement and not do all that other changes. And I’ve had some people who seem to be eating a really healthy diet, and they still benefit from the neurotransmitter support. So it is very unique, but it’s a yeah, great point.
How to use amino acids for optimal solutions
Ari: Is there any research to show that let’s say taking isolated amino acids on an empty stomach, not in the context of a meal, are metabolized in a different way than they would be in the context of a meal?
Trudy: Yes, absolutely. They all should be used on an empty stomach, so they’re taken away from protein. So it doesn’t compete for absorption with the other amino acids in that protein-containing food. Now, there are a few little variations. Tryptophan, which supports serotonin levels, definitely needs to be taken away from protein-containing foods. 5-HTP, which also supports serotonin doesn’t necessarily need to be, but just for ease of use, it’s just easier for folks to just take it away from protein-containing food. Yeah, so definitely, it does make a difference. And the ideal is to take it away from protein.
Ari: Well, so what specifically is going on there? How do we explain that? Is it that like proteins, amino acids in the context of a meal are more likely to be involved in protein synthesis, whereas the isolated amino acids are more likely to go to the brain for neurotransmitter support? How does that work?
Trudy: I don’t think we really know. Some of it’s going to the brain; some of it’s impacting the gut. We know that the microbiome has a huge impact. We know we make a lot of serotonin in the gut, and we know that serotonin support helps with motility. So maybe it’s helping with the synthesis in the gut as well. Maybe some of it’s going into the brain. So we don’t have all the answers certainly with GABA. We don’t really know. There’s a big myth that GABA doesn’t even work. A lot of people will say, well, GABA doesn’t even work. It doesn’t cross the blood-brain barrier, but we know we have these receptors in other parts of the body. And with GABA, it’s more physical tension. And when people use GABA, they’ll just feel this sort of physical tension ease.
So it may be that it’s affecting receptors in other parts of the body. So yeah, we don’t have all the answers.
The key neurotransmitters to support for anxiety
Ari: Okay. So talk to me about the key neurotransmitters, and I’m sure you could talk — you could answer this question with a two-hour answer if you wanted to, but if you could do a very succinct sort of rundown of what are the key neurotransmitters for people to be aware of, and what are a few of the symptoms or sort of traits associated with those neurotransmitters?
Trudy: Okay, let’s start with the low GABA. So with low GABA — GABA stands for gamma-Aminobutyric acid, and it’s our calming neurotransmitter. And it’s with the low GABA; you will feel anxiety. You may have panic attacks; you may have some fear. There’s some new research that talks about how it helps with the inhibition of unwanted thoughts. So most of the time we think of low serotonin when we think about that sort of thinking aspect, but there is some new research showing that GABA can help with having these sort of thoughts that you don’t want.
But the main thing when I think about low GABA I think about the physical change. And so, people will be sitting with these tense shoulders, tense tension in the neck. They may have physical pain in other parts of the body. They may lie awake at night. So sleep is a big issue with low GABA. Sorry, problems with sleep is a big issue, and this lying in bed physically tense.
And then the other thing that we see MOTC with all of the low neurotransmitters is this addiction aspect, and this needs to self-medicate. And the big clue with low GABA often it’s alcohol. At the end of the day, I’ve just got to have that glass of wine, and it becomes two glasses, three glasses, four glasses, a bottle. You’re self-medicating in order to feel calm. And there’s an issue in itself with alcohol in terms of energy levels. It can actually make you sleep worse. But it’s used like a drug. It’s used to self-medicate to feel good, but the problems with alcohol, depletion of zinc, magnesium, B6, it damages the gut lining. So that’s not something that we want to be relying on. So we’ve got these symptoms.
We look at the symptoms that I’ve just described, the physical anxiety, the needing for alcohol, or something. Sometimes people will use sugar to relax. Using something to relax and then there’s physical tension. I’ll have my clients rate their symptoms on a scale of one to 10, and then we’ll trial some GABA.
We’ll use a GABA supplement. Now, a lot of people will hear about GABA. They’ll rush out and buy 500 milligrams or 750 milligrams. And that’s way too high for most people to start.
So the starting dose I’ll use is 125 milligrams. And I’ll do a trial there and then with my client so we can get immediate feedback. You get feedback within five minutes if you haven’t eaten. So I’ll say before we meet, don’t eat within an hour before we meet, and I’ll do this trial of GABA, and they might say I’m feeling anxious, and I’ve got this physical tension. It’s like an eight or nine out of 10, and we’ll try the GABA. And they can say within five minutes, oh, that felt like a glass of wine.
