Nutrition IV - Common Ailments in Clinic - Anxiety

Question 1

Anxiety

Answer 1

Feelings of worry, apprehension and fear, which can range in intensity from mild to severe
* Anxiety is part of the body’s natural defence system and alerts to a threat, either real or perceived
* It functions to facilitate response to adverse or unexpected situations
* However, persistent or extreme anxiety that interferes with daily life is counter-productive, signifying an anxiety disorder
* Anxiety disorders classifications include:
o Generalised anxiety disorder (GAD)
o Panic disorder
o Social anxiety disorder
o Post-traumatic stress disorder (PTSD)

Question 2

Causes and risk factors

Answer 2

Causes and risk factors:
* Anxiety disorders are often preceded by stressful life experiences such as childhood trauma, death of a loved one or serious illness
* Chronic stress: increases sympathetic nervous system (SNS) activity, adrenaline and cortisol release. It decreases parasympathetic activity, impeding nutrient absorption (e.g. tryptophan)
* Poor gut health (e.g. dysbiosis). Lactobacillus and Bifidobacterium have been shown to produce GABA
* Lack of essential nutrients to support the production of inhibitory neurotransmitters (i.e. GABA) – vit C, B vitamins (esp B6), mag & zinc
* Sugar and processed foods: promote inflammation and oxidation in neuronal cells; are nutrient poor and cause fluctuations in blood glucose. Hypoglycaemia (low blood sugar) triggers adrenaline release and promotes fatigue, worsening anxiety
* Caffeine: is a stimulant and taxes the adrenals; as an adenosine antagonist caffeine negatively impacts sleep; it depletes nutrients essential for mental well-being, in particular the B vitamins
* Alcohol: depletes the body of vital nutrients; fragments sleep and blocks the REM phase (sleep is less restorative); regular consumption decreases serotonin levels affecting mood

Question 3

General nutritional guidelines

Answer 3

• Ensure a good intake of fresh fruit and vegetables, grains and legumes to supply essential nutrients
• Probiotic and prebiotic food/supplements – support microbiome
• To maintain stable blood sugars:
  o Include protein with every meal (to also support neurotransmitter production)
  o Avoid refined carb/sugar and include complex carbs/low GI/GL foods; e.g. beans, whole grains, vegetables etc.
  o Chew well, eat mindfully, don’t over eat, three meals a day

Question 4

Magnesium

Answer 4

Magnesium: 500 - 1000 mg / day / Epsom salt bath
* Food sources:
o Dark leafy greens
o Seeds
o Nuts
o Whole grains
o Legumes

• Functions:
  o Cofactor for GABA synthesis and in the serotonin – melatonin pathway
  o Essential for nerve transmission, cell signalling and also muscle relaxation
  o Low-levels increase anxiety risk

Question 5

Tryptophan

Answer 5

Tryptophan: 300 – 2000 mg / day
* Food sources:
o Brown rice
o Quinoa
o Pumpkin seeds
o Bananas
o Oats
o Turkey

• Functions:
  o Used for serotonin and melatonin synthesis
  o Serotonin helps regulate mood. Low levels are common in anxiety
  o Melatonin regulates the sleep-wake cycle and is a potent antioxidant

Question 6

B complex vitamins

Answer 6

B complex vitamins:
* Food sources:
o Whole grains
o Legumes
o Sunflower seeds
o Fish (Especially salmon)
o Pistachios
o Eggs

• Functions:
  o Many B vitamins play a role in energy production and healthy nervous system function
  o B6 is especially important for the conversion of glutamate (excitatory) to GABA (inhibitory)
  o B1 is required for metabolism of amino acids used in neurotransmitter production

Question 7

Zinc

Answer 7

Zinc: 25 – 60 mg / per)
* Food sources:
o Pumpkin and hemp seeds
o Cashews
o Legumes
o Whole grains
o Oysters
o Sardines
* Functions:
o Zinc is essential for the synthesis of GABA
o Decreased Zink in the nerve synapse leads to increased NMDA receptors, which respond to glutamate (increases anxiety)

Question 8

Vitamins C

Answer 8

Vitamins C: 500 mg / day
* Food sources:
o Peppers
o Broccoli
o Kale
o Cauliflower
o Tomatoes
o Strawberries
o Kiwifruit
o Citrus
* Functions:
o Vitamin C is necessary for the production of cortisol (anxiety increases adrenal output)
o It is a cofactor in the synthesis of serotonin
o Shown to lower anxiety by reducing oxidative stress, a factor in this type of disorder

Question 9

Theanin

Answer 9

Theanine: 50 – 200 mg / day
* Food sources:
o Green tea
o Black tea (Lower amounts)
* Functions:
o Blocks glutamate receptors, whilst increasing GABA activity (which has a calming effect)
o Increases alpha – brain waves producing a calming, mood enhancing effect without drowsiness
o Increases serotonin and dopamine levels

Question 10

Other naturopathic advice

Answer 10

• Regular exercise (Focus on calming exercise - Pilates, Yoga, tai chi, walking)
• Diaphragmatic breathing exercises to calm the SNS
• Include herbal teas with relaxant and anxiolytic properties e.g. passionflower (Passiflora incarnate), lemon balm (Melisaa officinalis), chamomile (Matricaria recutita)
• Bach flowers, homoeopathy and acupressure (covered later)