That’s the feeling we’re looking for. A lot of people can relate to that feeling, and they can feel immediate relaxation. And it can go down from an eight or nine out of 10 to maybe a six or seven. For some people, it may go down to four or five out of 10, depending on how much they need. Some people may need to bump that up, to double that, in that same trial to see, okay, my starting dose is not actually 125. It’s a little bit higher. And then we will have them dose that when they need it through the day. GABA is used through the day in between meals. And then also at night. Now, a lot of people will need higher amounts at night to help them sleep, and they’re going to have a restful sleep. And then they’re going to have better energy through the rest of the day.
And I mentioned earlier about the whole GABA blood-brain barrier issue. There is more and more research. It’s not as much research as we would like, but we are seeing more and more research. A recent paper came out looking at GABA and theanine and how that improves sleep. And this is a combination. So some people do well just on GABA. Others will add in a little bit of theanine as well. But the synergistic effect of those two can help. Now, keep in mind with the anxiety and with the sleep issues, it may not just be low GABA. It could also be low serotonin, and I can go into low serotonin now, but I’m going to pause here and see if you’ve got any questions from me on GABA..
Ari: Nice. So next neurotransmitter, let’s talk about serotonin. So what are the sort of symptoms and traits that would be associated with deficiencies in this neurotransmitter?
Trudy: So, with low serotonin, there’s also anxiety. There’s also this worry. I mentioned the ruminations, the rethinking, the sleep problems also very common. The main thing with low serotonin compared to the low GABA is it’s in the head more so than GABA. The worry, the panic, the fear, the phobias, anyone who’s having panic attacks, classically it’s low serotonin. These other symptoms that we may not think about as being mood issues like imposter syndrome. That sort of lack of confidence. The feeling like who am I to be doing this? The irritability, anger issues.
I’ve worked with a number of kids with terrible explosive anger issues and sugar cravings and sleep problems. And they turn out to be low serotonin. The winter blues that’s very common and related to low serotonin. Serotonin taking a dip in the wintertime. And there’s actually one paper showing that there’s winter anxiety as well.
More people can be more anxious in the winter because of serotonin taking a dip. PMS and then, of course, as with all the neurotransmitter deficiencies, this need to self-medicate with something usually carbohydrates with serotonin, but that’s not always the case. It could be alcohol, but it’s typically carbs. And with low serotonin, the clue that it’s a low serotonin craving or addiction is that it tends to be late afternoon or evening. And that’s when serotonin takes a dip. So if you’re having those kinds of carbs, that could be a clue that it’s low serotonin. And again, I have my clients rate their symptoms on a scale of one to 10. We’ll do a trial of other tryptophan or 5-HTP. And I’ll tell you in a second when I use one versus the other, but again, it’s used sublingually in the trial.
So opening up a capsule as a starting dose for tryptophan is 500 milligrams for tryptophan. For 5-HTP, it’s 50 milligrams, but opening up that capsule and putting it on the tongue to get those results right away. Once someone’s figured out, do I need a tryptophan, or do I need GABA? Using them sublingually, I have found is the most effective way. Some of them don’t taste that good. The tryptophan is pretty bitter. That can be used with a little bit of an acetyl or may be mixed into a little bit of mashed up banana, or apple sauce can help with the taste. But a lot of people just get used to it because they get such good benefits. And I think some of the benefits using it sublingually, firstly, it’s getting into the system very quickly.
But the other thing is if some people have digestive issues, it may be that it’s helping in that aspect as well. Say someone rates his symptoms on a scale of one to 10. We’ll trial the amino acid, and then we’ll see how quickly they get results. Now we know that yes, low serotonin is something we need to be thinking about. And the timing for tryptophan or 5-HTP supplements are midafternoon because that’s when serotonin starts to go down and then in the evening, and maybe someone may need more in the evening if they’ve got the sleep problems — and then tying this back to energy levels. If you are obviously not having this worry, this constant worry, that’s going to help with your energy levels. But if you’re sleeping better, then that’s going to obviously help with your energy levels as well.
Now, there is more. I said I’ll tell you when I use tryptophan versus 5-HTP. So I typically start with tryptophan. There is some controversy. Some people are not big fans of tryptophan. There are concerns that it may go down the wrong pathway and cause problems. I have not seen that to be an issue. I use tryptophan just because I’ve had good results with it, but they are some instances where some people do better on one versus the other. So if tryptophan doesn’t work, we’ll switch to 5-HTP. There is one study that showed that 5-HTP can raise cortisol levels. So if someone does have high cortisol, I would be cautious, but I have actually had some people where their cortisol is high, and they get on 5-HTP, and they do great. So it is really a matter of doing a trial and seeing how you do. Most of the research in this area is with 5-HTP.
We’ve got a lot of studies on 5-HTP and fibromyalgia, 5-HTP and pain, 5-HTP, and insomnia, but because they are both supporting serotonin, we can extrapolate to tryptophan as well. One very nice study on tryptophan helping with PMS, it was a double-blind placebo-controlled trial. So we do have some tryptophan research, but the main thing is that people get results, and it works. I love the research, and I love to quote the research and show that there is research, but I also am a big fan of showing what works. One study that I did want to quote in this area is a study — It was actually using caffeinated fruit flies. Can you imagine all of these little fruit flies buzzing around after having being given caffeine, but they used fruit flies to show how this combination of GABA and 5-HTP had these neuromodulation effects.
And the interesting thing, which I didn’t realize until I read the study, is that the circadian regulation in fruit flies is comparable to those in mammals when you’re looking at sleep research. So I thought that was pretty interesting. So I’m guessing that’s why they chose the fruit flies, but they found that using this combination of GABA and 5-HTP modulates subjective nighttime activity, sleep episodes, and the total duration of subjective nighttime sleep to a great extent than a single administration of each amino acid. And this occurs via GABA and serotonin signaling. Now, I love studies like this and this particular one, it showed the combination was more effective, but keep in mind, each person has their own unique biochemistry. Some people do great with GABA on its own. Some need GABA and theanine. Some do fine with GABA and tryptophan, so it’s a matter of figuring out what’s going to work for each person.
Ari: Got you. Is it just a personal preference issue which one works better, or do you have some specific symptoms or traits that determine whether you use 5-HTP or tryptophan?
Trudy: It’s a personal preference. I had a lot of good results with tryptophan, so I start with it. I know some other practitioners start with, prefer to start with 5-HTP, and then go to tryptophan. So that’s what worked for me, and that’s what I continue to do. Yeah, it is the issue of tryptophan possibly converting to quinolinic acid. I know Dr. Shaw from Great Plains is not a fan of tryptophan for that reason. He’s very against tryptophan for that reason.
Ari: It converts to what acid?
Trudy: Quinolinic acid, which can be a problem. There’s a lot of research, as you know, on quinolinic acid and Alzheimer’s and it’s neuroinflammatory. I have not seen it to be an issue. They’ve got a marker on their organic acid test that shows high quinolinic acid levels. And they say, if it’s high, don’t use tryptophan. I’ve had people come into me that didn’t know they had high levels on their test — used tryptophan with success. And then after the fact found it. So I’m not sure if it is an actual concern. There is some research showing that if you’ve got sufficient levels of vitamin B6, that can prevent that tryptophan going down the wrong pathway, and it can be used to make serotonin. And then, of course, once you’ve got good serotonin levels, that’s going to help us make melatonin, which helps us sleep as well.
Ari: Got you. I want to get to that in a second because the melatonin relates to the serotonin, as you said. Serotonin is this most famous neurotransmitter. Everyone knows about serotonin, and everybody knows depression. The narrative that big pharma has promoted depression is a chemical imbalance. Depression is a serotonin deficiency.
We need specific serotonin reuptake inhibitor antidepressant drugs and my understanding of things, and I’m sure you’ve delved into this much deeper than I have, but my understanding of things is there definitely is research linking serotonin imbalances to depression and mood disturbances. And yet there’s also research showing that these SSRI antidepressant drugs are often no better than placebo. What is your take on that? Is it that the drugs don’t work, or is it that long-term versus short term, the body makes adaptations, or what’s your take on why those two things can both be the case?
Trudy: So a lot of people will use that argument that it’s not a brain chemical imbalance, and I think it’s possibly because of an aversion to maybe using medication. So there’s that part. It’ll be often functional medicine practitioners or nutritionists. And then we do know that with the SSRIs, that a small subset of people responds to SSRIs, and it’s often a short-term benefit. And then, over time, they might start to get a lot of side effects. And a lot of people will come to work with me because they want to stop using the SSRIs. And I do work with people who are wanting to taper from the SSRIs. I work in conjunction with the doctor and make sure that the doctor’s onboard and that we first support them nutritionally before we even consider a taper, but it’s always working with the doctor and the doctors monitoring them.
But the problem is with the side effects, and they are some people who are on SSRIs on the long-term, and they do great. So I don’t want to just say SSRIs are bad, but they are the — so it’s a difficult question to answer. I think the main thing is not to say because of people saying that the SSRI research is making that connection, and now we must say, we just need to throw that whole theory out. I believe there’s definitely that connection. The problem is for some people; these SSRIs are working. For some, they’re not. And then for others, we’re getting all these side effects. I hope I answered that, okay. I wasn’t sure. That’s okay.
Show Notes
00:00 – intro
00:40 – Guest intro – Dr. Uma Naidoo and Trudy Scott
01:24 – How nutrition ties into brain health
14:25 – Mental health issues and neurotransmitters
28:11 – Artificial sweeteners’ impact on health
32:12 Trudy Scott – How amino acids can be used to treat anxiety
41:30 – The key neurotransmitters to support for anxiety
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